Journal of Clinical Practice · Published 2026-06-18 · DOI 10.17816/clinpract705122
Ilya L. Gubskiy, Mikhail M. Beregov, Nikolai E. Staroverov, Ivan A. Larionov, Kirill Yu. Kazachkov, Andrey P. Stepanchenko, Valentin A. Nechaev, Nataliya A. Marskaya, Nikolay A. Shamalov
BACKGROUND: Neurological improvement after acute ischemic stroke depends on multiple clinical and imaging factors, including baseline stroke severity, infarct volume, and the success of reperfusion therapy. Despite technically successful recanalization, 30–50% of patients show no meaningful clinical improvement. AIM: The aim of this study was to assess the association and prognostic significance of computed tomography perfusion parameters, as well as the use of intravenous thrombolysis and mechanical thrombectomy (taking into account the degree of recanalization on the TICI scale), with 24-hour NIHSS (National Institutes of Health Stroke Scale) dynamics in patients with acute ischemic stroke due to large vessel occlusion. METHODS: This retrospective single-center cohort included 52 patients with acute ischemic stroke caused by large vessel occlusion. Computed tomography perfusion data were analyzed using the ArchiMed PRO software. Ridge regression was applied to assess the effects of perfusion parameters, reperfusion therapies, and their characteristics on 24-hour change in NIHSS. RESULTS: The regression model that included clinical and perfusion parameters explained 44% of the variability in 24-hour change in NIHSS score. A lower baseline NIHSS score and the performance of mechanical thrombectomy were associated with a smaller decrease in NIHSS (p 0.05), whereas a higher degree of recanalization on the TICI scale (Thrombolysis in Cerebral Infarction) was associated with a greater decrease in NIHSS (p 0.05). For infarct core volume (trend toward worse outcome with larger volume), penumbra volume (trend toward greater improvement with larger volume), and the use of intravenous thrombolysis (trend toward greater improvement), directed but statistically non-significant associations were observed (in all three cases p 0.05). CONCLUSION: Successful recanalization is the leading predictor of short-term neurological improvement after acute ischemic stroke. Computed tomography perfusion parameters show trends consistent with previous literature; however, the limited statistical power of this cohort prevented these associations from reaching formal statistical significance.
Abstract from DOAJ. Public domain (CC0 1.0).
Read the article at the publisher →
Gubskiy, I., Beregov, M., Staroverov, N., et al. (2026). CT-perfusion parameters and reperfusion therapy in acute ischemic stroke: 24-hour NIHSS dynamics in a retrospective cohort.. Journal of Clinical Practice. https://doi.org/10.17816/clinpract705122