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Updated: May 27, 2026
Real-Time Monitoring of Neurocritical Patients with Diffuse Optical Spectroscopies
Published on: November 19, 2020
Prediction of infarct growth and neurologic deterioration in patients with positive perfusion-diffusion mismatch
Chien-Tai Hong1, Yu Sun, Chien-Jung Lu
1Department of Neurology, En Chu Kong Hospital, Taipei, Taiwan.
Background:
To assess the value of baseline clinical severity and perfusion-diffusion mismatch as predictors for further infarct growth and clinical outcome.
Methods:
Patients with acute ischemic stroke and initial perfusion-diffusion mismatch within 72 h were enrolled. Baseline perfusion defects on time-to-peak (TTP) and cerebral blood volume (CBV) maps were measured. Infarct volume and stroke severity were assessed by diffusion-weighted image (DWI) and NIHSS, and were repeatedly assessed 7 days later. The predictive value of baseline NIHSS and perfusion defects on further infarct growth and neurologic deterioration was determined.
Results:
Fifty-two patients (mean age 68.3±12.8 years, 42% women) were enrolled. CBV defects were significantly associated with infarct growth (CBV, p=0.02). Initial stroke severity, but not TTP and CBV mismatch (p=0.65 and 0.76, respectively), significantly inversely correlated with neurologic deterioration (p=0.001).
Conclusions:
In patients with mismatch, those with severe symptoms initially are more likely to have infarct growth, while those with minor symptoms tend to suffer from larger extent of neurologic deterioration within 1 week. CBV is associated with further infarct growth but not clinical deterioration.
