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Magnetic resonance brain imaging in patients with acute stroke: feasibility and patient related difficulties
  1. P J Hand2,
  2. J M Wardlaw1,
  3. A M Rowat1,
  4. J A Haisma3,
  5. R I Lindley4,
  6. M S Dennis1
  1. 1Division of Clinical Neurosciences, Western General Hospital, Crewe Road, Edinburgh EH4 2XU, UK
  2. 2RMH Stroke Centre, Department of Neurology, Royal Melbourne Hospital, Victoria, Australia 3050
  3. 3Department of Rehabilitation Medicine, Erasmus Medical Centre, Postbus 2040, 3000 CA Rotterdam, The Netherlands
  4. 4Department of Geriatric Medicine, Westmead Hospital, Western Clinical School (C24), University of Sydney, Westmead, NSW 2006, Australia
  1. Correspondence to:
 Professor J M Wardlaw
 Division of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Crewe Road, Edinburgh EH4 2XU, UK; joanna.wardlawed.ac.uk

Abstract

Objectives: To assess organisational and patient specific limitations and safety of magnetic resonance imaging (MRI) as the first line investigation for hospital admitted stroke patients.

Methods: Consecutive patients admitted with acute stroke were assessed and an attempt was made to perform MRI in all patients. Oxygen saturation and interventions required during scanning were recorded.

Results: Among 136 patients recruited over 34 weeks, 85 (62%) underwent MRI. The patients’ medical instability (15 of the 53 not scanned), contraindications to MRI (six of the 53 not scanned), and rapid symptom resolution (10 of the 53 not scanned) were the main reasons for not performing MRI. Of the 85 patients who underwent MRI, 26 required physical intervention, 17 did not complete scanning, and 11 of the 61 who had successful oxygen saturation monitoring were hypoxic during MRI. Organisational limitations accounted for only 13% of failures to scan.

Conclusions: Up to 85% of hospital admitted acute stroke patients could have MRI as first line imaging investigation, but medical instability is the major limitation. Hypoxia is frequent in MRI. Patients should be monitored carefully, possibly by an experienced clinician, during scanning.

  • MRI, magnetic resonance imaging
  • NIHSS, National Institutes of Health Stroke Scale Score
  • SaO2, arterial oxygen saturation
  • stroke
  • magnetic resonance imaging
  • safety

https://doi.org/10.1136/jnnp.2005.062539

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    Footnotes

    • Competing interests: none declared

    • Ethics and consent: The study was approved by the Lothian research ethics committee reference number LREC/1702/98/4/1, the regional committee for single centre research conducted in Lothian Region. Consent to participate in the study was obtained from the patient, or assent from a relative, as approved by the ethics committee.