title: Final infarct volume discriminates outcome in mild strokes.
abstract: BACKGROUND
  Knowledge of whether final infarct volume (FIV) predicts disability after mild stroke is limited. We sought to determine if FIV could differentiate good versus poor outcome after mild stroke.
  
  
  METHODS
  We retrospectively identified 65 patients with mild stroke (National Institutes of Health Stroke Scale≤5) in a multicenter registry of 2453 patients. We evaluated associations between FIV and clinical outcome and evaluated the optimal FIV threshold that discriminated favorable (modified Rankin scale (mRS) 0-1) versus poor (mRS 2-6) outcome.
  
  
  RESULTS
  The FIV cut-point of 20 mL differentiated favorable and poor outcomes (area under curve (AUC) 0.73, 95% confidence interval: 0.58-0.88). Favorable outcome was observed in 37/45 (82%) with FIV<20 mL, compared to 5/14 (36%) with FIV≥20 mL (p<0.01). FIV≥20 mL remained strongly associated with poor outcome independent of age, gender, stroke severity, Alberta Stroke Program Early CT Score (ASPECTS), and proximal arterial occlusion.
  
  
  CONCLUSIONS
  In our small sample size, an FIV of 20 mL best differentiated between the likelihood of good versus poor outcome in patients with mild stroke. Further validation of infarct volume as a surrogate marker in mild stroke is warranted.
authors.affiliation: Department of Radiology, University of Cincinnati (UC) College of Medicine and Comprehensive Stroke Center at UC Neuroscience Institute, Cincinnati, OH, USA Achala.Vagal@uchealth.com.
authors.forename: Achala S
authors.initials: AS
authors.lastname: Vagal
authors.affiliation: Department of Biostatistics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Heidi
authors.initials: H
authors.lastname: Sucharew
authors.affiliation: Department of Neurology, Northwestern University, Evanston, IL, USA.
authors.forename: Shyam
authors.initials: S
authors.lastname: Prabhakaran
authors.affiliation: Department of Neurology, University of Cincinnati (UC) College of Medicine and Comprehensive Stroke Center at UC Neuroscience Institute, Cincinnati, OH, USA.
authors.forename: Pooja
authors.initials: P
authors.lastname: Khatri
authors.affiliation: Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Tudor
authors.initials: T
authors.lastname: Jovin
authors.affiliation: Neurology Centre Hospitalier Universitaire, Lausanne, Switzerland; Department of Radiology, Stanford University, Palo Alto, CA, USA.
authors.forename: Patrik
authors.initials: P
authors.lastname: Michel
authors.affiliation: Neurology Centre Hospitalier Universitaire, Lausanne, Switzerland; Department of Radiology, Stanford University, Palo Alto, CA, USA.
authors.forename: Max
authors.initials: M
authors.lastname: Wintermark
mesh_terms: D000368:Aged; D002544:Cerebral Infarction / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014481:United States
keywords: Final infarct volume; mild stroke; outcome