Leukoaraiosis and Early Neurological Recovery after Intravenous Thrombolysis

Background Early neurological recovery after intravenous thrombolysis (IVT) is associated with favorable outcome after acute ischemic stroke. Leukoaraiosis, a marker of chronic ischemia, is a possible negative predictive factor of early recovery. However, its negative attenuating effects remain inadequately studied, leading to uncertainty in the prediction of outcomes after IVT. We aim to determine the influence of leukoaraiosis on early neurologic recovery. Methods We included consecutive acute ischemic stroke patients who received IVT between 2007 and 2011. The following data were included: demographics, vascular risk factors, stroke type, National Institutes of Health Stroke Scale (NIHSS) at onset, and at 24 hours after IVT. Baseline computed tomography (CT) brain scans were analyzed. Two blinded assessors rated the CT scans using the van Swieten scale for leukoaraiosis. Median regression was used to assess the relationship between leukoaraiosis and neurologic recovery. Results We included 158 patients. The median (interquartile range [IQR]) age was 77 (68-84) and 71 (45%) were female. The median (IQR) NIHSS was 13 (7-18.75) at baseline and 7.5 (2-16) at 24 hours. After taking into account variables independently associated with leukoaraiosis, median regression analysis failed to demonstrate the association between the presence of leukoaraiosis and early neurologic recovery (NIHSS relative one) after IVT, for either of the 3 prespecified dichotomization-based definitions of leukoaraiosis. Conclusions In our sample, there was no evidence of the association between the degree of leukoaraiosis and early neurological recovery after IVT.