scholarly journals STROKE ISKEMIK DENGAN MANIFESTASI DIZZINESS/VERTIGO TERISOLASI

2020 ◽  
Vol 37 (2) ◽  
Author(s):  
Diyan Anita Sari ◽  
Sri Sutarni ◽  
Ismail Setyopranoto
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Diffusion Weighted Imaging ◽  
Posterior Inferior Cerebellar Artery ◽  
Posterior Circulation ◽  
Resonance Imaging ◽  
Acute Vestibular Syndrome ◽  
Cerebellar Artery ◽  
Magnetic Resonance Imaging Mri

ISCHEMIC STROKE PRESENTS WITH ISOLATED DIZZINESS/VERTIGOABSTRACTDizziness/vertigo, unstable walking or loss of balance are symptoms in about 50% of stroke cases. However, only about 20% are accompanied by focal neurological signs. In the last decade, there is increasing evidence that vertigo can be the only ischemic symptom of posterior circulation stroke without a focal sign. The purpose of this systematic review is to examine the literature on ischemic stroke with the manifestation of isolated dizziness/vertigo. The literature search is done through several electronic database (Pubmed, Ebscohost, and Proquest) from 2000 to 2017 using keywords; isolated vertigo, isolated dizziness, ischemic stroke, vertebrobasilar, posterior stroke, magnetic resonance imaging (MRI). Six articles were obtained that meet the criteria. Approximately 9-10% of patients with isolated dizziness/vertigo who had a history of vascular risk factors, found to have infarct lesions from MRI diffusion weighted  imaging (DWI) examination. In this case, the territory of posterior inferior cerebellar artery (PICA) is most often involved. Acute ischemic stroke can not be excluded only on the basis of negative DWI examination results. Head impulse, nystagmus, and test of skew (HINTS) plus examination may identify acute vestibular syndrome with a central cause with better accuracy than MRI DWI at the onset of symptom.Keywords: Acute vestibular syndrome, ischemic stroke, isolated dizziness, isolated vertigo, posterior circulation strokeABSTRAKDizziness/vertigo, berjalan tidak stabil atau kehilangan keseimbangan merupakan gejala pada sekitar 50% kasus stroke. Namun, hanya sekitar 20% disertai tanda neurologis fokal. Pada dekade terakhir, semakin banyak bukti bahwa vertigo dapat sebagai satu-satunya gejala iskemik sirkulasi posterior tanpa tanda fokal. Tujuan penulisan tinjauan sistematik ini adalah untuk mengkaji literatur tentang stroke iskemik dengan manifestasi hanya dizziness/vertigo terisolasi. Pencarian literatur dilakukan melalui database elektronik (Pubmed, Ebscohost, dan Proquest) dari tahun 2000 hingga 2017 dengan kata kunci; isolated vertigo, isolated dizziness, ischemic stroke, vertebrobasilar, posterior stroke, magnetic resonance imaging (MRI). Didapatkan 6 artikel yang memenuhi kriteria. Sebanyak 9-10% dari pasien dengan dizziness/vertigo terisolasi yang memiliki riwayat faktor risiko vaskular, ditemukan lesi infark dari pemeriksaan MRI diffusion weighted  imaging (DWI). Dalam hal ini, teritori posterior inferior cerebellar artery (PICA) yang paling sering terlibat. Stroke iskemik akut tidak dapat disingkirkan hanya berdasar hasil pemeriksaan DWI negatif. Pemeriksaan head impulse, nystagmus, and test of skew (HINTS) plus dapat mengidentifikasi sindrom vestibular akut dengan penyebab sentral dengan akurasi yang lebih baik dibanding MRI DWI di awal onset gejala.Kata kunci: Dizziness terisolasi, sindrom vestibular akut, stroke iskemik, stroke sirkulasi posterior, vertigo terisolasi

Diffusion imaging of cerebral diaschisis in childhood arterial ischemic stroke

2016 ◽  
Vol 11 (9) ◽  
pp. 1028-1035 ◽  
Author(s):  
Adam Kirton ◽  
Elizabeth Williams ◽  
Michael Dowling ◽  
Sarah Mah ◽  
Jacquie Hodge ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Diffusion Weighted Imaging ◽  
Infarct Volume ◽  
Resonance Imaging ◽  
Arterial Ischemic Stroke ◽  
Diffusion Weighted ◽  
Motor Outcome

