Diffusion-Weighted-Imaging Negative Stroke Syndromes
Yıl: 2021 Cilt: 27 Sayı: 2 Sayfa Aralığı: 151 - 157 Metin Dili: İngilizce DOI: 10.4274/tnd.2021.67878 İndeks Tarihi: 19-01-2022
Diffusion-Weighted-Imaging Negative Stroke Syndromes
Öz: Objective: Normal diffusion-weighted imaging (DWI) during the acute symptomatic phase of an ischemic stroke is a rare, but a well-known phenomenon. The exact rate and the clinical correlates of this phenomenon are not satisfactorily elucidated. Materials and Methods: Consecutive patients who were hospitalized with the diagnosis of acute ischemic stroke in the last 10 years and who had DWI (with a bmax of 1000 s/mm2) in the first 12 hours were included. A systematic review of published DWI-negative stroke cases and case series was performed. Alternate diagnoses including transient ischemic attack or stroke mimics such as seizure, migraine, functional disorders, and post-stroke recrudescence were excluded. Results: The diagnosis of DWI-negative stroke syndrome was made in 20 (1.3%) of 1.506 patients hospitalized in Hacettepe Hospitals. A literature search disclosed another 535 (6.6%) DWI-negative strokes out of 8.101 cases. A total of 115, identified in case reports and cohort (n=19) articles, were combined with our cases to delineate further characteristics of DWI-negative clinical stroke syndromes. DWI-negative syndromes (n=135) were “brainstem mini-strokes” (31.1%), “cortical small embolic infarcts” (5.2%), “pure penumbral stroke” (normal DWI with magnetic resonance perfusion deficit) (34.8%); “aborted stroke” (early and fully recanalized stroke, only diagnosable in patients with documented acute vessel occlusion) (5.2%); and “miscellaneous” (23.7%). Corresponding clinical stroke syndromes include partial hemispheric deficits (36.1%), focal cortical syndromes (4.3%), caudal brainstem syndromes (9.3%), acute isolated vertigo (9.3%), vertigo-plus syndromes (10.1%), ocular syndromes (7.4%), movement disorders (1.9%), typical lacunar syndromes (11.1%), and atypical lacunar syndromes such as ataxia ± dysatrhria (9.3%). Conclusion: In clinical practice of acute ischemic stroke, early DWI imaging can be negative in various clinical syndromes. Imaging repetition is necessary for the diagnosis and management plan of these patients.
Anahtar Kelime: Difüzyon Ağırlıklı Görüntüleme Negatif İnme Sendromları
Öz: Amaç: İskemik inmenin akut fazında normal diffüzyon ağırlıklı görüntüleme (DAG) izlenmesi nadir, ama iyi bilinen bir fenomendir. Bu durumun kesin oranı ve karşılık gelen klinik korelasyonları yeterli derecede incelenmemiştir. Gereç ve Yöntem: Son 10 yıl içerisinde akut iskemik inme tanısı ile hastaneye yatırılan ve ilk 12 saat içerisinde DAG çekilen peşi sıra hastalar çalışmaya alındı. Ek olarak, literatürde yayınlanan DAG negatif inme olgu sunumu ve serileri sistematik olarak derlendi. Geçici iskemik atak ve epileptik nöbet, migren, fonksiyonel bozukluklar, inme rekrüdesansı gibi inme taklitçileri dışlandı. Bulgular: Hacettepe Hastaneleri’nde yatan 1,506 hastanın 20’sinde (%1,3) DAG negatif inme sendromu tanısı kondu. Literatür taramasında 8,101 olgudan 535 (%6,6) DAG negatif inme olgusu daha saptandı. Olgu sunumları ve kohort makalelerinde tanımlanan toplam 115 olgu DAG negatif klinik inme sendromlarının özelliklerini tanımlamak için bizim olgularımızla birleştirildi. DAG negatif sendromlar (n=135) “beyin sapı mini-inmeler” (%31,1), “kortikal küçük embolik enfarktlar” (%5,2), “saf penumbral inme” (manyetik rezonans perfüzyon defekti olduğu halde normal