Prognostic study of intracranial branch atheromatous disease in the blood-supplying areas of the lenticulostriate and paramedian pontine arteries

Yang Liu; Lihua Wang; Kuang Fu; Xiaotong Kong; Wenhui Guo; Ning Wang; Xuesong Sun; Hanlu Cai; Yan Yu; Zhaobo Zhang; Xingbang Zou; Ying Cao; Doudou Luo; Peifang Liu

doi:10.1016/j.jstrokecerebrovasdis.2024.108210

Prognostic study of intracranial branch atheromatous disease in the blood-supplying areas of the lenticulostriate and paramedian pontine arteries

J Stroke Cerebrovasc Dis. 2024 Dec 20;34(2):108210. doi: 10.1016/j.jstrokecerebrovasdis.2024.108210. Online ahead of print.

Authors

Yang Liu¹, Lihua Wang¹, Kuang Fu², Xiaotong Kong¹, Wenhui Guo², Ning Wang¹, Xuesong Sun¹, Hanlu Cai¹, Yan Yu¹, Zhaobo Zhang¹, Xingbang Zou¹, Ying Cao¹, Doudou Luo¹, Peifang Liu³

Affiliations

¹ Department of Neurology, the Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang 150000, China.
² Department of MRI Diagnosis, the Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang 150000, China.
³ Department of Neurology, the Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang 150000, China.. Electronic address: liupeifang@hrbmu.edu.cn.

PMID: 39710081
DOI: 10.1016/j.jstrokecerebrovasdis.2024.108210

Abstract

Introduction: Branch atheromatous disease (BAD) is prone to early neurological deterioration (END), leading to a poor prognosis. The most common arteries causing END are the lenticulostriate arteries (LSA) and the paramedian pontine arteries (PPA). To gain insight into the characteristics of symptomatic plaques and their association with poor prognosis in patients with BAD, we conducted a prospective study using high-resolution magnetic resonance imaging (HRMRI).

Methods: A total of 75 patients with BAD in the vascular range of LSA or PPA were recruited for this study. The vascular and plaque features of the carrier middle cerebral artery (MCA) and basilar artery (BA) were evaluated through the application of HRMRI, and the local cerebral blood flow (CBF) of the lesion was assessed through pseudo-continuous arterial spin-labeling (pCASL), and the number and location of cerebral microbleeds (CMBs) were documented by susceptibility-weighted imaging (SWI). Univariable and multivariable logistic regression analyses were performed to analyze the factors that affected the prognosis.

Results: A poor prognosis was observed in 24 patients (32%) with BAD. A total of 28 patients (37%) developed END. Multifactorial analysis showed statistically significant differences in the dorsal plaque of BA (OR: 19.15, 95% CI 1.72-385.37, p=0.028), male (OR: 26.22, 95% CI 3.18-406.31, p=0.007), and NIHSS at 7 days of onset (OR: 2.24, 95% CI 1.4-4.45, p=0.004).

Conclusions: In patients with BAD in LSA and PPA areas, the dorsal plaque of BA, male, and NIHSS at 7 days of onset were independent risk factors for poor prognosis.

Keywords: Branch atheromatous disease; Cerebral blood flow; Cerebral microbleeds; Early neurological deterioration; High-resolution magnetic resonance; Prognosis.