In:
Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 30, No. 8 ( 1999-08), p. 1577-1582
Abstract:
Background and Purpose — 1 H MR spectroscopy can be used to study biochemical changes occurring in the brain in stroke. We used it to examine the relationship between metabolite concentration ( N -acetyl aspartate [NAA], lactate, cholines and creatines), size of infarct, clinical deficit, and 3-month clinical outcome in patients with middle cerebral artery (MCA) territory infarction. Methods —Thirty-one patients with acute MCA territory infarction were recruited within 72 hours of the onset of symptoms. Single-voxel short echo time stimulated echo acquistion mode spectroscopy was used to obtain metabolite data from the infarct core. Metabolite concentrations were determined with use of variable projection time domain-fitting analysis. Infarct size was determined with T2-weighted images. Patient outcome groups at 3 months were “independent,” “dependent,” or “dead.” Results —All patients (100%; 95% CI 75% to 100%) who had an infarct 〉 70 mL did poorly. Eighteen of 20 patients (90%; 95% CI 68% to 99%) with a core NAA concentration 〈 7 mmol/L did poorly at 3 months, whereas 7 of 11 patients (64%; 95% CI 31% to 89%) with an initial NAA concentration 〉 7 mmol/L did well. Combining these results showed that all patients who had an initial infarct volume 〉 70 mL did poorly, irrespective of the NAA concentration. Of those patients with infarcts 〈 70 mL, those who had a core NAA concentration 〉 7 mmol/L did well (88%; 95% CI 47% to 100%), whereas those with a lower NAA concentration did poorly (80%; 95% CI 44% to 97%). There was no association between other metabolite concentrations and outcome. Conclusions —Infarct volume and NAA concentration can together predict clinical outcome in MCA infarction in humans.
Type of Medium:
Online Resource
ISSN:
0039-2499
,
1524-4628
DOI:
10.1161/01.STR.30.8.1577
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
1999
detail.hit.zdb_id:
1467823-8
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