title: The association between hyperintense vessel sign and final ischemic lesion differ in its location.
abstract: BACKGROUND
  The hyperintense vessel sign (HVS) on fluid-attenuated inversion recovery images can frequently be detected in patients with acute cerebral infarction attributable to large artery stenosis or occlusion. The prognostic values and clinical characteristics of HVS remain to be elucidated. The aim of this study was to evaluate the association of HVS with ischemic lesions and severity of neurologic deficit.
  
  
  METHODS
  A total of 96 consecutive acute ischemic stroke patients (54 women, median age 76.5 [range 39-97] years), who had symptomatic severe stenosis or occlusion in the proximal middle cerebral artery that was detected with magnetic resonance angiography within 24 hours of onset, were enrolled. The extent of HVS was graded by a systematic quantitative scoring system (the HVS distribution score) based on Alberta Stroke Program Early Computed Tomographic Score.
  
  
  RESULTS
  An HVS was detected in 89 patients (93%) at admission, and the patients who displayed wider HVS distribution scores exhibited more severe neurologic deficits at admission (P<.05). The follow-up magnetic resonance imaging, which was obtained in 79 patients (82%), was performed an average of 13 days. The association between HVS distribution score and final ischemic lesions was strongly observed (n=67, P<.05) but not in the patients with intravenous thrombolysis (n=12, P=.06).
  
  
  CONCLUSIONS
  Although the distribution of HVS reflected final ischemic lesion, this association might not apply to the patients with the thrombolysis treatment. The interpretation of HVS distribution score with acute ischemic stroke patients should be discussed dependent on thrombolysis.
authors.affiliation: Department of Clinical Neuroscience and Therapeutics, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kono
authors.affiliation: Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Naka
authors.affiliation: Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan.
authors.forename: Eiichi
authors.initials: E
authors.lastname: Nomura
authors.affiliation: Department of Clinical Neuroscience and Therapeutics, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan. Electronic address: nhosomi@hiroshima-u.ac.jp.
authors.forename: Naohisa
authors.initials: N
authors.lastname: Hosomi
authors.affiliation: Department of Clinical Neuroscience and Therapeutics, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Aoki
authors.affiliation: Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Imamura
authors.affiliation: Department of Clinical Neuroscience and Therapeutics, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan.
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Sueda
authors.affiliation: Department of Clinical Neuroscience and Therapeutics, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan.
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Nezu
authors.affiliation: Department of Clinical Neuroscience and Therapeutics, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Mukai
authors.affiliation: Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Ohshita
authors.affiliation: Department of Clinical Neuroscience and Therapeutics, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan.
authors.forename: Toshiho
authors.initials: T
authors.lastname: Ohtsuki
authors.affiliation: Department of Neurosurgery, Suiseikai Kajikawa Hospital, Hiroshima, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Wakabayashi
authors.affiliation: Department of Clinical Neuroscience and Therapeutics, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan.
authors.forename: Masayasu
authors.initials: M
authors.lastname: Matsumoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology*; D002545:Brain Ischemia / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D015912:Thrombolytic Therapy
chemical_list: D005343:Fibrinolytic Agents
keywords: Alberta Stroke Programme Early CT Score; Hyperintense vessel sign; National Institutes of Health Stroke Scale; acute ischemic stroke