Early CT perfusion mismatch in acute stroke is not time-dependent but relies on collateralization grade

Neuroradiology
Louisa von BaumgartenWieland H Sommer

Abstract

Factors that determine the extent of the penumbra in the initial diagnostic workup using whole brain CT Perfusion (WB-CTP) remain unclear. The purpose of the current study was to determine a possible dependency of the initial mismatch size between cerebral blood flow (CBF) and cerebral blood volume (CBV) from time after symptom onset, leptomeningeal collateralization, and occlusion localization in acute middle cerebral artery (MCA) infarctions. Out of an existing cohort of 992 consecutive patients receiving multiparametric CT scans including WB-CTP due to suspected stroke, we included patients who had (1) a witnessed time of symptom onset, (2) an infarction of the MCA territory as documented by follow-up imaging, and (3) an initial CBF volume of >10 ml. CBF and CBV lesion sizes, collateralization grade, and the site of occlusion were determined. We included 103 patients. Univariate analysis showed that time from symptom onset (168 +/- 91.2 min) did not correlate with relative or absolute mismatch volumes (p = 0.458 and p = 0.921). Higher collateralization gradings were associated with small absolute mismatch volumes (p = 0.004 and p < 0.001). Internal carotid artery (ICA) occlusions were associated with large absolute mismatch ...Continue Reading

References

Jun 1, 1981·Journal of Neurosurgery·T H JonesR G Ojemann
Aug 6, 1999·Stroke; a Journal of Cerebral Circulation·T Neumann-HaefelinH J Freund
Oct 8, 1999·Stroke; a Journal of Cerebral Circulation·D G DarbyS M Davis
Jul 24, 2004·Stroke; a Journal of Cerebral Circulation·Jens FiehlerHermann Zeumer
Dec 13, 2005·Stroke; a Journal of Cerebral Circulation·Jeffrey L Saver
Jun 11, 2009·Brain : a Journal of Neurology·Ferdinand MiteffMark W Parsons
Jul 11, 2009·Stroke; a Journal of Cerebral Circulation·Matthew B MaasKaren L Furie
Sep 30, 2009·Neurology·P KhatriUNKNOWN IMS I and II Investigators
Feb 4, 2010·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Hua ZhangJames E Faber
Jul 21, 2011·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Bruce C V CampbellUNKNOWN EPITHET–DEFUSE Investigators
Sep 24, 2011·Lancet Neurology·Ashfaq ShuaibDavid S Liebeskind
Oct 27, 2011·Annals of Neurology·Deidre A De SilvaUNKNOWN EPITHET-DEFUSE Investigators
Aug 4, 2012·Stroke; a Journal of Cerebral Circulation·Bruce C V CampbellMark W Parsons
Feb 9, 2013·The New England Journal of Medicine·Joseph P BroderickUNKNOWN Interventional Management of Stroke (IMS) III Investigators
Feb 12, 2013·The New England Journal of Medicine·Chelsea S KidwellUNKNOWN MR RESCUE Investigators
Mar 28, 2013·Stroke; a Journal of Cerebral Circulation·Mohammed A AlmekhlafiMayank Goyal
May 9, 2013·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Bruce C V CampbellUNKNOWN EPITHET Investigators
Aug 28, 2013·Journal of the Neurological Sciences·Laszlo K SztrihaLalit Kalra
Sep 26, 2013·Brain : a Journal of Neurology·Simon JungUrs Fischer
Dec 29, 2013·AJNR. American Journal of Neuroradiology·V NambiarB K Menon
Jan 30, 2014·Stroke; a Journal of Cerebral Circulation·David S LiebeskindUNKNOWN IMS III Investigators
Sep 6, 2014·Stroke; a Journal of Cerebral Circulation·Reza HakimelahiR Gilberto González
Nov 6, 2014·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Sebastian E BeyerWieland H Sommer
Feb 7, 2015·Stroke; a Journal of Cerebral Circulation·Kjell AsplundUNKNOWN Riksstroke Collaboration

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Citations

May 18, 2019·International Journal of Stroke : Official Journal of the International Stroke Society·Bin JiangMax Wintermark
Jun 15, 2019·Neurosurgery·Phillip A BonneyWilliam J Mack

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