Natural course of total mismatch and predictors for tissue infarction
OBJECTIVE:We longitudinally assessed patients presenting with total mismatch and hypothesized that hypoperfusion intensity ratio (HIR), severity of stroke, and occlusion of blood vessel are predictors of tissue fate. METHODS:Patients with suspected stroke or TIA admitted to our emergency department...
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| Veröffentlicht in: | Neurology 2015-09, Vol.85 (9), p.770-775 |
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| creator | Hotter, Benjamin Ostwaldt, Ann-Christin Levichev-Connolly, Anastasia Rozanski, Michal Audebert, Heinrich J Fiebach, Jochen B |
| description | OBJECTIVE:We longitudinally assessed patients presenting with total mismatch and hypothesized that hypoperfusion intensity ratio (HIR), severity of stroke, and occlusion of blood vessel are predictors of tissue fate.
METHODS:Patients with suspected stroke or TIA admitted to our emergency department between September 2008 and October 2012 with suspected stroke or TIA were eligible to participate in the ongoing stroke imaging study 1000Plus. Patients received acute and follow-up stroke MRI, basic demographics were collected, and stroke severity was rated according to the NIH Stroke Scale (NIHSS). Inclusion criteria for the substudy were total mismatch on admission examination and available follow-up.
RESULTS:We identified 23 patients with total mismatchmedian age 70 years (interquartile range 66–78), 10 female (43.5%). Infarction was found on follow-up diffusion-weighted imaging (median lesion size 1.3 mL) in 9 patients (39.1%). Infarction was correlated with NIHSS at admission (p = 0.026) and HIR (p = 0.015) but not with vessel occlusion. Clinical outcome as measured by last recorded NIHSS score and modified Rankin Scale score at discharge was significantly worse in patients with infarction on follow-up.
CONCLUSION:Final infarction is frequently seen in patients with total mismatch. Clinical presentation at admission and severity of hypoperfusion measured by HIR, but not occlusion of the supplying vessel, predict tissue fate. |
| doi_str_mv | 10.1212/WNL.0000000000001889 |
| format | Article |
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METHODS:Patients with suspected stroke or TIA admitted to our emergency department between September 2008 and October 2012 with suspected stroke or TIA were eligible to participate in the ongoing stroke imaging study 1000Plus. Patients received acute and follow-up stroke MRI, basic demographics were collected, and stroke severity was rated according to the NIH Stroke Scale (NIHSS). Inclusion criteria for the substudy were total mismatch on admission examination and available follow-up.
RESULTS:We identified 23 patients with total mismatchmedian age 70 years (interquartile range 66–78), 10 female (43.5%). Infarction was found on follow-up diffusion-weighted imaging (median lesion size 1.3 mL) in 9 patients (39.1%). Infarction was correlated with NIHSS at admission (p = 0.026) and HIR (p = 0.015) but not with vessel occlusion. Clinical outcome as measured by last recorded NIHSS score and modified Rankin Scale score at discharge was significantly worse in patients with infarction on follow-up.
CONCLUSION:Final infarction is frequently seen in patients with total mismatch. Clinical presentation at admission and severity of hypoperfusion measured by HIR, but not occlusion of the supplying vessel, predict tissue fate.</description><identifier>ISSN: 0028-3878</identifier><identifier>EISSN: 1526-632X</identifier><identifier>DOI: 10.1212/WNL.0000000000001889</identifier><identifier>PMID: 26231256</identifier><language>eng</language><publisher>United States: American Academy of Neurology</publisher><subject>Acute Disease ; Aged ; Brain - pathology ; Cerebral Angiography ; Cerebrovascular Circulation ; Chronic Disease ; Cross-Sectional Studies ; Diffusion Magnetic Resonance Imaging ; Female ; Follow-Up Studies ; Humans ; Ischemic Attack, Transient - diagnosis ; Ischemic Attack, Transient - pathology ; Longitudinal Studies ; Magnetic Resonance Angiography ; Male ; Prognosis ; Severity of Illness Index ; Stroke - diagnosis ; Stroke - pathology</subject><ispartof>Neurology, 2015-09, Vol.85 (9), p.770-775</ispartof><rights>2015 American Academy of Neurology</rights><rights>2015 American Academy of Neurology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3899-8ebee0f10e198e510c061eb7b0635733ad2ecdbac1cb76f2fbb7d7296ca666bd3</citedby><cites>FETCH-LOGICAL-c3899-8ebee0f10e198e510c061eb7b0635733ad2ecdbac1cb76f2fbb7d7296ca666bd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26231256$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hotter, Benjamin</creatorcontrib><creatorcontrib>Ostwaldt, Ann-Christin</creatorcontrib><creatorcontrib>Levichev-Connolly, Anastasia</creatorcontrib><creatorcontrib>Rozanski, Michal</creatorcontrib><creatorcontrib>Audebert, Heinrich J</creatorcontrib><creatorcontrib>Fiebach, Jochen B</creatorcontrib><title>Natural course of total mismatch and predictors for tissue infarction</title><title>Neurology</title><addtitle>Neurology</addtitle><description>OBJECTIVE:We longitudinally assessed patients presenting with total mismatch and hypothesized that hypoperfusion intensity ratio (HIR), severity of stroke, and occlusion of blood vessel are predictors of tissue fate.
