急性脑梗死患者血清IL-6、TNF-α、S-100b变化及临床意义

目的分析急性脑梗死患者血清IL-6、TNF-α、S-100b的动态变化规律及临床意义。方法选择发病24 h以内的符合试验入选条件的颈内动脉系统急性脑梗死患者58例,同时收集相匹配的同期体检者30例作为对照组,用ELISA法测定血清IL- 6、TNF-α、S-100b浓度。病例组进行动态监测,并同时记录患者神经功能缺损评分(NIHSS)。所有急性脑梗死患者依据发病后72h的脑CT扫描结果计算脑梗死体积。结果急性脑梗死患者血清IL-6、TNF-α、S-100b发病当天就明显增高,IL-6、TNF-α发病后第1d即达高峰,S-100蛋白第3d达高峰。其后浓度随时间的推移逐渐下降。血清IL-6、TNF-α、S-100b的峰值浓度和脑梗死体积、NIHSS评分呈正相关。发病后进展性脑卒中患者血清IL-6、TNF-α和S-100b蛋白高峰水平高于无进展性脑卒中患者。结论急性脑梗死患者血清IL-6、TNF-α和S-100b蛋白水平升高,与进展性脑卒中相关。血清水平值能够反映脑缺血后病理损伤的程度和脑梗死体积大小,可能作为急性脑梗死病人病情的标志物。     

急性脑梗死患者S-100、MBP的检测及其临床关系的相关性研究

目的动态观察急性脑梗死患者(acute cerebral infarction,ACI)血浆中S-100蛋白(s-100 protein,S-100)、髓鞘碱性蛋白(myelin basic protein,MBP)的变化,探讨其与脑梗死体积、神经功能缺损程度及梗死部位等方面的相关性.方法该实验采用酶联免疫吸附法(eyzyme-linked immunosorbent assay,ELISA)对50例ACI患者的血浆S-100、MBP水平进行动态检测,并与30例对照组患者进行比较,同时应用NIHSS进行神经功能缺损评分及CT扫描测定梗死体积.结果ACI患者S-100、MBP浓度在发病早期明显升高,S-100 1～3 d达到峰值,MBP 5～7 d达到峰值,有严重神经功能缺损的患者S-100、MBP升高更明显,S-100＞1.0 μg/L、MBP＞8.0μg/L、NIHSS＞12分,均提示患者预后不良;S-100、MBP的血浆浓度与梗死体积呈显著正相关(r≥0.480,P＜0.01),与神经功能缺损程度也呈显著正相关(r≥0.443,P＜0.01).结论缺血性脑损伤后血浆中S-100、MBP的出现分别与神经胶质细胞、髓鞘受损有关,并通过受损的血脑屏障进入血液,S-100、MBP可作为缺血性脑损伤尤其是大面积脑梗死早期的外周标志物,是比CT更为敏感的指标,对指导治疗有帮助.     

S-100b蛋白、神经元特异性烯醇化酶与进展性卒中的关系

目的探讨血清S-100b蛋白、神经元特异性烯醇化酶与进展性缺血性脑卒中的关系。方法应用ELISA法检测150例急性脑梗死患者入院72h内S-100b蛋白及NSE的水平变化,并根据美国国立卫生院卒中量表判断是否为进展性卒中。同时进行神经功能缺损评分(NIHSS评分)、改良神经功能评分(mRS评分)及颅脑MRI/MRA扫描。结果 150例急性脑梗死患者中有30例(20%)于入院后3d内发展为进展性脑卒中,进展组患者入院后24h、36h、48h、72h血清S-100b蛋白、NSE明显高于无进展组(P0.01)。急性脑梗死患者S-100b蛋白、NSE与NIHSS评分、mRS评分及脑梗死体积呈正相关(r=0.65～0.75,P0.01;r=0.59～0.69,P0.01),颈内动脉颅内段、大脑中动脉M1段闭塞/狭窄的患者血清S-100b蛋白、NSE的水平较无血管闭塞组明显增高(P0.05)。结论急性脑梗死患者血清S-100b蛋白及NSE水平可能是进展性脑卒中的有效预测指标,且S-100b蛋白及NSE水平与颅内动脉狭窄、神经功能评分以及脑梗死体积密切相关。     

