Early ischemic lesion recurrence within a week after acute ischemic stroke

Dong Wha Kang, Lawrence L. Latour, Julio A. Chalela, James Dambrosia, Steven Warach

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Abstract

Previous observations suggested that multiple ischemic lesions on diffusion-weighted imaging (DWI) are common in acute stroke patients. We hypothesized that a source of these multiple lesions was the recurrence of ischemic lesions within a week after a clinically symptomatic stroke. We analyzed 99 acute ischemic stroke patients scanned within 6 hours of onset and at subsequent times within the first week. Ischemic lesion recurrence was defined as any new lesion separate from the index lesion. Recurrent lesions occurring outside initial perfusion deficit were termed 'distant lesion recurrence'. We estimated the hazard ratio (HR) of recurrence associated with clinical and imaging characteristics using log-rank test. Any lesion recurrence was found in 34%, with distant lesion recurrence in 15%, while clinical recurrence was evident in 2%. Initial multiple DWI lesions were associated with any lesion recurrence (HR, 2.83; 95% confidence interval [CI], 1.65-10.29; p = 0.002) and with distant lesion recurrence (HR, 5.99; 95% CI, 4.05-64.07; p < 0.0001). Large-artery atherosclerosis was the most frequent stroke subtype associated with any lesion recurrence (p = 0.026). These results may indicate a prolonged state of increased ischemic risk over the first week and suggest DWI as a possible surrogate measure for recurrent stroke.

Original languageEnglish (US)
Pages (from-to)66-74
Number of pages9
JournalAnnals of Neurology
Volume54
Issue number1
DOIs
StatePublished - Jul 1 2003

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Stroke
Recurrence
Confidence Intervals
Atherosclerosis
Arteries
Perfusion

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Kang, D. W., Latour, L. L., Chalela, J. A., Dambrosia, J., & Warach, S. (2003). Early ischemic lesion recurrence within a week after acute ischemic stroke. Annals of Neurology, 54(1), 66-74. https://doi.org/10.1002/ana.10592

Early ischemic lesion recurrence within a week after acute ischemic stroke. / Kang, Dong Wha; Latour, Lawrence L.; Chalela, Julio A.; Dambrosia, James; Warach, Steven.

In: Annals of Neurology, Vol. 54, No. 1, 01.07.2003, p. 66-74.

Research output: Contribution to journalArticle

Kang, DW, Latour, LL, Chalela, JA, Dambrosia, J & Warach, S 2003, 'Early ischemic lesion recurrence within a week after acute ischemic stroke', Annals of Neurology, vol. 54, no. 1, pp. 66-74. https://doi.org/10.1002/ana.10592
Kang, Dong Wha ; Latour, Lawrence L. ; Chalela, Julio A. ; Dambrosia, James ; Warach, Steven. / Early ischemic lesion recurrence within a week after acute ischemic stroke. In: Annals of Neurology. 2003 ; Vol. 54, No. 1. pp. 66-74.
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