Seo Y, Kim J, Chang MC, Huh H, Lee EH. Relationship between treatment types and blood–brain barrier disruption in patients with acute ischemic stroke: Two case reports. World J Clin Cases 2022; 10(7): 2351-2356 [PMID: 35321157 DOI: 10.12998/wjcc.v10.i7.2351]
Corresponding Author of This Article
Jonghoon Kim, MD, PhD, Doctor, Neurosurgeon, Professor, Department of Neurosurgery, College of Medicine, Yeungnam University, 170, Hyeonchung Street, Nam-Gu, Daegu 42415, South Korea. kjhns@yu.ac.kr
Research Domain of This Article
Neuroimaging
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Mar 6, 2022; 10(7): 2351-2356 Published online Mar 6, 2022. doi: 10.12998/wjcc.v10.i7.2351
Relationship between treatment types and blood–brain barrier disruption in patients with acute ischemic stroke: Two case reports
Youngbeom Seo, Jonghoon Kim, Min Cheol Chang, Hyungkyu Huh, Eun-Hee Lee
Youngbeom Seo, Jonghoon Kim, Department of Neurosurgery, College of Medicine, Yeungnam University, Daegu 42415, South Korea
Min Cheol Chang, Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu 42415, South Korea
Hyungkyu Huh, Eun-Hee Lee, Medical Interdisciplinary Team, Medical Device Development Center, Daegu-Gyeongbuk Medical Innovation Foundation, Daegu 41061, South Korea
Author contributions: Kim J contributed to conception and design of the study; Huh H and Lee EH organized the database; Kim J and Seo Y wrote the first draft of the manuscript; Huh H, Kim J, Chang MC, and Seo J wrote sections of the manuscript; all authors contributed to manuscript revision, read, and approved the submitted version.
Supported bythe National Research Foundation of Korea grant, No. 2019M3E5D1A02069399.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jonghoon Kim, MD, PhD, Doctor, Neurosurgeon, Professor, Department of Neurosurgery, College of Medicine, Yeungnam University, 170, Hyeonchung Street, Nam-Gu, Daegu 42415, South Korea. kjhns@yu.ac.kr
Received: October 12, 2021 Peer-review started: October 12, 2021 First decision: October 22, 2021 Revised: October 26, 2021 Accepted: January 17, 2022 Article in press: January 17, 2022 Published online: March 6, 2022 Processing time: 140 Days and 22.9 Hours
Abstract
BACKGROUND
Blood-brain barrier (BBB) disruption plays an important role in the development of neurological dysfunction in ischemic stroke. However, diagnostic modalities that can clearly diagnose the degree of BBB disruption in ischemic stroke are limited. Here, we describe two cases in which the usefulness of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in detecting BBB disruption was evaluated after treatment of acute ischemic stroke using two different methods.
CASE SUMMARY
The two patients of similar age and relatively similar cerebral infarction locations were treated conservatively or with thrombectomy, although their sex was different. As a result of analysis by performing DCE-MRI, it was confirmed that BBB disruption was significantly less severe in the patient who underwent thrombectomy (P = 3.3 × 10-7), whereas the average Ktrans of the contralateral hemisphere in both patients was similar (2.4 × 10-5 min-1 and 2.0 × 10-5 min-1). If reperfusion is achieved through thrombectomy, it may indicate that the penumbra can be saved and BBB recovery can be promoted.
CONCLUSION
Our cases suggest that BBB disruption could be important if BBB permeability is used to guide clinical treatment.
Core Tip: We describe two cases in which the usefulness of dynamic contrast-enhanced magnetic resonance imaging in detecting blood–brain barrier (BBB) disruption was evaluated after treatment of acute ischemic stroke using two different methods. Our cases suggest that BBB disruption could be important if BBB permeability is used to guide clinical treatment.
