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ASA: Flat Head Position Before Thrombectomy Tied to Better Neurological Function

0-degree versus 30-degree position tied to fewer neurological deficits after surgery and at discharge in stroke patients

By Lori Solomon HealthDay Reporter

THURSDAY, Feb. 15, 2024 (HealthDay News) — A flat position for a stroke patient’s head before surgery may improve neurological function, according to a study presented at the annual American Stroke Association International Stroke Conference, held from Feb. 7 to 9 in Phoenix. 

Anne W. Alexandrov, Ph.D., from the University of Tennessee Health Science Center in Memphis, and colleagues sought to determine whether 0-degree positioning of large vessel occlusion (LVO) thrombectomy candidates was associated with greater clinical stability and/or improvement compared to 30-degree positioning in the prethrombectomy period. The analysis included 92 patients with computed tomography angiography-confirmed LVO and viable parenchyma.

The Data and Safety Monitoring Board stopped enrollment due to overwhelming efficacy of 0-degree head positioning following a preplanned interim analysis. The researchers found that compared with patients with 30-degree head positioning, 0-degree head positioning before thrombectomy resulted in greater stability or clinical improvement prior to surgery, based on repeated National Institutes of Health Stroke Scale (NIHSS) scores. At both 24 hours following surgery and at seven days or discharge (whichever came first), the 0-degree head-position patients had fewer neurological deficits on the NIHSS versus patients with head positioning at a 30-degree incline before surgery.

“By three months following surgery, there was no difference in outcomes for patients in either group; however, it’s exciting to see that we were able to discharge patients from the hospital with less disability requiring rehabilitation,” Alexandrov said in a statement.

One author disclosed ties to Cerenovus, Genentech, Medtronic, Stryker, and Rapid Medical.

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