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Predictive value of intracranial high-density areas in neurological function
Zhi-Juan Lu1, Jin-Xing Lai1, Jing-Ru Huang1
1Department of Neurology, Ganzhou People's Hospital, Ganzhou 341000, Jiangxi Province, China.
Insights
Intracranial high-density areas (HDAs) detected on CT scans after endovascular mechanical thrombectomy (EMT) indicate a poorer prognosis for acute ischemic stroke (AIS) patients. These findings also correlate with increased neurological deficits and severe depression and anxiety symptoms.
Area of Science:
- Neurology
- Radiology
- Stroke Medicine
Background:
- Intracranial high-density areas (HDAs) are increasingly recognized markers in stroke imaging.
- Their predictive value for post-treatment neurological function and mental health remains incompletely understood.
- Further investigation is crucial to clarify the prognostic significance of HDAs.
Purpose of the Study:
- To evaluate the predictive capability of intracranial HDAs for neurological outcomes and mental health.
- To assess the association between HDAs and prognosis following endovascular treatment for acute ischemic stroke (AIS).
Main Methods:
- A prospective study included 96 patients undergoing endovascular mechanical thrombectomy (EMT) for AIS.
- Cranial computed tomography (CT) scans were performed within 24 hours post-EMT.
- Neurological function (NIHSS), functional outcome (mRS), depression (SDS), and anxiety (SAS) were assessed.
Main Results:
- Patients with HDAs showed more severe neurological deficits and higher rates of disability (mRS).
- HDAs were associated with significantly higher scores for depression (SDS) and anxiety (SAS).
- Multivariate analysis confirmed HDAs as independent negative prognostic factors.
Conclusions:
- Intracranial HDAs on CT imaging predict a poor prognosis in AIS patients treated with EMT.
- HDAs are linked to worse neurological function and increased depressive and anxiety symptoms.
- This highlights the importance of identifying HDAs for risk stratification and patient management.
Background:
Intracranial high-density areas (HDAs) have attracted considerable attention for predicting clinical outcomes; however, whether HDAs predict worse neurological function and mental health remains controversial and unclear, which requires further investigation.
Aim:
To investigate the predictive value of intracranial HDAs for neurological function and mental health after endovascular treatment.
Methods:
In this prospective study, 96 patients with acute ischemic stroke (AIS) who accepted endovascular mechanical thrombectomy (EMT) were included. The enrolled patients underwent cranial computed tomography (CT) examination within 24 hours after EMT. Clinical data in terms of National Institutes of Health Stroke Scale (NIHSS), the 3-month modified Rankin Scale (mRS), self-rating depression scale (SDS), and self-rating anxiety scale (SAS) scores were collected and compared between patients with HDAs and non-HDAs and between patients with good and poor clinical prognosis.
Results:
Compared to patients without HDAs, patients with HDAs presented severe neurological deficits (admission NIHSS score: 18 ± 3 vs 19 ± 4), were more likely to have post-stroke disabilities (mRS < 3: 35% vs 62%), and suffered more severe depression (SDS score: 58 ± 16 vs 64 ± 13) and anxiety disorder (SAS score: 52 ± 8 vs 59 ± 10). Compared to patients with a good prognosis, patients with a poor prognosis presented severe neurological deficits (admission NIHSS score: 17 ± 4 vs 20 ± 3), were more likely to have HDAs on CT images (64% vs 33%), and suffered more severe depression (SDS score: 55 ± 19 vs 65 ± 11) and anxiety (SAS score: 50 ± 8 vs 58 ± 12). Multivariate analysis revealed that HDAs were independent negative prognostic factors.
Conclusion:
In conclusion, HDAs on CT images predicted poor prognosis and severe depressive and anxiety symptoms in patients with AIS who underwent EMT.