血清高敏C反应蛋白水平与脑梗死关系的研究

目的探讨血清高敏C反应蛋白(hsCRP)水平与脑梗死病情及预后的关系。方法测定90例急性脑梗死患者入院时血清hsCRP含量,观察梗死灶大小不同、神经功能缺损程度不同时含量变化,应用美国国立卫生研究院卒中量表(NIHSS)及Barthel指数(BI)分别对患者入院时及治疗6个月后进行评分,并将血清hsCRP水平与NIHSS及BI评分进行相关性分析。同时选取80例健康体检人员血清hsCRP含量进行对照。结果脑梗死患者血清hsCRP含量明显高于健康对照组(P<0.01);脑梗死血清hsCRP水平越高,梗死灶越大,神经功能缺损程度越重;患者血清hsCRP水平与入院时NIHSS呈显著正相关(P<0.01),与6个月后BI评分呈显著负相关(P<0.01)。结论血清hsCRP水平是临床评价脑梗死严重程度和预后的一个重要生物学指标。     

进展性脑梗死患者血清C-反应蛋白、S-100β蛋白水平变化及意义

目的探讨进展性脑梗死(PCI)患者血清C-反应蛋白(CRP)与S-100β蛋白(S-100β)水平的变化及意义。方法100例急性脑梗死(ACI)患者根据发病后7 d内神经功能缺损量表评分(SSS)的变化分为PCI组(38例)和非PCI(NPCI)组(62例)。检测两组发病后第1 d、3 d、7 d、14 d血清CRP与S-100β的水平,并与健康对照组比较。结果与NPCI组比较,PCI组发病后各时间点血清CRP及S-100β水平明显升高(均P<0.01);与健康对照组比较,NPCI组血CRP与S-100β水平在发病第1~7 d明显增高(均P<0.01),14 d恢复正常水平。ACI组血清S-100β与CRP水平呈正相关(r=0.856,P<0.01);PCI组发病第1 d血清CRP和S-100β水平与分别第7 d SSS正相关(r1=0.695,r2=0.731;均P<0.05)。结论ACI患者发病早期血清CRP及S-100β水平增高与其病情及PCI的发生相关。     

脑梗死患者急性期血清高敏C-反应蛋白的动态变化及临床意义

目的　探讨急性脑梗死(ACI)患者高敏C-反应蛋白(hsCRP)的含量变化及其临床意义。方法　随机选择60例急性脑梗死患者,利用Dade-Behring ProSpec全自动特定蛋白分析系统,采用散射免疫比浊法检测各组患者hsCRP血清水平,观察ACI不同病程含量变化。并对其神经功能缺损进行标准评分。并选取30例健康体检者作为对照组。结果　急性脑梗死组不同时期血清hsCRP含量均高于对照组(P <0.05),卒中后第7天水平最高,随后逐渐下降;血清hsCRP含量与神经功能缺损程度呈正相关(r =0.53,P <0.01),重型患者hsCRP浓度明显高于轻、中型患者。结论　急性脑梗死患者血清hsCRP明显升高,且与神经功能缺损程度呈正相关,可作为急性脑梗死患者病变稳定程度的敏感指标之一。     

网膜素-1与急性脑梗死的相关性分析

目的探讨网膜素(Omentin)-1水平与急性脑梗死(ACI)发病、病情严重程度及90d预后之间的关系以及血清Omentin-1水平在急性脑梗死后的动态演变情况。方法选择2016年12月-2018年1月本院神经内科收治的110例ACI患者(病例组)及113例同期体检健康者(对照组),并进行血清Omentin-1水平检测,同时搜集入组患者的临床资料。结果病例组男性患者例数、吸烟史、饮酒史、房颤、冠心病的比例、白细胞数目、胱抑素C、糖化血红蛋白、同型半胱氨酸水平均高于对照组,血清Omentin-1水平低于对照组(P0.05);Logistic回归分析显示吸烟史、冠心病、白细胞数目、糖化血红蛋白、血清Omentin-1水平与急性脑梗死发病密切相关(p0.05)。中重度神经功能缺损组的患者(NIHSS3分)的Omentin-1水平低于轻度神经功能缺损组的患者(NIHSS≤3分)(P=0.001);脑梗死体积≥5 cm~3组患者的血清Omentin-1水平低于脑梗死体积5 cm~3的患者(P0.001);90 d预后不良组入院NIHSS评分、脑梗死体积高于预后良好组(分别为P0.001,P0.001),血清Omentin-1水平低于预后良好组(P=0.001);Omentin-1水平与NIHSS评分、脑梗死病灶体积及mRS评分呈负相关(分别r=-0.254,P=0.008;r=-0.274,P=0.004;r=-0.284,P=0.004)。结论急性脑梗死患者血清Omentin-1水平显著降低,且与神经功能缺损程度、脑梗死体积呈负相关;病例组血清Omentin-1水平呈动态波动,急性期显著降低,随后呈上升趋势,1周后水平仍低于对照组;Omentin-1水平与病例组患者的短期预后相关。因此,血清Omentin-1水平可能作为急性脑梗死评价病情轻重程度及预测短期预后的血清标志物。     

