Can Patients with Eye Deviation and Contralateral Hemıparesıs Be Taken Directly to The Angiography Suıte?

Öz

Objective: Eye or head deviation accompanied by contralateral hemiparesis or hemiplegia is common in patients with large vessel occlusion, as it indicates frontoparietal lobe damage. This study aimed to investigate the frequency of large vessel occlusion in patients presenting with eye or head deviation accompanied by contralateral hemiparesis or hemiplegia. Materials and Methods: Patients with contralateral hemiparesis or hemiplegia accompanied by eye or head deviation who were admitted to our emergency department between January 2018 and January 2020 were retrospectively evaluated and included in the study. Patients diagnosed with ischemic stroke due to large vessel occlusion and who underwent mechanical thrombectomy were identified. Results: A total of 164 patients were included in the study, eight of whom were diagnosed with intracranial hemorrhage. Thus, 95.1% of patients presenting with these symptoms had an ischemic stroke. Mechanical thrombectomy was performed in 93.9% of patients presenting with these symptoms to the emergency department and in 98.7% of patients diagnosed with ischemic stroke. Successful reperfusion (mTICI ≥ 2b) was achieved in 92.8% of patients, and good functional outcomes (mRS ≤ 2) were observed in 39.6% of patients at discharge. The symptomatic intracranial hemorrhage rate was 5.1%, while mortality was 14.2%. Conclusions: This study suggests that contralateral hemiparesis or hemiplegia accompanied by eye or head deviation is highly indicative of large vessel occlusion. Patients with these symptoms can be admitted directly to the angiography suite in appropriate centers.

Anahtar Kelimeler

• Acute Stroke
• Angiography Suite
• Cerebral Angiography
• Thrombectomy

Göz Deviasyonu ve Kontralateral Hemiparezisi Olan Hastalar Doğrudan Anjiyografi Odasına Alınabilir Mı?

Öz

Amaç: Kontralateral hemiparezi/hemiplejinin eşlik ettiği göz/baş deviasyonu, frontoparietal lob hasarına işaret etmesi nedeniyle büyük damar tıkanıklığı olan hastalarda sık görülür. Bu çalışmada kontralateral hemiparezi/ hemiplejinin eşlik ettiği göz/baş deviasyonu olan hastalarda büyük damar tıkanıklığı sıklığını araştırmayı amaçladık. Materyal ve Metot: Ocak 2018 ile Ocak 2020 tarihleri arasında acil servisimize başvuran kontralateral hemiparezi/hemipleji ile birlikte göz/baş deviasyonu olan hastalar retrospektif olarak değerlendirildi ve çalışmaya dahil edildi. Büyük damar tıkanıklığına bağlı iskemik inme tanısı ile mekanik trombektomi uygulanan hastalar belirlendi. Bulgular: 164 hasta çalışmaya dahil edildi. Sekiz hastaya intrakraniyal kanama tanısı konuldu. Bu nedenle bu klinikle başvuran hastaların %95,1’i iskemik inme geçirmişti. Acil servise bu semptomlarla başvuran hastaların %93,9’una, iskemik inme tanısı alan hastaların ise %98.7’sine mekanik trombektomi işlemi uygulandı. İşlem sonunda hastaların %92,8’inde başarılı reperfüzyon (mTICI ≥ 2b) sağlandı ve taburculukta hastaların %39,6’sında iyi fonksiyonel sonuçlar (mRS ≤ 2) gözlendi. Semptomatik intrakraniyal kanama oranı %5,1 iken, mortalite %14,2 idi. Sonuçlar: Bu çalışmada, göz ve/veya baş deviasyonunun eşlik ettiği kontralateral hemiparezi/hemiplejinin yüksek oranda büyük damar tıkanıklığının göstergesi olabileceği ve bu kliniğe sahip hastaların uygun merkezlerde doğrudan anjiyografi odasına alınabileceği kanaatindeyiz.

Anahtar Kelimeler

• Akut inme
• Anjiografi odası
• Serebral anjiografi
• Trombektomi

Kaynakça

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