الفهرس 
CEREBROVASCULAR STROKEOnly 14 pages are availabe for public view
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Abstract
Background: Stroke is the second highest cause of death globally and a leading cause of disability, with an increasing incidence in developing countries.D-dimer (D-D) is the ultimate product of plasmin-mediated degradation of fibrin-rich thrombi. D-D is a simple readily accessible biomarker employed within the diagnostic algorithms for the exclusion of venous thromboembolism. The correlation between D-D and infarct size in MRI brain in acute stroke patients and predict their functional outcome by using modified Rankin scale (mRS) has not been fully investigated before.
Objectives: We aimed to investigate correlation between plasma D-Dimer level and the ischemic lesion size of non-lacunar MCA infarction in MRI brain and predict functional outcome of these patients.
Patients and methods: This cross sectional study Included 30 acute ischemic stroke (MCA) patients fulfilled the inclusion and exclusion criteria admitted to Stroke Unites of Ain Shams University hospitals in which particle-enhanced, immunoturbidimetric assay to detect plasma D-Dimer concentration measured upon admission. additionally, demographic, clinical, laboratory, and neuroimaging information was abstracted. Also, using mdified Rankin scale (mRS) to follow up patients as a tool to assess functional outcome.
Results: In this study there was a statistically significant positive correlation between of D-dimer levels on admission and the initial infarction volume in MRI (DWI) (Test-value)=21.28 and p-value.000). The Increase of D-dimer level was associated with increase of the initial infarction volume in MRI and vice versa. There was direct statistically significant positive correlation between the D-dimer and the mRS scores of the patients (r=.155 and p- value =.005)and the best cut- off limit of D-dimer levels done to patients early after admission (in the 1st 24 hours) in predicting poor outcome was 650 ng/ml which achieves 85.71 % sensitivity and 87.5% specificity.
Conclusion: The plasma D-D biomarker can be a simple readily available test reliable predictor of infarct lesion size in DW-MRI and functional outcome for patients with ischemic stroke in union with the common practice instrumental tests.