Prevalence and Prognostic Factors of Cortical Laminar Necrosis in Acute Ischemic Stroke.

IF 2 4区医学 Q3 CLINICAL NEUROLOGY

Current neurovascular research Pub Date : 2023-01-01 DOI:10.2174/1567202620666230515152331

Zhi-Li Wang, Wei Qin, Yuelei Lyu, Wenli Hu

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引用次数: 0

Abstract

Background: Cortical laminar necrosis (CLN) is a specific type of cortical infarction, and little is known about its frequency and outcomes. We aimed to investigate the prevalence and outcomes of CLN caused by brain infarction and its prognostic factors.

Methods: This retrospective cohort study included patients with acute ischemic stroke (AIS) between 2019 and 2022 and for whom magnetic resonance images obtained at our center showed acute-stage CLN. Their medical records were collected and analyzed. An unfavorable outcome was defined as a modified Rankin Scale score of 3-6 at 90 days. Logistic regression was performed to identify independent predictors of an unfavorable outcome.

Results: Among 5548 consecutive patients with AIS, 151 patients (2.7%) were diagnosed with CLN, and 112 had CLN enrolled in the final analysis. At 90 days, 25 patients (22.3%) had an unfavorable outcome. Compared with the favorable group, poor outcome patients had higher rates of previous stroke (p = 0.012), higher National Institutes of Health Stroke Scale (NIHSS) scores at admission (p < 0.001), and were more likely to have early neurologic deterioration (END) (p = 0.014), diffuse ischemic lesions (p = 0.011), and lesions involving multiple lobes (p = 0.030). In multivariable analysis, the initial NIHSS score (OR, 1.258, (95% CI 1.090 - 1.453), p = 0.002) and END (OR, 5.695, [95% CI 1.410 - 23.007], p = 0.015) were independently associated with unfavorable outcome.

Conclusion: CLN is a rare ischemic event but has a good prognosis in most cases. A higher initial NIHSS score and END may predict an unfavorable outcome.

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急性缺血性脑卒中皮质层状坏死的患病率及预后因素分析。

背景:皮质层状坏死(CLN)是一种特殊类型的皮质梗死，其发病率和预后知之甚少。我们的目的是调查脑梗死引起的CLN的患病率和预后及其预后因素。方法:本回顾性队列研究纳入2019年至2022年间急性缺血性脑卒中(AIS)患者，这些患者在本中心获得的磁共振图像显示为急性期CLN。他们的医疗记录被收集和分析。不良结果定义为90天时改良Rankin量表得分为3-6分。进行逻辑回归以确定不利结果的独立预测因素。结果:在5548例连续AIS患者中，151例(2.7%)被诊断为CLN，最终分析中有112例患有CLN。在90天，25例患者(22.3%)出现不良结果。与预后良好组相比，预后差的患者既往卒中发生率更高(p = 0.012)，入院时美国国立卫生研究院卒中量表(NIHSS)评分更高(p < 0.001)，更有可能出现早期神经系统恶化(END) (p = 0.014)、弥漫性缺血性病变(p = 0.011)和多叶病变(p = 0.030)。在多变量分析中，初始NIHSS评分(OR, 1.258， (95% CI 1.090 - 1.453)， p = 0.002)和END (OR, 5.695， [95% CI 1.410 - 23.007]， p = 0.015)与不良结局独立相关。结论:CLN是一种罕见的缺血性事件，但大多数病例预后良好。较高的初始NIHSS评分和END可能预示不利的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current neurovascular research 医学-临床神经学

CiteScore

3.80

自引率

9.50%

发文量

审稿时长

3 months

期刊介绍： Current Neurovascular Research provides a cross platform for the publication of scientifically rigorous research that addresses disease mechanisms of both neuronal and vascular origins in neuroscience. The journal serves as an international forum publishing novel and original work as well as timely neuroscience research articles, full-length/mini reviews in the disciplines of cell developmental disorders, plasticity, and degeneration that bridges the gap between basic science research and clinical discovery. Current Neurovascular Research emphasizes the elucidation of disease mechanisms, both cellular and molecular, which can impact the development of unique therapeutic strategies for neuronal and vascular disorders.