Impact of cerebral venous reflux on functional outcome in patients with acute lacunar stroke

Several reports have shown that cerebral venous reflux was associated with cerebral small vessel disease. We assessed the association between cerebral venous reflux and functional outcome in patients with acute lacunar stroke.

Consecutive patients with acute lacunar stroke admitted within 7 days were enrolled. Cerebral venous reflux was deemed present when abnormal high signal intensity was observed in the internal jugular vein or dural venous sinuses on intracranial TOF-MRA at admission. The primary outcome was poor functional outcome, defined as a mRS score of 2-6 at 90 days. The association between cerebral venous reflux and functional outcome was assessed using the multivariable logistic regression model.

A total of 216 consecutive patients with acute lacunar stroke were analyzed. Of these 216 patients, 37 (17.1%) had cerebral venous reflux. Patients with cerebral venous reflux were significantly more likely to have poor functional outcome than those without cerebral venous reflux (83.3% vs. 51.5%, P <0.001). Cerebral venous reflux was independently associated with poor functional outcome (adjusted OR, 4.67; 95% CI, 1.56-14.00; P = 0.006).

Cerebral venous reflux seems to be associated with poor functional outcome in patients with acute lacunar stroke. Validation in additional studies is warranted.