Early diffusion-weighted imaging predicts early neurological deterioration after acute isolated basal ganglia infarct

Abstract

Objective To investigate the predictive value of early diffusion-weighted imaging (DWI) for early neurological deterioration (END) after acute isolated basal ganglia infarct. Methods Patients with acute isolated basal ganglia infarct in middle cerebral artery perforators completed head MRI examination at 24 h after onset were analyzed retrospectively. According to the axial DWI revealed lesion size, the maximum diameters were divided into 30 mm. END was defined as an increase in the National Institute of Health Stroke Scale (NIHSS) score ≥2 or the motor score of NIHSS≥1 at any time within the first 72 h after admission compare with the baseline scores. Results A total of 336 patients were enrolled, including 126 patients (37.5%) with END. There were significant differences in the constituent ratios of the sex (P=0.044), maximum diameter of the lesion (P=0.001), and guilty artery stenosis (P=0.006), as well as baseline NIHSS score (P=0.001), high-density lipoprotein cholesterol (HDL-C) (P=0.033), and C-reactive protein (P=0.039) between the END group and the non-END group. Multiple logistic regression showed that the maximum diameter of the lesions 15-30 mm (odds ratio [OR] 2.360, 95% confidence interval [CI] 1.370-4.066; P=0.002), female (OR 1.660, 95%CI 1.024-2.691; P=0.040), and guilty large artery stenosis (OR 1.713, 95%CI 1.036-2.833; P=0.036) were the independent risk factors for patients occurring END, while the high HDL-C (OR 0.355, 95%CI 0.141-0.894; P=0.028) was an independent protective factor of occurring END. Conclusion Early DWI revealed that the maximum diameter of the lesions may have certain clinical value for prediction of the occurrence of END in patients with acute isolated basal ganglia infarct. Key words: Cerebral Infarction; Brain Ischemia; Disease Progression; Diffusion Magnetic Resonance Imaging; Magnetic Resonance Angiography; Risk Factors