Acute Cortical Infarction Research Articles

Prediction of worsening consciousness from edema after hemispheric infarction

We sought to develop a risk profile that would predict worsening consciousness from edema after hemispheric infarction. Charts were reviewed correlating initial computed tomography scan, neurologic examination, demographic features, and ischemic mechanism with worsening consciousness from massive edema after hemispheric infarction. An edema risk profile composed of two of three clinical factors (gaze preference, hemiplegia, or hemineglect) and evidence of acute cortical infarction on initial computed tomography scan highly correlated with the later development of worsening consciousness from edema. The edema risk profile correlated with worsening consciousness from edema after hemispheric infarction. The profile requires prospective verification before use for family counseling, for anticipatory care, and for randomizing patients in acute stroke trials aimed at controlling the formation and sequelae of edema after ischemic stroke.

Prediction of Functional Outcome and Tissue Loss in Acute Cortical Infarction

To compare the acute Allen's Prognostic Score, Canadian Neurological Score, and subacute Barthel Index as predictors of outcome functional status and infarct size at 3 months in patients with acute cortical infarction. A prospective study of acute stroke predictors and outcome measurements in a cohort of sequential hospitalized patients. Fifty-one patients with acute cortical infarction and without previous disability assessed 24 hours after onset with Allen's Prognostic Score and the Canadian Neurological Score and at 7 days with the Barthel Index. Mortality, Barthel Index, and volumetric measurement of infarct size on computed tomography 3 months after stroke. There were seven deaths. The outcome Barthel Index was measured in all 44 survivors, of whom 29 had computed tomography at the time outcome was determined. In a multivariate analysis, functional outcome was best predicted by Allen's Prognostic Score, a score of less than -15 having a sensitivity of 82% and specificity of 97% in predicting a poor outcome (Barthel Index, < or = 12 or death). Volumetric tissue loss was predicted only by Allen's Prognostic Score (r = .62, P < .001). Allen's Prognostic Score is a robust predictor of both functional outcome and tissue loss in acute cortical infarction and has a potentially important role in the analysis of the results of acute stroke intervention trials.

Oral administration of glycerol may not cause hemolysis.

HomeStrokeVol. 23, No. 10Oral administration of glycerol may not cause hemolysis. Free AccessAbstractPDF/EPUBAboutView PDFSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessAbstractPDF/EPUBOral administration of glycerol may not cause hemolysis. R Nau, S Sommer, H W Prange and E Wieland R NauR Nau Search for more papers by this author , S SommerS Sommer Search for more papers by this author , H W PrangeH W Prange Search for more papers by this author and E WielandE Wieland Search for more papers by this author Originally published5 Apr 2018https://doi.org/10.1161/str.23.10.1533aStroke. 1992;23:1533–1534"Oral administration of glycerol may not cause hemolysis.." Stroke, 23(10), pp. 1533–1534 Previous Back to top Next FiguresReferencesRelatedDetailsCited By Nau R (2000) Osmotherapy for Elevated Intracranial Pressure, Clinical Pharmacokinetics, 10.2165/00003088-200038010-00002, 38:1, (23-40), Online publication date: 1-Jan-2000. Yu Y, Kumana C, Lauder I, Cheung Y, Chan F, Kou M, Fong K, Cheung R and Chang C (1993) Treatment of acute cortical infarct with intravenous glycerol. A double-blind, placebo-controlled randomized trial., Stroke, 24:8, (1119-1124), Online publication date: 1-Aug-1993. October 1992Vol 23, Issue 10 Advertisement Article InformationMetrics Copyright © 1992 by American Heart Associationhttps://doi.org/10.1161/str.23.10.1533aPMID: 1412592 Originally publishedApril 5, 2018 PDF download Advertisement

MR imaging of acute cortical venous infarction: preliminary experience with an animal model.

Surgically ligated cortical veins in rabbits produced areas of hemorrhage and infarction. Pathological correlation with serial magnetic resonance (MR) imaging of these surgically created lesions was obtained. Imaging within 4 hours after ligation showed the site of venous infarction to be a focus of low signal intensity on T1-weighted images (T1WI) within a larger overlapping area of high intensity on T2-weighted images (T2WI). The serial imaging showed persistence of T1WI and T2WI changes without alteration of pattern. At 3-day follow-up, both the T1WI and T2WI changes were maximal. At 7- and 14-day follow-up, T1WI and T2WI changes showed regression. There was no identifiable site of paramagnetic influence within the lesions produced. This lack of local paramagnetic effect may be related to the acuteness and minute size of the lesions, partial volume effects, and/or atmospheric exposure of the lesion related to the surgical procedure. Our preliminary results are encouraging not only for trying to image cortical venous infarction but also in trying to define the sensitivity of MRI for small cortical lesions.

Acute long bone diaphyseal infarcts in sickle cell disease.

One hundred and ninety-eight acute diaphyseal cortical infarcts in 81 patients with S and C haemoglobinopathies are reviewed. The great majority (65 patients) were genotype SS. Chronic forms of diaphyseal infarction, such as “tram lines” or cortical thickening, are not included. Cases of dactylitis alone are not included. Fifty-nine of the 65 SS patients in this series, unselected as to age, were less than nine years old. In sickle cell disease this is clearly a complication of the young. The SC patients were older than the SS patients. Two predominant patterns are seen: infarction of almost the entire shaft, primarily in young infants, and localised infarctions more commonly in older infants, children and young adults. Eighty-five per cent of the localised infarctions occurred in the metadiaphyseal region. Some specific sites appear to be more commonly involved than others, the distal femora and proximal tibiae being the most commonly involved. Multiple sites of involvement and symmetrical lesions are common. A frequent pattern is bilateral symmetrical infarcts of the distal femora often with fractures. The way the vascular anatomy of the diaphysis changes with age and other developmental factors is discussed in relation to the location, and radiological appearances of acute and sub-acute long bone diaphyseal infarcts in sickle cell disease.