CT-Measured Infarct Volume as a Marker of Stroke Severity at Presentation

Background: Acute ischemic stroke is a leading cause of death and disability worldwide.Early assessment of severity guides management and improves prognosis.Infarct volume indicates irreversible brain injury and is an important imaging-based biomarker.Non-contrast computed tomography is the most accessible imaging modality for acute stroke.This study assessed CT-based infarct volume at presentation and its association with stroke severity using the National Institutes of Health Stroke Scale (NIHSS).Methods: This cross-sectional observational study was conducted at the Department of Radiology and Imaging, Uttara Adhunik Medical College Hospital, Dhaka, from January to December 2025.A total of 120 patients with acute ischemic stroke who underwent non-contrast CT brain imaging within 24 hour of symptom onset were included.Infarct volume was measured and categorized as small (70 cm³).Stroke severity was assessed using the NIHSS.Statistical analysis was performed using SPSS version 25.0.Results: Moderate infarct volumes were most frequently observed (38.3%), followed by small (31.7%) and large (30.0%) infarcts.Patients with small infarct volumes predominantly presented with mild stroke severity.In contrast, large infarct volumes were strongly associated with severe NIHSS scores.A clear gradient was observed, with increasing infarct volume corresponding to higher stroke severity.Conclusion: Acute ischemic stroke, computed tomography, infarct volume, NIHSS, stroke severity.