title: Prediction of infarct growth and neurologic deterioration in patients with positive perfusion-diffusion mismatch.
abstract: BACKGROUND
  To assess the value of baseline clinical severity and perfusion-diffusion mismatch as predictors for further infarct growth and clinical outcome.
  
  
  METHODS
  Patients with acute ischemic stroke and initial perfusion-diffusion mismatch within 72 h were enrolled. Baseline perfusion defects on time-to-peak (TTP) and cerebral blood volume (CBV) maps were measured. Infarct volume and stroke severity were assessed by diffusion-weighted image (DWI) and NIHSS, and were repeatedly assessed 7 days later. The predictive value of baseline NIHSS and perfusion defects on further infarct growth and neurologic deterioration was determined.
  
  
  RESULTS
  Fifty-two patients (mean age 68.3±12.8 years, 42% women) were enrolled. CBV defects were significantly associated with infarct growth (CBV, p=0.02). Initial stroke severity, but not TTP and CBV mismatch (p=0.65 and 0.76, respectively), significantly inversely correlated with neurologic deterioration (p=0.001).
  
  
  CONCLUSIONS
  In patients with mismatch, those with severe symptoms initially are more likely to have infarct growth, while those with minor symptoms tend to suffer from larger extent of neurologic deterioration within 1 week. CBV is associated with further infarct growth but not clinical deterioration.
authors.affiliation: Department of Neurology, En Chu Kong Hospital, Taipei, Taiwan.
authors.forename: Chien-Tai
authors.initials: CT
authors.lastname: Hong
authors.forename: Yu
authors.initials: Y
authors.lastname: Sun
authors.forename: Chien-Jung
authors.initials: CJ
authors.lastname: Lu
authors.forename: Hsiu-Chen
authors.initials: HC
authors.lastname: Shin
authors.forename: Rong-Chi
authors.initials: RC
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000209:etiology; D002544:Cerebral Infarction / Q000150:complications / Q000473:pathology* / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D038524:Diffusion Magnetic Resonance Imaging; D018450:Disease Progression; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D020521:Stroke / Q000473:pathology / Q000503:physiopathology