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• W2802870147 abstract "Background and purpose Increased supratentorial white matter hyperintensities volume (S‐ WMHV ) has been reported to be a predictor of worse outcome in patients with acute ischemic stroke ( AIS ). However, few studies have focused on less common locations, such as brainstem white matter hyperintensities (B‐ WMH ), and their relationship to S‐ WMHV . This study aimed to examine whether B‐ WMH affect clinical outcome after AIS or transient ischemic attack ( TIA ). Methods Based on magnetic resonance imaging evidence, B‐ WMH were evaluated in 313 prospectively identified patients with AIS / TIA and registered as absent or present. Standardized S‐ WMHV was quantified using a validated volumetric image analysis and natural log‐transformed (Log_S‐ WMHV ). Poor outcome was defined as a modified Rankin Scale score of 3–6 at 3 months after the index event. Results Brainstem white matter hyperintensities were detected in 57 (18.2%) patients. In unadjusted analyses for outcome, the presence of B‐ WMH was associated with worse outcome, compared with patients without B‐ WMH ( P = 0.034). In multivariate analysis controlling for age, atrial fibrillation, stroke severity, reperfusion therapies and Log_S‐ WMHV , only B‐ WMH [odds ratio ( OR ), 2.46; P = 0.021] and stroke severity ( OR , 1.23; P < 0.001) remained independently associated with unfavourable 90‐day modified Rankin Scale score. Patients with B‐ WMH were older ( OR , 1.06; P < 0.001) and tended to have more hyperlipidaemia ( OR , 2.21; P = 0.023) and peripheral arterial disease ( OR , 2.57; P = 0.031). Conclusions Brainstem white matter hyperintensities are an independent predictor of poor outcome after AIS / TIA and this relationship persists after adjustment for important prognostic factors. Our results also show that leukoaraiosis in this location identifies patients with a specific risk factor profile, suggesting differences in the underlying pathogenesis." @default.
• W2802870147 created "2018-05-17" @default.
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• W2802870147 date "2018-05-10" @default.
• W2802870147 modified "2023-10-16" @default.
• W2802870147 title "Brainstem leukoaraiosis independently predicts poor outcome after ischemic stroke" @default.
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• W2802870147 doi "https://doi.org/10.1111/ene.13659" @default.
• W2802870147 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/29660221" @default.
• W2802870147 hasPublicationYear "2018" @default.
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