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Territorial and cortical infarct patterns independently predicts early recurrent stroke in symptomatic intracranial atherosclerotic disease patients.
Recurrent stroke remains a significant concern in symptomatic intracranial atherosclerotic disease (ICAD), despite ongoing medical therapy. Even though both clinical and imaging features are believed to play a role, their relevance in non-Western populations is not well established; consequently, region-specific insights are needed. Therefore, the study led by Rinta Paul et al. aimed to determine the imaging and clinical predictors of early and late stroke recurrence in an Indian cohort within one month of symptom commencement.
In this ambispective cohort study, detailed imaging parameters, such as degree and length of arterial stenosis, infarct patterns, white matter hyperintensity, and collateral flow, were systematically assessed. The primary outcome was recurrence of ischemic stroke or transient ischemic attack within 3 months (early) and up to 1 year (late).
Statistical analyses were executed to check the predictors of recurrence. The analysis demonstrated a notable risk of stroke recurrence in symptomatic ICAD, driven by specific clinical and imaging factors. Of 229 patients, 24% experienced recurrent ischemic events within one year.
Importantly, multivariate analysis revealed that a territorial and cortical infarct patterns independently doubled the risk of early repeat stroke. This finding suggests that artery-to-artery embolism and unstable atherosclerotic plaques may play a central role in early post-event risk. In conclusion, the study reinforces the value of imaging features as key tools for assessing recurrence risk in symptomatic ICAD.
Cerebrovascular Diseases Extra
Imaging Markers Predict the Short-Term and Long-Term Stroke Recurrence in Symptomatic Intracranial Atherosclerotic Disease
Rinta Paul et al.
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