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@ARTICLE{Berberich:153436,
      author       = {A. Berberich and C. Schneider and C. Herweh and T.
                      Hielscher$^*$ and T. Reiff and M. Bendszus and C. Gumbinger
                      and P. Ringleb},
      title        = {{R}isk factors associated with progressive lacunar strokes
                      and benefit from dual anti-platelet therapy.},
      journal      = {European journal of neurology},
      volume       = {27},
      number       = {5},
      issn         = {1351-5101},
      address      = {Oxford},
      publisher    = {Blackwell Science65503},
      reportid     = {DKFZ-2020-00287},
      pages        = {817-824},
      year         = {2020},
      note         = {2020 May;27(5):817-824},
      abstract     = {Early neurological deterioration (END) occurs in $20-30\%$
                      of patients with lacunar stroke and challenges their
                      clinical management. This retrospective cohort study
                      analyzed clinical and neuroimaging risk factors predicting
                      the occurrence of END, the functional outcome after END and
                      potential benefit from dual anti-platelet therapy (DAPT) in
                      patients with lacunar strokes.Factors associated with END
                      and benefit from DAPT were retrospectively analyzed in 308
                      patients with lacunar stroke symptoms and detected lacunar
                      infarction by MRI. END was defined by deterioration of ≥3
                      total NIHSS points, ≥2 NIHSS points for limb paresis or
                      documented deterioration within five days after admission.
                      Patients were treated with DAPT according to in-house
                      standards. Primary efficacy endpoint for functional outcome
                      was fulfilled if NIHSS at discharge improved after END at
                      least to the score at admission.Male gender (OR=2.08;
                      $95\%CI$ 1.09-4.00), higher age (OR=1.65 per 10 years;
                      $95\%CI$ 1.18-2.31), motor paresis (OR=18.89, $95\%CI$
                      4.66-76.57) and infarction of the internal capsule or basal
                      ganglia (OR=3.58, $95\%CI$ 1.26-10.14) were associated with
                      an increased risk for END. Larger diameter of infarction
                      (OR=0.85, $95\%CI$ 0.76-0.95), more microangiopathic lesions
                      (OR=0.75, $95\%CI$ 0.57-0.99) and pontine localization
                      (OR=0.29, $95\%CI$ 0.12-0.65) were factors associated with
                      unfavorable functional outcome after END occurred.
                      Localization in the internal capsule or basal ganglia was
                      identified as significant predictive factor for a benefit
                      from DAPT after END.Identified clinical and neuroimaging
                      factors predicting END occurrence, functional outcome after
                      END and potential benefit from DAPT might improve the
                      clinical management of patients with lacunar strokes.},
      cin          = {C060},
      ddc          = {610},
      cid          = {I:(DE-He78)C060-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:31994783},
      doi          = {10.1111/ene.14159},
      url          = {https://inrepo02.dkfz.de/record/153436},
}