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(Stroke. 1999;30:2119-2125.)
© 1999 American Heart Association, Inc.
Original Contributions |
Effects of Spontaneous Recanalization on Functional and Electrophysiological Recovery in Acute Ischemic Stroke
From the Discipline of Medicine, University of Tasmania, Australia.
Correspondence and reprint requests to Dr David Dunbabin; Discipline of Medicine, University of Tasmania, 43 Collins St, Hobart, TAS 7000 Australia. E-mail David.Dunbabin{at}med.utas.edu.au
Background and Purpose—Transcranial Doppler ultrasound (TCD) studies have shown that spontaneous recanalization results in a better clinical improvement after the onset of stroke. However, its effect on electrophysiological recovery is still unknown. The aim of this study was to determine the effects of spontaneous recanalization on the change in central motor conduction time (CMCT) in acute ischemic stroke.
Methods—Seventeen healthy subjects and 38 consecutive patients
with a first acute ischemic stroke involving the middle
cerebral artery territory were included. TCD was used to detect
spontaneous recanalization.
Transcranial magnetic stimulation was used to determine the
change in CMCT on days 1 and 14. Improvement of the CMCT at day 14 was
indicated if it decreased in comparison with previous data recorded
at day 1 or when a nonrecordable motor response at day 1 reappeared
at day 14. No CMCT improvement was indicated when there was no
recordable motor response at day 1 and day 14 or the CMCT at day 14
worsened, becoming absent or more delayed. The Pearson 
2
test was used to assess the statistical significance of the results in
this study.
Results—Spontaneous recanalization was observed in 62% of the patients: 24% before 24 hours and 38% after this period. No recanalization was observed in 14 patients. The CMCT improved in 87% of the patients who had recanalized before 24 hours and 62% in the recanalized after 24 hours group (P=0.005). In contrast, CMCT improved in only 17% of the patients in the non-recanalized group
Conclusions—These data show that spontaneous recanalization results in a better recovery of the central motor pathway leading to a better CMCT improvement in acute ischemic stroke.
Key Words: electrophysiology • reperfusion • stroke, ischemic • stroke outcome
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