ĐẶC ĐIỂM LÂM SÀNG, HÌNH ẢNH HỌC VÀ KẾT QUẢ ĐIỀU TRỊ NGƯỜI BỆNH NHỒI MÁU NÃO DO TẮC ĐỘNG MẠCH NÃO GIỮA ĐOẠN M2

Abstract

Objectives: This study aimed to find out the clinical characteristics, imaging features and treatment results of acute ischemic stroke (AIS) patients due to M2-segment occlusion at Bach Mai Stroke Center. Methods: We conducted a descriptive cross-sectional study which enrolled acute ischemic stroke patients due to M2-segment occlusion at Bach Mai stroke center from January of 2021 to May of 2022. Reperfusion therapies were carried out in patients who met criteria for thrombolysis and/or thrombectomy. NIHSS score was collected at admission, after 24 hours and mRS score was collected after 90 days. Results: 105 AIS patients due to M2-segment occlusion were enrolled, in which the male/female ratio = 1.1/1. Mean age was 68.0 ± 12.4, age group 70 - 79 accounted for the largest proportion (31%). The number of patients admitted to the hospital within 4.5 hours after onset accounted for the largest proportion (49.5%). The average door-to-needle time was 39.5 ± 22.1 minutes, and the mean door-to-groin-puncture time was 110.6 ± 63.5 minutes. According to TOAST classification, large arterial atherosclerosis accounted for the highest rate (55.2%), cardioembolism accounted 20%. After 24 hours, the median NIHSS score of the group of patients who received reperfusion therapies decreased by 4 points while that of the optimal medical treatment group did not change (p<0.05). At 90 days, patients who recieved reperfusion therapy had better recovery (mRS 0-2: 59.7% vs 42,2% in optimal medical treatment group) and symptomatic intracerebral hemorrhage rate was 8% of 105 AIS patiens. Conclusion: This study showed some distinguish features of AIS patients due to M2-segment occlusion at Bach Mai stroke center. Repefusion therapies improved the median NIHSS score after 24 hour and led to better outcome after 90 days in comparison with best medical treatment alone.