Dysautonomia and symptoms aggravation in acute lacunar stroke

초록

Objective:To evaluate the role of dysautonomia in symptoms aggravation of acute lacunar stroke Background:Symptoms aggravation in patients with acute lacunar stroke was not uncommon. However, the causative factors were not yet determined if the patient does not have arterial steno-occlusion or embolic sources. We hypothesized that dysautonomia can aggravate acute lacunar stroke.Design/Methods:We have performed the 30° head-up tilt, Valsalva, and heart rate variability, and sympathetic skin response tests in acute lacunar stroke patients. These tests were performed within 72 hours of stroke development. The patients who have a major cerebral arterial stenosis over 50% and embolic sources were ruled out. The patients who developed the stroke prior to 3 days ago were also excluded. Sixty-two patients with lacunar stroke were enrolled in the study. Age, sex, hypertension, diabetes mellitus, hypercholesterolemia, smoking, and BMI were evaluated as tentative factors in aggravating acute lacunar stroke. The primary outcome is the aggravation of acute lacunar stroke which was defined the adding over 1 point in NIHSS during hospitalization.Results:Twenty-five among 61 acute lacunar stroke patients have experienced the symptoms aggravation during hospitalization. Abnormal blood pressure recovery in Valsalva test and old age were associated with the aggravation of symptoms in acute lacunar stroke.Conclusions:Sympathetic dysfunction, especially in elderly patients may be associated with the symptoms aggravation of acute lacunar stroke.Disclosure: Dr. Shin has nothing to disclose. Dr. Ha has nothing to disclose.