Can Early Ischemic Lesion Recurrence on Diffusion-Weighted MRI Affect Functional Outcome after Acute Ischemic Stroke?
Journal of Clinical Neurology
; : 19-26, 2010.
Article
in English
| WPRIM (Western Pacific)
| ID: wpr-57292
Responsible library:
WPRO
ABSTRACT
BACKGROUND AND PURPOSE:
Ischemic lesion recurrence on diffusion-weighted imaging (DWI-LR) is a frequently observed phenomenon after acute ischemic stroke. However, no study has elucidated the impact of DWI-LR on functional outcome.METHODS:
Among a consecutive series of patients who presented with focal symptoms or signs compatible with stroke within 48 hours from the onset over a 50-month period, those who had relevant ischemic lesions on initial DWI and underwent follow-up DWI within 14 days after the onset were enrolled in this study. As outcome variables, the scores on the modified Rankin Disability Scale (mRDS) at 3 months and 1 year were measured prospectively and dichotomized into good (0-2) vs. poor (3-6). When calculating odds ratios (ORs), adjustment was performed for age, previous stroke, initial score on the NIH Stroke Scale, stroke subtype, and IV thrombolysis.RESULTS:
Among those 786 patients finally enrolled in this study, 221 (28.1%) had DWI-LR. For a poor outcome at 3 months, the crude ORs of any, symptomatic, and asymptomatic DWI-LR were 2.70 [95% confidence interval (CI), 1.96 to 3.72], 10.03 (95% CI, 4.39 to 22.96), and 2.04 (95% CI, 1.44 to 2.88), respectively. With adjustment, the OR of symptomatic DWI-LR was 6.44 (95% CI, 2.50 to 16.57), whereas those of any and asymptomatic DWI-LR lost their statisticalsignificance:
1.44 (95% CI, 0.94 to 2.20) and 1.04 (95% CI, 0.65 to 1.65), respectively. Analyzing with the 1-year outcome produced similar results.CONCLUSIONS:
This study shows that symptomatic early lesion recurrence can affect functional outcome after acute ischemic stroke, whereas an asymptomatic one may not.
Full text:
Available
Database:
WPRIM (Western Pacific)
Main subject:
Recurrence
/
Odds Ratio
/
Cerebral Infarction
/
Prospective Studies
/
Follow-Up Studies
/
Stroke
/
Diffusion Magnetic Resonance Imaging
/
Electrolytes
Type of study:
Etiology study
/
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Journal of Clinical Neurology
Year:
2010
Document type:
Article