Magnetic Resonance Imaging in Middle Cerebral Artery Infarct and Its Correlation With Functional Recovery

Abstract

CONTEXTMiddle cerebral artery stroke is described as the sudden onset of focal neurological deficit due to brain infarction in the territory supplied by the MCA. Patients have variable recovery of neurological functions after MCA stroke, but knowledge of the time course and extent of recovery is limited. It will be beneficial to know the stroke patient's early outcome and association between MR imaging findings and the clinical outcome. AIMSTo assess the extent of infarction in MCA stroke from the MRI brain taken within 48 hours of onset of stroke. To study the association between MRI findings and clinical outcome in MCA stroke. MATERIALS AND METHODSFifty patients who presented with symptoms of MCA stroke within 24 hours in medicine casualty of Govt. Medical College, Kozhikode, from March 2014 to September 2015 were taken for study. MRI brain including diffusion weighted images and MR angiogram were taken within 48 hours. Neurological status at the time of admission and after seven days was assessed using GCS score. Correlation between MRI findings and early clinical outcome was studied. RESULTSMajority of patients with MCA stroke were in age group between 50-69 years. Ninety four percentage of patients had one or more comorbidities, of which hypertension was the most common one; 20% patients expired within 7 days. Neurological improvement after one week was seen only in 32%; 60% of all deaths occurred in patients with age more than 70 years. Majority of patients (86%) had infarct size less than 50%. Infarct size and DW-ASPECTS showed significant correlation with neurological outcome and day 7 survival. M1 occlusion showed poor early outcome in MCA infarct. CONCLUSIONPatients with larger area of infarct and M1 occlusion has poor immediate post infarct recovery. DW ASPECTS score can be used as a good method for assessing extent of MCA infarct. However, large scale study with large sample size are needed for definite conclusion. KEYWORDSMCA Infarct, DW ASPECTS, M1 Occlusion, Early Neurological Outcome. HOW TO CITE THIS ARTICLE:Jose NT, Padinharoot R, Rajendran VR, et al. Magnetic resonance imaging in middle cerebral artery infarct and its correlation with functional recovery.