How much diffusion lesion reversal occurs after treatment within three-hours of stroke onset?

Abstract

In this issue of the journal, Sakamoto etal. present an analysis of diffusion lesion evolution in acute ischemic stroke patients first imaged less than three-hours from stroke onset. Although temporary lesion volume reduction was observed following reperfusion, the affected regions were generally abnormal on follow-up fluid attenuated inversion recovery imaging, indicating lack of tissue salvage. Taken in conjunction with other recent articles, it seems that temporary postreperfusion 'reversal' of diffusion lesions is quite common but usually does not translate to permanent tissue salvage. A minority of patients demonstrate permanent reversibility of a component of the acute diffusion lesion..