RESUMEN
OBJECTIVE: To evaluate the diagnostic value of eye movements and vestibular function tests in PCI patients. METHODS: Thirty-eight PCI patients and 31 patients with unilateral vestibular neuritis (UVN) were enrolled and underwent eye movement tests and vestibular function tests (spontaneous nystagmus [SN], head-shaking nystagmus [HSN]). RESULTS: The rates of eye movement abnormality were 78.9% and 41.9% in PCI and UVN patients, respectively. The positive rate of SN and HSN were, respectively, 41.2% and 43.8% in cerebellar infarction patients, 33.3% and 66.7% in medullary infarction patients, and 100.0% and 86.2% in UVN patients. The horizontal direction of SN and HSN coincided with the affected side in cerebellar infarction patients, and the healthy side in UVN patients, which coincided with the healthy side and the affected side, respectively in medullary infarction patients. The horizontal direction of HSN was bidirectional nystagmus in 16.0% (4/25) of UVN patients. CONCLUSIONS AND SIGNIFICANCE: Eye movement and vestibular function tests contribute to the early diagnosis of PCI. The horizontal direction of SN and HSN are consistently toward the affected side in cerebellar infarction patients and the healthy side in UVN patients, in contrast to medullary infarction patients, and deserve further investigations.
Asunto(s)
Movimientos Oculares/fisiología , Infarto de la Arteria Cerebral Posterior/diagnóstico , Nistagmo Patológico/diagnóstico , Neuronitis Vestibular/diagnóstico , Adulto , Factores de Edad , Anciano , Estudios de Cohortes , Mareo/diagnóstico , Mareo/etiología , Diagnóstico Precoz , Femenino , Humanos , Infarto de la Arteria Cerebral Posterior/complicaciones , Infarto de la Arteria Cerebral Posterior/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Medición de Riesgo , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad , Vértigo/diagnóstico , Vértigo/etiología , Pruebas de Función Vestibular , Neuronitis Vestibular/complicacionesRESUMEN
BACKGROUND: Disability and mortality represent the most relevant clinical outcomes after acute ischemic stroke. Recently, a number of prognostic models of acute ischemic stroke have been developed, but they have not been extensively validated. In this study, we evaluated the ability of 3 prognostic models including the iScore, the PLAN score, and the ASTRAL score in predicting clinical poor outcomes or mortality at 6 months in patients with acute ischemic stroke. METHODS: A total of 323 patients were divided into a good-prognosis group and a poor-prognosis group based on the modified Rankin Scale. Model discrimination was quantified by calculating the area under the receiver operating characteristic (ROC) curve, and calibration was assessed by Hosmer-Lemeshow goodness of fit test and Pearson correlation coefficient. RESULTS: We identified 96 (29.7%) patients with poor prognosis, including 21 who were dead. All 3 models showed good ability in predicting poor prognosis and mortality in patients with acute ischemic stroke (all ROC > .70). There was no difference between these 3 models in terms of sensitivity and accuracy (all P > .05). CONCLUSIONS: The results of this study suggest that the iScore, the PLAN score, and the ASTRAL score were equal in predicting 6-month poor prognosis and mortality in patients with acute ischemic stroke. Overall, there was a very high correlation between observed and expected outcomes at the risk score level.