Association between plaque characteristics and severity of acute ischemic stroke

Abstract

Background & Objective: Cerebrovascular atherosclerotic disease is the major cause of ischemic stroke and transient ischemia attack (TIA). Atherosclerosis commonly affects intracranial and extracranial carotid arteries simultaneously. Plaque characteristics are significantly associated with the severity of ischemic stroke. We studied the characteristics of atheromatous plaques in ischemic stroke patients and correlated characteristics of atheromatous plaques with the patient’s National Institute of Health Score (NIHSS) at the time of presentation with ischemic stroke.

Methods: We conducted a cross-sectional analysis of 83 in-patient adults presenting with complaints of acute stroke within seven days of stroke. Those who consented were included in the study. The management, investigations and treatment of the cases were according to the hospital’s stroke protocol. An NIHSS score was calculated. MRI brain and MRA/HR-MRI (vessel wall imaging) were done as stroke protocol. The data was analyzed using SPSS 22.0 and R.3.2.0.

Results: A total of 83 patients were enrolled, of which 59% were males and 41% were females, with a mean age of 52.8 ± 11.6 years and 54.5 ± 11 years, respectively. The mean NIHSS score, internal carotid artery stenosis, and lumen area of ICA (mm2) for all plaques were statistically significant (p< 0.001).

Conclusion: We established a strong association between carotid atherosclerotic plaque characteristics and ischemic stroke severity. We found that a CT scan is better for diagnosing calcified plaques than HR-MRI.