MR angiography in acute cerebral ischemia of the anterior circulation: a preliminary report.
OBJECTIVE
To determine the prevalence of major vessel occlusion in cases of acute cerebral ischemia of the anterior circulation by using MR angiography and to assess the frequency of spontaneous thrombolysis.


METHODS
Thirty patients with an initial clinical diagnosis of possible acute stroke of the anterior circulation made within 24 hours of the event were studied with conventional T2-weighted MR imaging and with two-dimensional and three-dimensional time-of-flight MR angiography. Studies were repeated if the initial study showed partial or complete occlusion.


RESULTS
Of the 30 patients studied six (20%) had a final diagnosis of a transient ischemic attack and 24 (80%) had a stroke of the anterior circulation as confirmed by T2 abnormalities and persistence of clinical symptoms. Twelve (50%) of the stroke patients had a major vessel abnormality, either partial or complete occlusion, at MR angiography. Of these 12 patients, nine subsequently had follow-up MR angiography, and only two of these had a change in the findings. One patient with diminished flow signal had progression of the occlusion and another patient had flow signal in a vessel where no flow was seen initially.


CONCLUSIONS
MR angiography can show patients with acute cerebral ischemia and major vascular occlusive disease. Of those with partial or complete occlusion, progression of thrombus or spontaneous recanalization occurs infrequently.
Gillard
J H
JH
Department of Neurology, Johns Hopkins Medical Institutions, Baltimore, Md, USA.
Oliverio
P J
PJ
Barker
P B
PB
Oppenheimer
S M
SM
Bryan
R N
RN
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged