Abstract
INTRODUCTION: Diffusion-weighted (DW) MR imaging enables early identification of ischemic lesions in stroke. Stroke subtype may be related to different lesion patterns. The aim of this study was to analyze the subtype of ischemic lesions as determined by the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria by using DW MR imaging.
METHODS AND RESULTS: In this study, 510 consecutive patients with ischemic stroke (95%) and transient ischemic attack (5%) aged 65 ± 12 years were investigated by use of DW MR imaging within 48 hours of the clinical onset of symptoms. Lesions on DW imaging were classified as single, scattered, or multiple lesions in one vascular territory and multiple in more than one vascular territory. We found a significant overall association of DW imaging lesion patterns and classification with stroke subtype by using the TOAST criteria (P < .001). Single corticosubcortical lesions (P < .01) and multiple bilateral lesions in the anterior (AC) and posterior circulation (P < .001) on DW imaging were significantly associated with a cardiac embolic source. Multiple unilateral lesions in the AC were significantly associated with large-artery arteriosclerosis. Because of the 15-mm criterion for small-artery occlusion, cryptogenic stroke was significantly associated with subcortical lesions ≥15 mm.
CONCLUSION: We found a strong relationship between stroke subtype and DW imaging lesion pattern. The finding of multiple bilateral lesions was significantly associated with a cardiac embolic source, which may be caused by a specific thrombus texture with a tendency for embolus dissemination.
- Copyright © American Society of Neuroradiology
In this issue
Jump to section
Related Articles
Cited By...
- Motor impairment and adaptation in a novel non-human primate model of internal capsule infarct
- Perfusion patterns as a tool for emergency stroke diagnosis: differentiating proximal and distal MCA occlusions
- Exploring the relationship between embolic acute stroke distribution and supra-aortic vessel patency: key findings from an in vitro model study
- The connectional diaschisis and normalization of cortical language network dynamics after basal ganglia and thalamus stroke
- Predictive Value of Lipoprotein(a) for Stroke Recurrence Risk in Embolic Stroke Patients with Different Pathogenesis
- Association of elevated hs-CRP and multiple infarctions with outcomes of minor stroke or TIA: subgroup analysis of CHANCE randomised clinical trial
- Diagnosing cerebral ischemia with door-to-thrombolysis times below 20 minutes
- Multiple Infarcts Are Associated With Long-Term Stroke Recurrence and All-Cause Mortality in Cryptogenic Stroke Patients
- Implication of Left Ventricular Diastolic Dysfunction in Cryptogenic Ischemic Stroke
- Evaluation of Cryptogenic Stroke With Advanced Diagnostic Techniques
- Prolonged Cardiac Monitoring for Detection of Paroxysmal Atrial Fibrillation After Cerebral Ischemia
- Imaging Recommendations for Acute Stroke and Transient Ischemic Attack Patients: A Joint Statement by the American Society of Neuroradiology, the American College of Radiology, and the Society of NeuroInterventional Surgery
- A new era for stroke patients
- An urgent access neurovascular clinic
- A woman with sudden headache followed by collapse
- Cardiogenic and Aortogenic Brain Embolism
- Patterns and Predictors of Early Risk of Recurrence After Transient Ischemic Attack With Respect to Etiologic Subtypes
- Mobile Aortic Plaques Are a Cause of Multiple Brain Infarcts Seen on Diffusion-Weighted Imaging
- Embolic Lesion Pattern in Stroke Patients With Patent Foramen Ovale Compared With Patients Lacking an Embolic Source