Published online Jul 19, 2024. doi: 10.5498/wjp.v14.i7.1080
Revised: May 21, 2024
Accepted: June 5, 2024
Published online: July 19, 2024
Processing time: 94 Days and 18.6 Hours
Intracranial high-density areas (HDAs) have attracted considerable attention for predicting clinical outcomes; however, whether HDAs predict worse neurological function and mental health remains controversial and unclear, which requires further investigation.
To investigate the predictive value of intracranial HDAs for neurological function and mental health after endovascular treatment.
In this prospective study, 96 patients with acute ischemic stroke (AIS) who accepted endovascular mechanical thrombectomy (EMT) were included. The enrolled patients underwent cranial computed tomography (CT) examination within 24 hours after EMT. Clinical data in terms of National Institutes of Health Stroke Scale (NIHSS), the 3-month modified Rankin Scale (mRS), self-rating depression scale (SDS), and self-rating anxiety scale (SAS) scores were collected and compared between patients with HDAs and non-HDAs and between patients with good and poor clinical prognosis.
Compared to patients without HDAs, patients with HDAs presented severe neurological deficits (admission NIHSS score: 18 ± 3 vs 19 ± 4), were more likely to have post-stroke disabilities (mRS < 3: 35% vs 62%), and suffered more severe depression (SDS score: 58 ± 16 vs 64 ± 13) and anxiety disorder (SAS score: 52 ± 8 vs 59 ± 10). Compared to patients with a good prognosis, patients with a poor prognosis presented severe neurological deficits (admission NIHSS score: 17 ± 4 vs 20 ± 3), were more likely to have HDAs on CT images (64% vs 33%), and suffered more severe depression (SDS score: 55 ± 19 vs 65 ± 11) and anxiety (SAS score: 50 ± 8 vs 58 ± 12). Multivariate analysis revealed that HDAs were independent nega
In conclusion, HDAs on CT images predicted poor prognosis and severe depressive and anxiety symptoms in patients with AIS who underwent EMT.
Core Tip: High-density areas (HDAs) have great potential in predicting clinical outcomes in patients with acute ischemic stroke (AIS). This prospective study focused on the association of intracranial HDAs with neurological function and mental health after endovascular mechanical thrombectomy for AIS. Through comprehensive evaluation of National Institutes of Health Stroke Scale, the 3-month modified Rankin Scale, self-rating depression scale, and self-rating anxiety scale scores, our study demonstrated that intracranial HDAs on computed tomography images predict poor prognosis and severe depressive and anxiety symptoms.