SynthesisInternational journal of stroke : official journal of the International Stroke Society2025
Early neurological deterioration in acute lacunar ischemic stroke: Systematic review of incidence, mechanisms, and prospects for treatment.
Synthesis in International journal of stroke : official journal of the International Stroke Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
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Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Efficacy and safety of tirofiban for acute ischemic stroke without large and medium vessel occlusion: a systematic review and meta-analysis.Frontiers in neurology · 2026Pooled it
- Optimal pharmacological therapy for minor acute ischemic stroke: a network meta-analysis.Frontiers in neurology · 2026Pooled it
- Discharge NIHSS scores are predictive of poor 3-month outcomes in patients with acute Ischemic stroke receiving intravenous thrombolysis.Annals of medicine · 2026Article
- CT Perfusion in lacunar stroke: a powerful tool to enhance lacunar stroke detection and prediction of patients' outcome.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Early deterioration in isolated pontine stroke: predictors and outcomes.Journal of neurology · 2026Article
- Neutrophil Extracellular Traps Are Associated With Early Neurological Deterioration in Patients With Acute Ischemic Stroke Receiving Intravenous Thrombolysis: A Prospective Cohort Study.Journal of the American Heart Association · 2026Article
- Combined ipsilateral peak systolic velocity and ASPECTS are associated with early neurological deterioration after endovascular thrombectomy: a prospective cohort study.BMC neurology · 2026Article
- Association of cerebral collateral cascade with early neurological deterioration after endovascular thrombectomy in patients with acute ischemic stroke.Quantitative imaging in medicine and surgery · 2026Article
- Early Neurological Deterioration in Subcortical Infarcts: A Narrative Review.Brain sciences · 2026Review
- Risk estimation for stroke-associated pneumonia in acute ischemic stroke: a nomogram-based approach.Arquivos de neuro-psiquiatria · 2026Article
- Association between stress hyperglycemia ratio and early neurological deterioration after acute ischemic stroke: a retrospective cohort study.BMC neurology · 2026Article
- Risk factors for early neurological deterioration in patients with acute ischaemic stroke and assessment of short-term prognosis.Frontiers in neurology · 2026Article
- Prediction model for early neurological deterioration in large artery atherosclerotic stroke.Frontiers in neurology · 2026Article
- Real-world experience with RESCUE BT2 tirofiban protocol versus standard care for select patients with acute ischemic stroke at a United States comprehensive stroke center: a single-center retrospective study.Frontiers in neurology · 2026Article
- Incidence, outcomes and risk factors of rebound neurological deterioration after initial improvement following intravenous thrombolysis: a retrospective cohort study.Frontiers in aging neuroscience · 2026Article
- Association of infarct volume with early neurological deterioration in ischemic stroke patients undergoing endovascular treatment.Frontiers in neurology · 2026Article
- Efficacy and safety of Qingre Huatan Formula for the prevention of early neurological deterioration in patients with acute ischemic stroke (QUIET): rationale and design for a randomized double-blind placebo-controlled study.Frontiers in medicine · 2026Article
- Stroke progression index as a dynamic metric is associated with functional outcome in progressive ischemic stroke with large vessel occlusion.Frontiers in neurology · 2026Article
- Hemostatic Activation Markers and Early Neurological Deterioration in Branch Atheromatous Disease-Related Stroke.Journal of atherosclerosis and thrombosis · 2025Observational
- The effect of remote ischemic conditioning combined with tirofiban on early neurological deterioration in small artery occlusive stroke.BMC neurology · 2025Article
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCerebral small vessel disease (CSVD) causes between 25% and 30% of all ischemic strokes. In acute lacunar ischemic stroke, despite often mild initial symptoms, early neurological deterioration (END) occurs in approximately 15-20% of patients and is associated with poor functional outcome, yet its mechanisms are not well understood.
aimsIn this review, we systematically evaluated data on: (1) definitions and incidence of END, (2) mechanisms of small vessel occlusion, (3) predictors and mechanisms of END, and (4) prospects for the prevention or treatment of patients with END. SUMMARY OF REVIEW: We identified 67 reports (including 13,407 participants) describing the incidence of END in acute lacunar ischemic stroke. The specified timescale for END varied from <24 h to 3 weeks. The rate of END ranged between 2.3% and 47.5% with a pooled incidence of 23.54% (95% confidence interval (CI) = 21.02-26.05) but heterogeneity was high (
conclusionsEND occurs in more than 20% of patients with acute lacunar ischemic stroke and might provide a novel target for clinical trials. A definition of an NIHSS ⩾2 decrease is most used and provides the best between-study homogeneity. END is consistently associated with poor functional outcome. Further research is needed to better identify patients at risk of END, to understand the underlying mechanisms, and to carry out new trials to test potential interventions.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.