Significance and characteristics of patients with Ribbon-like signal hyperintensity after acute ischemic stroke

Abstract

Objectives:We discovered a novel finding of ribbon-like signal hyperintensity of the cerebral cortex, named the ribbon sign, after reperfusion therapy. Herein, we report the significance and clinical characteristics of ribbon signs. Materials and Methods:Data 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 findings were retrospectively assessed in patients with acute ischemic stroke with large-vessel occlusion, with or without treatment. Results:A total of 140 patients (78 males, average age:75.7 years) were enrolled in the study. Among the patients, 113 (80.7%) underwent reperfusion therapy. Eighty-one (57.9%) patients underwent successful recanalization. The ribbon sign was more common in patients with successful recanalization than in patients with unsuccessful recanalization (53.1% vs. 8.5%, respectively;p<0.01). The ribbon sign is a specific finding after successful recanalization. Conclusions:Our study is the first to report that the ribbon sign is a specific finding in patients with acute ischemic stroke. The patients with extensive DWI lesion, including those in the cortex on adimisson, exhibited the ribbon sign after successful recanalization. J. Med. Invest. 73 : 36-43, February, 2026