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Acute Ischemic Strokes Improving During the First 48 Hours of Onset:Predictability, Outcome & Possible Mechanisms
Stroke 28:10-14, Toni,D.,et al, 1997
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Article Abstract
Thirty-four patients(22%)improved,84(56%)remained stable,and 34(22%) deteriorated.Logistic regression,which took into account vascular risk factors,baseline clinical and CT data,and therapies administered,selected younger age,lower admission CNS score and absence of early hypodensity at first CT as independent predictors of early improvement.Among the patients who underwent angiography,logistic regression selected arterial patency and presence of collateral blood supply as independent predictors of early improvement.At the repeated CT scan and autopsy,improving patients presented the highest frequency of small infarcts.Thirty-day case-fatality rate and disability were lowered in improving patients.Variables independently associated with outcome at logistic regression were admission CNS score,early deterioration,and early improvement.Early improvement can be predicted by the absence of early CT hypodensity and is highly predictive of good outcome.Presence of collateral blood supply and presumably early spontaneous recanalization are likely to be the mechanisms underlying early improvement.
 
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