Implications of the Presence of Hyperdense Middle Cerebral Artery Sign in Determining the Subtypes of Stroke Etiology

Background. Identifying stroke subtypes is crucial in choosing appropriate treatment, predicting outcomes, and managing recurrent stroke prevention. Objectives. To study the association of hyperdense middle cerebral artery sign (HMCAS) on noncontrast computed tomography (NCCT) brain and subtypes of...

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Autores principales:	Suchada Sangpetch, Chayasak Wantaneeyawong, Atiwat Soontornpun, Nantaporn Tiyapun, Surat Tanprawate, Kitti Thiankhaw
Formato:	article
Lenguaje:	EN
Publicado:	Hindawi Limited 2021
Materias:	Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/60f6033caa5b45dca96a623ee8188d3a
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spelling	oai:doaj.org-article:60f6033caa5b45dca96a623ee8188d3a2021-11-29T00:55:38ZImplications of the Presence of Hyperdense Middle Cerebral Artery Sign in Determining the Subtypes of Stroke Etiology2042-005610.1155/2021/6593541https://doaj.org/article/60f6033caa5b45dca96a623ee8188d3a2021-01-01T00:00:00Zhttp://dx.doi.org/10.1155/2021/6593541https://doaj.org/toc/2042-0056Background. Identifying stroke subtypes is crucial in choosing appropriate treatment, predicting outcomes, and managing recurrent stroke prevention. Objectives. To study the association of hyperdense middle cerebral artery sign (HMCAS) on noncontrast computed tomography (NCCT) brain and subtypes of stroke etiology. Methods. This is a retrospective hypothesis testing study. Patients aged 18 or over who had middle cerebral artery occlusion symptoms with HMCAS with verification on brain NCCT and received intravenous thrombolysis between January 2016 and June 2019 were enrolled. The demographic data, clinical outcomes, stroke subtypes, and characteristics of HMCAS were collected from medical records. Results. Ninety-nine out of 299 enrolled patients presented with HMCAS. The most common stroke subtype was cardioembolism (59%). Of the baseline characteristics, hypertension was more common in cases of large-artery atherosclerosis (LAA) (86.4%), and atrial fibrillation (AF) was the highest in cardioembolism (44.8%). HMCAS disappearance in cardioembolism was lowest compared to LAA and others (63% vs. 91% vs. 94.7%, respectively). The univariable analysis found that HMCAS disappearance is significantly associated with all stroke subtypes (Odds ratio, 95% confidence interval 10.58, 1.31-85.43; P=0.027 for other and 5.88, 1.24-27.85; P=0.026 for LAA). Multinomial logistic regression found that body weight and hypertension were associated with the LAA subtype. AF and intracranial hemorrhage (ICH) were associated with cardioembolism. Conclusion. The most likely diagnosis from the presence of HMCAS is cardioembolism, but the definite stroke etiologic subtype can not be identified. Combining the patient risk factors, including body weight, hypertension, and AF, with HMCAS and its characteristics will predict stroke subtypes more accurately.Suchada SangpetchChayasak WantaneeyawongAtiwat SoontornpunNantaporn TiyapunSurat TanprawateKitti ThiankhawHindawi LimitedarticleNeurology. Diseases of the nervous systemRC346-429ENStroke Research and Treatment, Vol 2021 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurology. Diseases of the nervous system RC346-429 Suchada Sangpetch Chayasak Wantaneeyawong Atiwat Soontornpun Nantaporn Tiyapun Surat Tanprawate Kitti Thiankhaw Implications of the Presence of Hyperdense Middle Cerebral Artery Sign in Determining the Subtypes of Stroke Etiology
