Prevalence and prognosis of intracranial stenosis in acute ischemic stroke;a single center registry from Turkey

Abstract

The medical records of 619 consecutive patients who were admitted with acute ischemic stroke from January 2012 to November 2014 were retrospectively evaluated. Approval was obtained from the research ethics committee in advance of the study. ICS was defined as any intracranial stenosis >50% on cerebrovascular imaging such as computerized tomography angiography, magnetic resonance angiography, or digital subtraction angiography performed within 1 week of ischemic stroke. The degree of stenosis was calculated according to the WASID method (22). Clot was defined if there was an angiographic evidence of abrupt cut-off or there was vascular imaging evidence that the occluded intracranial artery has been completely recanalized. The patients were divided into two groups: group 1 included patients with ICS and group 2 included patients without ICS.Patient demographics and medical risk factors, including history of hypertension, diabetes, hyperlipidemia, atrial fibrillation, congestive heart failure, coronary artery disease, previous transient ischemic attack, previous Background/aim: Intracranial stenosis (ICS) is identified in 2.2%-70.4% of patients with ischemic stroke and transient ischemic attack. This study aimed to determine the prevalence of ICS in a single center registry from Turkey. Materials and methods:We reviewed the charts of 619 patients with acute ischemic stroke. ICS was defined as any ICS > 50% on cerebrovascular imaging. The demographic data, risk factors, NIHSS scores and C reactive protein level at admission, mortality in hospital, recurrent stroke, and mRS in the follow-up period were recorded.Results: A total of 72 (11.6%) patients with ICS (45 males (62.5%); mean age 68.3 ± 12.6 years) were included. Sixty-seven patients (10.8%) had symptomatic ICS and 44 patients (7.1%) had ICS without extracranial stenosis. Diabetes mellitus (DM) was significantly higher in the ICS group compared to the others (P = 0.017). Disability was significantly better in patients with ICS compared to the others (P < 0.001). On logistic regression analysis, DM and follow up mRS were significantly associated with ICS (P < 0.05). Conclusion:ICS was seen in 11.6% of acute ischemic stroke cases in our registry. DM appears to be the major risk factor for ICS. Disability was better in patients with ICS. Ethnicity could be a factor causing better disability.