Risk factors and clinical significance of post‐stroke incident ischemic lesions

Fang, Rong ; Duering, Marco ; Bode, Felix J.; Stösser, Sebastian; Meißner, Julius N.; Hermann, Peter; Liman, Thomas G.; Nolte, Christian H. ; Kerti, Lucia; Ikenberg, Benno; Bernkopf, Kathleen; Glanz, Wenzel; Janowitz, Daniel ; Wagner, Michael; Neumann, Katja; Speck, Oliver; Düzel, Emrah; Gesierich, Benno; Dewenter, Anna ; Spottke, Annika; Waegemann, Karin; Görtler, Michael; Wunderlich, Silke; Zerr, Inga; Petzold, Gabor C.; Endres, Matthias ; Georgakis, Marios K. und Dichgans, Martin (2024): Risk factors and clinical significance of post‐stroke incident ischemic lesions. In: Alzheimer's & Dementia, Bd. 20, Nr. 12: S. 8412-8428

Abstract

Introduction : While incident ischemic lesions (IILs) are not unusual on follow-up magnetic resonance imaging (MRI) following stroke, their risk factors and prognostic significance remain unknown. Methods : In a prospective multicenter study of 503 acute stroke patients, we assessed IILs on registered MRI images at baseline and 6 months, analyzing risk factors and clinical outcomes across 36 months. Results : At 6 months, 78 patients (15.5%) had IILs, mostly diffusion-weighted imaging-positive (72%) and clinically covert (91%). Older age and small vessel disease (SVD) lesions were baseline risk factors for IILs. IILs were associated with worse cognitive (beta for global cognition: −0.31, 95% confidence interval [CI]: −0.48 to −0.14) and functional outcomes (beta for modified Rankin scale [mRS]: 0.36, 95% CI: 0.14 to 0.58), and higher recurrent stroke risk (hazard ratio: 3.81, 95% CI: 1.35 to 10.69). IILs partially explained the relationship between SVD and poor cognition. Discussion : IILs are common and are associated with worse cognitive and functional outcomes and stroke recurrence risk. Assessing IILs following stroke might aid prognostication.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin > Munich Cluster for Systems Neurology (SyNergy) ; Medizin > Institut für Schlaganfall- und Demenzforschung (ISD)
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1552-5260
• Sprache: Englisch
• DFG: Gefördert durch die Deutsche Forschungsgemeinschaft (DFG) - 390857198