We aimed to evaluate the impact of BIS monitoring before and shortly after reperfusion on early and delayed clinical improvement on stroke patients. Consecutive patients with acute anterior circulation ischemic stroke who received reperfusion therapies were monitored with bicortical BIS during the first 6 hours of admission. We registered initial and final BIS value on the affected and contralateral side and determined asymmetry and changes in relation to recanalization and other clinical variables as

sedation and perprocedure complications. We defined major clinical Selleck BEZ235 improvement decrease ≥8 points at discharge or 5 day at admission. Infarct volume was measure on 24-hour CT scan. Modified Rankin score at 3 months was evaluated. A total of 53 patients were monitored with BIS. Median age was 73 years, median baseline National Institutes of Health Stroke Scale (NIHSS) 16. We observed an inverse correlation between final BIS score and NIHSS at discharge (P < .001; r = −.538) and infarct volume at 24 hours (P = .031; r = −.430). A receiver–operator Metabolism inhibitor characteristic curve identified a final BIS score of >81 as the value that better predicted further clinical improvement. After adjusting for recanalization, posttreatment NIHSS and age, final BIS emerged as the

only independent predictor of clinical improvement(OR 1.21; CI 95%:1.01–1.28; P = .024). Among patients without improvement at 24 hours, after adjusting for recanalization, posttreatment NIHSS and age, final BIS value >81 emerged as the only independent predictor of clinical improvement(OR 11.6; CI 95%:1.112–122.3; P = .04). BIS value is associated with clinical and radiological variables in acute stroke patients. The final BIS value is a powerful independent predictor of further clinical improvement. Larger studies are needed to assess 上海皓元 the value of post

reperfusion cortical activity measured by BIS. “
“Computed tomography perfusion provides information on tissue viability according to proposed thresholds. We evaluated thresholds for ischemic core and tissue at risk and subsequently tested their accuracy in independent datasets. Tissue at risk was evaluated in patients with persistent arterial occlusions, and ischemic core thresholds in patients with recanalization and major clinical improvement. Scans were randomly allocated to derivation or validation groups for tissue at risk and core analysis. Optimum thresholds using mean transit time (MTT), cerebral blood flow (CBF), cerebral blood volume, and delay time (DT) were assessed. Absolute MTT, relative MTT and DT were best derived predictors of tissue at risk with thresholds of ≥7 seconds, ≥125%, and ≥2 seconds respectively. DT ≥ 2 seconds was the best predictor in the validation dataset (95% agreement levels = −44 to +30 mL, Bias = −6.9).