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Article10.1161/str.44.suppl_1.atp33

Abstract TP33: Early DWI Changes in the Thrombolysis Time Window: From DWI-Negative to Malignant Stroke in More than 300 Cases

David S. Liebeskind,Nerses Sanossian,Sidney Starkman,Fabien Scalzo,Rodelito Alfonso,Mark S. Johnson+9 more-2013-02-01-Stroke
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TL;DRAbstract

Background: Thrombolysis for acute stroke is routinely based on time from last known well (TLKW) as the extent of ischemic injury during early epochs is assumed to be minimal. DWI is extremely sensitive, yet rarely acquired prior to thrombolysis and the nature of DWI lesions is largely unknown during this time window. Large or malignant strokes on DWI, however, result in poor outcome after thrombolysis. We retrospectively analyzed a large cohort of DWI acquired as part of a standard MRI protocol for triage of patients at a single center over 8 years. Methods: Consecutive patients with discharge diagnosis of ischemic stroke and documented time last known well to DWI MRI acquisition < 4.5 hours were identified. An imaging expert outlined DWI lesions on every axial slice for all MRIs to calculate corresponding lesion volumes as often-subtle changes may evade automated detection. Total DWI volumes were analyzed with respect to age, gender, TLKW and time of day. Results: 307 stroke patie

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Background: Thrombolysis for acute stroke is routinely based on time from last known well (TLKW) as the extent of ischemic injury during early epochs is assumed to be minimal. DWI is extremely sensitive, yet rarely acquired prior to thrombolysis and the nature of DWI lesions is largely unknown during this time window. Large or malignant strokes on DWI, however, result in poor outcome after thrombolysis. We retrospectively analyzed a large cohort of DWI acquired as part of a standard MRI protocol for triage of patients at a single center over 8 years. Methods: Consecutive patients with discharge diagnosis of ischemic stroke and documented time last known well to DWI MRI acquisition < 4.5 hours were identified. An imaging expert outlined DWI lesions on every axial slice for all MRIs to calculate corresponding lesion volumes as often-subtle changes may evade automated detection. Total DWI volumes were analyzed with respect to age, gender, TLKW and time of day. Results: 307 stroke patie

Keywords

MedicineThrombolysisStroke (engine)LesionRadiologyNuclear medicineMagnetic resonance imagingSurgery

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