Clinical Significance Of FLAIR Vascular Hyperintensity In Acute Anterior Circulation Cerebral Infarction Patients With Severe Middle Cerebral Artery Stenosis

Objective: Fluid-attenuated inversion recovery vascular hyperintensity(FVH)refers to focal,tubular,or serpentine hyperintensities seen,often transiently,in the subarachnoid space against the relative hypointensity of the CSF.The clinical significance of FVH is unclear.This study was designed to investigate the relationship between FVH and the severity of neurological deficits in patients with severe middle cerebral artery stenosis.Methods: In 282 consecutive acute ischemic stroke patients with proximal MCA occlusion or severe stenosis,we collected the baseline data,clinical data(including NIHSS score.)and imaging data(whether FVH was present or not and FVH score).We evaluated the relationship between FVH and NIHSS score.Results: A total of 235(83.33%)AIS patients with positive FVH were observed.FVH(+)group tended to have more alcoholics(65(27.66%)VS 6(12.77%),P = 0.032),higher NIHSS score at the 7th day(3 [1,6] VS 2 [1-3],P = 0.039),more likely to have early neurological deterioration(END)(27(11.4%)and 1(2.12%),P = 0.05).Compared with a low FVH score,a high FVH score represents a more severe neurological impairment(NIHSS score at admission(P=.009)and NIHSS score at day 7(P=.02).Spearman rank correlation analysis indicated that FVH score showed a positive linear correlation with NIHSS score at admission and NIHSS score at 7 day after admission(P= 0.039;P = 0.017).Conclusions: In patients with proximal middle cerebral artery occlusion or stenosis ?70%,a high FVH score represents severe clinical impairment.