Outcomes/Effectiveness Research
Severity of small blood vessel damage predicts clinical outcome after stroke
Common among the elderly, leukoaraiosis is a disease of the small blood vessels in the brain. It is an independent predictor of risk for symptomatic stroke, recurrence, and poststroke dementia. Now, a new study has found an association between the severity of leukoaraiosis and the clinical outcome after a stroke.
Researchers calculated the volume of leukoaraiosis in 240 patients with stroke. All had magnetic resonance imaging (MRI) within 24 hours of the onset of stroke symptoms such as weakness, blurred vision, confusion, and slurred speech. The average time from symptom onset to MRI was 7.5 hours. Among the patients studied, the volume of leukoaraiosis ranged from 0.1 to 57.4 mL. Those who had a higher volume of diseased blood vessels at the time of their stroke ended up with more severe functional deficits after 6 months. They were also more likely to be discharged to a rehabilitation center compared with patients with lower volumes. After the researchers adjusted for factors such as age, initial stroke severity, and the amount of brain tissue damaged, the volume of leukoaraiosis remained a predictor of clinical outcome.
The researchers suggest that any therapies that may slow the progression of leukoaraiosis may also reduce how severe a stroke is and improve its clinical outcome. The study was supported in part by the Agency for Healthcare Research and Quality (HS11392).
See "Severity of leukoaraiosis correlates with clinical outcome after ischemic stroke," by Ethem M. Arsava, M.D., Rosanna Rahman, Ph.D., Jonathan Rosand, M.D., M.Sc., and others, in the February 2009 Neurology 72, pp. 1403-1410.
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Research Activities, December 2009: Outcomes/Effectiveness Research: Severity of small blood vessel damage predicts clinical outcome after stroke
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