Abstract
The objective of this study is to assess the impact of recanalization (spontaneous and therapeutic) on upper limb functioning and general patient functioning after stroke. This is a prospective, observational study of patients hospitalized due to acute ischemic stroke in the territory of the middle cerebral artery (n = 98). Patients completed a comprehensive rehabilitation program and were followed-up for 24 weeks. The impact of recanalization on patient functioning was evaluated using the modified Rankin Scale (mRS) and Stroke Upper Limb Capacity Scale (SULCS). General and upper limb functioning improved markedly in the first three weeks after stroke. Age, gender, and National Institutes of Health Stroke Scale (NIHSS) score at admission were associated with general and upper limb functioning at 12 weeks. Successful recanalization was associated with better functioning. Among patients who underwent therapeutic recanalization, NIHSS scores ≥16.5 indicate lower general functioning at 12 weeks (sensibility = 72.4%; specificity = 78.6%) and NIHSS scores ≥13.5 indicate no hand functioning at 12 weeks (sensibility = 83.8%; specificity = 76.5%). Recanalization, either spontaneous or therapeutic, has a positive impact on patient functioning after acute ischemic stroke. Functional recovery occurs mostly within the first 12 weeks after stroke, with greater functional gains among patients with successful recanalization. Higher NIHSS scores at admission are associated with worse functional recovery.
Highlights
Stroke is a leading cause of functional disability worldwide
This study aims to assess the impact of recanalization on upper limb functioning and general patient functioning after ischemic stroke of the middle cerebral artery
During the period of the study, 115 patients were admitted with acute ischemic stroke fulfilling the selection criteria, and provided their informed consent to participate in the study
Summary
Stroke is a leading cause of functional disability worldwide. Most patients surviving an acute stroke present hemiparesis of brachial predominance, which constitutes a major challenge in the rehabilitation program and often leads to long-term disability [1].Most acute strokes are of ischemic etiology [2,3] and among those, patients with the cardioembolic subtype (approximately 25%) tend to show worse clinical and functional prognosis, with higher in-hospital mortality in the acute phase and worse functioning at discharge [4,5]. Stroke is a leading cause of functional disability worldwide. Most patients surviving an acute stroke present hemiparesis of brachial predominance, which constitutes a major challenge in the rehabilitation program and often leads to long-term disability [1]. Revascularization of at-risk brain tissue (ischemic penumbra area) is considered an important predictor of both clinical and functional recovery post-stroke [6]. Cell viability is maintained for a few hours after acute stroke and function can be recovered if blood flow is restored in an adequate timeframe [7,8]. The restoration of vessel patency (vascular permeability) at the site of occlusion, termed recanalization, can occur spontaneously or as a result of a therapeutic intervention. Spontaneous recanalization occurs in up to 67% of ischemic strokes, mostly within the first 48 h [9]. The factors determining spontaneous recanalization are still poorly understood, but atrial fibrillation is associated
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