Background Diffusion-weighted imaging magnetic resonance imaging may detect changes in brain structures remote but connected to stroke consistent with neuropathological descriptions of diaschisis. Early diffusion-weighted imaging demonstrates restriction in corticospinal pathways after arterial ischemic stroke of all ages that correlates with motor outcome. Aim/hypothesis We hypothesized that cerebral diaschisis is measurable in childhood arterial ischemic stroke and explored associations with outcome. Methods This sub-study of the validation of the Pediatric NIH Stroke Scale study prospectively enrolled children with acute arterial ischemic stroke and both acute and early follow-up (5–14 days) diffusion-weighted imaging. Inclusion criteria were (1) unilateral middle cerebral artery arterial ischemic stroke, (2) acute and subacute diffusion-weighted imaging ( b = 1000), and (3) 12 month neurological follow-up (Pediatric Stroke Outcome Measure). A validated method using ImageJ software quantified diffusion-weighted imaging diaschisis in anatomically connected structures. Diaschisis measures were corrected for infarct volume, compared to age, imaging timing, and outcomes (Chi square/Fisher, Mann–Whitney test). Results Nineteen children (53% male, median 8.1 years) had magnetic resonance imaging at medians of 21 and 168 h post-stroke onset. Diaschisis was common and evolved over time, observed in one (5%) on acute but eight (42%) by follow-up diffusion-weighted imaging. Thalamic and callosal diaschisis were most common (5, 26%). Estimates of perilesional diaschisis varied (54 ± 18% of infarct volume). Children with diaschisis tended to be younger (7.02 ± 5.4 vs. 11.82 ± 4.3 years, p = 0.08). Total diaschisis score was associated with poor cognitive outcomes ( p = 0.03). Corticospinal tract diaschisis was associated with motor outcome ( p = 0.004). Method reliability was excellent. Conclusions Diffusion-weighted imaging diaschisis occurs in childhood arterial ischemic stroke. Mistaking diaschisis for new areas of infarction carries important clinical implications. Improved recognition and study are required to establish clinical relevance.

Abstract TP400: The Differences of Vessel Wall Features Between the Anterior and Posterior Brain Arteries Detected by High Resolution Magnetic Resonance Imaging in Patients With Acute Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Xiangyan Chen ◽  
Lu Zheng ◽  
Jia LI ◽  
Wenjie Yang
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
High Resolution ◽  
Acute Ischemic Stroke ◽  
Vessel Wall ◽  
Posterior Circulation ◽  
Intraplaque Hemorrhage ◽  
Resonance Imaging ◽  
Anterior Circulation

Backgrounds: The purpose of this study was to investigate vessel wall features visualization by high resolution magnetic resonance imaging (HRMRI) in a series of ischemic stroke patients and to identify differences between lesions in the anterior and posterior circulation. Methods: We consecutively recruited Chinese patients with acute ischemic stroke or transient ischemic attack from 2016 to 2018. All patients were scanned at 3T magnetic resonance imaging. We evaluated pre-and post-contrast cross-sectional views of M1 and M2 segments of middle cerebral arteries (MCAs), basilar arteries (BA) and V4 segments of vertebral arteries (VAs). Results: A total of 74 patients (males 52.3%; median age 62 years old) were included in this study, among which, 234 lesions were identified on HRMRI, including 117 MCA lesions, 26 BA lesions, and 91 VA lesions. The sensitivity and specificity of MRA for diagnosing stenosis in anterior circulation were 89.3% (95% CI, 81.8%- 94.2%) and 50.0 (95% CI, 9.2%- 90.8%). The sensitivity and specificity of MRA for diagnosing stenosis in posterior circulation were 73.2% (95% CI, 63.9%- 80.9%) and 40.0 (95% CI, 7.3%- 83.0%). VA had a significantly higher contrast enhancement index (43.71± 7.74, p <0.016) than MCA (23.32± 2.46) or BA (22.69± 5.31) . Anterior circulation plaques had higher degree of stenosis (anterior versus posterior: 68.5% vs. 62.9%, p =0.036), more eccentric distribution (anterior versus posterior: 70.1% versus 53.8%, p =0.015) and higher rate of intraplaque hemorrhage (anterior versus posterior: 17.1% versus 7.7%, p =0.046). The plaques in posterior circulation had a thicker lesion wall (posterior versus anterior 16.58± 8.25 mm 2 vs. 9.10± 4.07 mm 2 , p <0.001) and higher enhancement index (posterior versus anterior 39.04± 8.50 vs. 23.32± 2.46, p <0.001) than the plaques in anterior circulation. Conclusions: The lesions in posterior circulations could be obscure on MRA. The area stenosis, intraplaque hemorrhage and enhancement index differed between circulations.

