Peripheral blood AKAP7 expression as an early marker for lymphocyte-mediated post-stroke blood brain barrier disruption

O’Connell, Grant C.; Treadway, Madison B.; Petrone, Ashley B.; Tennant, Connie S.; Lucke-Wold, Noelle; Chantler, Paul D.; Barr, Taura L.

Magnetic resonance imaging for assessment of HARM. MRI was performed on discovery cohort patients using a 1.5-Tesla clinical magnetic resonance system both at emergency department admission and at 24 hour follow-up. The standardized protocol included: diffusion-weighted imaging, T2-weighted gradient-recalled echo, FLAIR, and perfusion-weighted imaging. Perfusion-weighted imaging was obtained using a bolus passage of Gd-DTPA (0.1 mmol/kg). FLAIR images were assessed for location and level of HARM as previously described 8 . HARM was positivity identified by the post-contrast appearance of CSF hyperintensity in the sulci or ventricles (Fig. 1) . Level of HARM was classified based on the following criteria: no hyperintensity (none), punctate regions of hyperintensity (mild), continuous regions of hyperintensity on 1-10 consecutive images (moderate), continuous regions of hyperintensity on >10 consecutive images (severe). Images were reviewed sequentially by expert readers, blinded to clinical information.