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Research ArticleAdult Brain

Degree of Collaterals and Not Time Is the Determining Factor of Core Infarct Volume within 6 Hours of Stroke Onset

E. Cheng-Ching, J.A. Frontera, S. Man, J. Aoki, Y. Tateishi, F.K. Hui, D. Wisco, P. Ruggieri, M.S. Hussain and K. Uchino
American Journal of Neuroradiology July 2015, 36 (7) 1272-1276; DOI: https://doi.org/10.3174/ajnr.A4274
E. Cheng-Ching
aFrom the Cerebrovascular Center (E.C.-C., J.A.F., S.M., F.K.H., D.W., M.S.H., K.U.)
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J.A. Frontera
aFrom the Cerebrovascular Center (E.C.-C., J.A.F., S.M., F.K.H., D.W., M.S.H., K.U.)
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S. Man
aFrom the Cerebrovascular Center (E.C.-C., J.A.F., S.M., F.K.H., D.W., M.S.H., K.U.)
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J. Aoki
cDepartment of Neurology and Cerebrovascular Disease (J.A.), Nippon Medical School, Tokyo, Japan
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Y. Tateishi
dCerebrovascular Center (Y.T.), Department of Neurology and Strokology, Nagasaki University Hospital, Nagasaki, Japan.
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F.K. Hui
aFrom the Cerebrovascular Center (E.C.-C., J.A.F., S.M., F.K.H., D.W., M.S.H., K.U.)
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D. Wisco
aFrom the Cerebrovascular Center (E.C.-C., J.A.F., S.M., F.K.H., D.W., M.S.H., K.U.)
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P. Ruggieri
bDepartment of Neuroradiology (P.R.), Imaging Institute, Cleveland Clinic, Cleveland, Ohio
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M.S. Hussain
aFrom the Cerebrovascular Center (E.C.-C., J.A.F., S.M., F.K.H., D.W., M.S.H., K.U.)
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K. Uchino
aFrom the Cerebrovascular Center (E.C.-C., J.A.F., S.M., F.K.H., D.W., M.S.H., K.U.)
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    Fig 1.

    CTA collateral status in the region of the occluded vessel. A, Absent collaterals. B, Minimal (<50%) collaterals. C, Partial (>50%) collaterals. D, Full presence of collaterals.

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    Fig 2.

    Distribution of DWI infarct volume of each patient according to the time from last seen well to MR imaging and collateral status.

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    Fig 3.

    Receiver operating characteristic curve demonstrating no association between the time from LSW to MR imaging (0–3 hours versus 3–6 hours) and DWI infarct volume.

Tables

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  • Imaging characteristics by time from last seen well to MRI

    0 to <3 Hours (n = 21)3–6 Hours (n = 70)0–6 Hours (Entire Cohort) (n = 91)P Value (Difference, 0–3 vs 3–6)
    Age (yr) (median) (IQR)58 (54–77)73 (63.25–83)70 (59–82).034
    NIHSS (median) (IQR)13 (11–19)17 (13–22.75)17 (12–21.5).050
    CT ASPECTS (median) (IQR)9 (7–10)8 (I6–9)8 (6–9).202
    CT ASPECTS ≥7 (No.) (%)17/20 (85%)42/61 (69%)59/81 (72%).159
    CTA collaterals >50% (No.) (%)14/19 (74%)37/57 (65%)51/76 (67%).481
    DWI volume (mL) (median) (IQR)24.7 (13.9–63.8)29.4 (12.1–68.5)29.2 (12.3–68.5).906
    MRI DWI volume ≥70 mL of DWI volume (No.) (%)5 (23.8%)16 (22.8%)21 (22.8%).928
    MRI DWI volume ≥100 mL of DWI volume (No.) (%)4 (19%)13 (18.6%)17 (18.7%).961
    Terminal ICA occlusion (No.) (%)5 (23.8%)18 (25.7%)23 (25.3%).961
    Proximal M1 occlusion (No.) (%)5 (23.8%)21 (30%)26 (28.6%).706
    Distal M1 occlusion (No.) (%)11 (52.4%)31 (44.3%)42 (46.1%).393
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American Journal of Neuroradiology: 36 (7)
American Journal of Neuroradiology
Vol. 36, Issue 7
1 Jul 2015
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E. Cheng-Ching, J.A. Frontera, S. Man, J. Aoki, Y. Tateishi, F.K. Hui, D. Wisco, P. Ruggieri, M.S. Hussain, K. Uchino
Degree of Collaterals and Not Time Is the Determining Factor of Core Infarct Volume within 6 Hours of Stroke Onset
American Journal of Neuroradiology Jul 2015, 36 (7) 1272-1276; DOI: 10.3174/ajnr.A4274

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Degree of Collaterals and Not Time Is the Determining Factor of Core Infarct Volume within 6 Hours of Stroke Onset
E. Cheng-Ching, J.A. Frontera, S. Man, J. Aoki, Y. Tateishi, F.K. Hui, D. Wisco, P. Ruggieri, M.S. Hussain, K. Uchino
American Journal of Neuroradiology Jul 2015, 36 (7) 1272-1276; DOI: 10.3174/ajnr.A4274
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