Inflammatory lesions in the paranasal sinuses in patients with ischemic stroke who underwent mechanical thrombectomy

Chronic rhinosinusitis is one of the most widespread chronic diseases in the world, whereas stroke is the leading cause of death and disability. There are numerous reports on the relationship between chronic inflammatory diseases and cardio‑cerebrovascular diseases.

The study aimed to assess whether inflammatory lesions in the sinuses can be a risk factor for stroke, similar to other known risk factors such as arterial hypertension, atrial fibrillation, atherosclerosis, diabetes, or cigarette smoking.

We analyzed the results of head computed tomography performed in 163 patients with ischemic stroke (79 men) at a mean (SD) age of 68.5 (12.7) years who were deemed eligible for mechanical thrombectomy. The control group included 75 patients (31 men) with neurological diseases of nonvascular origin.

Among patients with stroke, inflammatory lesions in the sinuses were found in 95 individuals (58.3%), with a frequency comparable to that of atrial fibrillation (77 [47.2%]). Chronic rhinosinusitis occurred more often than diabetes (33 [20.2%]; P <0.001) and self‑reported nicotinism (18 [11%]; P <0.001), yet less frequently than arterial hypertension and generalized atherosclerosis (124 [76.1%]; P <0.001 and 116 [71.2%]; P = 0.02, respectively). Inflammatory sinus lesions of moderate or high severity were more often observed in patients with stroke than in the control group and they mainly involved the ethmoid sinuses.

Moderate‑to‑severe inflammatory lesions indicating chronic rhinosinusitis are common in patients with stroke, which suggests the role of local inflammation in inducing acute cerebral ischemia.