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Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
Published on: September 25, 2019
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Hyperdense cerebral artery computed tomography sign is associated with stroke severity rather than stroke subtype
Jana Novotná1, Pavla Kadlecová2, Anna Czlonkowska3
1International Clinical Research Center, Department of Neurology, St. Anne's Hospital, Brno, Czech Republic; Masaryk University, Brno, Czech Republic.
Summary
The hyperdense cerebral artery sign (HCAS) on CT scans for acute ischemic stroke is linked to stroke severity, not stroke type. Detection rates for HCAS varied significantly across different stroke centers.
Area of Science:
- Neurology
- Radiology
- Stroke Medicine
Background:
- The hyperdense cerebral artery sign (HCAS) on unenhanced computed tomography (CT) is a marker in acute ischemic stroke.
- Its association with clot composition and stroke etiology requires further investigation.
Purpose of the Study:
- To identify factors independently associated with HCAS in patients receiving intravenous thrombolysis.
- To analyze the relationship between HCAS and stroke characteristics using a large international dataset.
Main Methods:
- Analysis of data from the Safe Implementation of Treatments in Stroke-EAST (SITS-EAST) database (February 2003 - December 2011).
- Utilized a general estimating equation model to account for within-center clustering and identify factors associated with HCAS.
Main Results:
- HCAS was detected in 19% of 8375 analyzed patients.
- HCAS independently correlated with higher baseline National Institutes of Health Stroke Scale (NIHSS) scores, vessel occlusion, early ischemic CT changes, and year of treatment.
- Age was inversely associated with HCAS, while cardioembolic stroke was not independently associated with HCAS after adjusting for NIHSS.
Conclusions:
- Significant inter-center variability exists in the detection of HCAS in routine clinical practice.
- Stroke subtype was not independently associated with HCAS; however, HCAS was significantly associated with the severity of the neurological deficit.
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