White Matter Lesion Severity in Mild Acute Ischemic Stroke Patients and Functional Outcome After 1 Year

To determine if severity of visually assessed white matter disease is associated with disability after ischemic stroke. In this Berlin "Cream & Sugar" substudy, all first ischemic stroke patients who received magnetic resonance imaging and completed follow-up between January 2009 and D...

Full description

Saved in:

Bibliographic Details
Published in:	Stroke (1970) Vol. 43; no. 11; pp. 3046 - 3051
Main Authors:	LEONARDS, Christopher O, IPSEN, Nils, MALZAHN, Uwe, FIEBACH, Jochen B, ENDRES, Matthias, EBINGER, Martin
Format:	Journal Article
Language:	English
Published:	Hagerstown, MD Lippincott Williams & Wilkins 01-11-2012
Subjects:	Aged Biological and medical sciences Brain - pathology Female Follow-Up Studies Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Humans Image Interpretation, Computer-Assisted Magnetic Resonance Imaging Male Medical sciences Middle Aged Nerve Fibers, Myelinated - pathology Nervous system (semeiology, syndromes) Neurology Recovery of Function Stroke - pathology Treatment Outcome Vascular diseases and vascular malformations of the nervous system Human Cerebral infarction Stroke Nervous system diseases Prognosis Cardiovascular disease White matter Cerebral disorder ischemia Vascular disease white matter disease Central nervous system disease Brain ischemia Leucoaraïosis leukoaraiosis Cerebrovascular disease outcome
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	To determine if severity of visually assessed white matter disease is associated with disability after ischemic stroke. In this Berlin "Cream & Sugar" substudy, all first ischemic stroke patients who received magnetic resonance imaging and completed follow-up between January 2009 and December 2010, were enrolled. Severity of white matter disease was assessed on fluid-attenuated inversion recovery or T2-weighted sequences using the Wahlund and Fazekas visual scales. Functional outcome was assessed after 1 year using the modified Rankin Scale (follow-up [FU] modified Rankin Scale [mRS]). Of 101 patients (37% female; median age, 67 years; interquartile range, 54-75; National Institutes of Health Stroke Scale score, 1; interquartile range, 0-2), median FU mRS was 1 (interquartile range, 0-2). Binary logistical regression adjusted for age (at 5-year intervals), acute National Institutes of Health Stroke Scale scores, fasting glucose, insulin, glycosylated hemoglobin, creatinine, C-reactive protein quartiles, waist circumference, and systolic blood pressure revealed that Fazekas scores of 2 and 3 independently associated with FU mRS (Fazekas score 2: adjusted odds ratio, 8.4; 95% confidence interval, 2.35-30.09; P=0.001; Fazekas score 3: adjusted odds ratio, 4.2; 95% confidence interval, 1.04-16.96; P=0.044). Wahlund scores>10 were significantly associated with FU mRS when fasting glucose levels were removed from the regression analysis (adjusted odds ratio, 12.17; 95% confidence interval, 1.91-77.54; P=0.008). Severe white matter disease defined by standard criteria in acute ischemic stroke patients is associated with disability at 1 year and can be assessed quickly using visual rating scales. URLs: http://www.clinicaltrials.gov and https://eudract.ema.europa.eu. Unique identifiers: NCT 01378468 and 2009-010356-97.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0039-2499 1524-4628
DOI:	10.1161/strokeaha.111.646554