Title:Neuroimaging Marker-CT Perfusion of Early Neurological Deterioration
in Patients with Minor Stroke and Large Vessel Occlusion after Intravenous
Thrombolysis
Volume: 21
Issue: 2
Author(s): Hongli Zhang, Wanli Bao, Meiyan Yu, Xiang Li, Yongkun Gui, Hongkai Cui and Ping Zhang*
Affiliation:
- Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
Keywords:
Intravenous thrombolysis, early neurological deterioration, CT perfusion, NIHSS, minor stroke, intravenous thrombolysis.
Abstract:
Objective: Early Neurological Deterioration (END) is one of the complications in
Acute ischemic stroke (AIS) and relates to prognosis. However, the reason why it occurs is still
unclear. Our study is to investigate if CT perfusion (CTP) can predict END in patients with Minor
Stroke and Large Vessel Occlusion after Intravenous Thrombolysis (IVT).
Methods: Patients who underwent IVT with Large Vessel Occlusion were enrolled continuously
from January 2021 to August 2023. After evaluating the National Institutes of Health Stroke
Scale (NIHSS) score, they were divided into the END group (n=21) and the Non-END group
(n=20). Multivariate logistic regression analysis was performed to explore the factors of END.
Receiver-operating characteristic (ROC) curve analysis was also used to assess the discriminative
ability of CTP in predicting END.
Results: A total of 41 patients (mean age, 62.34 ± 10.82 years, 27 male) were finally included in
the analysis; 21 patients had END, and 9 patients underwent Endovascular thrombectomy
(EVT). Multivariate logistic regression analysis indicated that rCBV (OR=0.081, 95%CI=0.009-
0.721, p = 0.024) and admission-NIHSS (OR=1.990, 95%CI=1.049-3.772, p = 0.035) were significantly
associated with END. The area under the curve (AUC) of rCBV and NIHSS to discriminate
END were 0.708 and 0.758. We found patients with END had a higher modified Rankin
Scale (mRS) in 3 months.
Conclusions: The rCBV and NIHSS were associated with post-thrombolysis END and may become
reliable markers to predicate END. END might predict a poor 3-month functional outcome.
