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Fluid-attenuated inversion recovery vascular hyperintensities in anterior circulation acute ischemic stroke: associations with cortical brain infarct volume and 90-day prognosis

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Abstract

Background and purpose

Fluid-attenuated inversion recovery vascular hyperintensity (FVH) is often observed in conjunction with acute ischemic stroke (AIS) of the carotid system. However, the significance of FVH in patients with AIS has not been fully elucidated. The purpose of this study is to investigate the effects of FVH on the final infarct volume (including cortical and deep brain infarct volume) and on 90-day prognosis in AIS patients.

Material and methods

We analyzed data of 160 patients who had AIS of anterior circulation. FVH was identified and the cortical brain infarct volume (CBIV) and deep brain infarct volume (DBIV) were calculated. We assessed 90-day clinical outcome using the modified Rankin Scale (mRS).

Results

FVH was identified in 83 of the 160 patients (51.88%). Patients with FVH showed larger CBIV (13.94 ± 25.55 vs. 6.56 ± 13.49 ml; p = 0.025), more frequent intracranial-large artery disease (74.70 vs. 27.27%; p < 0.001), and more severe clinical impairment on admission (NIHSS 7.22 ± 4.01 vs. 5.42 ± 4.52; p = 0.009). Considering the factors influencing prognosis, FVH positivity (OR = 2.12, 95% CI 1.13–3.99; p = 0.02) and NIHSS (at discharge) (OR = 2.14, 95% CI 1.64–2.78; p < 0.001) were independently associated with 90-day clinical outcome of AIS patients.

Conclusion

FVH is a more common finding associated with larger CBIV, intracranial-large artery disease, and more severe strokes on admission. In the presence of good collateral circulation, FVH may be a predictor of better outcome in anterior circulation AIS patients at 90 days.

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Authors and Affiliations

  1. Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People’s Republic of China

    Xiaoyu Dong

  2. Department of Neurology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, Liaoning, People’s Republic of China

    Jianfei Nao

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  1. Xiaoyu Dong
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Dong, X., Nao, J. Fluid-attenuated inversion recovery vascular hyperintensities in anterior circulation acute ischemic stroke: associations with cortical brain infarct volume and 90-day prognosis. Neurol Sci 40, 1675–1682 (2019). https://doi.org/10.1007/s10072-019-03909-0

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