Related Experiment Video
Updated: Aug 6, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
CT angiography in acute stroke: does it provide additional information on occurrence of infarction and functional
Martin A Ritter1, Tobias Poeplau, Anne Schaefer
1Department of Neurology, University of Münster, Münster, Germany. ritterm@uni-muenster.de
Insights
Acute phase CT angiography (CTA) findings in ischemic stroke do not independently predict poor functional outcomes. While initial analysis showed correlations, only stroke severity, measured by NIHSS, predicted outcomes after adjustments.
Area of Science:
- Neurology
- Radiology
- Stroke Medicine
Background:
- Ischemic stroke requires timely and accurate prognostication.
- Intracranial CT angiography (CTA) is used in acute stroke assessment.
- Predicting long-term functional outcomes remains a clinical challenge.
Purpose of the Study:
- To determine if acute intracranial CTA findings independently predict stroke infarction.
- To assess if acute intracranial CTA findings predict functional outcomes at 3 months.
- To evaluate the prognostic value of CTA in acute ischemic stroke.
Main Methods:
- 151 acute ischemic stroke patients (<12h) underwent intracranial CTA.
- Stroke severity assessed by NIHSS; functional outcome by modified Rankin Scale at 3 months.
- Logistic regression analyzed CTA findings, NIHSS, age, sex, therapy, and time to presentation for prediction.
Main Results:
- 40% of patients had pathological CTA findings.
- Pathological CTA correlated with infarction (98%) and dependency (p<0.001) in univariate analysis.
- Only NIHSS score (≥10) independently predicted dependency at 3 months (p<0.001) after multivariate adjustment.
Conclusions:
- Acute phase intracranial CTA findings are not independent predictors of poor functional outcome in ischemic stroke.
- Stroke severity (NIHSS) is a stronger predictor of long-term functional outcome.
- CTA's role in predicting outcomes requires further investigation beyond initial pathological findings.
Objective:
To investigate whether acute phase intracranial CT angiography (CTA) independently predicts infarction and functional outcome in ischemic stroke.
Methods:
Hundred and fifty-one consecutive patients with acute (<12 h) ischemic stroke who received intracranial CTA were investigated. Stroke severity on admission was determined using the National Institute of Health Stroke Scale (NIHSS). Reconstructed CTAs were investigated for relevant pathology. Follow-up imaging was performed 24-48 h after admission. Functional outcome was assessed after 3 months using the modified Rankin scale. Single factor and multiple logistic regression analyses were performed to predict infarction and dependency (modified Rankin scale > or = 3) on follow-up.
Results:
Median NIHSS on admission was 10 (IQR 3-14). Out of the 151 patients, 61 (40%) had pathological CTA findings. Infarction was demonstrated in 60/61 patients (98%) with and in 67/90 patients (74%) without vessel pathology. Presence of infarction on follow-up imaging and dependency at 3 months were correlated with pathological CTA findings on admission in single factor analysis (each p < 0.001). After adjustment for age (> or =/<65 years), NIHSS (> or =/<10), sex, therapy, and time to presentation (> or =/<3 h), only NIHSS > or = 10 on admission was predictive of dependency at follow-up (p < 0.001).
Conclusions:
Pathological CTA findings in the acute phase of ischemic stroke do not independently predict a poor outcome at 3 months after acute stroke.
