Persistent visual deficits in minor ischemic stroke

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-09-25 DOI:10.1016/j.jstrokecerebrovasdis.2025.108458

Humza Qureshi BA , Raj G. Saraiya BS , Manisha Koneru MD, MS , Karandeep S. Bhatti MD , Manurag Khullar BS , Michael J. Dubinski BS , Mary Penckofer MD , Jane Khalife MD, MS , Hermann C. Schumacher MD , Khalid A. Hanafy MD, PhD , Courtney Curran MD , James E. Siegler MD , Olga R. Thon MD , Jesse M. Thon MD

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引用次数: 0

Abstract

Background

Compared to more severe presentations, minor ischemic stroke (MIS) remains poorly characterized regarding predictors of long-term outcomes. Particularly there is a need to assess the impact of persistent visual deficits on functional disability in this population. This study aims to compare functional outcomes of MIS between patients with persistent visual deficits (PeVD) and patients without PeVD.

Methods

This retrospective single-center cohort study included adult acute ischemic stroke patients who presented to a comprehensive stroke center from 2019 to 2023. MIS was defined as a National Institutes of Health Stroke Scale (NIHSS) score ≤5 on admission and at 24 hours. PeVD was defined as a nonzero visual field NIHSS subscore at 24 hours. The primary outcome was the 90-day modified Rankin Scale (mRS) score.

Results

Among 1041 MIS patients, 108 (10.4%) had PeVD. Both median presenting (PeVD+: 2 [IQR 1-4] v. PeVD-: 1 [IQR 0-3], p<0.001) and 24-hour NIHSS (PeVD+: 2 [IQR 1-3] v. PeVD-: 1 [IQR 0-2], p<0.001) were higher in patients with PeVD than those without PeVD. At 90 days, patients with PeVD had higher mortality rate (14.3% vs. 7.8%, p=0.04) and mRS scores (p=0.003). After multivariable regression and sensitivity analyses, 24-hour NIHSS was associated with worse 90-day functional outcomes (p<0.001) while PeVD was not (p=0.21).

Conclusion

This study suggests a minority of MIS patients have PeVD, which is associated with stroke severity but not with 90-day functional outcomes. Future studies should evaluate alternative and impactful functional outcome measures not captured by mRS in MIS patients with PeVD.

查看原文本刊更多论文

轻度缺血性脑卒中的持续性视力缺陷。

背景：与更严重的表现相比，轻度缺血性卒中（MIS）的长期预后预测指标仍然很差。特别是有必要评估持续性视力缺陷对这一人群功能障碍的影响。本研究旨在比较持续性视力缺陷（PeVD）患者和非PeVD患者的MIS功能结局。方法：这项回顾性单中心队列研究纳入了2019年至2023年在综合卒中中心就诊的成年急性缺血性卒中患者。MIS定义为入院时和24小时时美国国立卫生研究院卒中量表（NIHSS）评分≤5分。PeVD定义为24小时非零视野NIHSS评分。主要观察指标为90天改良Rankin量表（mRS）评分。结果：1041例MIS患者中，有108例（10.4%）有PeVD。PeVD+: 2 [IQR 1-4] vs . PeVD-: 1 [IQR 0-3]，结论：本研究提示少数MIS患者存在PeVD，其与卒中严重程度相关，但与90天功能结局无关。未来的研究应评估MIS合并PeVD患者的mRS未捕获的替代和有效的功能结局指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.