• D Renard, N Landragin, A Robinson, H Brunel, A Bonafe, C Heroum, and C Milhaud.
• Department of Neurology, Hôpital Gui de Chauliac, CHU Montpellier, Montpellier, France. dimitrirenard@hotmail.com
• Cerebrovasc. Dis. 2008 Jan 1;25(6):511-6.

BackgroundIntra-arterial thrombolysis may reduce mortality in acute basilar artery (BA) occlusion. We wanted to identify an easy-to-use pre-treatment MR-based predictor of clinical outcome in patients with acute BA occlusion treated with IAT.MethodsWe analyzed 16 patients with acute BA occlusion prospectively. Vascular risk factors, as well as National Institutes of Health Stroke Scale (NIHSS) and Glasgow Coma Scale (GCS) scores were recorded on admission, together with a 10-point semiquantitative score reflecting the number of acute ischaemic brain lesions on diffusion-weighted imaging. The recanalization grade was evaluated by angiography. The clinical outcome, using the modified Rankin scale (mRs), was measured 3 months later.ResultsRisk factors, NIHSS and GCS scores, time from symptom onset to treatment, recanalization rate, outcome and outcome predictors (such as age, NIHSS and GCS scores) were comparable to other studies. Haemorrhagic transformation of infarction occurred in 2 patients (12.5%). We found that a high lesion score was an additional predictor of poor outcome (p = 0.026).ConclusionsIn patients with acute BA occlusion, treated with intra-arterial recombinant tissue plasminogen activator, a high number of acute ischaemic lesions, based on diffusion-weighted imaging, is a predictor of poor clinical outcome.2008 S. Karger AG, Basel.

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