Skip to main content Accessibility help
×
Home
Hostname: page-component-544b6db54f-prt4h Total loading time: 0.279 Render date: 2021-10-22T11:22:43.298Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Lesions on DWI and the Outcome in Hyperacute Posterior Circulation Stroke

Published online by Cambridge University Press:  23 September 2014

Hye Mi Lee
Affiliation:
Department of Neurology, College of Medicine, Korea University, Seoul, Republic of Korea
Minjik Kim
Affiliation:
Department of Neurology, College of Medicine, Korea University, Seoul, Republic of Korea
Sang-il Suh
Affiliation:
Department of Radiology, College of Medicine, Korea University, Seoul, Republic of Korea
Ji Hyun Kim
Affiliation:
Department of Neurology, College of Medicine, Korea University, Seoul, Republic of Korea
Kyungmi Oh
Affiliation:
Department of Neurology, College of Medicine, Korea University, Seoul, Republic of Korea
Seong-Beom Koh
Affiliation:
Department of Neurology, College of Medicine, Korea University, Seoul, Republic of Korea
Woo-Keun Seo*
Affiliation:
Department of Neurology, College of Medicine, Korea University, Seoul, Republic of Korea
*
Department of Neurology, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, [152-703], South Korea. Email: nukseo@korea.ac.kr
Rights & Permissions[Opens in a new window]

Abstract

HTML view is not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background:

few studies have addressed the association between the characteristics of ischemic lesions detected by diffusion-weighted imaging (dWi) and the clinical outcome in patients with hyperacute posterior circulation ischemic stroke. this study demonstrates a relationship between the findings assessed by dWi and the outcome in patients with hyperacute posterior circulation ischemic stroke.

Methods:

We reviewed data from 118 patients who had posterior circulation ischemic stroke within six hours from the onset of their symptoms. the clinical outcome included early neurological deterioration (end) and a favorable outcome at three months after the onset of symptoms. using dWi, the lesion volume and the number and location of injured anatomical regions were analyzed to evaluate whether the results correlated with the clinical outcome measures.

Results:

the number of injured anatomical regions assessed by dWi was associated with the initial and delayed neurological status. Both the total volume and the number of injured anatomical regions associated with end and a favorable outcome. analysis of the location of the injured regions determined that only a pontine lesion independently associated with end. interestingly, four out of five patients who underwent decompressive craniectomy exhibited a large infarction volume but minor symptoms.

Conclusions:

in patients with hyperacute posterior circulation ischemic strokes, the lesions assessed by dWi were associated with the clinical outcome, regardless of the initial neurological status. dWi is an effective initial imaging tool for assessing the extent of lesions and clinical outcomes in patients with hyperacute posterior circulation ischemic stroke.

Type
Original Article
Copyright
Copyright © The Canadian Journal of Neurological 2014

