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The Relationship Between Lesion Localization and Dysphagia in Acute Stroke

AbstractFactors that can facilitate early identification of individuals at risk of dysphagia such as stroke location are potentially of great benefit. The aim of this study was to examine the role of hemisphere and lesion location in assessing dysphagia pattern and airway invasion as identified through the use of validated, standardized interpretation measures for the videofluoroscopic swallowing study. Consecutive patients (N = 80) presenting with stroke symptoms who had a first-time acute ischemic stroke confirmed on diffusion-weighted magnetic resonance imaging (DW-MRI) scan participated. Three swallowing outcome variables were assessed using regression models: modified barium swallow impairment profile (MBSImP) ora l impairment (OI) and pharyngeal impairment (PI) scores and penetration aspiration scale (PAS) score. Subjects were primarily male and demonstrated mild stroke and mild to moderate dysphagia. There was a significantly higher likelihood of abnormal PAS scores for infratentorial lesions compared to ri ght hemisphere location (Odds ratio: 3.1, SE: 1.8,p = 0.046) and for Whites compared to African Americans (Odds ratio: 5.5, SE: 2.6,p = 
Source: Dysphagia - Category: Speech-Language Pathology Source Type: research

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Abstract OBJECTIVE: To determine the relationship between intravoxel incoherent motion (IVIM) imaging derived quantitative metrics and serum soluble CD40 ligand (sCD40L) level in an embolic canine stroke model. MATERIALS AND METHODS: A middle cerebral artery occlusion model was established in 24 beagle dogs. Experimental dogs were divided into low- and high-sCD40L group according to serum sCD40L level at 4.5 hours after establishing the model. IVIM imaging was scanned at 4.5 hours after model establishment using 10 b values ranging from 0 to 900 s/mm(2). Quantitative metrics diffusion coefficient (D), pseudod...
Source: Korean J Radiol - Category: Radiology Authors: Tags: Korean J Radiol Source Type: research
Background and Purpose—We assessed whether the presence, number, and distribution of cerebral microbleeds (CMBs) on pre-intravenous thrombolysis MRI scans of acute ischemic stroke patients are associated with an increased risk of intracerebral hemorrhage (ICH) or poor functional outcome.Methods—We performed an individual patient data meta-analysis, including prospective and retrospective studies of acute ischemic stroke treated with intravenous tissue-type plasminogen activator. Using multilevel mixed-effects logistic regression, we investigated associations of pre-treatment CMB presence, burden (1, 2–4, ...
Source: Stroke - Category: Neurology Authors: Tags: Magnetic Resonance Imaging (MRI), Prognosis, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research
ABSTRACT BACKGROUND AND PURPOSEBlood–brain barrier (BBB) disruption detected on magnetic resonance imaging (MRI) in acute ischemic stroke as a hyperintense acute reperfusion marker (HARM) is associated with upregulation of matrix metalloproteinase‐9 (MMP‐9). Although activated leukocytes, including monocytes, are the main source of MMPs, limited data exist to support relationship between leukocyte activation and BBB disruption in patients with acute ischemic stroke. The goal of this study is to investigate the relationship between neutrophils, lymphocytes, and monocytes with BBB disruption detected as HARM (+) in...
Source: Journal of Neuroimaging - Category: Radiology Authors: Tags: Short Communication Source Type: research
Stroke mimics, especially those involving chemotherapy related neurotoxicity, can confound the clinical diagnosis of acute stroke. Here we describe the case of a 63year-old male with a recent history of stage IIIC colon cancer who presented with confusion on the second day of modified FOLFOX6 (5-fluorouracil/oxaliplatin) chemotherapy and subsequently received alteplase, tissue plasminogen activator therapy (tPA), for presumed ischemic stroke. Magnetic resonance imaging scans after tPA administration did not reveal evidence of an infarction and the patients' neurological symptoms resolved completely after discontinuation of...
