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J Korean Neurol Assoc. 2014;32(3):158-162.
- Clinical and Radiological Characteristics of Acute Ischemic Stroke
Consulted from Nonneurology Departments
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Sangwon Yoo
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Department of Neurology, School of Medicine, Catholic University of Korea, Seoul, Korea
- 타과에서 의뢰된 급성뇌경색의 임상과 영상 특징
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유상원, 김승유 배대웅 김우준 조아현
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가톨릭대학교 의과대학 신경과학교실
- Abstract
- Background
An acute ischemic infarction can occur in patients admitted to a nonneurology department, which can
result in a delay in the diagnosis that could produce a poor outcome. The aim of this study was to identify the clinical and
radiologic features of ischemic stroke diagnosed during consultations in nonneurology departments.
Methods
Acute ischemic stroke patients who were admitted to a neurology department or who were diagnosed after a
consultation to a neurology department between October 2007 and February 2009 were enrolled. Acute ischemic stroke
was diagnosed by a stroke neurologist with the aid of diffusion-weighted MRI. Clinical variables [age, sex, risk factors,
initial score on the National Institutes of Health Stroke Scale, stroke subtype, and modified Rankin scale (mRS) score at 3
months] were obtained. Poor clinical outcome was defined as a mRS score of 3-6. Stroke lesion types based on MRI were
classified into single vascular territory, multiple vascular territories, and multiple circulations.
Results
In total, 340 patients were enrolled, 84 (24.7%) of whom were diagnosed in nonneurology departments. Among
the 84 consultations, 57 cases were symptomatic ischemic strokes, and 27 cases exhibited irrelevant acute ischemic
lesions. With respect to the stroke subtype, other cause (10.7% vs 4.8%) and undetermined cause (42.9% vs 20.7%) were
more common in the nonneurology department patients (p<0.0001). Acute ischemic strokes in multiple circulations were
also more common in those from nonneurology departments (44.0% vs 11.0%, p<0.0001), along with higher
high-sensitivity C-reactive protein levels. A poor clinical outcome was more common among patients in the
nonneurology departments than among those in the neurology department (75.0% vs 27.5%, p<0.0001).
Conclusions
Ischemic strokes from nonneurology departments tend to appear as nonlocalizing neurologic symptoms
and spread in multiple circulations, and are associated with a worse outcome than those from neurology departments. Key Words: Ischemic stroke, Stroke subtypes, Stroke lesion types, Consultation, Nonneurologists
Keywords :
- 초록
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