Abstract Body: Introduction: Branch atheromatous disease involving the lenticulostriate artery (LSA) is strongly associated with early neurological deterioration. We aimed to investigate whether an apparent thalamostriate vein (TSV) or brush sign on susceptibility-weighted imaging (SWI) can predict infarct growth.
Methods: Consecutive patients with the small subcortical infarction of the LSA presenting within 24 h of onset were retrospectively evaluated. MRI, including SWI, was performed on admission and within 1 week of admission. An apparent TSV was defined as a difference in the diameter of the TSV between the right and left sides on SWI upon admission. Infarct growth was defined as an increase in infarct size on axial or coronal diffusion-weighted imaging from <15 mm at admission to ≥15 mm at follow-up. Progressive paralysis was defined as an increase in the manual muscle test score by >1 point.
Results: Of the 76 patients (median age, 76 [67.25–82] years, 48 male) with the small subcortical infarction of the LSA, 22 (median age, 75.5 [64.75–82.5] years, 13 male) presented with an apparent TSV and/or brush sign. On univariable logistic analysis, only the presence of apparent TSV and/or brush sign (OR, 3.12; 95% CI, 1.11–8.73; p=0.03) was associated with infarct growth. In multivariable logistic regression analysis, age (OR, 1.07; 95% CI, 1.01–1.14; p=0.02) and infarct growth (OR, 4.46; 95% CI, 1.37–14.54; p=0.01) were independently associated with progressive paralysis.
Conclusion: An apparent TSV or brush sign could indicate infarct growth in cases of the small subcortical infarction of the LSA.