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RELATIONSHIP BETWEEN SEVERE CALCIFICATION OF INTRACRANIAL ARTERY AND EARLY NEUROLOGICAL DETERIORATION IN ACUTE ISCHEMIC STROKE
Abstract
Background and Aims
In recent studies, Intracranial arterial calcification (IAC) is known to be associated with ischemic stroke. IAC is information that can be easily obtained by a non-enhanced brain CT scan during an early stage of stroke. We investigated the relationship between IAC and early neurological deterioration in acute ischemic stroke.
Methods
Consecutive patients with acute cerebral infarction who had been through brain imaging from Jan 2014 to May 2017 were included in the study. For cerebral atherosclerosis, intracranial arterial calcification status at the cavernous portion of the internal carotid artery and cerebral atherosclerosis score as the sum of major cerebral arterial stenosis was measured from brain CT angiography. Early neurological deterioration (END) was defined as an increment change of at least one point in motor power or total National Institute of Health Stroke Scale (NIHSS) score deterioration ≥2 points within the first 5 days after admission.
Results
A total of 861 patients were included with 384 female patients (mean age = 71.6 ± 12.8 years). We confirmed that there was a significant difference in having traditional vascular risk factors except for atrial fibrillation, in the severe calcification group (N=238). Multivariable logistic regression analysis revealed that severe calcification of the intracranial artery was independently associated with END (odds ratio = 1.72, confidence interval = 1.11 – 2.67).
Conclusions
Severe calcification of the intracranial artery is independently associated with END. A nonenhanced brain CT scan is a very useful tool for the prediction of early neurological deterioration in acute ischemic stroke.