ArticleFrontiers in neurology2017
Role of Hyperintense Acute Reperfusion Marker for Classifying the Stroke Etiology.
Article in Frontiers in neurology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- Hyperintense acute reperfusion marker and gadolinium leakage in ocular structures in stroke: a systematic review.Neuroradiology · 2025Pooled it
- CSF enhancement on post-contrast fluid-attenuated inversion recovery images; a systematic review.NeuroImage. Clinical · 2020Pooled it
- Poor venous outflow is associated with hyperintense acute reperfusion marker on follow-up MRI in patients with acute ischemic stroke with a large vessel occlusion.Journal of neurointerventional surgery · 2025Article
- Predictive Value of Hyperintense Acute Reperfusion Marker in Transient Ischemic Attacks: Stroke Recurrence and TOAST Classification.Brain sciences · 2025Article
- Blood-brain barrier disruption mediates the association between cerebral small vessel disease and clinical outcome after stroke: a secondary analysis of the Lesion Evolution in Stroke and Ischemia on Neuroimaging study.Frontiers in stroke · 2024Article
- Why Does It Shine?-A Prognostic Analysis about Predisposing Factors for Blood-Brain Barrier Damage after Revascularisation of Cerebral Large-Vessel Occlusion.Journal of cardiovascular development and disease · 2023Article
- The Vessel Has Been Recanalized: Now What?Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2023Review
- Ipsilateral blooming of microbleeds after Hyperintense Acute Reperfusion Marker sign in an ischemic Stroke patient, a case report.BMC neurology · 2022Article
- The Clinical Significance of the Hyperintense Acute Reperfusion Marker Sign in Subacute Infarction Patients.Diagnostics (Basel, Switzerland) · 2021Article
- Hyperintense acute reperfusion marker associated with hemorrhagic transformation in the WAKE-UP trial.European stroke journal · 2021Article
- Contrast leakage distant from the hematoma in patients with spontaneous ICH: A 7 T MRI study.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2020Observational
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe hyperintense acute reperfusion marker (HARM) is a delayed enhancement of the subarachnoid or subpial space observed on post-contrast fluid-attenuated inversion recovery (FLAIR) images and is associated with permeability changes to the blood-brain barrier in acute stroke. We investigated the relationship between HARM and stroke etiology based on the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification. In addition, we evaluated the relationship between HARM and stroke locations with respect to vascular territories and anatomic compartments. MATERIALS AND
methodsWe recruited 264 consecutive patients (109 women; mean age 68.63 years) who were diagnosed with acute ischemic stroke and underwent brain magnetic resonance imaging (MRI) including post-contrast FLAIR and DWI within 7 days of symptom onset from May 2015 to March 2016 for this retrospective study. Post-contrast FLAIR images were obtained 5 min after gadolinium administration. The mean time interval between the onset of stroke symptoms and MRI acquisition in total included patients was 18 h and 7 min (median 12 h and 57 min, range 2-127 h). We analyzed the overall incidence and distribution patterns of HARM in acute ischemic stroke cases and compared the relative incidence and distribution patterns of HARM between the subgroups of stroke etiology based on conventional TOAST classification. We obtained odds ratio (OR) of HARM in different stroke locations based on vascular territories and anatomical compartments. This study was approved by our institutional review board.
resultsAmong the 264 patients, 67 (25.38%) patients were HARM positive and 197 (74.62%) patients were HARM negative. There was significant difference in HARM incidence among the stroke subgroups (
conclusionThe presence of the HARM was significantly associated with embolic infarctions including LAA and CE. Conversely, SVO was exclusively associated with the absence of the HARM. Second, MCA and cortical infarction showed a more pronounced HARM compared to infarctions at other vascular territories and anatomic compartments. According to the results in the current study, we speculate that the presence of HARM on post-contrast FLAIR images was associated with specific stroke causes especially in embolic causes.
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