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Journal of stroke: It is looming: In stroke, why is there no abnormality in the first diffusion-weighted imaging in some patients, but abnormal in the second imaging?

 Last Update: 2021-08-04
 Source: Internet
 Author: User

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cerebral cortex damage

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The development of magnetic resonance imaging (MRI) technology allows neurologists to diagnose acute ischemic stroke (AIS) based on diffusion-weighted imaging (DWI) because of its high sensitivity (88% to 100%)
.

Diagnose stroke

However, a recent meta-analysis showed that a small percentage of AIS cases were negative for DWI
.

In the initial DWI-negative clinically suspected stroke patients, DWI lesions occasionally appeared on the follow-up MRI

Accurately determining the presence of DWI lesions is clinically important because their presence is related to the long-term and short-term risks of recurrence after transient ischemic attack (TIA) or minor stroke
.

DWI-positive may prompt the brain to the inherent fragility infarction (intrinsic vulnerability) increases, a large population-based study show, DWI-positive men, atrial fibrillation (AF), a non-cryptogenic cause of stroke and diabetes related

In addition, they also developed a clinical score that predicts the delayed appearance of DWI lesions and compared it with the ABCD2 score, which is currently the most important tool for calculating the short-term risk of stroke in patients with TIA
.

They also developed a clinical score that predicts the delayed appearance of DWI lesions and compared it with the ABCD2 score, which is currently the most important tool for calculating the short-term risk of stroke in patients with TIA
.

Estimated adjusted odds (ORs) of positive transitions in initially DWI-negative patients

Early neurological deterioration (OR=15.
1), atrial fibrillation (aOR=6.
17), smoking (aOR=3.
76), pre-stroke dependence (aOR=1.
62), objective hemiplegia (aOR=4.
39), long duration of symptoms (aOR= 2.
17), high cholesterol (aOR=4.
70), NIHSS score (aOR=1.
44) and high systolic blood pressure (aOR=1.
01) are related to the higher incidence of delayed appearance of the disease
.

cholesterol

Follow-up DWI lesion locations, 34.
6% and 21.
2% were in the cerebral cortex and brainstem, respectively
.

The important significance of this study lies in the discovery: In DWI-negative stroke/TIA, positive conversion is associated with a higher risk of recurring stroke
.

DWI-negative strokes with positive conversion factors may require follow-up MRI to confirm the diagnosis

In DWI-negative stroke/TIA, positive conversion is associated with a higher risk of recurring stroke

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