Correlation study between small vessel disease and early neurological deterioration in patients with mild/moderate acute ischemic stroke

Chen, Zhonglun; Li, Wei; Sun, Wen; Xiao, Lulu; Dai, Qiliang; Cao, Yuezhou; Han, Yaling; Zhu, Wusheng; Xu, Gelin; Liu, Xinfeng

doi:10.1080/00207454.2016.1214825

Cited by 15 publications

(8 citation statements)

References 37 publications

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“…The history of diabetes and systolic blood pressure on admission is associated with END as well (P < 0.05), which is consistent with the previous studies [8]. Contrary to previous studies, which reported no correlation between white matter lesions classification and lacunar cerebral infarction induced END [9], our research suggested that the protective factors in lacunar stroke include history of stroke, white matter lesions and age. A brain ischemia tolerance after lacunar stroke may be activated by the protective factors.…”

Section: Discussionsupporting

confidence: 91%

Associated factors of early neurological deterioration in isolated acute lacunar infarction in basal ganglia

Man

et al. 2019

Journal of Neurorestoratology

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Objective:To investigate, in basal ganglia, the factors associated with early neurological deterioration (END) of isolated acute lacunar infarction.Methods:167 patients, in the retrospective group, with isolated acute lacunar infarction in basal ganglia, were defined by magnetic resonance imaging (MRI). The National Institutes of Health Stroke Scale (NIHSS) defined early neurological deterioration as increases of ≥ 2 within 72 hours following admission. Baseline variables predicting END were investigated with multivariate logistic regression analysis.Results:In the study, END occurred in 42 (25.15%) patients. Lesions located in posterior limb of internal capsule were independent risk factors for END (P < 0.01). Associated with END were the age of onset, history of cerebral infarction, history of diabetes, systolic blood pressure at admission and lesions of cerebral white matter. This presented significant differences (P < 0.05). With or without diabetes and different lesion location at varying layers and inter-layers, single-factor and multi-factor analysis revealed no effect on the association between positive ENT and age, history of stroke, white matter. Previous history of stroke, pathological changes of white matter, and age of onset, correlates with END which showed significant difference (P < 0.05).Conclusions:There is a close relationship between the lesion location and other related factors, such as lesions of cerebral white matter, history of cerebral infarction, history of diabetes and age, etc. and END in patients with isolated acute lacunar infarction in basal ganglia. Protective factors of END included age ≥ 65, high systolic pressure, stroke history, cerebral white matter lesions in our study.

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Section: Discussionsupporting

confidence: 91%

Associated factors of early neurological deterioration in isolated acute lacunar infarction in basal ganglia

Man

et al. 2019

Journal of Neurorestoratology

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“…In our stroke unit, patients with AIS received a daily NIHSS assessment until 72 h after admission. The definition of END in our study refers to neurological deterioration with an increase in the NIHSS score ≥ 2 points in the first 72 h after admission [17,18].…”

Section: Definition Of Endmentioning

confidence: 99%

Asymmetrical cortical vein sign predicts early neurological deterioration in acute ischemic stroke patients with severe intracranial arterial stenosis or occlusion

Xiao

Luo

et al. 2020

BMC Neurol

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Background Susceptibility weighted imaging (SWI) provides an approximate assessment of tissue perfusion and shows prominent hypointense cortical veins in the ischemic territory because of the increased concentration of deoxyhemoglobin. We aimed to evaluate whether asymmetrical prominent cortical vein sign (APCVS) on SWI can predict early neurological deterioration (END) in acute ischemic stroke patients with severe intracranial arterial stenosis or occlusion (SIASO). Methods One hundred and nine acute ischemic stroke patients with SIASO who underwent SWI were retrospectively recruited. END was defined as an increase in the National Institutes of Health Stroke Scale score ≧2 points despite standard treatment in the first 72 h after admission. The APCVS was defined as more and/or large vessels with greater signal loss than those in the opposite hemisphere on SWI. Results Thirty out of the 109 (27.5%) patients developed END. Sixty (55.0%) patients presented with APCVS on SWI. APCVS occurred in 24 (80%) patients with END, whereas it only occurred in 36 (45.6%) patients without END (P = 0.001). Patients with APCVS were more likely to have END (40.0%, vs. 12.2%, P = 0.001) than those without END. Multivariate logistic regression indicated that APCVS (OR = 4.349, 95% C.I. = 1.580–11.970, P = 0.004) was a significant predictor of END in acute ischemic stroke patients with SIASO, adjusted for previous stroke history and acute infarct volume. Conclusions In acute ischemic stroke patients with SIASO, the APCVS might be a useful neuroimaging marker for predicting END, which suggests the importance of evaluation of perfusion status.

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“…On the contrary, Marek and colleagues [ 49 ] having analyzed 77 head CT scans of patients admitted from the emergency room to the Radiology Department due to suspected AIS, demonstrated that baseline LA severity was not correlated to NIHSS scale upon admission. Similarly, Chen and colleagues [ 47 ] evaluated 687 AIS patients with NIHSS score < 12 upon admission and failed to reveal a relationship between END and several imaging markers of small vessel disease (SVD), including silent lacunar infarction, deep CMBs, brain atrophy, basal ganglia and semiovale EPVSs and periventricular or semiovale WMHs. Furthermore, Jeong and colleagues [ 44 ] studied 587 AIS exhibiting single small subcortical infarctions and revealed that despite END association with large vessel pathologies, no correlation was evident between END and markers of SVD, such as previous lacunar infarction, CMBs or WMHs.…”

Section: Discussionmentioning

confidence: 99%

The Clinical Utility of Leukoaraiosis as a Prognostic Indicator in Ischemic Stroke Patients

Christidi

Tsiptsios

Sousanidou

et al. 2022

Neurology International

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Stroke constitutes a major cause of functional disability with increasing prevalence among adult individuals. Thus, it is of great importance for both clinicians and stroke survivors to be provided with a timely and accurate prognostication of functional outcome. A great number of biomarkers capable of yielding useful information regarding stroke patients’ recovery propensity have been evaluated so far with leukoaraiosis being among them. Literature research of two databases (MEDLINE and Scopus) was conducted to identify all relevant studies published between 1 January 2012 and 25 June 2022 that dealt with the clinical utility of a current leukoaraiosis as a prognostic indicator following stroke. Only full-text articles published in English language were included. Forty-nine articles have been traced and are included in the present review. Our findings highlight the prognostic value of leukoaraiosis in an acute stroke setting. The assessment of leukoaraiosis with visual rating scales in CT/MRI imaging appears to be able to reliably provide important insight into the recovery potential of stroke survivors, thus significantly enhancing stroke management. Yielding additional information regarding both short- and long-term functional outcome, motor recovery capacity, hemorrhagic transformation, as well as early neurological deterioration following stroke, leukoaraiosis may serve as a valuable prognostic marker poststroke. Thus, leukoaraiosis represents a powerful prognostic tool, the clinical implementation of which is expected to significantly facilitate the individualized management of stroke patients.

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Correlation study between small vessel disease and early neurological deterioration in patients with mild/moderate acute ischemic stroke

Cited by 15 publications

References 37 publications

Associated factors of early neurological deterioration in isolated acute lacunar infarction in basal ganglia

Associated factors of early neurological deterioration in isolated acute lacunar infarction in basal ganglia

Asymmetrical cortical vein sign predicts early neurological deterioration in acute ischemic stroke patients with severe intracranial arterial stenosis or occlusion

The Clinical Utility of Leukoaraiosis as a Prognostic Indicator in Ischemic Stroke Patients

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