Angiographic findings in super-early period of ischemic stroke

Objective To evaluate the frequency and localization of the involved arteries in ischemic stroke within 6 hours after onset. Methods The patients suffered from ischemic stroke with 5-30 points of NIHSS and cerebral hemorrhage should be excluded by CT scan. All subjects underwent high selective angiographies for the observation of aorta, carotid arteries, vertebral arteries, and all the intracranial arteries. The degree of stenosis, the localization and numbers of the arteries involved and the morphology of plaque or the stenosis were assessed. Results Thirty patients were enrolled with 23 males and a mean age of 57 years. The angiographies were performed with average time of (218 ±64) minutes after the onset of stroke symptom. The brain CT found old lesions in 2 cases and suspected hypodensitive lesions in 9. Angiography showed occlusive findings of cerebral arteries in 87% of the patients, among them 77% were located in anterior circulation and 23% in posterior. Additional 10 asymptomatic oclusive arteries were found. Angiograms were normal in 13%. The internal carotid arteries and middle cerebral arteries are most frequently involved in this series. The vertebral arteries were the most commonly involved in the posterior circulation. Only were the residual endings of occlusive arteries or the high grade of stenosis shown in high selective angiogram. The patients with the symptoms of posterior circulation were angiographied about 30 minutes later than the anteriorl ( (246. 6 ±87. 1) , (218. 9±65. 2) minutes,respectively). The aneurisms concurred in one case. Conclusion Most of patients with ischemic stroke with 6 hours were documented with definitive occlusion of cerebral arteries. The options of treatment should be based on the location, the number and the morphology of the involved arteries.