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Reperfusion after ischemic stroke is associated with reduced brain edema

Overview of attention for article published in Cerebrovascular and Brain Metabolism Reviews, July 2017
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Title
Reperfusion after ischemic stroke is associated with reduced brain edema
Published in
Cerebrovascular and Brain Metabolism Reviews, July 2017
DOI 10.1177/0271678x17720559
Pubmed ID
Authors

Hannah J Irvine, Ann-Christin Ostwaldt, Matthew B Bevers, Simone Dixon, Thomas WK Battey, Bruce CV Campbell, Stephen M Davis, Geoffrey A Donnan, Kevin N Sheth, Reza Jahan, Jeffrey L Saver, Chelsea S Kidwell, W Taylor Kimberly

Abstract

Rapid revascularization is highly effective for acute stroke, but animal studies suggest that reperfusion edema may attenuate its beneficial effects. We investigated the relationship between reperfusion and edema in patients from the Echoplanar Imaging Thrombolysis Evaluation Trial (EPITHET) and Mechanical Retrieval and Recanalization of Stroke Clots Using Embolectomy (MR RESCUE) cohorts. Reperfusion percentage was measured as the difference in perfusion-weighted imaging lesion volume between baseline and follow-up (day 3-5 for EPITHET; day 6-8 for MR RESCUE). Midline shift (MLS) and swelling volume were quantified on follow-up MRI. We found that reperfusion was associated with less MLS (EPITHET: Spearman ρ = -0.46; P < 0.001, and MR RESCUE: Spearman ρ = -0.49; P < 0.001) and lower swelling volume (EPITHET: Spearman ρ = -0.56; P < 0.001, and MR RESCUE: Spearman ρ = -0.27; P = 0.026). Multivariable analyses performed in EPITHET and MR RESCUE demonstrated that reperfusion independently predicted both less MLS (ß coefficient = -0.056; P = 0.025, and ß coefficient = -0.38; P = 0.028, respectively) and lower swelling volumes (ß coefficient = -4.7; P = 0.007, and ß coefficient = -10.7; P = 0.009, respectively), after adjusting for age, sex, NIHSS, admission glucose and follow-up lesion size. Taken together, our data suggest that even modest improvement in perfusion is associated with less brain edema in EPITHET and MR RESCUE.

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Geographical breakdown

Country Count As %
Unknown 67 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 10 15%
Student > Bachelor 10 15%
Student > Ph. D. Student 9 13%
Other 7 10%
Student > Doctoral Student 4 6%
Other 10 15%
Unknown 17 25%
Readers by discipline Count As %
Medicine and Dentistry 23 34%
Neuroscience 13 19%
Pharmacology, Toxicology and Pharmaceutical Science 2 3%
Biochemistry, Genetics and Molecular Biology 2 3%
Psychology 1 1%
Other 3 4%
Unknown 23 34%