Hyper-attenuating brain lesions on CT after ischemic stroke and thrombectomy are associated with final brain...

Area of Science:

• Neurology
• Radiology
• Stroke Medicine

Background:

• Hyper-attenuating lesions on non-contrast computed tomography (NCCT) scans, also known as contrast staining, are studied as predictors of hemorrhagic transformation after endovascular treatment for acute ischemic stroke (AIS).
• The relationship between these hyper-attenuating lesions and the final extent of ischemic brain damage post-thrombectomy is less understood.

Purpose of the Study:

• To investigate the correlation between hyper-attenuating lesions observed on NCCT scans and the final infarcted areas in patients undergoing thrombectomy for AIS.
• To evaluate the predictive value of hyper-attenuating lesions for final infarct volume after endovascular stroke treatment.

Main Methods:

• Retrospective analysis of NCCT scans from patients with AIS in the anterior circulation who received endovascular treatment.
• Comparison of hyper-attenuating areas identified on early and late post-thrombectomy NCCT scans with final ischemic areas using the Alberta Stroke Program Early CT Score (ASPECTS).

Main Results:

• The study included 71 out of 123 eligible patients.
• The association between hyper-attenuating regions and final ischemic areas demonstrated varying sensitivity (58.3%–96.9%), specificity (42.9%–95.6%), positive predictive values (71.4%–97.7%), negative predictive values (53.8%–79.5%), and accuracy (68%–91%).
• Highest sensitivity was noted for deep brain structures like the lentiform nucleus (96.9%) and caudate nucleus (80.4%), and the internal capsule (87.5%), while lower sensitivity was observed for cortical regions such as M1 (58.3%) and M6 (66.7%).

Conclusions:

• Hyper-attenuating lesions on post-endovascular treatment NCCT scans can serve as a predictor of the final brain infarcted area in AIS.
• The predictive capability of these lesions is more pronounced in deep brain regions than in cortical areas.