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2016 ; 15
(2
): 159-64
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The Usefulness of the TOAST Classification and Prognostic Significance of
Pyramidal Symptoms During the Acute Phase of Cerebellar Ischemic Stroke
#MMPMID26041073
Dziadkowiak E
; Chojdak-?ukasiewicz J
; Guzi?ski M
; Noga L
; Paradowski B
Cerebellum
2016[Apr]; 15
(2
): 159-64
PMID26041073
show ga
Cerebellar stroke is a rare condition with very nonspecific clinical features.
The symptoms in the acute phase could imitate acute peripheral vestibular
disorders or a brainstem lesion. The aim of this study was to assess the
usefulness of the Trial of Org 10172 in Acute Stroke Treatment (TOAST)
classification in cerebellar stroke and the impact of clinical features on the
prognosis. We retrospectively analyzed 107 patients with diagnosed ischemic
cerebellar infarction. We studied the clinical features and compared them based
on the location of the ischemic lesion and its distribution in the posterior
interior cerebellar artery (PICA), superior cerebellar artery (SCA), and anterior
inferior cerebellar artery (AICA) territories. According to the TOAST
classification, stroke was more prevalent in atrial fibrillation (26/107) and
when the lesion was in the PICA territory (39/107). Pyramidal signs occurred in
29/107 of patients and were more prevalent when the lesion was distributed in
more than two vascular regions (p?=?0.00640). Mortality was higher among patients
with ischemic lesion caused by cardiac sources (p?=?0.00094) and with pyramidal
signs (p?=?0.00640). The TOAST classification is less useful in assessing
supratentorial ischemic infarcts. Cardioembolic etiology, location of the
ischemic lesion, and pyramidal signs support a negative prognosis.
|Adult
[MESH]
|Aged
[MESH]
|Aged, 80 and over
[MESH]
|Arteries/*pathology
[MESH]
|Cerebellar Diseases/*diagnosis/pathology
[MESH]
|Diffusion Magnetic Resonance Imaging/methods
[MESH]