Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:253-259
RESEARCH PAPERS
Microembolic signals at 48 hours after stroke onset contribute to new ischaemia within a week
Department of Stroke Medicine, Kawasaki Medical School, Kurashiki City, Okayama, Japan
Dr Y Iguchi, Department of Stroke Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, 701-0192, Japan; yigu{at}med.kawasaki-m.ac.jp
Background and aim: We investigated whether new ischaemic lesions (NIL) on follow-up diffusion weighted magnetic resonance imaging (DWI) are associated with microembolic signals (MES) within 24 h or at 48 h after stroke onset.
Methods: Patients had acute ischaemic stroke and were studied within 24 h of onset. Transcranial Doppler ultrasonography (TCD) was prospectively examined twice, within 24 h and at 48 h after onset. DWI was conducted twice, on admission and on day 7. NIL were defined as the presence of hyperintense lesions undetected on initial DWI.
Results: 125 patients were consecutively enrolled from November 2004 to March 2006. TCD detected MES in 49% within 24 h and in 29% at 48 h after onset. In 27 patients with small vessel disease, MES were found in 8 (30%) patients within 24 h and in 5 (19%) patients at 48 h after stroke onset. In contrast, in 20 patients with large vessel disease, 11 (55%) patients within 24 h and 7 (35%) at 48 h had MES. Follow-up DWI detected NIL in 28 of 125 patients (22%) and NIL were significantly more frequent in MES positive patients (42%) than in MES negative patients at 48 h (15%; p = 0.002). MES at 48 h (OR 3.9; 95% CI 1.5 to 10; p = 0.005), atrial fibrillation (OR 3.6; 95% CI 1.3 to 11; p = 0.013) and arterial lesions (OR 4.3; 95% CI 1.5 to 12; p = 0.007) represented independent factors for NIL.
Conclusion: The presence of MES at 48 h, atrial fibrillation and arterial lesions were associated with recurrence of cerebral ischaemia on DWI.
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
Relevant Article
- MES, what a mess! A modern version of Russian roulette
- Erich Bernd Ringelstein, Ralf Dittrich
J. Neurol. Neurosurg. Psychiatry 2008 79: 238.[Extract] [Full Text] [PDF]
This article has been cited by other articles:
-
Ringelstein, E. B., Dittrich, R.
(2008). MES, what a mess! A modern version of Russian roulette. J. Neurol. Neurosurg. Psychiatry
79: 238-238
[Full Text]
- Full Text
- Full Text (PDF)
-
All Versions of this Article:
jnnp.2007.123414v1
79/3/253 most recent - Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
