Frailty in cerebellar ischemic stroke-The significance of temporal muscle thickness

Abstract

While comprising only 2% of all ischemic strokes, cerebellar strokes are responsible for substantial morbidity and mortality due to their subtle initial presentation and the morbidity of posterior fossa swelling. Furthermore, low temporal muscle thickness (TMT) has recently been identified as a prognostic imaging parameter to assess patient frailty and outcome. We analyzed radiological and clinical data sets of 282 patients with cerebellar ischemic stroke. Our analysis showed a significant association between low TMT, reduced NIHSS and mRS at discharge (p = 0.035, p = 0.004), and reduced mRS at 12 months (p = 0.001). TMT may be used as a prognostic imaging marker and objective tool to assess outcomes in patients with cerebellar ischemic stroke.

Keywords: cerebellar stroke; ischemic stroke; out-come; posterior fossa; risk factors; sarcopenia; temporal muscle thickness.

Figure 1

Representative cases for the assessment of temporalis muscle thickness (TMT) on cranial CT scan shown in red arrows. (A) TMT measurement on axial images of a patient with high TMT (bilateral median TMT = 10.5 mm), and (B) a patient with a low TMT on axial CT scan analysis (bilateral median TMT = 1.5).

Figure 2

(A) Plotted infarct volume in ml stratified according to low vs. high temporal muscle thickness. (B) Plotted cerebellar volume in ml stratified into low vs. high temporal muscle thickness. (C) mRS at 12 months stratified into low vs. high temporal muscle thickness. TMT, temporal muscle thickness; mRS, modified Rankin scale; ns, not significant.