English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

88 Background: Diabetes and stress hyperglycemia  occur in about 1/3 of stroke patients and are associated with worse  stroke outcome. In animal stroke, MR spectroscopy (MRS) studies have  established a relationship between hyperglycemia, increased brain  lactate level, and larger final infarct size following reperfusion. We  therefore used 1H-MRS to measure regional lactate, and MR  diffusion-weighted (DWI) and perfusion-weighted imaging (PWI) to assess  reperfusion of the ischemic penumbra.Methods: Forty-two  hemispheric stroke patients were studied with DWI and PWI within 24  hours of symptom onset, and again at days 3 and 90. A subgroup of 24  patients had acute and day 3 MRS to determine lactate level in the  ischemic region. Blood glucose was measured acutely within 1 hour of  the acute scan.Results: Twenty-two patients were identified  as not yet having undergone major reperfusion (acute PWI lesion &gt;  acute DWI lesion). The extent of the acute PWI lesion that did not  progress to infarction was termed “penumbral salvage”. In the 22  patients who had not reperfused at time of acute scan, a correlation  was found between acute blood glucose and final infarct size (r=0.62,  p&lt;0.01). Furthermore, hyperglycemia was associated with reduced  penumbral salvage (r=0.75, p&lt;0.01). Fourteen patients in the group yet  to undergo reperfusion had MRS to measure lactate level in the ischemic  region before reperfusion (mean 7 hours), and following reperfusion at  day 3 (which may provide an indication of the amount of lactate  generated during reperfusion). In these patients, acute blood glucose  correlated strongly with day 3 lactate levels (r=0.85, p&lt;0.01). Day 3  lactate level was also strongly associated with reduced penumbral  salvage (r=0.90, p&lt;0.01).Conclusions: In acute stroke,  hyperglycemia may lead to increased lactate production during  reperfusion, thus contributing to reperfusion injury, resulting in  reduced penumbral salvage and increased final infarct size. These  findings are the first reported in human stroke and help explain the  worse outcome in diabetic stroke patients. Future research should  evaluate the effects of glycemic control on these  determinants.

Acute Hyperglycemia in Stroke leads to increased brain lactate production and greater final infarct size.