Article Figures & Data
Figures
- Fig 1.
Types of occlusion were defined on MRA, as follows: a + c was an occlusion of the ICA at the neck accompanied by an MCA embolism, or ICA/MCA occlusion; b, occlusion of the intracranial bifurcation of the ICA, or carotid T occlusion, which included one of 17 cases with an occlusion of the proximal anterior and middle cerebral artery; c, occlusion of the MCA trunk, which included nine of 48 occlusions of the bifurcation or trifurcation lateral to the medial lenticulostriate arteries; and d, occlusion of a single or multiple MCA branch occlusion with free trifurcation, which included three of 36 cases with an additional occlusion of the peripheral anterior cerebral artery.
- Fig 2.
Boxplots of lesion volumes for ADCman <6 hours after stroke onset and lesion volume on days 5–8 (on T2-weighted or CT images) for each type of occlusion. Asterisk = significant differences in ADCman in multiple pairwise comparisons between types. Infarct volumes were significantly different (P < .05) for all types except for ICA/MCA versus MCA trunk occlusions (MCA-trunc). CTO = carotid-T occlusion.
- Fig 3.
Reperfusion assessed on day 1 after stroke onset for each type of occlusion in 65 patients treated with intravenous thrombolysis. CTO = carotid-T occlusion.
- Fig 4.
T2-weighted (b = 0 s/mm2, top) and ADC (bottom) images obtained in patients with proximal vascular occlusions show considerable lesion growth without recanalization. Left box, Images obtained in a 71-year-old man with an ICA/MCA occlusion treated with intravenous thrombolysis. Right box, Images in a 67-year-old woman with a carotid-T occlusion treated with craniotomy.
- Fig 5.
Smallest (top row) and largest (bottom row) ADC lesions <6 hours after stroke onset are depicted for each type of occlusion (arrow). Section showing the maximal extent of the lesion was chosen in each case. CTO = carotid-T occlusion.
Tables
Patient data
Occlusion Age (y) Time of MR Imaging (h) Lesion Volume (cm3) NIHSS Score Barthel Index at 90 d ADCman ADC<550 Infarct ICA/MCA (n = 19) 61 (31–77) 3.2 (1.1–5.1) 23 (9–158) 10 (0–87) 32 (1–385) 14 (8–22) 100 (0–100) Carotid T (n = 17) 69 (27–83) 3.2 (1.5–5.5) 37 (10–187) 11 (1–67) 138 (14–370) 16 (9–24) 43 (0–100) MCA trunk (n = 48) 64 (35–90) 2.8 (1.5–5.7) 27 (4–156) 11 (1–90) 44 (1–355) 15 (8–23) 100 (0–100) MCA Branch (n = 36) 63 (34–82) 3.0 (1.0–5.0) 27 (1–78) 8 (0–41) 21 (1–96) 9 (3–20) 100 (0–100) Note.—Data are the median (range).
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