急性脑梗死患者血清S100B蛋白的动态测定及其与神经功能缺损的相关性

目的动态观察急性脑梗死(ACI)患者血清S100B蛋白的表达,探讨其与神经功能缺损程度的相关性。方法应用酶联免疫双抗体夹心法(ELISA)动态观察52例ACI患者血清S100B蛋白水平变化,并与52名健康对照者血清S100B蛋白水平进行比较。同时应用美国国立卫生研究院卒中量表(NIHSS)进行神经功能缺损评分,探讨S100B蛋白与NIHSS评分的相关性。结果健康对照组血清S100B蛋白水平为(0.025±0.009)ng/mL。ACI组血清S100B蛋白水平于发病后第3天[(0.217±0.142)ng/mL]已升高,于发病后第7天[(0.250±0.143)ng/mL]达高峰,发病后第15天为[0.198±0.109)ng/mL],均高于健康对照组(P0.01)。ACI组发病后第7天S100B蛋白水平高于发病后第3天和第15天(分别P0.05、P0.01),而后两者比较差异无统计学意义(P0.05)。发病后第3、7、15天S100B蛋白水平与同期临床神经功能缺损程度评分成正相关[分别r=0.736,P0.01;r=0.327,P0.05;r=0.654,P0.01]。结论血清S100B蛋白水平与神经功能缺损程度具有相关性,可以作为反应缺血性脑损伤程度的一个指标。     

急性脑卒中患者血清神经元特异性烯醇化酶、S-100B蛋白、髓鞘碱性蛋白水平的变化

目的探讨急性脑卒中患者血清神经元特异性烯醇化酶(NSE)、S-100B蛋白、髓鞘碱性蛋白(MBP)水平变化及其临床意义。方法回顾性对照分析发病在48 h内的45例急性脑卒中患者(其中脑梗死组19例,脑出血组15例,短暂性脑缺血发作组11例)血清NSE、S-100B蛋白、MBP水平变化及其与脑梗死、脑出血患者神经功能缺损程度的相关性。结果脑梗死组和脑出血组患者血清NSE、S-100B蛋白、MBP水平均较对照组有不同程度增高(P<0.05),而短暂性脑缺血发作组与正常对照组比较均无明显变化。脑梗死组和脑出血组患者中神经功能缺损较重的中重型亚组患者血清NSE、S-100B蛋白、MBP水平较轻型亚组水平高(P<0.05)。结论血清NSE、S-100B蛋白、MBP水平可作为急性脑卒中患者病情判断、预后评估的指标之一,对早期脑梗死与短暂性脑缺血发作也有鉴别诊断价值,尤其适用于无法进行影像学检查的脑卒中患者。     

亚低温对大面积脑梗死病人临床疗效及血清NSE、S-100蛋白的影响

目的　观察亚低温(MHT)技术治疗急性大面积脑梗死的临床疗效和对血清神经元特异性烯醇化酶(NSE)、S-100蛋白的影响。方法　将收治的 68 例急性大面积脑梗死病人随机份如治疗组合对照组各34例,治疗组在药物治疗脑梗死的同时加用 MHT治疗技术,在治疗前、治疗后 3 d、7 d、14 d进行神经功能缺损评分及NSE、S-100蛋白含量的测定。结果　在治疗后7 d、14 d治疗组神经功能缺损评分较对照组降低(P <0.05),在治疗后 3 d、7 d、14 d治疗组血清 NSE、S-100 蛋白含量明显降低(P <0.01)。结论　MHT治疗技术可改善急性大面积脑梗死病人神经功能、对神经细胞有较好的保护作用。     

