A lesion extending three or more slices as a predictor of progressive infarction in anterior circulation small subcortical infarction

Lin, Jing; Mao, Xiaocheng; Liao, Yunfang; Luo, Si; Huang, Qin; Song, Ziwei; Li, Shumeng; Li, Chengjin; Qiu, Yuexin; Wu, Yuhang; Zhu, Min; Li, Xiaobing; Yu, Qiulong; Hong, Daojun

doi:10.3389/fneur.2022.926187

Cited by 5 publications

(11 citation statements)

References 19 publications

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“…The layers of slices were defined as a variable because multiple layers represented the enlargement of the infarct volume, leading to neurological deterioration in patients with SVD [ 34 ]. Previous studies indicated that the number of slices significantly differed between patients with and without END [ 15 , 35 ]. However, in the present study, neither BAD nor the visible layers of axial slices on DWI would be associated with the risk of END.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for early neurologic deterioration in single small subcortical infarction without carrier artery stenosis: predictors at the early stage

et al. 2023

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Objectives This study aimed to assess the epidemiological features and explore the potential risk factors for early neurological deterioration (END) in patients with acute single small subcortical infarction (SSSI) who underwent antiplatelet therapy without carotid artery stenosis. Materials & methods Patients with SSSI, as confirmed by cranial magnetic resonance imaging (MRI), who were hospitalized within 48 h after the onset of symptoms were enrolled. END was mainly defined as increment in the National Institutes of Health Stroke Scale (NIHSS) score of ≥ 2 points or any new neurological deficit. Poor functional outcome was defined as modified Rankin Scale (mRS) score of > 2 points at 3-month after the onset. The association of END with multiple indicators was assessed at the early stage of admission using multivariate logistic regression analysis, and adjusted odds ratios (aORs) were calculated. Results A total of 280 patients were enrolled from June 2020 to May 2021, of whom, END occurred in 44 (15.7%) patients (median age, 64 years; 70.5% male), while END occurred during sleep in 28 (63.6%) patients. History of hypertension (aOR: 4.82, p = 0.001), infarction in internal capsule (aOR: 3.35, p = 0.001), and elevated level of low-density lipoprotein cholesterol (LDL-C; aOR: 0.036, p = 0.0016) were significantly associated with the risk of END. Patients with END (aOR: 5.74, p = 0.002), history of diabetes (aOR: 2.61, p = 0.020), and higher NIHSS scores at discharge (per 1-score increase, aOR: 1.29, p = 0.026) were associated with the poor functional outcome at 3-month after the onset. Conclusion Patients with a history of hypertension, infarction in internal capsule or a higher level of LDL-C were found to be at a higher risk of END.

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Section: Discussionmentioning

confidence: 99%

Risk factors for early neurologic deterioration in single small subcortical infarction without carrier artery stenosis: predictors at the early stage

et al. 2023

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“…ACSSI was defined as a single subcortical infarct supplied from the lenticulostriate artery, Heubner's artery or AchA 6 . PI was defined as an increase of ≥1 point in motor power or ≥2 points in the total NIHSS score within 7 days after admission, and extension of the original infarction was further confirmed by DWI or CT 8 …”

Section: Methodsmentioning

confidence: 99%

“…ACSSI was defined as a single subcortical infarct supplied from the lenticulostriate artery, Heubner's artery or AchA. 6 PI was defined as an increase of ≥1 point in motor power or ≥2 points in the total NIHSS score within 7 days after admission, and extension of the original infarction was further confirmed by DWI or CT. 8 792 ª 2024 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.…”

Section: Definitionmentioning

confidence: 99%

“…However, the predictive factors of END between the ACSSI and PCSSI are inconsistent, indicating that different mechanisms may be responsible for END at different lesion locations 12 . In addition, some intuitive imaging markers for predicting END are not universal in the ASCCI or PCSSI 8,13 . For example, our previous research showed that a lesion extending three or more slices could predict PI, but this cannot predict PI in PCSSI because the single infarction in the brainstem rarely extends three slices 8 .…”

Section: Introductionmentioning

confidence: 98%

“…Posterior circulation single subcortical infarction (PCSSI) usually results from the occlusion of perforating branches, including thalamoperforating branches, paramedian branches, and short circumferential branches 6 . Previous studies by others and our group have shown that multiple factors, including inflammatory factors, fast glucose levels, blood pressure variability, hypertriglyceridemia, and some imaging markers, are associated with END in patients with acute ischemic stroke 7–11 . However, the predictive factors of END between the ACSSI and PCSSI are inconsistent, indicating that different mechanisms may be responsible for END at different lesion locations 12 .…”

