Document Detail


Early functional recovery and the fate of the diffusion/perfusion mismatch in patients with proximal middle cerebral artery occlusion.
MedLine Citation:
PMID:  14530633     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The relationship between early neurological recovery, time to recanalization and the salvage of hypoperfused, but not diffusion-restricted tissue was investigated. METHODS: In 17 patients with acute middle cerebral artery occlusion, a multiparametric stroke MRI protocol was performed < 6 h after symptom onset, as well as at day 2 and 7. Recanalization was monitored with transcranial Doppler or with conventional angiography (during local thrombolysis). Functional improvement was defined as a change of > or = 4 points on the National Institutes of Health Stroke Scale score. RESULTS: In patients with functional improvement, 78% (median, range 66-95%) of the acute mean transit time (MTT) lesion escaped infarction compared with 28% (median, range -13 to 78%) in patients without neurological improvement (p < 0.01). Similarly, the percentage of tissue with a time-to-peak (TTP) delay of > or = 2 s not progressing to infarction was 80 and 4% in the groups with and without improvement, respectively (p < 0.01). Neurological improvement was more frequent in patients with early (< or = 3 h after presentation) recanalization, due to the salvage of larger areas of initially hypoperfused tissue. CONCLUSIONS: The salvage of hypoperfused tissue is a major factor influencing early neurological improvement.
Authors:
Oliver C Singer; Richard Du Mesnil De Rochemont; Christian Foerch; Astrid Stengel; Matthias Sitzer; Heiner Lanfermann; Tobias Neumann-Haefelin
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2003-10-03
Journal Detail:
Title:  Cerebrovascular diseases (Basel, Switzerland)     Volume:  17     ISSN:  1015-9770     ISO Abbreviation:  Cerebrovasc. Dis.     Publication Date:  2004  
Date Detail:
Created Date:  2003-12-19     Completed Date:  2004-04-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9100851     Medline TA:  Cerebrovasc Dis     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  13-20     Citation Subset:  IM    
Copyright Information:
Copyright 2004 S. Karger AG, Basel
Affiliation:
Department of Neurology, J.W. Goethe University Frankfurt am Main, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cerebrovascular Circulation / physiology*
Diffusion Magnetic Resonance Imaging*
Female
Follow-Up Studies
Humans
Infarction, Middle Cerebral Artery / diagnosis*,  physiopathology*,  therapy
Magnetic Resonance Angiography*
Male
Middle Aged
Prognosis
Recovery of Function / physiology
Thrombolytic Therapy
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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