Specific DWI lesion patterns predict prognosis after acute ischaemic stroke within the MCA territory

O. Y. Bang, philhyu Lee, K. G. Heo, U. S. Joo, S. R. Yoon, S. Y. Kim

Research output: Contribution to journalArticle

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Abstract

Background: Apart from diffusion-weighted imaging (DWI) lesion volume and diffusion-perfusion mismatching, there is limited information about neuroradiological predictors of early prognosis after an ischaemic stroke. This study sought to identify specific DWI lesion patterns that would help prediction of early prognosis of three different endpoints: unstable hospital course, recurrence of stroke, and poor neurological outcome at 90 days after ischaemic stroke. Methods: A total of 426 patients with acute cerebral infarcts within the middle cerebral artery territory were prospectively studied. Using the DWI data the patients were divided into six groups (territorial, other cortical, small superficial, internal border zone, small deep, and other deep infarcts), and any recurrent strokes and prognosis over the following 90 days were recorded. Results: DWI lesion pattern was a stronger and more consistent independent outcome predictor than DWI lesion volume. The specific DWI lesion patterns associated with each endpoint differed. An unstable hospital course was frequently observed in patients with internal border zone infarcts, whereas recurrent strokes after the index stroke were commoner in those who had small superficial infarcts (p<0.05 in both cases). Similarly, poor outcome after stroke was associated with older age, severe neurological deficits at admission, and a DWI lesion pattern showing internal border zone infarcts. Conclusions: The results of the present study indicate that the DWI lesion pattern may help in recognition of the likely differences in the early prognostic endpoints after ischaemic stroke, and DWI analysis may guide targeted interventions to prevent negative outcomes.

Original languageEnglish
Pages (from-to)1222-1228
Number of pages7
JournalJournal of Neurology, Neurosurgery and Psychiatry
Volume76
Issue number9
DOIs
Publication statusPublished - 2005 Sep 1

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Stroke
Middle Cerebral Artery
Perfusion
Recurrence

All Science Journal Classification (ASJC) codes

  • Neuropsychology and Physiological Psychology
  • Neuroscience(all)
  • Psychiatry and Mental health

Cite this

Bang, O. Y. ; Lee, philhyu ; Heo, K. G. ; Joo, U. S. ; Yoon, S. R. ; Kim, S. Y. / Specific DWI lesion patterns predict prognosis after acute ischaemic stroke within the MCA territory. In: Journal of Neurology, Neurosurgery and Psychiatry. 2005 ; Vol. 76, No. 9. pp. 1222-1228.
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Specific DWI lesion patterns predict prognosis after acute ischaemic stroke within the MCA territory. / Bang, O. Y.; Lee, philhyu; Heo, K. G.; Joo, U. S.; Yoon, S. R.; Kim, S. Y.

In: Journal of Neurology, Neurosurgery and Psychiatry, Vol. 76, No. 9, 01.09.2005, p. 1222-1228.

Research output: Contribution to journalArticle

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T1 - Specific DWI lesion patterns predict prognosis after acute ischaemic stroke within the MCA territory

AU - Bang, O. Y.

AU - Lee, philhyu

AU - Heo, K. G.

AU - Joo, U. S.

AU - Yoon, S. R.

AU - Kim, S. Y.

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N2 - Background: Apart from diffusion-weighted imaging (DWI) lesion volume and diffusion-perfusion mismatching, there is limited information about neuroradiological predictors of early prognosis after an ischaemic stroke. This study sought to identify specific DWI lesion patterns that would help prediction of early prognosis of three different endpoints: unstable hospital course, recurrence of stroke, and poor neurological outcome at 90 days after ischaemic stroke. Methods: A total of 426 patients with acute cerebral infarcts within the middle cerebral artery territory were prospectively studied. Using the DWI data the patients were divided into six groups (territorial, other cortical, small superficial, internal border zone, small deep, and other deep infarcts), and any recurrent strokes and prognosis over the following 90 days were recorded. Results: DWI lesion pattern was a stronger and more consistent independent outcome predictor than DWI lesion volume. The specific DWI lesion patterns associated with each endpoint differed. An unstable hospital course was frequently observed in patients with internal border zone infarcts, whereas recurrent strokes after the index stroke were commoner in those who had small superficial infarcts (p<0.05 in both cases). Similarly, poor outcome after stroke was associated with older age, severe neurological deficits at admission, and a DWI lesion pattern showing internal border zone infarcts. Conclusions: The results of the present study indicate that the DWI lesion pattern may help in recognition of the likely differences in the early prognostic endpoints after ischaemic stroke, and DWI analysis may guide targeted interventions to prevent negative outcomes.

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