Perfusion CT matters more than time to stroke treatment

For ischemic stroke patients who are candidates for revascularization, CT perfusion...Read more on AuntMinnie.comRelated Reading: Mobile stroke units, spectral CT take spots on ECRI watch list DWI-MRI shows which stroke patients need fast therapy Mobile stroke unit with CT improves survival, recovery CT reveals cardioembolic stroke that echo misses Mobile stroke unit with CT scanner speeds care in Cleveland
Source: AuntMinnie.com Headlines - Category: Radiology Source Type: news

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Written by Meyers, edits by SmithA 50-ish year old man was working construction when he suddenly collapsed. Coworkers started CPR within 1 minute of collapse. EMS arrived within 10 minutes and continued CPR and ACLS, noting alternating asystole and sinus bradycardia during rhythm checks. He received various ACLS medications and arrived at the ED with a perfusing rhythm.Initial vitals included heart rate around 100 bpm and BP 174/96. Here is his initial ECG, very soon after ROSC:What do you think?Sinus tachycardia.  There is incomplete RBBB (QRS duration less than 120 ms).  There is diffuse STD, maximal in V4-V5 a...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Publication date: Available online 16 October 2019Source: Epilepsy &BehaviorAuthor(s): Giada Pauletto, Francesco Bax, Gian Luigi Gigli, Simone Lorenzut, Lorenzo Verriello, Elisa Corazza, Mariarosaria ValenteAbstractAim of the studyThe aim of the study was to evaluate the clinical characteristics of patients with previous stroke (either ischemic or hemorrhagic), who developed status epilepticus (SE) mimicking a stroke relapse.Materials and methodsWe performed a retrospective cohort study of patients brought to hospital by the emergency service between December 2016 and January 2018 with a stroke code as possible candida...
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
Abstract AIM OF THE STUDY: The aim of the study was to evaluate the clinical characteristics of patients with previous stroke (either ischemic or hemorrhagic), who developed status epilepticus (SE) mimicking a stroke relapse. MATERIALS AND METHODS: We performed a retrospective cohort study of patients brought to hospital by the emergency service between December 2016 and January 2018 with a stroke code as possible candidates for intravenous thrombolysis and who had already have a previous stroke. Among them, patients admitted for negative symptoms and finally discharged with a diagnosis of SE mimicking stroke...
Source: Epilepsy and Behaviour - Category: Neurology Authors: Tags: Epilepsy Behav Source Type: research
Conclusion: This case report suggests that further randomized studies may evaluate whether repeated IVtPA may be safe and effective in ERS occurring shortly after a previous stroke when patients experience a period of complete neurological regression, minor disability, and a small infarct volume. Should the hypothesis be confirmed, small volume core and wide volume penumbra at perfusion CT may support the decision of adopting IVtPA repetition.
Source: The Neurologist - Category: Neurology Tags: Case Report/Case Series Source Type: research
AbstractThis technical note describes a novel CT scan protocol that includes a non-enhanced CT, dynamic CTA, and perfusion of the whole brain and CTA of the carotid arteries using a 320-row area detector CT scanner, with a unique contrast injection and acceptable radiation exposure dose in patients presenting with acute ischemic stroke. The acquisition parameters and reconstruction parameters will be discussed including the use of model-based iterative reconstruction (MBIR), time summing (tMIP), and subtraction techniques to optimize the results of this protocol.Key Points• Scanning on a 320-row area detector CT can a...
Source: European Radiology - Category: Radiology Source Type: research
In this issue of JAMA Neurology, Sarraj et al report on the clinical and radiologic outcomes in an observational cohort of 105 patients who had extensive ischemic changes on noncontrast computed tomographic (CT) scans (Alberta Stroke Program Early CT Scores [ASPECTS] of 0-5) or CT perfusion scans with ischemic core volume greater than 50 mL and who were treated within 24 hours of stroke onset with endovascular thrombectomy or medical management. All but 1 of the patients who received endovascular treatment and were included based on low ASPECTS had a score of 4 or 5. The ASPECTS regions are not volumetrically or functional...
Source: JAMA Neurology - Category: Neurology Source Type: research
Publication date: Available online 16 July 2019Source: Academic RadiologyAuthor(s): Ruoyao Cao, Yun Jiang, Jun Lu, Guogeng Wu, Lei Zhang, Juan ChenRationale and ObjectivesTo describe the application of time maximum intensity projection CTA (t-MIP CTA) in acute ischemic stroke and compare t-MIP CTA and single-phase CTA (sCTA) in assessing collateral circulation and predicting prognosis.Materials and MethodsTwenty-nine acute ischemic stroke patients who underwent one-stop CT angiography (CTA)-CT perfusion scan were reviewed retrospectively. sCTA and t-MIP CTA were developed by CT perfusion scanning data. Image quality and co...
Source: Academic Radiology - Category: Radiology Source Type: research
iSchemaView today announced that it received registration approval in Japan for its Rapid imaging platform. The company received registration approval through the Japanese Pharmaceutical Affairs Law and through a third party review by the Japanese Assn. for the Advancement of Medical Equipment for the Rapid imaging platform. Rapid is designed to give physicians a fast, fully automated and easy-to-interpret imaging system that can help doctors make clinical decisions about stroke. “Stroke remains the fourth most common cause of death in Japan, and as the population ages, stroke is likely to become an increasing health...
Source: Mass Device - Category: Medical Devices Authors: Tags: Cardiovascular Hospital Care Imaging ischemaview Source Type: news
In this study, we identify a link between members of the genus Veillonella and exercise performance. We observed an increase in Veillonella relative abundance in marathon runners postmarathon and isolated a strain of Veillonella atypica from stool samples. Inoculation of this strain into mice significantly increased exhaustive treadmill run time. Veillonella utilize lactate as their sole carbon source, which prompted us to perform a shotgun metagenomic analysis in a cohort of elite athletes, finding that every gene in a major pathway metabolizing lactate to propionate is at higher relative abundance postexercise. Us...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Simple human dignity and self-ownership demands the right to end one's own life on one's own terms, and to be able to help others achieve this goal where they are not capable of doing so themselves. Yet these acts remain forbidden to most people in most parts of the world. Painless, effective euthanasia requires medical assistance, and providing that service remains largely illegal. This state of affairs is slowly starting to change in the US, however, and so late last year the first cryopreservation following voluntary euthanasia took place. Cryopreservation is the only presently available end of life option that o...
Source: Fight Aging! - Category: Research Authors: Tags: Of Interest Source Type: blogs
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