[Hyperdense Middle Cerebral Arteries Sign Detected by Multi-mode CT in Acute Ischemic Stroke: A Cohort Study]

Area of Science:

• Neurology
• Radiology
• Stroke Medicine

Background:

• Acute ischemic stroke is a leading cause of disability and death.
• Early detection of large vessel occlusion (LVO) is critical for timely intervention.
• The hyperdense middle cerebral artery sign (HMCAS) is a potential early imaging marker.

Purpose of the Study:

• To investigate the association between HMCAS and LVO in acute ischemic stroke patients.
• To evaluate the predictive value of HMCAS for clinical outcomes, including hemorrhagic transformation and functional recovery.

Main Methods:

• Retrospective analysis of 292 acute ischemic stroke patients admitted within 6 hours of symptom onset.
• Logistic regression and ROC curve analysis were used to assess HMCAS for predicting LVO, hemorrhagic transformation, and 90-day functional outcomes.

Main Results:

• HMCAS was present in 17.1% of patients, with 82% of these having confirmed LVO.
• HMCAS demonstrated significant predictive value for LVO (AUC=0.682), outperforming early CT infarct signs.
• HMCAS was an independent predictor of hemorrhagic transformation and poor functional recovery at 90 days.

Conclusions:

• HMCAS is a valuable early indicator for LVO in acute ischemic stroke.
• The presence of HMCAS is associated with increased risk of hemorrhagic complications and adverse functional outcomes.
• HMCAS aids in risk stratification and management decisions for stroke patients.