CT angiography in acute stroke: does it provide additional information on occurrence of infarction and functional outcome after 3 months?
OBJECTIVE
To investigate whether acute phase intracranial CT angiography (CTA) independently predicts infarction and functional outcome in ischemic stroke.


METHODS
Hundred and fifty-one consecutive patients with acute (<12 h) ischemic stroke who received intracranial CTA were investigated. Stroke severity on admission was determined using the National Institute of Health Stroke Scale (NIHSS). Reconstructed CTAs were investigated for relevant pathology. Follow-up imaging was performed 24-48 h after admission. Functional outcome was assessed after 3 months using the modified Rankin scale. Single factor and multiple logistic regression analyses were performed to predict infarction and dependency (modified Rankin scale > or = 3) on follow-up.


RESULTS
Median NIHSS on admission was 10 (IQR 3-14). Out of the 151 patients, 61 (40%) had pathological CTA findings. Infarction was demonstrated in 60/61 patients (98%) with and in 67/90 patients (74%) without vessel pathology. Presence of infarction on follow-up imaging and dependency at 3 months were correlated with pathological CTA findings on admission in single factor analysis (each p < 0.001). After adjustment for age (> or =/<65 years), NIHSS (> or =/<10), sex, therapy, and time to presentation (> or =/<3 h), only NIHSS > or = 10 on admission was predictive of dependency at follow-up (p < 0.001).


CONCLUSIONS
Pathological CTA findings in the acute phase of ischemic stroke do not independently predict a poor outcome at 3 months after acute stroke.
Ritter
Martin A
MA
Department of Neurology, University of Münster, Münster, Germany. ritterm@uni-muenster.de
Poeplau
Tobias
T
Schaefer
Anne
A
Kloska
Stephan P
SP
Dziewas
Rainer
R
Ringelstein
E Bernd
EB
Heindel
Walter
W
Nabavi
Darius G
DG
D000208:Acute Disease; D000368:Aged; D020520:Brain Infarction / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D002533:Cerebral Angiography; D005163:Factor Analysis, Statistical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000628:therapy; D015912:Thrombolytic Therapy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome