Abstract TP90: Lesion Topography Role On Functional Outcome Of Stroke Patients

Background: The anatomical site of ischemia in stroke patients might impact functional outcome and can be a relevant factor for prognosis and clinical decision. Methods: We included patients from the MR CLEAN stroke trial population who had an adequate 5-9-day control CT scan. The images were segmented and registered over two neuroanatomical atlases. Each anatomical region was classified as affected or spared based on the total amount of voxels in each region interpreted as ischemic on CT imaging. Analysis were conducted with a threshold level of 20% and 50% of the total voxels as a binary classification criteria for considering a brain area as affected by the ischemic core. Univariate and multivariate analysis were conducted to assess for relationships between specific brain regions involvement and worse functional outcome (defined by the 90-day mRS). Results: A total of 356 patients was included. The left dorsal striatum and left insular ribbon were significantly associated with worse outcomes after correction for the total lesion volume (p < 0,05). On a binary logistic model, no areas were significantly associated with worse outcome when a threshold of 20% was used. Both left and right dorsal striatum’s were significantly associated with worse outcome after adjustment for volume when a threshold of 50% was used. Conclusion: Some areas of the brain appear to have a higher impact on clinical outcomes for stroke patients. Areas related to motor function were strongly associated with the 90-day mRS when compared to other brain areas. The impact of a brain region on outcome also seems to depend on which hemisphere has been affected and on the extent to which the region that has ben involved in the ischemia.