London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 309 59 Stroke prognosis Non-invasive monitoring of cortical activity post–reperfusion. A powerful tool to improve the prediction of early clinical improvement immediately after recanalization A.A. Flores Flores1, M. Ribo Jacobi2, M. Rubiera3, M. Gonzalez Cuevas4, J. Pagola5, D. Rodri-guez- Luna6, M. Muchada7, J. Kallas8, P. Meler9, E. San Juan10, J. Montaner11, J. Alvarez-Sabín12, C.A. Molina13 Hospital Vall D’ Hebron, Barcelona, SPAIN1, Hospital Vall D’ Hebron, Barcelona, SPAIN2, Hos-pital Vall D’ Hebron, Barcelona, SPAIN3, Hospital Vall D’ Hebron, Barcelona, SPAIN4, Hospital Vall D’ Hebron, Barcelona, SPAIN5, Hospital Vall D’ Hebron, Barcelona, SPAIN6, Hospital Vall D’ Hebron, Barcelona, SPAIN7, Hospital Vall D’ Hebron, Barcelona, SPAIN8, Hospital Vall D’ Hebron, Barcelona, SPAIN9, Hospital Vall D’ Hebron, Barcelona, SPAIN10, Hospital Vall D’ Hebron, Barcelona, SPAIN11, Hospi-tal Vall D’ Hebron, Barcelona, SPAIN12, Hospital Vall D’ Hebron, Barcelona, SPAIN13 Serial NIHSS assessment predict outcome, however in some cases such as stunned brain clinical status does not immediately correlate to outcome. Currently the use of BIS(bispectral index)is re-stricted to monitoring level of conscious and sedo-analgesia in critical care patients or undergoing surgery. Real-time assessment of cortical activity during ischemia/ reperfusion could give informa-tion about the viability of the tissue and be useful as surrogate of reperfusion. We aimed to evaluate the impact of BIS monitoring before and shortly after reperfusion on stroke outcome. Methods Consecutive patients with acute anterior ischemic stroke who received reperfusion therapies were monitored with BIS during the first 6 hours of admission. We registered initial and final BIS score on the affected and contralateral side and determined asymmetry and changes with recanalization and other variables. We defined NIHSS variation:(discharge – admission)and major clinical im-provement decrease >/=8 points at discharge. We performed a 24 hours CT scan. Results A total of 50 patients were monitored with bicortical BIS Median age was 73 years, baseline NIHSS 15. We observed a correlation between final BIS score and NIHSS variation(p=0.004) and inverse cor-relation with infarct volume(p= 0.031). Patients with clinical improvement at discharge had higher final BIS score(88,4 vs 78,9 p=0,007) A ROC curve identified a Final BIS score of >81 that better predicted further clinical improvement. After adjusting for recanalization, post recanalization NIHSS and age, a logistic regression showed that final BIS emerged as the only independent predictor of clinical improvement(p=0.024 OR1.21 CI 95%: 1.01-1.28). Conclusion BIS score is associated with clinical and radiological variables in acute stroke patients. The final BIS score is a powerful independent predictor of further clinical improvements. Larger studies are need-ed to assess the value of post reperfusion cortical activity measured by BIS
Karger_ESC London_2013
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