Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Factors Linking Stroke, Cervical Artery Dissection

Stroke; ePub 2018 Sep 11; McNally, Hinckley, et al

Along with stenosis, intramural hematoma (IMH) detection significantly contributed to acute ischemic stroke pathogenesis in patients with suspected cervical artery dissection, a recent study found. In addition, IMH detection can be made more reliable with heavily T1-weighted sequences. Researchers conducted a retrospective study of 227 patients undergoing MRI/magnetic resonance angiography for suspected dissection. Imaging included standard turbo spin–echo (TSE) T1-fat saturation and heavily T1-weighted flow-suppressed magnetization-prepared rapid acquisition gradient–recalled echo sequences. Patients consisted of 41.9% men, mean age of 47.3±16.6 years, with 114 dissections and 107 strokes. They found:

  • IMH interrater reliability was significantly higher for magnetization-prepared rapid acquisition gradient–recalled echo vs T1-fat saturation.
  • The final acute stroke prediction model included magnetization-prepared rapid acquisition gradient–recalled echo-detected IMH, stenosis, pseudoaneurysm, male sex, current smoking, and nondissection stroke sources.
  • The final model had high discrimination for acute stroke, compared with models without stenosis, and without stenosis and IMH.
Citation:

McNally JS, Hinckley PJ, Sakata A, et al. Magnetic resonance imaging and clinical factors associated with ischemic stroke in patients suspected of cervical artery dissection. [Published online ahead of print September 11, 2018]. Stroke. doi:STROKEAHA.118.021868.

This Week's Must Reads

Risk Factors for Suicidality in Huntington Disease, Neurology; ePub 2019 Mar 8; McGarry, et al

Socioeconomic Disparities in US Stroke Survivors, Stroke; ePub 2019 Mar 11; Elfassy, Grasset, et al

Treating Stroke Patients with tPA via Telemedicine, Stroke; ePub 2019 Mar 11; Wysocki, et al

Can a Modified Ketogenic Diet Reduce Seizures?, Epilepsy Behav; ePub 2019 Mar 10; Roehl, et al

No Association Between Self-Reported TBI and AD, Alzheimers Dement; ePub 2019 Mar 6; Sugarman, et al