血清S-100β神经元特异性烯醇化酶水平与脑卒中患者神经功能损害程度的相关性研究

目的探讨血清S-100β、神经元特异性烯醇化酶(NSE)与脑卒中患者神经功能损害程度的相关性。方法选取2017-02—2020-02开封市人民医院治疗的115例急性缺血性脑卒中患者为观察组,同时选取健康志愿者50例为对照组,检测2组血清S-100β、NSE水平。结果观察组血清S-100β、NSE水平明显高于对照组(P<0.05);观察组中大面积梗死患者S-100β、NSE水平高于腔隙性梗死和小面积梗死患者(P<0.05);观察组美国国立卫生研究院卒中量表(NIHSS)评分≥31分患者血清S-100β、NSE水平高于NIHSS评分16~30分和≤15分患者(P<0.05);血清S-100β、NSE水平与梗死面积呈正相关(P<0.05),与NIHSS评分亦呈正相关(P<0.05)。结论急性缺血性脑卒中患者血清S-100β、NSE水平升高,与梗死面积、神经功能损害程度存在正相关关系。     

Relationship between plasma metalloproteinase-9 levels and volume and severity of infarct in patients with acute ischemic stroke

Matrix metalloproteinases (MMP) constitute an endopeptidase family involved in various physiological and pathological processes. It was demonstrated that plasma MMP-9 level was increased in patients with acute ischemic stroke. In this study, it was investigated whether there was a relationship between the levels of plasma MMP-9 and the severity of stroke and infarct volume in patients with acute ischemic stroke. A total of 32 patients with acute ischemic stroke, (16 males and 16 females) and 30 healthy controls were included in the study. Plasma MMP-9 levels were measured using ELISA method. Computed tomography was performed at 48th?hour and infarct volume was calculated using the Cavalieri method. The National Institute of Health Stroke Scale (NIHSS) was checked at baseline, 12, 24, and 48th?hour. Plasma MMP-9 levels of the patient group at baseline, 12, 24, and 48th?hour were found significantly higher compared to the control group (p?<?0.05). An important correlation between MMP-9 levels and the infarct volume was observed at baseline, 12, 24, and 48th?hour (p?<?0.001). Furthermore, a positive correlation was recorded between plasma MMP-9 levels and NIHSS scores at baseline, 12, 24, and 48th?hour (p?<?0.001). Plasma MMP-9 levels of those of suffering medium and heavy damages were found significantly higher when compared to those of having slight damage (p?<?0.05). A significant relationship was also observed between infarct volumes and neurological deficits (p?<?0.05). Plasma MMP-9 levels of the patients at 48th?hour were found to be significantly lower in recovered patients compared to those who did not improved or worsened (p?<?0.05). A positive correlation was recorded between the infarct volume and infarct progression (p?<?0.05). In conclusion, this study showed that plasma MMP-9 level substantially increased during the acute period of ischemic cerebrovascular disease and correlated with the severity of the disease and infarct volume. The definition of the exact role of plasma MMP-9 after ischemic stroke will have important diagnostic implications for stroke and for the development of therapeutic strategies aimed at modulating plasma MMP-9.     

Diagnostic and prognostic role of resistin and copeptin in acute ischemic stroke

Objectives: Our aim was to evaluate (i) whether there is a difference in the concentration of resistin and copeptin between acute ischemic stroke patients and stroke-free controls; and (ii) if there is any prognostic value of resistin and copeptin in predicting stroke infarct volume, stroke severity, and outcome.

Methods: Our case-control study has recruited 112 acute ischemic stroke patients admitted within 24 h after the stroke onset. We have also included 63 age and gender matched stroke-free controls. Resistin and copeptin levels were measured by a commercial ELISA kits. Stroke severity was assessed according to the modified National Institute of Health Stroke Scale (mNIHSS) and the degree of disability was assessed using Barthel index (BI). Stroke infarct volume was determined by the volumetric estimation.

Results: Resistin concentrations were significantly higher in patients (3.2 mg/L; IQR: 1.9–6.4) than in stroke-free controls (2.5 mg/L; IQR: 1.4–5.2; p = 0.024) whereas the concentration of copeptin did not differ between patients and controls. Copeptin concentrations were significantly higher in patients with poor functional outcome (Barthel index <60) (p = 0.021). There was a significant negative correlation between copeptin and BI score (ρ = ?0.309, p = 0.020).

Discussion: Resistin, but not copeptin levels are higher in acute ischemic stroke patients early after the stroke onset, than in age and gender matched stroke-free controls. Moreover, higher copeptin concentrations are predictive of poor short term functional outcome after ischemic stroke. If confirmed in larger prospective studies, resistin and copeptin could improve clinical diagnosis of stroke and effective management of patient recovery.     

