Relative versus absolute early neurological improvement after mechanical thrombectomy for large vessel occlusion stroke - hot or not?

Early clinical surrogates for long-term functional outcomes represent valuable clinical adjuncts. Lately, the National Institutes of Health Stroke Scale (NIHSS) score 24 hours after mechanical thrombectomy (MT) for large vessel occlusion (LVO) ischemic stroke has been repeatedly demonstrated to serve as a robust and independent predictor of 90-day functional outcomes.1–5 We read the article ‘Early neurological improvement as a predictor of outcomes after endovascular thrombectomy for stroke: a systematic review and meta-analysis’ by Kobeissi et al with great interest.6 Briefly, the authors synthesized nine studies with different definitions of early neurological improvement (ENI), such as relative improvement of NIHSS. They observed ENI be strongly associated with good functional outcomes and inversely with mortality and symptomatic intracranial hemorrhage. We want to point out several aspects that deserve further attention. First, the authors contend that having incorporated various definitions...
Source: Journal of NeuroInterventional Surgery - Category: Neurosurgery Authors: Tags: Letter Source Type: research