Work

The Correlations of Clinical Outcomes and Vascular Morphology With Infarct Patterns in Middle Cerebral Arterial Occlusion

Year: 2026

Type: article

Abstract: ABSTRACT Objective To compare the clinical outcomes among various infarct patterns and to investigate the associations between the morphological parameters of contralateral middle cerebral artery (cMCA) M 1 segment and infarct patterns in ischemic stroke attributed to large vessel occlusion (LVO) in M 1 segment caused by intracranial atherosclerotic disease (ICAD). Methods Patients with stroke attributed to M 1 ‐ICAD‐LVO were enrolled. The infarct patterns were categorized into artery‐to‐artery embolism (AAE), large infarct, borderzone infarct (BZI), and perforating artery infarction (PAI). The morphological parameters of cMCA‐M 1 segment included proximal and distal diameter, arc, and chord length. The tortuosity index of cMCA‐M 1 segment was calculated by (arc length/chord length − 1) × 100%. Results A total of 171 participants were enrolled. Compared to AAE, the risk of poor outcome increased in BZI (odds ratio [OR] = 5.51, 95% confidence interval [CI] = 1.71–17.78, p = 0.004) and large infarct (OR = 10.92, 95% CI = 2.01–59.27, p = 0.006) and was comparable in PAI. The tortuosity index (OR = 2.85, 95% CI = 1.13–7.18, p = 0.026) and arc length (OR = 2.47, 95% CI = 1.02–5.97, p = 0.045) significantly increased in BZI than other three patterns. Participants other than BZI were categorized into large infarct ( n = 32) and non‐large‐infarct ( n = 46) groups, and the proximal diameter (OR = 0.22, 95% CI = 0.07–0.72, p = 0.012), arc length (OR = 0.88, 95% CI = 0.78–0.98, p = 0.018), and chord length (OR = 0.87, 95% CI = 0.77–0.995, p = 0.042) were associated with large infarct. Conclusion For patients with M 1 ‐ICAD‐LVO, large infarct and BZI had poorer outcomes than PAI and AAE. The cMCA‐M 1 segment with elevated tortuosity and arc length was associated with BZI, whereas a thin and short M 1 segment was correlated with large infarct in patients with a less tortuous cMCA trunk.

Source: Brain and Behavior

DOI: 10.1002/brb3.71226