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Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
Published on: September 25, 2019
Failed recovery from thrombolysis is predicted by the initial diffusion weighted imaging lesion
Rüdiger J Seitz1, Hagen Oberstrass, Adrian Ringelstein
1Department of Neurology, University Hospital Düsseldorf, Germany. seitz@neurologie.uni-duesseldorf.de
Cerebrovascular Diseases (Basel, Switzerland)
|April 14, 2011
Summary
Early recanalization after recombinant tissue plasminogen activator (rtPA) treatment is crucial for stroke recovery. Failed recanalization in stroke patients leads to more severe brain damage, lesion growth, and poor outcomes.
Area of Science:
- Neurology
- Radiology
- Cardiovascular Medicine
Background:
- Clinical response to recombinant tissue plasminogen activator (rtPA) therapy for stroke is linked to early recanalization.
- Investigating early recanalization's impact on stroke lesion development using magnetic resonance imaging (MRI) is critical.
Purpose of the Study:
- To determine the effect of early recanalization on stroke lesion development.
- To correlate recanalization status with infarct volume changes and neurological recovery.
Main Methods:
- 37 stroke patients treated with rtPA and tirofiban were analyzed.
- Patients were categorized by successful or failed recanalization via angiographic imaging.
- Infarct lesion volumes were measured using MRI before treatment and at 4-day follow-up.
Main Results:
- Patients with failed recanalization had larger perfusion (PWI) and diffusion-weighted imaging (DWI) lesion volumes.
- DWI lesion volumes significantly increased in patients with failed recanalization compared to those with successful recanalization (p < 0.001).
- Initial DWI lesion volume correlated with follow-up DWI lesion volumes and neurological recovery.
Conclusions:
- Ischemic brain damage is more severe in patients without recanalization before rtPA treatment.
- Lack of recanalization predicts further lesion growth and poor neurological recovery in stroke patients.
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