S100 as a Marker of Acute Brain Ischemia: A Systematic Review

Background  Studies show S100 as a possible acute ischemic stroke (AIS) marker. Objectives  Determine (1) whether S100 serum concentrations correlate with stroke symptom onset, infarction volume, stroke severity, functional outcome, or length of hospital stay; (2) whether S100 serial measurements are useful markers for ongoing brain ischemia, and (3) whether S100 levels at various time intervals are higher in AIS patients than controls. Methods  Literature was searched using OVID and MEDLINE from January 1950 to February 2007, and all relevant reports were included. Results  Eighteen studies (1,643 patients) satisfied entry criteria. S100 peaks from symptom onset between 24 and 120 h with significantly raised values measured from 0 to 120 h. Higher S100 values indicated significantly larger infarction volumes, more severe strokes, and worse functional outcome. There was a significant difference in S100 levels between AIS patients and controls. Conclusion  Peak values after stroke onset varied. S100 was significantly increased after stroke onset, and correlates with infarct volume, stroke severity, and functional outcome, and was a possible marker for ongoing ischemia. Its serum concentration during acute stroke is a useful marker of infarct size and long-term clinical outcome.     

Association of higher serum calcium levels with smaller infarct volumes in acute ischemic stroke

BACKGROUND: Elevated serum calcium levels at admission in patients with stroke have been associated with less severe clinical deficits and with better outcomes; however, the relationship between serum calcium levels and volumetric measurement of cerebral infarct size on neuroimaging has not been studied, to our knowledge. OBJECTIVE: To assess the relationship between serum calcium levels at admission and initial diffusion-weighted magnetic resonance imaging (DWI) infarct volumes among patients with acute ischemic stroke. DESIGN: Secondary analysis of prospectively collected hospital quality improvement data. SETTING: Tertiary university hospital. PATIENTS: One hundred seventy-three consecutive patients with acute ischemic stroke initially seen within 24 hours of the last known well time. MAIN OUTCOME MEASURES: Total serum calcium levels were measured on admission and were collapsed into quartiles. The DWI lesions were outlined using a semiautomated threshold technique. The relationship between serum calcium level quartiles and DWI infarct volumes was examined using multivariate quartile regression analysis. RESULTS: One hundred seventy-three patients (mean age, 70.3 years [age range, 24-100 years]; median National Institutes of Health Stroke Scale score, 4 [range, 0-38]) met the study criteria. The median DWI infarct volumes for the serum calcium level quartiles (lowest to highest quartile) were 9.42, 2.11, 1.03, and 3.68 mL. The median DWI infarct volume in the lowest serum calcium level quartile was larger than that in the other 3 quartiles (P < .005). After multivariate analysis, the median adjusted DWI infarct volumes for the serum calcium level quartiles (lowest to highest) were 8.9, 5.8, 4.5, and 3.8 mL. The median adjusted DWI infarct volume in the lowest serum calcium level quartile was statistically significantly larger than that in the other 3 quartiles (P < .05). CONCLUSIONS: Higher serum calcium levels at admission are associated with smaller cerebral infarct volumes among patients with acute ischemic stroke. These results suggest that serum calcium level may serve as a clinical prognosticator following stroke and may be a potential therapeutic target for improving stroke outcome.     

Infarct volume on apparent diffusion coefficient maps correlates with length of stay and outcome after middle cerebral artery stroke

BACKGROUND: Diffusion-weighted MRI (DWI) can depict acute ischemia based on decreased apparent diffusion coefficient (ADC) values. ADC maps, unlike DWI (which have contributions from T2 properties), solely reflect diffusion properties. Recent studies indicate that severity of neurological deficit corresponds with degree of ADC alteration. PURPOSE: To determine whether infarct volume on ADC maps correlates with length of hospitalization and clinical outcome in patients with acute ischemic middle cerebral artery (MCA) stroke. STUDY POPULATION: Forty-five consecutive patients with acute (3 SDs below the average ADC value of a contralateral control region. Infarct volume was correlated with length of hospitalization and 6-month outcome assessed with Glasgow Outcome Scale (GOS), Modified Rankin Score (mRS), Barthel Index (BI) and a dichotomized outcome status with favorable outcome defined as GOS 1, mRS or=95. RESULTS: Infarct volume on ADC maps ranged from 0.2 to 187 cm(3) and was significantly correlated with length of hospitalization (p < 0.001, r = 0.67). Furthermore, ADC infarct volume was significantly correlated with GOS (r = 0.73), mRS (r = 0.68), BI (r = 0.67) and outcome status (r = 0.65) (each p < 0.001). Multiple logistic regression revealed a statistically significant correlation between ADC infarct volume and outcome status (p < 0.05), but none for Canadian Neurological Scale score, age and gender (p >0.05 each). CONCLUSION: Infarct volume measured by using a quantitative definition for infarcted tissue on ADC maps correlated significantly with length of hospitalization (as a possible surrogate marker for short-term outcome) and functional outcome after 6 months. ADC infarct volume may provide prognostic information for patients with acute ischemic MCA stroke.     

