The predictive value of radiological conjugate eye deviation sign for acute ischemic stroke due to large vessel occlusion
Objective To furnish clinical evidence supporting its utilization in resource-limited settings,we conducted a retrospective analysis to assess the predictive role of radiological conjugate eye deviation(RCED)for acute ischemic stroke caused by large vessel occlusion.Methods A total of 134 patients diagnosed with acute anterior circulation ischemic stroke in The center hospital of Enshi Tujia and Miao autonomous prefecture from January 2020 to December 2023 were selected for the study.According to whether patients with the presence of RCED,patients were divided into RCED(+)and RCED(-)group.The accuracy,sensitivity,specificity,and area under the receiver operating characteristic(ROC)curve of RCED in the diagnosis of LVO-AIS were calculated separately.To minimize case bias,propensity score matching(PSM)was conducted in a1∶1 ratio.Results Before PSM,there were55 patients in the RCED group and 97 patients in the Non-RCED group.Significant differences were observed between the two groups in terms of atrial fibrillation,National Institute of Health stroke scale(NIHSS)scores,cranial eye deviation(CED),and the hyperdense middle cerebral artery sign(HMCAS)(P<0.05).Following PSM,a total of 55 pairs of successfully matched patients were obtained,with no statistically significant differences in baseline data between the two groups(P>0.05),RCED was found to be associated with acute large vessel occlusive ischemic stroke[OR(95%CI):10.5(4.11～31.2),P<0.001].The cutoff grade of RCED to predict LVO-AIS was 13.31°.The accuracy of RCED in diagnosing LVO-AIS was 77.6%,with a sensitivity of 0.84,a specificity of 0.75 and an area under the ROC curve of 0.80(95%CI:0.72～0.87).Conclusion The RCED sign serves as a predictive indicator for LVO-AIS.In emergency scenarios where cerebrovascular imaging is unavailable,the presence of RCED can assist clinicians in making treatment decisions for AIS patients.
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