Abstract
ObjectiveThe aim of this prospective cohort study was to determine the incidence and neuroimaging risk factors associated with Babinski sign following acute ischemic stroke, as well as its relationship with the functional outcome of patients.MethodsA total of 351 patients were enrolled in the study within 7 days of acute ischemic stroke. The Babinski sign along with other upper motor neuron signs were examined upon admission and between days 1 and 3 and days 5 and 7 after admission. Neuroimaging parameters included site and volume of infarction and white matter lesions. All patients were followed up at 3 months. Functional outcome was assessed with the Lawton Activities of Daily Living scale and modified Rankin Scale.ResultsBabinski sign was observed in 115 of 351 (32.8%) patients in the acute ischemic stroke. These patients had higher National Institutes of Health Stroke Scale (NIHSS) scores at admission and higher rates of atrial fibrillation and cardioembolism; higher frequencies of frontal, temporal, and limbic lobes and basal ganglia infarcts; and larger infarct volume. Higher NIHSS score and basal ganglia infarct were significant predictors of the presence of Babinski sign. After adjusting for confounds, the presence of Babinski sign did not predict poor functional outcome.ConclusionThe incidence of Babinski sign was 32.8% in the acute ischemic stroke. Severe infarction and basal ganglia infarct were independent predictors of Babinski sign. Although Babinski sign is common in acute ischemic stroke patients, it does not predict poor functional outcome 3 months later.
Highlights
Babinski sign, known as the great toe sign, is the most sensitive and important indicator of an upper motor neuron lesion and was first described by Joseph Babinski in 1896
We found that the incidence of Babinski sign was 32.8% in the acute stage of overall ischemic stroke
The presence of Babinski sign was associated with higher National Institutes of Health Stroke Scale (NIHSS) score and infarct in the basal ganglia
Summary
Known as the great toe sign, is the most sensitive and important indicator of an upper motor neuron lesion and was first described by Joseph Babinski in 1896. The pyramidal tract is a large structure supplied by blood from many different arteries, with any occlusion leading to a wide variety of symptoms that include the presence of Babinski sign This reflex has seldom been investigated in the acute ischemic stroke population by magnetic resonance imaging (MRI). Brain MRI can reveal structural details of acute ischemic stroke lesions and has greater sensitivity in detecting preexisting brain abnormalities It is not known whether the presence of Babinski sign is related to the functional outcome in stroke patients; if this is the case, it could provide prognostic information to neurologists and inform clinical decisions on how best to manage patients’ care in order to accelerate recovery.
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