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July2011 Vol.48 Issue:        3       (Supp.) Table of Contents
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Prognostic Value of D-Dimer in Diffusion Weighted-MRI Defined Early Ischemic Stroke Recurrence

Alaa A.M. Abdel Ghani1, Ashraf M. Zaitoun1, Heba Hassan Gawish2, Mohamad H. Abo Warda3


Departments of Neurology1, Clinical Pathology2, Radiology3, Zagazig University; Egypt



Background: The identification of factors associated with early stroke recurrence is of great importance to establish effective treatment for secondary stroke prevention. Objective: Study of D-dimer in diffusion weighted-MRI defined early ischemic stroke recurrence. Methods: This study was carried out on 50 acute ischemic stroke patients, 33 males and 17 females, with ages ranging from 20-80years. All patients were subjected to full history taking, complete general and neurological examination and laboratory investigations including routine laboratory investigations and plasma levels of hemostatic biomarkers within the first 24 hours of symptom onset. Diffusion weighted- magnetic resonance imaging (DW-MRI) was performed to all patients on admission and after five days. Results: Early recurrent ischemic lesions (ERILs) were detected in 15(30%) of our patients. Atherosclerotic subtype of stroke was more associated with ERILs, while lacunar subtype was more in patients without ERILIs. A statistically significant difference was found between the two groups regarding the infarcts volume, acute multiple infarcts on initial DW-MRI and the onset to initial DW-MRI (P<0.05). Of the laboratory findings, only D-dimer results were highly statistically significant between patients with and those without ERILs (P<0.001). It was highest in stroke patients with other or undetermined etiology and cardio-embolic stroke followed by atherosclerotic and lacunar subtypes. There was a highly statistically significant difference regarding the level of D-dimer in relation to the number and volume of infarcts on initial DW-MRI (P<0.001). Based on logistic regression analysis, D-dimer and atherosclerosis were found to be significant predictors of ERILs. Conclusion: Measurement of D-dimer, which is cheep and widely available, independently predicts progressing ischemic stroke and may also be helpful in selecting  patients who could benefit from measures taken to prevent early neurologic deterioration after ischemic stroke. [Egypt J Neurol Psychiat Neurosurg.  2011; 48(3): 215-222]


Key words: Prognostic, D-dimer, Diffusion weighted-MRI, Ischemic stroke, Recurrence.


Correspondence to Alaa Abdel Ghani, Neurology Department, Zagazig university, Egypt,

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