Capsular warning syndrome: clinical analysis and treatment

Area of Science:

• Neurology
• Stroke Medicine
• Clinical Neuroscience

Background:

• Capsular warning syndrome (CWS) is a rare condition characterized by recurrent transient lacunar syndromes.
• The underlying mechanisms and optimal clinical management of CWS are not well-established.
• This study investigates the clinical features of CWS and compares outcomes with and without rt-PA therapy.

Purpose of the Study:

• To elucidate the clinical characteristics of patients with Capsular Warning Syndrome (CWS).
• To evaluate and compare the therapeutic effects and prognosis of rt-PA versus no rt-PA treatment in CWS patients.
• To identify risk factors and common infarct locations in CWS.

Main Methods:

• A multicenter retrospective study involving 72 patients diagnosed with CWS between January 2013 and December 2018.
• Patients were categorized into rt-PA and no rt-PA treatment groups.
• Outcomes were assessed using the modified Rankin Scale (mRS) at 3 months, with a good prognosis defined as mRS ≤ 2.

Main Results:

• Hypertension and dyslipidemia were the most prevalent risk factors in the 72 included patients.
• Acute infarction lesions were detected in 80.55% of patients, predominantly in the internal capsule.
• No statistically significant difference in therapeutic effects or 3-month prognosis was observed between the rt-PA and no rt-PA groups (85.19% vs. 84.44% good prognosis).

Conclusions:

• The optimal treatment strategy for CWS remains undetermined.
• Intravenous thrombolysis (rt-PA) appears to be a safe treatment option for CWS patients.
• Despite frequent infarction, a favorable functional prognosis is achieved by over 80% of CWS patients.