{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T12:34:12Z","timestamp":1789821252239,"version":"4.0.1"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>Major anterior circulation ischemic strokes caused by occlusion of the distal internal carotid artery or proximal middle cerebral artery or both account for about one third of ischemic strokes with mostly poor outcomes. These strokes are treatable by intravenous tissue-type plasminogen activator and endovascular methods. However, dynamics of infarct growth in these strokes are poorly documented. The purpose was to help understand infarct growth dynamics by measuring acute infarct size with diffusion-weighted imaging (DWI) at known times after stroke onset in patients with documented internal carotid artery\/middle cerebral artery occlusions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>Retrospectively, we included 47 consecutive patients with documented internal carotid artery\/middle cerebral artery occlusions who underwent DWI within 30 hours of stroke onset. Prospectively, 139 patients were identified using the same inclusion criteria. DWI lesion volumes were measured and correlated to time since stroke onset. Perfusion data were reviewed in those who underwent perfusion imaging.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>\n              Acute infarct volumes ranged from 0.41 to 318.3 mL. Infarct size and time did not correlate (\n              <jats:italic>R<\/jats:italic>\n              <jats:sup>2<\/jats:sup>\n              =0.001). The majority of patients had DWI lesions that were &lt;25% the territory at risk (&lt;70 mL) whether they were imaged &lt;8 or &gt;8 hours after stroke onset. DWI lesions corresponded to areas of greatly reduced perfusion.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Poor correlation between infarct volume and time after stroke onset suggests that there are factors more powerful than time in determining infarct size within the first 30 hours. The observations suggest that highly variable cerebral perfusion via the collateral circulation may primarily determine infarct growth dynamics. If verified, clinical implications include the possibility of treating many patients outside traditional time windows.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.114.005644","type":"journal-article","created":{"date-parts":[[2014,9,5]],"date-time":"2014-09-05T05:24:55Z","timestamp":1409894695000},"page":"2936-2941","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":81,"title":["Time and Diffusion Lesion Size in Major Anterior Circulation Ischemic Strokes"],"prefix":"10.1161","volume":"45","author":[{"given":"Reza","family":"Hakimelahi","sequence":"first","affiliation":[{"name":"From the Neuroradiology Division and the Stroke Service, Massachusetts General Hospital, Harvard Medical School, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Behroze A.","family":"Vachha","sequence":"additional","affiliation":[{"name":"From the Neuroradiology Division and the Stroke Service, Massachusetts General Hospital, Harvard Medical School, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William A.","family":"Copen","sequence":"additional","affiliation":[{"name":"From the Neuroradiology Division and the Stroke Service, Massachusetts General Hospital, Harvard Medical School, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo D.E.","family":"Papini","sequence":"additional","affiliation":[{"name":"From the Neuroradiology Division and the Stroke Service, Massachusetts General Hospital, Harvard Medical School, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"He","sequence":"additional","affiliation":[{"name":"From the Neuroradiology Division and the Stroke Service, Massachusetts General Hospital, Harvard Medical School, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud M.","family":"Higazi","sequence":"additional","affiliation":[{"name":"From the Neuroradiology Division and the Stroke Service, Massachusetts General Hospital, Harvard Medical School, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael H.","family":"Lev","sequence":"additional","affiliation":[{"name":"From the Neuroradiology Division and the Stroke Service, Massachusetts General Hospital, Harvard Medical School, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela W.","family":"Schaefer","sequence":"additional","affiliation":[{"name":"From the Neuroradiology Division and the Stroke Service, Massachusetts General Hospital, Harvard Medical School, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert J.","family":"Yoo","sequence":"additional","affiliation":[{"name":"From the Neuroradiology Division and the Stroke Service, Massachusetts General Hospital, Harvard Medical School, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee H.","family":"Schwamm","sequence":"additional","affiliation":[{"name":"From the Neuroradiology Division and the Stroke Service, Massachusetts General Hospital, Harvard Medical School, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Gilberto","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"From the Neuroradiology Division and the Stroke Service, Massachusetts General Hospital, Harvard Medical School, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0b013e31828124ad"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.113.001938"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.109.192535"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60491-6"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0b013e318284056a"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000196957.55928.ab"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.21.2019"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03530130023023"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)08020-9"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181b9c847"},{"key":"e_1_3_3_12_2","first-page":"728","article-title":"Imaging-guided acute ischemic stroke therapy: From \u201ctime is brain\u201d to \u201cphysiology is brain\u201d.","volume":"27","author":"Gonz\u00e1lez RG","year":"2006","unstructured":"Gonz\u00e1lez RG. Imaging-guided acute ischemic stroke therapy: From \u201ctime is brain\u201d to \u201cphysiology is brain\u201d. AJNR Am J Neuroradiol. 2006;27:728\u2013735.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2007.132100"},{"key":"e_1_3_3_14_2","first-page":"1789","article-title":"Angiographic assessment of pial collaterals as a prognostic indicator following intra-arterial thrombolysis for acute ischemic stroke.","volume":"26","author":"Christoforidis GA","year":"2005","unstructured":"Christoforidis GA, Mohammad Y, Kehagias D, Avutu B, Slivka AP. Angiographic assessment of pial collaterals as a prognostic indicator following intra-arterial thrombolysis for acute ischemic stroke. AJNR Am J Neuroradiol. 2005;26:1789\u20131797.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nic.2005.08.012"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.110.578997"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000217403.66996.6d"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.brainres.2005.02.073"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.31.8.1965"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2503080811"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-12-132"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-10-13"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.111.639401"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.108.541656"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-006-0105-0"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(12)70203-X"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000335929.06390.d3"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3174"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.113.003857"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.110.601609"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.56.8.1015"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000152041.20486.2F"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.9.1151"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.107.490375"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.111.624163"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.114.005644","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T14:10:56Z","timestamp":1715609456000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.114.005644"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,10]]},"references-count":34,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2014,10]]}},"alternative-id":["10.1161\/STROKEAHA.114.005644"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.114.005644","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,10]]},"assertion":[{"value":"2014-04-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-07-31","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-09-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}