Abstract

ROJAS VILLABONA, Álvaro. ¿What is the evidence, from behavioural and imaging data, that we can predict how well people recover after ischemic stroke?. Medicas UIS [online]. 2012, vol.25, n.3, pp.229-238. ISSN 0121-0319.

Background: the incidence of stroke in developing countries is increasing and it is the leading cause of longstanding disability in developed countries. Early prediction of future functional abilities is important for stroke management. It is intended to review whether the initial severity of the deficit and the imaging findings could predict long term recovering after ischemic stroke. Methods: the PubMed database was searched to identify studies evaluating how the initial neurological deficit and the imaging findings could predict long term recovery after ischemic stroke. 35 articles were selected to develop a non systematic review and the Oxford Centre for Evidence-based Medicine Levels of Evidence model was used to grade the quality of the found evidence. Results: age and initial deficit evaluated with the National Institutes of Health Stroke Scale were the best predictors of long term recovery after ischemic stroke. The severity of the deficit in specific categories such as upper limb functions, walking and activities of the daily life had a lower level of evidence on prediction of post-stroke disability. Not a definite prognostic value had been convincingly demonstrated for size of infarction. Location of the lesion, particularly the compromise of the cortico-spinal tract evaluated with diffusion tensor imaging appeared to be a good predictor of recovery, and the pattern of brain activation after stroke evaluated with functional magnetic resonance imaging or positron emission tomography scan had a moderate level of evidence as predictor of recovery after stroke. Conclusion: the severity of the initial deficit can be used to predict how well subjects will recover from an ischemic stroke and novel imaging techniques are very promising tools to predict long time recovery after ischemic stroke. (MÉD.UIS. 2012;25(3):229-38)

Keywords : Stroke; Forecasting; Recovery of Function; Diagnostic Imaging.

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