Relationship between treatment types and blood–brain barrier disruption in patients with acute ischemic stroke: Two case reports

Abstract

BACKGROUND Blood-brain barrier (BBB) disruption plays an important role in the development of neurological dysfunction in ischemic stroke. However, diagnostic modalities that can clearly diagnose the degree of BBB disruption in ischemic stroke are limited. Here, we describe two cases in which the usefulness of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in detecting BBB disruption was evaluated after treatment of acute ischemic stroke using two different methods. CASE SUMMARY The two patients of similar age and relatively similar cerebral infarction locations were treated conservatively or with thrombectomy, although their sex was different. As a result of analysis by performing DCE-MRI, it was confirmed that BBB disruption was significantly less severe in the patient who underwent thrombectomy ( P = 3.3 × 10 -7 ), whereas the average K trans of the contralateral hemisphere in both patients was similar (2.4 × 10 -5 min -1 and 2.0 × 10 -5 min -1 ). If reperfusion is achieved through thrombectomy, it may indicate that the penumbra can be saved and BBB recovery can be promoted. CONCLUSION Our cases suggest that BBB disruption could be important if BBB permeability is used to guide clinical treatment.