Early and late recurrence of ischemic lesion on MRI: Evidence for a prolonged stroke-prone state?

D. W. Kang, L. L. Latour, J. A. Chalela, J. A. Dambrosia, Steven Warach

Research output: Contribution to journalArticle

61 Citations (Scopus)

Abstract

Background: Based on previous observations of a high rate of ischemic lesion recurrence on diffusion-weighted imaging (DWI) within 1 week after an acute ischemic stroke, the authors hypothesized that silent new ischemic lesions are common between 1 week and 90 days after index stroke and that early lesion recurrence may be associated with late lesion recurrence. Methods: The authors studied 80 acute ischemic stroke patients who had initial MRI performed within 48 hours, and follow-up scans at 5 days and at 30 or 90 days after onset. Early lesion recurrences were defined as new ischemic lesions on 5-day DWI, and late lesion recurrences were defined as those on 30- or 90-day DWI or fluid attenuation inversion recovery image. Early lesion recurrence occurring outside the initial perfusion deficit was termed distant lesion recurrence. Results: Late lesion recurrence occurred in 26%, more frequently observed on 30-day MRI than 90-day MRI (p = 0.016). Early lesion recurrence (OR 4.0; 95% CI 1.3 to 11.7) and distant early lesion recurrence (OR 6.9; 95% CI 1.5 to 32.2) were independently associated with late lesion recurrence by multiple logistic regression analyses. Conclusions: There may be a continued risk for recurrent ischemic lesions in the weeks following the clinically symptomatic stroke. Future studies are needed to investigate whether MRI-defined ischemic lesion recurrences predict subsequent clinical recurrence and thus may be a potential surrogate endpoint in stroke secondary prevention trials.

Original languageEnglish (US)
Pages (from-to)2261-2265
Number of pages5
JournalNeurology
Volume63
Issue number12
StatePublished - Dec 28 2004

Fingerprint

Stroke
Recurrence
Secondary Prevention
Perfusion
Biomarkers
Logistic Models
Regression Analysis

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Kang, D. W., Latour, L. L., Chalela, J. A., Dambrosia, J. A., & Warach, S. (2004). Early and late recurrence of ischemic lesion on MRI: Evidence for a prolonged stroke-prone state? Neurology, 63(12), 2261-2265.

Early and late recurrence of ischemic lesion on MRI : Evidence for a prolonged stroke-prone state? / Kang, D. W.; Latour, L. L.; Chalela, J. A.; Dambrosia, J. A.; Warach, Steven.

In: Neurology, Vol. 63, No. 12, 28.12.2004, p. 2261-2265.

Research output: Contribution to journalArticle

Kang, DW, Latour, LL, Chalela, JA, Dambrosia, JA & Warach, S 2004, 'Early and late recurrence of ischemic lesion on MRI: Evidence for a prolonged stroke-prone state?', Neurology, vol. 63, no. 12, pp. 2261-2265.
Kang DW, Latour LL, Chalela JA, Dambrosia JA, Warach S. Early and late recurrence of ischemic lesion on MRI: Evidence for a prolonged stroke-prone state? Neurology. 2004 Dec 28;63(12):2261-2265.
Kang, D. W. ; Latour, L. L. ; Chalela, J. A. ; Dambrosia, J. A. ; Warach, Steven. / Early and late recurrence of ischemic lesion on MRI : Evidence for a prolonged stroke-prone state?. In: Neurology. 2004 ; Vol. 63, No. 12. pp. 2261-2265.
@article{966c8fe86e0f4481ae7c0745a3c5edf9,
title = "Early and late recurrence of ischemic lesion on MRI: Evidence for a prolonged stroke-prone state?",
abstract = "Background: Based on previous observations of a high rate of ischemic lesion recurrence on diffusion-weighted imaging (DWI) within 1 week after an acute ischemic stroke, the authors hypothesized that silent new ischemic lesions are common between 1 week and 90 days after index stroke and that early lesion recurrence may be associated with late lesion recurrence. Methods: The authors studied 80 acute ischemic stroke patients who had initial MRI performed within 48 hours, and follow-up scans at 5 days and at 30 or 90 days after onset. Early lesion recurrences were defined as new ischemic lesions on 5-day DWI, and late lesion recurrences were defined as those on 30- or 90-day DWI or fluid attenuation inversion recovery image. Early lesion recurrence occurring outside the initial perfusion deficit was termed distant lesion recurrence. Results: Late lesion recurrence occurred in 26{\%}, more frequently observed on 30-day MRI than 90-day MRI (p = 0.016). Early lesion recurrence (OR 4.0; 95{\%} CI 1.3 to 11.7) and distant early lesion recurrence (OR 6.9; 95{\%} CI 1.5 to 32.2) were independently associated with late lesion recurrence by multiple logistic regression analyses. Conclusions: There may be a continued risk for recurrent ischemic lesions in the weeks following the clinically symptomatic stroke. Future studies are needed to investigate whether MRI-defined ischemic lesion recurrences predict subsequent clinical recurrence and thus may be a potential surrogate endpoint in stroke secondary prevention trials.",
author = "Kang, {D. W.} and Latour, {L. L.} and Chalela, {J. A.} and Dambrosia, {J. A.} and Steven Warach",
year = "2004",
month = "12",
day = "28",
language = "English (US)",
volume = "63",
pages = "2261--2265",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "12",

