Stroke: Negative cranial FLAIR may predict clinical outcome more accurately than the time from onset to admission

FLAIR brain magnetic resonance signal variations are considered to be due to cytotoxic edema after diffusion weighted imaging (DWI) shows, the blood brain barrier destruction caused by vascular development-edema, resulting in increased interstitial water between the brain

Vascular when a positive result FLAI DWI negative signal (Flair- negative), it indicates that - there is a strong possibility - to the present time from the onset of a period of 4.

Stroke

The two recent major randomized trials are the DAWN trial (DWI or CT perfusion assessment and clinically mismatched wake-ups and advanced strokes undergoing Trevo neurointervention) and DEFUSE 3 trial (after imaging assessment of ischemic stroke) Endovascular treatment) ushered in a new era of stroke management , expanding the time window of intravascular thrombectomy (EVT) to within 24 hours of onset

The two recent major randomized trials are the DAWN trial (DWI or CT perfusion assessment and clinically mismatched wake-ups and advanced strokes undergoing Trevo neurointervention) and DEFUSE 3 trial (after imaging assessment of ischemic stroke) Endovascular treatment) ushered in a new era of stroke management , expanding the time window of intravascular thrombectomy (EVT) to within 24 hours after the onset of disease

diabetes

Recently, researchers from the Department of Neurology at the Graduate School of Japan Medical University included consecutive acute stroke patients who received EVT treatment from September 2014 to December 2018 to assess whether the signal changes on FLAIR can be used as a tissue clock to predict stroke The patient's clinical results after EVT

According to the changes in the parenchymal signal on FLAIR, patients were divided into FLAIR-negative group and FLAIR-positive group

Examples of FLAIR-negative and DWI-positive patients

Examples of FLAIR-negative and DWI-positive patients

Compared with the FLAIR-positive group, the patients in the FLAIR-negative group are older, have a shorter time from onset to imaging , have a higher frequency of myocardial infarction , and have a higher rate of intravenous thrombolysis

Although there was no difference in the complete recanalization rate after EVT between the two groups (P=0.

Three months after the onset, according to FLAIR imaging, the revised Rankin Scale (mRS) score

Three months after the onset, according to FLAIR imaging, the revised Rankin Scale (mRS) score

It was suggested that good outcome was significantly correlated with changes in FLAIR signal (P=0.

In summary, FLAIR-negative status may predict clinical outcome more accurately than the time from onset to admission, which may support the role of FLAIR as a tissue clock

references:

Fluid-Attenuated Inversion Recovery May Serve As a Tissue Clock in Patients Treated With Endovascular Thrombectomy.

Fluid-Attenuated Inversion Recovery May Serve As a Tissue Clock in Patients Treated With Endovascular Thrombectomy.
https://doi.
org/10.
1161/STROKEAHA.
120.
033374

Leave a message here