Global White Matter Hypoperfusion on CT Predicts Larger Infarcts and Hemorrhagic Transformation after Acute Ischemia

CNS Neuroscience & Therapeutics
Andrew BivardMark W Parsons

Abstract

Presence of white matter hyperintensity (WMH) on MRI is a marker of cerebral small vessel disease and is associated with increased small vessel stroke and increased risk of hemorrhagic transformation (HT) after thrombolysis. We sought to determine whether white matter hypoperfusion (WMHP) on perfusion CT (CTP) was related to WMH, and if WMHP predisposed to acute lacunar stroke subtype and HT after thrombolysis. Acute ischemic stroke patients within 12 h of symptom onset at 2 centers were prospectively recruited between 2011 and 2013 for the International Stroke Perfusion Imaging Registry. Participants routinely underwent baseline CT imaging, including CTP, and follow-up imaging with MRI at 24 h. Of 229 ischemic stroke patients, 108 were Caucasians and 121 Chinese. In the contralateral white matter, patients with acute lacunar stroke had lower cerebral blood flow (CBF) and cerebral blood volume (CBV), compared to those with other stroke subtypes (P = 0.041). There were 46 patients with HT, and WMHP was associated with increased risk of HT (R(2) = 0.417, P = 0.002). Compared to previously reported predictors of HT, WMHP performed better than infarct core volume (R(2) = 0.341, P = 0.034), very low CBV volume (R(2) = 0.249, P = 0.0...Continue Reading

References

Oct 28, 1997·Stroke; a Journal of Cerebral Circulation·J HatazawaT Okudera
Apr 6, 2002·Stroke; a Journal of Cerebral Circulation·J R MarstrandH B W Larsson
Jul 2, 2002·JAMA : the Journal of the American Medical Association·Tien Yin WongUNKNOWN ARIC Investigators. Atheroslerosis Risk in Communities Study
Apr 12, 2003·Stroke; a Journal of Cerebral Circulation·Sarah E VermeerUNKNOWN Rotterdam Scan Study
Nov 25, 2003·Stroke; a Journal of Cerebral Circulation·H HénonD Leys
Aug 26, 2006·Stroke; a Journal of Cerebral Circulation·Tobias Neumann-HaefelinUNKNOWN MR Stroke Group
Mar 29, 2007·Neurology·V PalumboUNKNOWN CASES Investigators
Sep 21, 2007·Annals of Neurology·Oliver C SingerUNKNOWN MR Stroke Study Group Investigators
Jun 19, 2008·Cerebrovascular Diseases·Andrew M DemchukUNKNOWN NINDS rt-PA Stroke Study Group
Sep 5, 2008·AJNR. American Journal of Neuroradiology·T J HuynhR I Aviv
Aug 28, 2009·Journal of Neurology, Neurosurgery, and Psychiatry·R TopakianH S Markus
Sep 25, 2010·Annals of Neurology·Götz ThomallaUNKNOWN Clinical Trial Net of the German Competence Network Stroke
Jul 23, 2013·Lancet Neurology·Joanna M WardlawUNKNOWN STandards for ReportIng Vascular changes on nEuroimaging (STRIVE v1)
Sep 5, 2013·Stroke; a Journal of Cerebral Circulation·Nawaf YassiBruce C V Campbell
Nov 19, 2013·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Wenjie CaoQiang Dong
Jan 18, 2014·Journal of Neuroradiology. Journal De Neuroradiologie·A BivardM Parsons

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Citations

Oct 21, 2016·Neuroradiology·Norbert NighoghossianYves Berthezene
Dec 19, 2018·Frontiers in Human Neuroscience·Xuemei ChenJunrong Li
Aug 26, 2020·Nature Reviews. Neurology·Andrew BivardMark Parsons
Dec 12, 2020·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Fengzhen QiuBei Shao

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