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ISSN: 2329-6895

Journal of Neurological Disorders
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Research Article

CT Angiography and Presentation NIH stroke Scale in Predicting TIA in Patients Presenting with Acute Stroke Symptoms

Bedriye Karaman1, James Selph2, Joselyn Burdine2, Cole Blease Graham2 and Souvik Sen2*
1Ege University Medical School, Department of Neurology, Izmir, Turkey
2University of South Carolina School of Medicine, Department of Neurology, Columbia, South Carolina, USA
Corresponding Author : Souvik Sen
Professor and Chair, Department of Neurology
University of South Carolina School of Medicine
8 Medical Park, Suite 420 Columbia, South Carolina, USA 29203
Tel: 803-545-6050/6073
Fax: 803-545-6051
E-mail: [email protected]
Received Septemebr 09, 2013; Accepted November 05, 2013; Published November 08, 2013
Citation: Karaman B, Selph J, Burdine J, Graham CB, Sen S (2013) CT Angiography and Presentation NIH stroke Scale in Predicting TIA in Patients Presenting with Acute Stroke Symptoms. J Neurol Disord 2:140. doi: 10.4172/2329-6895.1000140
Copyright: © 2013 Karaman B, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Abstract

Abstract

Patient candidacy for acute stroke intervention, is currently assessed using brain computed tomography angiography (CTA) evidence of significant stenosis/occlusion (SSO) with a high National Institutes of Health Stroke Scale (NIHSS) (>6). This study examined the association between CTA without significant stenosis/occlusion (NSSO) and lower NIHSS (≤ 6) with transient ischemic attack (TIA) and other good clinical outcomes at discharge. Patients presenting <8 hours from stroke symptom onset, had an NIHSS assessment and brain CTA performed at presentation. Good clinical outcomes were defined as: discharge diagnosis of TIA, modified Rankin Score [mRS] ≤ 1, and home as the discharge disposition. Eighty-five patients received both an NIHSS at presentation and a CTA at 4.2 ± 2.2 hours from stroke symptom onset. Patients with NSSO on CTA as well as those with NIHSS≤6 had better outcomes at discharge (p<0.001). NIHSS ≤ 6 were more likely than NSSO (p=0.01) to have a discharge diagnosis of TIA (p<0.001). NSSO on CTA and NIHSS ≤ 6 also correlated with fewer deaths (p<0.001). Multivariable analyses showed NSSO on CTA (Adjusted OR: 5.8 95% CI: 1.2- 27.0, p=0.03) independently predicted the discharge diagnosis of TIA. Addition of NIHSS ≤ 6 to NSSO on CTA proved to be a stronger independent predictor of TIA (Adjusted OR 18.7 95% CI: 3.5-98.9, p=0.001).

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