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Objectives <p>A single small subcortical infarction is sometimes strongly associated with infarct growth, ultimately leading to early neurological deterioration. We aimed to investigate whether a brush sign (BS) on susceptibility-weighted imaging (SWI) can predict infarct growth or progressive paralysis in a single small subcortical infarction.</p> Materials and methods <p>Consecutive patients with a single small subcortical infarction presenting within 24 h of onset were retrospectively evaluated. MRI, including SWI, was performed on admission and within 1 week of admission. Infarct growth was defined as an increase in infarct volume exceeding 0.5 cm<sup>3</sup> between admission and follow-up on diffusion-weighted imaging. Progressive paralysis was defined as an increase in the manual muscle test score by &gt; 1 point.</p> Results <p>Of the 67 patients (median age, 75 [62–83] years, 46 male) with a single small subcortical infarction, 13 (median age, 75 [59.5–84] years, 10 male) presented with a BS. The presence of a BS was associated with infarct growth; however, it was not an independent factor associated with progressive paralysis. On the other hand, infarct growth and age were independent factors associated with progressive paralysis.</p> Conclusion <p>A BS could indicate infarct growth in cases of a single small subcortical infarction.</p> Key Points <p><Emphasis Type="BoldItalic">Question</Emphasis><i> The usefulness of MRI in predicting infarct growth in a single small subcortical infarction has not been reported sufficiently</i>.</p> <p><Emphasis Type="BoldItalic">Findings</Emphasis><i> The presence of a brush sign on susceptibility-weighted imaging was independently associated with infarct growth in a single small subcortical infarction</i>.</p> <p><Emphasis Type="BoldItalic">Clinical relevance</Emphasis><i> A brush sign on susceptibility-weighted imaging has important implications, as early identification of patients at high risk of infarct growth can guide tailored treatment strategies and monitoring to improve patient outcomes</i>.</p> Graphical Abstract <p></p>

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Brush sign on susceptibility-weighted imaging as a predictor of infarct growth in a single small subcortical infarction

  • 期刊论文

  • 发表日期：

    2025年10月31日

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  • Shota Yoshimura,
  • Susumu Yamaguchi,
  • Hikaru Nakamura,
  • Kosuke Hirayama,
  • Kei Sato,
  • Yoichi Morofuji,
  • Takeshi Hiu,
  • Yukishige Hayashi,
  • Yoshiharu Tokunaga,
  • Tsuyoshi Izumo,
  • Takayuki Matsuo

摘要

Objectives

A single small subcortical infarction is sometimes strongly associated with infarct growth, ultimately leading to early neurological deterioration. We aimed to investigate whether a brush sign (BS) on susceptibility-weighted imaging (SWI) can predict infarct growth or progressive paralysis in a single small subcortical infarction.

Materials and methods

Consecutive patients with a single small subcortical infarction presenting within 24 h of onset were retrospectively evaluated. MRI, including SWI, was performed on admission and within 1 week of admission. Infarct growth was defined as an increase in infarct volume exceeding 0.5 cm3 between admission and follow-up on diffusion-weighted imaging. Progressive paralysis was defined as an increase in the manual muscle test score by > 1 point.

Results

Of the 67 patients (median age, 75 [62–83] years, 46 male) with a single small subcortical infarction, 13 (median age, 75 [59.5–84] years, 10 male) presented with a BS. The presence of a BS was associated with infarct growth; however, it was not an independent factor associated with progressive paralysis. On the other hand, infarct growth and age were independent factors associated with progressive paralysis.

Conclusion

A BS could indicate infarct growth in cases of a single small subcortical infarction.

Key Points

Question The usefulness of MRI in predicting infarct growth in a single small subcortical infarction has not been reported sufficiently.

Findings The presence of a brush sign on susceptibility-weighted imaging was independently associated with infarct growth in a single small subcortical infarction.

Clinical relevance A brush sign on susceptibility-weighted imaging has important implications, as early identification of patients at high risk of infarct growth can guide tailored treatment strategies and monitoring to improve patient outcomes.

Graphical Abstract