Türk Beyin Damar Hast Derg. 2006; 12(2): 45-51

PROGNOSTIC VALUE OF TRANSCRANIAL MAGNETIC STIMULATION IN ACUTE STROKE PATÝENTS DUE TO MIDDLE CEREBRAL ARTERY INFARCTION

Kemal BALCI¹, Nilda TURGUT¹, Ufuk UTKU¹, Talip ASÝL¹

Objective: Although it is important to know the prognosis of stroke in the early stages of the event, it is not easy to evaluate the prognosis only with clinical examination on admission. Purpose: The aim of our study is to determine the prognostic value of transcranial magnetic stimulation (TMS) in a homogeneous group of patients with ischemic stroke due to middle cerebral artery territory infarction. Patients and Methods: Fifteen healthy subjects and forty patients with acute stroke due to middle cerebral artery territory infarction were studied. After the first TMS evaluation was performed within the three days after the event, the TMS test was repeated at the end of the first month. Bilateral hemispheres of the control subjects and the healthy hemispheres of the patients, healthy and lesioned hemispheres of the patients were compared. The functional recovery was assessed at fourth month with Orgogozo’s MCA scale, NIH-NINDS score and Barthel index. Results and Conclusion : Statistically significant functional improvement was found in patients with MEP response at the end of fourth month. Our results showed that TMS technique provides a useful early prognostic indicator of functional recovery in ischemic stroke patients when used togethet with clinicical predictors.

Keywords: Transcranial magnetic stimulation, ischemic stroke, prognosis

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ORTA SEREBRAL ARTER SULAMA ALANI ÝNFARTINA BAÐLI OLARAK AKUT ÝSKEMÝK ÝNME GEÇÝREN HASTALARDA TRANSKRANYAL MANYETÝK STÝMÜLASYONUN PROGNOSTÝK DEÐERÝ

Kemal BALCI¹, Nilda TURGUT¹, Ufuk UTKU¹, Talip ASÝL¹
University of Trakya, School of Medicine Department of Neurology, Edirne

Amaç: Ýnme sonrasý erken dönemde prognozu tahmin etmek tedavi ve rehabilitasyon planý açýsýndan önemlidir. Ancak sadece klinik muayene bulgularýyla prognozu tahmin etmek kolay deðildir. Bu çalýþmanýn amacý orta serebral arter sulama alaný infarktýna baðlý olarak iskemik inme geçiren homojen bir hasta populasyonunda transkranyal manyetik stimülasyonun (TMS) prognostik deðerini araþtýrmaktýr. Hastalar ve Metodlar: Onbeþ saðlýklý gönüllü ve orta serebral arter sulama alanýnda akut infarkt geliþen 40 hasta çalýþmaya alýndý. Ýnme geliþiminden sonraki ilk üç günde ilk TMS testi yapýldýktan sonra takip eden birinci ayýn sonunda TMS deðerlendirmesi tekrarlandý. Kontrol vakalarýnýn her iki hemisferi, hastalarýn saðlam ve lezyonlu hemisferlerinden elde edilen TMS yanýtlarý karþýlaþtýrýldý. Fonksiyonel düzelme dördüncü ayýn sonunda Orgogozo’nun MCA skalasý, NIH-NINDS skoru ve Barthel indeksi ile deðerlendirildi. Sonuçlar ve Yorum : Dördüncü ayýn sonunda MEP cevabý elde edilebilen hastalarda istatistiksel anlamlý derecede fonksiyonel düzelme gözlendi. Sonuçlarýmýz TMS’nin klinik prediktörlerle birlikte kullanýlmasýnýn iskemik inme prognozunu belirlemede faydalý olabileceðini gösterdi.

Anahtar Kelimeler: Transkranyal manyetik stimülasyon, iskemik inme, prognoz

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