Ischemic Volumes and Early Neurologic Deterioration in Acute Brainstem Infarctions with Hemoglobin A1c

Abstract

Aim: To investigate the association of hemoglobin A_1c (HbA_1c) with acute diffusion-weighted imaging lesion volumes (DIV) and early neurologic deterioration (END) in brainstem infarctions (BSIs). Methods: 152 patients with acute BSIs were included in this study. The relationship between HbA_1c and DIV quartiles was examined. Data considered potentially associated with HbA_1c and END after admission and patients' symptomatic changes prior to admission were collected. Results: There was a significant correlation between HbA_1c (%) and DIV (Spearman ρ = 0.201, p = 0.013). The median HbA_1c (%) values for successive DIV quartiles (lowest to highest quartile) were as follows: 5.90, 6.35, 6.25, and 7.50 (p = 0.033). The incidence of diabetes mellitus had a significant association with DIV quartiles (p = 0.042). HbA_1c was significantly associated with symptomatic progression prior to admission (p = 0.015). 29 patients developed END after admission. Age, HbA_1c, systolic blood pressure, and fibrinogen were significantly associated with END. On logistic regression analysis, HbA_1c and fibrinogen proved to be independent variables. Conclusions: HbA_1c may be a possible predictor for ischemic severity, early deterioration of acute BSIs, and short-term prognosis. Long-term good glycemic control is very important in BSIs. Further studies are warranted to confirm these results.