[The difference among patients with acute ischemia stroke and with reversed flow in the ophthalmic artery and the ones with a correct direction of the flow]

Abstract

Method: Fifty-four patients with acute ischaemic stroke (AIS) and with reversed flow direction in the ophthalmic artery (OA) were compared prospectively with patients with normal flow in that artery. Age, sex, presence of atrial fibrillation (AF) and ischaemic heart disease, the course in the acute period within 30 days after stroke onset were analysed. On the first day the following examinations were performed in all patients: routine laboratory investigations, X-ray, ECG and Doppler and USG examinations of the extracranial arteries. In some cases CT of the head was obtained. The condition of the patients was assessed by Rankin scale on the first and 30-th days after stroke onset. Improvement was accepted if on the 30-th day the score was 1 point better than on the first assessment.

Results: The mean age in the group with reversed blood flow in OA was 60.7 years, and in the group with normal flow it was 69 years (p < 0.0001). The male/female ratio was statistically significantly different in these groups (p = 0.01): in the younger group with reversed flow males accounted for 76% and in the older group with normal flow--52.5%. AF in the younger group was present in a low proportion of cases (3.7%) but in the older group it was 21.3%, the difference was statistically significant (p = 0.005). No significant difference was found in the presence of ischaemic heart disease. In the patients scoring 4 and 5 in Rankin scale in the first assessment no worsening was noted in the group with reversed blood flow, while in the other group 24% of the patients were worse or died (statistically significant difference, p = 0.004). The course of mild and medium severe stroke within 30 days was similar in both groups.

Conclusions: Patients with AJS and reversed flow in OA-differed from those with normal flow in OA, they were younger, more often were males. AF was present in isolated cases and the course of major stroke was milder.