scholarly journals Curative Effect of Interventional Therapy and Neurological Changes in Ischemic Stroke of Posterior Circulation Evaluated by Magnetic Resonance Imaging under Genetic Algorithm

2022 ◽  
Vol 2022 ◽  
pp. 1-11
Author(s):  
Xiaodu Yu ◽  
Xingyou Zheng ◽  
Daoyou Cheng
Keyword(s):  
Magnetic Resonance Imaging ◽  
Genetic Algorithm ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Compressed Sensing ◽  
Interventional Therapy ◽  
Neurological Function ◽  
Posterior Circulation ◽  
Resonance Imaging ◽  
Before And After

Objective. This study aimed to evaluate the improvement and neurological function changes of patients with ischemic stroke in the posterior circulation before and after interventional therapy using magnetic resonance imaging (MRI) under genetic algorithm and compressed sensing algorithm. Methods. Thirty-six patients with posterior circulation ischemia who visited the interventional cerebrovascular disease area were included in this study. The treatment effect was observed through abnormal signal changes in the lesion area on each sequence of MRI images before and after treatment. The National Institutes of Health Stroke Scale (NIHSS) was used for the evaluation of the changes in neurological function. Results. The real data experiment results suggested that the peak signal-to-noise ratio (PSNR) = 39.33 and structure similarity (SSIM) = 0.96 in the algorithm reconstructed image, which showed no significant difference with the simulation experiment results of PSNR = 35.19 and SSIM = 0.96 ( P < 0.05 ). In addition, the stenosis rate after interventional treatment (13.89%) was substantially lower than that before treatment (91.67%) ( P < 0.05 ). Cerebral blood flow (CBF) of the bilateral occipital lobes and cerebellum after six months of treatment was higher than that before treatment ( P < 0.05 ), and the incidence of postoperative restenosis was 11.11% (4/36). Conclusion. The combination of genetic algorithm and compressed sensing algorithm had a good effect on MRI image processing. The posterior circulation ischemia interventional stent implantation can effectively improve the stenosis of the vertebral artery and vertebral basilar artery as well as the cerebral tissue perfusion in the ischemic area, which improved the clinical symptoms substantially and reduced the probability of restenosis.

Magnetic resonance imaging and diffusion‐weighted imaging in methylmalonic acidemia

2005 ◽  
Vol 46 (1) ◽  
pp. 101-103 ◽  
Author(s):  
A. Yeşildağ ◽  
A. Ayata ◽  
B. Baykal ◽  
M. Koroglu ◽  
H. Yıldız ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Diffusion Weighted Imaging ◽  
Methylmalonic Acidemia ◽  
Resonance Imaging ◽  
Laboratory Findings ◽  
Diffusion Weighted ◽  
Magnetic Resonance Imaging Mri ◽  
The Brain ◽  
And Diffusion

Methylmalonic acidemia (MMA) is an inborn disorder of amino acid metabolism, often presenting with neurological symptoms. We present the results of magnetic resonance imaging (MRI) and diffusion‐weighted imaging (DWI) of the brain in a 16‐month‐old male patient with classic neurological and laboratory findings for MMA. MRI demonstrated the hyperintensity within globi pallidi both on T2‐weighted image and DWI during the acute episode of metabolic acidosis.

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