title: Cerebral arterial calcification is an imaging prognostic marker for revascularization treatment of acute middle cerebral arterial occlusion.
abstract: OBJECTIVE
  To study the significance of intracranial artery calcification as a prognostic marker for acute ischemic stroke patients undergoing revascularization treatment after middle cerebral artery (MCA) trunk occlusion.
  
  
  METHODS
  Patients with acute MCA trunk occlusion, who underwent intravenous and/or intra-arterial revascularization treatment, were enrolled. Intracranial artery calcification scores were calculated by counting calcified intracranial arteries among major seven arteries on computed tomographic angiography. Patients were divided into high (HCB; score ≥3) or low calcification burden (LCB; score <3) groups. Demographic, imaging, and outcome data were compared, and whether HCB is a prognostic factor was evaluated. Grave prognosis was defined as modified Rankin Scale 5-6 for this study.
  
  
  RESULTS
  Of 80 enrolled patients, the HCB group comprised 15 patients, who were older, and more commonly had diabetes than patients in the LCB group. Initial National Institutes of Health Stroke Scale (NIHSS) scores did not differ (HCB 13.3±2.7 vs. LCB 14.6±3.8) between groups. The final good reperfusion after revascularization treatment (thrombolysis in cerebral infarction score 2b-3, HCB 66.7% vs. LCB 69.2%) was similarly achieved in both groups. However, the HCB group had significantly higher NIHSS scores at discharge (16.0±12.3 vs. 7.9±8.3), and more frequent grave outcome at 3 months (57.1% vs. 22.0%) than the LCB group. HCB was proven as an independent predictor for grave outcome at 3 months when several confounding factors were adjusted (odds ratio 4.135, 95% confidence interval, 1.045-16.359, P=0.043).
  
  
  CONCLUSIONS
  Intracranial HCB was associated with grave prognosis in patients who have undergone revascularization for acute MCA trunk occlusion.
authors.affiliation: Department of Neurology, Ajou University School of Medicine, Ajou University Medical Center, Suwon, Korea.
authors.forename: Seong-Joon
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Neurology, Ajou University School of Medicine, Ajou University Medical Center, Suwon, Korea.
authors.forename: Ji Man
authors.initials: JM
authors.lastname: Hong
authors.affiliation: Department of Neurology, Ajou University School of Medicine, Ajou University Medical Center, Suwon, Korea.
authors.forename: Manyong
authors.initials: M
authors.lastname: Lee
authors.affiliation: Department of Neurology, Ajou University School of Medicine, Ajou University Medical Center, Suwon, Korea.
authors.forename: Kyoon
authors.initials: K
authors.lastname: Huh
authors.affiliation: Department of Radiology, Ajou University School of Medicine, Ajou University Medical Center, Suwon, Korea.
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Choi
authors.affiliation: Department of Neurology, Ajou University School of Medicine, Ajou University Medical Center, Suwon, Korea.
authors.forename: Jin Soo
authors.initials: JS
authors.lastname: Lee
keywords: Intracranial embolism; Intracranial thrombosis; Middle cerebral artery infarction; Risk factors; Thrombolytic therapy; Vascular calcification