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In acute ischemic stroke caused by occlusion of large vessels , the occluded arteries are recanalized through intravenous or endovascular treatment, which aims to quickly restore the blood supply to the ischemic brain tissue and prevent the expansion of the disease .
Previous studies using CT or magnetic resonance imaging have shown that ischemic lesions are not stable.
In fact, they continue to develop after treatment .
Due to the cascade of various pathophysiological processes, such as excitotoxicity, oxidative stress, destruction of the blood-brain barrier, microvascular injury and inflammation, there may be continued damage after the initial ischemic injury
.
However, the relationship between the evolution of ischemic lesions and functional outcomes after subacute treatment is still unclear
In this way, Praneeta Konduri and others of the University of Amsterdam in the Netherlands explored: In patients with acute ischemic stroke caused by large vessel occlusion, the evolution of ischemic lesions in the subacute phase from 24 hours to 1 week after the stroke and the functional outcome after 90 days Relationship between
.
In addition, the impact of successful recanalization on this relationship was also evaluated
The evolution of the lesion was defined as the difference between the volume measured by non-contrast CT at 1 week and 24 hours
.
Unadjusted and adjusted logistic regression was used to assess the relationship between lesion evolution and functional outcome
The baseline, clinical, and imaging parameters were adjusted.
These parameters were associated with favorable functional outcomes in univariate analysis and were defined as a modified Rankin scale score ≤2
Of the 226 patients included, 69 (31%) achieved good functional results
.
The median of lesion evolution was 22 (interquartile range, 10-45) mL
The evolution of the lesion is obviously inversely proportional to the good functional outcome : the unadjusted OR was 0.
76 (95% CI, 0.
66-0.
The evolution of the disease is obviously inversely proportional to the good functional outcome
In the relationship between lesion evolution and good functional outcome, successful recanalization had no significant interaction (OR=1.
01[95%CI, 0.
77-1.
36]; P=0.
94)
.
The important significance of this study lies in the discovery that the evolution of subacute ischemic lesions is related to adverse functional outcomes
.
Even 24 hours after the onset of the stroke, the deterioration of the brain continues, which has an adverse effect on the functional outcome
The evolution of subacute ischemic lesions is related to adverse functional outcomes
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