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Clinical and Radiographic Considerations in Acute Stroke Triage

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Neurointervention in the Medical Specialties

Part of the book series: Current Clinical Neurology ((CCNEU))

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Abstract

Despite approaching a 90 % rate of recanalization, good clinical outcomes are only seen in about 50 % of the patients who undergo stroke intervention. This discrepancy indicates that the recanalization of the artery does not always result in good clinical outcome. Also a subset of patients will not have any significant clinical improvement despite achieving early or late recanalization (Broderick et al., N Engl J Med 368:893–903, 2013; Kidwellet al., N Engl J Med 368:914–923, 2013). Therefore, there is a need to more accurately identify patients who will benefit from early or late recanalization using interventional therapy. Clinical assessment scales like National Institutes of Health Stroke Scale (NIHSS) and Houston Intra-arterial Therapy (HIAT) score can help identify patients with moderate to severe strokes, who may benefit from interventional therapies. The evolution of CT and MR imaging in conjunction with clinical assessment may allow us to further refine our ability to identify subgroups of patients who benefit from stroke intervention. These clinical and imaging criteria for patient selection are the focus of discussion in this chapter.

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Authors and Affiliations

  1. Neurology and Neurosurgery, University of Missouri, Columbia, MO, 65212, USA

    Ashish Nanda M.D.

  2. Department of Neurology, University of Missouri, Columbia, MO, 65212, USA

    Anantha Vellipuram M.D.

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  1. Ashish Nanda M.D.
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Correspondence to Ashish Nanda M.D. .

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Editors and Affiliations

  1. Department of Neurology and Psychiatry, Saint Louis University, St. Louis, Missouri, USA

    Randall C. Edgell

  2. Department of Neurology, University of Texas Health Science Center, UT-HEALTH, Houston, Texas, USA

    Sean I. Savitz

  3. Department of Neurosurgery, Albany Medical Center, Albany, New York, USA

    John Dalfino

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Nanda, A., Vellipuram, A. (2015). Clinical and Radiographic Considerations in Acute Stroke Triage. In: Edgell, R., Savitz, S., Dalfino, J. (eds) Neurointervention in the Medical Specialties. Current Clinical Neurology. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-1942-0_6

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  • DOI: https://doi.org/10.1007/978-1-4939-1942-0_6

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