25 Dec 2025 • Patients presenting with decreased level of consciousness (DLOC) at acute ischemic stroke onset had markedly worse outcomes and higher mortality, new data showed.

Key Findings:

• Among nearly 6,500 patients, 12% arrived with impaired consciousness, most commonly associated with lesions in the upper brainstem, thalamus, or temporal lobes.
• DLOC was more frequent in strokes involving multiple vascular territories, posterior circulation, and right hemispheric localization, and it showed a U-shaped link with admission temperature and systolic BP.
• These patients were also more likely to have unwitnessed onset and missed initial diagnosis.
• Compared with alert patients, those with DLOC were nearly half as likely to achieve favorable functional outcomes at 3 months (aOR 0.54) and had a 35% higher risk of death at 12 months (aOR 1.35).

The findings identify reduced consciousness at presentation as an early marker of complex stroke and poor prognosis, underscoring the need for rapid recognition and aggressive evaluation.

Source: Springer Nature | Read full story