Tuesday, July 25, 2017

Early Prediction of Delayed Ischemia and Functional Outcome in Acute Subarachnoid Hemorrhage - Role of Diffusion Tensor Imaging

Who the fuck cares about predicting recovery? The non-negotiable goal is 100% recovery for all stroke survivors. Research dollars could be much better spent getting patients recovered.  
http://stroke.ahajournals.org/content/48/8/2091?etoc=
Isabel Fragata, Marta Alves, Ana Luísa Papoila, Ana Paiva Nunes, Patrícia Ferreira, Nuno Canto-Moreira, Patrícia Canhão
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Abstract

Background and Purpose—Diffusion tensor imaging (DTI) parameters are markers of cerebral lesion in some diseases. In patients with acute subarachnoid hemorrhage (SAH), we investigated whether DTI parameters measured at <72 hours might be associated with delayed cerebral ischemia (DCI) and with poor functional outcome at 3 months (modified Rankin Scale score ≥3).
Methods—DTI was performed in a prospective cohort of 60 patients with nontraumatic SAH at <72 hours. Association of fractional anisotropy and apparent diffusion coefficient values at <72 hours with the occurrence of DCI and outcome at 3 months was evaluated with logistic regression models, adjusting for known predictors of prognosis.
Results—At <72 hours after SAH, fractional anisotropy values at the cerebellum were associated with DCI occurrence (78% less odds of DCI for each 0.1 increase in fractional anisotropy; P=0.019). Early apparent diffusion coefficient values were not associated with DCI. After adjusting for confounding variables, an increase of 10 U in apparent diffusion coefficient at the frontal centrum semiovale corresponded to 15% increased odds of poor outcome (P=0.061).
Conclusions—DTI parameters at <72 hours post-SAH are independently associated with the occurrence of DCI and functional outcome. These preliminary results suggest the role of DTI parameters as surrogate markers of prognosis in nontraumatic SAH.

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