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MRI of small human stroke shows reversible diffusion changes in subcortical gray matter
C A Doege1, C M Kerskens, B I Romero
1Klinik und Poliklinik für Neurologie, Universitätsklinikum Charité, Medizinische Fakultät der Humboldt-Universität zu Berlin, Germany.
Abstract:
Six patients who had suffered small cerebral ischemia affecting subcortical gray matter were examined with diffusion weighted imaging (DWI) and T2-weighted imaging within the first 8 h, during the next 2 days and after 5-16 days. Areas of apparent diffusion coefficient (ADC) decreases were observed acutely and reached the maximum size during the subsequent 2 days. Noticeably, in all subjects, a large portion of the ADC lesion was reversible as judged from the lesion size on final T2 image. The regular reversibility of the ADC decreases in this setting may indicate a hitherto not understood pathophysiological process occurring in small ischemic stroke.
Insights
Small cerebral ischemia in subcortical gray matter showed reversible diffusion changes. This suggests an unknown pathophysiological process in acute ischemic stroke, impacting apparent diffusion coefficient (ADC) lesion size.
Area of Science:
- Neurology
- Radiology
- Neuroscience
Background:
- Small cerebral ischemia can affect subcortical gray matter.
- Diffusion-weighted imaging (DWI) and T2-weighted imaging are crucial for stroke assessment.
Purpose of the Study:
- To investigate the evolution and reversibility of apparent diffusion coefficient (ADC) decreases in small subcortical gray matter ischemic strokes.
Main Methods:
- Six patients with small cerebral ischemia were evaluated using DWI and T2-weighted imaging.
- Imaging was performed acutely (within 8 hours), subacutely (2 days), and later (5-16 days).
Main Results:
- ADC decreases were observed acutely and peaked within 2 days.
- A significant portion of the ADC lesion was found to be reversible on later T2-weighted images.
Conclusions:
- The observed reversibility of ADC decreases in small ischemic strokes suggests a novel pathophysiological mechanism.
- Further research is needed to understand this phenomenon in subcortical gray matter ischemia.