Recurrent Stroke Risk High with Reduced Blood Flow: Study

Recurrent Stroke Risk High with Reduced Blood Flow: Study

Authored by DesiMD Doctor on 29 Dec 2015 - 12:40


A stroke in the back of the brain increases the risk of recurrence within two years, if the blood flow to the vertebrobasilar region is impaired. This region in the back of the brain is responsible for mobility and balance. Strokes occurring in the vertebrobasilar region can be dangerous as it may cause total or partial paralysis, which accounts for 30 – 40 percent of all strokes.

The narrowing of blood vessels in the back of the brain due to atherosclerosis can be addressed with angioplasty, a procedure to open up blocked arteries, but this can be very risky.

However, researchers at the University of Illinois at Chicago (UIC), explain that patients of this stroke benefit with an intervention to unblock arteries, which can be very risky.  The blocked arteries can be determined with a new technology based MRI available at UIC.

Having a blockage in the blood vessel does not always relate to low blood flow, says Dr. Sepideh Amin-Hanjani, professor of neurological surgery at the UIC College of Medicine. It is quite possible that the blood flow can be normal, with the blockage present in the blood vessel. Dr Hanjani and her group wanted to determine which patients are at greatest risk for recurrent strokes who may benefit from angioplasty (clear up blocked arteries).

Research Study: The researchers conducted a study to determine the association between arterial blockages, blood flow, and continual strokes. They enrolled about 72 adult patients who had a stroke or a transient ischemic attack (symptoms of stroke), in the back of the brain and who had minimum 50 percent blockage of the arteries in that part of the brain. They used a NOVA (Noninvasive Optimal Vessel Analysis) technology to visualize the blood flow in the brain using standard MRI equipment.

Study Findings: After a follow-up of about 22 months, researchers discovered that 25 percent of the patients showed reduced blood flow in the back of the brain, which proved to be a considerable factor for predicting a stroke. These patients had 12- and 24-month stroke-free survival rates of 78 and 70 percent respectively, as compared to 96 and 87 percent for patients with normal blood flow.

"At one year, the risk for patients with low blood flow was about five times as high as risk for patients without low flow in the back of the brain. For these patients, the benefits of angioplasty probably outweigh the risks. About three-quarters of patients didn't have low blood flow in the vertebrobasilar region -- other arteries are doing the job of ensuring that proper blood flow is reaching that area -- and these patients would not benefit from treatments aimed at opening the vessels, such as angioplasty -- in fact, the procedure would put these patients at unnecessary risk," Hanjani said.

The researchers hope that new therapies will be evaluated to further reduce the risk of recurrent stroke.


Reference: Effect of Hemodynamics on Stroke Risk in Symptomatic Atherosclerotic Vertebrobasilar Occlusive Disease. JAMA Neurology, December 2015; University of Illinois at Chicago. "Low blood flow in back of brain increases risk of recurrent stroke."



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