Work

Early vs. delayed neurological improvements in acute ischemic stroke patients following endovascular treatment

Year: 2026

Type: article

Abstract: Objectives: Early neurological improvement (ENI) at 24 h after endovascular treatment (EVT) is a surrogate marker for predicting functional improvement of acute ischemic stroke (AIS) patients; however, using delayed neurological improvement (DNI) at seven days post-EVT remains understudied. We investigated differences between ENI and DNI in predicting functional outcome of AIS patients undergoing EVT. Methods: We retrospectively analyzed the prospectively collected data from 187 patients undergoing EVT. ENI was defined as a reduction of more than four points on the National Institute of Health Stroke Scale (NIHSS) after 24 h compared with admission or an NIHSS of 0 or 1 after 24 h; whereas the same parameter at seven days post-EVT was defined as DNI. A favorable outcome was a modified Rankin scale (mRS) score of 0-2 after 90 days. Results: There were no statistically significant differences in sex, age, hypertension, diabetes, coronary artery disease, atrial fibrillation, hyperlipidemia, successful recanalization (modified thrombolysis in cerebral infarction (mTIC)=2b-3), complete recanalization (mTICI=3), pre-EVT NIHSS, bridging thrombolysis, door-to-puncture time, last-known well time, and parenchymal hematoma. 62.96 % of patients in the DNI group achieved favorable outcome compared to 78.21 % in the ENI group (p=0.118). Conclusions: DNI may be used similarly to ENI to predict favorable outcomes post-EVT.

Source: Translational Neuroscience

DOI: 10.1515/tnsci-2025-0395