METHODS:Patients with suspected stroke or TIA admitted to our emergency department between September 2008 and October 2012 with suspected stroke or TIA were eligible to participate in the ongoing stroke imaging study 1000Plus. Patients received acute and follow-up stroke MRI, basic demographics were collected, and stroke severity was rated according to the NIH Stroke Scale (NIHSS). Inclusion criteria for the substudy were total mismatch on admission examination and available follow-up.
RESULTS:We identified 23 patients with total mismatchmedian age 70 years (interquartile range 66–78), 10 female (43.5%). Infarction was found on follow-up diffusion-weighted imaging (median lesion size 1.3 mL) in 9 patients (39.1%). Infarction was correlated with NIHSS at admission (p = 0.026) and HIR (p = 0.015) but not with vessel occlusion. Clinical outcome as measured by last recorded NIHSS score and modified Rankin Scale score at discharge was significantly worse in patients with infarction on follow-up.
CONCLUSION:Final infarction is frequently seen in patients with total mismatch. Clinical presentation at admission and severity of hypoperfusion measured by HIR, but not occlusion of the supplying vessel, predict tissue fate.</description><subject>Acute Disease</subject><subject>Aged</subject><subject>Brain - pathology</subject><subject>Cerebral Angiography</subject><subject>Cerebrovascular Circulation</subject><subject>Chronic Disease</subject><subject>Cross-Sectional Studies</subject><subject>Diffusion Magnetic Resonance Imaging</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Ischemic Attack, Transient - diagnosis</subject><subject>Ischemic Attack, Transient - pathology</subject><subject>Longitudinal Studies</subject><subject>Magnetic Resonance Angiography</subject><subject>Male</subject><subject>Prognosis</subject><subject>Severity of Illness Index</subject><subject>Stroke - diagnosis</subject><subject>Stroke - pathology</subject><issn>0028-3878</issn><issn>1526-632X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE1LAzEQhoMotlb_gcgevWzNRzcfRyl-QakXRW9Lkp3Q1d1NTbIU_70rrSIexLkMA887MzwInRI8JZTQi6flYop_FJFS7aExKSjPOaPP-2iMMZU5k0KO0FGMLwNTUKEO0Yhyyggt-BhdLXXqg24y6_sQIfMuSz4Nc1vHVie7ynRXZesAVW2TDzFzPmSpjrGHrO6cDjbVvjtGB043EU52fYIer68e5rf54v7mbn65yC2TSuUSDAB2BANREgqCLeYEjDCYs0IwpisKtjLaEmsEd9QZIypBFbeac24qNkHn273r4N96iKkc3rTQNLoD38eSCF4oRbFk_0CxVJgVMzGgsy1qg48xgCvXoW51eC8JLj9dl4Pr8rfrIXa2u9CbFqrv0JfcAZBbYOObBCG-Nv0GQrkC3aTV37s_ACRVi2M</recordid><startdate>20150901</startdate><enddate>20150901</enddate><creator>Hotter, Benjamin</creator><creator>Ostwaldt, Ann-Christin</creator><creator>Levichev-Connolly, Anastasia</creator><creator>Rozanski, Michal</creator><creator>Audebert, Heinrich J</creator><creator>Fiebach, Jochen B</creator><general>American Academy of Neurology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7TK</scope></search><sort><creationdate>20150901</creationdate><title>Natural course of total mismatch and predictors for tissue infarction</title><author>Hotter, Benjamin ; Ostwaldt, Ann-Christin ; Levichev-Connolly, Anastasia ; Rozanski, Michal ; Audebert, Heinrich J ; Fiebach, Jochen B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3899-8ebee0f10e198e510c061eb7b0635733ad2ecdbac1cb76f2fbb7d7296ca666bd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Acute Disease</topic><topic>Aged</topic><topic>Brain - pathology</topic><topic>Cerebral Angiography</topic><topic>Cerebrovascular Circulation</topic><topic>Chronic Disease</topic><topic>Cross-Sectional Studies</topic><topic>Diffusion Magnetic Resonance Imaging</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Ischemic