}

TY - JOUR

T1 - Early and late recurrence of ischemic lesion on MRI

T2 - Evidence for a prolonged stroke-prone state?

AU - Kang, D. W.

AU - Latour, L. L.

AU - Chalela, J. A.

AU - Dambrosia, J. A.

AU - Warach, Steven

PY - 2004/12/28

Y1 - 2004/12/28

N2 - Background: Based on previous observations of a high rate of ischemic lesion recurrence on diffusion-weighted imaging (DWI) within 1 week after an acute ischemic stroke, the authors hypothesized that silent new ischemic lesions are common between 1 week and 90 days after index stroke and that early lesion recurrence may be associated with late lesion recurrence. Methods: The authors studied 80 acute ischemic stroke patients who had initial MRI performed within 48 hours, and follow-up scans at 5 days and at 30 or 90 days after onset. Early lesion recurrences were defined as new ischemic lesions on 5-day DWI, and late lesion recurrences were defined as those on 30- or 90-day DWI or fluid attenuation inversion recovery image. Early lesion recurrence occurring outside the initial perfusion deficit was termed distant lesion recurrence. Results: Late lesion recurrence occurred in 26%, more frequently observed on 30-day MRI than 90-day MRI (p = 0.016). Early lesion recurrence (OR 4.0; 95% CI 1.3 to 11.7) and distant early lesion recurrence (OR 6.9; 95% CI 1.5 to 32.2) were independently associated with late lesion recurrence by multiple logistic regression analyses. Conclusions: There may be a continued risk for recurrent ischemic lesions in the weeks following the clinically symptomatic stroke. Future studies are needed to investigate whether MRI-defined ischemic lesion recurrences predict subsequent clinical recurrence and thus may be a potential surrogate endpoint in stroke secondary prevention trials.

AB - Background: Based on previous observations of a high rate of ischemic lesion recurrence on diffusion-weighted imaging (DWI) within 1 week after an acute ischemic stroke, the authors hypothesized that silent new ischemic lesions are common between 1 week and 90 days after index stroke and that early lesion recurrence may be associated with late lesion recurrence. Methods: The authors studied 80 acute ischemic stroke patients who had initial MRI performed within 48 hours, and follow-up scans at 5 days and at 30 or 90 days after onset. Early lesion recurrences were defined as new ischemic lesions on 5-day DWI, and late lesion recurrences were defined as those on 30- or 90-day DWI or fluid attenuation inversion recovery image. Early lesion recurrence occurring outside the initial perfusion deficit was termed distant lesion recurrence. Results: Late lesion recurrence occurred in 26%, more frequently observed on 30-day MRI than 90-day MRI (p = 0.016). Early lesion recurrence (OR 4.0; 95% CI 1.3 to 11.7) and distant early lesion recurrence (OR 6.9; 95% CI 1.5 to 32.2) were independently associated with late lesion recurrence by multiple logistic regression analyses. Conclusions: There may be a continued risk for recurrent ischemic lesions in the weeks following the clinically symptomatic stroke. Future studies are needed to investigate whether MRI-defined ischemic lesion recurrences predict subsequent clinical recurrence and thus may be a potential surrogate endpoint in stroke secondary prevention trials.

UR - http://www.scopus.com/inward/record.url?scp=11144257010&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=11144257010&partnerID=8YFLogxK

M3 - Article

C2 - 15623684

AN - SCOPUS:11144257010

VL - 63

SP - 2261

EP - 2265

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 12

ER -