Transient Ischemic Attack versus Acute Ischemic Stroke: Differential Atherosclerotic Plaque Features in the Culprit Middle Cerebral Artery Stenosis

Background. The significance of the Hyperdense Middle Cerebral Artery Sign (HMCAS) is uncertain. Aims. This prospective study investigated the sensitivity, specificity, prevalence, prognosis, interobserver variability, and associated clinical features of HMCAS in acute ischemic stroke. Methods. Initial CT scans of 117 patients with acute ischemic stroke or transient ischemic attack (TIA) and 65 age-matched controls were reported independently by two neuroradiologists blinded to diagnosis. Details of initial stroke severity and comorbidities were collected, and outcome on the modified Rankin scale (mRS) was assessed at 3–6 months. Results. HMCAS was seen in 15% of all ischemic strokes and 25% of all middle cerebral artery (MCA) strokes; specificity was 100%. HMCAS was associated with more severe initial deficit and atrial fibrillation. Only 21% of patients with a first-ever MCA stroke and HMCAS had a good outcome (mRS≤2) compared to 55% of those without the sign (P<0.001). Interobserver agreement was only 0.747 (Kappa statistic). Conclusion. The prevalence, specificity, sensitivity, and clinical associations of HMCAS were similar to previous reports. This study confirmed prospectively that HMCAS was associated with a poorer outcome at 3 to 6 months and demonstrated interobserver variability in detection of the sign.

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Sufficient collateral blood supply from accessory middle cerebral artery in a patient with acute ischemic stroke

Interventional Neuroradiology ◽

10.1177/1591019915583230 ◽

2015 ◽

Vol 21 (2) ◽

pp. 215-217 ◽

Cited By ~ 6

Author(s):

Zhen-Sheng Liu ◽

Long-Jiang Zhou ◽

Yong Sun ◽

Xiong-Wei Kuang ◽

Wei Wang ◽

...

Keyword(s):

Ischemic Stroke ◽

Basal Ganglia ◽

Middle Cerebral Artery ◽

Blood Supply ◽

Cerebral Artery ◽

Transient Ischemic Attack ◽

Modified Rankin Scale ◽

Nihss Score ◽

Accessory Middle Cerebral Artery ◽

Ischemic Attack

We reported a case of acute embolic occlusion of the middle cerebral artery with a patent accessory middle cerebral artery. Because of the presence of sufficient collateral blood supply from the accessory middle cerebral artery, the patient only underwent transient ischemic attack and did not need endovascular treatment. There was mild infarction in the basal ganglia and temporal lobe, NIHSS score of the patient at discharge seven days after stroke onset was 0, and modified Rankin scale score at 90 days was 0.

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A High-Resolution MRI Study of Relationship between Remodeling Patterns and Ischemic Stroke in Patients with Atherosclerotic Middle Cerebral Artery Stenosis

Frontiers in Aging Neuroscience ◽

10.3389/fnagi.2017.00140 ◽

2017 ◽

Vol 9 ◽

Cited By ~ 14

Author(s):

Dan-Feng Zhang ◽

Yu-Chen Chen ◽

Huiyou Chen ◽

Wei-Dong Zhang ◽

Jun Sun ◽

...

Keyword(s):

Ischemic Stroke ◽

High Resolution ◽

Middle Cerebral Artery ◽

Cerebral Artery ◽

Artery Stenosis ◽

High Resolution Mri ◽

Mri Study ◽

Middle Cerebral Artery Stenosis

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Association of Cerebral Artery Stenosis With Post-stroke Depression at Discharge and 3 Months After Ischemic Stroke Onset

Frontiers in Psychiatry ◽

10.3389/fpsyt.2020.585201 ◽

2020 ◽

Vol 11 ◽

Author(s):

Xiuli Qiu ◽

Jinfeng Miao ◽

Yan Lan ◽

Wenzhe Sun ◽

Yuxi Chen ◽

...

Keyword(s):

Ischemic Stroke ◽

Middle Cerebral Artery ◽

Cerebral Artery ◽

Artery Stenosis ◽

Stroke Onset ◽

Left Middle Cerebral Artery ◽

Basilar Artery Stenosis ◽

Post Stroke Depression ◽

Middle Cerebral Artery Stenosis ◽

Left Middle

Background: Post-stroke depression (PSD) is one of the most common complications after stroke, which seriously affects patients' recovery outcome. Although vascular depression has been extensively studied, the relationship between cerebral artery stenosis and PSD has not been clarified so far.Methods: Two hundred ninety-eight patients with ischemic stroke (72 women, 226 men) with computed tomography angiography (CTA) or magnetic resonance angiography (MRA) were included in this study. Cerebral artery stenosis ≥50% was used as the cut-off value. The DSM-V diagnostic criteria of PSD was met and the 17-item Hamilton Rating Scale for Depression (HAMD-17) score over 7 at discharge and 3 months after stroke onset was regarded as the primary outcome. The χ2-test, Mann-Whitney U-test, and t-test were used to check for statistical significance.Results: At discharge, Barthel index (p < 0.001), left middle cerebral artery stenosis (p = 0.019), drinking history (p = 0.048), basilar artery stenosis (p = 0.037) were significantly associated with PSD. At 3 months after ischemic stroke onset, Barthel index (p = 0.011), left middle cerebral artery stenosis (p = 0.012), female gender (p = 0.001) were significantly associated with PSD.Conclusions: The findings demonstrated that left middle cerebral artery and basilar artery stenosis are associated with PSD. It was suggested that cerebral artery stenosis was a risk factor of PSD and should be recognized and intervened early.Registration Number: ChiCTR-ROC-17013993.

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