Junichiro Ohira1, Nobuyuki Ohara2, Takuya Hinoda3, Takeshi Morimoto4,5, Nobuo Kohara2. 1. Department of Neurology, Kobe City Medical Center General Hospital, 650-0047, 2-1-1 Minatojima-Minamimachi, Chuou-ku, Kobe, Hyogo, Japan. j.ohira0614@gmail.com. 2. Department of Neurology, Kobe City Medical Center General Hospital, 650-0047, 2-1-1 Minatojima-Minamimachi, Chuou-ku, Kobe, Hyogo, Japan. 3. Department of Radiology, Kobe City Medical Center General Hospital, 650-0047, 2-1-1 Minatojima-Minamimachi, Chuou-ku, Kobe, Hyogo, Japan. 4. Clinical Research Center, Kobe City Medical Center General Hospital, 650-0047, 2-1-1 Minatojima-Minamimachi, Chuou-ku, Kobe, Hyogo, Japan. 5. Department of Clinical Epidemiology, Hyogo College of Medicine, 663-8501, 1-1 Mukogawa, Nishinomiya, Hyogo, Japan.
Abstract
BACKGROUND: Diffusion-weighted imaging (DWI) on magnetic resonance imaging (MRI) shows limited sensitivity in the acute-phase brainstem infarctions, including lateral medullary infarction (LMI), and the detailed characteristics of acute LMI patients with initially negative DWI-MRI findings have not been reported previously. Therefore, we aimed to investigate the differences in the backgrounds or symptoms of acute LMI patients with initially negative findings in standard axial DWI-MRI and those with positive findings. METHODS: In this retrospective cohort study, we collected the data for 35 consecutive acute LMI patients who were hospitalized in our hospital from January 2011 to December 2018. Initial standard axial DWI-MRI was assessed, and the patients were divided into positive and negative groups. The characteristics of the two groups were compared, and the usefulness of additional thin-slice coronal DWI-MRI was also investigated. RESULTS: Nine (26%) acute LMI patients were initially negative on standard axial DWI-MRI. The patients were independently associated with smoking history (78% vs. 23%, p = 0.021) and headache (78% vs. 31%, p = 0.046). Thin-slice coronal DWI-MRI showed positive findings in 50% of the patients with negative findings in standard axial DWI-MRI. All four patients with negative findings in both standard axial and thin-slice coronal DWI-MRI had smoking history and headache. CONCLUSION: Smoking history and headache were associated with initial negative results in standard axial DWI-MRI in acute LMI. Additional thin-slice coronal DWI-MRI was sometimes useful in detecting acute LMI. Follow-up MRI is important for patients showing negative findings in initial DWI-MRI.
BACKGROUND: Diffusion-weighted imaging (DWI) on magnetic resonance imaging (MRI) shows limited sensitivity in the acute-phase brainstem infarctions, including lateral medullary infarction (LMI), and the detailed characteristics of acute LMI patients with initially negative DWI-MRI findings have not been reported previously. Therefore, we aimed to investigate the differences in the backgrounds or symptoms of acute LMI patients with initially negative findings in standard axial DWI-MRI and those with positive findings. METHODS: In this retrospective cohort study, we collected the data for 35 consecutive acute LMI patients who were hospitalized in our hospital from January 2011 to December 2018. Initial standard axial DWI-MRI was assessed, and the patients were divided into positive and negative groups. The characteristics of the two groups were compared, and the usefulness of additional thin-slice coronal DWI-MRI was also investigated. RESULTS: Nine (26%) acute LMI patients were initially negative on standard axial DWI-MRI. The patients were independently associated with smoking history (78% vs. 23%, p = 0.021) and headache (78% vs. 31%, p = 0.046). Thin-slice coronal DWI-MRI showed positive findings in 50% of the patients with negative findings in standard axial DWI-MRI. All four patients with negative findings in both standard axial and thin-slice coronal DWI-MRI had smoking history and headache. CONCLUSION: Smoking history and headache were associated with initial negative results in standard axial DWI-MRI in acute LMI. Additional thin-slice coronal DWI-MRI was sometimes useful in detecting acute LMI. Follow-up MRI is important for patients showing negative findings in initial DWI-MRI.
Authors: Alejandro M Brunser; Gabriel Cavada; Paula Muñoz Venturelli; Verónica Olavarría; Alexis Rojo; Juan Almeida; Violeta Díaz; Arnold Hoppe; Pablo Lavados Journal: Neuroradiology Date: 2018-05-22 Impact factor: 2.804
Authors: C Oppenheim; R Stanescu; D Dormont; S Crozier; B Marro; Y Samson; G Rancurel; C Marsault Journal: AJNR Am J Neuroradiol Date: 2000-09 Impact factor: 3.825
Authors: William J Powers; Alejandro A Rabinstein; Teri Ackerson; Opeolu M Adeoye; Nicholas C Bambakidis; Kyra Becker; José Biller; Michael Brown; Bart M Demaerschalk; Brian Hoh; Edward C Jauch; Chelsea S Kidwell; Thabele M Leslie-Mazwi; Bruce Ovbiagele; Phillip A Scott; Kevin N Sheth; Andrew M Southerland; Deborah V Summers; David L Tirschwell Journal: Stroke Date: 2019-10-30 Impact factor: 7.914
Authors: William J Powers; Colin P Derdeyn; José Biller; Christopher S Coffey; Brian L Hoh; Edward C Jauch; Karen C Johnston; S Claiborne Johnston; Alexander A Khalessi; Chelsea S Kidwell; James F Meschia; Bruce Ovbiagele; Dileep R Yavagal Journal: Stroke Date: 2015-06-29 Impact factor: 10.170
Authors: Ji-Soo Kim; David E Newman-Toker; Kevin A Kerber; Klaus Jahn; Pierre Bertholon; John Waterston; Hyung Lee; Alexandre Bisdorff; Michael Strupp Journal: J Vestib Res Date: 2022 Impact factor: 2.354