Mismatch concept between clinical symptom and core location

2023 Fiscal Year Final Research Report

• Project/Area Number: 19K07980
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 52020:Neurology-related
• Research Institution: Kyorin University
• Principal Investigator: Hirano Teruyuki 杏林大学, 医学部, 教授 (50346996)
• Project Period (FY): 2019-04-01 – 2024-03-31
• Keywords: 急性期脳梗塞 / 虚血コア / ミスマッチ / 機能局在 / 灌流画像

Outline of Final Research Achievements

The association between ischemic core determination by perfusion imaging and early ischemic lesions by ASPECTS was investigated in 133 consecutive patients (2019~2023) who underwent mechanical thrombectomy at the Kyorin University Stroke Center. The ASPECTS corresponding to an ischemic core size of 70 mL was 5. The combined volume of ischemic core and penumbra was associated with stroke severity as assessed by NIHSS. Good outcome (mRS 0-2 or recovery to pre-morbid mRS level) after mechanical therobectomy was associated with M3 and M5 regions among the ASPECTS assessment sites. In particular, when the M5 region, including the primary motor cortex, is included in the ischaemic extent, obtaining reperfusion in this region has a significant impact on improving outcome.

Free Research Field

脳卒中医学

Academic Significance and Societal Importance of the Research Achievements

急性期脳梗塞に対する脳画像所見に基づく治療、すなわち tissue-based therapyにおいて重要となる、実践的な虚血コアサイズの評価法を提唱した。脳の機能局在を考慮することで、より適切な治療方針の決定、ならびに転帰改善に重要とされる一次運動野への血流再開に重きを置くべきことを明らかにした。Clinical symptom-Core location Mismatchという概念を提唱することで簡便かつ迅速な治療選択が可能となった。