Abstract TP171: Eloquence of White Matter Tracts in Acute Ischemic Stroke Patients

Stroke ◽  
2019 ◽  
Vol 50 (Suppl_1) ◽  
Author(s):  
Deepthi Rajashekar ◽  
Ravinder-Jeet Singh ◽  
Bijoy K Menon ◽  
Nils Daniel Forkert
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Acute Ischemic Stroke ◽  
Stroke Patients ◽  
White Matter Tracts

scholarly journals What can DTI add in acute ischemic stroke patients?

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Bahaa Eldin Mahmoud ◽  
Mohammad Edrees Mohammad ◽  
Dalia K. Serour
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Clinical Outcome ◽  
Acute Ischemic Stroke ◽  
Clinical Score ◽  
Statistical Association ◽  
Stroke Patients ◽  
White Matter Tracts ◽  
Clinical Recovery ◽  
Significant Statistical Association

Abstract Background Cerebrovascular stroke is one of the leading causes of death worldwide. Imaging with conventional MR techniques cannot provide reliable information as regard the integrity of the white matter tracts and therefore limiting its ability to predict the clinical outcome. While prediction of the motor outcome becomes more crucial for determining the specific rehabilitation strategies and final clinical outcomes, the purpose of this study was to assess the value of diffusion tensor MR imaging in patients with acute ischemic stroke as a prognostic imaging modality to predict the clinical outcome. Results A significant statistical association was found between the tractography findings and the clinical score at admission (p 0.0005) and the clinical recovery after 3 months (p 0.001). Residual neurological deficits were found in patients with disrupted tracts; on the other hand, near complete clinical recovery was found in patients with non-disrupted tracts. Also, significant statistical association was found between the degree of FA reduction in the affected tracts and the clinical score at admission (p 0.001) and the clinical recovery after 3 months (p 0.01). Correlation between the FA values at the site of infarctions and the corresponding area of the brain on the contralateral side revealed significant statistical difference. Conclusion DTI offers a potential tool for prediction of the clinical outcome of acute stroke patients as it can detect the microstructural changes in the white matter tracts affected by the ischemic lesions which cannot be detected by conventional MRI and therefore can help in determining the rehabilitation strategy

Structural integrity of white matter tracts as a predictor of acute ischemic stroke outcome

2020 ◽  
Vol 15 (9) ◽  
pp. 965-972
Author(s):  
Deepthi Rajashekar ◽  
Pauline Mouchès ◽  
Jens Fiehler ◽  
Bijoy K Menon ◽  
Mayank Goyal ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Acute Ischemic Stroke ◽  
Support Vector Regression ◽  
Support Vector ◽  
Stroke Severity ◽  
Lesion Volume ◽  
White Matter Tract ◽  
Support Vector Regression Model ◽  
White Matter Tracts

Background and purpose Clinical assessment scores in acute ischemic stroke are only moderately correlated with lesion volume since lesion location is an important confounding factor. Many studies have investigated gray matter indicators of stroke severity, but the understanding of white matter tract involvement is limited in the early phase after stroke. This study aimed to measure and model the involvement of white matter tracts with respect to 24-h post-stroke National Institutes of Health Stroke Scale (NIHSS). Material and methods A total of 96 patients (50 females, mean age 66.4 ± 14.0 years, median NIHSS 5, interquartile range: 2–9.5) with follow-up fluid-attenuated inversion recovery magnetic resonance imaging data sets acquired one to seven days after acute ischemic stroke onset due to proximal anterior circulation occlusion were included. Lesions were semi-automatically segmented and non-linearly registered to a common reference atlas. The lesion overlap and tract integrity were determined for each white matter tract in the AALCAT atlas and used to model NIHSS outcomes using a supervised linear-kernel support vector regression method, which was evaluated using leave-one-patient-out cross validation. Results The support vector regression model using the tract integrity and tract lesion overlap measurements predicted the 24-h NIHSS score with a high correlation value of r = 0.7. Using the tract overlap and tract integrity feature improved the modeling accuracy of NIHSS significantly by 6% (p < 0.05) compared to using overlap measures only. Conclusion White matter tract integrity and lesion load are important predictors for clinical outcome after an acute ischemic stroke as measured by the NIHSS and should be integrated for predictive modeling.

