Abstract Details

Title Racial Differences in Salvageable Ischemic Penumbra

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P02 - (-)

Poster/Presentation
Number 051

Objective

Background BACKGROUND: African Americans (AA) have higher incidence of intracranial atherosclerosis than Caucasians. chronic ischemia may lead to formation of collateral circulation With increased sustainability of penumbra after acute stroke.

Design/Methods DESIGN/METHODS: Admission perfusion computed tomography (PCT) of patients from August 2011 to March 2012 were reviewed. PCT included 4 supratentorial slices, 8 mm thick. Images were processed using Vitrea® to obtain cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT). Areas of increased MTT were marked as ischemic area. Corresponding area of preserved CBV was labeled penumbra. mean CBF, MTT or CBV for the total ischemic area (or penumbra) was estimated by multiplying each ischemic area (or penumbra) by the corresponding CBF (MTT or CBV), adding value of four slices and dividing by total area. Ischemic and penumbra areas in four slices were added and multiplied by slice thickness (0.8 cm) for ischemic (IV), penumbra volume (PV).

Results RESULTS: Perfusion was abnormal in 43 (65.1 % AA vs. 30.2 % Caucasian) patients. mean IV was less in AA compared to Caucasians (63.64 ±36.7 cm3 vs. 89.57 ±52.6 cm3) as was mean PV (42.77±28.9 cm3 vs. 64.36 ± 43.8 cm3). Within the penumbra in AA, CBF was increased (28 ±12.2 ml/100 gm/sec vs. 23.11 ±12.5 ml/100 gm/sec) as was CBV (3.46 ±1.4 ml/100gm vs. 2.98 ±1.1 ml/100gm). Penumbra MTT was faster in AA (8.59 ±2.2 sec vs. 9.46 ±2.72 sec). Trends in CBF, CBV and MTT did not reach statistical significance due to the small sample size. only 36% of AA had CBF < 20 ml/100 gm/min (vulnerable ischemic tissue) vs 61.5% in Caucasians (p=0.17).

Conclusions CONCLUSIONS: exploratory analysis suggests AA have greater CBF and CBV with faster MTT in the region of penumbra compared to Caucasians indicating the presence of biological mechanisms to preserve the penumbra.

Authors/Disclosures
Kushak Suchdev, MD PRESENTER	Dr. Suchdev has nothing to disclose.
Mark Gudesblatt, MD (South Shore Neurology Assoc. PC)	The institution of Dr. Gudesblatt has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for genentech. The institution of Dr. Gudesblatt has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen.
Wazim Mohamed, MD (Detroit Medical Center/Wayne State University)	Dr. Mohamed has nothing to disclose.
Pratik D. Bhattacharya, MD, MPH (International Medical Clinic)	Dr. Bhattacharya has a non-compensated relationship as a Research Advisor with Defeat MSA Alliance 501 (c) (3) that is relevant to AAN interests or activities.
	No disclosure on file

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