지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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초록· 키워드
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Background: Malignant middle cerebral artery (MCA) infarction is one of the leading cause of death for patients with acute MCA infarction. We investigated the predicting factors for developing malignant MCA infarction (MMI) using multi-parametric magnetic resonance imaging (MRI). Methods: We included 159 MCA infarction patients who visited Dong-A University Stroke Center from January 2007 to December 2010 and were diagnosed MCA occlusion within 6 hours after symptom onset.
All patients underwent brain MRI including diffusion and perfusion-weighted image. The definition of the malignant MCA infarction is as follows: 1) deterioration of neurological symptoms and consciousness with clinical signs of uncal herniation, and 2)at least two-thirds of the MCA territory with compression of ventricles or midline shifting. The neurological deterioration was observed for 7 days. The severity of neurological symptom and clinical outcome were assessed by using National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS). Results: Among 159 patients, 49 patients (30.8%) developed MMI. In a multivariate analysis, a larger diffusion volume on diffusion-weighted image, a lower regional cerebral blood volume (rCBV) ratio on perfusion-weighted image, and a higher NIHSS score on admission were identified as the predictive factors of MMI. The cut-off values of diffusion volume, NIHSS on admission and rCBV ratio were 69 mL, 15 points and 0.78. Conclusion:A large diffusion volume, a high NIHSS score and particularly a low rCBV ratio can predict a malignant course in MCA infarction within 6 hours of symptom onset in MCA occlusion.
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참고문헌 (20)
참고문헌 신청
Adams HP Jr / 1993 / Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treat
Albers GW / 2006 / DEFUSE investigators. Magnetic resonance imaging profiles predict clinical response to early reperfusion: the diffusion and perfusion imaging evaluation fo
Bivard A / 2011 / Defining the extent of irreversible brain ischemia using perfusion computed tomography / Cerebrovasc Dis 31 : 238 ~ 245
Chalela JA / 2007 / Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison / Lancet 369
Furlan A / 1999 / Intra-arterial prourokinase for acute ischemic stroke. The PROACT II Study: a randomized controlled trial / JAMA 282 : 2003 ~ 2011
Albers GW / 2006 / DEFUSE investigators. Magnetic resonance imaging profiles predict clinical response to early reperfusion: the diffusion and perfusion imaging evaluation fo
Bivard A / 2011 / Defining the extent of irreversible brain ischemia using perfusion computed tomography / Cerebrovasc Dis 31 : 238 ~ 245
Chalela JA / 2007 / Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison / Lancet 369
Furlan A / 1999 / Intra-arterial prourokinase for acute ischemic stroke. The PROACT II Study: a randomized controlled trial / JAMA 282 : 2003 ~ 2011
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