[Clinical diagnosis of proximal occlusion of a major cerebral artery in the very early stage of ischemic stroke].

AIM: To find clinical criteria applied in the first hours of disease for the identification of severe ischemic stroke caused by an occlusion of proximal major arteries.

MATERIAL AND METHODS: The authors have analyzed 133 medical histories of patients with the diagnosis of acute cerebral blood circulation disorder admitted in the first 6 h from onset. All patients underwent CT-angiography or digital subtraction angiography. Occlusion of the inner carotid artery, occlusion of M1-segment of the middle cerebral artery and occlusion of a major artery were considered as proximal occlusion of major cerebral arteries. Neurological status was assessed by the signs of proximal arterial occlusion (PAO).

RESULTS AND CONCLUSION: Checking of 5 PAO symptoms allows the prediction of occlusion location in approximately 80% of cases. Presence of ≥3 out of 5 symptoms is characterized by 70% sensitivity and 90% specificity with regard to the occlusion of the inner carotid artery, M1-segment of the middle cerebral artery and/or a major artery. Predictive value of this model should be verified in a prospective study.