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Ischemic Stroke and Asymptomatic Pulmonary Opacities.

Carmelo Tiberio Currò1, Masina Cotroneo1, Antonio Ciacciarelli1

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Summary

Asymptomatic pulmonary opacities (APO) in ischemic stroke patients are linked to atrial fibrillation (AF). However, APO do not predict neurological or functional outcomes in these patients.

Keywords:
Asymptomatic pulmonary opacitiesAtrial fibrillationInflammationIschemic strokePneumonia

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Area of Science:

  • Neurology
  • Radiology
  • Cardiology

Background:

  • Pulmonary opacities are frequently observed in chest radiographs of stroke patients.
  • These opacities are often asymptomatic, posing a diagnostic challenge.
  • Understanding their clinical significance in ischemic stroke is crucial.

Purpose of the Study:

  • To investigate the clinical features associated with asymptomatic pulmonary opacities (APO) in ischemic stroke patients.
  • To evaluate the prognostic value of APO in predicting neurological severity and functional outcomes.

Main Methods:

  • Prospective analysis of acute ischemic stroke patients without pneumonia symptoms.
  • Chest X-ray performed within 48 hours of admission.
  • Comparison of clinical, laboratory, and echocardiographic parameters between patients with and without APO.
  • Evaluation of APO as a predictor of discharge neurological severity and 90-day functional outcome.

Main Results:

  • APO were significantly associated with higher neutrophil counts, atrial fibrillation (AF), cardioembolic etiology, and thrombectomy.
  • Patients with APO had higher admission and discharge National Institutes of Health Stroke Scale (NIHSS) scores.
  • APO were associated with worse 90-day modified Rankin Scale (mRS) scores on univariate analysis.
  • Multivariate analysis revealed APO were significantly associated with admission NIHSS and AF.

Conclusions:

  • Asymptomatic pulmonary opacities in acute ischemic stroke are associated with atrial fibrillation.
  • APO were not found to be an independent predictor of neurological or functional outcomes in this cohort.