CORRELATION BETWEEN ASPECT SCORE OF NCCT SCAN/DIFFUSION WEIGHTED MRI AND FUNCTIONAL NEUROLOGICAL OUTCOME IN PATIENTS OF ACUTE ISCHEMIC STROKE.

Abstract

INTRODUCTION-“Stroke—a generic term meaning sudden onset of a neurologic event—is also referred to as a cerebrovascular accident (CVA) or "brain attack.” The distinction between cerebral ischemia and cerebral infarction is subtle but important. In cerebral ischaemia, the affected tissue remains viable although blood flow is inadequate to sustain normal cellular function. In cerebral infarction, frank cell death occurs with loss of neurons, glia, or both.Timing is important in patient triage. Hyperacute stroke designates events within the first 6 hours following symptom onset. In hyperacute stroke, cell death has not yet occurred, so the combined term acute cerebral ischemia-infarction is often used. Acute strokes are those 6-48 hours from onset”¹.

“Alberta Stroke Program Early CT score (ASPECTS) is a valid, robust and reliable method to judge degree of early ischaemic changes (EIC) (focal parenchymal hypo-attenuation, loss of graywhite differentiation, and sulcal effacement) on CT scan in patients with acute ischemic stroke”².”ASPECTS has been shown to have modest prognostic value for determining clinical outcome after intravenous tissue plasminogen activator (i.v. tPA) in management of acute ischaemic stroke”³.”The mRS is the most widely used  global outcome scale in clinical trials for stroke.The mRS is also associated with long term outcome predicition after stroke”⁴.

METHODS-Prospective cohort study,45 patients of acute ischaemic stroke included,Study period from janurary 2018 to janurary 2019 at shri b.m.patil medical college and hospital.Aspect score of NCCT on admission and modified rankin scale on admission and on 7^th day calculated and compared. Data presented in mean,standard deviation and diagram.association between variables was found using chi square test.Data were analysed using spss software version seventeen.A pvalue of  <0.005 was considered statistically significant.

RESULTS-we studied 45 patients in which 73.3% with aspect score >7 had good functional neurological outcome at day 7,statistically significant (p=0.001).26.7% patients with aspect score <7 had worst functional neurological outcome at day 7,statistically significant (p=0.001).no statistically significant correlation found between aspect score and risk factors diabetes mellitus type 2 and essential hypertension(p=0.420). CONCLUSION-Aspect score determined on ncct scan/diffusion weighted mri on day of admission can serve as useful marker to predict early functional neurological outcome