Can We Predict the Width of the Infarct Area in Patients with Acute Ischemic Stroke Using Near Infrared Spectrophotometry?

Abstract

Background and Purpose: The purpose of this study to determine whether an association exists between near infrared spectrophotometry (NIRS) measurements and affected brain tissue by using NIRS to measure cerebral oxygenations in patients brought to the emergency department with acute ischemic stroke (AIS). Methods: Thirty-one patients diagnosed with ischemic stroke at diffusion weighted magnetic resonance imaging (MRI) of the brain, aged or over, with no history of ischemic or hemorrhagic stroke and diagnosed at the Recep Tayyip Erdoğan University Education and Research Hospital emergency department, Turkey, were included in the study. Patients with foci of intracranial hemorrhage at cranial computerized tomography (CT) of the brain and no ischemic area identified at brain diffusion MRI were excluded. Cerebral saturation was recorded after being measured for at least 10 min with an INVOS 5100C cerebral/ somatic oximeter (Covidien). Results: Mean age of the 31 patients presenting to the emergency department with AIS was 76.32 ± 10.26. Sixteen (51.6%) were female. Mean Glasgow Coma Score (GCS) was 12.68 ± 3.16. Mean oxygenation values of the ischemic areas in these patients were 57.03 ± 9.03 (min: 40, max: 81), while the mean measurement from areas with no cerebral changes was 67.13 ± 9.64 (min: 54, max: 89) (p<0.001). Mean dimension of the ischemic areas visualized at diffuse MRI was 979.77 ± 635.85 mm2 (min: 43, max: 2180). A positive moderate correlation was observed between ischemic area dimensions and cerebral oximeter values for those areas (r=0,597, p=<0.001). The linear regression model established between patients’ ischemic area diameters and level of decrease in cerebral oxygenations revealed a fall in cerebral oxygenation of 5.945 + (0.005 x infarct area (mm2)). Conclusion: We conclude that that greater the fall in cerebral oxygenation levels the greater the dimensions of the ischemic area. NIRS may be a method that can be used in predicting width of infarct area in patients with AIS.

Keywords

• Acute Ischemic Stroke
• Near Infrared Spectrophotometry
• Infarct Area

References

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