{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T03:45:50Z","timestamp":1793418350261,"version":"4.5.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>We sought to establish whether the presence (versus absence) of a lesion on magnetic resonance imaging (MRI) with diffusion weighting (DWI-MRI) at presentation with acute stroke is associated with worse clinical outcomes at 1 year.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>We recruited consecutive patients with a nondisabling ischemic stroke and performed DWI-MRI. Patients were followed up at 1 year to establish stroke recurrence (clinical or on MRI), cognitive impairment (Addenbrooke Cognitive Assessment Revised,&lt;88) and modified Rankin Scale.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>\n              A median of 4 days post stroke, one third (76\/264; 29%) of patients did not have a DWI lesion (95% confidence interval, 23%\u201335%). There was no statistically significant difference between those with and without a DWI lesion with respect to age or vascular risk factors. Patients without a lesion were more likely to be women or have previous stroke. At 1 year, 11 of 76 (14%) patients with a DWI-negative index stroke had a clinical diagnosis of recurrent stroke or transient ischemic attack, 33% had cognitive impairment (Addenbrooke Cognitive Assessment Revised &lt;88), and 40% still had modified Rankin Scale &gt;1, no different from DWI-positive patients; DWI-positive patients were more likely to have a new lesion on MRI (14%), symptomatic or asymptomatic, than DWI-negative patients (2%;\n              <jats:italic>P<\/jats:italic>\n              =0.02). Our data were consistent with 6 other studies (total n=976), pooled proportion of DWI-negative patients was 21% (95% confidence interval, 12%\u201332%).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Nearly one third of patients with nondisabling stroke do not have a relevant lesion on acute DWI-MRI. Patients with negative DWI-MRI had no better prognosis than patients with a lesion. DWI-negative stroke patients should receive secondary prevention.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.115.010665","type":"journal-article","created":{"date-parts":[[2015,9,30]],"date-time":"2015-09-30T03:13:12Z","timestamp":1443582792000},"page":"3142-3148","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":138,"title":["Clinically Confirmed Stroke With Negative Diffusion-Weighted Imaging Magnetic Resonance Imaging"],"prefix":"10.1161","volume":"46","author":[{"given":"Stephen D.J.","family":"Makin","sequence":"first","affiliation":[{"name":"From the Centre for Clinical Brain Sciences, Western General Hospital, Edinburgh, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fergus N.","family":"Doubal","sequence":"additional","affiliation":[{"name":"From the Centre for Clinical Brain Sciences, Western General Hospital, Edinburgh, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin S.","family":"Dennis","sequence":"additional","affiliation":[{"name":"From the Centre for Clinical Brain Sciences, Western General Hospital, Edinburgh, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna M.","family":"Wardlaw","sequence":"additional","affiliation":[{"name":"From the Centre for Clinical Brain Sciences, Western General Hospital, Edinburgh, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.109.568667"},{"key":"e_1_3_4_3_2","volume-title":"National Clinical Guideline for Diagnosis and Initial Management of Acute Stroke and Transient Ischaemic Attack (TIA)","author":"National Collaborating Centre for Chronic Conditions (UK)","year":"2008","unstructured":"National Collaborating Centre for Chronic Conditions (UK). National Clinical Guideline for Diagnosis and Initial Management of Acute Stroke and Transient Ischaemic Attack (TIA). Royal College of Physicians of London.; 2008."},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000143455.55877.b9"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2009.190298"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)93206-O"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.30.9.1751"},{"key":"e_1_3_4_8_2","first-page":"151","volume-title":"Stroke: A Practical Guide to Management","author":"Wardlaw JM.","year":"2001","unstructured":"Wardlaw JM. What pathological type of stroke is it? Stroke: A Practical Guide to Management. 2nd Ed. Oxford: Blackwell Scientific Ltd; 2001:151\u2013222.","edition":"2"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.149.2.351"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.110.590547"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/gps.1610"},{"key":"e_1_3_4_12_2","article-title":"Diffusion-weighted imaging and diagnosis of transient ischemic attack.","author":"Brazzelli M","year":"2013","unstructured":"Brazzelli M, Chappell FM, Miranda H, Shuler K, Dennis M, Sandercock PA, et al.. Diffusion-weighted imaging and diagnosis of transient ischemic attack. Ann Neurol 2013.","journal-title":"Ann Neurol"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-002-0793-2"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.72.5.572"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0059420"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000125720.02983.fe"},{"key":"e_1_3_4_17_2","first-page":"95","article-title":"Stroke without Acute Ishchaemic Lesions on Diffusion Weighted Imaging - Fukuoka Stroke Registrary.","volume":"34","author":"Fujimoto S","year":"2012","unstructured":"Fujimoto S, Junnouch J, Matsuki T, Mezuki S, Ishitsucka T, Kitazono T. Stroke without Acute Ishchaemic Lesions on Diffusion Weighted Imaging - Fukuoka Stroke Registrary. Cerebrovasc Dis 2012;34(suppl 1):95.","journal-title":"Cerebrovasc Dis"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0b013e318296f288"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2007.04.023"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1038\/399a007"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000202524.43850.81"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1159\/000084691"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(03)00621-5"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.501932"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.115.010665","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T14:23:09Z","timestamp":1715610189000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.115.010665"}},"subtitle":["Longitudinal Study of Clinical Outcomes, Stroke Recurrence, and Systematic Review"],"short-title":[],"issued":{"date-parts":[[2015,11]]},"references-count":23,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2015,11]]}},"alternative-id":["10.1161\/STROKEAHA.115.010665"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.115.010665","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,11]]},"assertion":[{"value":"2015-07-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-08-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-09-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}