ArticleCerebrovascular diseases (Basel, Switzerland)2020
Effects of White Matter Hyperintensities on 90-Day Functional Outcome after Large Vessel and Non-Large Vessel Stroke.
Article in Cerebrovascular diseases (Basel, Switzerland), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 16 citations in OpenAlex.
- The Role of Brain Frailty in Stroke Outcomes: A Systematic Review.Neurology international · 2026Review
- The Role of Leukoaraiosis and Microbleeds in Acute Ischemic Stroke Outcome Prediction.Journal of clinical medicine · 2026Article
- Localized network damage related to white matter hyperintensities is linked to worse outcome after severe stroke.Neurological research and practice · 2025Article
- Machine learning prediction model for functional prognosis of acute ischemic stroke based on MRI radiomics of white matter hyperintensities.BMC medical imaging · 2025Article
- Diffusion-Weighted Imaging-Based Radiomics Features and Machine Learning Method to Predict the 90-Day Prognosis in Patients With Acute Ischemic Stroke.The neurologist · 2025Article
- Quantitative Analysis of White Matter Hyperintensities as a Predictor of 1-Year Risk for Ischemic Stroke Recurrence.Neurology and therapy · 2024Article
- Combination of White Matter Hyperintensity and Neutrophil-to-Lymphocyte Ratio Predicts Short-Term Prognosis of Acute Ischemic Stroke Patients.International journal of general medicine · 2024Article
- Impact of white matter hyperintensity volumes estimated by automated methods using deep learning on stroke outcomes in small vessel occlusion stroke.Frontiers in aging neuroscience · 2024Article
- Association of Plasma Lipids with White Matter Hyperintensities in Patients with Acute Ischemic Stroke.International journal of general medicine · 2023Article
- Texture analysis of apparent diffusion coefficient maps in predicting the clinical functional outcomes of acute ischemic stroke.Frontiers in neurology · 2023Article
- The Clinical Utility of Leukoaraiosis as a Prognostic Indicator in Ischemic Stroke Patients.Neurology international · 2022Review
- Corneal nerve loss as a surrogate marker for poor pial collaterals in patients with acute ischemic stroke.Scientific reports · 2021Article
- Prevalence and Effect of Cerebral Small Vessel Disease in Stroke Patients With Aspirin Treatment Failure-A Hospital-Based Stroke Secondary Prevention Registry.Frontiers in neurology · 2021Article
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Authors and funding
18 authors at 3 institutions in 3 countries.
Funding
Abstract
introductionWhite matter hyperintensity (WMH) burden is a critically important cerebrovascular phenotype related to the diagnosis and prognosis of acute ischemic stroke. The effect of WMH burden on functional outcome in large vessel occlusion (LVO) stroke has only been sparsely assessed, and direct LVO and non-LVO comparisons are currently lacking. MATERIAL AND
methodsWe reviewed acute ischemic stroke patients admitted between 2009 and 2017 at a large healthcare system in the USA. Patients with LVO were identified and clinical characteristics, including 90-day functional outcomes, were assessed. Clinical brain MRIs obtained at the time of the stroke underwent quantification of WMH using a fully automated algorithm. The pipeline incorporated automated brain extraction, intensity normalization, and WMH segmentation.
resultsA total of 1,601 acute ischemic strokes with documented 90-day mRS were identified, including 353 (22%) with LVO. Among those strokes, WMH volume was available in 1,285 (80.3%) who had a brain MRI suitable for WMH quantification. Increasing WMH volume from 0 to 4 mL, age, female gender, a number of stroke risk factors, presence of LVO, and higher NIHSS at presentation all decreased the odds for a favorable outcome. Increasing WMH above 4 mL, however, was not associated with decreasing odds of favorable outcome. While WMH volume was associated with functional outcome in non-LVO stroke (p = 0.0009), this association between WMH and functional status was not statistically significant in the complete case multivariable model of LVO stroke (p = 0.0637).
conclusionThe burden of WMH has effects on 90-day functional outcome after LVO and non-LVO strokes. Particularly, increases from no measurable WMH to 4 mL of WMH correlate strongly with the outcome. Whether this relationship of increasing WMH to worse outcome is more pronounced in non-LVO than LVO strokes deserves additional investigation.
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