THE ROLE OF CT ANGIOGRAPHY IN ISCHEMIC STROKE AND ITS CORRELETION
WITH THE SEVERITY OF NEUROLOGICAL DEFICIT
ACCORDING TO THE NIHSS SCALE
Brodetsky B.M.1,4, Gaman S.A.1,3, Ternovoy S.K.2,3
1 – L.A. Vorohobova City Clinical Hospital.
2 – Sechenov University.
3 – National Medical Research Center of Cardiology of the Ministry of Health of Russia. Moscow, Russia.
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urpose. To analyze the results of CT angiography usage in patients with ischemic stroke and evaluate the relationship with the severity of neurological symptoms according to the NIHSS scale as part of a cohort study.
Materials and methods. This study included 201 patients with ischemic stroke, 94 were male and 107 were female. The average age was 70.22 years. There were following inclusion criteria for patients: admission within the “stroke network” mechanism and patients undergoing CT angiography (CTA). We used the following parameters in our study: time from the onset of the disease to admission; NIHSS score on admission; presence of thrombosis; localization of thrombosis in the vessels of the brain by CTA; type of treatment provided; Doppler ultrasound results; number of days in the intensive care unit; number of days in the neurological department; treatment outcome assessed on the NIHSS scale at discharge.
Results. On admission the majority of patients were characterized by a neurological deficit ranging from 5 to 25 points on the NIHSS scale (168 out of 201 patients; 83.58%; p=0.0137). The average NIHSS score for the entire cohort of patients was 10.58 points (standard deviation 6.90 points). The mean length of stay in the intensive care unit was 4.3 days (standard deviation 4.41 days). The average length of stay for patients in the neurology department was 6.57 days (standard deviation 4.41 days). It was found that the threshold value on the NIHSS scale at admission, at which the probability of detecting cerebral thrombosis on CT angiography is less than 5%, is equal to 6 points or less (p<0.00001); 95% confidence interval: 4.86; 10.38. The NIHSS score at admission has a statistically significant direct correlation of moderate strength (R=0.3452; p<0.0001) with the number of days in the intensive care unit. It was shown that MRI examinations before or after treatment are not a significant predictor of disease outcome.
Conclusion. Thus, the cohort study made it possible to identify a significant relationship between the assessment of neurological deficit on the NIHSS scale at admission and the presence of thrombosis in the cerebral vessels according to CT angiography, and also made it possible to determine the threshold value for assessing neurological deficit on the NIHSS scale at admission (6 points and less), in which the probability of detecting cerebral thrombosis according to CT angiography is less than 5%. Therefore, the appointment of CT angiography in patients with an NIHSS neurological deficit score of 6 points or less may be reconsidered, including within the framework of clinical guidelines.
Keywords: CT angiography, extra- and intracranial arteries, thrombosis, stroke of ischemic type, NIHSS score.
Corresponding author: Brodetsky B.M., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript
For citation: Brodetsky B.M, Gaman S.A., Ternovoy S.K. The role of CT angiography in ischemic stroke and its correletion with the severity of neurological deficit according to the NIHSS scale. REJR 2025; 15(4):7-19. DOI: 10.21569/2222-7415-2025-15-4-7-19.
Received: 13.10.25 Accepted: 11.12.25