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Neurological Sciences

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01-11-2020 | Magnetic Resonance Imaging | Original Article

Association of FLAIR vascular hyperintensity and acute MCA stroke outcome changes with the severity of leukoaraiosis

Authors: W. J. Shang, L. M. Shu, X. Zhou, H. Q. Liao, X. H. Chen, H. Hong, H. B. Chen

Published in: Neurological Sciences | Issue 11/2020

Abstract

Purpose

The clinical significance of FLAIR vascular hyperintensity (FVH), a marker of collateral circulation in ischaemic stroke, remains controversial. We hypothesised that the association between FVH and outcomes varies with the severity of leukoaraiosis (LA), another marker of collaterals, and that their combined significance may vary with time.

Methods

We included 459 consecutive patients with middle cerebral artery (MCA) stroke. Proximal and distal FVHs were distinguished based on location. LA was divided into two grades, according to Fazekas scores of 0–2 and 3–6. Symptom-to-MRI time was divided into two categories: ≤ 14 days and ≥ 15 days.

Results

We found no difference in FVH proportion according to LA grade. Multivariate analysis revealed that LA and FVH status were independently associated with unfavourable outcomes (modified Rankin scale ≥ 2) in patients with symptom-to-MRI times ≤ 14 days (P = 0.008), but not in those with symptom-to-MRI times ≥15 days (P = 0.61). In the group with symptom-to-MRI times ≤14 days, patients with LA 3–6 and FVH(+) (OR, 3.044; 95% CI, 1.116–8.305) were more likely to have unfavourable clinical outcomes compared with patients with LA 0–2 and FVH(+) but not compared with those with LA 0–2 and FVH(−) or LA 3–6 and FVH(−). In addition, FVH location did not influence the relationship between FVH and outcomes.

Conclusions

The association between FVH and outcomes was influenced by the degree of LA in the acute but not in the subacute and chronic stages of MCA infarction. FVH predicts clinical outcomes independently only in those with more extensive LA.

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Title: Association of FLAIR vascular hyperintensity and acute MCA stroke outcome changes with the severity of leukoaraiosis
Authors: W. J. Shang
L. M. Shu
X. Zhou
H. Q. Liao
X. H. Chen
H. Hong
H. B. Chen
Publication date: 01-11-2020
Publisher: Springer International Publishing
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Stroke
Published in: Neurological Sciences / Issue 11/2020
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-020-04411-8

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Association of FLAIR vascular hyperintensity and acute MCA stroke outcome changes with the severity of leukoaraiosis

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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