scholarly journals Hemorrhage After Endovascular Recanalization in Acute Stroke: Lesion Extent, Collaterals and Degree of Ischemic Water Uptake Mediate Tissue Vulnerability

2019 ◽  
Vol 10 ◽  
Author(s):  
Jawed Nawabi ◽  
Helge Kniep ◽  
Gerhard Schön ◽  
Fabian Flottmann ◽  
Hannes Leischner ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Water Uptake ◽  
Endovascular Recanalization ◽  
Stroke Lesion

scholarly journals Impact of endovascular recanalization on quantitative lesion water uptake in ischemic anterior circulation strokes

2019 ◽  
Vol 40 (2) ◽  
pp. 437-445 ◽  
Author(s):  
Gabriel Broocks ◽  
Fabian Flottmann ◽  
Uta Hanning ◽  
Gerhard Schön ◽  
Peter Sporns ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Brain Edema ◽  
Water Uptake ◽  
Imaging Biomarker ◽  
Anterior Circulation ◽  
Vessel Occlusion ◽  
Ischemic Brain ◽  
Multicenter Observational Study ◽  
Endovascular Recanalization ◽  
Ischemic Brain Edema

Studies evaluating the effect of reperfusion on ischemic edema in acute stroke described conflicting results. Net water uptake (NWU) per brain volume is a new quantitative imaging biomarker of space-occupying ischemic edema, which can be measured in computed tomography (CT). We sought to investigate the effects of vessel recanalization on the formation of ischemic brain edema using quantitative NWU. In this multicenter observational study, acute ischemic stroke patients with a large vessel occlusion (LVO) in the anterior circulation were consecutively screened. Patients with vessel recanalization (thrombolysis in cerebral infarction (TICI) 2 b or 3) versus persistent vessel occlusion (no thrombectomy, TICI 0-1) were compared. Lesion-NWU was quantified in multimodal admission CT and follow-up CT (FCT), and ΔNWU was calculated as difference. Of 194 included patients, 150 had successful endovascular recanalization and 44 persistent LVO. In FCT after treatment, the mean (standard deviation) ΔNWU was 15.8% (5.7) in patients with persistent LVO and 9.8% (5.8) with vessel recanalization ( p < 0.001). In multivariate regression analysis, vessel recanalization was independently associated with a lowered ΔNWU by 6.3% compared to LVO (95% confidence interval: 3.7–9.0, p < 0.001). Successful vessel recanalization was associated with a significantly reduced formation of ischemic brain edema. Quantitative NWU may be used to compare the treatment effects in acute stroke.

scholarly journals Ischemic Lesion Water Uptake in Acute Stroke: Is Blood Glucose Related to Cause and Effect?

2019 ◽  
Vol 21 (3) ◽  
pp. 347-349 ◽  
Author(s):  
Gabriel Broocks ◽  
Andre Kemmling ◽  
Jens Aberle ◽  
Helge Kniep ◽  
Matthias Bechstein ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Acute Stroke ◽  
Water Uptake ◽  
Ischemic Lesion ◽  
Cause And Effect

scholarly journals Perfusion magnetic resonance neuroimaging

2019 ◽  
Author(s):  
Adnan Šehić ◽  
Fuad Julardžija ◽  
Merim Jusufbegović ◽  
Deniz Bulja ◽  
Hadžan Konjo ◽  
...  
Keyword(s):  
Blood Flow ◽  
Magnetic Resonance ◽  
Acute Stroke ◽  
Cerebral Perfusion ◽  
Technology Development ◽  
Regional Blood Flow ◽  
Mr Perfusion ◽  
Endovascular Recanalization

The clinical appliance of perfusion is being continuously developed and it is closely related to technology development. The role of perfusion neuroimaging in the management of acute stroke has been to prove reduced regional blood flow and to give the contribution in the identification of ischemic areas, respectively the regions of hypoperfusion that can be treated by thrombolytic and/or endovascular recanalization therapy. There are two main approaches to the measurement of cerebral perfusion by magnetic resonance. The aim of this article is to compare different measuring approaches of MR perfusion neuroimaging.

