OCSP分型与脑梗死急性期神经功能缺损和预后的相关性研究

目的研究脑梗死急性期OCSP分型与神经功能缺损和预后的关系.方法连续收集首次发病的急性脑梗死(发病时间在10 d以内)患者160例,按OCSP分型分为完全前循环梗死(TACI)、部分前循环梗死(PACI)、腔隙性脑梗死(LACI)、后循环梗死(POCI),比较斯堪的纳维亚神经功能缺损评分,入组后30 d、6个月的患者病死率、脑卒中复发率(包括缺血性和出血性)和日常生活能力.结果急性期神经功能缺损以TACI最重,POCI、PACI次之,LACI最轻,入组后30 d的患者病死率为TACI＞POCI＞PACI＞LACI,6个月时病死率仍然是TACI＞POCI＞PACI＞LACI,而6个月内脑卒中复发率是PACI＞POCI＞LACI＞TACI,存活6个月者残疾程度TACI最重(重度依赖),其余3个亚型均为轻度依赖.结论脑梗死急性期不同OCSP分型之间的脑梗死患者急性期神经功能缺损、30 d及6月时预后存在差异,不同的OCSP分型可以反映脑梗死急性期神经功能缺损的严重程度和预后,OCSP分型有利于脑梗死急性期治疗和康复方法的选择.     

缺血性脑卒中OCSP分型与神经影像学及脑血管改变之间的关系

目的以OCSP分型为基础,结合影像学和DSA表现探讨缺血性卒中OCSP分型、神经影像学改变、血管改变之间的关系。方法回顾性分析227例经DSA证实存在血管狭窄患者的临床资料,据患者主要症状和体征、MRI、CT、DSA的结果进行OCSP分型、影像学分型、及血管病变部位分型。分析OCSP分型与神经影像学及脑血管改变之间的关系。结果 OCSP各型所占的比例依次为:(1)部分前循环梗死型(PACI)占47%;后循环梗死型(POCI)占31%;完全前循环梗死型(TACI)占13%;腔隙性梗死型LACI占9%。(2)OCSP分型中前循环梗死型(TACI+PACI)、腔隙性梗死型(LACI)、后循环梗死型(PCI)与影像学分型中皮质梗死和低灌流区梗死(CO+LFI)、皮质下小梗死(SSI)、后循环病变部位梗死(PCI)的一致率分别为77.97%、79.30%、79.30%。(3)OCSP分型中前循环型(TACI+PACI)和后循环型(POCI)与前循环血管狭窄(ICA+MCA)和后循环血管狭窄(VA+BA)一致率分别为78.41%、71.84%。结论 OCSP分型与神经影像学改变分型和血管改变分型的一致性较好。     

脑梗死早期康复对OCSP各亚型NIHSS评分的影响

目的探讨早期康复对脑梗死OCSP分型中各亚型NIHSS评分的影响。方法将251例急性脑梗死患者入院后按OCSP分型标准分为完全前循环梗死型(TACI)、部分前循环梗死型(PACI)、后循环梗死型(POCI)和腔隙性梗死型(LACI)4型。每型随机分为康复组和对照组,康复组在综合治疗的基础上给予早期康复干预,康复组患者均在康复前、康复治疗1个月和3个月时(对照组在相应时间点)采用NIHSS评分进行神经功能评定。比较各型中康复组和对照组NIHSS评分。结果按脑梗死OCSP分型,TACI型、PACI型和POCI型中康复组NIHSS评分较对照组降低,差异有统计学意义(P0.05);LACI型中康复组NIHSS评分与对照组比较,差异无统计学意义(P0.05)。结论按脑梗死OCSP分型,早期康复治疗可改善PACI亚型、POCI亚型和TACI亚型1~3个月的预后,对LACI亚型预后改善不明显,早期康复治疗应针对不同的脑梗死患者实施。     

