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ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2026

The role of computed tomography in thrombus characterization: Insights from a stroke cohort of known and unknown etiology.

Maurizio Paciaroni, Giorgio Busto, Andrea Bernardoni, Marina Padroni, Alessandro De Vito, Cristiano Azzini, Guido Fanfani, Alessia Maruccia, Maria Elena Fraccalanza, Tatiana Favaro and 7 more

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Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

17 authors.

Maurizio PaciaroniDepartement of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy. maurizio.paciaroni@unife.it.ORCID http://orcid.org/0000-0002-5483-8795
Giorgio BustoNeuroradiology Unit, Department of Radiology, Careggi University Hospital, Florence, Italy.
Andrea BernardoniNeuroradiology Unit, Department of Radiology, Arcispedale S. Anna, Ferrara, Italy.
Marina PadroniU.O. Neurologia, Stroke Unit, Azienda Ospedaliera Universitaria S. Anna, Ferrara, Italy.
Alessandro De VitoU.O. Neurologia, Stroke Unit, Azienda Ospedaliera Universitaria S. Anna, Ferrara, Italy.
Cristiano AzziniU.O. Neurologia, Stroke Unit, Azienda Ospedaliera Universitaria S. Anna, Ferrara, Italy.
Guido FanfaniNeuroradiology Unit, Department of Radiology, Careggi University Hospital, Florence, Italy.
Alessia MarucciaDepartement of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy.
Maria Elena FraccalanzaDepartement of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy.
Tatiana FavaroDepartement of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy.
Francesco CastellanaDepartement of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy.
Laura RabboniDepartement of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy.
Andrea Galeazzo RigutiniInternal, Vascular and Emergency Medicine, Stroke Unit, University of Perugia, Perugia, Italy.
Andrea SalettiNeuroradiology Unit, Department of Radiology, Arcispedale S. Anna, Ferrara, Italy.
Daniela GragnanielloU.O. Neurologia, Stroke Unit, Azienda Ospedaliera Universitaria S. Anna, Ferrara, Italy.
Maura PugliattiDepartement of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy.
Enrico FainardiNeuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis study aimed to investigate: (1) the correlation between stroke cause and thrombus computed tomography (CT) characteristics in acute ischemic stroke (AIS) patients and large vessel occlusion (LVO); (2) whether thrombus features in cryptogenic stroke (CS) can help differentiate cardioembolic from non-cardioembolic causes. PATIENTS AND

methodsIn consecutive AIS patients with LVO recruited retrospectively (2022-2025), associations between stroke etiology and thrombus CT characteristics (location, density and length) were estimated. The association of cause with thrombus location was estimated with multivariable logistic regression and presented as odds ratio (OR). The association of cause with Hounsfield Unit (HU) and the thrombus length was estimated with multivariable linear regression and was presented as coefficients (ß). A latent class analysis was performed in CSs to identify clinically meaningful sub-phenotypes based on demographic and thrombus characteristics.

resultsAmong 580 patients (mean age, 75.8 ± 12.4 years; 274 women), 26.2% had large artery atherosclerosis, 58.8% cardioembolism (79.2% of these with atrial fibrillation), 5.7% other determined causes, and 9.3% CS. Non-cardioembolic strokes were associated with a more proximal thrombus location (OR 2.00 [95% CI 1.15-3.44]), higher HU (ß 2.63 [95% CI 0.20-5.06]) and longer thrombus (ß 1.23 [95% CI 0.66-1.79]) compared to cardioembolic strokes. Thrombus characteristics for CS were similar to those of cardioembolic strokes. Within the group of CS patients, two sub-phenotypes emerged: one showing higher thrombus density and length, and another mirroring cardioembolic characteristics.

conclusionWithin the cohort of patients with CS, thrombus characteristics allowed to identify patients with a stroke likely of cardioembolic origin.

Indexed as

Intracranial ThrombosisIschemic StrokeStrokeThrombosisTomography, X-Ray ComputedAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesComputed tomographyCryptogenic strokeThrombus

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.