Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Mar;269(3):1142-1153.
doi: 10.1007/s00415-021-10540-7. Epub 2021 Apr 11.

Does radiological conjugate eye deviation sign play a role in acute stroke imaging? A meta-analysis

Mengxue Li #  1 , Wenzhao Liang #  1 , Peng Yue  2 , Xinzhao Jiang  1 , Zhongyu Zhao  1 , Bingyang Zhao  1 , Zhongxin Xu  3 , Jing Mang  4
Affiliations
Review

Does radiological conjugate eye deviation sign play a role in acute stroke imaging? A meta-analysis

Mengxue Li et al. J Neurol. 2022 Mar.

Abstract

Background and purpose: The diagnostic value of non-contrast CT (NCCT) in acute stroke imaging remains indispensable, especially under emergency conditions with limited resources. The radiological conjugate eye deviation (RCED) has been demonstrated as a NCCT sign to predict acute ischemic stroke (AIS) or AIS secondary to large vessel occlusion (LVO) in recent studies. We performed a meta-analysis to gain a better understanding into the predictive role of RCED for AISs and LVO-AISs.

Methods: We conducted a systematic literature search using PubMed, Embase, and Cochrane. The search focused on studies published between January 2000 and August 2020 that reported the predictive value of RCED for the diagnosis of AIS or LVO-AIS. Principal measurements of the meta-analysis were the overall sensitivity, specificity, the positive likelihood ratio (PLR), and the negative likelihood ratio (NLR) of RCED in predicting AIS and LVO-AIS.

Results: We included 11 studies (n = 2304). For AIS, RCED had a sensitivity of 0.37 (95% CI 0.27-0.47), a specificity of 0.86 (95% CI 0.73-0.93), the area under the receiver operating characteristic curve (AUC) was 0.58 (95% CI 0.53-0.62), PLR was 2.5 (95% CI 1.5-4.4), and NLR was 0.74 (95% CI 0.65-0.84). For LVO-AIS, RCED had a sensitivity of 0.63 (95% CI 0.46-0.77), a specificity of 0.77 (95% CI 0.71-0.82), AUC was 0.63 (95% CI 0.46-0.77), PLR was 2.7 (95% CI 1.7-4.3), and NLR was 0.49 (95% CI 0.3-0.78).

Conclusion: RCED can be used to predict LVO-AIS. It is expected that this method will be extensively used and validated in acute stroke imaging, especially under emergency conditions with limited resources.

Keywords: Acute ischemic stroke; Acute stroke imaging; Large vessel occlusion; Meta-analysis; Radiological conjugate eye deviation.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Berkhemer OA, Fransen PSS, Beumer D et al (2015) A randomized trial of intraarterial treatment for acute ischemic stroke. New Engl J Med 372:11–20. https://doi.org/10.1056/NEJMoa1411587 - DOI - PubMed
    1. Saver JL (2006) Time is brain—quantified. Stroke 37:263–266. https://doi.org/10.1161/01.STR.0000196957.55928.ab - DOI - PubMed
    1. Aronovich BD, Reider-Groswasser II, Segev Y et al (2004) Early CT changes and outcome of ischemic stroke. Eur J Neurol 11:63–65. https://doi.org/10.1046/j.1351-5101.2003.00708.x - DOI - PubMed
    1. Alshoabi S, Alnajmani R, Shamsuddin M et al (2019) Early signs of middle cerebral artery infarction on multidetector computed tomography: review of 20 cases. Brain Circ 5:27–31. https://doi.org/10.4103/bc.bc_28_18 - DOI - PubMed - PMC
    1. Haussen DC, Lima A, Frankel M et al (2015) Sulcal effacement with preserved gray-white junction a sign of reversible ischemia. Stroke 46:1704–1706. https://doi.org/10.1161/strokeaha.115.009304 - DOI - PubMed

LinkOut - more resources