DAG; %34,8), “durdurulmuş “(aborted)” “inme” (erken/ tamamen rekanalize inme, sadece akut damar tıkanıklığının tıkanıp açıldığı gösterilen olgularda teşhis edilebilir; (%5,2) ve “çeşitli” (%23,7). Karşılık gelen klinik inme sendromları “kısmi hemisferik defisitler” (%36,1), “fokal kortikal sendromlar” (%4,3), “kaudal beyin sapı sendromları” (%9,3), “akut izole vertigo” (%9,3), “vertigo-plus sendromlar” (%10,1), oküler sendromlar (%7,4), hareket bozuklukları (%1,9) ile tipik laküner sendromlar (%11,1) ve ataksi ± dizatri gibi atipik laküner sendromlar (%9,3) şeklindedir. Sonuç: Akut iskemik inme klinik pratiğinde “DAG negatif inme sendromu” nadir değildir. Ancak, çok sayıda klinik tablo ve nöroanatomik lokalizasyonla birlikte olabildiği için spesifik olmaktan uzaktır. Klinik bulgular temelinde kontrol görüntüleme alınması ve difüzyon negatifliğinin mekanizmasının aydınlatılması makuldur.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | pektezel m, Arsava E, Gocmen R, KARLI OGUZ H, TOPCUOGLU M (2021). Diffusion-Weighted-Imaging Negative Stroke Syndromes. , 151 - 157. 10.4274/tnd.2021.67878 |
| Chicago | pektezel mehmet yasir,Arsava Ethem Murat,Gocmen Rahsan,KARLI OGUZ H.KADER,TOPCUOGLU MEHMET Diffusion-Weighted-Imaging Negative Stroke Syndromes. (2021): 151 - 157. 10.4274/tnd.2021.67878 |
| MLA | pektezel mehmet yasir,Arsava Ethem Murat,Gocmen Rahsan,KARLI OGUZ H.KADER,TOPCUOGLU MEHMET Diffusion-Weighted-Imaging Negative Stroke Syndromes. , 2021, ss.151 - 157. 10.4274/tnd.2021.67878 |
| AMA | pektezel m,Arsava E,Gocmen R,KARLI OGUZ H,TOPCUOGLU M Diffusion-Weighted-Imaging Negative Stroke Syndromes. . 2021; 151 - 157. 10.4274/tnd.2021.67878 |
| Vancouver | pektezel m,Arsava E,Gocmen R,KARLI OGUZ H,TOPCUOGLU M Diffusion-Weighted-Imaging Negative Stroke Syndromes. . 2021; 151 - 157. 10.4274/tnd.2021.67878 |
| IEEE | pektezel m,Arsava E,Gocmen R,KARLI OGUZ H,TOPCUOGLU M "Diffusion-Weighted-Imaging Negative Stroke Syndromes." , ss.151 - 157, 2021. 10.4274/tnd.2021.67878 |
| ISNAD | pektezel, mehmet yasir vd. "Diffusion-Weighted-Imaging Negative Stroke Syndromes". (2021), 151-157. https://doi.org/10.4274/tnd.2021.67878 |
| APA | pektezel m, Arsava E, Gocmen R, KARLI OGUZ H, TOPCUOGLU M (2021). Diffusion-Weighted-Imaging Negative Stroke Syndromes. Türk Nöroloji Dergisi, 27(2), 151 - 157. 10.4274/tnd.2021.67878 |
| Chicago | pektezel mehmet yasir,Arsava Ethem Murat,Gocmen Rahsan,KARLI OGUZ H.KADER,TOPCUOGLU MEHMET Diffusion-Weighted-Imaging Negative Stroke Syndromes. Türk Nöroloji Dergisi 27, no.2 (2021): 151 - 157. 10.4274/tnd.2021.67878 |
| MLA | pektezel mehmet yasir,Arsava Ethem Murat,Gocmen Rahsan,KARLI OGUZ H.KADER,TOPCUOGLU MEHMET Diffusion-Weighted-Imaging Negative Stroke Syndromes. Türk Nöroloji Dergisi, vol.27, no.2, 2021, ss.151 - 157. 10.4274/tnd.2021.67878 |
| AMA | pektezel m,Arsava E,Gocmen R,KARLI OGUZ H,TOPCUOGLU M Diffusion-Weighted-Imaging Negative Stroke Syndromes. Türk Nöroloji Dergisi. 2021; 27(2): 151 - 157. 10.4274/tnd.2021.67878 |
| Vancouver | pektezel m,Arsava E,Gocmen R,KARLI OGUZ H,TOPCUOGLU M Diffusion-Weighted-Imaging Negative Stroke Syndromes. Türk Nöroloji Dergisi. 2021; 27(2): 151 - 157. 10.4274/tnd.2021.67878 |
| IEEE | pektezel m,Arsava E,Gocmen R,KARLI OGUZ H,TOPCUOGLU M "Diffusion-Weighted-Imaging Negative Stroke Syndromes." Türk Nöroloji Dergisi, 27, ss.151 - 157, 2021. 10.4274/tnd.2021.67878 |
| ISNAD | pektezel, mehmet yasir vd. "Diffusion-Weighted-Imaging Negative Stroke Syndromes". Türk Nöroloji Dergisi 27/2 (2021), 151-157. https://doi.org/10.4274/tnd.2021.67878 |
