CLINICAL AND INSTRUMENTAL PREDICTORS OF EARLY NEUROLOGICALDETERIORATIONIN ISCHEMIC STROKE

Objective. To identify clinical and instrumental predictors of early neurological deteriorationinpatients with ischemic stroke in order to optimize early diagnosis and management strategies intheacutephase of the disease. Material and Methods. An observational clinical study was conducted in patients withischemicstroke hospitalized in a specialized neurological department during the acute phase of thedisease.Allpatients underwent comprehensive clinical and neurological assessment using the National InstitutesofHealth Stroke Scale (NIHSS). Instrumental examinations included computed tomography and/ormagneticresonance imaging of the brain, duplex ultrasonography of the brachiocephalic arteries, andelectrocardiography. Early neurological deterioration was defined as an increase in the NIHSSscorewithinthe first 72 hours of observation. Clinical and instrumental parameters associated with the developmentofearly neurological deterioration were analyzed. Results. Early neurological deterioration in ischemic stroke was found to be associatedwithgreaterbaseline neurological deficit severity, the presence of large ischemic lesions on neuroimaging, pronouncedhemodynamic disturbances, and atherosclerotic involvement of the major cerebral arteries. Thehighestprognostic value was observed for the combination of clinical indicators of stroke severity andinstrumentalsigns of ischemic brain damage. The use of an integrated clinical and instrumental assessment enabledearlyidentification of patients at high risk of unfavorable disease progression at the initial stagesofhospitalization. Conclusion. Comprehensive evaluation of clinical and instrumental parameters inpatientswithischemic stroke allows identification of predictors of early neurological deterioration and facilitatestimelyadjustment of diagnostic and therapeutic strategies. Implementation of clinical and instrumental prognosticcriteria into routine practice may improve the ef ectiveness of patient management in the acutephaseofischemic stroke.