Lu P, Cui L, Zhao X, et al. - Prominent veins (PVS) on susceptibility-weighted imaging (PVS-SWI) after an acute ischemic stroke were not only associated with a poor functional prognosis [risk ratios (RR) 1.62] but also with an elevated risk of early neurological damage (RR 2.85). Routine PVS-SWI assessment in acute ischemic stroke cases is recommended to improve the prognosis of stroke.

• A quantitative meta-analysis of 16 studies with 1605 patients was conducted.

• A poor functional outcome was evident with both cortical and medullary prominent veins.

• When patients received conservative treatment, PVS-SWI were not associated with poor functional outcomes (RR 1.35).

• There was no association of PVS-SWI with an augmented risk of hemorrhagic transformation.