Interleukin-12 in acute ischemic stroke patients

Cytokines are important mediators of stroke-induced immunological/inflammatory reaction which contributes to brain infarct progression as well as to the disease severity and outcome. The aim of the study was to evaluate the levels of the proinflammatory and immunomodulatory cytokine interleukin-12 (IL-12) in serum of acute ischemic stroke patients, and to investigate the relation between these levels and demographic, laboratory, neuroimaging, and clinical data. The study comprised 23 first-ever ischemic stroke patients and 15 age- and sex-matched controls. Blood sampling for the determination of IL-12 and such peripheral markers of inflammation as erythrocyte sedimentation rate (ESR) and leukocyte count, together with cranial CT were performed within 24 h of stroke, while neurological and functional deficits were estimated, respectively, with the Scandinavian Stroke Scale (SSS) and Barthel Index (BI) within the same period and two weeks later. Stroke patients displayed significantly higher serum IL-12 levels in comparison with controls. The serum IL-12 levels in stroke patients correlated significantly with the ESR values, the volume of early brain CT hypodense areas, and with the SSS and BI scores calculated within both studied times. The results indirectly suggest that IL-12 may play a role in the pathophysiology of ischemic stroke.     

尿酸对急性缺血性卒中患者血管再通和梗死体积的影响

目的 探讨急性缺血性卒中患者尿酸（UA）浓度的变化对血管再通和梗死体积的影响.方法 对176例发病24 h内患者应用弥散加权磁共振（DWI）检查,证实为前循环急性缺血性卒中.经改良的NIH卒中（mNIHSS）评分5分以上,随访观察尿酸、尿囊素（尿酸的非酶代谢产物）浓度的变化对血管再通和梗死体积的影响.结果 66例血管再通病人多数接受溶栓治疗,UA浓度在48 h降低,然后逐渐升高呈U行改变,14 d时mNIHSS评分降低,UA和尿囊素浓度变化与DWI梗死体积明显相关.结论 UA是急性缺血性卒中的一种消耗和再生性抗氧化剂,其浓度变化与血管再通和梗死体积有关.     

Correlation between diffusion- and perfusion-weighted MRI and neurological deficit measured by the Scandinavian Stroke Scale and Barthel Index in hyperacute subcortical stroke (< or = 6 hours)

OBJECTIVE: We used combined diffusion-weighted (DWI) and perfusion-weighted (PWI) MRI to characterize hyperacute infarctions within 6 h of symptom onset with special reference to subcortical infarctions, and investigated the relation between perfusion-diffusion mismatch volume and functional outcome. MATERIAL AND METHODS: Twenty-two patients presenting with symptoms of acute stroke underwent DWI and PWI within 6 h of symptom onset, and follow-up MRI 30 days later. Twelve of these had a subcortical infarction on acute DWI. Lesion volumes were measured by acute DWI and PWI as well as chronic T(2)-weighted MRI (T2WI). Clinical severity was measured by the Scandinavian Stroke Scale (SSS) and the Barthel Index (BI). RESULTS: In the 12 patients with subcortical infarctions, PWI and especially DWI correlated strongly with acute and chronic neurological SSS score, as well as with final infarct volume. Furthermore, a hyperacute PWI/DWI mismatch in this subgroup predicted lesion growth. There was a weaker correlation between acute DWI/PWI and neurological score among all 22 patients, and patients with a PWI/DWI mismatch larger than 100 ml had a significantly larger lesion growth and a poorer outcome than patients with a smaller mismatch. CONCLUSIONS: Subcortical infarctions may represent a sizeable subgroup of acute stroke patients. Also subcortical infarctions may have a PWI/DWI mismatch and therefore may respond to neuroprotective/thrombolytic therapy. Hyperacute DWI may reflect the acute clinical status and predict the outcome in patients with subcortical infarction.