Related Experiment Video
Updated: Jul 16, 2026
10:25
Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
Published on: September 25, 2019
Clinical-diffusion mismatch defined by NIHSS and ASPECTS in non-lacunar anterior circulation infarction
1Department of Neurology, Toda Central General Hospital, 1-19-3 Hon-cho, Toda City, Saitama, 3350023, and Neurological Institute, Tokyo Women's Medical University, Japan. hideaki-tei@m5.dion.ne.jp
Journal of Neurology
|March 9, 2007
Summary
Clinical-DWI mismatch (CDM) in acute ischemic stroke indicates a higher risk of early neurological deterioration and lesion growth. This marker may help identify patients with brain tissue at risk of infarction, though further research is needed for clinical application.
Area of Science:
- Neurology
- Radiology
- Stroke Medicine
Background:
- Clinical-DWI mismatch (CDM) is a novel marker for brain tissue at risk in acute ischemic stroke.
- The Alberta Stroke Program Early CT Score (ASPECTS) is used to assess early ischemic changes.
Purpose of the Study:
- To investigate the utility of CDM, defined by the NIH Stroke Scale (NIHSS) and ASPECTS, in patients with non-lacunar anterior circulation infarction.
- To evaluate CDM's association with early neurological deterioration (END) and lesion growth.
Main Methods:
- Eighty-seven patients with acute ischemic stroke within 24 hours were enrolled.
- CDM was defined as NIHSS score ≥ 8 and DWI-ASPECTS ≥ 8.
- Patients were divided into CDM-positive and CDM-negative groups for comparison.
Main Results:
- 40.2% of patients were CDM-positive and showed a higher risk of END (37.1% vs 13.5%).
- Lesion growth, indicated by a ≥ 2-point decrease in ASPECTS, accompanied END in CDM-positive patients.
- CDM was not an independent predictor of END in multiple logistic regression analysis.
Conclusions:
- CDM identifies patients with acute ischemic stroke at high risk for early neurological deterioration and lesion growth.
- CDM, defined by NIHSS and DWI-ASPECTS, may serve as a marker for identifying tissue at risk of infarction.
- Further research is required to establish the clinical utility of this CDM definition in acute stroke management.
Related Concept Videos
01:26Transient Ischemic Attack l: Introduction
A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...
01:15Ischemic Stroke ll: Pathophysiology
An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
01:15Ischemic Stroke l: Introduction
Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
01:17Assessment of Diffusion and Perfusion
Understanding and evaluating diffusion and perfusion is critical in assessing a patient's respiratory and circulatory health. These processes play key roles in maintaining the body's internal environment, ensuring that tissues receive adequate oxygen while waste products are efficiently removed.
The Role of Diffusion in Respiration
Diffusion is the process by which molecules move from an area of higher concentration to an area of lower concentration. In the respiratory system, this principle...
The Role of Diffusion in Respiration
Diffusion is the process by which molecules move from an area of higher concentration to an area of lower concentration. In the respiratory system, this principle...
01:22Dementia l: Introduction
Dementia is an acquired, progressive syndrome characterized by a decline in multiple cognitive domains severe enough to impair daily functioning and reduce independence. Although memory loss is a central feature, the diagnosis requires additional deficits involving language, executive function, visuospatial skills, judgment, calculation, or abstract reasoning. These cognitive impairments reflect underlying neurodegenerative or vascular processes that gradually disrupt neuronal networks...
01:29Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...