open access
The association of vertebrobasilar calcification with etiological subtypes, stroke recurrence and outcome in acute brainstem ischemic stroke
- Bezmialem Vakıf University, Neurology Department, Istanbul, Türkiye
- Mengücek Gazi Educational and Training Hospital, Erzincan, Türkiye
open access
Abstract
Arterial calcification (AC), a frequent finding on imaging studies, has been reported as a risk factor for ischemic stroke. However few studies have explored the association of AC with etiological subtypes and prognostic implications. The purpose of this study was to investigate the association of AC with demograhics, risk factors and etiological subtypes and to determine whether it predicts stroke recurrence and functional outcome in patients with acute brainstem ischemic stroke. We analyzed our database consisting of patients who were diagnosed as acute brainstem ischemic stroke admitted within 24hours of onset. Etiological classification of stroke was made based on The Trial of ORG in Acute Stroke Treatment (TOAST) Classification. AC in vertebral and basilar arteries were assessed from baseline brain CT. AC degree was categorized according to calcification along the circumference in the densest calcified segment of each vessel (0 point if no calcification in any of the CT slices, 1 point if calcification <50% of circumference and 2 points if calcification ≥50% of circumference). Three AC categories were defined according to the total AC score as follows: no AC (0 point), mild AC (1–2 points), severe AC (≥3 points). Recurrent stroke within the first 3 months of follow up and modified Rankin Score (mRS) at 3-month were reviewed. 42% of 188 patients had AC in at least of the vertebrobasilar arteries. Severe AC was related to age and the presence of diabetes mellitus and coronary artery disease. The prevalence of AC was significantly higher in large artery atherosclerosis subtype. The presence of AC was marginally associated with recurrent stroke but did not find to be related with functional outcome. Further studies with larger sample size are warranted to explore this topic.
Abstract
Arterial calcification (AC), a frequent finding on imaging studies, has been reported as a risk factor for ischemic stroke. However few studies have explored the association of AC with etiological subtypes and prognostic implications. The purpose of this study was to investigate the association of AC with demograhics, risk factors and etiological subtypes and to determine whether it predicts stroke recurrence and functional outcome in patients with acute brainstem ischemic stroke. We analyzed our database consisting of patients who were diagnosed as acute brainstem ischemic stroke admitted within 24hours of onset. Etiological classification of stroke was made based on The Trial of ORG in Acute Stroke Treatment (TOAST) Classification. AC in vertebral and basilar arteries were assessed from baseline brain CT. AC degree was categorized according to calcification along the circumference in the densest calcified segment of each vessel (0 point if no calcification in any of the CT slices, 1 point if calcification <50% of circumference and 2 points if calcification ≥50% of circumference). Three AC categories were defined according to the total AC score as follows: no AC (0 point), mild AC (1–2 points), severe AC (≥3 points). Recurrent stroke within the first 3 months of follow up and modified Rankin Score (mRS) at 3-month were reviewed. 42% of 188 patients had AC in at least of the vertebrobasilar arteries. Severe AC was related to age and the presence of diabetes mellitus and coronary artery disease. The prevalence of AC was significantly higher in large artery atherosclerosis subtype. The presence of AC was marginally associated with recurrent stroke but did not find to be related with functional outcome. Further studies with larger sample size are warranted to explore this topic.
Keywords
Vertebrobasilar calcification, Brainstem stroke, Recurrent stroke, Outcome
Title
The association of vertebrobasilar calcification with etiological subtypes, stroke recurrence and outcome in acute brainstem ischemic stroke
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
188-193
Published online
2017-10-09
Page views
424
Article views/downloads
810
DOI
10.1016/j.pjnns.2017.09.010
Bibliographic record
Neurol Neurochir Pol 2018;52(2):188-193.
Keywords
Vertebrobasilar calcification
Brainstem stroke
Recurrent stroke
Outcome
Authors
Elif Gökçal
Elvin Niftaliyev
Tuğçe Özdemir
Mehmet Kolukısa
Talip Asil