急性脑梗死不同临床亚型患者血清髓鞘碱性蛋白的变化

目的 观察不同临床类型急性脑梗死(ACI)患者血清髓鞘碱性蛋白(MBP)水平变化,探讨MBP与美国国立卫生研究所卒中量表(NIHSS)评分之间的关系.方法 208例ACI患者按照牛津郡社区卒中计划(OCSP)分型标准分为4组并行NIHSS评分,采用ELISA法检测血清MBP的含量;观察不同亚型ACI患者MBP含量的变化,分析MBP与NIHSS评分的相关性.结果 (1)本组OCSP各亚型构成比:完全前循环型(TACI) 13.46％、部分前循环型(PACI)30.29％、后循环型(POCI) 19.71％、腔隙性梗死型(LACI)36.54％;(2)OCSP分型中TACI、PACI及POCI亚型MBP含量升高,LACI变化不明显.与LACI比较,TACI、PACI及POCI有显著性差异(P＜0.05);(3)TACI、PACI中血清MBP含量与相应时间段NIHSS评分具有有相关性,相关系数为0.62、0.60 (P＜0.05);POCI和LACI中MBP与NIHSS之间相关性较差.结论 MBP随OCSP亚型的不同而变化.TACI、PACI、POCI亚型的缺血性卒中患者血清MBP可以作为病情、预后判断的一个参考依据.     

不同脑梗死亚型患者血清Fractalkine浓度的差异

目的：探讨不同牛津郡社区卒中项目（OCSP）亚型急性脑梗死患者血清Fractalkine（FKN）浓度的变化。方法：45例急性脑梗死患者按OCSP分型分为完全前循环梗死（TACI）组、部分前循环梗死（PACI）组、后循环梗死（POCI）组和腔隙性梗死（LACI）组。采用酶联免疫吸附法检测发病1～3d、7d、14d和28d时血清FKN浓度，比较各组间的差异。分析FKN浓度与相应时间点美国国立卫生研究院卒中量表（NIHSS）评分和3个月时Barthel指数（BI）的相关性。结果：各种亚型急性脑梗死患者血清FKN浓度均升高，TACI组最为显著；在不同时间点，血清FKN浓度变化大致为TACI〉PACI〉LACI〉POCI，与相应时间点NIHSS评分呈正相关，与3个月时BI呈负相关。结论：血清FKN浓度的变化可能提示急性脑梗死各OCSP亚型患者炎症损伤的差异，并影响神经功能缺损程度和患者3个月时的转归。     

血清缺血修饰清蛋白与急性脑梗死的相关性研究

目的探讨血清缺血修饰清蛋白与急性缺血性脑卒中各亚型及患者早期预后的相关性。方法选取我院2013-04-2016-03收治的符合研究标准的104例急性缺血性脑卒中患者为研究组,另选取同期门诊体检健康者54例为对照组。根据英国牛津郡社区脑卒中分型(OCSP)标准将104例急性缺血性脑卒中患者分为腔隙性梗死(LACI)组(n=25)、后循环梗死(POCI)组(n=25)、部分前循环梗死(PACI)组(n=28)、完全前循环梗死(TACI)组(n=26)。抽取各组血清进行检测,对比不同亚型急性缺血性脑卒中患者血清缺血修饰清蛋白水平,并与对照组比较,统计不同亚型急性缺血性脑卒中患者治疗前后神经功能缺损评分(NIHSS)及日常生活活动能力评分(Barthel指数)变化情况。结果 LACI组、POCI组、PACI组、TACI组血清缺血修饰清蛋白水平均明显高于对照组,差异有统计学意义(P0.05);TACI组血清缺血修饰清蛋白水平明显高于LACI组、POCI组、PACI组,差异有统计学意义(P0.05);治疗前各组NIHSS评分及Barthel指数对比差异无统计学意义(P0.05),治疗后各组均较治疗前改善,且TACI组与其余3组对比差异有统计学意义(P0.05)。结论血清缺血修饰清蛋白作为急性缺血性脑卒中分型参考指标,其表达水平与患者预后具有密切相关性,血清缺血修饰清蛋白水平越高,预后效果越差。     

