Original Research ARTICLE

Front. Neurol., 21 March 2011 | http://dx.doi.org/10.3389/fneur.2011.00018

Stroke severity predicted by aortic atheroma detected by ultra-fast and cardiac-gated chest tomography

Marc A. Lazzaro1, Osama O. Zaidat1,2,3*, Mohammad A. Issa1, Robert C. Gilkeson4, Jeffrey L. Sunshine4, Robert W. Tarr2,3, Shakir Husain5* and Jose I. Suarez6
  • 1 Department of Neurology, Medical College of Wisconsin/Froedtert Hospital, Milwaukee, WI, USA
  • 2 Department of Neurosurgery, Medical College of Wisconsin/Froedtert Hospital, Milwaukee, WI, USA
  • 3 Department of Radiology, Medical College of Wisconsin/Froedtert Hospital, Milwaukee, WI, USA
  • 4 Department of Radiology, Case Medical School, Cleveland, OH, USA
  • 5 Department of Neurology, MAX Institute of Neurosciences, New Delhi, India
  • 6 Department of Neurology, Baylor College of Medicine, Houston, TX, USA

Background and Purpose: The presence of aortic atherosclerosis is an independent risk factor for secondary stroke. The present study was designed to have an initial exploration of the correlation between the load and extent of aortic atheroma (AA) and initial stroke severity or clinical outcome 3 months after stroke. Methods: Cardiac-gated chest tomography (CGCT) was used to detect and measure AA in patients with acute ischemic stroke as shown by our group in prior prospective studies and this is part four sub-exploratory study of the same cohort. The National Institute of Health Stroke Scale (NIHSS) was used to assess the initial stroke severity, and the modified Rankin Scale (mRS) was used to assess 3-month outcome. Results: Thirty-two patients underwent CGCT for evaluation of AA, and 21 were found to have AA. AA was more prevalent in patient with NIHSS >6 (14/17 versus 7/15, p-value 0.03). Applying the multiple logistic regression and propensity score adjustment (using the propensity of having AA given the baseline features as covariates) showed a non-significant trend that AA is three times more likely to be associated with NIHSS >6 (p = 0.08, OR 3.08, 95% CI 0.94–13.52). There was no evidence of association of AA with 3-month functional outcome (mRS): 11/14 (78.6%) mRS >1 had AA, and 10/18 (55.5%) of those with mRS ≤1 had AA (p = 0.27). Conclusion: In our current study with limited sample number and exploratory nature, the presence of AA on CGCT with acute ischemic stroke patients may be associated with worse neurological deficit at presentation. There was no evidence of association with 3-month functional outcome using the mRS.

Keywords: stroke, outcome, aortic atheroma, cardiac-gated CT, TEE, stroke severity, atherosclerosis

Citation: Lazzaro MA, Zaidat OO, Issa MA, Gilkeson RC, Sunshine JL, Tarr RW, Husain S and Suarez JI (2011) Stroke severity predicted by aortic atheroma detected by ultra-fast and cardiac-gated chest tomography. Front. Neur. 2:18. doi:10.3389/fneur.2011.00018

Received: 06 January 2011; Accepted: 09 March 2011;
Published online: 21 March 2011.

Edited by:

Afshin A. Divani, University of Minnesota, USA

Reviewed by:

Afshin Borhani Haghighi, Saint Louis University, USA
Afshin A. Divani, University of Minnesota, USA

Copyright: © 2011 Lazzaro, Zaidat, Issa, Gilkeson, Sunshine, Tarr, Husain and Suarez. This is an open-access article subject to an exclusive license agreement between the authors and the Articles Research Foundation, which permits unrestricted use, distribution, and reproduction in any medium, provided the original authors and source are credited.

*Correspondence: Osama O. Zaidat, Department of Neurology, Neurosurgery and Radiology, Medical College of Wisconsin/Froedtert Hospital, Milwaukee, WI 53226, USA e-mail: szaidat@mcw.edu Shakir Husain, Department of Neurology, MAX Institute of Neurosciences, 2 Press Enclave Marg, Saket, New Delhi 110017, India. e-mail: drshakir@gmail.com