Low NIHSS Stroke due to Large Vessel Occlusion: What is the prognosis?

INTRODUCTION: The benefit of mechanical thrombectomy (MT) vs medical therapy to mild stroke (NIHSS <6) is still investigated. In this study, we evaluate the prognosis of low NIHSS patients that have large vessel occlusion (LVO) but did not undergo MT at admission.
METHODS: This was a retrospective study. Thirty-nine patients with acute ischemic stroke due to large vessel occlusion with mRS 0-2, NIHSS 0-6 were included in the study between 2021-2023. Outcome was evaulated by modified Rankin Scale score was at 90 days.
RESULTS: The mean age of patients was 68.4 (32-97). Twenty-four of them were male and 15 were female. Median NIHSS score at admission was 3. The most common occlusion site was M2 segment. Nineteen patients had bridging IVT. Only three of the patients had clinical deterioration and underwent MT during hospitalization. The outcomes between clinical deteriotation and non-deteriotation groups did not differ statistically.
DISCUSSION AND CONCLUSION: MT can be performed in low NIHSS stroke patients especially with ICA occlusions. For defining the exact candidate, the results of the ongoing trials such as ENDOLOW and MOSTE are needed.

Büyük Damar Oklüzyonuna Baðlý Düþük NIHSS Skorlu Ýnmelerde Prognoz

GÝRÝÞ ve AMAÇ: Düþük NIHSS skorlu inmelerde (<6) mekanik trombektominin (MT) týbbi tedaviye karþý faydasý halen araþtýrýlmaktadýr. Bu çalýþmada büyük damar oklüzyonu (BDO) olan ancak baþvuru sýrasýnda MT yapýlmayan düþük NIHSS inmelerinin prognozunu deðerlendirdik.
YÖNTEM ve GEREÇLER: Bu retrospektif çalýþmaya 2021-2023 yýllarý arasýnda mRS 0-2, NIHSS 0-6 olan büyük damar týkanýklýðýna baðlý akut iskemik inme geçiren 39 hasta dahil edildi. Prognozlar 90. Gün modifiye Rankin Skalasý ile deðerlendirildi.
BULGULAR: Hastalarýn yaþ ortalamasý 68,4 (32-97) idi. Bu nüfusun 24'si Erkek, 15'si Kadýndýr. Baþvuru sýrasýnda medyan NIHSS skoru 3 idi. En sýk týkanýklýk bölgesi M2 segmentiydi. On dokuz hastada köprü IVT vardý. Hastalarýn sadece üçünde klinik kötüleþme oldu ve hastanede yatýþ sýrasýnda MT uygulandý. Klinik bozulma olan ve olmayan gruplar arasýndaki sonuçlar istatistiksel olarak farklý deðildi.
TARTIÞMA ve SONUÇ: Özellikle ICA oklüzyonlarý olan düþük NIHSS inmeli hastalarda MT yapýlabilir. Adayýn kesin olarak belirlenebilmesi için ENDOLOW ve MOSTE gibi devam eden araþtýrmalarýn sonuçlarýna ihtiyaç duyulmaktadýr.