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Early recurrent ischemic lesions on diffusion-weighted imaging in symptomatic intracranial atherosclerosis.
- Source :
-
Archives of neurology [Arch Neurol] 2007 Jan; Vol. 64 (1), pp. 50-4. - Publication Year :
- 2007
-
Abstract
- Background: Prior observations have shown that early recurrent ischemic lesions (ERILs) on diffusion-weighted imaging occur frequently within the first week after an index stroke.<br />Objective: To investigate differential patterns of ERILs among stroke subtypes, particularly intracranial large-artery atherosclerosis (IC-LAA).<br />Design: Retrospective study.<br />Setting: Tertiary university hospital.<br />Patients: We included 133 patients who experienced an acute ischemic stroke and who underwent initial diffusion-weighted imaging within 24 hours and subsequent diffusion-weighted imaging within 7 days after onset, and whose stroke subtype was IC-LAA, extracranial LAA (EC-LAA), or cardioembolism (CE).<br />Main Outcome Measure: Early recurrent ischemic lesions were defined as new ischemic lesions on follow-up diffusion-weighted imaging, separate from the index stroke lesion.<br />Results: Early recurrent ischemic lesions were observed in the following proportions: 50.9% (28/55) in the IC-LAA group, 47.4% (9/19) in the EC-LAA group, and 44.1% (26/59) in the CE group. Early recurrent ischemic lesions in the IC-LAA group had the following characteristics: (1) they occurred mostly (27 [96.4%] of 28) in the pial area of the same vascular territory as the index stroke; (2) they were more frequently observed in a higher grade of stenosis than in milder stenosis (P<.001), whereas ERILs in the EC-LAA group were not related to the degree of stenosis; (3) they were not associated with subsequent recanalization, whereas ERILs in the CE group were mostly associated with subsequent recanalization (P<.001); and (4) they were more closely associated with clinical recurrence than in the EC-LAA or CE group (P=.02).<br />Conclusion: Early recurrent ischemic lesions in the IC-LAA group are relatively frequent and have different patterns than in the EC-LAA or CE group.
- Subjects :
- Aged
Brain Mapping
Female
Humans
Ischemic Attack, Transient classification
Male
Middle Aged
Recurrence
Retrospective Studies
Severity of Illness Index
Time Factors
Diffusion Magnetic Resonance Imaging
Intracranial Arteriosclerosis complications
Intracranial Arteriosclerosis diagnosis
Ischemic Attack, Transient diagnosis
Ischemic Attack, Transient etiology
Subjects
Details
- Language :
- English
- ISSN :
- 0003-9942
- Volume :
- 64
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Archives of neurology
- Publication Type :
- Academic Journal
- Accession number :
- 17210808
- Full Text :
- https://doi.org/10.1001/archneur.64.1.50