Type and extent of hemispheric brain infarctions and clinical outcome in early and delayed middle cerebral artery recanalization

• DOI: 10.1212/wnl.42.2.289
• Publication Date: 2012-05-13T13:03:24Z
• Authors: E. B. Ringelstein; R. Biniek; C. Weiller; B. Ammeling; P. N. Nolte; A. Thron
• Keywords: Collateral circulation; Stroke

We evaluated the influence of time recanalization or degree initial leptomeningeal collateral blood flow in cardioembolic arterio-arterial middle cerebral artery (MCA) occlusion on infarct size and clinical outcome a series 34 consecutive acute stroke patients with main stem (N = 31) major branch 3) occlusions using CT, arteriography 21), repetitive close-meshed transcranial Doppler ultrasonography, neurologic scale. treated 15 tissue plasminogen activator intravenously within first 6 hours. The type infarction depended location occluding lesions MCA trunk. Proximal always led to involving striatum internal capsule. Sixty-five percent showed occluded 1 week. Following recanalization, hyperperfusion was present 38 44% cases. There marginally significant relation between CT 24 more rapidly occurred, smaller infarct. When greater than 8 hours, extended cortex. An additional good significantly reduced improved after 17 days 10 months. Early embolic up conjunction transcortical collateralization, has favorable impact may constitute therapeutic window opportunity.