J 2018

24-Hour Alberta Stroke Program Early CT Score Assessment in Post-Stroke Spasticity Development in Patients with a First Documented Anterior Circulation Ischemic Stroke

VOLNÝ, Ondřej, Mária JUSTANOVÁ, Petra CIMFLOVÁ, Linda MACHOVÁ, Ivana SVOBODOVÁ et. al.

Basic information

Original name

24-Hour Alberta Stroke Program Early CT Score Assessment in Post-Stroke Spasticity Development in Patients with a First Documented Anterior Circulation Ischemic Stroke

Authors

VOLNÝ, Ondřej (203 Czech Republic, guarantor, belonging to the institution), Mária JUSTANOVÁ (203 Czech Republic, belonging to the institution), Petra CIMFLOVÁ (203 Czech Republic, belonging to the institution), Linda MACHOVÁ (203 Czech Republic), Ivana SVOBODOVÁ (203 Czech Republic, belonging to the institution), Jan MUŽÍK (203 Czech Republic, belonging to the institution) and Martin BAREŠ (203 Czech Republic, belonging to the institution)

Edition

Journal of Stroke and Cerebrovascular Diseases, Amsterdam, Elsevier Science BV. 2018, 1052-3057

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30210 Clinical neurology

Country of publisher

Netherlands

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 1.646

RIV identification code

RIV/00216224:14110/18:00102114

Organization unit

Faculty of Medicine

DOI

UT WoS

000419584400033

Keywords in English

Middle cerebral artery territory; Modified; Ashworth scale; Post-stroke spasticity; Stroke

Tags

Tags

International impact, Reviewed
Změněno: 13/9/2021 15:01, Mgr. Tereza Miškechová

Abstract

V originále

Background: Neuroanatomic substrates responsible for development of post-stroke spasticity are still poorly understood. The study is focused on identification of brain regions within the territory of the middle cerebral artery associated with spasticity development. Methods: This is a single-center prospective cohort study of first documented anterior circulation ischemic strokes with a neurologic deficit lasting >7 days (from March 2014 to September 2016, all patients are involved in a registry). Ischemic cerebral lesions within the territory of middle cerebral artery were evaluated using the Alberta Stroke Program Early CT Score (ASPECTS) on control 24-hour computed tomography or magnetic resonance imaging. Spasticity was assessed with modified Ashworth scale. Results: Seventy-six patients (mean age 72 years, 45% females; 30% treated with IV tissue plasminogen activator, 6.5% mechanical thrombectomy) fulfilled the study inclusion criteria. Forty-nine (64%) developed early elbow or wrist flexor spasticity defined as modified Ashworth scale >1 (at day 7-10), in 44 (58%) the spasticity remained present at 6 months. There were no differences between the patients who developed spasticity and those who did not when comparing admission stroke severity (National Institutes of Health Stroke Scale 5 [interquartile range (IQR) 4-8] versus 6 [IQR 4-10]) and vascular risk factors (hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, coronary artery disease). Nor was there a difference in 24-hour ASPECTS score (9 [IQR 8-10] versus 9 [IQR 7-10]). No differences were found between the groups with and without the early upper limb flexor spasticity of particular regions (M1, M2, M3, M4, M5, M6, lentiform, insula, caudate, internal capsule) and precentral-postcentral gyrus, premotor cortex, supplementary motor area, posterior limb of internal capsule, and thalamus were compared. Conclusions: We did not find any middle cerebral artery territory associated with post-stroke spasticity development by detailed evaluation of ASPECTS.