| Early functional recovery and the fate of the diffusion/perfusion mismatch in patients with proximal middle cerebral artery occlusion. | |
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MedLine Citation:
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PMID: 14530633 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't Date: 2003-10-03 |
Journal Detail:
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Title: Cerebrovascular diseases (Basel, Switzerland) Volume: 17 ISSN: 1015-9770 ISO Abbreviation: Cerebrovasc. Dis. Publication Date: 2004 |
Date Detail:
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Created Date: 2003-12-19 Completed Date: 2004-04-13 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9100851 Medline TA: Cerebrovasc Dis Country: Switzerland |
Other Details:
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Languages: eng Pagination: 13-20 Citation Subset: IM |
Copyright Information:
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Copyright 2004 S. Karger AG, Basel |
Affiliation:
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Department of Neurology, J.W. Goethe University Frankfurt am Main, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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