Fenstermacher MJ and Narayana PA. Serial proton magnetic resonance spectroscopy of ischemic brain injury in humans. Invest Radiol 1990;25:1034–1039. Four patients were observed serially with 1H magnetic resonance spectroscopy (MRS) at times ranging from 3 days to 10 weeks after a documented ischemic event. Spectra were obtained from 8 cc volumes in infarcted regions and contralateral matched normal regions. Reproducible variations in a-acetyl aspartate (NAA), creatine + phosphocreatine (Cr + PCr), and the sequential changes in lactate and lipid resonances are related to the pathophysiology of stroke. A conspicuous lack of significant change in the choline (Cho) resonance with concomittant decrease in NAA and Cr + PCr is reported as a possible marker of ischemic injury.
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Fenstermacher et al. (1990) studied this question.