title: Reduction of diffusion-weighted MRI lesion volume after early moderate hypothermia in ischemic stroke.
abstract: 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.
authors.affiliation: Department of Neurology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. christian_berger@med.uni-heidelberg.de
authors.forename: Christian
authors.initials: C
authors.lastname: Berger
authors.forename: Peter
authors.initials: P
authors.lastname: Schramm
authors.forename: Stefan
authors.initials: S
authors.lastname: Schwab
mesh_terms: 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
chemical_list: D018698:Glutamic Acid