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research
In this study, we established a multiparametric perfusion imaging model and cross-validated it using positron emission tomography perfusion for detection of penumbral flow.Methods—In a retrospective analysis of 17 subacute stroke patients with consecutive magnetic resonance imaging and H2O15 positron emission tomography scans, perfusion maps of cerebral blood flow, cerebral blood volume, mean transit time, time-to-maximum, and time-to-peak were constructed and combined using a generalized linear model (GLM). Both the GLM maps and the single perfusion maps alone were cross-validated with positron emission tomography-c...
Source: Stroke - Category: Neurology Authors: Tags: Imaging, Magnetic Resonance Imaging (MRI), Ischemic Stroke Original Contributions Source Type: research
Conclusions—We show that hyperglycemia primes the thromboinflammatory cascade, thus, amplifying middle cerebral artery occlusion–induced DMT. DMT exacerbation in hyperglycemic rats impaired reperfusion and precipitated neurovascular damage, blood–brain barrier disruption, and hemorrhagic transformation. Our results designate DMT as a possible target for reduction of the deleterious impact of hyperglycemia in acute ischemic stroke.
Source: Stroke - Category: Neurology Authors: Tags: Biomarkers, Inflammation, Pathophysiology, Blood-Brain Barrier, Ischemic Stroke Original Contributions Source Type: research
Authors: Xia J, Yin A, Li Z, Liu X, Peng X, Xie N Abstract BACKGROUND The aim of this study was to explore the accuracy of in vivo magnetic resonance imaging (MRI) in the quantitative evaluation of lipid-rich necrotic core (LRNC) in carotid atherosclerotic plaques compared with histopathology, and to assess the association of LRNC size with cerebral ischemia symptoms. MATERIAL AND METHODS Thirty patients were enrolled and 19 patients (16 men and 3 women) were analyzed. All the patients were submitted to MRI on a Siemens Avanto (1.5-Tesla) device before carotid endarterectomy (CEA). The scanning protocol included th...
Source: Medical Science Monitor - Category: Research Tags: Med Sci Monit Source Type: research
Background and Purpose—Perivascular spaces (PVSs) are considered markers of small vessel disease. However, their long-term prognostic implications in transient ischemic attack/ischemic stroke patients are unknown. Ethnic differences in PVS prevalence are also unknown.Methods—Two independent prospective studies were conducted, 1 comprising predominantly whites with transient ischemic attack/ischemic stroke (OXVASC [Oxford Vascular] study) and 1 comprising predominantly Chinese with ischemic stroke (University of Hong Kong). Clinical and imaging correlates, prognostic implications for stroke and death, and ethnic...
Source: Stroke - Category: Neurology Authors: Tags: Imaging, Magnetic Resonance Imaging (MRI), Prognosis, Ischemic Stroke, Transient Ischemic Attack (TIA) Original Contributions Source Type: research
We report the case of a 55-year-old patient who developed sudden-onset right-sided hemiplegia and aphasia. Computed tomography angiography showed a thrombus in the M1 segment of the left middle cerebral artery. The thrombus was removed by mechanical thrombectomy 85 min after the onset of symptoms. A magnetic resonance imaging (MRI) scan showed no infarct, and the patient was discharged symptom free. To the best of our knowledge, this is the first report of thrombectomy of a symptomatic proximal middle cerebral artery occlusion leading to complete rescue, both clinically and radiologically assessed by MRI. Our case report s...
Source: Case Reports in Neurology - Category: Neurology Source Type: research
Objective:We investigated the relationship between plaque imaging and stroke recurrence in our cohort of stroke patients with recently symptomatic carotid stenosis, using 18F-fluoro-deoxy-glucose positron emission tomography (FDG-PET)/computed tomography (CT) and high resolution magnetic resonance imaging (HR-MRI).Background:Symptomatic carotid stenosis is associated with an increased risk of early stroke recurrence. The severity of stenosis, the current basis of revascularization, explains only the cerebral ischemic mechanism of regional hypoperfusion. Plaque inflammation, the initiating event for plaque rupture and throm...
Source: Neurology - Category: Neurology Authors: Tags: Prevention of Cerebrovascular Disease Source Type: research
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