PROGNOSTIC CRITERIA FOR THE ACUTE PHASE OF ISCHEMIC STROKE IN THE POSTERIOR INFERIOR CEREBELLAR ARTERY (PICA) TERRITORY

Аннотация

Objective. To determine neuroimaging criteria in the acute phase that possess prognostic value for the functional recovery of patients with ischemic stroke in the posterior inferior cerebellar artery (PICA) territory. Materials and Methods. A total of 100 patients (mean age 58.4±2.6 years) with a confirmed diagnosis of ischemic stroke in the PICA territory based on MRI data were examined. All patients underwent multislice computed tomography with perfusion within the first 24 hours; a follow-up study was performed on day 7. The outcome was assessed at 3 months using the mRS scale. Results. A favorable functional outcome (mRS ≤ 2) was observed in 64% of patients. It was statistically proven that a small infarct volume (<5 cm³) is a strong predictor of a favorable outcome (OR=4.3; p<0.05). Restoration of collateral blood flow by day 7 was associated with better clinical recovery. Progressive cerebellar atrophy on follow-up MRI significantly correlated with severe disability (r = -0.72; p<0.001). Conclusion. Infarct volume, perfusion dynamics, and the presence of cerebellar atrophic changes are key prognostic markers in the acute phase that allow for the stratification of patients into risk groups.