急性脑梗死患者临床分型及梗死面积与心电图改变的关系

目的 探讨急性脑梗死患者临床分型和梗死面积与心电图(ECG)改变的关系.方法 给216例急性脑梗死患者进行ECG检查,按牛津郡社区卒中项目(OCSP)分型和梗死面积分型,对各组患者的ECG检查结果进行分析比较.结果 OCSP分型完全前循环梗死(TACI)组、部分前循环梗死(PACI)组、后循环梗死(POCI)组和腔隙性梗死(LACI)组患者的ECG异常率分别是: 95. 5%、80.4%、62.5%和48.5%,TACI组和PACI组明显高于LACI组(P＜0.05～0.01);大中面积梗死组(83.7%)的ECG异常率明显高于小面积梗死组(60.4%)和腔隙性梗死组(53.2%)(P＜0.05～0.01);小面积梗死组的ECG异常率高于腔隙性梗死组(P＜0.05).OCSP和梗死面积分型各亚型组出现ST-T改变和心律失常的比率差异有统计学意义(P＜0.05～0.01).结论 急性脑梗死临床分型病情重和梗死面积大的患者ECG异常率高.     

吞咽功能训练联合低频电刺激术治疗缺血性卒中吞咽障碍的疗效观察

目的探讨吞咽功能训练联合低频电刺激术对缺血性卒中患者吞咽障碍的疗效。方法共68例缺血性卒中合并吞咽障碍患者,分别予常规吞咽功能训练(包括吞咽训练和进食策略训练,对照组)及常规吞咽功能训练联合低频电刺激术(联合治疗组),于治疗前和治疗后15 d,采用视频透视吞咽检查(VFSS)和标准吞咽功能评价量表(SSA)评价患者吞咽功能。结果 34例予以常规吞咽功能训练,英国牛津郡社区脑卒中项目(OCSP)分型完全前循环梗死型(TACI型)12例、部分前循环梗死型(PACI型)8例、后循环梗死型(POCI型)10例、腔隙性梗死型(LACI型)4例;34例予以常规吞咽功能训练联合低频电刺激术,OCSP分型TACI型10例、PACI型7例、POCI型11例、LACI型6例。与治疗前相比,两组患者治疗后VFSS评分增加(P=0.003,0.000)、SSA评分减少(P=0.003,0.000);与对照组相比,联合治疗组患者VFSS评分增加(P=0.004)、SSA评分减少(P=0.020)。结论吞咽功能训练联合低频电刺激术对急性缺血性卒中患者吞咽障碍具有较好疗效,优于单纯吞咽功能训练。     

OCSP分型对脑梗死患者NHISS BI rankin评分及预后的相关性分析

目的探讨脑梗死OCSP分型构成比,分析各亚型神经功能缺损评分（中国）、NHISS、BI、rankin评分之间的差异及相关性。方法回顾分析2008-2012年我院426例脑梗死住院患者,按照OCSP分型标准分为4大类型：完全前循环梗死（TACI）、部分前循环梗死（PACI）、后循环梗死（POCI）、腔隙性梗死（LACI）,3个月后随访,应用Barthel指数（BI）和改良Rankin量表评分（MRS）评估日常生活能力和残疾程度,比较各型之间神经功能缺损评分（中国）、NHISS评分、BI及rankin的差异,进行相关性分析。结果 （1）OCSP分型的各亚型中,LACI分型所占比率最多,POCI比例最小,入院时NHISS评分较高,说明神经损伤较重,LACI评分最低。（2）TACI 3个月BI指数最低,表明日常生活能力恢复较差,rankin评分最高,为重度依赖;LACI各项指标较好,预后最好。结论急性脑梗死患者早期进行临床分型,并应用NHISS、BI及rankin评定,有助于合理评估病情,早期采取正确的治疗及对疾病的预后有着重要的指导意义。     

