Clinical significance of evaluation of collateral circulation in short-term prognosis of wake-up stroke patients

Abstract

Background. In recent years, the clinical significance of collateral circulation in vascular embolism has been gradually found. Objectives. To investigate the relationship between collateral circulation and short-term prognosis of wake-up stroke patients. Material and methods. The present observational study enrolled 269 cases of wake-up ischemic stroke patients. All patients presented with mismatched low perfusion volume/main infraction volume and received thrombolytic therapy after admission. The hemorrhagic transformation rate was recorded. The American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) grading was used for evaluation of collateral circulation. The stroke condition was determined using the National Institutes of Health Stroke Scale (NIHSS). The Barthel Index (BI) score was used for measurement of quality of life. The Modified Rankin Scale (mRS) was used for measurement of prognosis. Results. The hypertension, diabetes and current smoker rates were significantly higher. The baseline NHISS scores and NIHSS scores after 24 h were remarkably lower. The NIHSS scores were markedly lower in ASITN/SIR grade 2–3 patients compared with ASITN/SIR grade 0–1 patients at 1 week, 2 weeks, 4 weeks, and 3 months after treatment. Patients with ASITN/SIR grade 2–3 had lower mRS score and higher BI scores. The ASITN/SIR grade was an independent risk factor for bad prognosis of wake-up ischemic stroke patients in 3 months. Conclusions. Collateral circulation condition may be associated with short-term prognosis of wake-up stroke patients. Patients with worse collateral circulation may present higher risk for bad short-term prognosis.