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Stroke. 2018 Feb;49(2):458-460. doi: 10.1161/STROKEAHA.117.020140. Epub 2018 Jan 10.

Detection of Anterior Circulation Large Artery Occlusion in Ischemic Stroke Using Noninvasive Cerebral Oximetry.

Author information

1
From the Division of Research, Kaiser Permanente, Oakland, CA (A.C.F.); and Neuroscience Department, Kaiser Permanente, Redwood City, CA (A.C.F., S.G.B., S.P.C., A.V.R., D.P.H., V.A.R., M.P., J.P., N.J.E., S.L.C.). alexander.c.flint@kp.org.
2
From the Division of Research, Kaiser Permanente, Oakland, CA (A.C.F.); and Neuroscience Department, Kaiser Permanente, Redwood City, CA (A.C.F., S.G.B., S.P.C., A.V.R., D.P.H., V.A.R., M.P., J.P., N.J.E., S.L.C.).

Abstract

BACKGROUND AND PURPOSE:

Large artery occlusion (LAO) in ischemic stroke requires recognition and triage to an endovascular stroke treatment center. Noninvasive LAO detection is needed to improve triage.

METHODS:

Prospective study to test whether noninvasive cerebral oximetry can detect anterior circulation LAO in acute stroke. Interhemispheric ΔBrSO2 in LAO was compared with controls.

RESULTS:

In LAO stroke, mean interhemispheric ΔBrSO2 was -8.3±5.8% (n=19), compared with 0.4±5.8% in small artery stroke (n=17), 0.4±6.0% in hemorrhagic stroke (n=14), and 0.2±7.5% in subjects without stroke (n=19) (P<0.001). Endovascular stroke treatment reduced the ΔBrSO2 in most LAO subjects (16/19). Discrimination of LAO at a -3% ΔBrSO2 cut had 84% sensitivity and 70% specificity. Addition of the G-FAST clinical score (gaze-face-arm-speech- time) to the BrSO2 measure had 84% sensitivity and 90% specificity.

CONCLUSIONS:

Noninvasive cerebral oximetry may help detect LAO in ischemic stroke, particularly when combined with a simple clinical scoring system.

KEYWORDS:

brain ischemia; oximetry; stroke; triage

PMID:
29321339
DOI:
10.1161/STROKEAHA.117.020140
[Indexed for MEDLINE]

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