Early Brain Volume Changes After Stroke: Subgroup Analysis From the AXIS-2 Trial.

Area of Science:

• Neurology
• Radiology
• Neuroimaging

Background:

• Understanding early brain volume changes after stroke is crucial.
• The evolution of total brain volume in the initial month post-stroke remains poorly understood.

Purpose of the Study:

• To investigate the associations between patient age, specific imaging features, and brain volume changes in the first month following an acute ischemic stroke.

Main Methods:

• Retrospective analysis of 173 acute ischemic stroke patients from the AXIS-2 trial.
• Total brain volume change was assessed using unified segmentation in SPM12 from hyperacute MRI to 1-month follow-up.
• Evaluated associations between age, baseline diffusion-weighted imaging (DWI) lesion size, white matter hyperintensities (WMH), enlarged perivascular spaces (EPVSs), and lacunes with brain volume change.

Main Results:

• A median brain volume decrease of 6 ml (0.5%) was observed over the first month post-stroke.
• Older age was significantly associated with greater brain volume loss (5 ml per 10 years).
• Increasing deep white matter hyperintensities (WMH) correlated with greater tissue loss (5 ml), while baseline lesion size showed no significant association.

Conclusions:

• Brain volume changes heterogeneously in the first month after stroke.
• Age and deep white matter disease are key factors associated with early brain volume loss post-stroke.
• No evidence suggests that more severe strokes lead to increased early tissue loss.