Efficacy of Cerebral Autoreguiation in Early Ischemic Stroke Predicts Smaller Infarcts and Better Outcome

• Type: Article in International Scientific Journal
• Date: 2017

Authors

Pedro Castro (Author) FMUP; Serrador, JM (Author) Other; Rocha, I (Author) Other; Sorond, F (Author) Other; Elsa Azevedo (Author) FMUP

Journal

Title: Frontiers in Neurology

Vol. 8

ISSN: 1664-2295

Publisher: Frontiers Media

Indexing

ISI Web of Knowledge - 54 Citations

Scopus - 61 Citations

Other information

Authenticus ID: P-00M-KT1

DOI: 10.3389/fneur.2017.00113

Abstract (EN): Background and purpose: Effective cerebral autoregulation (CA) may protect the vulnerable ischemic penumbra from blood pressure fluctuations and minimize neurological injury. We aimed to measure dynamic CA within 6 h of ischemic stroke (IS) symptoms onset and to evaluate the relationship between CA, stroke volume, and neurological outcome. Methods: We enrolled 30 patients with acute middle cerebral artery IS. Within 6 h of IS, we measured for 10 min arterial blood pressure (Finometer), cerebral blood flow velocity (transcranial Doppler), and end-tidal-CO2. Transfer function analysis (coherence, phase, and gain) assessed dynamic CA, and receiver-operating curves calculated relevant cut-off values. National Institute of Health Stroke Scale was measured at baseline. Computed tomography at 24 h evaluated infarct volume. Modified Rankin Scale (MRS) at 3 months evaluated the outcome. Results: The odds of being independent at 3 months (MRS 0-2) was 14-fold higher when 6 h CA was intact (Phase > 37 degrees) (adjusted OR = 14.0 (IC 95% 1.7-74.0), p = 0.013). Similarly, infarct volume was significantly smaller with intact CA [median (range) 1.1 (0.2-7.0) vs 13.1 (1.3-110.5) ml, p = 0.002]. conclusion: In this pilot study, early effective CA was associated with better neurological outcome in patients with IS. Dynamic CA may carry significant prognostic implications.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 5