Prognostic Role of Chronic Rhinosinusitis in Acute Ischemic Stroke Patients Undergoing Mechanical Thrombectomy

Abstract

Background: The aim of the study was to assess the relevance of chronic rhinosinusitis (CRS) CT features to the efficacy of mechanical thrombectomy (MT) in patients with acute ischemic stroke. Methods: This study included 311 patients qualified for MT in whom the CRS features were assessed based on a CT scan, according to the Lund-Mackay (L-M) score. Clinical, inflammatory parameters, patients neurological (NIHSS) and functional status (mRS), and recanalisation efficacy (TICI) were compared between patients with mild lesions (L-M score 0–3 points)-group 1, and patients with more severe lesions (L–M score 4–24)-group 2. Results: There was a significant difference in the NIHSS on day seven after stroke onset-10 points in group 1 and 14 points in group 2, p = 0.02. NIHSS ≤ 6 points on day seven was found in 41.9% of patients in group 1, and in 27.5% in group 2, p = 0.042. There were no significant differences in mRS score and in the TICI score. L-M score, lipid abnormalities and CRP were factors associated with NIHSS ≥ 7 points on day 7. Conclusions: The CT features of CRS may be used as a prognostic tool for early prognosis assessment in stroke patients.

Intelligent Decision Support System for Differential Diagnosis of Chronic Odontogenic Rhinosinusitis Based on U-Net Segmentation

“…Ref. [20] is devoted to assessing the relevance of chronic rhinosinusitis CT features to the efficacy of mechanical thrombectomy in patients with acute ischemic stroke. To do this, the study included 311 patients qualified for mechanical thrombectomy in whom the chronic rhinosinusitis features were assessed based on a CT scan, according to the Lund-Mackay score.…”

Rhinosinusitis and Stroke: A Systematic Review

“…On the contrary, Lee et al showed that CRS patients under 60 years of age were at greater risk of stroke [ 3 ]. Moreover, the impact of CRS on the short-term prognosis in stroke patients has also been confirmed [ 15 ]. The neurological status in patients with mild signs of CRS, as evaluated with CT scans, was significantly better than in those with moderate or severe lesions.…”

“…As a result, the authors proposed the CT features of CRS as an early prognostic tool for patients with ischemic stroke. Notably, when moderate or severe CRS is diagnosed, intensive maximal medical therapy or interventional treatment should be started as early as possible, as this may improve the short-term efficacy of endovascular treatment of patients with stroke [ 15 ].…”

“…In nearly half of the collected cohort studies the CRS diagnosis was based on inflammatory lesions apparent on sinus imaging, either with CT or MRI scans [ 4 , 14 , 15 ]. The lack of data on the history of sinus complaints, severity, disease status, and possible treatment in accordance with the EPOS 2020 guidelines [ 34 ] limits these studies.…”