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The Relationship between CT Angiography Collateral Score and Biochemical Parameters during Acute Ischemic Stroke
Halil Güllüoğlu1, Hasan Armağan Uysal1, Erkan Şahin2
1Department of Neurology, Izmir Ekonomi University Medical Point Hospital, Izmir 35575, Turkey.
Insights
Biochemical markers significantly correlate with collateral circulation in acute ischemic stroke (AIS) patients within 9 hours. These findings aid in predicting outcomes and guiding treatment for MCA infarction.
Area of Science:
- Neurology
- Biochemistry
- Radiology
Background:
- Collateral development is crucial for prognosis and treatment in acute ischemic stroke (AIS).
- Understanding factors influencing collateralization aids in patient management.
- CT angiography is vital for assessing collateral status.
Purpose of the Study:
- To investigate the correlation between biochemical parameters and CT angiography collateral score in AIS patients.
- To determine the effect of collateralization on neurological outcomes in MCA infarction.
- To identify specific biochemical markers associated with collateral distribution.
Main Methods:
- A cohort of 98 patients with MCA infarction underwent CT angiography within 9 hours of stroke onset.
- Demographic, biochemical, and clinical data, including NIHSS scores, were collected.
- Souza's scoring system was used to evaluate collateral distribution.
Main Results:
- A significant association was found between various biochemical markers (uric acid, lipids, inflammatory markers, coagulation factors, etc.) and collateral distribution.
- Patients with a malignant collateral profile had higher NIHSS scores (27) compared to those with a good profile (9).
- Specific biochemical parameters showed statistically significant differences based on collateral distribution.
Conclusions:
- Biochemical parameters significantly influence the development of malignant and benign collaterals in AIS.
- These associations are independent of patient age and gender.
- Identifying these biochemical links can improve prognostication and treatment strategies for AIS.
Abstract:
Background/Objectives: Collateral development after AIS is important for prognosis and treatment. In this study, we aimed to investigate the relationship and correlation between biochemical parameters and CT angiography collateral score within the first 9 h and its effect on the neurological outcomes of patients with AIS due to MCA infarction. Methods: A total of 98 patients with MCA infarction were hospitalized for diagnosis and treatment after undergoing CT angiography within 9 h of suffering a stroke. Demographic data, admission biochemical parameters, hospitalization data, and discharge NIHSS scores were recorded. Souza's scoring system for collateral distribution was used to evaluate collaterals. Souza CS system and clinical disability comparison outcomes identified. Results: According to the Souza CS system, 13 patients were in the malignant profile category, and 85 patients were in the good profile category. The NIHSS value of patients with a malignant profile was 27, while the mean NIHSS value of patients with a good profile was 9. There was a statistically significant difference in uric acid, total cholesterol, triglyceride, HDL cholesterol, CRP, hsCRP, D-Dimer, troponin I, vitamin B12, fibrinogen, NSE, homocysteine, aPTT, and INR levels according to collateral distribution. Conclusions: This study demonstrates that biochemical parameters can influence the distribution of malignant and benign collaterals in AIS independent of age and gender.
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