What is the relationship among penumbra volume, collaterals, and time since onset in the first 6 h after acute ischemic stroke?

International Journal of Stroke : Official Journal of the International Stroke Society
Bharath Kumar CheripelliKeith W Muir

Abstract

The steep, time-dependent loss of benefit from reperfusion in clinical trials is consistent with loss of penumbra over the early hours of ischemia, as observed in animal models. Human imaging studies, however, show persistent penumbra for up to 48 h. We investigated core and penumbra volumes and collateral status in relation to time after stroke onset within the first 6 h. Using data from three multimodal computer tomography-based studies in acute ischemic stroke patients <6 h after onset, we measured core and penumbra volumes, collateral status, and target mismatch (defined as core volume < 50 ml, perfusion lesion volume > 15 ml, mismatch ratio > 1.8). Patients were grouped by onset to imaging time (<3, 3-4.5, 4.5-6 h). We explored correlates of penumbra proportion by multivariable linear regression. Analysis included 144 subjects. Across time epochs, neither proportions of penumbra (59%, 64%, 75% at <3, 3-4.5, >4. 5 h, respectively, p = 0.4) nor poor collaterals (15/56 (27%), 14/47 (30%), 4/15 (27%) at <3, 3-4.5, >4.5 h, p = 0.9) differed significantly. Penumbra proportion was not clearly related to time to imaging (R(2) = 0.003; p = 0.5) but a trend for divergent effects by collateral status was seen (slight increase in penu...Continue Reading

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Citations

Jul 30, 2019·The Journal of Medicine and Philosophy·Fredrik Svenaeus
Nov 7, 2019·The Journal of Clinical Investigation·Benjamin OkyereMichelle H Theus
Feb 23, 2020·Magnetic Resonance in Medicine : Official Journal of the Society of Magnetic Resonance in Medicine·Phillip Zhe Sun
Jul 12, 2018·Cardiovascular and Interventional Radiology·Benjamin FriedrichChristian Maegerlein
Oct 26, 2018·Stroke; a Journal of Cerebral Circulation·Achala VagalPooja Khatri

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Software Mentioned

SPSS Statistics
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IA
MiStar
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