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J Korean Neurol Assoc. 2011;29(4):309-316.
Hyperintense Vessel Signs on FLAIR MRI as a Predictor of Early Neurological Deterioration in Patients with Acute Posterior Circulation Infarction
Dong-Eun Kim
Department of Neurology, Cerebrovascular Center, Chonnam National University Medical School, Gwangju, Korea
후방 순환 뇌경색 환자에서 초기 신경학적 악화의 예측 인자로서 액체감쇠역전회복 자기공명영상의 고신호혈관징후
김동은, 김준태 조방훈 이세영 최강호 박만석 조기현
전남대학교 의과대학 신경과학교실, 뇌혈관센터
Abstract
Background
Hyperintense vessel sign (HVS) on fluid-attenuated inversion recovery imaging (FLAIR) is an indicator of slow flow and early ischemia. This study tested the hypothesis that HVS in the posterior circulation is associated with a worse outcome.
Methods
We retrospectively included 64 stroke patients with posterior circulation steno-occlusion within 6?hours of symptom onset and reviewed early neurological deterioration (END). END was defined as an increase in National Institutes of Health Stroke Scale (NIHSS) score of 4 or more from baseline during the first week. We analyzed demographic and laboratory information followed by an assessment of the magnetic resonance images. In addition, we assessed the posterior circulation Albert Stroke Program Early CT Score (pc-ASPECTS) on diffusion-weighted imaging (DWI).
Results
Among the 64 patients who met the inclusion criteria, END was seen in 17 patients. On univariate analysis, these END patients had higher baseline NIHSS scores and elevated initial systolic blood pressure (iSBP). Multiple logistic regression analysis revealed pc-ASPECTS (p=0.007), HVS on FLAIR (p=0.011), and iSBP (p=0.016) as independent predictors of END.
Conclusions
The presence of HVS on FLAIR in the posterior circulation might indicate the presence of more severe ischemic penumbrae and END. pc-ASPECTS may also be an independent predictor of functional outcome. Key Words: Fluid-attenuated inversion recovery imaging (FLAIR), Early neurological deterioration (END), Posterior circulation infarction, Albert Stroke Program Early CT Score (ASPECTS)

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