More articles from BRAIN
- Location of the Clot and Outcome of Perfusion Defects in Acute Anterior Circulation Stroke Treated with Intravenous Thrombolysis
These investigators studied the impact of clot location in patients with acute stroke receiving IV thrombolysis. Four locations (ICA, proximal M1, distal M1, and M2 segment and more distal) of clots were correlated with CT perfusion maps, mismatches, salvaged brain volumes, and outcomes in 105 patients. Clots that were more proximal in location produced larger perfusion defects and lesion volumes. The amount of tissue salvaged was greater in patients with more distally located clots. In conclusion, admission CBV defects were larger in proximal vessel occlusions. More of the penumbra was salvaged if the occlusion was located more distally. This effect reached a plateau in the distal M1 segment of the MCA.
- Perfusion-Weighted Imaging–Derived Collateral Flow Index is a Predictor of MCA M1 Recanalization after IV Thrombolysis
This article addresses the importance of collateral circulation in preserving the tissues contained within the ischemic penumbra in patients with acute stroke treated with IV thrombolysis. The authors evaluated not only the presence of collaterals but also their quality. They quantified a normalized collateral circulation deficit and correlated it with parameters thought to affect its quality, such as baseline NIHSS score, volume of DWI abnormalities, and modified Rankin scale at 3 months. The normalized collateral circulation deficit correlated with NIHSS, lesion volume as seen on DWI, and recanalization at 24 hours. Full recanalization as well as the probability of full recanalization also correlated with the normalized collateral circulation deficit. Thus, this index is a good predictor of recanalization and outcome in patients with acute stroke treated with IV thrombolysis.
- Robust Perfusion Deficits in Cognitively Impaired Patients with Secondary-Progressive Multiple Sclerosis
These authors investigated the effect of perfusion deficits on patients with MS with cognitive impairment. In 45 patients with secondary-progressive MS, cognition was assessed using standardized clinical tests and CBF and CBV perfusion maps were obtained, analyzed, and correlated with gray and white matter and lesion volumes. Perfusion in the deep gray matter nuclei and frontal cortex was significantly reduced in cognitively impaired patients with MS despite no significant differences regarding gray matter, white matter, and lesion volumes. Of the cognitive parameters investigated, information processing speed was most affected.
- Combined Diffusion and Perfusion MR Imaging as Biomarkers of Prognosis in Immunocompetent Patients with Primary Central Nervous System Lymphoma
Here, the authors sought to determine if ADC values and perfusion measurements provided prognostic information in 25 treatment-naïve immunocompetent patients with brain lymphoma. The studied parameters were obtained from the enhancing tumor regions. The results of this investigation reinforce the validity of ADC values as a prognostic biomarker and provide evidence of low tumor CBV as a novel risk factor for adverse prognosis in immunocompetent patients with primary brain lymphoma.