Multiple brain infarcts: clinical and neuroimaging patterns using diffusion-weighted magnetic resonance.

Details

Serval ID
serval:BIB_4A42A31136A3
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Multiple brain infarcts: clinical and neuroimaging patterns using diffusion-weighted magnetic resonance.
Journal
European Neurology
Author(s)
Altieri M., Metz R.J., Müller C., Maeder P., Meuli R., Bogousslavsky J.
ISSN
0014-3022
Publication state
Published
Issued date
1999
Peer-reviewed
Oui
Volume
42
Number
2
Pages
76-82
Language
english
Notes
Publication types: Journal Article
Abstract
The capability of diffusion-weighted (DW) magnetic resonance imaging (MRI) to identify very early ischemic brain injury better than conventional MRI is well known. This technique, which successfully discriminates acute from old infarcts, is particularly useful in patients with multiple brain infarcts (MBI). Among 142 patients with acute stroke consecutively admitted to our primary care center, we selected 43 patients with two or more brain infarcts on conventional MRI. All patients presented with clinical deficits consistent with acute cerebral ischemia and underwent conventional spin echo for T(1) (T1-WI) and T(2)-weighted images (T2-WI), T(1)-W gadolinium-enhanced images, and echo-planar technique for DW MRI sequences. Patients underwent DW MRI examinations within 15 days of stroke onset (mean +/- SD: 3 +/- 3 days). In all but 1 case, the infarcts detected on DW MRI were also visible on T2-WI. The different signal pattern on DW MRI, compared with T2-WI, facilitated the detection of acute infarcts in all patients. T1-WI with gadolinium enhancement was only helpful in 5 (11.6%) patients. DW MRI enabled precise clinicotopographic correlations in 79% of our patients and provided additional clinically relevant findings in 72% of the patients. Based on the neuroradiological findings, patients were divided into three clinicotopographic types of MBI as follows: 13 patients (30.2%) presented with multiple acute infarcts, 24 patients (55.8%) with a single acute infarct and multiple old infarcts, and 6 patients (13.9%) with multiple acute and old infarcts. In conclusion, DW MRI can easily be added to conventional MRI in order to be able to distinguish acute from old infarcts, and to identify acute multiple lesions. Therefore, a better correlation between clinical symptoms and the site of lesions can be obtained, considerably improving patient care.
Keywords
Adolescent, Adult, Aged, Aged, 80 and over, Brain/pathology, Cerebral Infarction/pathology, Diagnosis, Differential, Female, Humans, Magnetic Resonance Imaging/methods, Male, Middle Aged, Stroke/pathology
Pubmed
Web of science
Create date
11/04/2008 8:23
Last modification date
20/08/2019 13:57
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