J Korean Neurol Assoc.  2024 Nov;42(4):331-339. 10.17340/jkna.2024.0034.

Association between Asymptomatic Cerebrovascular Stenosis and Early Neurological Deterioration in Single Subcortical Infarction Patients

• Hong SM
• Lee HL
• Kim H
• Choi KH
• Kim JT
• Park MS
• Kim BC

• KMID: 2560988
• DOI: http://doi.org/10.17340/jkna.2024.0034

Abstract

Background
Patients with ischemic stroke may experience early neurological deterioration (END) during the acute phase. This study aimed to identify association between asymptomatic vascular stenosis and END in single subcortical infarction patients.
Methods
The study included 562 patients admitted within 48 hours of symptom onset between January 2015 and August 2022. END was defined as a decrease of ≥1 point in the National Institutes of Health stroke scale (NIHSS) motor score or ≥2 points in the total NIHSS score within the first 48 hours after stroke onset. Clinical characteristics, including age, sex, smoking habits, underlying vascular risk factors, initial NIHSS score, trial of Org 10172 in acute stroke treatment classification, laboratory parameters, and presence of vascular stenosis or occlusion, were analyzed to identify predictors of END.
Results
END occurred in 115 patients (20%) with single subcortical infarction. Age (odds ratio [OR], 1.0; p=0.011), female sex (OR, 1.7; p=0.042), location of cerebral infarction at corona radiata (OR, 3.0; p=0.023), systolic blood pressure (OR, 1.0; p=0.011) and presence of asymptomatic vascular stenosis (OR, 2.2; p=0.019) were independently associated with END in multivariable logistic regression.
Conclusions
This study suggests that age, sex, location of cerebral infarction, systolic blood pressure and the presence of asymptomatic vascular stenosis are independent predictors of END.

Keyword

Neurological deterioration; Subcortical infarction; Asymptomatic vascular stenosis