Section: Introductionmentioning

confidence: 99%

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A novel score to predict progression in anterior circulation single subcortical infarction patients

Lin,

Ruan,

Sun

et al. 2024

Ann Clin Transl Neurol

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ObjectiveProgressive infarction (PI) has a negative effect on functional prognosis. Our study aimed to develop and validate a risk score for predicting PI in patients with anterior circulation single subcortical infarction (ACSSI).MethodsBetween January 2020 and October 2022, we retrospectively enrolled 638 eligible patients with ACSSI. Two‐thirds of the eligible patients were randomly allocated to the training cohort (n = 425). Another resampling sample was formed through the bootstrap method and was used as the validation group (n = 425). Multivariate logistic regression analysis was used to identify the independent factors associated with PI. Each factor was then point assigned based on β‐coefficient and a risk scoring system was developed. This scoring system was internally validated through 1000‐bootstrap resamplings. The C‐statistic and Hosmer‐Lemeshow test were used to assess model discrimination and calibration.ResultsPI occurred in 121 patients, accounting for 19.0% of the total patients. A 7‐point NTS score system based on the initial NIHSS score, triglyceride‐glucose index, and the number of infarct slices on axial diffusion‐weighted imaging was developed. The NTS score showed good discrimination and calibration in the training cohort (C‐statistic = 0.686; p value of Hosmer–Lemeshow test = 0.797) and validation cohort (C‐statistic = 0.681; p value of Hosmer–Lemeshow test = 0.451). The three risk levels for predicting PI in the training and validation cohorts based on NTS score were as follows: low (0–2, 9.6% vs. 9.3%), intermediate (3–5, 28.2% vs. 26.7%), and high risk (6–7, 60.2% vs. 57.4%).InterpretationThe NTS score is a valid and convenient risk score for predicting PI in ACSSI patients.

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TG/HDL‐c ratio as a predictor of progressive infarction in patients with anterior circulation single subcortical infarction

Lin,

Dong,

Huang

et al. 2024

Brain and Behavior

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BackgroundThe contributors predicting progressive infarction (PI) in patients with anterior circulation single subcortical infarction (ACSSI) and pontine single infarction (PSI) may be unidentical. The role of triglyceride to high‐density lipoprotein cholesterol (TG/HDL‐c) ratio on PI is unclear. The purpose of our study is to evaluate the correlation between TG/HDL‐c ratio and PI in patients with ACSSI or PSI.MethodsBetween January 2020 and October 2022, we retrospectively enrolled 738 patients including 638 ACSSI patients and 100 PSI patients to analyze. Demographic characteristics, clinical information, and laboratory data were collected within 24 h of admission.ResultsPI occurred in 143 (19.4%) patients. In univariate analysis, patients with PI had higher initial National Institutes of Health Stroke Scale (NIHSS) scores, higher discharge NIHSS scores, higher levels of fasting glucose, total cholesterol, TG, low‐density lipoprotein cholesterol, and TG/HDL‐c ratio, but lower levels of creatinine compared to patients with non‐PI (p < .05). Furthermore, the results of the subgroup analyses revealed the independent association between TG/HDL‐c ratio and PI in ACSSI patients (OR 1.079, 95% CI 1.009–1.153, p = .026) rather than in PSI patients. Additionally, a receiver operating characteristic curve indicated that the optimal predictive cutoff value of the TG/HDL‐c ratio was 3.985, and a TG/HDL‐c ratio ≥3.985 was more likely to experience PI in ACSSI patients.ConclusionIn conclusion, the TG/HDL‐c ratio was independently associated with PI in patients with ACSSI.

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A lesion extending three or more slices as a predictor of progressive infarction in anterior circulation small subcortical infarction

Cited by 5 publications

References 19 publications

Risk factors for early neurologic deterioration in single small subcortical infarction without carrier artery stenosis: predictors at the early stage

Risk factors for early neurologic deterioration in single small subcortical infarction without carrier artery stenosis: predictors at the early stage

A novel score to predict progression in anterior circulation single subcortical infarction patients

TG/HDL‐c ratio as a predictor of progressive infarction in patients with anterior circulation single subcortical infarction

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