Internal border zone injury predicts the functional outcome of acute MCA stroke patients

• Published in: Journal of neuroradiology 2023-05, Vol.50 (3), p.281-287
• Main Authors: Grange, R., Grange, S., Lutz, N., Garnier, P., Marinescu, D., Varvat, J., Barral, F.G., Boutet, C., Schneider, F.C.
• Format: Article
• Language: English
• Subjects: cerebral stroke; Diffusion Magnetic Resonance Imaging; Humans; Infarction, Middle Cerebral Artery - pathology; Internal Borderzone; MRI; Prognosis; Retrospective Studies; Stroke - diagnostic imaging; Stroke - pathology; Treatment Outcome
• ISSN: 0150-9861
• DOI: 10.1016/j.neurad.2022.03.012

[Display omitted] •Injury of the internal borderzone is an early marker of large-volume infarction, poor functional prognosis and IV thrombolysis resistance.•The internal borderzone injury is an independent marker of stroke severity; regardless of lesion volume.•Detection of IBZ may help to identify patients who will most likely benefit from aggressive reperfusion therapies. Classification of deep (D), superficial (S) MCA territories and their junctional vascular area (the internal border zone, IBZ) can help to identify patients most likely to benefit from aggressive reperfusion therapy after stroke. We tested the prognostic value of an IBZ injury compared to DWI-ASPECTS and infarct volume. DW lesions of 168 patients with acute (4.2±6.5 h) MCA strokes were retrospectively examined and manually delineated. Patients with haemorrhagic transformation or other neurological diseases were excluded. Clinical data were recorded within 24 h following symptom onset and 48 h for patients who benefited from reperfusion therapy. The occurrence of an IBZ injury was determined using a standardized stereotaxic atlas. Performance to predict a good outcome (mRS