Predictive value of intracranial high-density areas in neurological function

BACKGROUND 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.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-tive prognostic factors.CONCLUSION In conclusion,HDAs on CT images predicted poor prognosis and severe depressive and anxiety symptoms in patients with AIS who underwent EMT.

Visit-to-visit Systolic Blood Pressure Variability and Stroke Risk: A Systematic Review and Meta-analysis

Visit-to-visit variability in systolic blood pressure(SBP)may have an important additional role in increasing the risk of vascular complications,including stroke.We conducted a meta-analysis to assess the relationship between visit-to-visit SBP variability(SBPV)and stroke risk.PubMed,EMBASE,and the Cochrane library databases were searched for cohort studies with data on visit-to-visit SBPV and stroke risk.Studies that reported adjusted relative risks(RRs)with 95%Cis of stroke associated with SBPV were included.Fourteen cohort studies met the inclusion criteria and were included in our meta-analysis.After adjustment for age,sex,and existing vascular risk factors,the analysis showed that the risk of stroke in patients with SBPV was significantly increased compared with patients with a small baseline SBPV[SD(RR=1.20,95%CI=(1.07-1.35),P=0.0005),CV(RR=1.12,95%CI=(1.00-1.26),P=0.008)].In addition,follow-up variations of more than 5 years were associated with a higher risk of stroke than those of less than 5 years[RR=1.08,95%CI=(1.04-1.11)].Visit-to-visit SBPV was associated with an increased risk of stroke,especially in terms of the time of variation.Taken together,SBPV data may be useful as a preventative diagnostic method in the management of stroke.