Serial proton magnetic resonance spectroscopy of ischemic brain injury in humans

Four patients were observed serially with 1H magnetic resonance spectroscopy (MRS) at times ranging from 3 days to 10 weeks after a documented ischemic event. Spectra were obtained from 8 cc volumes in infarcted regions and contralateral matched normal regions. Reproducible variations in n-acetyl aspartate (NAA), creatine + phosphocreatine (Cr + PCr), and the sequential changes in lactate and lipid resonances are related to the pathophysiology of stroke. A conspicuous lack of significant change in the choline (Cho) resonance with concomitant decrease in NAA and Cr + PCr is reported as a possible marker of ischemic injury.