scholarly journals Incidence of New Diffusion-Weighted Imaging Lesions Outside the Area of Initial Hypoperfusion Within 1 Week After Acute Ischemic Stroke

Stroke ◽  
2012 ◽  
Vol 43 (10) ◽  
pp. 2654-2658 ◽  
Author(s):  
Tatiana Usnich ◽  
Fredrik N. Albach ◽  
Peter Brunecker ◽  
Jochen B. Fiebach ◽  
Christian H. Nolte
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Diffusion Weighted Imaging ◽  
Diffusion Weighted

Reversible diffusion-weighted imaging lesions in acute ischemic stroke

Neurology ◽  
2020 ◽  
Vol 94 (13) ◽  
pp. 571-587 ◽  
Author(s):  
Nandakumar Nagaraja ◽  
John R. Forder ◽  
Steven Warach ◽  
Jośe G. Merino
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Endovascular Therapy ◽  
Diffusion Weighted Imaging ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Nihss Score ◽  
Diffusion Weighted ◽  
Ischemic Tissue ◽  
Fluid Attenuated Inversion Recovery

ObjectivesTo systematically review the literature for reversible diffusion-weighted imaging (DWIR) lesions and to describe its prevalence, predictors, and clinical significance.MethodsStudies were included if the first DWI MRI was performed within 24 hours of stroke onset and follow-up DWI or fluid-attenuated inversion recovery (FLAIR)/T2 was performed within 7 or 90 days, respectively, to measure DWIR. We abstracted clinical, imaging, and outcomes data.ResultsTwenty-three studies met the study criteria. The prevalence of DWIR was 26.5% in DWI-based studies and 6% in FLAIR/T2-based studies. DWIR was associated with recanalization or reperfusion of the ischemic tissue with or without the use of tissue plasminogen activator (t-PA) or endovascular therapy, earlier treatment with t-PA, shorter time to endovascular therapy after MRI, and absent or less severe perfusion deficit within the DWI lesion. DWIR was associated with early neurologic improvement in 5 of 6 studies (defined as improvement in the NIH Stroke Scale (NIHSS) score by 4 or 8 points from baseline or NIHSS score 0 to 2 at 24 hours after treatment or at discharge or median NIHSS score at 7 days) and long-term outcome in 6 of 7 studies (defined as NIHSS score ≤1, improvement in the NIHSS score ≥8 points, or modified Rankin Scale score up to ≤2 at 30 or 90 days) likely due to reperfusion.ConclusionsDWIR is seen in up to a quarter of patients with acute ischemic stroke, and it is associated with good clinical outcome following reperfusion. Our findings highlight the pitfalls of DWI to define ischemic core in the early hours of stroke.

scholarly journals Variability of optic nerve sheath diameter in acute ischemic stroke

2019 ◽  
Vol 27 (4) ◽  
pp. 223-228 ◽  
Author(s):  
Nalan Kozaci ◽  
Mustafa Avci ◽  
Gulsum Caliskan ◽  
Serkan Yuksel
Keyword(s):  
Ischemic Stroke ◽  
Optic Nerve ◽  
Acute Ischemic Stroke ◽  
Computerized Tomography ◽  
Diffusion Weighted Imaging ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Nerve Sheath ◽  
Diffusion Weighted ◽  
And Diffusion

Background: Stroke is the third leading cause of death and the first cause of disability in the world. It holds an important place in hospital admissions and health expenses in the industrialized world. Objective: The aim of the study was to evaluate the relationship between optic nerve sheath diameter and the findings of brain computerized tomography scans and brain diffusion-weighted imaging and investigate the variability of optic nerve sheath diameter measured by ultrasonography in acute ischemic stroke. Methods: Patients who had acute ischemic stroke were included in Group A. Healthy adults were included in Group B as the control group. In addition, according to computerized tomography scans and diffusion-weighted imaging findings, Group A was divided into three subgroups. Patients with normal computerized tomography and diffusion-weighted imaging were included in Group 1, patients with normal computerized tomography and ischemic area on diffusion-weighted imaging were included in Group 2, and patients with ischemic area on computerized tomography and diffusion-weighted imaging were included in Group 3. Results: A total of 100 patients were included in Group A and 100 healthy adults included in Group B. The optic nerve sheath diameter values of Groups A and B were 5.4 ± 0.6 and 4.2 ± 0.4 mm (p < 0.001), respectively. The optic nerve sheath diameter cutoff value for detection of acute ischemic stroke was determined as 4.7 mm. The sensitivity and specificity at this cutoff value were determined as 89% and 90%, respectively. According to computerized tomography scans and diffusion-weighted imaging findings, there were 18 patients in Group 1, 56 patients in Group 2, and 26 patients in Group 3. Time from onset of symptoms to presentation to emergency department was shortest in Group 1 (3.0 ± 1.8 h). The widest optic nerve sheath diameter was calculated in Group 3 (optic nerve sheath diameter: 5.7 ± 0.6 mm). Conclusion: This study demonstrates that the optic nerve sheath diameter increases in acute ischemic stroke and it increases earlier than computerized tomography and diffusion-weighted imaging alteration occur. Therefore, optic nerve sheath diameter can be applied to assist the diagnosis of acute ischemic stroke with other imaging techniques with equivocal/negative results and determination of appropriate treatment, especially in cases with normal computerized tomography scan and diffusion-weighted imaging.

44. Diffusion Weighted Imaging Lesion Reversal is rare after IV thrombolysis in Acute Ischemic Stroke

2009 ◽  
Vol 16 (11) ◽  
pp. 1540
Author(s):  
Thomas Chemmanam ◽  
Soren Christensen ◽  
F Bladin Christopher ◽  
M Desmond Patricia ◽  
Martin Ebinger ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Diffusion Weighted Imaging ◽  
Diffusion Weighted
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