| Blood-brain barrier permeability derangements in posterior circulation ischemic stroke: Frequency and relation to hemorrhagic transformation. | |
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MedLine Citation:
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PMID: 21945462 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Early disruption of the blood-brain barrier (BBB) due to severe ischemia can be detected by MRI T2* permeability imaging. In middle cerebral artery (MCA) infarction, pretreatment T2* permeability derangements have been found in 22% of patients and are powerful predictors of hemorrhagic transformation after revascularization therapy. The frequency, clinical correlates, and relation to hemorrhagic transformation of permeability derangements in posterior circulation have not been previously explored, and may differ as ischemia volume and collateral status are different between vertebrobasilar and MCA infarcts. METHODS: We analyzed clinical and pretreatment MRI data on consecutive patients undergoing recanalization therapy for acute vertebrobasilar ischemia at a medical center November 2001 through September 2009. Pretreatment MRI permeability images were derived from perfusion source imaging acquisitions. Permeability abnormality was detected as persisting increased signal intensity at later time points in perfusion MRI acquisition, indicating local accumulation of contrast caused by BBB leakage. RESULTS: Among the 14 patients meeting study entry criteria, mean age was 71.1years and median pretreatment NIHSS was 20.5. Permeability imaging abnormality was present in 1 of the 14 patients (7%). Among 14 patients, post-treatment parenchymal hematoma occurred in one and more minor degrees of hemorrhagic transformation in four. The one patient with pretreatment permeability abnormality was the patient to develop post-treatment parenchymal hematoma (Fisher's exact test, P=0.07). CONCLUSION: Pretreatment permeability abnormality, an indicator of BBB derangements, is an infrequent finding in acute posterior circulation ischemic stroke and may be associated with an increased risk of parenchymal hematoma development undergoing recanalization therapy. |
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Authors:
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Meng Lee; Jeffrey L Saver; Jeffry R Alger; Qing Hao; Sidney Starkman; Latisha K Ali; Doojin Kim; Bruce Ovbiagele; Paul M Vespa; Michael T Froehler; Matthew S Tenser; Noriko Salamon; J Pablo Villablanca; Reza Jahan; Gary R Duckwiler; Satoshi Tateshima; Nestor Gonzalez; Fernando Vinuela; David S Liebeskind |
Publication Detail:
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Type: - Date: 2011-9-24 |
Journal Detail:
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Title: Journal of the neurological sciences Volume: - ISSN: 1878-5883 ISO Abbreviation: - Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-9-27 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0375403 Medline TA: J Neurol Sci Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Elsevier B.V. All rights reserved. |
Affiliation:
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UCLA Stroke Center, Geffen School of Medicine, University of California, Los Angeles, CA, United States; Department of Neurology, Chang Gung Memorial Hospital at Chiayi and Chang Gung University College of Medicine, Taiwan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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