Are prominent medullary veins better than prominent cortical veins as predictors of early clinical outcome in patients with acute ischemic stroke?

Özet

PURPOSEThe prominent vessel sign (PVS) on susceptibility-weighted imaging (SWI) can be dichotomized into prominent cortical veins (PCV) and prominent medullary veins (PMV). This studywas designed to compare the predictive value of PCV and PMV in the evaluation of the severity of acute ischemic stroke (AIS) in patients within the reperfusion window.METHODSForty-seven consecutive patients with AIS within the middle cerebral artery territory wererecruited. Magnetic resonance imaging was performed within 8 hours of symptom onset andat 7 days after stroke onset. Infarct volume was measured, and the early clinical outcome at7 days was assessed using the modified Rankin Scale. PVS was dichotomized into cases withboth PCV and PMV and cases with only PCV according to location.RESULTSPatients with both PCV and PMV (n=32) had higher admission National Institutes of HealthStroke Scale scores (p = 0.020), larger infarct volumes at baseline (p = 0.026) and 7 days (p =0.007), and larger infarct growth at 7 days (p = 0.050) than those with PCV only. Multivariateregression analysis showed that both the time of onset at baseline (p = 0.013) and infarctgrowth at 7 days (p = 0.014) could independently predict poor early clinical outcome.CONCLUSIONPMV may predict poor early clinical outcome in AIS patients, and reperfusion therapy may,therefore, be required more urgently in patients with PMV.