Early New Ischemic Lesions Located Outside the Initially Affected Vascular Territory Appear More Often in Stroke Patients with Elevated Glycated Hemoglobin (HbA1c)
BackgroundEarly new ischemic lesions are common in patients with an acute ischemic stroke. These new ischemic lesions may represent the natural course of the initial stroke or de novo events.ObjectiveWe hypothesized that early new ischemic lesions located outside the initially affected vascular terr...
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Frontiers Media S.A.
2017-11-01
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| Series: | Frontiers in Neurology |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fneur.2017.00606/full |
| _version_ | 1831842417871945728 |
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| author | Tim Bastian Braemswig Tim Bastian Braemswig Tim Bastian Braemswig Christian H. Nolte Christian H. Nolte Christian H. Nolte Jochen B. Fiebach Tatiana Usnich |
| author_facet | Tim Bastian Braemswig Tim Bastian Braemswig Tim Bastian Braemswig Christian H. Nolte Christian H. Nolte Christian H. Nolte Jochen B. Fiebach Tatiana Usnich |
| author_sort | Tim Bastian Braemswig |
| collection | DOAJ |
| description | BackgroundEarly new ischemic lesions are common in patients with an acute ischemic stroke. These new ischemic lesions may represent the natural course of the initial stroke or de novo events.ObjectiveWe hypothesized that early new ischemic lesions located outside the initially affected vascular territory would point at de novo events. Therefore, we differentiated new ischemic lesions located outside the initially affected vascular territory from those occurring only inside the initially affected vascular territory to identify risk factors that are associated with de novo events.MethodsStroke patients underwent three magnetic resonance imaging examinations (at 3-T): on admission, on the next day and 4–7 days after symptom onset (clinicaltrials.gov: NCT00715533). Diffusion-weighted imaging (DWI) lesions were delineated, coregistered, and then analyzed for new hyperintensities on follow-up examinations by raters blinded to clinical details. Patients were classified as having “new distant lesions” if new DWI lesions appeared outside or both outside and inside the initially affected vascular territory or “new local lesions” if they were only inside.Results115 patients with early new DWI lesions constitute the study population. Sixteen patients (14%) had new distant lesions and 99 patients (86%) had new local lesions. In comparison between patients with new distant and new local lesions, patients with new distant lesions had significantly more often elevated glycated hemoglobin (HbA1c ≥ 6.5%; p = 0.022).ConclusionOur data indicate that patients with elevated HbA1c have an increased risk for new, de novo ischemic lesions in the acute phase after an ischemic stroke. |
| first_indexed | 2024-12-23T06:48:21Z |
| format | Article |
| id | doaj.art-69499484f98f4f7b91ff9b5492e900ec |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-23T06:48:21Z |
| publishDate | 2017-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-69499484f98f4f7b91ff9b5492e900ec2022-12-21T17:56:30ZengFrontiers Media S.A.Frontiers in Neurology1664-22952017-11-01810.3389/fneur.2017.00606290648Early New Ischemic Lesions Located Outside the Initially Affected Vascular Territory Appear More Often in Stroke Patients with Elevated Glycated Hemoglobin (HbA1c)Tim Bastian Braemswig0Tim Bastian Braemswig1Tim Bastian Braemswig2Christian H. Nolte3Christian H. Nolte4Christian H. Nolte5Jochen B. Fiebach6Tatiana Usnich7Department of Neurology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, GermanyBerlin Institute of Health (BIH), Berlin, GermanyCenter for Stroke Research Berlin (CSB), Charité—Universitätsmedizin Berlin, Berlin, GermanyDepartment of Neurology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, GermanyBerlin Institute of Health (BIH), Berlin, GermanyCenter for Stroke Research Berlin (CSB), Charité—Universitätsmedizin Berlin, Berlin, GermanyCenter for Stroke Research Berlin (CSB), Charité—Universitätsmedizin Berlin, Berlin, GermanyDepartment of Neurology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, GermanyBackgroundEarly new ischemic lesions are common in patients with an acute ischemic stroke. These new ischemic lesions may represent the natural course of the initial stroke or de novo events.ObjectiveWe hypothesized that early new ischemic lesions located outside the initially affected vascular territory would point at de novo events. Therefore, we differentiated new ischemic lesions located outside the initially affected vascular territory from those occurring only inside the initially affected vascular territory to identify risk factors that are associated with de novo events.MethodsStroke patients underwent three magnetic resonance imaging examinations (at 3-T): on admission, on the next day and 4–7 days after symptom onset (clinicaltrials.gov: NCT00715533). Diffusion-weighted imaging (DWI) lesions were delineated, coregistered, and then analyzed for new hyperintensities on follow-up examinations by raters blinded to clinical details. Patients were classified as having “new distant lesions” if new DWI lesions appeared outside or both outside and inside the initially affected vascular territory or “new local lesions” if they were only inside.Results115 patients with early new DWI lesions constitute the study population. Sixteen patients (14%) had new distant lesions and 99 patients (86%) had new local lesions. In comparison between patients with new distant and new local lesions, patients with new distant lesions had significantly more often elevated glycated hemoglobin (HbA1c ≥ 6.5%; p = 0.022).ConclusionOur data indicate that patients with elevated HbA1c have an increased risk for new, de novo ischemic lesions in the acute phase after an ischemic stroke.http://journal.frontiersin.org/article/10.3389/fneur.2017.00606/fullstrokediabetes mellitushemoglobin Aglycosylatedmagnetic resonance imagingnew ischemic lesions |
| spellingShingle | Tim Bastian Braemswig Tim Bastian Braemswig Tim Bastian Braemswig Christian H. Nolte Christian H. Nolte Christian H. Nolte Jochen B. Fiebach Tatiana Usnich Early New Ischemic Lesions Located Outside the Initially Affected Vascular Territory Appear More Often in Stroke Patients with Elevated Glycated Hemoglobin (HbA1c) Frontiers in Neurology stroke diabetes mellitus hemoglobin A glycosylated magnetic resonance imaging new ischemic lesions |
| title | Early New Ischemic Lesions Located Outside the Initially Affected Vascular Territory Appear More Often in Stroke Patients with Elevated Glycated Hemoglobin (HbA1c) |
| title_full | Early New Ischemic Lesions Located Outside the Initially Affected Vascular Territory Appear More Often in Stroke Patients with Elevated Glycated Hemoglobin (HbA1c) |
| title_fullStr | Early New Ischemic Lesions Located Outside the Initially Affected Vascular Territory Appear More Often in Stroke Patients with Elevated Glycated Hemoglobin (HbA1c) |
| title_full_unstemmed | Early New Ischemic Lesions Located Outside the Initially Affected Vascular Territory Appear More Often in Stroke Patients with Elevated Glycated Hemoglobin (HbA1c) |
| title_short | Early New Ischemic Lesions Located Outside the Initially Affected Vascular Territory Appear More Often in Stroke Patients with Elevated Glycated Hemoglobin (HbA1c) |
| title_sort | early new ischemic lesions located outside the initially affected vascular territory appear more often in stroke patients with elevated glycated hemoglobin hba1c |
| topic | stroke diabetes mellitus hemoglobin A glycosylated magnetic resonance imaging new ischemic lesions |
| url | http://journal.frontiersin.org/article/10.3389/fneur.2017.00606/full |
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