Intracranial Thrombus Morphology and Composition Undergoes Time-Dependent Changes in Acute Ischemic Stroke: A CT...

Area of Science:

• Neurology
• Radiology
• Biochemistry

Background:

• Acute ischemic stroke is often caused by cerebral artery clots.
• Understanding clot changes is crucial for effective treatment.
• Time-dependent alterations in clot morphology and composition are not fully characterized.

Purpose of the Study:

• To investigate time-dependent changes in the morphology and composition of cerebral artery clots in acute ischemic stroke.
• To correlate these changes with time from symptom onset, clinical severity, stroke etiology, and laboratory parameters.

Main Methods:

• Retrospective chart review of 2565 patients admitted within 5 hours of symptom onset to three European stroke centers.
• Analysis of non-contrast-enhanced CT (NECT) scans for hyperdense artery signs (HAS).
• Evaluation of clot occlusion site, density (HU), area, and relative density (rHU) in relation to time.

Main Results:

• A time-dependent loss of clot density was observed in the M1 segment within the first 5 hours (p=0.01).
• Thrombus area in the M2 segment showed a decrease over time (p=0.02).
• Lower clot area, particularly in the M2 segment, was associated with higher fibrinogen levels (p=0.009).

Conclusions:

• Intracranial thrombi exhibit significant time-dependent changes in density and area within the initial 5 hours of acute ischemic stroke.
• These findings highlight the dynamic nature of clots and their potential association with specific biomarkers like fibrinogen.
• Further research can leverage these insights for improved stroke diagnosis and therapeutic strategies.