普通肝素间断静脉滴注治疗脑梗死的临床研究

目的观察普通肝素间断静脉滴注治疗脑梗死的疗效,并与常规治疗、巴曲酶、低分子肝素进行对比。方法将入院患者按入院先后顺序半随机分为常规治疗组,普通肝素组,巴曲酶组,低分子肝素组,每组200例;记录在该患入院时,入院后第一周,及出院时的神经功能缺损评分分值;记录每个患者的牛津郡社区脑卒中规划分型;仅对于普通肝素及巴曲酶两组进行凝血象监测。结果（1）第一周及出院时评分差值比较：普通肝素组与其他三组比较均有统计学意义（P〈0．05）,出院时评分差值巴曲酶组与常规治疗组比较差异有统计学意义（P〈0．05）;（2）疗效比较（按疗效等级）：普通肝素组与常规治疗组及低分子肝素组相比疗效差异有统计学意义,肝素组与巴曲酶组疗效差异无统计学意义;（3）各治疗组出血事件发生率：常规治疗组4％,普通肝素组11．5％,巴曲酶组13．5％,低分子肝素组9％,几乎均为尿隐血及牙龈出血事件,其中常规治疗与其他三组比较差异均有统计学意义（P〈0．05）;（4）肝素组与巴曲酶组组间AVIT值比较及FbgC值比较差异均有统计学意义（P〈0．001）;（5）各梗死类型间评分差值比较无统计学意义;（6）各梗死类型问疗效比较：腔隙性梗死（LACI）与全前循环梗死（TACI）、部分前循环梗死（PACI）、后循环梗死（POCI）比较差异均有统计学意义;TACI与POCI比较差异有统计学意义。TACI与PACI比较差异无统计学意义;PACI与POCI比较差异无统计学意义;（7）各梗死类型间出血倾向比较：TACI与PACI、POCI、LACI比较差异有统计学意义,PACI与LACI比较有统计学意义;（8）男女间评分差值、疗效、出血倾向比较差异均无统计学意义。结论静脉内使用普通肝素间断静脉滴注较低分子肝素及常规活血类药物有更好的疗效,有助神经功能改善,方法简便,且并不比低分子肝素及巴曲酶具更多的出血风险,相对安全。     

Correlation between symptomatic, radiological and etiological diagnosis in acute ischemic stroke

OBJECTIVES: The aim of this study was to correlate with the symptomatic, radiological and etiological diagnosis in acute ischemic stroke. SUBJECTS AND METHODS: Two hundred and fifty patients with first-ever ischemic stroke within 24 h of onset were prospectively studied with 3-step diagnoses: 1) symptomatic diagnosis based on the Oxfordshire Community Stroke Project criteria (OCSP), 2) radiological diagnosis (CT or MRI) and 3) etiological diagnosis based on the Lausanne Stroke Registry criteria. RESULTS: Most of the patients with symptoms of total anterior circulation infarcts (TACI), partial anterior circulation infarcts (PACI) and posterior circulation infarcts (POCI) had corresponding lesions on CT or MRI, while only 68% of lacunar infarcts (LACI) patients had small subcortical infarction (SSI). More than 60% of patients with TACI were classified into cardioembolism in the third diagnosis, while the etiology of PACI was either CE or large-artery atherosclerosis (LAA) in equal numbers. Only 58% of LACI patients were classified into small-artery disease (SAD) and 29% of them (30 cases) into LAA, of which 23 patients had lesions other than SSI. The positive predictive value of SAD in the combination of LACI and SSI was 0.78. The etiology of POCI was variable. CONCLUSION: Except for LACI, the symptomatic classification by OCSP corresponds well to the radiological diagnosis. The etiological diagnosis can be predicted by OCSP in TACI and PACI, but it is hard in POCI, and a number of LACI are due to LAA.     

