Correlation between cerebral microbleeds and early neurological deterioration in patients with acute ischemic stroke

Abstract

Objective To investigate the correlation between cerebral microbleeds (CMBs) and early neurological deterioration (END) in patients with acute ischemic stroke. Methods Consecutive patients with acute ischemic stroke were enrolled prospectively. The clinical data, imaging data, and laboratory data were collected. END was defined as the National Institutes of Health Stroke Scale (NIHSS) score increased ≥2 within 7 d compared with the baseline. Susceptibility-weighted imaging was used to detecte CMBs. Multivariate logistic regression analysis was used to identify the independent correlation between CMBs and END. Results A total of 246 patients with acute acute ischemic stroke were enrolled. The incidence of END was 38.21% (94/246), 72.34% (68/94) occurred within 72 h and 21.28% (20/94) occurred from 72 h to 7 d. The detection rate of CMBs in the END group was 72.34% (68/94) and that of CMBs in the non-END group was 43.42% (66/152). There was significant difference between the two groups (χ2=19.587, P<0.001). Multivariate logistic regression analysis showed that previous stroke or transient ischemic attack (odds ratio [OR] 1.883, 95%confidence interval [CI] 1.284-2.277; P=0.033), large artery atherosclerosis (OR 4.119, 95% CI 2.564-5.771; P=0.003), baseline NIHSS score (OR 1.682, 95% CI 1.320-1.876; P=0.042), severe stroke (OR 4.228, 95% CI 2.634-5.917; P=0.003), onset to admission time (OR 2.070, 95% CI 1.454-2.582; P=0.029), and number of CMB ≥10 (OR 2.728, 95% CI 1.834-3.217; P=0.016) were the independent risk factors for END. Conclusions END is common in patients with acute ischemic stroke, most of them occurred within 72 h. It is closely associated with the number of CMB, but it is not associated with the location of CMB lesions. Key words: Stroke; Brain Ischemia; Cerebral Hemorrhage; Disease Progression; Magnetic Resonance Imaging; Risk Factors; Time Factors