Deteriorating ischaemic stroke: cytokines, soluble cytokine receptors, ferritin, systemic blood pressure, body temperature, blood glucose, diabetes, stroke severity, and CT infarction-volume as predictors of deteriorating ischaemic stroke

Abstract

Background and purpose: Although the causes of neurological deterioration in acute cerebral infarction have not yet been identified, many variables have been associated with deterioration. The aim of this study was to investigate deteriorating ischaemic stroke. Methods: Deterioration was defined as a decrease in Scandinavian Stroke Scale (SSS) of at least 2 points occurring within 72 h of stroke onset and lasting at least 6 h. The earlier found associations between neurological deterioration and systemic blood pressure, blood glucose, body temperature, stroke severity, and diabetes were investigated in a population of 896 consecutive patients with acute cerebral infarction. In a substudy of 162 of these patients, we evaluated the relations of neurological deterioration to s-ferritin, p-tumor necrosis factor-α, p-interleukin-1β, p-interleukin-1 receptor antagonist, p-interleukin-6, p-interleukin-10, and p-soluble tumor necrosis factor receptors 1 and 2. Results: Patients with neurological deterioration had more severe strokes than nondeteriorating patients: median SSS on admission 31 versus 40, p<0.001, Mann–Whitney. We could not confirm previous reports of an association of deteriorating stroke with blood pressure, blood glucose, body temperature, diabetes, s-ferritin or cytokines. Conclusions: Severe stroke was a predictor of neurological deterioration. This study did not confirm other reported predictors of deterioration.