1UHC Mother Teresa, Neurosciences, tirana, Albania. Background and Aims: A posterior circulation (PC) stroke is classi- cally defined by infarction occurring ...
322 Chisinau, Moldova; 6Municipal Clinical Hospital, Neurology, Balti, Moldova; 7Shaare Zedek Medical Center, Brain Division, Jerusalem, Israel Background and Aims: Currently no national database exists in the Republic of Moldova that provides information on the overall approach of management of acute stroke patients. The purpose of the study was to identify the gaps existing at the inhospital acute stroke management in the Republic of Moldova based on RES-Q (Registry of Stroke Care Quality) data. Method: We collected data of all consecutive acute ischemic and haemorrhagic stroke patients in 4 hospitals in the Republic of Moldova for one month. The information was entered in the on-line RES-Q. The statistical analysis of data was performed centrally. Results: 251 acute stroke patients from 4 hospitals were included. 83% presented with ischemic stroke and 17% - with hemorrhagic stroke. The mean age was 66.8 years (52.5% male). The in- hospital mortality rate was 23.6%. Only 37.8% of patients were admitted to Intensive Care Stroke Units. The diagnosis of stroke was confirmed by brain CT / MRI in 95.1% of cases. Thrombolytic treatment with rtPA was applied to 1.2% of patients. Patients diagnosed with atrial fibrillation were given anticoagulants in 62% of cases. Antiplatelet are most commonly prescribed at discharge for secondary stroke prevention (99%), followed by antihypertensive (80%) and statins (66.7%). 17.3% of patients were discharged to a neurorehabilitation unit. Conclusion: RES-Q registry data revealed that the acute stroke treatment and the access to the neurorehabilitation units are the weakest segments of the in-hospital stroke management in the Republic of Moldova. Trial registration number: N/A
AS15-002 FREQUENCY OF CLASSICAL CROSSED MEDULLARY SYNDROMES IN THE MRI ERA G. Delgado-Garcıa1, F. Serrano-Arias2, F. Gonza´lez-Carvajal2, M. Chavarrıa-Medina2, J.G. Merino3 and A. Arauz2 1 National Institute of Neurology and Neurosurgery, Division of Neurology, Mexico City, Mexico; 2National Institute of Neurology and Neurosurgery, Stroke Clinic, Mexico City, Mexico; 3University of Maryland School of Medicine, Department of Neurology, Baltimore, USA Background and Aims: Classical crossed medullary syndromes (CCMS), initially described in the previous two centuries, are taught to neurological trainees around the world but it is not known how often they are the presenting semiology in patients with MRI-confirmed medullary infarction (McMI). The objective of our study was to determine the frequency of CCMS in patients with McMI. Method: Medical records of patients with McMI seen at our center (1998-2017) were reviewed to determine their initial clinical findings and to ascertain if they presented with one CCMS. Results: 102 patients had an McMI. All of these patients had clinical and imaging features of a medullary infarction but 64 (63%) did not have a CCMS: most of these patients had a non-classical crossed syndrome (83%). The rest had an uncrossed syndrome. Only 38 patients (37%) had a CCMS at presentation: in 14 (6 with concomitant cerebellar infarction), the clinical presentation matched Wallenberg’s description (1895). An additional 14 patients (3 with concomitant cerebellar infarction) had a similar presentation but their thermoalgesic examination was not adequately described. In 7 patients, the presenting clinical features matched Opalski’s description from 1946 (one of these patients had a cerebellar infarction), in two it matched that of Babinski-Nageotte (1902) and in one it matched Reinhold’s (1894). Conclusion: Most patients with McMI do not have a CCMS but among the third of patients who have a classical presentation, the most common was Wallenberg’s syndrome. Trial registration number: N/A
European Stroke Journal 3(1S) AS15-003 FREQUENCY OF ANATOMICAL LESIONS OF ISCHEMIC STROKE IN POSTERIOR CIRCULATION R. Gjini1, D. Dobi1, O. Taka1, O. Cibuku1, E. Rraklli1 and R. Mira1 UHC Mother Teresa, Neurosciences, tirana, Albania
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Background and Aims: A posterior circulation (PC) stroke is classically defined by infarction occurring within the vascular territory supplied by the vertebrobasilar (VB) arterial system. The vertebral arteries (VAs) arise from the right and left subclavian arteries and travel cranially through the transverse foramina of the cervical vertebrae. When reaching the foramen magnum, they pierce the dura mater to start their intracranial course. Both VAs join at the pontomedullary junction forming the basilar artery (BA). Posterior circulation strokes represent approximately 20% of all ischemic strokes. To study the frequency of anatomical lesions of ischemic stroke in posterior circulation. Method: We include in this study 91 patients (52M þ39F, who was admitted at the Service of Cerebrovascular Disorders in UHC “Mother Teresa”, Tirana, Albania. They was admitted in this service, for the first time ischemic stroke, with different etiologies, during Feb 2017 to Oct 2017. MRI of brain was made for all of them during the hospitalization. Results: From this study resulted that 30 patients (32,9%) presented ischemic lesion in PICA territory, 24 patients (26,4%), presented ischemic lesion in PCA territory, 9 patients (9,9%), presented ischemic lesion in AICA territory, 6 patients (6.6%) presented ischemic lesion in TOB territory, 10 patients (11% ) in ICVA ( Intracerebral Vertebral artery) and 12 patients (13.2%) non localization. Conclusion: As in the other studies, ischemic stroke in PICA territory, is the most frequent, and ICVA stroke is less. Other studies needed to verify this findings, with more patient included. Trial registration number: n/a
AS15-004 FACTORS INFLUENCING SURVIVAL FROM HAEMORRHAGIC STROKE IN AN URBAN UK CENTRE C. Wharton1, A. Sadiq2, P. Nightingale3 and S. Ispoglou4 1 Queen Elizabeth Hospital Birmingham, Stroke Medicine, Birmingham, United Kingdom; 2Heartlands Hospital, Stroke Medicine, Birmingham, United Kingdom; 3Queen Elizabeth Hospital Birmingham, Statistics, Birmingham, United Kingdom; 4Sandwell General Hospital, Stroke Medicine, Birmingham, United Kingdom Background and Aims: Haemorrhagic stroke (HS) has a high case fatality. Serving an ethnically diverse, low-income population, we retrospectively reviewed registry data to determine how certain parameters influenced 30-day survival. Method: By reviewing registry data and excluding SAH and haemorrhagic transformation of infarcts, we identified 404 HS cases admitted between 2010-2015. We examined how age, sex, ethnicity, hypertension, diabetes, atrial fibrillation, anticoagulation, HbA1c and haematoma location related to 30-day survival. Fisher’s exact test was used for univariable analysis and binary logistic regression for multivariable analysis. Results: In univariable analysis, the 30-day survival for males and females was 69% and 54% respectively (p ¼ 0.002). 67% of patients with history of hypertension were alive at 30 days compared to 50% of patients without (p ¼ 0.001). 71% of patients with deep, and 48% with lobar haematoma were alive at 30 days (p < 0.001). Ethnicity and diabetes mellitus did not significantly influence this.
