The significance and characteristics of the patients with Ribbon-like signal hyperintensity after acute ischemic stroke

BackgroundWe discovered a novel finding of ribbon-like signal hyperintensity of the cerebral cortical gyri, named the ribbon sign, after reperfusion therapy. Herein, we report the significance and clinical characteristics of ribbon signs. MethodsData from consecutive patients with acute ischemic stroke and anterior large-vessel occlusion were prospectively extracted from the Tokushima University Hospital Stroke Registry between January 2011 and March 2020. Diffusion-weighted imaging (DWI) was retrospectively assessed in patients with acute ischemic stroke with large-vessel occlusion, with or without treatment. ResultsA total of 140 patients (78 males, Average age: 75.7 years) were enrolled in the study. The mean DWI-Alberta Stroke Program Early Computed Tomography Score (DWI- ASPECTS) was 7.0. Among the patients, 113 (80.7%) underwent reperfusion therapy and 95 (67.9%) had unfavorable outcomes. Eighty-one (57.9%) patients underwent successful recanalization. The ribbon sign was more common in patients with successful recanalization than in the patients with unsuccessful recanalization (53.1% vs. 8.5%, respectively; p<0.01). ConclusionOur study is the first to report that the ribbon sign is a specific finding after successful recanalization in patients with acute ischemic stroke.