Clinical characteristics of unknown symptom onset stroke patients with and without diffusion-weighted imaging and fluid-attenuated inversion recovery mismatch - Archive ouverte HAL Access content directly
Journal Articles International Journal of Stroke Year : 2018

Clinical characteristics of unknown symptom onset stroke patients with and without diffusion-weighted imaging and fluid-attenuated inversion recovery mismatch

Götz Thomalla
  • Function : Author
Florent Boutitie
  • Function : Author
Jochen Fiebach
  • Function : Author
Claus Simonsen
  • Function : Author
Salvador Pedraza
  • Function : Author
Robin Lemmens
  • Function : Author
Norbert Nighoghossian
  • Function : Author
Keith Muir
  • Function : Author
Martin Ebinger
  • Function : Author
Ian Ford
  • Function : Author
Bastian Cheng
  • Function : Author
Ivana Galinovic
  • Function : Author
Tae-Hee Cho
  • Function : Author
Josep Puig
  • Function : Author
Vincent Thijs
  • Function : Author
Matthias Endres
  • Function : Author
Jens Fiehler
  • Function : Author
Christian Gerloff
  • Function : Author

Abstract

Background Diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) mismatch was suggested to identify stroke patients with unknown time of symptom onset likely to be within the time window for thrombolysis. Aims We aimed to study clinical characteristics associated with DWI-FLAIR mismatch in patients with unknown onset stroke. Methods We analyzed baseline MRI and clinical data from patients with acute ischemic stroke proven by DWI from WAKE-UP, an investigator-initiated, randomized, placebo-controlled trial of MRI-based thrombolysis in stroke patients with unknown time of symptom onset. Clinical characteristics were compared between patients with and without DWI-FLAIR mismatch. Results Of 699 patients included, 418 (59.8%) presented with DWI-FLAIR mismatch. A shorter delay between last seen well and symptom recognition (p = 0.0063), a shorter delay between symptom recognition and arrival at hospital (p = 0.0025), and history of atrial fibrillation (p = 0.19) were predictors of DWI-FLAIR mismatch in multivariate analysis. All other characteristics were comparable between groups. Conclusions There are only minor differences in measured clinical characteristics between unknown symptom onset stroke patients with and without DWI-FLAIR mismatch. DWI-FLAIR mismatch as an indicator of stroke onset within 4.5 h shows no relevant association with commonly collected clinical characteristics of stroke patients. Clinical Trial Registration URL: http://www.clinicaltrials.gov . Unique identifier: NCT01525290; URL: https://www.clinicaltrialsregister.eu . Unique identifier: 2011-005906-32.

Dates and versions

hal-04152570 , version 1 (05-07-2023)

Identifiers

Cite

Götz Thomalla, Florent Boutitie, Jochen Fiebach, Claus Simonsen, Salvador Pedraza, et al.. Clinical characteristics of unknown symptom onset stroke patients with and without diffusion-weighted imaging and fluid-attenuated inversion recovery mismatch. International Journal of Stroke, 2018, 13 (1), pp.66-73. ⟨10.1177/1747493017706245⟩. ⟨hal-04152570⟩

Collections

HCL
3 View
0 Download

Altmetric

Share

Gmail Facebook X LinkedIn More