Abstract
Cerebral small vessel diseases (cSVDs) affect the prognosis of various types of ischemic stroke. Therefore, we evaluated the association between cSVD and the prognosis of cryptogenic stroke patients with active cancer. We enrolled patients diagnosed with cryptogenic stroke and active cancer from 2010 to 2016. Early neurological deterioration (END) was defined as a ≥ 2-point increase in the total NIHSS score or a ≥ 1-point increase in the motor NIHSS score within the first 72 h. We defined an unfavorable outcome as the modified Rankin Scale (mRS) score ≥ 3 points. We analyzed cSVD separately for each subtype including white matter hyperintensity (WMH), silent brain infarct (SBI), and cerebral microbleed (CMB). A total of 179 cryptogenic stroke patients with active cancer were evaluated. In the multivariable analysis, SBI was significantly associated with END (adjusted odds ratio = 3.97, 95% confidence interval: 1.53–10.33). This close relationship between SBI and END increased proportionally with an increase in SBI burden. However, WMH and CMB showed no significant association with END. None of the cSVD subtypes showed a statistically significant relationship with the 3-month unfavorable outcome. SBI was the only parameter closely associated with END in cryptogenic stroke patients with active cancer.
Highlights
Cerebral small vessel diseases affect the prognosis of various types of ischemic stroke
We aimed to elucidate the relationship between Cerebral small vessel diseases (cSVDs) subtypes and the prognosis in these patients. Based on these comparisons, we aimed to determine whether the influence of cSVD subtypes on the prognosis resulted from the general pathological mechanism of cSVD or from a mechanism related to a specific subtype
In the multivariable logistic regression analysis, silent brain infarct (SBI) remained significant after adjusting for confounders [adjusted odds ratio = 3.97, 95% confidence interval (CI) 1.53–10.33]
Summary
Cerebral small vessel diseases (cSVDs) affect the prognosis of various types of ischemic stroke. We evaluated the association between cSVD and the prognosis of cryptogenic stroke patients with active cancer. A total of 179 cryptogenic stroke patients with active cancer were evaluated. SBI was the only parameter closely associated with END in cryptogenic stroke patients with active cancer. Cerebral small vessel disease (cSVD) is a sub-clinical condition encompassing diverse pathologies such as white matter hyperintensity (WMH), silent brain infarct (SBI), and cerebral microbleeds (CMBs). A high cSVD burden increased the risks of vascular dementia, ischemic stroke, and m ortality. CSVD is closely related to the prognosis of ischemic stroke through various mechanisms, such as large artery disease or cardioembolism in addition. CSVD is believed to have a significant effect on the prognosis of stroke patients with active cancer.
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