CT angiography in acute stroke - Does it provide additional information on occurrence of infarction and functional outcome after 3 months?

Objective: To investigate whether acute phase intracranial CT angiography (CTA) independently predicts infarction and functional outcome in ischemic stroke. Methods: Hundred and fifty-one consecutive patients with acute (< 12 h) ischemic stroke who received intracranial CTA were investigated. Stroke severity on admission was determined using the National Institute of Health Stroke Scale (NIHSS). Reconstructed CTAs were investigated for relevant pathology. Followup imaging was performed 24-48 h after admission. Functional outcome was assessed after 3 months using the modified Rankin scale. Single factor and multiple logistic regression analyses were performed to predict infarction and dependency (modified Rankin scale >= 3) on follow-up. Results: Median NIHSS on admission was 10 (IQR 3-14). Out of the 151 patients, 61 (40%) had pathological CTA findings. Infarction was demonstrated in 60/61 patients (98%) with and in 67/90 patients (74%) without vessel pathology. Presence of infarction on follow-up imaging and dependency at 3 months were correlated with pathological CTA findings on admission in single factor analysis (each p < 0.001). After adjustment for age (>=/< 65 years), NIHSS (>=/< 10), sex, therapy, and time to presentation (>=/< 3 h), only NIHSS >= 10 on admission was predictive of dependency at follow-up (p < 0.001). Conclusions: Pathological CTA findings in the acute phase of ischemic stroke do not independently predict a poor outcome at 3 months after acute stroke. Copyright (c) 2006 S. Karger AG, Basel.