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Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
Concurrent acute brain infarcts in patients with monocular visual loss
Johanna Helenius1, E Murat Arsava, Joshua N Goldstein
1A. A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Annals of Neurology
|August 29, 2012
Summary
Monocular visual loss (MVL) can indicate concurrent brain infarcts. Approximately 24% of patients with MVL showed acute brain infarcts on diffusion-weighted imaging (DWI), suggesting a potential embolic source.
Area of Science:
- Neurology
- Ophthalmology
- Cardiology
Background:
- Retinal artery embolism can originate from proximal sources, potentially affecting the brain.
- Monocular visual loss (MVL) of presumed ischemic origin may signal broader embolic events.
Purpose of the Study:
- To determine the frequency of acute brain infarcts using diffusion-weighted imaging (DWI) in patients experiencing MVL.
- To investigate the association between MVL and concurrent cerebral ischemia.
Main Methods:
- Retrospective study of 129 patients with MVL due to retinal ischemia.
- All patients underwent DWI, comprehensive ophthalmologic and neurologic examinations, and etiological evaluations.
- Statistical analyses identified predictors of DWI-positive acute brain infarcts.
Main Results:
- 24% of patients (31/129) with MVL had concurrent acute brain infarcts on DWI.
- Positive DWI findings were more frequent in embolic MVL, permanent visual loss, and those with hemispheric symptoms.
- Patients with positive DWI were more likely to have a major underlying embolic etiology (OR 3.7).
Conclusions:
- MVL is not always an isolated retinal event; nearly 1 in 4 patients exhibit concurrent brain infarcts.
- DWI evidence of brain injury in MVL patients can guide diagnostic evaluations for embolic sources.
- Identifying concurrent brain infarcts highlights the importance of investigating cardiac and vascular embolic origins.
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