Key result
Carotid intraplaque hemorrhage is linked to greater ischemic stroke severity on NIHSS.
Why the study?
Plaque characteristics are significantly associated with ischemic stroke severity, prompting the study to correlate atheromatous plaque characteristics with NIHSS presentation scores.
Are specific carotid atherosclerotic plaque characteristics associated with the severity of acute ischemic stroke in adult patients?
Cross-Sectional (n=83)
No
Are specific carotid atherosclerotic plaque characteristics associated with the severity of acute ischemic stroke in adult patients?
p-value: p=<0.001
High-risk carotid plaque features, particularly intraplaque hemorrhage, are strongly associated with greater ischemic stroke severity as measured by the NIHSS score.
Should not yet change acute management; leaves open whether plaque features predict outcomes in prospective cohorts.
Background & Objective: Cerebrovascular atherosclerotic disease is the major cause of ischemic stroke and transient ischemia attack (TIA). Atherosclerosis commonly affects intracranial and extracranial carotid arteries simultaneously. Plaque characteristics are significantly associated with the severity of ischemic stroke. We studied the characteristics of atheromatous plaques in ischemic stroke patients and correlated characteristics of atheromatous plaques with the patient’s National Institute of Health Score (NIHSS) at the time of presentation with ischemic stroke. Methods: We conducted a cross-sectional analysis of 83 in-patient adults presenting with complaints of acute stroke within seven days of stroke. Those who consented were included in the study. The management, investigations and treatment of the cases were according to the hospital’s stroke protocol. An NIHSS score was calculated. MRI brain and MRA/HR-MRI (vessel wall imaging) were done as stroke protocol. The data was analyzed using SPSS 22.0 and R.3.2.0. Results: A total of 83 patients were enrolled, of which 59% were males and 41% were females, with a mean age of 52.8 ± 11.6 years and 54.5 ± 11 years, respectively. The mean NIHSS score, internal carotid artery stenosis, and lumen area of ICA (mm2) for all plaques were statistically significant (p< 0.001). Conclusion: We established a strong association between carotid atherosclerotic plaque characteristics and ischemic stroke severity. We found that a CT scan is better for diagnosing calcified plaques than HR-MRI.
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Kumar et al. (2023) conducted a cross-sectional in Acute ischemic stroke (n=83). Plaque characterization via MRI was evaluated on Mean NIHSS score across different plaque morphologies (p=<0.001). Carotid atherosclerotic plaque characteristics, particularly intraplaque hemorrhage, were significantly associated with greater ischemic stroke severity as measured by higher NIHSS scores (p < 0.001).
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