Admission hyperglycemia causes infarct volume expansion in patients with ICA or MCA occlusion: association of collateral grade on conventional angiography
| Autor: | Soichiro Mochio, Kazumi Kimura, Takashi Shiromoto, Yasuyuki Iguchi, Takashi Shimoyama, T. Inoue, Kensaku Shibazaki, Masao Watanabe, Jyunichi Uemura |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Blood Glucose Brain Infarction Carotid Artery Diseases Male medicine.medical_specialty Infarction Risk Factors medicine.artery Internal medicine medicine Humans Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test Cerebral infarction business.industry Penumbra Endovascular Procedures Angiography Infarction Middle Cerebral Artery Magnetic resonance imaging Retrospective cohort study Middle Aged medicine.disease Collateral circulation Magnetic Resonance Imaging Surgery Neurology Hyperglycemia Tissue Plasminogen Activator Cardiology Female Neurology (clinical) Internal carotid artery business |
| Zdroj: | European Journal of Neurology. 20:109-116 |
| ISSN: | 1351-5101 |
| DOI: | 10.1111/j.1468-1331.2012.03801.x |
| Popis: | Background and purpose Hyperglycemia (HG) is associated with infarct volume expansion in acute ischaemic stroke patients. However, collateral circulation can sustain the ischaemic penumbra and limit the growth of infarct volume. The aim of this study was to determine whether the association between HG and infarct volume expansion is dependent on collateral circulation. Methods We performed a retrospective analysis of 93 acute ischaemic stroke patients with internal carotid artery or middle cerebral artery occlusion within 24 h of onset were retrospectively studied. HG was diagnosed in patients with an admitting blood glucose value ≥140 mg/dl. Angiographic collateral grade 0–1 was designated as poor collateral circulation and grade 2–4 as good collateral circulation. Infarct volume was measured at admission and at again within 7 days using diffusion-weighted magnetic resonance images. Results Among 34 patients with poor collateral grade, the change in infarct volume was significantly greater in the HG group than in the non-HG group (106.0 ml vs. 22.7 ml, P = 0.002). Among the 59 patients with good collateral circulation, the change in infarct volume was greater in the HG group than in the non-HG group (53.3 ml vs. 10.9 ml, P = 0.047). Multiple regression analysis indicated that admission HG (P = 0.004), baseline National Institutes of Health Stroke Scale score (P = 0.018), and poor collateral circulation (P = 0.040) were independently associated with infarct volume expansion. Conclusions Infarct volume expansion was greater in individuals with HG on admission regardless of collateral circulation status. |
| Databáze: | OpenAIRE |
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