Relationship Between Deep White Matter Lesions And Short-term Recurrence Of Minor Ischemic Stroke

Objective:It has been reported that white matter lesions can predict poor prognosis in patients with stroke,but the prognostic value of the location and severity of white matter lesions for recurrence of acute minor ischemic stroke is not clear.The aim of this study was to investigate whether deep white matter lesions are predictors of short-term recurrence of minor ischemic stroke。Methods:From July 1,2019 to November 31,2021,a total of 3031 patients with acute mild ischemic stroke and NIHSS ≤ 5 were prospectively enrolled in the study.The basic clinical data and imaging data were collected,and all the selected patients completed the head MRI and CT examination.Experienced radiologists and neurologists graded the severity of deep white matter lesions using the Fazekas scale as no(Fazekas=0),mild(Fazekas=1),moderate(Fazekas=2)and severe(Fazekas=3).Kaplan-Meier curves were used to compare the recurrence rates within 90 days in patients with different degrees of white matter lesions.Cox regression analysis was used to evaluate the relationship between deep white matter injury and ischemic stroke recurrence。Results:A total of 180(8.5%)patients with acute mild ischemic stroke with DWML had a recurrence within 90 days.DWML score ≥1 is a risk factor for mild ischemic stroke recurrence.With the increase of Fazekas score,the recurrence rate increases.Univariate Cox regression analysis showed a hazard ratio of 1.77(95%CI,1.13 to 2.78)for mild deep white matter lesions,1.65(95%CI,1.01 to 2.7)for moderate deep white matter lesions,and2.56(95%CI,1.39 to 4.72)for severe deep white matter lesions.Multivariate Cox regression analysis showed that deep white matter lesions may still be an independent predictor of short-term recurrence of ischemic stroke。Conclusion:Deep white matter lesions may be an independent risk factor for 90-day recurrence in patients with acute mild ischemic stroke。...