Related Experiment Video
Updated: Jun 10, 2026
06:59
Middle Cerebral Artery Occlusion Allowing Reperfusion via Common Carotid Artery Repair in Mice
Published on: January 23, 2019
Ischemic diffusion lesion reversal is uncommon and rarely alters perfusion-diffusion mismatch
T Chemmanam1, B C V Campbell, S Christensen
1Department of Neurology, The Royal Melbourne Hospital, Grattan Street, Parkville VIC 3050, Australia.
Neurology
|August 20, 2010
Summary
True diffusion-weighted imaging (DWI) lesion reversal in acute ischemic stroke is uncommon. Apparent reversal volumes are small and rarely impact treatment decisions based on perfusion-diffusion mismatch analysis.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Diffusion-weighted imaging (DWI) is used to define infarct core in acute ischemic stroke.
- Potential partial reversal of DWI abnormalities challenges its definition of irreversibly damaged tissue.
- Previous studies have not fully accounted for infarct involution in DWI reversal assessments.
Purpose of the Study:
- To investigate the prevalence of DWI lesion reversal in acute ischemic stroke patients.
- To assess the impact of apparent DWI lesion reversal on infarct core volume.
- To determine if DWI lesion reversal affects treatment decisions based on perfusion-diffusion mismatch.
Main Methods:
- Analysis of 60 patients from the EPITHET Trial randomized to tissue plasminogen activator (tPA) or placebo.
- Coregistration of pretreatment DWI and day 90 T2-weighted images.
- Definition of apparent reversal as DWI lesion not incorporated into final infarct, adjusted for atrophy by subtracting CSF voxels.
Main Results:
- Apparent reversal involved a median 46% of the baseline DWI lesion, associated with less severe hypoperfusion and increased by reperfusion.
- Adjusting for atrophy reduced the median apparent reversal volume by 45%.
- True DWI lesion reversal was identified in only 6 of 93 patients, with minimal impact on perfusion-diffusion mismatch classification.
Conclusions:
- True DWI lesion reversal is rare in acute ischemic stroke.
- The volume of apparent DWI lesion reversal is small and unlikely to alter clinical treatment decisions.
- DWI remains a valuable tool for assessing infarct core, with minor adjustments for reversal.
Related Concept Videos
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...
01:17Assessment 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...