Pre-Existing Cerebral Small Vessel Disease Limits Early Recovery in Patients with Acute Lacunar Infarct

Gómez-Choco, Manuel; Mengual, Juan José; Rodríguez‐Antigüedad, Jon; Paré-Curell, M.; Purroy, Francisco; Palomeras, Ernest; Fuentes, Blanca; Ustrell, Xavier; Tembl, José Ignacio; Rodríguez‐Yáñez, Manuel; Martí‐Fàbregas, Joan; Serena, Joaquı́n

doi:10.1016/j.jstrokecerebrovasdis.2019.104312

Cited by 7 publications

(2 citation statements)

References 20 publications

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“…The absence of small vessel changes and presence of larger brain volumes are imaging markers of brain health [ 5 , 6 ]. An increasing number of researchers believe that global brain health may also influence recovery [ 7 ], as the recovery process after stroke involves the re-optimization of cellular, structural, and vascular functions throughout the brain, while maintaining their integrity [ 8 ]. General prestroke features, including white matter hyperintensity (WMH), cerebral atrophy, and old infarct lesions, have been independently associated with poor outcome and may represent markers of brain frailty [ 9 – 12 ].…”

Section: Introductionmentioning

confidence: 99%

Brain frailty associated with stroke events in anterior circulation large artery occlusion

Tian,

Zhang,

Cui

et al. 2024

BMC Neurol

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Objective To investigate the factors associated with brain frailty and the effect of brain frailty in patients with anterior circulation large artery occlusion (AC-LAO). Methods 1100 patients with AC-LVO consecutively admitted to the Second Hospital of Hebei Medical University, North China between June 2016 and April 2018 were retrospectively analyzed. The variables associated with brain frailty and stroke outcome were analyzed by ANOVA analysis, the Mann-Whitney U test and multiple linear regression. Based on previous research. Brain frailty score comprises 1 point each for white matter hyperintensity (WMH), old infarction lesions, and cerebral atrophy among 983 participants with baseline brain magnetic resonance imaging or computed tomography. Results Among AC-LAO participants, baseline brain frailty score ≥ 1 was common (750/983, 76.3%). Duration of hypertension > 5 years (mean difference [MD] 0.236, 95% CI 0.077, 0.395, p = 0.004), multiple vessel occlusion (MD 0.339, 95% CI 0.068, 0.611, p = 0.014) and basal ganglia infarction (MD -0.308, 95% CI -0.456, -0.160, p < 0.001) were independently associated with brain frailty score. Brain frailty score was independently associated with stroke events, and higher brain frailty scores were associated with higher rates of stroke events (p < 0.001). However, brain frailty has no independent effect on short-term outcome of ACI in AC-LAO patients. Conclusions In AC-LAO patients, older age, duration of hypertension > 5 years, and multiple vessel occlusion influenced the brain frailty score. Brain frailty score was independently associated with the occurrence of stroke events in AC-LAO patients.

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Section: Introductionmentioning

confidence: 99%

Brain frailty associated with stroke events in anterior circulation large artery occlusion

Tian,

Zhang,

Cui

et al. 2024

BMC Neurol

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“…Studies have found that WMLs are a risk factor for stroke, dementia and death in the general and high-risk population 3 . In addition, they can determine the severity and hinder the neurological recovery of stroke [4][5][6] .…”

Section: Introductionmentioning

confidence: 99%

Influence of white matter lesions on the prognosis of acute cardioembolic stroke without reperfusion therapy

Guo

Zou

Chen

et al. 2021

Preprint

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Background Few studies have investigated the influence of white matter lesions (WMLs) on the prognosis of acute cardioembolic stroke (CES). We aimed to explore the role of WMLs in predicting 3-month prognosis of CES without reperfusion therapy. Methods A number of 251 acute CES patients without reperfusion therapy at a single center were retrospectively recruited. The severity of WMLs was evaluated by Fazekas scale and patients were divided into mild WMLs group (188 cases, Fazekas ≤ 2 points) and moderate to severe WMLs group (63 cases, Fazekas ≥ 3 points) accordingly. General data and clinical features of the two groups were compared. Functional outcomes of patients were followed up for 3 months using the modified Rankin scale (mRS) and patients were divided into poor outcome group (mRS ≥ 3) and favorable outcome group (mRS ≤ 2). The effect of WMLs on the prognosis was identified by binary logistic regression. Results Patients in moderate to severe WMLs group were older (P < 0.001). Also, they had higher baseline NIHSS score (P < 0.001) and elevated incidence of asymptomatic cerebral hemorrhage (P = 0.040) and stroke associated pneumonia (P = 0.001) than those in mild WMLs group. At 3 months, there were 100 cases in the poor outcome group. Patients in poor outcome group had higher baseline NIHSS score, increased proportion of moderate to severe WMLs, and elevated incidence of stroke associated pneumonia than those in favorable outcome group (P < 0.001). Binary logistic regression analysis showed that moderate to severe WMLs (odds ratio [OR] = 4.105, 95% confidence interval [CI] = 1.447–11.646), baseline NIHSS score (OR = 1.368, 95% CI = 1.240–1.511), and stroke-associated pneumonia (OR = 4.840, 95%CI = 1.889–12.400) were independent risk factors for poor outcome. Conclusion Moderate to severe WMLs is an independent risk factor for prognosis of CES patients without reperfusion therapy.

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Total cerebral small vessel disease burden and stroke outcomes in large vessel occlusion stroke receiving endovascular treatment: A systematic review and meta-analysis

Cheng,

Chen,

Ren

et al. 2024

Journal of Clinical Neuroscience

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Pre-Existing Cerebral Small Vessel Disease Limits Early Recovery in Patients with Acute Lacunar Infarct

Cited by 7 publications

References 20 publications

Brain frailty associated with stroke events in anterior circulation large artery occlusion

Brain frailty associated with stroke events in anterior circulation large artery occlusion

Influence of white matter lesions on the prognosis of acute cardioembolic stroke without reperfusion therapy

Total cerebral small vessel disease burden and stroke outcomes in large vessel occlusion stroke receiving endovascular treatment: A systematic review and meta-analysis

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