References

1.Warach, S, Dashe, JF, Edelman, RR.Clinical outcome in ischemic stroke predicted by early diffusion-weighted and perfusion magnetic resonance imaging: a preliminary analysis. J Cereb Blood Flow Metab. 1996;16(1):539.CrossRefGoogle ScholarPubMed
2.Lövblad, KO, Baird, AE, Schlaug, G, et al. Ischemic lesion volumes in acute stroke by diffusion-weighted magnetic resonance imaging correlate with clinical outcome. Ann Neurol. 1997;42(2):16470.CrossRefGoogle ScholarPubMed
3.Thijs, VN, Lansberg, MG, Beaulieu, C, Marks, MP, Moseley, ME, Albers, GW.Is early ischemic lesion volume on diffusion-weighted imaging an independent predictor of stroke outcome? A multivariable analysis. Stroke. 2000;31(11):2597602.CrossRefGoogle ScholarPubMed
4.Arenillas, JF, Rovira, A, Molina, CA, Grivé, E, Montaner, J, Alvarez-Sabín, J.Prediction of early neurological deterioration using diffusion- and perfusion-weighted imaging in hyperacute middle cerebral artery ischemic stroke. Stroke. 2002;33(9):2197203.CrossRefGoogle ScholarPubMed
5.Bang, OY, Lee, PH, Heo, KG, Joo, US, Yoon, SR, Kim, SY.Specific DWI lesion patterns predict prognosis after acute ischaemic stroke within the MCA territory. J Neurol Neurosurg Psychiatry. 2005;76(9):12228.CrossRefGoogle ScholarPubMed
6.Kimura, K, Iguchi, Y, Shibazaki, K, et al. Large ischemic lesions on diffusion-weighted imaging done before intravenous tissue plasminogen activator thrombolysis predicts a poor outcome in patients with acute stroke. Stroke. 2008;39(8):238891.CrossRefGoogle ScholarPubMed
7.Tei, H, Uchiyama, S, Usui, T, Ohara, K.Posterior circulation ASPECTS on diffusion-weighted MRI can be a powerful marker for predicting functional outcome. J Neurol. 2010;257(5):76773.CrossRefGoogle ScholarPubMed
8.Engelter, ST, Wetzel, SG, Radue, EW, Rausch, M, Steck, AJ, Lyrer, PA.The clinical significance of diffusion-weighted MR imaging in infratentorial strokes. Neurology. 2004;62(4):57480.CrossRefGoogle ScholarPubMed
9.Muir, KW, Buchan, A, von Kummer, R, Rother, J, Baron, JC.Imaging of acute stroke. Lancet Neurol. 2006;5(9):75568.CrossRefGoogle ScholarPubMed
10.Mullins, ME, Schaefer, PW, Sorensen, AG, et al. CT and conventional and diffusion-weighted MR imaging in acute stroke: study in 691 patients at presentation to the emergency department. Radiology. 2002;224(2):35360.CrossRefGoogle ScholarPubMed
11.Linfante, I, Llinas, RH, Schlaug, G, Chaves, C, Warach, S, Caplan, LR.Diffusion-weighted imaging and National Institutes of Health Stroke Scale in the acute phase of posterior-circulation stroke. Arch Neurol. 2001;58(4):6218.CrossRefGoogle ScholarPubMed
12.Adams, HP Jr., del Zoppo, G, Alberts, MJ, et al. Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: the American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Stroke. 2007;38(5):1655711.CrossRefGoogle ScholarPubMed
13.Adams, HP Jr., Bendixen, BH, Kappelle, LJ, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke. 1993;24(1):3541.Google ScholarPubMed
14.Thanvi, B, Treadwell, S, Robinson, T.Early neurological deterioration in acute ischaemic stroke: predictors, mechanisms and management. Postgrad Med J. 2008;84(994):4127.CrossRefGoogle ScholarPubMed
15.Kwan, J, Hand, P.Early neurological deterioration in acute stroke: clinical characteristics and impact on outcome. QJM. 2006;99(9):62533.CrossRefGoogle Scholar
16.Brott, T, Adams, HP Jr., Olinger, CP, et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke. 1989;20(7):86470.CrossRefGoogle ScholarPubMed
17.Muir, KW, Weir, CJ, Murray, GD, Povey, C, Lees, KR.Comparison of neurological scales and scoring systems for acute stroke prognosis. Stroke. 1996;27(10):181720.CrossRefGoogle ScholarPubMed
18.Goldstein, LB, Samsa, GP.Reliability of the National Institutes of Health Stroke Scale. Extension to non-neurologists in the context of a clinical trial. Stroke. 1997;28(2):30710.Google ScholarPubMed
19.Sato, S, Toyoda, K, Uehara, T, et al. Baseline NIH Stroke Scale Score predicting outcome in anterior and posterior circulation strokes. Neurology. 2008;70(24 Pt 2):23717.CrossRefGoogle ScholarPubMed
20.Martin-Schild, S, Albright, KC, Tanksley, J, et al. Zero on the NIHSS does not equal the absence of stroke. Ann Emerg Med. 2011;57(1):425.CrossRefGoogle Scholar
21. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. N Engl J Med. 1995;333(24):15817.CrossRefGoogle Scholar
22.Hossmann, KA.Viability thresholds and the penumbra of focal ischemia. Ann Neurol. 1994;36(4):55765.CrossRefGoogle ScholarPubMed
You have Access
4
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Lesions on DWI and the Outcome in Hyperacute Posterior Circulation Stroke
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Lesions on DWI and the Outcome in Hyperacute Posterior Circulation Stroke
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Lesions on DWI and the Outcome in Hyperacute Posterior Circulation Stroke
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *