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(Stroke. 2003;34:2396.)
© 2003 American Heart Association, Inc.

Original Contributions

Editorial Comment—Measurement of Cognitive Deficits in Acute Stroke

Department of Neurology, University of Florida College of Medicine, Jacksonville, Florida
Department of Neurology, University of Florida College of Medicine, Veterans Affairs Medical Center, Gainesville, Florida

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Whereas diffusion-weighted imaging (DWI) identifies areas of metabolic failure and cellular injury that are often, but not invariably, irreversible,¹ perfusion-weighted imaging (PWI) depicts areas of hypoperfusion that, when not matched by a diffusion abnormality, constitute the potentially reversible ischemic penumbra.² Early neurological deficits correlate with core and penumbral lesion volume rather than with the diffusion abnormality.³ These new imaging techniques are powerful tools that provide insights into the pathophysiology of the deficits and the effects of therapeutic interventions in patients with acute stroke.

Earlier SPECT observations showed that patients with subcortical stroke and aphasia or neglect had decreased cortical perfusion that was attributed to the interruption of neural connections (diaschisis).⁴ Using neuropsychological tests and PWI, however, Hillis and colleagues have shown that patients with subcortical strokes have aphasia and neglect because of the cortical hypoperfusion,⁵ and that these deficits improve when blood flow to the cortex is restored.^5,6 In this issue of Stroke, Hillis et al demonstrate that a battery of neurobehavioral tests that assess language and attention correlates well with the volume of hypoperfused cortex but that the National Institute of Health Stroke Scale (NIHSS) score correlates poorly when the left hemisphere is involved and not at all when right hemisphere is injured. Neither neurobehavioral nor NIHSS scores correlated with DWI abnormalities, regardless of which hemisphere was affected.⁷ Furthermore, in a second experiment, they found that among patients with right-sided stroke, treatment-induced changes in perfusion correlate with changes in performance on the line cancellation task but not with . . . [Full Text of this Article]

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				A. Croquelois and J. Bogousslavsky Cognitive Deficits in Hyperacute Stroke Stroke, February 1, 2004; 35 (2): e25 - e25. [Full Text] [PDF]