Lesion volume increase is related to neurologic progression in patients with subcortical infarction

Kyung-Hee Cho, Dong Wha Kang, Sun U. Kwon, Jong S. Kim

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

It remains unknown whether subacute lesion volume increase is related to neurologic progression (NP) and clinical outcome (CO) in patients with single subcortical infarct (SSI) in the middle cerebral artery (MCA) territory. We studied 77 patients who underwent diffusion-weighted MRI (DWI) within 48 h after stroke onset, which revealed unilateral SSI in the MCA territory, and follow-up DWI and MR angiography within 7 days of onset. Neurologic progression was defined as the increase of the National Institutes of Health Stroke Scale (NIHSS) score by ≥ 2 during the first week. Clinical outcome was dichotomized as good (≤ 2) and poor (≥ 3) according to the modified Rankin Scale at 1 month after the onset. Lesion volume increase was defined when the infarct volume in the follow-up MRI exceeds the initial one by either ≥ 30% or 50%. Fourteen patients (18.2%) had NP, and 17 (22.1%) had poor CO. Increase in lesion volume, found in 42 patients (54.5%) when defined by 50% increase and in 51 (66.2%) by 30%, was significantly associated with NP (50%, p = 0.010; 30%, p = 0.027) and poor CO (50%, p = 0.040; 30%, 0.111). Multivariate logistic analyses revealed that lesion volume increase was independently related to NP (odd ratio, 8.48; 95% CI, 1.55-46.46) and that NP was the important predictor for poor CO (odd ratio, 39.69; 95% CI, 3.44-458.68). We conclude that subacute lesion volume growth is closely related to the NP and that the NP predicts subsequent poor CO.

Original languageEnglish
Pages (from-to)163-167
Number of pages5
JournalJournal of the Neurological Sciences
Volume284
Issue number1-2
DOIs
Publication statusPublished - 2009 Sep 15
Externally publishedYes

Fingerprint

Cerebral Infarction
Nervous System
Diffusion Magnetic Resonance Imaging
Middle Cerebral Artery
Stroke
Odds Ratio
Magnetic Resonance Angiography
National Institutes of Health (U.S.)
Multivariate Analysis
Growth

Keywords

  • Cerebrovascular disease
  • Lacune
  • Middle cerebral artery
  • Progression
  • Subcortical infarct

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Lesion volume increase is related to neurologic progression in patients with subcortical infarction. / Cho, Kyung-Hee; Kang, Dong Wha; Kwon, Sun U.; Kim, Jong S.

In: Journal of the Neurological Sciences, Vol. 284, No. 1-2, 15.09.2009, p. 163-167.

Research output: Contribution to journalArticle

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abstract = "It remains unknown whether subacute lesion volume increase is related to neurologic progression (NP) and clinical outcome (CO) in patients with single subcortical infarct (SSI) in the middle cerebral artery (MCA) territory. We studied 77 patients who underwent diffusion-weighted MRI (DWI) within 48 h after stroke onset, which revealed unilateral SSI in the MCA territory, and follow-up DWI and MR angiography within 7 days of onset. Neurologic progression was defined as the increase of the National Institutes of Health Stroke Scale (NIHSS) score by ≥ 2 during the first week. Clinical outcome was dichotomized as good (≤ 2) and poor (≥ 3) according to the modified Rankin Scale at 1 month after the onset. Lesion volume increase was defined when the infarct volume in the follow-up MRI exceeds the initial one by either ≥ 30{\%} or 50{\%}. Fourteen patients (18.2{\%}) had NP, and 17 (22.1{\%}) had poor CO. Increase in lesion volume, found in 42 patients (54.5{\%}) when defined by 50{\%} increase and in 51 (66.2{\%}) by 30{\%}, was significantly associated with NP (50{\%}, p = 0.010; 30{\%}, p = 0.027) and poor CO (50{\%}, p = 0.040; 30{\%}, 0.111). Multivariate logistic analyses revealed that lesion volume increase was independently related to NP (odd ratio, 8.48; 95{\%} CI, 1.55-46.46) and that NP was the important predictor for poor CO (odd ratio, 39.69; 95{\%} CI, 3.44-458.68). We conclude that subacute lesion volume growth is closely related to the NP and that the NP predicts subsequent poor CO.",
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