Ren Hongwei, Wang Du, Wang Xing, Wu Jinlong, Huang Junli, Jin Honghua, Huang Chengfang, Lei Lei
Department of Medical Imaging, Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China.
Department of Neurology, Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China.
Front Neurol. 2025 Jun 25;16:1583318. doi: 10.3389/fneur.2025.1583318. eCollection 2025.
This study investigates the association between white matter hyperintensities (WMH), specifically periventricular hyperintensity (PVH) and deep white matter hyperintensity (DWMH), and the prognosis and recurrence risk in patients with ischemic stroke.
A retrospective analysis was conducted on 278 patients with acute ischemic stroke, including 112 with PVH and 166 with DWMH. Key outcome measures included functional outcome (modified Rankin Scale score), mortality, neurological recovery, and stroke recurrence at 3, 6, and 12 months after treatment.
Severe PVH was significantly associated with unfavorable functional outcomes at 3, 6, and 12 months, while severe DWMH was only linked to unfavorable outcomes at 3 months. Mild PVH, but not DWMH, was associated with neurological recovery. Both higher PVH and DWMH were significantly correlated with stroke recurrence, with PVH showing an association at 12 months and DWMH at all time points. Severe PVH, but not DWMH, was also associated with stroke-related deaths.
These findings highlight the significant prognostic value of PVH and DWMH subtypes in ischemic stroke, suggesting their potential utility in predicting long-term functional outcomes, recurrence, and mortality.
本研究调查了脑白质高信号(WMH),特别是脑室周围高信号(PVH)和深部脑白质高信号(DWMH)与缺血性脑卒中患者预后及复发风险之间的关联。
对278例急性缺血性脑卒中患者进行回顾性分析,其中112例有PVH,166例有DWMH。关键结局指标包括治疗后3个月、6个月和12个月时的功能结局(改良Rankin量表评分)、死亡率、神经功能恢复情况及卒中复发情况。
重度PVH与治疗后3个月、6个月和12个月时不良功能结局显著相关,而重度DWMH仅与3个月时的不良结局相关。轻度PVH与神经功能恢复相关,而DWMH则不然。PVH和DWMH程度越高,与卒中复发的相关性越强,PVH在12个月时显示出相关性,DWMH在所有时间点均显示出相关性。重度PVH而非DWMH也与卒中相关死亡有关。
这些发现突出了PVH和DWMH亚型在缺血性脑卒中中的重要预后价值,表明它们在预测长期功能结局、复发和死亡率方面的潜在效用。