Associations of cerebral perfusion with infarct patterns and early neurological outcomes in symptomatic intracranial atherosclerotic stenosis
ObjectivesIntracranial atherosclerotic stenosis (ICAS) is a major cause of ischemic stroke, with various infarct patterns. We aimed to investigate the cerebral perfusion features underlying different infarct patterns and the relationship between cerebral perfusion and early neurological outcomes in...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-05-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1551364/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849762459420721152 |
|---|---|
| author | Xiangming Xu Linfang Lan Zhuhao Li Wenli Zhou Jing Yang Xinyi Leng Yuhua Fan |
| author_facet | Xiangming Xu Linfang Lan Zhuhao Li Wenli Zhou Jing Yang Xinyi Leng Yuhua Fan |
| author_sort | Xiangming Xu |
| collection | DOAJ |
| description | ObjectivesIntracranial atherosclerotic stenosis (ICAS) is a major cause of ischemic stroke, with various infarct patterns. We aimed to investigate the cerebral perfusion features underlying different infarct patterns and the relationship between cerebral perfusion and early neurological outcomes in symptomatic ICAS (sICAS).MethodsPatients with 50%–99% sICAS in the anterior circulation were enrolled. Cerebral perfusion measures were obtained from computed tomography (CT) perfusion images, including infarct core volumes, penumbra defined with Tmax values > 6 s and > 4 s, and penumbra-core mismatch. Infarct patterns on diffusion-weighted magnetic resonance imaging (MRI) were categorized into four categories: borderzone, perforator, territorial, and mixed patterns. A favorable early neurological outcome was a decrease in the National Institutes of Health Stroke Scale (NIHSS) of ≥1 point at discharge compared with admission.ResultsWe recruited 144 patients (median age: 66 years; 61.8% male patients). Significant perfusion compromise was observed in patients with borderzone or territorial infarcts compared to those with perforator infarct patterns. Patients with a favorable early neurological outcome exhibited smaller volumes of penumbra and penumbra-core mismatch at baseline. A multivariate logistic regression analysis revealed that penumbra (defined by Tmax of >4 s)-core mismatch volume of >15 mL was independently associated with a lower chance of achieving a favorable early neurological outcome (adjusted odds ratio, 0.323; 95% confidence interval, 0.121–0.866; p = 0.03).ConclusionHemodynamic compromise likely underlies borderzone and territorial cortical/subcortical infarcts in patients with sICAS. The penumbra-infarct core mismatch volume in CT perfusion, with Tmax of >4 s defining the penumbra, was associated with early neurological outcomes of sICAS patients. |
| format | Article |
| id | doaj-art-1798e276dec7481b8e146884e7d7224b |
| institution | DOAJ |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj-art-1798e276dec7481b8e146884e7d7224b2025-08-20T03:05:44ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-05-011610.3389/fneur.2025.15513641551364Associations of cerebral perfusion with infarct patterns and early neurological outcomes in symptomatic intracranial atherosclerotic stenosisXiangming Xu0Linfang Lan1Zhuhao Li2Wenli Zhou3Jing Yang4Xinyi Leng5Yuhua Fan6Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaDepartment of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaDepartment of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaDepartment of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaDepartment of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, ChinaDepartment of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaObjectivesIntracranial atherosclerotic stenosis (ICAS) is a major cause of ischemic stroke, with various infarct patterns. We aimed to investigate the cerebral perfusion features underlying different infarct patterns and the relationship between cerebral perfusion and early neurological outcomes in symptomatic ICAS (sICAS).MethodsPatients with 50%–99% sICAS in the anterior circulation were enrolled. Cerebral perfusion measures were obtained from computed tomography (CT) perfusion images, including infarct core volumes, penumbra defined with Tmax values > 6 s and > 4 s, and penumbra-core mismatch. Infarct patterns on diffusion-weighted magnetic resonance imaging (MRI) were categorized into four categories: borderzone, perforator, territorial, and mixed patterns. A favorable early neurological outcome was a decrease in the National Institutes of Health Stroke Scale (NIHSS) of ≥1 point at discharge compared with admission.ResultsWe recruited 144 patients (median age: 66 years; 61.8% male patients). Significant perfusion compromise was observed in patients with borderzone or territorial infarcts compared to those with perforator infarct patterns. Patients with a favorable early neurological outcome exhibited smaller volumes of penumbra and penumbra-core mismatch at baseline. A multivariate logistic regression analysis revealed that penumbra (defined by Tmax of >4 s)-core mismatch volume of >15 mL was independently associated with a lower chance of achieving a favorable early neurological outcome (adjusted odds ratio, 0.323; 95% confidence interval, 0.121–0.866; p = 0.03).ConclusionHemodynamic compromise likely underlies borderzone and territorial cortical/subcortical infarcts in patients with sICAS. The penumbra-infarct core mismatch volume in CT perfusion, with Tmax of >4 s defining the penumbra, was associated with early neurological outcomes of sICAS patients.https://www.frontiersin.org/articles/10.3389/fneur.2025.1551364/fullintracranial atherosclerotic stenosiscerebral perfusioninfarct patternsneurological outcomecomputed tomography perfusion |
| spellingShingle | Xiangming Xu Linfang Lan Zhuhao Li Wenli Zhou Jing Yang Xinyi Leng Yuhua Fan Associations of cerebral perfusion with infarct patterns and early neurological outcomes in symptomatic intracranial atherosclerotic stenosis Frontiers in Neurology intracranial atherosclerotic stenosis cerebral perfusion infarct patterns neurological outcome computed tomography perfusion |
| title | Associations of cerebral perfusion with infarct patterns and early neurological outcomes in symptomatic intracranial atherosclerotic stenosis |
| title_full | Associations of cerebral perfusion with infarct patterns and early neurological outcomes in symptomatic intracranial atherosclerotic stenosis |
| title_fullStr | Associations of cerebral perfusion with infarct patterns and early neurological outcomes in symptomatic intracranial atherosclerotic stenosis |
| title_full_unstemmed | Associations of cerebral perfusion with infarct patterns and early neurological outcomes in symptomatic intracranial atherosclerotic stenosis |
| title_short | Associations of cerebral perfusion with infarct patterns and early neurological outcomes in symptomatic intracranial atherosclerotic stenosis |
| title_sort | associations of cerebral perfusion with infarct patterns and early neurological outcomes in symptomatic intracranial atherosclerotic stenosis |
| topic | intracranial atherosclerotic stenosis cerebral perfusion infarct patterns neurological outcome computed tomography perfusion |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1551364/full |
| work_keys_str_mv | AT xiangmingxu associationsofcerebralperfusionwithinfarctpatternsandearlyneurologicaloutcomesinsymptomaticintracranialatheroscleroticstenosis AT linfanglan associationsofcerebralperfusionwithinfarctpatternsandearlyneurologicaloutcomesinsymptomaticintracranialatheroscleroticstenosis AT zhuhaoli associationsofcerebralperfusionwithinfarctpatternsandearlyneurologicaloutcomesinsymptomaticintracranialatheroscleroticstenosis AT wenlizhou associationsofcerebralperfusionwithinfarctpatternsandearlyneurologicaloutcomesinsymptomaticintracranialatheroscleroticstenosis AT jingyang associationsofcerebralperfusionwithinfarctpatternsandearlyneurologicaloutcomesinsymptomaticintracranialatheroscleroticstenosis AT xinyileng associationsofcerebralperfusionwithinfarctpatternsandearlyneurologicaloutcomesinsymptomaticintracranialatheroscleroticstenosis AT yuhuafan associationsofcerebralperfusionwithinfarctpatternsandearlyneurologicaloutcomesinsymptomaticintracranialatheroscleroticstenosis |