Hyperattenuated intracerebral lesions after mechanical recanalization in acute stroke

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Nina Lummel - , Ludwig Maximilian University of Munich (Author)
  • G. Schulte-Altedorneburg - , Clinc Harlaching Munich (Author)
  • C. Bernau - , Ludwig Maximilian University of Munich (Author)
  • T. Pfefferkorn - , Ludwig Maximilian University of Munich (Author)
  • M. Patzig - , Ludwig Maximilian University of Munich (Author)
  • H. Janssen - , Ludwig Maximilian University of Munich (Author)
  • C. Opherk - , Ludwig Maximilian University of Munich (Author)
  • H. Brückmann - , Ludwig Maximilian University of Munich (Author)
  • J. Linn - , Hospital of the Ludwig-Maximilians-University (LMU) Munich, Ludwig Maximilian University of Munich (Author)

Abstract

BACKGROUND AND PURPOSE: Following mechanical recanalization of an acute intracranial vessel occlusion, hyperattenuated lesions are frequently found on postinterventional cranial CT. They represent either blood or - more frequently - enhancement of contrast agent. Here, we aimed to evaluate the prognostic value of these hyperattenuated intracerebral lesions. MATERIALS AND METHODS: One hundred one consecutive patients with acute stroke in the anterior circulation who underwent mechanical recanalization were included. Risk factors for hyperattenuated intracerebral lesions were assessed, and lesion volume was compared with the volume of final infarction. Clinical outcome and relative risk of secondary hemorrhage were determined in patients with and without any hyperattenuated lesions and compared. RESULTS: The frequency of hyperattenuated lesions was 84.2%. Risk factors for hyperattenuated lesions were female sex, higher NIHSS score on admission, and higher amount of contrast agent applied. On follow-up, 3 patients showed no infarction; 53 patients, an ischemic infarction; and 45 patients, a hemorrhagic infarction. In all except 1 case, final volume of infarction (median = 92.4 mL) exceeded the volume of hyperattenuated intracerebral lesions (median = 5.6 mL). Patients with hyperattenuated lesions were at a 4 times higher relative risk for hemorrhagic transformation but had no significantly worse clinical outcome. CONCLUSIONS: Our data show that the extent of postinterventional hyperattenuated intracerebral lesions underestimates the volume of final infarction. Although hyperattenuated lesions indicate a higher risk of secondary hemorrhagic transformation, their presence seems not to be of any prognostic value regarding clinical outcome.

Details

Original languageEnglish
Pages (from-to)345-351
Number of pages7
JournalAmerican journal of neuroradiology
Volume35
Issue number2
Publication statusPublished - Feb 2014
Peer-reviewedYes
Externally publishedYes

External IDs

PubMed 23907245