Relationship between subtypes of MRI-confirmed acute ischemic stroke based on OCSP and TOAST classifications

BACKGROUND： Two classification systems exist for subtypes of acute cerebral infarction. One was developed for the Trial of Org 10172 in Acute Stroke Treatment （TOAST）, based primarily on etiology. The other is the Oxfordshire Community Stroke Project （OCSP）, based on clinical features.
OBJECTIVE： To evaluate the relationship between OCSP and TOAST classifications in terms of stroke location and etiology in 126 patients with acute ischemic stroke confirmed by transcranial magnetic resonance imaging （MRI）.
DESIGN, TIME AND SETTING： Retrospective case analysis. Transcranial MRI, diffusion weighted imaging, and magnetic resonance angiography were performed in 126 patients with acute stroke during the first 48 hours following admission to the Department of Neurology, Navy General Hospital of Chinese PLA.
PARTICIPANTS： A total of 126 patients with acute stroke, comprised of 71 males and 55 females, admitted to the Navy General Hospital of Chinese PLA between December 2005 and April 2006 were included.
METHODS： Of 126 patients with acute stroke, 13 exhibited total anterior circulation infarcts （TACI）, 51 had partial anterior circulation infarcts （PACI）, 28 suffered posterior circulation infarcts （POCI）, and 34 had lacunar infarcts （LACI） based on OCSP classification. However, according to TOAST classification, 19 cases were a result of large-artery atherosclerosis, 32 by cardioembolism, 36 by small-vessel occlusion, 1 by stroke of other determined etiology, and 38 by stroke of undetermined etiology.
MAIN OUTCOME MEASURES： The corresponding relationship of the subtypes of acute stroke based on OCSP and TOAST.
RESULTS： Of patients with TACI, 8 （61.5%） were caused by cardioembolism. Of patients with PACI, 16 （31.4%） were caused by large-artery atherosclerosis and 17 （33.3%） by cardioembolism. Of patients with POCI, 12 （42.8%） were a result of small-vessel occlusion. Of patients with LACI, 17 （50.0%） were caused by hypertension and arteriolar sclerosi     

Intracranial large artery disease among OCSP subtypes in ethnic South Asian ischemic stroke patients

The site of vascular stenosis correlates well with the Oxfordshire Community Stroke Project (OCSP) classification among Caucasians, but not among ethnic Chinese patients. We prospectively studied 205 consecutive ethnic South Asian ischemic stroke patients to investigate the prevalence of intracranial large artery disease determined by transcranial color-coded doppler and magnetic resonance angiography among OCSP subtypes. The distribution of OCSP subtypes was 7% total anterior circulation infarction (TACI), 17% partial anterior circulation infarction (PACI), 14% posterior circulation infarction (POCI) and 62% lacunar infarction (LACI). Significant intracranial large artery disease was common among all OCSP subtypes; 79% with TACI, 47% PACI, 65% POCI and 44% LACI. This is similar to ethnic Chinese data and is likely due to the predominance of intracranial disease over extracranial disease. Clinical axioms using OSCP subtypes based on Caucasian data may be misleading if applied to ethnic South Asians.     

Oxfordshire Community Stroke Project classification but not NIHSS predicts symptomatic intracerebral hemorrhage following thrombolysis

BackgroundThe Oxfordshire Community Stroke Project (OCSP) classification is a simple tool to categorize clinical stroke syndromes. We compared the outcomes of stroke patients after intravenous thrombolysis stratified by the baseline National Institutes of Health Stroke Scale (NIHSS) score or by the OCSP classification.MethodsWe assessed the safety of thrombolysis in consecutive stroke patients who received intravenous thrombolysis within 3 h after onset. The patients were grouped by the NIHSS score into mild to moderate stroke (≤ 20) and severe stroke (> 20), and also by the OCSP classification as having total anterior circulation infarcts (TACI), partial anterior circulation infarcts (PACI), posterior circulation infarcts (POCI), or lacunar infarcts (LACI). Symptomatic intracerebral hemorrhage (SICH) was used as the primary outcome.ResultsOf the 145 patients included in the study, 45 had a baseline NIHSS score > 20. Their stroke syndromes were as follows: 78 with TACI, 29 with PACI, 16 with POCI, and 22 with LACI. The proportion of SICH was comparable between patients with high or low NIHSS score (11.1% vs. 9.0%, P = 0.690). The chance of SICH was highest in patients with TACI (15.4%), followed by LACI (4.5%), PACI (3.4%), and POCI (0%). After adjustment for age, baseline glucose, and use of antiplatelet agents before admission, SICH was significantly increased in patients with TACI relative to those with non-TACI (odds ratio 5.92; 95% confidence interval 1.24–28.33, P = 0.026).ConclusionsThe OCSP clinical classification may help clinicians evaluate the risk of SICH following intravenous thrombolysis.     

