Atherosclerotic Processes May Increase Neurological Deterioration after Stroke

NASHVILLE — Localized atherosclerotic processes may contribute to early neurological deterioration in patients with single small subcortical infarctions (SSSIs), according to a study presented at the American Stroke Association’s International Stroke Conference 2015.

Early neurological deterioration occurs in more than 20% of SSSI cases. SSSIs are thought to have two distinct pathological processes: micovasculopathies of arteriolar walls and localized atherosclerosis of upstream arteries. In this study, the researchers wanted to determine whether pathological processes affected the occurrence of neurological deterioration in SSSI patients.

The study looked at 4,961 stroke cases between July 2007 and July 2013. The researchers assessed 587 of these patients who had SSSI within 48 hours of onset. Early neurological deterioration and functional outcomes were assessed after stroke care, with the researchers reviewing relevant artery stenosis, branched atheromatous lesion, white matter hyperintensities, old lacunar infarction, and cerebral microbleeds.

The researchers detected early neurological deterioration in 79 (13.5%) of the patients, with six recurrences (8%), 66 progressions (84%), and seven other causes (9%). The results indicated that relevant artery stenosis and branch atheromatous lesions, both atherosclerotic processes, were significantly associated with early neurological deterioration in SSSIs. This association was not present in the stigmas of small vessel diseases.

The researchers recommend clinicians take extra precautions with SSSI patients who have higher atherosclerotic burdens to help prevent neurological deterioration.

For more coverage of the International Stroke Conference 2015, go here.