Early Magnetic Resonance Imaging Predicts Early Neurological Deterioration in Acute Middle Cerebral Artery Minor Stroke

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• 作者：Dezhi Liu ; MD^* ; ^&dagger ; ; ¹ ; Wen Sun ; MD ; PhD^* ; ¹ ; Fabien Scalzo ; PhD^&dagger ; ; Yunyun Xiong ; MD ; PhD^* ; Xiaohao Zhang ; MD^* ; Zhongming Qiu ; MD^* ; Wusheng Zhu ; MD ; PhD^* ; Minmin Ma ; MD ; PhD^* ; Wenhua Liu ; MD ; PhD^* ; Gelin Xu ; MD ; PhD^* ; Guangming Lu ; MD ; PhD^&Dagger ; ; David S. Liebeskind ; MD^&dagger ; ; Xinfeng Liu ; MD ; PhD^* ; ^{xfliu2@vip.163.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Stroke prognosis ; neuroimaging of acute stroke ; clinical outcome ; outcome predictive factors ; magnetic resonance imaging ; infarct pattern ; early neurological deterioration
• 刊名：Journal of Stroke and Cerebrovascular Diseases
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：25
• 期：2
• 页码：469-474
• 全文大小：107 K

文摘

Early neurological deterioration (END) is an important factor associated with worse clinical outcome in minor strokes. Early magnetic resonance imaging (MRI) findings can provide better sensitivity to delineate stroke pathophysiology and have diagnostic value associated with causative mechanisms. The aim of this study was to investigate the relationship between early MRI finding and the presence of END in minor stroke patients with lesions in the middle cerebral artery (MCA) territory.

Methods

Consecutive MCA minor stroke patients who were admitted to our center within 24 hours of symptom onset were included in this study. All patients underwent MRI within 24 hours of admission. We analyzed baseline characteristics, infarction patterns, and treatment algorithms. The correlation between early MRI findings and END, defined as National Institutes of Health Stroke Scale score increasing more than 2 points during 72 hours after admission, was also determined.

Results

Across 211 patients meeting entry criteria between January 2010 and December 2013, internal border-zone (IBZ) infarcts on early MRI scan were observed in 23 of 65 patients with END (35.4%) and in 18 of 146 patients without END (12.3%, P < .001). Patients with IBZ infarcts were found to have more hyperlipidemia, less perforating artery infarcts, more pial artery infarcts, more cortical border-zone infarcts and more ipsilateral large arterial stenosis. Logistic regression analysis revealed that IBZ infarct was independently associated with END after adjustment for other factors (odds ratio, 2.50; 95% confidence interval, 1.09-5.74; P = .031).

Conclusions

Early MRI patterns of IBZ infarction are associated with END in minor stroke patients with acute infarcts of the MCA territory.