Acute autonomic dysfunction (AD) contralateral to stroke: A prospective study of 100 consecutive cases

Détails

ID Serval
serval:BIB_44D5CA67FA8B
Type
Actes de conférence (partie): contribution originale à la littérature scientifique, publiée à l'occasion de conférences scientifiques, dans un ouvrage de compte-rendu (proceedings), ou dans l'édition spéciale d'un journal reconnu (conference proceedings).
Sous-type
Abstract (résumé de présentation): article court qui reprend les éléments essentiels présentés à l'occasion d'une conférence scientifique dans un poster ou lors d'une intervention orale.
Collection
Publications
Titre
Acute autonomic dysfunction (AD) contralateral to stroke: A prospective study of 100 consecutive cases
Titre de la conférence
56th Annual Meeting of the American Academy of Neurology
Auteur(s)
Diserens  K, Vuadens  P, Reichhart  M, Michel  P, Herrmann  F, Bogousslavsky  J, Ghika  J
Adresse
San Francisco, CA, APR 24-MAY 01, 2004
ISBN
0028-3878
ISSN-L
0028-3878
Statut éditorial
Publié
Date de publication
2004
Volume
62
Série
Neurology
Pages
A141-A142
Langue
anglais
Notes
Poster Session II: Tuesday, April 27, 2004
Résumé
OBJECTIVE: To study acute autonomic dysfunction (AD) on the hemibody contralateral to the lesion in the acute phase of stroke.
BACKGROUND: Acute AD on the hemibody involved by the deficit is sometimes mentioned in acute stroke. It is reported mainly as hand edema or discoloration of skin with hypersudation and sometimes painful syndromes, but it has not been studied prospectively.
DESIGN/METHODS: 100 consecutive patients (median age ±IQR: 74 y ±21, range 19-93 y, 51 women 80 y±17 and 49 men 70 y ±17) were studied prospectively in the acute phase of stroke for acute AD. Changes in cutaneous temperature, aspect or coloration, diaphoresis, pain or edema were noted in the first three days post stroke. Associatons of AD with topography (cortical pre- and/or post-central, corona radiata, basal ganglia, internal capsule, thalamus, brainstem), age, gender, ischemic or hemorrhagic etiology and presence of sensorimotor deficits or ataxia was performed using chi-square statistic and logistic regression analysis.
RESULTS: AD was significantly associated with the presence of a lesion in the following localizations: postcentral cortex (p=0.034), internal capsule (p=0.003) or the basal ganglia (p=0.001) and negatively with the presence of a lesion in the brainstem (p=0.001). Logistic regression analysis including all studied topographic variables show that brainstem strokes were significantly associated with a decreased risk to develop AD (OR = .095, 95 %CI 0.011-0.801, p=0.031) whereas internal capsule lesions had a risk for more severe dysautonomia (OR =3.3, 95% CI 1.04-10.1, p=0.04). More severe AD dysfunction with edema of the hand was observed in association with internal capsule (p=0.001) or basal ganglia (p=0.003) lesions, while a negative association was seen when lesions were located in the brainstem (p=0.007). AD was not associated with the ischemic or hemorrhagic nature of the lesion, side of lesion, age, gender, hyper-or hypo-tonic paresis, hyper- or hyporeflexia. AD was significantly found in association with sensory deficits (p=0.0001) and ipsilateral hyperkinesia (p=0.004).
CONCLUSIONS: acute AD on the side of the deficit is more prone to be seen in hemispheric lesions involving sensory pathways from cortex to internal capsule. AD is significantly absent with isolated thalamus and brainstem lesions.
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Création de la notice
12/12/2013 0:00
Dernière modification de la notice
20/08/2019 13:49
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