Preexisting Cerebral Abnormalities and Functional Outcomes After Acute Ischemic Stroke

Area of Science:

• Neurology
• Neuroimaging
• Stroke Medicine

Background:

• Acute ischemic stroke significantly impacts patient function.
• Preexisting cerebral abnormalities may influence stroke recovery.
• Identifying predictors of functional outcomes is vital for patient management.

Purpose of the Study:

• To investigate the association between preexisting cerebral abnormalities and functional outcomes in acute ischemic stroke patients.
• To determine if specific MRI-detected abnormalities predict long-term functional status.

Main Methods:

• 272 patients with first-ever acute ischemic stroke were recruited.
• Cerebral abnormalities (infarcts, SBI, WMLs, atrophy) were assessed via MRI.
• Functional outcomes (IADL, BADL) were evaluated at 3 and 6 months post-stroke.

Main Results:

• Poor functional outcomes were associated with older age, male sex, higher NIHSS scores, and specific stroke subtypes.
• Cortical/subcortical/infratentorial infarcts, larger infarct volume, SBI, severe WMLs, and MTLA were linked to poorer outcomes.
• NIHSS, subcortical infarcts, and MTLA predicted poor IADL at 3 months; NIHSS, SBI, and MTLA predicted poor IADL at 6 months.

Conclusions:

• Silent brain infarcts (SBI) and severe medial temporal lobe atrophy (MTLA) are significant predictors of poorer functional outcomes after acute ischemic stroke.
• These findings underscore the importance of preexisting cerebral abnormalities in predicting stroke recovery.