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Usefulness of hyperintense acute reperfusion marker sign in patients with transient neurologic symptom.
Medicine (Baltimore). 2019 May; 98(19):e15494.M

Abstract

It aimed to investigate the incidence and final diagnosis of hyperintense acute reperfusion marker (HARM) signs in patients initially suspected of having a transient ischemic attack (TIA).In retrospective manner, a series of consecutive series of patients who arrived at the emergency department and was initially assessed as TIA within 12 hours of symptom onset between July 2015 and December 2016 were enrolled. Conventional magnetic resonance imaging protocol including diffusion-weighted imaging (DWI) and pre- and post-contrast fluid attenuation inversion recovery imaging (FLAIR) was conducted to evaluate the ischemic lesion and prognosis. Through the review of medical records and imaging studies, their final diagnosis and its association with HARM signs on post-contrast FLAIR were investigated.A total of 174 subjects were enrolled (mean age, 64.0 ± 12.9 years old; male, 54.6%; DWI lesion, 17.8%). HARM signs were observed in 18 (10%) patients, and their final diagnoses were classified as true TIA (n = 11, 61%), seizure (2, 11%), posterior reversible encephalopathy (2, 11%), reversible cerebral vascular constriction (1, 6%) and unclassified encephalopathy (2, 11%). The co-occurrence of HARM and DWI lesions were observed in 7 subjects which were 6 subjects of true TIA (ischemic stroke) and 1 subject with RCVS related ischemic stroke.The observation of HARM sign would be helpful to confirm the ischemic insult and distinguish the other disease.

Authors+Show Affiliations

Department of Neurology, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si.Department of Emergency Medicine, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do.Department of Radiology, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Republic of Korea.Department of Neurology, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si.Department of Neurology, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si.Department of Neurology, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si.Department of Emergency Medicine, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31083188

Citation

Kang, Jihoon, et al. "Usefulness of Hyperintense Acute Reperfusion Marker Sign in Patients With Transient Neurologic Symptom." Medicine, vol. 98, no. 19, 2019, pp. e15494.
Kang J, Kwon H, Jung CK, et al. Usefulness of hyperintense acute reperfusion marker sign in patients with transient neurologic symptom. Medicine (Baltimore). 2019;98(19):e15494.
Kang, J., Kwon, H., Jung, C. K., Bae, H. J., Han, M. K., Kim, B. J., & Jo, Y. H. (2019). Usefulness of hyperintense acute reperfusion marker sign in patients with transient neurologic symptom. Medicine, 98(19), e15494. https://doi.org/10.1097/MD.0000000000015494
Kang J, et al. Usefulness of Hyperintense Acute Reperfusion Marker Sign in Patients With Transient Neurologic Symptom. Medicine (Baltimore). 2019;98(19):e15494. PubMed PMID: 31083188.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Usefulness of hyperintense acute reperfusion marker sign in patients with transient neurologic symptom. AU - Kang,Jihoon, AU - Kwon,Hyuksool, AU - Jung,Cheol Kyu, AU - Bae,Hee-Joon, AU - Han,Moon-Ku, AU - Kim,Beom Joon, AU - Jo,You Hwan, PY - 2019/5/15/entrez PY - 2019/5/15/pubmed PY - 2019/6/4/medline SP - e15494 EP - e15494 JF - Medicine JO - Medicine (Baltimore) VL - 98 IS - 19 N2 - It aimed to investigate the incidence and final diagnosis of hyperintense acute reperfusion marker (HARM) signs in patients initially suspected of having a transient ischemic attack (TIA).In retrospective manner, a series of consecutive series of patients who arrived at the emergency department and was initially assessed as TIA within 12 hours of symptom onset between July 2015 and December 2016 were enrolled. Conventional magnetic resonance imaging protocol including diffusion-weighted imaging (DWI) and pre- and post-contrast fluid attenuation inversion recovery imaging (FLAIR) was conducted to evaluate the ischemic lesion and prognosis. Through the review of medical records and imaging studies, their final diagnosis and its association with HARM signs on post-contrast FLAIR were investigated.A total of 174 subjects were enrolled (mean age, 64.0 ± 12.9 years old; male, 54.6%; DWI lesion, 17.8%). HARM signs were observed in 18 (10%) patients, and their final diagnoses were classified as true TIA (n = 11, 61%), seizure (2, 11%), posterior reversible encephalopathy (2, 11%), reversible cerebral vascular constriction (1, 6%) and unclassified encephalopathy (2, 11%). The co-occurrence of HARM and DWI lesions were observed in 7 subjects which were 6 subjects of true TIA (ischemic stroke) and 1 subject with RCVS related ischemic stroke.The observation of HARM sign would be helpful to confirm the ischemic insult and distinguish the other disease. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/31083188/Usefulness_of_hyperintense_acute_reperfusion_marker_sign_in_patients_with_transient_neurologic_symptom. L2 - https://doi.org/10.1097/MD.0000000000015494 DB - PRIME DP - Unbound Medicine ER -