• Zurab Nadareishvili, Alexis N Simpkins, Emi Hitomi, Dennys Reyes, and Richard Leigh.
• National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA.
• Cerebrovasc. Dis. 2019 Jan 1; 47 (3-4): 135-142.

Background And PurposeThe role played by post-stroke inflammation after an ischemic event in limiting functional recovery remains unclear. One component of post-stroke inflammation is disruption of the blood-brain barrier (BBB). This study examines the relationship between post-stroke BBB disruption and functional outcome.MethodsAcute stroke patients treated with thrombolysis underwent magnetic resonance imaging scanning 24 h and 5 days after their initial event. BBB permeability maps were generated from perfusion weighted imaging. Average permeability was calculated in the affected hemisphere. Good functional outcome, defined as a modified Rankin score of 0 or 1, was compared with average permeability using logistic regression.ResultsOf the 131 patients enrolled, 76 patients had the necessary data to perform the analysis at 24 h, and 58 -patients had data for the 5-day assessment. Higher BBB permeability measured at 24 h (OR 0.57; 95% CI 0.33-0.99, p = 0.045) and at 5 days (OR 0.24; 95% CI 0.09-0.66, p = 0.005) was associated with worse functional outcome 1-3 months after the acute ischemic stroke. For every percentage increase in BBB disruption at 5 days, there was a 76% decrease in the chance of achieving a good functional outcome after stroke. Multivariate analysis found this to be independent of age, stroke volume, or clinical stroke severity.ConclusionsPost-stroke BBB disruption appears to be predictive of functional outcome irrespective of stroke size.© 2019 S. Karger AG, Basel.

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