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Abstract Details

Prevalence of Multiple Territory Stroke Pattern after Thrombolysis in Patients with or without known Atrial Fibrillation.
Cerebrovascular Disease and Interventional Neurology
P3 - Poster Session 3 (5:30 PM-6:30 PM)
3-062

To determine the association between a multiple territory stroke pattern (MTSP) and stroke etiology in patients treated with intravenous thrombolysis for acute ischemic stroke.
It has been proposed that the presence of an MTSP on brain imaging may aid identification of patients with covert atrial fibrillation. However, it is uncertain whether this association holds true among patients treated with intravenous recombinant tissue plasminogen activator (rtPA) because lysis of small clot fragments may reduce prevalence of an embolic pattern.
Retrospective analysis of 149 acute ischemic stroke patients treated with intravenous rtPA who underwent brain MRI. Presence of multiple acute infarctions on brain MRI that have occurred closely related in time, involved more than one hemisphere or cerebral circulation, and absent (near) occlusive stenosis of all relevant arteries were considered to denote an embolic pattern. Stroke etiology was categorized as non-embolic, cardioembolic, and embolic stroke of undetermined source (ESUS).

In the entire cohort, the prevalence of an MTSP was similar between patients with cardioembolic strokes (n=13 [8.7]) and ESUS (n=10 [6.7%)]; P>0.05). Further, after exclusion of patients with known atrial fibrillation, patients with ESUS (10 [10.2%]) had a significantly more often an MTSP than patients with a non-embolic (n=3 [3.1%]) and cardioembolic (n=2 [2.0%]) stroke cause (p=0.043, Fisher’s exact test).
Our findings suggest that the known association of multi territory infarct with ESUS is maintained after thrombolysis. This result may aid clinical decision making to tailor work up for covert atrial fibrillation.
Authors/Disclosures
Muhammad Azeem, MD (University of Massachusetts Medical School)
PRESENTER 		No disclosure on file
Mehdi Ghasemi, MD Dr. Ghasemi has nothing to disclose.
Muhammad Nagy, MBBCh, MSc (JFK Neuroscience institute (Neurology Department)) Dr. Nagy has nothing to disclose.
No disclosure on file
Majaz Moonis, MD, FAHA, FAAN (University of Massachusetts, Department of Neurology) Dr. Moonis has nothing to disclose.
Brian Silver, MD, FAAN (UMass Memorial Medical Center) Dr. Silver has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Various legal firms. Dr. Silver has received intellectual property interests from a discovery or technology relating to health care. Dr. Silver has received publishing royalties from a publication relating to health care. Dr. Silver has received publishing royalties from a publication relating to health care. Dr. Silver has received publishing royalties from a publication relating to health care. Dr. Silver has received personal compensation in the range of $500-$4,999 for serving as a Consultant with Women's Health Initiative. Dr. Silver has received personal compensation in the range of $500-$4,999 for serving as a Consultant with Best Doctors, Inc./Teladoc, Inc.. Dr. Silver has a non-compensated relationship as a Consultant with ABPN that is relevant to AAN interests or activities. Dr. Silver has a non-compensated relationship as a Member, Regional Board of Directors with American Heart Association that is relevant to AAN interests or activities.
Nils Henninger, MD, PhD, FANA, FWSO (UMass Memorial Medical Center) Dr. Henninger has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Henninger has stock in United Health. Dr. Henninger has stock in Novo Nordisk. Dr. Henninger has stock in Elli Lilly. Dr. Henninger has stock in Kenvue. Dr. Henninger has stock in Voyager. Dr. Henninger has stock in Alnylam. Dr. Henninger has stock in Entrada. The institution of Dr. Henninger has received research support from NIH. Dr. Henninger has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Verge Genomics.