Characterizing anterior and posterior circulation strokes using high-resolution magnetic resonance imaging

Area of Science:

• Neurology
• Radiology
• Cardiovascular Science

Background:

• Intracranial atherosclerosis (ICAS) poses varying risks for anterior circulation stroke (ACS) and posterior circulation stroke (PCS).
• Understanding clinical risk factors influencing these differences is crucial for effective patient management.

Purpose of the Study:

• To investigate the impact of clinical risk factors on ICAS features in ACS and PCS using high-resolution magnetic resonance imaging (HR-MRI).
• To specifically analyze arterial remodeling patterns in relation to stroke circulation and risk factors.

Main Methods:

• Retrospective, cross-sectional study of 208 patients with acute ischemic stroke or transient ischemic attack (TIA) undergoing HR-MRI.
• Comparison of plaque characteristics and remodeling patterns between ACS and PCS groups.
• Analysis of clinical and radiological features, including factors associated with arterial remodeling.

Main Results:

• Posterior circulation stroke (PCS) was significantly associated with diabetes and positive remodeling.
• Differences in HbA1c, fibrinogen levels, and plaque enhancement were noted between ACS and PCS.
• Smoking and uric acid levels were identified as independent factors associated with non-positive remodeling.

Conclusions:

• HR-MRI effectively differentiates risk factors and plaque characteristics between ACS and PCS.
• Smoking and uric acid levels are key predictors of non-positive arterial remodeling in ICAS.
• These findings underscore HR-MRI's role in identifying plaque vulnerability and guiding clinical interventions for stroke prevention.