Neurology Medical News about symptomatic carotid stenosis;early neurological recurrence

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High risk of early neurological recurrence in symptomatic carotid stenosis
Stroke, 06/16/09

Ois A et al. – Pts with first-ever mild stroke or TIA and symptomatic carotid stenosis are at high risk for neurological recurrence (NR), especially within the first 72 hrs. Results support testing pharmacologic or interventional strategies for use during the hyperacute stroke phase in these pts.

Methods

Study of very early stroke recurrence evaluated within first hours after onset of symptoms and outcome for unselected pts with first-ever mild stroke or TIA and symptomatic carotid stenosis ≥50%
Evaluation of 163 pts with symptomatic carotid stenosis and initial mild stroke (121) or TIA (42) within 6 hrs from onset of symptoms in a single tertiary hospital
NR defined as clearly defined new neurological event (TIA or stroke) or an increase of 4 points in initial NIHSS
NR rate determined at 72 hrs, 7 days, and 14 days
Disability defined as score 3-6 on modified Rankin scale at 14 days

Results

NR in 45 pts (27.6%): 6 with 2 episodes in different time periods: 34 (20.9%) within first 72 hrs; 11 (6.7%) between 72 hrs and 7 days; and 6 (3.7%) at 14 days
Only carotid stenosis ≥70% associated with NR; diabetes marginally associated
At 2 wks, 19 pts (11.7%) had disability; 14 of experienced NR in first 72 hrs

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