脑梗死OCSP分型和预后

目的了解脑梗死患者OCSP临床分型的构成及不同亚型与预后及复发的关系。方法采用回顾性队列研究,登记2002年1月~2005年6月第四军医大学西京医院神经内科确诊的617例脑梗死患者,按照OCSP标准分型并进行随访,分析各亚型与预后及复发的关系。结果OCSP各亚型构成比分变为:TACI占7.3%,PACI23.3%,POCI6.0%,LACI63.4%,分型与预后明显相关,TACI的预后最差,POCI和LACI预后相对较好,PACI次之,卒中复发与分型无明显相关。结论OCSP分型作为一种脑梗死临床分型方法,可以为脑梗死的预后判断提供参考依据。     

急性脑梗死OCSP分型与吞咽困难的相关性分析

目的研究急性脑梗死OCSP分型与吞咽困难发生的关系。方法收集急性脑梗死患者199例,按牛津郡社区卒中项目（OCSP）分型划分为4型,于入院24h之内行标准床旁吞咽功能评估（SSA）,判断有无吞咽困难,比较其吞咽困难发生率的差异。结果199例患者中吞咽困难者占45．73％（91／199）,TACI（完全前循环梗死）中为76％（19／25）;PACI（部分前循环梗死）中为42．25％（50／113）;POCI（后循环梗死）中为35％（14／40）;LACI（腔隙性梗死）中为38．10％（8／21）。各型患者的吞咽困难发生率的差异存在统计学意义（χ^2=11．679,P〈0．05）,两两比较只有TAcI和其他3型之间差异存在统计学意义（P〈0．05）。结论吞咽困难是脑梗死后的常见症状,OCSP各型吞咽困难发生率的不同与缺血损伤不同区域的吞咽中枢以及缺血的范围和程度有关。     

Practical significance of ischemic stroke OCSP (Oxfordshire Community Stroke Project) classification

OCSP classification based on neurological signs and syndromes contains four subtypes of ischaemic stroke: lacunar infarct (LACI), total anterior circulation infarcts (TACI), partial anterior circulation infarcts (PACI), posterior circulation infarcts (POCI). Literature reports suggest that this classification may be useful in estimation of after stroke complications and prognostication, and can raise the sensitivity of therapeutic clinical tests. The aim of this study was to estimate the occurrence of risk factors, accompanying complications and prognosis in a material of clinical records of 346 hospitalized patients. Attention is drawn to limited importance of brain CT as shown in frequent discordance between clinical syndromes and CT findings in establishing to which stroke subtype a given patient belongs. The results obtained in the study are highly similar to those reported from other clinical centres. It was found that PACI syndrome was most frequently occurring, and that TACI subtype was associated with the highest frequency of complications and risk factors, and worst prognosis. The prognosis was best in the LACI subtype. The subtype of OCSP classification seems to be determining the possibility of complications and prognosis, and could suggest the most effective medical treatment.     

