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Seventeen patients died,all of intracranial mass effect,and all within a week after stroke.In nine of these fatalities,DSA revealed carotid"T" occlusion(CTO),which affected 19 patients.In five of the fatalities,a major early sign of ischemia(MESI,referring to cortical hypodensity in more than a third of the territory of the middle cerebral artery,as seen in 14 patients)was recognizable on the initial CT scan.This led to a higher predictive value and sensitivity of CTO relative to MESI for estimating early fatality.CTO as determined by DSA is a substantially better predictor of fatal outcome in patients undergoing intraarterial thrombolytic therapy than is MESI as determined by CT. |
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