scholarly journals JOURNAL CLUB: Evaluation of Diffusion Kurtosis Imaging of Stroke Lesion With Hemodynamic and Metabolic MRI in a Rodent Model of Acute Stroke

2018 ◽  
Vol 210 (4) ◽  
pp. 720-727 ◽  
Author(s):  
Dongshuang Lu ◽  
Yinghua Jiang ◽  
Yang Ji ◽  
Iris Yuwen Zhou ◽  
Emiri Mandeville ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Journal Club ◽  
Rodent Model ◽  
Diffusion Kurtosis Imaging ◽  
Stroke Lesion ◽  
Diffusion Kurtosis

Elevated early lesion water uptake in acute stroke predicts poor outcome despite successful recanalization – When “tissue clock” and “time clock” are desynchronized

2019 ◽  
pp. 174749301988452 ◽  
Author(s):  
Jawed Nawabi ◽  
Fabian Flottmann ◽  
Andre Kemmling ◽  
Helge Kniep ◽  
Hannes Leischner ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Acute Stroke ◽  
Water Uptake ◽  
Quantitative Imaging ◽  
Receiver Operating Curve ◽  
Imaging Biomarker ◽  
Poor Clinical Outcome ◽  
Similar Time ◽  
Poor Outcome ◽  
Malignant Infarction

Background Ischemic water uptake in acute stroke is a reliable indicator of lesion age. Nevertheless, inter-individually varying edema progression has been observed and elevated water uptake has recently been described as predictor of malignant infarction. Aims We hypothesized that early-elevated lesion water uptake indicates accelerated “tissue clock” desynchronized with “time clock” and therefore predicts poor clinical outcome despite successful recanalization. Methods Acute middle cerebral artery stroke patients with multimodal admission-CT who received successful thrombectomy (TICI 2b/3) were analyzed. Net water uptake (NWU), a quantitative imaging biomarker of ischemic edema, was determined in admission-CT and tested as predictor of clinical outcome using modified Rankin Scale (mRS) after 90 days. A binary outcome was defined for mRS 0–4 and mRS 5–6. Results Seventy-two patients were included. The mean NWU (SD) in patients with mRS 0–4 was lower compared to patients with mRS 5–6 (5.0% vs. 12.1%; p < 0.001) with similar time from symptom onset to imaging (2.6 h vs. 2.4 h; p = 0.7). Based on receiver operating curve analysis, NWU above 10% identified patients with very poor outcome with high discriminative power (AUC 0.85), followed by Alberta Stroke Program Early CT Score (ASPECTS) (AUC: 0.72) and National Institutes of Health Stroke Scale (NIHSS) (AUC: 0.72). Conclusions Quantitative NWU may serve as an indicator of “tissue clock” and pronounced early brain edema with elevated NWU might suggest a desynchronized “tissue clock” with real “time clock” and therefore predict futile recanalization with poor clinical outcome.

scholarly journals Lesion Age Imaging in Acute Stroke: Water Uptake in CT Versus DWI‐FLAIR Mismatch

2020 ◽  
Vol 88 (6) ◽  
pp. 1144-1152 ◽  
Author(s):  
Gabriel Broocks ◽  
Hannes Leischner ◽  
Uta Hanning ◽  
Fabian Flottmann ◽  
Tobias D. Faizy ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Water Uptake

scholarly journals Acute and sub-acute stroke lesion segmentation from multimodal MRI

2020 ◽  
Vol 194 ◽  
pp. 105521
Author(s):  
Albert Clèrigues ◽  
Sergi Valverde ◽  
Jose Bernal ◽  
Jordi Freixenet ◽  
Arnau Oliver ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Lesion Segmentation ◽  
Multimodal Mri ◽  
Stroke Lesion
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