Impact of brain volume and intracranial cerebrospinal fluid volume on the clinical outcome in endovascularly treated stroke patients

Sebastian Mönch, Dominik Sepp, Dennis Hedderich, Tobias Boeckh-Behrens, Maria Berndt, Christian Maegerlein, Silke Wunderlich, Claus Zimmer, Benedikt Wiestler, Benjamin Friedrich

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Purpose: Previously, brain volume (BV) and intracranial cerebrospinal fluid volume (CSFV) have been investigated regarding clinical outcomes of subgroups of ischemic stroke patients. This study aimed to examine if the preexisting, preischemic BV and CSFV have an impact on good functional outcome and mortality in acute ischemic stroke (AIS) patients treated with mechanical thrombectomy (MT). Methods: Preischemic BV, CSFV, and CSFV/Total intracranial volume (TICV)-ratio were calculated with a fully automated segmentation platform. Univariate and multivariate analyses were used to study associations. Results: In this retrospective study 107 subsequent AIS patients of a prospective database were included. The segmentation results of the fully automated algorithm based on non-contrast computerized tomography scans (NCCT) correlated significantly with the segmentation results obtained from 3D T1 weighted magnetic resonance images (P < 0.001). In the univariate analysis a preexisting BV (P < 0.001), preexisting CSFV (P = 0.009), and the ratio CSFV/total intracranial volume (P < 0.001) each significantly correlated with good functional outcome and mortality. However, in the multivariate regression analysis, also correcting for patient age, none of these volumes remained to correlate with these outcome parameters. Conclusion: In summary, an association of BV, CSFV, and the CSFV/TICV-ratio with good functional outcome and mortality in AIS treated with MT could not be established. A fully automated segmentation algorithm based on NCCT was successfully developed in-house for calculating the volumes of interest.

Original languageEnglish
Article number104831
JournalJournal of Stroke and Cerebrovascular Diseases
Volume29
Issue number7
DOIs
StatePublished - Jul 2020
Externally publishedYes

Keywords

  • Acute stroke
  • Brain volume
  • Intracranial cerebrospinal fluid volume
  • Outcome
  • Thrombectomy

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