Final infarct volume discriminates outcome in mild strokes

Neuroradiol J. 2015 Aug;28(4):404-8. doi: 10.1177/1971400915609347. Epub 2015 Oct 1.

Abstract

Introduction: Knowledge of whether final infarct volume (FIV) predicts disability after mild stroke is limited. We sought to determine if FIV could differentiate good versus poor outcome after mild stroke.

Methods: We retrospectively identified 65 patients with mild stroke (National Institutes of Health Stroke Scale≤5) in a multicenter registry of 2453 patients. We evaluated associations between FIV and clinical outcome and evaluated the optimal FIV threshold that discriminated favorable (modified Rankin scale (mRS) 0-1) versus poor (mRS 2-6) outcome.

Results: The FIV cut-point of 20 mL differentiated favorable and poor outcomes (area under curve (AUC) 0.73, 95% confidence interval: 0.58-0.88). Favorable outcome was observed in 37/45 (82%) with FIV<20 mL, compared to 5/14 (36%) with FIV≥20 mL (p<0.01). FIV≥20 mL remained strongly associated with poor outcome independent of age, gender, stroke severity, Alberta Stroke Program Early CT Score (ASPECTS), and proximal arterial occlusion.

Conclusion: In our small sample size, an FIV of 20 mL best differentiated between the likelihood of good versus poor outcome in patients with mild stroke. Further validation of infarct volume as a surrogate marker in mild stroke is warranted.

Keywords: Final infarct volume; mild stroke; outcome.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cerebral Infarction / diagnostic imaging*
  • Cerebral Infarction / pathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Registries
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Stroke / diagnostic imaging*
  • Stroke / pathology
  • Tomography, X-Ray Computed
  • United States