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The Hyperdense Internal Carotid Artery Sign: Prevalence and Prognostic Relevance in Stroke Thrombolysis

Introduction. The hyperdense internal carotid artery sign (HICAS) has been suggested as a common marker of terminal internal carotid artery (ICA) thrombus associated with poor outcomes following thrombolysis. We aimed to investigate the prevalence and prognostic significance of the HICAS in an unsel...

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Autores principales: Fitzsimmons, P. R., Biswas, S., Hill, A. M., Kumar, R., Cullen, C., White, R. P., Sharma, A. K., Durairaj, R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE-Hindawi Access to Research 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3159985/
https://www.ncbi.nlm.nih.gov/pubmed/21876847
http://dx.doi.org/10.4061/2011/843607
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author Fitzsimmons, P. R.
Biswas, S.
Hill, A. M.
Kumar, R.
Cullen, C.
White, R. P.
Sharma, A. K.
Durairaj, R.
author_facet Fitzsimmons, P. R.
Biswas, S.
Hill, A. M.
Kumar, R.
Cullen, C.
White, R. P.
Sharma, A. K.
Durairaj, R.
author_sort Fitzsimmons, P. R.
collection PubMed
description Introduction. The hyperdense internal carotid artery sign (HICAS) has been suggested as a common marker of terminal internal carotid artery (ICA) thrombus associated with poor outcomes following thrombolysis. We aimed to investigate the prevalence and prognostic significance of the HICAS in an unselected cohort of patients receiving intravenous thrombolysis. Methods. Prethrombolysis NCCTs of 120 patients were examined for the presence of the HICAS and hyperdense middle cerebral artery sign (HMCAS). A poor outcome was defined as a discharge Barthel score <15 or inpatient death. Results. A HICAS was present in 3 patients (2.5%). Prethrombolysis neurological deficits were significantly more severe in patients with a HICAS (P = 0.019). HICAS was not significantly associated with a poor outcome (P = 0.323). HMCAS was significantly associated with severe prethrombolysis neurological deficits (P = 0.0025) and a poor outcome (P = 0.015). Conclusions. This study suggests that the prevalence of the HICAS may be lower than previously reported. The presence of a HICAS was associated with severe prethrombolysis neurological deficits in keeping with terminal ICA occlusion. The role of the HICAS as a prognostic marker in stroke thrombolysis remains unclear.
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spelling pubmed-31599852011-08-29 The Hyperdense Internal Carotid Artery Sign: Prevalence and Prognostic Relevance in Stroke Thrombolysis Fitzsimmons, P. R. Biswas, S. Hill, A. M. Kumar, R. Cullen, C. White, R. P. Sharma, A. K. Durairaj, R. Stroke Res Treat Clinical Study Introduction. The hyperdense internal carotid artery sign (HICAS) has been suggested as a common marker of terminal internal carotid artery (ICA) thrombus associated with poor outcomes following thrombolysis. We aimed to investigate the prevalence and prognostic significance of the HICAS in an unselected cohort of patients receiving intravenous thrombolysis. Methods. Prethrombolysis NCCTs of 120 patients were examined for the presence of the HICAS and hyperdense middle cerebral artery sign (HMCAS). A poor outcome was defined as a discharge Barthel score <15 or inpatient death. Results. A HICAS was present in 3 patients (2.5%). Prethrombolysis neurological deficits were significantly more severe in patients with a HICAS (P = 0.019). HICAS was not significantly associated with a poor outcome (P = 0.323). HMCAS was significantly associated with severe prethrombolysis neurological deficits (P = 0.0025) and a poor outcome (P = 0.015). Conclusions. This study suggests that the prevalence of the HICAS may be lower than previously reported. The presence of a HICAS was associated with severe prethrombolysis neurological deficits in keeping with terminal ICA occlusion. The role of the HICAS as a prognostic marker in stroke thrombolysis remains unclear. SAGE-Hindawi Access to Research 2011 2011-08-22 /pmc/articles/PMC3159985/ /pubmed/21876847 http://dx.doi.org/10.4061/2011/843607 Text en Copyright © 2011 P. R. Fitzsimmons et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Fitzsimmons, P. R.
Biswas, S.
Hill, A. M.
Kumar, R.
Cullen, C.
White, R. P.
Sharma, A. K.
Durairaj, R.
The Hyperdense Internal Carotid Artery Sign: Prevalence and Prognostic Relevance in Stroke Thrombolysis
title The Hyperdense Internal Carotid Artery Sign: Prevalence and Prognostic Relevance in Stroke Thrombolysis
title_full The Hyperdense Internal Carotid Artery Sign: Prevalence and Prognostic Relevance in Stroke Thrombolysis
title_fullStr The Hyperdense Internal Carotid Artery Sign: Prevalence and Prognostic Relevance in Stroke Thrombolysis
title_full_unstemmed The Hyperdense Internal Carotid Artery Sign: Prevalence and Prognostic Relevance in Stroke Thrombolysis
title_short The Hyperdense Internal Carotid Artery Sign: Prevalence and Prognostic Relevance in Stroke Thrombolysis
title_sort hyperdense internal carotid artery sign: prevalence and prognostic relevance in stroke thrombolysis
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3159985/
https://www.ncbi.nlm.nih.gov/pubmed/21876847
http://dx.doi.org/10.4061/2011/843607
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