高血压脑卒中

Schematic depiction of ROI volumes
ROIs were defined on initial MRI (<6 h after symptom onset) as perfusion abnormality (PERF-ROI), diffusion abnormality (DIFF-ROI), and the contralateral hemisphere (REF-
Image analysis - Realignment of images for pixel-by-pixel comparison - Calculation of parameter maps of the apparent diffusion coefficient (ADC), cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time - Comparison of the degree of local diffusion and perfusion impairment in the HT area with the entire diffusion and perfusion abnormality
Cerebrovasc Dis 2005;19:117–124
Local reperfusion in the HT area was seen in 18/19 patients.
Presence of HT did not coincide with a worse clinical outcome.
Cerebrovasc Dis 2005;19:117–124
ROI). The region displaying HT in the follow-up imaging was transferred after spatial realignment to the initial ADC and perfusion maps (HT-ROI).
Incomplete reperfusion after 24 h in a typical case of HT in the basal ganglia
After 24 h, the region with hyperperfusion can be separated from persistent hypoperfusion (TTP delay) in the periphery.
HT occurred in the area with reperfusion.
Cerebrovasc Dis 2005;19:117–124ห้องสมุดไป่ตู้
Methods
A total of 51 acute ischemic stroke patients were studied by diffusion- and perfusion-weighted MR imaging (DWI-MRI and PWI-MRI) within 3.0 ± 0.8 h, on day 1 and days 5–8.
Cerebrovasc Dis 2005;19:117–124
Results
HT was observed in 19/51 patients (37.2%) within 8 days after symptom onset.
Areas destined for HT revealed a more severe decrease in ADC (to 70 ± 13%; p< 0.01), CBV (to 31 ± 26%; p< 0.001) and CBF (to 28 ± 19%; p< 0.001) compared to the entire perfusion abnormality.
We used MRI to study potential predictors of HT such as the degree of local diffusion and perfusion abnormalities in tissue with subsequent hemorrhagic transformation to study.
Background
Cerebral hemorrhage is the most feared adverse event of thrombolytic therapy in acute ischemic stroke and occurs in 6.8 % of patients.1
Hemorrhagic transformation (HT) after thrombolysis is thought to correlate with bad neurological outcome.2,3
Conclusions
HT results of local reperfusion within the region with the severest perfusion impairment HT did not worsen the clinical outcome since HT occurs in infarcted tissue The prediction of HT is of limited clinical value
Hypothesis: HT does not affect the clinical course of acute
stroke patients.
1 NINDS. N Engl J Med 1995 2 Oppenheim et al. J Neuroradiol 2002;29:6–13 3 Selim et al. Stroke 2002;33:2047–2052