Hyperdense cerebral artery computed tomography sign is associated with stroke severity rather than stroke subtype

Jana Novotná, Pavla Kadlecová, Anna Czlonkowska, Miroslav Brozman, Viktor Švigelj, Laszlo Csiba, Janika Korv, Vida Demarin, Aleksandras Vilionskis, Robert Mikulík

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: The hyperdense cerebral artery sign (HCAS) on unenhanced computed tomography (CT) in acute ischemic stroke is a valuable clinical marker, but it remains unclear if HCAS reflects clot composition or stroke etiology. Therefore, variables independently associated with HCAS were identified from a large international data set of patients treated with intravenous thrombolysis. Methods: All stroke patients undergoing intravenous thrombolysis from the Safe Implementation of Treatments in Stroke-EAST (SITS-EAST) database between February 2003 and December 2011 were analyzed.Ageneral estimating equation model accounting for within-center clustering was used to identify factors independently associated with HCAS. Results: Of all 8878 consecutive patients, 8375 patients (94%) with available information about HCAS were included in our analysis. CT revealed HCAS in 19% of patients. Median baseline National Institutes of Health Stroke Scale (NIHSS) score was 12, mean age was 67 ± 12 years, and 3592 (43%) patients were females. HCAS was independently associated with baseline NIHSS (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.10-1.12), vessel occlusion (OR, 5.02; 95% CI, 3.31- 7.63), early ischemic CT changes (OR, 1.63; 95% CI, 1.31-2.04), year (OR, 1.07; 95% CI, 1.02-1.12), and age (10-year increments; OR, .90; 95% CI, .84-.96). Cardioembolic stroke was not associated with HCAS independently of baseline NIHSS. In different centers, HCAS was reported in 0%-50% of patients. Conclusions: This study illustrates significant variation in detection of HCAS among stroke centers in routine clinical practice. Accounting for within-center data clustering, stroke subtype was not independently associated with HCAS; HCAS was associated with the severity of neurologic deficit.

Original languageEnglish
Pages (from-to)2533-2539
Number of pages7
JournalJournal of Stroke and Cerebrovascular Diseases
Volume23
Issue number10
DOIs
Publication statusPublished - Jan 1 2014

Keywords

  • Acute stroke
  • Brain computed tomography
  • Dense artery sign
  • Thrombolysis

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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    Novotná, J., Kadlecová, P., Czlonkowska, A., Brozman, M., Švigelj, V., Csiba, L., Korv, J., Demarin, V., Vilionskis, A., & Mikulík, R. (2014). Hyperdense cerebral artery computed tomography sign is associated with stroke severity rather than stroke subtype. Journal of Stroke and Cerebrovascular Diseases, 23(10), 2533-2539. https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.04.034