title: The Association between Diffusion MRI-Defined Infarct Volume and NIHSS Score in Patients with Minor Acute Stroke.
abstract: Prior studies have shown a correlation between the National Institutes of Health Stroke Scale (NIHSS) and stroke volume on diffusion weighted imaging (DWI); data are more limited in patients with minor stroke. We sought to determine the association between DWI lesion(s) volume and the (1) total NIHSS score and (2) NIHSS component scores in patients with minor stroke.
  
  
  
  We included all patients with minor stroke (NIHSS 0-5) enrolled in the Stroke Warning Information and Faster Treatment study. We calculated lesion(s) volume (cm3) on the DWI sequence using Medical Image Processing, Analysis, and Visualization (MIPAV, NIH, Version 7.1.1). We used nonparametric tests to study the association between the primary outcome, DWI lesion(s) volume, and the predictors (NIHSS score and its components).
  
  
  
  We identified 894 patients with a discharge diagnosis of minor stroke; 709 underwent magnetic resonance imaging and 510 were DWI positive. There was a graded relationship between the NIHSS score and median DWI lesion volume in cm3: (NIHSS 0: 7.1, NIHSS 1: 8.0, NIHSS 2: 17.1, NIHSS 3: 11.6, NIHSS 4: 19.0, and NIHSS 5: 23.6, P < .01). The median lesion volume was significantly higher in patients with neglect (105.6 vs. 12.5, P = .025), language disorder (34.6 vs. 11.9, P < .001), and visual field impairment (185.6 vs. 11.6, P < .001). Other components of the NIHSS were not associated with lesion volume.
  
  
  
  In patients with minor stroke, the nature of deficit when used with the NIHSS score can improve prediction of infarct volume. This may have clinical and therapeutic implications.
authors.affiliation: Division of Stroke and Cerebrovascular Diseases, Department of Neurology, The Warren Alpert Medical School of Brown University, Providence, RI.
authors.forename: Shadi
authors.initials: S
authors.lastname: Yaghi
authors.affiliation: Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Columbia University Medical Center, New York, NY.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Herber
authors.affiliation: Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Columbia University Medical Center, New York, NY.|Department of Epidemiology, The Mailman School of Public Health, Columbia University, New York, NY.
authors.forename: Amelia K
authors.initials: AK
authors.lastname: Boehme
authors.affiliation: Department of Epidemiology, The Mailman School of Public Health, Columbia University, New York, NY.
authors.forename: Howard
authors.initials: H
authors.lastname: Andrews
authors.affiliation: Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Columbia University Medical Center, New York, NY.
authors.forename: Joshua Z
authors.initials: JZ
authors.lastname: Willey
authors.affiliation: Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Columbia University Medical Center, New York, NY.
authors.forename: Sara K
authors.initials: SK
authors.lastname: Rostanski
authors.affiliation: Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University, Providence, RI.
authors.forename: Matthew
authors.initials: M
authors.lastname: Siket
authors.affiliation: Department of Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, RI.|Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Providence, RI.
authors.forename: Mahesh V
authors.initials: MV
authors.lastname: Jayaraman
authors.affiliation: Department of Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, RI.
authors.forename: Ryan A
authors.initials: RA
authors.lastname: McTaggart
authors.affiliation: Division of Stroke and Cerebrovascular Diseases, Department of Neurology, The Warren Alpert Medical School of Brown University, Providence, RI.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Furie
authors.affiliation: Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Columbia University Medical Center, New York, NY.
authors.forename: Randolph S
authors.initials: RS
authors.lastname: Marshall
authors.affiliation: Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Columbia University Medical Center, New York, NY.
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Lazar
authors.affiliation: Division of Social Epidemiology, Department of Neurology, Global Institute of Public Health, NYU Langone Medical Center and Department of Epidemiology, College of Dentistry, New York University, New York, NY.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Boden-Albala
mesh_terms: D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging*; D002545:Brain Ischemia / Q000000981:diagnostic imaging*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D020521:Stroke / Q000000981:diagnostic imaging*
keywords: Minor stroke; NIHSS; infarct volume; ischemic stroke; neuroimaging; outcome