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Magnetic resonance spectroscopic findings in patients with subcortical ischemic stroke
1Department of Neurology, National Cheng-Kung University, Tainan, Taiwan, R.O.C.
Background:
Biochemical changes inside the brain during acute ictus have been extensively studied by means of magnetic resonance spectroscopy (MRS). Previous reports revealed that cerebral cortical infarction causes reduction of N-acetylaspartate (NAA) and elevation of lactate. This study was designed to evaluate the biochemical changes in subcortical infarction.
Methods:
Nine normal controls and four patients, including two thalamic infarct, one basal ganglia infarct, and one putamen infarct cases were examined using MRS in addition to magnetic resonance imaging (MRI). Evaluation experiments were performed on a Siemens Wagnetom 63SP machine. A spin echo sequence with TE 270 msec was applied for the measurement. The voxel was located at basal ganglia in the controls and at the lesion site, as well as at the contralateral corresponding region in the patients.
Results:
Three resonance signals were present in the spectrum-NAA, choline-containing compounds (Cho) and creatine-phosphocreatine (Cr). The NAA/Cho and NAA/Cr ratios were reduced significantly on the lesion side compared with the controls. NAA/Cho also decreased on the lesion side compared with the healthy side.
Conclusions:
There is a remarkable reduction of NAA concentration even in subcortical infarction. Further study is needed for the detection of changes in lactate in patients with subcortical lesion.