London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 411 236 Brain imaging Fluid-attenuated inversion recovery hyperintense vessels in posterior cerebral artery infarc-tion K.D. Seo1, H.I. Kim2, K.O. Lee3, K.Y. Lee4 Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medi-cine, Seoul, SOUTH KOREA1, Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, SOUTH KOREA2, Department of Neurology, Konyang Uni-versity College of Medicine, Daejon, SOUTH KOREA3, Department of Neurology, Gangnam Sev-erance Hospital, Yonsei University College of Medicine, Seoul, SOUTH KOREA4 Background and Purpose: Fluid-attenuated inversion recovery hyperintense vessels (FHVs) are fre-quently observed in patients with acute cerebral infarction accompanied by arterial occlusion or sig-nificant stenosis of anterior circulation. FHVs have not been studied in the posterior cerebral artery (PCA), so we investigated the prevalence of FHVs and the clinical significance in patients with PCA territory infarction. Materials and Methods: In this retrospective study, patients with PCA territory infarction who under-went MRI within 1 week after symptom onset were enrolled. The FHVs were graded by the extent and location. The clinical outcome between groups of patients based on FHV grading was compared using the National Institutes of Health Stroke Scale (NIHSS). Among the PCA occlusion patients, infarction volume was compared between the two groups with and without distal FHVs. Results: FHVs were observed in 25 (28.7%) out of 87 patients and in 65.7% of 35 patients with sig-nificant arterial stenosis and occlusion. Eighteen patients had occlusion of the PCA, and the NIHSS score was significantly improved in patients with distal FHVs compared to the others (2.00 ± 2.18 vs. 0.56 ± 1.01, p = 0.04). The infarction volume was smaller in the distal FHV group than in the others, but the difference was not statistically significant. Conclusions: FHVs are detected in patients with PCA territory infarction, especially those with a PCA occlusive lesion. FHVs can be used as an imaging marker of PCA occlusion. Further study is needed to elucidate the clinical meaning of FHVs. 237 Brain imaging DTI correlates of cognition and hand function in acute subcortical stroke patients – an explor-atory study D. Pinter1, M. Loitfelder2, T. Gattringer3, C. Langkammer4, G. Reiter5, F. Fazekas6, C. Enzinger7 Medical University Graz, Graz, AUSTRIA1, Medical University Graz, Graz, AUSTRIA2, Medical University Graz, Graz, AUSTRIA3, Medical University Graz, Graz, AUSTRIA4, Medical Universi-ty Graz, Graz, AUSTRIA5, Medical University Graz, Graz, AUSTRIA6, Medical University Graz, Graz, AUSTRIA7 Background: Recovery of motor function after subcortical stroke has been shown to be related to the integrity of the ipsilesional corticospinal tract (CST), but it is still unclear whether there are remote effects on other white matter tracts with impact on cognition. We here used diffusion tensor imaging (DTI) to test relationships between white matter microstructure, cognition and motor function after stroke. Methods: We investigated patients with small acute subcortical strokes leading to mild hemiparesis (n=9, aged between 46 and 74 years) and compared findings to age-matched healthy controls (HC; n=14). All participants underwent neuropsychological testing (memory, verbal fluency and atten-tion), assessment of hand function and brain MRI at 3.0 Tesla (T1, FLAIR and DTI). We compared fractional anisotropy (FA) values between patients and HC and, within stroke patients, between the lesioned and unlesioned hemispheres. Region of interest (ROI) analyses, including the CST and the genu of the corpus callosum (CC) were computed. Results: As expected, patients showed worse motor function of the affected hand compared to HC (nine Hole Peg test: 32 vs. 22; p<.05), but they also showed decreased attention (Trail Making B test: 126 vs. 96; p<.05). In patients, lower FA in the ipsilesional CST, splenium of CC, and inferior longitudinal fasciculus compared to HC was found (TFCE, p<.10). Hand function correlated with FA of the ipsilesional CST (r=-0.45; p<.05). Within stroke patients, ROI analyses showed reduced FA in the ipsilesional (0.42) compared to the contralesional CST (0.56; p<.05). In addition, in the patients, higher FA in the genu of the CC correlated with better cognitive function (r=0.74-0.86; p<.05), but not with hand function. Conclusion: These results suggest that DTI represents a valuable tool to assess not only direct dam-age to the major motor tracts after stroke, but also to capture remote effects on white matter tracts correlating with cognitive function.
Karger_ESC London_2013
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