Distal hyperintense vessel sign is associated with neurological deterioration in acute ischaemic stroke

Abstract

Distal HVS is associated with END in acute ischaemic stroke patients with large vessel steno-occlusion.

The Association between FLAIR Vascular Hyperintensity and Stroke Outcome Varies with Time from Onset

“…The sample size in Maeda et al 24 was 27 patients, with only 2 patients imaged within 10 -13 days of onset, which would have led to serious errors. The prognostic value of FVH has been widely investigated, 4,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] with greatly divergent results. Besides populations, end points, and FVH classifications, we think that the symptomto-MR imaging time plays an important role in explaining the discrepancies in the literature.…”

“…[6][7][8][9] FVH is also thought to be a marker of collaterals and a predictor of outcome. 4,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] However, the relationship between these interpreta-tions is confusing. FVH may represent slow collateral flow effective in maintaining perfusion to penumbral regions, restricting the progress of ischemic lesions and improving outcome.…”

“…[10][11][12][13][14][15][16][17] However, FVH can also seem to correspond to a perfusion deficit, larger lesions, and poor outcomes. [6][7][8][18][19][20][21][22][23] The exact reason for such a huge discrepancy is still unclear. In addition to the differences in patient populations and FVH classifications, we found that many reported symptom-to-MR imaging times ranged from 3 hours to several days.…”

“…Moreover, most studies [6][7][8][10][11][12][13][14][15][16][17][18]21,22 were performed during the superacute or acute stages of ischemic stroke; however, many patients with subacute or even chronic ischemic strokes present to hospitals and undergo MR imaging. FVH has been observed in areas supplied by collateral blood flow in patients with symptomto-MR imaging times that are several weeks in duration.…”

Progress in neurology 2017–2018

“…Stroke remains the most common problem for neurologists to diagnose and treat . Preventative measures, such as control of hypertension, reduction in smoking and treatment of hyperlipidaemia, have made a significant contribution to preventing and delaying stroke onset.…”