Risk factors and outcome of subtypes of ischemic stroke. Data from a multicenter multinational hospital-based registry. The European Community Stroke Project

BACKGROUND: Information on determinants and prognosis of ischemic stroke subtypes is scarce. We aimed at evaluating risk factors, pathogenesis, treatment and outcome of different ischemic stroke subtypes. METHODS: In a European Concerted Action involving seven countries, ischemic stroke subtypes defined according to the Oxfordshire Community Stroke Project (OCSP) were evaluated for demographics, baseline risk factors, resource use, 3-month survival, disability (Barthel Index) and handicap (Rankin Scale). RESULTS: During the 12-month study period, cerebral infarction was diagnosed in 2740 patients with first-in-a-lifetime stroke (mean age 70.5+/-12.4 years, 53.4% males). OCSP classification was achieved in 2472 (90.2%). Of these, 26.7% were total anterior circulation infarctions (TACI), 29.9% partial anterior circulation infarctions (PACI), 16.7% posterior circulation infarctions (POCI) and 26.7% lacunar infarctions (LACI). In multivariate analysis, atrial fibrillation was predictive of TACI (odds ratio [OR], 1.61; 95% CI, 1.28-2.03), hypertension (OR, 1.38; 95% CI, 1.16-1.65) and myocardial infarction (OR, 1.42; 95% CI, 1.08-1.86) predictive of PACI, hypertension (OR, 1.25; 95% CI, 1.04-1.50) predictive of LACI. A negative association was observed between TACI and hypertension (OR, 0.51; 95% CI, 0.42-0.61). Discharge home was 50% less probable in TACI and PACI than in LACI patients. As compared to LACI, TACI significantly increased the risk of 3-month death (OR, 5.73; 95% CI, 3.91-8.41), disability (OR, 3.27; 95% CI, 2.30-4.66) and handicap (OR, 2.71; 95% CI, 1.91-3.85). CONCLUSIONS: Ischemic stroke subtypes have different risk factors profile, with consequences on pathogenesis and prognosis. Information on determinants of the clinical syndromes may impact on prevention and acute-phase interventions.     

Stroke severity, early recovery and outcome are each related with clinical classification of stroke: data from the 'Tinzaparin in Acute Ischaemic Stroke Trial' (TAIST)

INTRODUCTION: Baseline severity and clinical stroke syndrome (Oxford Community Stroke Project, OCSP) classification are predictors of outcome in stroke. We used data from the 'Tinzaparin in Acute Ischaemic Stroke Trial' (TAIST) to assess the relationship between stroke severity, early recovery, outcome and OCSP syndrome. METHODS: TAIST was a randomised controlled trial assessing the safety and efficacy of tinzaparin versus aspirin in 1484 patients with acute ischaemic stroke. Severity was measured as the Scandinavian Neurological Stroke Scale (SNSS) at baseline and days 4, 7 and 10, and baseline OCSP clinical classification recorded: total anterior circulation infarct (TACI), partial anterior circulation infarct (PACI), lacunar infarct (LACI) and posterior circulation infarction (POCI). Recovery was calculated as change in SNSS from baseline at day 4 and 10. The relationship between stroke syndrome and SNSS at days 4 and 10, and outcome (modified Rankin Scale at 90 days) were assessed. RESULTS: Stroke severity was significantly different between TACI (most severe) and LACI (mildest) at all four time points (p<0.001), with no difference between PACI and POCI. The largest change in SNSS score occurred between baseline and day 4; improvement was least in TACI (median 2 units), compared to other groups (median 3 units) (p<0.001). If SNSS did not improve by day 4, then early recovery and late functional outcome tended to be limited irrespective of clinical syndrome (SNSS, baseline: 31, day 10: 32; mRS, day 90: 4); patients who recovered early tended to continue to improve and had better functional outcome irrespective of syndrome (SNSS, baseline: 35, day 10: 50; mRS, day 90: 2). CONCLUSIONS: Although functional outcome is related to baseline clinical syndrome (best with LACI, worst with TACI), patients who improve early have a more favourable functional outcome, irrespective of their OCSP syndrome. Hence, patients with a TACI syndrome may still achieve a reasonable outcome if early recovery occurs.