Vascular tortuosity is related to reduced thalamic volume after middle cerebral artery occlusion

The mechanisms underlying secondary brain injury in remote areas remains unclear. This study aimed to investigate the relationship between vascular tortuosity and thalamic volume.

Methods: In this study, we retrospectively analyzed sixty-five patients with unilateral middle cerebral artery occlusion (MCAO) who underwent magnetic resonance angiography. We compared the vascular tortuosity in patients with MCAO and controls, and analyzed the relationship between vascular tortuosity and thalamic volume.

Results: Compared with controls, the MCAO group exhibited a significantly smaller thalamus volume on the affected side (5874 ± 183 mm³ vs. 5635 ± 383 mm³, p < 0.0001). The vascular tortuosity of the posterior cerebral artery (PCA) was higher in the MCAO group than in the controls (82.8 ± 17.3 vs. 76.7 ± 17.3, p = 0.040). Logistic regression analysis revealed that PCA tortuosity was an independent risk factor for reduced thalamic volume after MCAO (p = 0.034). In the subgroup analysis, only the 4-7-day group was not statistically different in thalamic volume between the MCAO and control groups. In the MCAO group, patients older than 60 years and female patients had a more tortuous PCA.

Conclusion: Reduced thalamic volume after MCAO was associated with a tortuous PCA. After MCAO, PCA tortuosity increased more significantly in patients aged >60 years and in female patients.