This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Davis, S. M. Articles by Hopper, J. L. Search for Related Content PubMed PubMed Citation Articles by Davis, S. M. Articles by Hopper, J. L.

Stroke, Vol 24, 1691-1696, Copyright © 1993 by American Heart Association

ARTICLES

Cerebral hypoperfusion in stroke prognosis and brain recovery

SM Davis, MG Chua, M Lichtenstein, SC Rossiter, D Binns and JL Hopper
University Department of Medicine, Royal Melbourne Hospital, Victoria, Australia.

BACKGROUND AND PURPOSE: The value of acute cerebral blood flow measurements in stroke prognosis is controversial. No previous study has determined whether acute perfusion deficits independently add to a validated clinical prognostic score. We aimed to compare the value of acute hypoperfusion deficits with a quantitative clinical score in stroke prognosis and to correlate the changes in perfusion with brain recovery. METHODS: Volumetric analysis of regional hypoperfusion was performed in 38 patients with middle cerebral infarction within 72 hours of onset by use of single photon emission computed tomography and 99mTc hexamethylpropylene amine oxime. Stroke severity was assessed by the Canadian Neurological Score and Barthel Index. Allen's prognostic score was determined acutely in all patients. Clinical outcome was evaluated in 36 of 38 patients, of whom 18 had repeat blood flow studies. RESULTS: Acute hypoperfusion correlated with both the outcome Barthel Index (P < .001, r = -.61) and Canadian Neurological Score (P < .001, r = -.64). Allen's score correlated better with both the outcome Barthel Index (P < .001, r = .80) and Canadian Neurological Score (P < .001, r = .81). Acute hypoperfusion deficits, after allowing for Allen's score, independently predicted neurological but not functional outcome. Despite overall neurological improvement, mean hypoperfusion increased on the repeat blood flow studies (P < .05). CONCLUSIONS: Volumetric analysis of acute regional hypoperfusion within 72 hours of onset predicts stroke outcome after 3 months, but Allen's score is a better prognostic method. Neurological recovery is not associated with chronic infarct reperfusion.

This article has been cited by other articles:

				B. Infeld, S. M. Davis, G. A. Donnan, M. Yasaka, M. Lichtenstein, P. J. Mitchell, and G. J. Fitt Nimodipine and Perfusion Changes After Stroke Stroke, July 1, 1999; 30(7): 1417 - 1423. [Abstract] [Full Text] [PDF]

				J. C. Grotta and A. V. Alexandrov tPA-Associated Reperfusion After Acute Stroke Demonstrated by SPECT Stroke, February 1, 1998; 29(2): 429 - 432. [Abstract] [Full Text] [PDF]

				J V Bowler, J P H Wade, B E Jones, K S Nijran, and T J Steiner Natural history of the spontaneous reperfusion of human cerebral infarcts as assessed by 99mTc HMPAO SPECT J. Neurol. Neurosurg. Psychiatry, January 1, 1998; 64(1): 90 - 97. [Abstract] [Full Text]

				A. V. Alexandrov, J. C. Masdeu, M. D. Devous Sr, S. E. Black, and J. C. Grotta Brain Single-Photon Emission CT With HMPAO and Safety of Thrombolytic Therapy in Acute Ischemic Stroke : Proceedings of the Meeting of the SPECT Safe Thrombolysis Study Collaborators and the Members of the Brain Imaging Council of the Society of Nuclear Medicine Stroke, September 1, 1997; 28(9): 1830 - 1834. [Abstract] [Full Text]

				B. Infeld, S. M. Davis, G. A. Donnan, M. Lichtenstein, A. E. Baird, D. Binns, P. J. Mitchell, and J. L. Hopper Streptokinase Increases Luxury Perfusion After Stroke Stroke, September 1, 1996; 27(9): 1524 - 1529. [Abstract] [Full Text]

				A. V. Alexandrov, S. E. Black, L. E. Ehrlich, C. F. Bladin, L. T. Smurawska, A. Pirisi, and C. B. Caldwell Simple Visual Analysis of Brain Perfusion on HMPAO SPECT Predicts Early Outcome in Acute Stroke Stroke, September 1, 1996; 27(9): 1537 - 1542. [Abstract] [Full Text]

				J.V. Bowler, J.P.H. Wade, B.E. Jones, K. Nijran, and T.J. Steiner Single-Photon Emission Computed Tomography Using Hexamethylpropyleneamine Oxime in the Prognosis of Acute Cerebral Infarction Stroke, January 1, 1996; 27(1): 82 - 86. [Abstract] [Full Text]

				P. Laloux, F. Richelle, J. Jamart, P. De Coster, and C. Laterre Comparative Correlations of HMPAO SPECT Indices, Neurological Score, and Stroke Subtypes With Clinical Outcome in Acute Carotid Infarcts Stroke, May 1, 1995; 26(5): 816 - 821. [Abstract] [Full Text]

				B. Infeld, S. M. Davis, M. Lichtenstein, P. J. Mitchell, and J. L. Hopper Crossed Cerebellar Diaschisis and Brain Recovery After Stroke Stroke, January 1, 1995; 26(1): 90 - 95. [Abstract] [Full Text]