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Clinical and Prognostic Characteristics of Acute BAD-Related Stroke: A Multicenter MRI-Based Prospective Study
Shengde Li1, Lihua Wang2, Bin Liu3
1Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China (S. Li, L.Z., Y.Z., J.N., B.P.).
Stroke
|September 24, 2024
Summary
Branch atheromatous disease (BAD)-related stroke, a distinct ischemic stroke subtype, shows unique characteristics. This study highlights its specific demographics, clinical features, and prognostic factors, including a high rate of early neurological deterioration.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Epidemiology
Background:
- Branch atheromatous disease (BAD)-related stroke is an understudied ischemic stroke subtype.
- Understanding its characteristics is crucial for targeted interventions and improved patient outcomes.
Purpose of the Study:
- To investigate the demographic, clinical, therapeutic, and prognostic features of BAD-related stroke.
- To characterize early neurological deterioration (END) and long-term outcomes in this patient cohort.
Main Methods:
- A nationwide, multicenter, prospective observational cohort study (BAD-study) in China.
- Enrolled 476 patients aged 18-80 with BAD-related stroke within 72 hours of onset.
- Assessed outcomes including good outcome (mRS 0-2), excellent outcome (mRS 0-1), END, and stroke recurrence at 90 days.
Main Results:
- Median age was 60 years, 70.2% male; median NIHSS score was 3.
- Lenticulostriate artery involvement was more common (60.7%) than paramedian pontine artery (39.3%).
- END occurred in 14.7% of patients; good and excellent outcomes were 86.5% and 72%, respectively. Stroke recurrence was 1.9% at 90 days. NIHSS score ≥4 and END predicted poor outcomes, while extracranial artery stenosis predicted good outcomes.
Conclusions:
- BAD-related stroke exhibits distinct demographic, clinical, and prognostic profiles, warranting classification as a separate entity.
- High incidence of END and low recurrence rate observed; acute-phase treatment strategies require further investigation.
