ArticleJournal of neurology2025
Decreased level of consciousness in acute ischemic stroke: risk factors, territories, stroke mechanisms and outcome. A single-centre cohort study.
Article in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Beyond the total NIHSS score: association between impaired level of consciousness and early neurological deterioration in mild large vessel occlusion stroke.Neuroradiology · 2026Article
- Neuroimaging of Disorder of Consciousness: From Brain Network Mechanisms to Clinical Translation.Journal of clinical neurology (Seoul, Korea) · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA decreased level of consciousness (DLOC) at onset is infrequent in patients with acute ischemic stroke (AIS). We assessed stroke localization, patient and stroke characteristics, revascularization rates, and long-term outcome in consecutive AIS patients presenting with acute DLOC.
methodsWe assessed all AIS patients from 1/2003-6/2021 admitted to a single academic hospital. DLOC at stroke onset was defined as being described in the prehospital phase or being present on hospital arrival based. Using multivariable regression analyses, we compared patients with and without DLOC regarding anatomical stroke localization, baseline characteristics, frequency of revascularization, favourable functional 3-month outcome, and 12-month mortality.
resultsAmong 6491 consecutive AIS patients (median age = 74.8 years, IQR:20.2; 44.2% female), 778 (12%) had DLOC, representing 10.0% of patients from the primary catchment area. Strokes affecting the upper brainstem, thalamus or temporal lobes more frequently showed DLOC. DLOC was independently associated with multiple territory lesions, posterior circulation and right cerebral localization, unwitnessed stroke onset, stroke severity, initially missed stroke diagnosis (all adjusted p-values < 0.05). Admission temperature and systolic blood pressure showed a U-shaped association with DLOC. After multiple adjustments, favourable 3-month outcome was less frequent (adjusted OR (ORadj):0.54,95%CI:0.43-0.69) and 12-month mortality rate higher in DLOC patients (ORadj:1.35 (95%CI:1.16-1.56). The latter difference disappeared after adjusting for change of goals of care.
conclusionsThe 10% of AIS patients with DLOC most often involve the upper brainstem, thalami and temporal lobes. DLOC patients have a higher likelihood of unwitnessed stroke onset and of their stroke being missed. Long-term functional outcome is clearly worse and mortality higher with DLOC even after adjustment for other prognostic factors.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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 OpenQuestion graph.