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Tmax 10VolumeIs Independently Associated with NWU Delta in Large Core Stroke.

Tmax 10VolumeIs Independently Associated with NWU Delta in Large Core Stroke. Clinical neuroradiology Yedavalli, V., Salim, H. A., Lakhani, D. A., Balar, A., Mei, J., Nguyen, T. N., Guenego, A., Dmytriw, A. A., Fiehler, J., Stracke, P., Broocks, G., Heitkamp, C., Wintermark, M., Albers, G. W., Heit, J. J., Faizy, T. D. 2025

Abstract

BACKGROUND: In patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO) and large ischemic cores, there is aneed for reliable imaging biomarkers to predict cerebral edema growth. We investigated the association between severely hypoperfused tissue, measured by time-to-maximum greater than 10?s (Tmax >?10?s) volume, and net water uptake (?NWU) progression.METHODS: This multicenter retrospective cohort study involved AIS-LVO patients with ASPECTS =?5, undergoing EVT at two comprehensive stroke centers between January 2013 and December 2019. We investigated the relationship between Tmax >?10?s volume derived from perfusion imaging and ?NWU measured on non-contrast head CT images, hypothesizing that larger Tmax >?10?s volumes are indicative of greater edema growth in large core strokes.RESULTS: Atotal of 95patients (median age, 74years; 55% women) were included. After adjustment for age, sex, glucose, intravenous thrombolysis, admission NIHSS, ASPECTS, Tan collateral score, last known well-to-CT time, and EVT, higher Tmax >?10?s volume (beta, -0.34; P?=0.043) and lower ASPECTS (beta, -0.30; P?=0.035) were independently associated with greater ?NWU.CONCLUSION: The study highlights the importance of considering severe pretreatment hypoperfusion, as reflected by larger Tmax >?10?s volumes, in predicting cerebral edema growth in AIS-LVO patients, which could inform clinical strategies, emphasizing the need for larger prospective studies to validate and explore implications.

View details for DOI 10.1007/s00062-025-01569-6

View details for PubMedID 41026194