scholarly journals White Matter Lesion Severity in Mild Acute Ischemic Stroke Patients and Functional Outcome After 1 Year

Stroke ◽  
2012 ◽  
Vol 43 (11) ◽  
pp. 3046-3051 ◽  
Author(s):  
Christopher O. Leonards ◽  
Nils Ipsen ◽  
Uwe Malzahn ◽  
Jochen B. Fiebach ◽  
Matthias Endres ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
White Matter Lesion ◽  
Stroke Patients ◽  
Lesion Severity

scholarly journals Thyroid-Stimulating Hormone, White Matter Hyperintensities, and Functional Outcome in Acute Ischemic Stroke Patients

2014 ◽  
Vol 4 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Christopher O. Leonards ◽  
Harald J. Schneider ◽  
Thomas G. Liman ◽  
Jochen B. Fiebach ◽  
Matthias Endres ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
White Matter Hyperintensities ◽  
Thyroid Stimulating Hormone ◽  
Stroke Patients ◽  
Stimulating Hormone

Abstract WP91: Cerebral Small Vessel Disease Burden Predicts Poor Collateral Flow in Acute Ischemic Stroke Patients With Large Artery Atherosclerosis

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Yueming Wang ◽  
Lumeng Yang ◽  
Lan Hong ◽  
Longting Lin ◽  
Mark Parsons ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
Small Vessel Disease ◽  
Flow Coefficient ◽  
Collateral Flow ◽  
Large Artery ◽  
Stroke Patients ◽  
Vessel Disease

Aim: We sought to determine whether the extent of chronic white matter hyper-intensities (WMH) and white matter hypo-perfusion (WMHP), as markers of cerebral small vessel disease (CSVD), were associated with poor collateral flow in acute ischemic stroke as a potential cause of unfavorable functional outcome. Methods: Acute ischemic stroke patients within 12 hours of symptom onset with complete baseline and follow-up clinical data, who: (1) had large vessel occlusion in anterior circulation, (2) underwent baseline perfusion CT (CTP), (3) had 24-hour MRI were prospectively recruited. The volume of WMH was measured in the unaffected hemisphere on MRI semi-automatically. WMHP was measured as Delay Time (DT)>2s in white matter of unaffected hemisphere on CTP. Quality of Collateral flow was defined by the volume ratio of DT>3s/DT>6s on CTP. Unfavorable functional outcome was 90-day modified Rankin Scale (mRS)>2. The association between volumes of WMH, WMHP, and collateral flow were evaluated using univariate and multivariate generalized linear models. We also assessed the relationship between WMH, WHMP, and functional outcome with logistic regression. Results: There were 96 (66.6±12.81 years old, 35 female) ischemic stroke patients, and 51 were due to large artery atherosclerosis (LAA). In all patients, after multivariate adjustment, WMH volume (5.6±7.11ml) did not correlate with collateral flow (coefficient -0.01, 95% CI -0.03 to 0, P=0.09), although it was marginally associated with unfavorable outcome (Odds Ratio: 1.08, p=0.06, 95% CI 1 to 1.17). In all patients, WMHP volume (8.6±8.54ml) did not correlate with collateral flow (coefficient -0.01, 95% CI -0.01 to 0, P=0.29). However, in the LAA subgroup, WMH volume was strongly related to poorer collateral flow, i.e. lower DT>3s/DT>6s ratio(coefficient -0.03, 95% CI -0.04 to -0.01, P=0.01). WMHP volume was also correlated with poor collateral flow (coefficient -0.01, 95% CI -0.02 to 0, P=0.02). Conclusion: CSVD may contribute to poor collateral flow in acute stroke, especially in patients with LAA. This potentially explains the association between CSVD and poor acute stroke outcomes.

scholarly journals The efficacy of intravenous thrombolysis in acute ischemic stroke patients with white matter hyperintensity

2018 ◽  
Vol 8 (12) ◽  
pp. e01149 ◽  
Author(s):  
Yanyan Liu ◽  
Min Zhang ◽  
Hanmo Bao ◽  
Zhixiang Zhang ◽  
Yuqing Mei ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Acute Ischemic Stroke ◽  
Intravenous Thrombolysis ◽  
White Matter Hyperintensity ◽  
Stroke Patients
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