Predictors of good prognosis in total anterior circulation infarction within 6 h after onset under conventional therapy.

Objective –  We investigated the predictors of good prognosis in total anterior circulation infarction (TACI), under conventional therapy. Methods –  We enrolled 166 patients with first-ever ischemic stroke within 6 h after onset with symptoms of TACI. Sixty-three patients (38.0%) with good outcome [G group, the modified Rankin Disability Scale (mRS) after 3 months ≤3] and 103 patients (62.0%) with bad outcome (B group, mRS >3) were compared. Results –  On univariate analysis, G group patients were significantly younger, had lower score in the National Institutes of Health Stroke Scale (NIHSS) of total and consciousness sub-score, had lower rate of clinical deterioration. On cranial CT at entry, three early CT signs [hyperdense middle cerebral artery (MCA) sign, hypodensity of >1/3 MCA and brain swelling] were significantly more frequent in the B group. On the second CT at 24–48 h, infarct area as assessed by the Alberta Stroke Programme Early CT Score (ASPECTS) was significantly smaller in the G group. Multivariate analysis with logistic regression revealed age<70 years, NIHSS≤15, no clinical deterioration, and only no brain swelling in early CT signs, and ASPECTS≥7 as independent predictors of good prognosis. Conclusions –  Some clinical variables are useful in predicting outcome in TACI within the early period after stroke onset.