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Performing Permanent Distal Middle Cerebral with Common Carotid Artery Occlusion in Aged Rats to Study Cortical Ischemia with Sustained Disability
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Hyperdense middle cerebral and/or internal carotid arteries in acute ischemic stroke: rate, predictive factors and

Maurizio Paciaroni1, Giancarlo Agnelli, Piero Floridi

  • 1Stroke Unit, Division of Cardiovascular Medicine, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy. mpaciaroni@med.unipg.it

Cerebrovascular Diseases (Basel, Switzerland)
|August 24, 2011
PubMed

Insights

Hyperdense arteries in the middle cerebral artery (MCA) and internal carotid artery (ICA) occur in about 15% of acute stroke patients. These findings are linked to larger infarcts and poorer functional outcomes at three months.

Area of Science:

  • Neurology
  • Radiology
  • Clinical Medicine

Background:

  • Hyperdense signs in the middle cerebral artery (MCA) and internal carotid artery (ICA) on CT scans indicate early ischemia in acute stroke patients.
  • The prognostic significance of these hyperdense signs has not been fully established.

Purpose of the Study:

  • To determine the incidence of hyperdense MCA and/or ICA in acute ischemic stroke patients.
  • To identify risk factors associated with hyperdense MCA and/or ICA.
  • To evaluate the correlation between hyperdense MCA and/or ICA and functional outcomes at 3 months post-stroke.

Main Methods:

  • A prospective single-center cohort study included consecutive patients admitted with ischemic stroke from January 2006 to June 2010.
  • Data collected included patient demographics, stroke characteristics, and CT scan findings.
  • Functional outcomes were assessed at 3 months, with analysis of factors associated with adverse outcomes.

Main Results:

  • Of 1,010 patients, 14.7% exhibited hyperdense MCA and/or ICA.
  • Patients with hyperdense arteries were more likely to have infarcts covering over one-third of the MCA territory (52.7% vs. 9.9%).
  • Independent predictors of adverse 3-month outcomes included age, NIH Stroke Scale score, atherosclerosis, hemorrhagic transformation, and hyperdense MCA and/or ICA (OR 2.0).

Conclusions:

  • Approximately 15% of acute ischemic stroke patients present with hyperdense MCA and/or ICA.
  • Hyperdense MCA and/or ICA are associated with larger final infarcts.
  • The presence of hyperdense MCA and/or ICA is a significant predictor of poor functional outcome at 3 months.
Abstract

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