Attack, Transient - diagnosis</topic><topic>Ischemic Attack, Transient - pathology</topic><topic>Longitudinal Studies</topic><topic>Magnetic Resonance Angiography</topic><topic>Male</topic><topic>Prognosis</topic><topic>Severity of Illness Index</topic><topic>Stroke - diagnosis</topic><topic>Stroke - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hotter, Benjamin</creatorcontrib><creatorcontrib>Ostwaldt, Ann-Christin</creatorcontrib><creatorcontrib>Levichev-Connolly, Anastasia</creatorcontrib><creatorcontrib>Rozanski, Michal</creatorcontrib><creatorcontrib>Audebert, Heinrich J</creatorcontrib><creatorcontrib>Fiebach, Jochen B</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Neurosciences Abstracts</collection><jtitle>Neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hotter, Benjamin</au><au>Ostwaldt, Ann-Christin</au><au>Levichev-Connolly, Anastasia</au><au>Rozanski, Michal</au><au>Audebert, Heinrich J</au><au>Fiebach, Jochen B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Natural course of total mismatch and predictors for tissue infarction</atitle><jtitle>Neurology</jtitle><addtitle>Neurology</addtitle><date>2015-09-01</date><risdate>2015</risdate><volume>85</volume><issue>9</issue><spage>770</spage><epage>775</epage><pages>770-775</pages><issn>0028-3878</issn><eissn>1526-632X</eissn><abstract>OBJECTIVE:We longitudinally assessed patients presenting with total mismatch and hypothesized that hypoperfusion intensity ratio (HIR), severity of stroke, and occlusion of blood vessel are predictors of tissue fate.
METHODS:Patients with suspected stroke or TIA admitted to our emergency department between September 2008 and October 2012 with suspected stroke or TIA were eligible to participate in the ongoing stroke imaging study 1000Plus. Patients received acute and follow-up stroke MRI, basic demographics were collected, and stroke severity was rated according to the NIH Stroke Scale (NIHSS). Inclusion criteria for the substudy were total mismatch on admission examination and available follow-up.
RESULTS:We identified 23 patients with total mismatchmedian age 70 years (interquartile range 66–78), 10 female (43.5%). Infarction was found on follow-up diffusion-weighted imaging (median lesion size 1.3 mL) in 9 patients (39.1%). Infarction was correlated with NIHSS at admission (p = 0.026) and HIR (p = 0.015) but not with vessel occlusion. Clinical outcome as measured by last recorded NIHSS score and modified Rankin Scale score at discharge was significantly worse in patients with infarction on follow-up.
CONCLUSION:Final infarction is frequently seen in patients with total mismatch. Clinical presentation at admission and severity of hypoperfusion measured by HIR, but not occlusion of the supplying vessel, predict tissue fate.</abstract><cop>United States</cop><pub>American Academy of Neurology</pub><pmid>26231256</pmid><doi>10.1212/WNL.0000000000001889</doi><tpages>6</tpages></addata></record> |
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| source | MEDLINE; Journals@Ovid Complete; Alma/SFX Local Collection |
| subjects | Acute Disease Aged Brain - pathology Cerebral Angiography Cerebrovascular Circulation Chronic Disease Cross-Sectional Studies Diffusion Magnetic Resonance Imaging Female Follow-Up Studies Humans Ischemic Attack, Transient - diagnosis Ischemic Attack, Transient - pathology Longitudinal Studies Magnetic Resonance Angiography Male Prognosis Severity of Illness Index Stroke - diagnosis Stroke - pathology |
| title | Natural course of total mismatch and predictors for tissue infarction |
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