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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
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Location-Specific ASPECTS Paradigm in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis
S M Seyedsaadat1, A A Neuhaus2, J M Pederson3,4
1From the Department of Radiology (S.M.S., W.B., D.F.K.).
AJNR. American Journal of Neuroradiology
|October 16, 2020
Summary
The ASPECTS M6 region significantly predicts poor outcomes in acute ischemic stroke patients. However, other ASPECTS regions showed no significant differences in predicting outcomes, necessitating further research in larger cohorts.
Area of Science:
- Neuroimaging
- Stroke Medicine
- Radiology
Background:
- The Alberta Stroke Program Early CT Score (ASPECTS) is crucial for evaluating acute ischemic stroke.
- Weighting neuroimaging findings by brain region eloquence may enhance ASPECTS' predictive accuracy.
- Informed treatment decisions in acute ischemic stroke can benefit from improved prognostic tools.
Purpose of the Study:
- To investigate the specific contribution of infarcts within ASPECTS-defined regions to patient outcomes.
- To determine if individual ASPECTS regions have differential impacts on acute ischemic stroke prognosis.
Main Methods:
- A systematic literature search was conducted on MEDLINE and EMBASE for studies published between 2000 and March 2019.
- Two independent reviewers extracted data, focusing on ASPECTS scoring and 3-month functional outcomes (modified Rankin Scale > 2).
- A random-effects meta-analysis was performed, with subgroup analyses based on stroke laterality, imaging technique, and intervention.
Main Results:
- Infarct in the M6 ASPECTS region was significantly associated with poor functional outcomes (OR = 3.26).
- No significant differences were found in pairwise comparisons of most ASPECTS regions regarding poor outcomes, except for M6 versus the lentiform nucleus (P = .009).
- Subgroup analyses by stroke laterality, imaging modality, and treatment strategy did not reveal significant differences among ASPECTS regions.
Conclusions:
- Certain ASPECTS subregions, particularly M6, have a disproportionately significant impact on predicting acute ischemic stroke outcomes.
- Despite this, overall differences between ASPECTS regions in outcome prediction were limited, especially in subgroup analyses.
- Larger cohort studies are needed to further elucidate the association between specific ASPECTS regions and acute ischemic stroke outcomes.
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