The Hyperdense Internal Carotid Artery Sign: Prevalence and Prognostic Relevance in Stroke Thrombolysis
2011

The Hyperdense Internal Carotid Artery Sign in Stroke Treatment

Sample size: 120 publication Evidence: moderate

Author Information

Author(s): Fitzsimmons P. R., Biswas S., Hill A. M., Kumar R., Cullen C., White R. P., Sharma A. K., Durairaj R.

Primary Institution: Aintree Stroke Centre, University Hospital Aintree

Hypothesis

What is the prevalence and prognostic significance of the hyperdense internal carotid artery sign (HICAS) in patients receiving intravenous thrombolysis?

Conclusion

The study suggests that the prevalence of the HICAS may be lower than previously reported and its role as a prognostic marker in stroke thrombolysis remains unclear.

Supporting Evidence

  • A HICAS was present in 3 patients (2.5%).
  • Patients with a HICAS had significantly higher baseline NIHSS scores.
  • The presence of a HICAS was not significantly associated with poor outcomes.

Takeaway

This study looked at a sign in the brain's blood vessels that might show if a stroke is really bad. They found it doesn't show up as often as thought and doesn't always mean a bad outcome.

Methodology

The study examined prethrombolysis NCCTs of 120 patients for the presence of HICAS and HMCAS, assessing their association with neurological deficits and outcomes.

Limitations

The study was retrospective for NCCT analysis and did not include CT angiography for validation.

Participant Demographics

Patients treated with intravenous rtPA for acute ischemic stroke at Aintree Stroke Centre.

Statistical Information

P-Value

P = 0.019 for HICAS association with severe neurological deficits; P = 0.323 for HICAS association with poor outcomes.

Confidence Interval

95% CI 46.3 to 66.4 for HICAS density; 95% CI 16.7 to 25.3 for NIHSS scores.

Digital Object Identifier (DOI)

10.4061/2011/843607

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