Contributor: Aaron Lessen MD
Educational Pearls:
- Recent prospective randomized clinical trial assessed optimal head-of-bed positioning in patients with LVO
- 0º vs. 30º elevation
- Objective was to determine superiority of the two angles in stability prior to thrombectomy for LVO patients
- 45 patients randomized to the group with 0° head positioning and 47 patients randomized to the group with 30° head positioning
- Patients in the 30º group experienced worsening of NIHSS by 2 points or more
- Patients with head position at 0° showed score stability
- Hazard ratio 34.40; 95% CI, 4.65-254.37; P < .001
- All-cause death occurred in 2 patients in the 0° group, compared with 10 patients in the 30° group.
- Results suggest that 0º positioning of the head of the bed may be protective to maintain clinical stability in patients with LVO prior to thrombectomy
References
- Alexandrov AW, Shearin AJ, Mandava P, et al. Optimal Head-of-Bed Positioning Before Thrombectomy in Large Vessel Occlusion Stroke: A Randomized Clinical Trial. JAMA Neurol. 2025;82(9):905-914. doi:10.1001/jamaneurol.2025.2253
Summarized & Edited by Jorge Chalit, OMS4
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