description	Background. Identifying stroke subtypes is crucial in choosing appropriate treatment, predicting outcomes, and managing recurrent stroke prevention. Objectives. To study the association of hyperdense middle cerebral artery sign (HMCAS) on noncontrast computed tomography (NCCT) brain and subtypes of stroke etiology. Methods. This is a retrospective hypothesis testing study. Patients aged 18 or over who had middle cerebral artery occlusion symptoms with HMCAS with verification on brain NCCT and received intravenous thrombolysis between January 2016 and June 2019 were enrolled. The demographic data, clinical outcomes, stroke subtypes, and characteristics of HMCAS were collected from medical records. Results. Ninety-nine out of 299 enrolled patients presented with HMCAS. The most common stroke subtype was cardioembolism (59%). Of the baseline characteristics, hypertension was more common in cases of large-artery atherosclerosis (LAA) (86.4%), and atrial fibrillation (AF) was the highest in cardioembolism (44.8%). HMCAS disappearance in cardioembolism was lowest compared to LAA and others (63% vs. 91% vs. 94.7%, respectively). The univariable analysis found that HMCAS disappearance is significantly associated with all stroke subtypes (Odds ratio, 95% confidence interval 10.58, 1.31-85.43; P=0.027 for other and 5.88, 1.24-27.85; P=0.026 for LAA). Multinomial logistic regression found that body weight and hypertension were associated with the LAA subtype. AF and intracranial hemorrhage (ICH) were associated with cardioembolism. Conclusion. The most likely diagnosis from the presence of HMCAS is cardioembolism, but the definite stroke etiologic subtype can not be identified. Combining the patient risk factors, including body weight, hypertension, and AF, with HMCAS and its characteristics will predict stroke subtypes more accurately.
format	article
author	Suchada Sangpetch Chayasak Wantaneeyawong Atiwat Soontornpun Nantaporn Tiyapun Surat Tanprawate Kitti Thiankhaw
author_facet	Suchada Sangpetch Chayasak Wantaneeyawong Atiwat Soontornpun Nantaporn Tiyapun Surat Tanprawate Kitti Thiankhaw
author_sort	Suchada Sangpetch
title	Implications of the Presence of Hyperdense Middle Cerebral Artery Sign in Determining the Subtypes of Stroke Etiology
title_short	Implications of the Presence of Hyperdense Middle Cerebral Artery Sign in Determining the Subtypes of Stroke Etiology
title_full	Implications of the Presence of Hyperdense Middle Cerebral Artery Sign in Determining the Subtypes of Stroke Etiology
title_fullStr	Implications of the Presence of Hyperdense Middle Cerebral Artery Sign in Determining the Subtypes of Stroke Etiology
title_full_unstemmed	Implications of the Presence of Hyperdense Middle Cerebral Artery Sign in Determining the Subtypes of Stroke Etiology
title_sort	implications of the presence of hyperdense middle cerebral artery sign in determining the subtypes of stroke etiology
publisher	Hindawi Limited
publishDate	2021
url	https://doaj.org/article/60f6033caa5b45dca96a623ee8188d3a
work_keys_str_mv	AT suchadasangpetch implicationsofthepresenceofhyperdensemiddlecerebralarterysignindeterminingthesubtypesofstrokeetiology AT chayasakwantaneeyawong implicationsofthepresenceofhyperdensemiddlecerebralarterysignindeterminingthesubtypesofstrokeetiology AT atiwatsoontornpun implicationsofthepresenceofhyperdensemiddlecerebralarterysignindeterminingthesubtypesofstrokeetiology AT nantaporntiyapun implicationsofthepresenceofhyperdensemiddlecerebralarterysignindeterminingthesubtypesofstrokeetiology AT surattanprawate implicationsofthepresenceofhyperdensemiddlecerebralarterysignindeterminingthesubtypesofstrokeetiology AT kittithiankhaw implicationsofthepresenceofhyperdensemiddlecerebralarterysignindeterminingthesubtypesofstrokeetiology
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Implications of the Presence of Hyperdense Middle Cerebral Artery Sign in Determining the Subtypes of Stroke Etiology

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