International journal of stroke : official journal of the International Stroke Society
June 9, 2026 · via Europe PMC
Small vessel disease burden and response to induced hypertension therapy in small vessel occlusion stroke with early neurological deterioration.
Yang W, Kim KY, Lee JK, +5 more, Chang JY.
AI summary — for doctors, generated from the abstract only
Greater small vessel disease burden was linked to poorer neurological response to induced hypertension in small vessel occlusion stroke with early deterioration.
What was studied
Prospective registry cohort of 178 patients with small vessel occlusion stroke and early neurological deterioration treated with induced hypertension, measuring white matter hyperintensity volume and SVD score.
Key findings
- 93 patients (52.2%) had early neurological improvement.
- Each twofold increase in total WMH volume lowered the odds of improvement (OR 0.57).
- Periventricular WMH and higher total SVD score were associated with worse 3-month mRS; SVD score trended against early improvement (p=0.056).
Clinical relevance
Imaging may identify patients unlikely to respond to induced hypertension and who may need other rescue strategies.
Who should care
Limitations
Single-registry observational study without a comparison group not receiving induced hypertension.
Consider baseline WMH burden when counseling on expectations from induced hypertension and think early about alternatives.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Induced hypertension therapy (iHT) is used to rescue early neurological deterioration (END) in small vessel occlusion (SVO) stroke. However, underlying perforator dysfunction reflected by small vessel disease (SVD) burden may attenuate its therapeutic effect.
Aim
To investigate whether white matter hyperintensity (WMH) volume and total SVD score are associated with neurological response to iHT.
Methods
Consecutive patients with acute SVO stroke who developed END and received iHT were identified from a prospective registry (January 2017-July 2025). Regional WMH volumes were quantified on magnetic resonance imaging fluid-attenuated inversion recovery images. Outcomes included early neurological improvement (ENI) following iHT and 3-month modified Rankin Scale (mRS). Associations were evaluated using binary and ordinal logistic regression.
Results
Among 178 patients (median age, 68 years; 55.6% men), 93 (52.2%) achieved ENI. Higher WMH volumes were independently associated with a lower likelihood of ENI (odds ratio (OR) per twofold increase [95% confidence interval]: total, 0.57 [0.43-0.76]; periventricular, 0.57 [0.43-0.76]; deep, 0.68 [0.54-0.86]). Periventricular WMH volume was also associated with an unfavorable shift in 3-month mRS (common OR, 0.80 [0.65-0.99]). Increasing total SVD score was associated with worse 3-month mRS shift (common OR, 0.61 [0.43-0.85]) and a non-significant trend against ENI (OR, 0.70 [0.48-1.01]; p = 0.056).
Conclusion
Greater SVD burden was associated with a poorer neurological response to iHT in SVO stroke with END. Imaging markers of SVD may help identify patients less likely to achieve neurological improvement following iHT, suggesting a need for alternative individualized rescue strategies.
DOI
10.1177/17474930261461834
PMID
42265861
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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