AUTHOR=Park Sangil , Kwon Boseong , Chang Jun Young , Song Yunsun , Lee Deok Hee , Ha Sang Hee , Kim Bum Joon 

TITLE=Factors associated with delayed neurologic improvement after complete endovascular reperfusion in anterior and posterior ischemic stroke

JOURNAL=Frontiers in Neurology

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2025.1543743

DOI=10.3389/fneur.2025.1543743

ISSN=1664-2295

ABSTRACT=BackgroundMechanisms underlying delayed neurological improvement (DNI) after endovascular thrombectomy (EVT) in patients with anterior (ACS) and posterior circulation stroke (PCS) may differ. This study aims to compare the factors associated with DNI in patients with ACS and PCS.Materials and methodsData of patients who underwent EVT with National Institute of Health Stroke Scale (NIHSS) score more than 6 and achieved successful reperfusion were retrospectively analyzed. DNI was defined as achieving favorable functional outcomes at 90 days, even without early neurological improvement. The factors associated with DNI in patients with ACS and PCS were investigated.ResultsA total of 241 patients were included. The proportions of DNI (30.8% vs. 20.0%; p = 0.184) were not significantly different between patients with ACS and PCS. In patients with ACS, absence of atrial fibrillation (aOR = 0.500; 95% CI, 0.264–0.945; p = 0.033), statin use (aOR = 2.842; 95% CI, 1.174–6.882; p = 0.021), lower NIHSS score after 24 h (aOR = 0.816; 95% CI 0.757–0.880; p < 0.001), and shorter onset-to-door time (aOR = 0.999; 95% CI, 0.998–1.000; p = 0.025) were significantly associated with DNI. In patients with PCS, male sex (aOR = 31.809; 95% CI, 1.816–557.074; p = 0.018) and lower initial NIHSS scores (aOR = 0.626; 95% CI, 0.410–0.957; p = 0.031) were significantly associated with DNI.ConclusionThe proportions of DNI were similar in patients with ACS and PCS. However, the factors associated with DNI were different between the two groups.