Abstract

Background: Thrombi originating from the left atrial appendage (LAA) can result in acute ischemic stroke (AIS). Although previous studies indicated some differences in characteristics between cardioembolic and non-cardioembolic stroke, little is known about the magnetic resonance imaging (MRI) pattern of brain injury in the elderly population. Objective: To identify the differences in brain MRI between elderly patients with AIS with and without LAA thrombus. Methods: This cross-sectional study was conducted on the elderly patients with AIS from June 2019 to March 2022 in Thong Nhat Hospital. Results: This study included 274 patients (aged ≥ 60 years; mean age 71.7 ± 8.4 years; male 55.8%). LAA thrombus was detected in 25 patients (9.1%). Compared to the group without LAA thrombus, the group with LAA thrombus had a greater left atrial diameter (37.0 ± 7.0 mm vs 31.4 ± 6.5 mm), higher rates of coronary artery disease (40.0% vs 10.0%) and atrial fibrillation (76.0% vs 0.8%). In the brain MRI, lesions in cortical-subcortical area occurred more frequently in the patients with LAA thrombus compared to those without LAA thrombus (40.0% vs 22.1%, p = 0.001). Additionally, the group with LAA thrombus had a significantly higher rate of bilateral brain infarction than that in the group without LAA thrombus (44.0% vs 19.7%, p = 0.011). Conclusion: In the elderly patients with AIS, our study found that lesions in cortical-subcortical area and bilateral brain infarction were more significantly prevalent in the patients with LAA thrombus than those without LAA thrombus.