Reduction of diffusion-weighted MRI lesion volume after early moderate hypothermia in ischemic stroke.
BACKGROUND
Large areas of restricted diffusion in the middle cerebral artery (MCA) territory are highly predictive of severe and potentially space-occupying MCA stroke. A reduction of diffusion-weighted MRI (DWI) lesions occurs in 20% to 40% of acute stroke patients with early reperfusion.


METHODS
We report of a patient with a severe stroke syndrome who was treated with early moderate hypothermia but not thrombolysis.


RESULTS
The initially large DWI deficit of the whole MCA territory contrasted to the relatively small final lesion restricted to the basal ganglia on MRI and computed tomography scan.


CONCLUSIONS
This case describes an unexpected reduction of a DWI lesion after early moderate hypothermia and spontaneous recanalization 3 days after stroke onset. We discuss potential reasons for the unexpected DWI lesion reduction.
Berger
Christian
C
Department of Neurology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. christian_berger@med.uni-heidelberg.de
Schramm
Peter
P
Schwab
Stefan
S
D001921:Brain / Q000473:pathology; D002545:Brain Ischemia / Q000175:diagnosis* / Q000628:therapy*; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000175:diagnosis; D004058:Diffusion; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D018698:Glutamic Acid / Q000378:metabolism; D006801:Humans; D007035:Hypothermia; D007036:Hypothermia, Induced; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000473:pathology; D015424:Reperfusion; D020521:Stroke / Q000175:diagnosis* / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000379:methods; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
D018698:Glutamic Acid