AUTHOR=Huang Kuankuan , Liu Jianfang , Yun Wenwei , Cao Yin , Zhang Min 

TITLE=The role of asymmetrical prominent veins sign in early neurological deterioration of acute ischemic stroke patients

JOURNAL=Frontiers in Neurology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.860824

DOI=10.3389/fneur.2022.860824

ISSN=1664-2295

ABSTRACT=Background and purpose: Asymmetrical prominent veins sign(APVS) often appears in patients with acute stroke on susceptibility-weighted angiography (SWAN)  image.  Early neurological deterioration(END) is highly correlated with the survival prognosis of ischemic stroke patients. The study aims to explore the relation between APVS and END in patients with acute stroke.
Methods: The subjects retrospectively enrolled in this study were patients with acute ischemic stroke, of whom the offending vessel was the middle cerebral artery. All patients underwent head MRI examination within 7 days of stroke symptom onset, which included SWAN sequence. END is usually defined as clinical deterioration or recurrence within 72 hours after ischemic stroke. The volume of infarction on diffusion-weighted imaging (DWI) was measured. Univariate and multivariate analyses were used to analyze the relation between APVS and  END. Spearman correlation between APVS grades and infarct volume, white matter hyperintensity(WMH) volume, offending vessel were also analyzed.
Results: A total of 157 patients with middle cerebral artery infarct from September 2018 through April 2020 retrospectively were included in the study. APVS appeared on MRI in 84 of 157 patients, and 34 out of all 157  patients developed END. In patients with END, the proportion of severe APVS was higher than patients without END(P=0.001, x 2=14.659). Patients with END had a higher age and larger volume of infarct and WMH than that of patients without END(all P<0.05). After adjusting for related risk factors of END, the severity of APVS was still related to END (OR=1.97, 95%CI, 1.03-3.39; P for trend=0.039). Spearman correlation showed APVS grades were positively related to infarct volume and 3 month mRS(r=0.289, P<0.001 and r=0.203, P-0.011), and negatively related to offending vessels(r=-0.170, P-0.034).
Conclusion: APVS may be an important predictor of END in acute ischemic stroke patients.