A comparison of hyperdense internal carotid artery sign, hyperdense middle cerebral artery sign and middle cerebral artery dot sign in acute ischemic stroke Akut iskemik İnme hastalarında hiperdens internal karotid arter işareti, hiperdens orta serebral arter işareti ve orta serebral arter nokta İşareti'nin karşılaştırılması


Ozdemir O. , Bas D. F. , ÖZKAN S. , ÇOLAK E. , UZUNER N.

Journal of Neurological Sciences, vol.32, no.4, pp.636-648, 2015 (Refereed Journals of Other Institutions) identifier identifier

  • Publication Type: Article / Article
  • Volume: 32 Issue: 4
  • Publication Date: 2015
  • Title of Journal : Journal of Neurological Sciences
  • Page Numbers: pp.636-648

Abstract

© 2015, Ege University Press. All rights reserved.Background: The aim of this study was to evaluate the clinical features of hyperdense internal carotid artery sign (HICAS), hyperdense middle cerebral artery sign (HMCAS) and MCA dot sign to understand their effect on the outcomes of acute ischemic stroke patients treated with intravenous recombinant tissue plasminogen activator (iv rtPA). Methods: Computed tomography (CT) scans, clinical features and outcomes of 252 patients with anterior circulation acute ischemic stroke treated with iv rtPA were evaluated. Initial CT scans were evaluated for hyperdense artery sign (HAS). Recanalization was evaluated with transcranial Doppler (TCD) in all available patients. Results: 99 of 252 patients had HAS; 12 had HICAS, 64 had HMCAS and 23 had MCA dot sign. None of the HICAS+ patients had a favorable outcome at three months. HMCAS+ patients achieved significantly less favorable outcomes. Mortality increased significantly in HICAS+ and HMCAS+ patients. MCA dot sign did not make a significant difference on baseline neurological status, recanalization, favorable outcome or mortality. At three months, there was no significant differences between HICAS and HMCAS whereas the MCA dot sign patients had better mRS scores compared with HICAS and HMCAS patients. HMCAS presence, baseline glucose levels and baseline NIHSS scores were all independent predictors of poor outcome. Conclusion: In acute ischemic stroke patients treated with iv rtPA, the presence of HICAS or HMCAS was found to be associated with insufficient recanalization and poor outcome, whereas MCA dot sign was a different entity and did not significantly influence the clinical course or outcome. Key words: Acute ischemic stroke; recombinant tissue plasminogen activator (rtPA); hyperdense artery sign (HAS); hyperdense internal carotid artery sign (HICAS); hyperdense middle cerebral artery sign (HMCAS); MCA dot sign Akut İskemik İnme Hastalarında Hiperdens İnternal Karotid Arter İşareti, Hiperdens Orta Serebral Arter İşareti ve Orta Serebral Arter Nokta İşareti'nin Karşılaştırılması