Background: Fluid-attenuated inversion recovery (FLAIR) sequences may reveal hyperintense vessel signals (HVS) at the acute stage of cerebral ischemia. The aim of this study was to test the hypothesis that HVS are associated with a worse outcome. Methods: We included 30 consecutive patients admitted within 12 h after onset of hemispheric cerebral ischemia. The outcome was assessed with the modified Rankin Scale at month 1. Results: Proximal HVS were present in 9 patients and distal HVS in 16. All patients with proximal occlusions on time-of-flight sequences had distal HVS on FLAIR. Patients with poor outcome at month 1 (modified Rankin Scale 3–6) more frequently had had HVS on MRI (12/13 vs. 4/17; p< 0.001). Conclusion: Distal HVS found on FLAIR sequences within 12 h of acute cerebral ischemia are associated with a worse 1-month outcome.

Albers GW, Lansberg MG, Norbash AM, Tong DC, O’Brien MW, Woolfenden AR, Marks MP, Moseley ME: Yield of diffusion-weighted MRI for detection of potentially relevant findings in stroke patients. Neurology 2000;54:1562–1567.
Schellinger PD, Fiebach JB, Hacke W: Imaging-based decision making in thrombolytic therapy for ischemic stroke: present status. Stroke 2003;34:575–583.
Lovblad KO, Laubach HJ, Baird AE, Curtin F, Schlaug G, Edelman RR, Warach S: Clinical experience with diffusion-weighted MR in patients with acute stroke. Am J Neuroradiol 1998;19:1061–1066.
Kamran S, Bates V, Bakshi R, Wright P, Kinkel W, Miletich R: Significance of hyperintense vessels on FLAIR MRI in acute stroke. Neurology 2000;55:265–269.
Makkat S, Vandevenne JE, Verswijvel G, Ijsewijn T, Grieten M, Palmers Y, De Schepper AM, Parizel PM: Signs of acute stroke seen on fluid-attenuated inversion recovery MR imaging. Am J Roentgenol 2002;179:237–243.
Oppenheim C, Logak M, Dormont D, Lehericy S, Manai R, Samson Y, Marsault C, Rancurel G: Diagnosis of acute ischaemic stroke with fluid-attenuated inversion recovery and diffusion-weighted sequences. Neuroradiology 2000;42:602–607.
Toyoda K, Ida M, Fukuda K: Fluid-attenuated inversion recovery intraarterial signal: an early sign of hyperacute cerebral ischemia. Am J Neuroradiol 2001;22:1021–1029.
Maeda M, Koshimoto Y, Uematsu H, Yamada H, Kimura H, Kawamura Y, Itoh H, Sakuma H, Takeda K: Time course of arterial hyperintensity with fast fluid-attenuated inversion-recovery imaging in acute and subacute middle cerebral arterial infarction. J Magn Reson Imaging 2001;13:987–990.
Cosnard G, Duprez T, Grandin C, Smith AM, Munier T, Peeters A: Fast FLAIR sequence for detecting major vascular abnormalities during the hyperacute phase of stroke: a comparison with MR angiography. Neuroradiology 1999;41:342–346.
Iancu-Gontard D, Oppenheim C, Touze E, Meary E, Zuber M, Mas JL, Fredy D, Meder JF: Evaluation of hyperintense vessels on FLAIR MRI for the diagnosis of multiple intracerebral arterial stenoses. Stroke 2003;34:1886–1891.
Lyden P, Brott T, Tilley B, Welch KM, Mascha EJ, Levine S, Haley EC, Grotta J, Marler J: Improved reliability of the NIH Stroke Scale using video training. NINDS TPA Stroke Study Group. Stroke 1994;25:2220–2226.
Bonita R, Beaglehole R: Recovery of motor function after stroke. Stroke 1988;19:1497–1500.
Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, Marsh EE 3rd: Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke 1993;24:35–41.
Gauvrit JY, Leclerc X, Girot M, Cordonnier C, Sotoares G, Henon H, Pertuzon B, Michelin E, Devos D, Pruvo JP, Leys D: Fluid-attenuated inversion recovery (FLAIR) sequences for the assessment of acute stroke. Inter-observer and inter-technique reproducibility. J Neurol 2005;253:631–635.
Schellinger PD, Chalela JA, Kang DW, Latour LL, Warach S: Diagnostic and prognostic value of early MR Imaging vessel signs in hyperacute stroke patients imaged <3 hours and treated with recombinant tissue plasminogen activator. Am J Neuroradiol 2005;26:618–624.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.