A Simple Geometric Assessment of Perfusion Lesion Volume at Hyperacute Stage of Ischemic Stroke in Patients with Symptomatic Steno-Occlusion of Major Cerebral Arteries and Risk of Subsequent Cerebral Ischemic Events

Jihoon Kang, Cheolkyu Jung, Nayoung Kim, Yoo Ri Son, Byungse Choi, Jae Hyoung Kim, Ji Sung Lee, Jun Lee, Myung Suk Jang, Mi Hwa Yang, Moon Ku Han, Hee Joon Bae, Juneyoung Lee

Research output: Contribution to journalArticle

Abstract

Our objective is to elucidate the association of baseline perfusion lesion volume on perfusion-weighted magnetic resonance imaging (PWI) obtained at hyperacute stage of ischemic stroke with subsequent cerebral ischemic events (SIEs) in patients with symptomatic steno-occlusion of major cerebral arteries. Using a prospective stroke registry database, patients arriving within 24 hours of onset with symptomatic steno-occlusion of major supratentorial cerebral arteries were identified. On baseline PWI, time-to-peak lesion volume (TTP-LV) was determined by a simple geometric method and dichotomized into the highest tertile (large) and the other tertiles (small to medium) according to the vascular territory of occluded arteries. Primary outcome was a time to SIE up to 1 year after stroke onset. A total of 385 patients (a median time delay from onset to arrival, 2.2 hours) were enrolled. During the first year of stroke, the SIE rate of the large TTP-LV group was twice that of the small-to-medium TTP-LV group (35.7% versus 17.4%; P <.001). Large TTP-LV independently raised the hazard of SIE (hazard ratio, 2.24; 95% confidence interval, 1.45-3.44). This study demonstrates that TTP-LV on PWI measured through a simple geometric method at an emergency setting can be used to predict progression or recurrence of ischemic stroke in patients with symptomatic steno-occlusion of major cerebral arteries.

Original languageEnglish
Pages (from-to)2669-2675
Number of pages7
JournalJournal of Stroke and Cerebrovascular Diseases
Volume24
Issue number12
DOIs
Publication statusPublished - 2015 Dec 1

Keywords

  • Cerebral ischemia
  • perfusion
  • progression
  • recurrence
  • stenosis and cerebrovascular occlusion

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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