Value of single-photon emission-computed tomography in acute stroke therapeutic trials

S. K. Hanson, J. C. Grotta, H. Rhoades, H. D. Tran, L. M. Lamki, B. J. Barron, W. J. Taylor

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

Background and Purpose: New therapeutic interventions for acute ischemic stroke are aimed at improving cerebral blood flow in the first 3 to 6 hours after symptom onset. Single-photon emission- computed tomography (SPECT) performed in the setting of clinical therapeutic trials may give us a better understanding of the physiological response to new forms of treatment and could impact acute management decisions. Methods: We prospectively studied 15 patients with hemispheric ischemic stroke with SPECT within 6 hours of symptom onset and again at 24 hours. The ischemic defect was assessed in a semiquantitative manner that used computer-generated regions of interest (SPECT graded scale). This measure was correlated with clinical presentation (National Institutes of Health [NIH] Stroke Scale), initial clinical course (change in NIH Stroke Scale), long-term outcome (Barthel Index at 3 months), and complications of cerebral hemorrhage and edema. Results: The severity of the SPECT graded scale on the admission scan correlated with the severity of neurological deficit (admission NIH Stroke Scale) (P<.05) and was positively associated with poor long-term outcome as measured with the Barthel Index (P<.001) and the complications of cerebral hemorrhage and massive cerebral edema (P<.005). In fact, there was a threshold value for the SPECT graded scale above which all patients suffered poor long-term outcome and the complications of cerebral hemorrhage and edema. Conclusions: The measurement of an ischemic defect using SPECT is a valid assessment of hemispheric stroke severity in the hyperacute setting and may be useful for selecting or stratifying patients in clinical therapeutic trials.

Original languageEnglish
Pages (from-to)1322-1329
Number of pages8
JournalStroke
Volume24
Issue number9
Publication statusPublished - 1993

Fingerprint

Single-Photon Emission-Computed Tomography
Stroke
Brain Edema
Cerebral Hemorrhage
National Institutes of Health (U.S.)
Cerebrovascular Circulation
Therapeutics
Clinical Trials

Keywords

  • Cerebral blood flow
  • Cerebral infarction
  • Clinical trials
  • Emission computed
  • Tomography

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialised Nursing

Cite this

Hanson, S. K., Grotta, J. C., Rhoades, H., Tran, H. D., Lamki, L. M., Barron, B. J., & Taylor, W. J. (1993). Value of single-photon emission-computed tomography in acute stroke therapeutic trials. Stroke, 24(9), 1322-1329.

Value of single-photon emission-computed tomography in acute stroke therapeutic trials. / Hanson, S. K.; Grotta, J. C.; Rhoades, H.; Tran, H. D.; Lamki, L. M.; Barron, B. J.; Taylor, W. J.

In: Stroke, Vol. 24, No. 9, 1993, p. 1322-1329.

Research output: Contribution to journalArticle

Hanson, SK, Grotta, JC, Rhoades, H, Tran, HD, Lamki, LM, Barron, BJ & Taylor, WJ 1993, 'Value of single-photon emission-computed tomography in acute stroke therapeutic trials', Stroke, vol. 24, no. 9, pp. 1322-1329.
Hanson SK, Grotta JC, Rhoades H, Tran HD, Lamki LM, Barron BJ et al. Value of single-photon emission-computed tomography in acute stroke therapeutic trials. Stroke. 1993;24(9):1322-1329.
Hanson, S. K. ; Grotta, J. C. ; Rhoades, H. ; Tran, H. D. ; Lamki, L. M. ; Barron, B. J. ; Taylor, W. J. / Value of single-photon emission-computed tomography in acute stroke therapeutic trials. In: Stroke. 1993 ; Vol. 24, No. 9. pp. 1322-1329.
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