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

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
Manuel Gómez-ChocoJoaquín Serena

Abstract

To assess whether neuroimaging markers of chronic cerebral small vessel disease (cSVDm) influence early recovery after acute ischemic stroke (AIS). Retrospective analysis of patients diagnosed with AIS and included in the Spanish Neurological Society Stroke Database. (1) Brain MRI performed after acute stroke and (2) Premorbid modified Rankin scale (mRS) = 0. (1) Uncommon stroke etiologies, (2) AIS not confirmed on neuroimaging, or (3) Old territorial infarcts on neuroimaging. Patients scored from 0 to 2 according to the amount of cSVDm. Patients were divided into lacunar ischemic stroke (LIS) and nonlacunar ischemic stroke (NLIS) groups according to TOAST classification. Distribution of mRS at discharge. NIHSS improvement more than or equal to 3 at 24 hours and at discharge, NIHSS worsening more than or equal to 3 points at 24 hours. We studied 4424 patients (3457 NLIS, 967 LIS). The presence of cSVDm increased the risk of worsening 1 category on the mRS at discharge in the LIS group ([1] cSVDm: OR 1.89 CI 95% 1.29-2.75, P = .001. [2] cSVDm: OR 1.87, CI 95% 1.37-2.56 P = .001) and was an independent factor for not achieving an improvement more than or equal to 3 points on the NIHSS at discharge for all the patients and the LIS...Continue Reading

Citations

Jan 29, 2021·Stroke; a Journal of Cerebral Circulation·Ning BuVincent Thijs

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