Which imaging before reperfusion strategy?

Which imaging before reperfusion strategy? Rev Neurol (Paris). 2017 Oct 13;: Authors: Olivot JM Abstract The ischemic penumbra is a transient and potentially reversible condition. Therefore, infarct progression and its counterpart penumbral salvage are highly variable and result from the interaction of 3 major factors: collateral flow, revascularization delay and success. Multimodal brain imaging now offers in clinical practice an exhaustive characterization of the acute ischemic injury: vessel site occlusion, infarction/critical hypoperfusion volume, and collateral flow. From 1995 to 2015, IV alteplase administered within 4.5hours after the onset of acute BI diagnosed by the absence of hemorrhage on a non-contrast head CT scan has been the only approved revascularization treatment. Over the past 2years, 6 randomized trials have confirmed the benefit of a thrombectomy performed within 6-8 hours after the onset of an acute anterior BI downstream of an ICA/M1 occlusion. The recommended imaging modality for such patients remains a NCCT to exclude an hemorrhage and a CTA to confirm the proximal vessel occlusion. As a consequence, in the absence of collateral or penumbral imaging, studies and meta-analyses, have emphasized the importance of treatment delay on the outcome of patient after a revascularisation treatment (tPA/thrombectomy). These findings have supported the development of mobile stroke unit for tPA administration and the direct transfer of the pat...
Source: Revue Neurologique - Category: Neurology Tags: Rev Neurol (Paris) Source Type: research

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Conclusion: This study is the first to signify that the risks of mortality and atherosclerotic complications in HD patients with new-onset SSHL are increased. Therefore, we should pay attention to risks of mortality and atherosclerotic events in HD patients with new-onset SSHL.
Source: Otology and Neurotology - Category: ENT & OMF Tags: SENSORINEURAL HEARING LOSS AND TINNITUS Source Type: research
CONCLUSION: MMA remains a rare cerebrovascular disease in Europe and requires multidisciplinary care. Epidemiological analysis showed differences with the Asian population, especially the predominance of ischemic forms in adults. PMID: 30447881 [PubMed - as supplied by publisher]
Source: Revue Neurologique - Category: Neurology Tags: Rev Neurol (Paris) Source Type: research
Nico Corp. said today that it raised nearly $13 million in a Series B round from a group of existing backers for its line of neurosurgery devices. Indianapolis-based Nico said the $12.5 million round is earmarked for new product development and commercialization, clinical and economic studies, growing its sales and clinical teams, and expanding its footprint in Europe. “Our shareholders have again confirmed their commitment and confidence in the value and outcomes of Nico technologies and our ability to both grow and create new markets in neurosurgery,” president &CEO Jim Pearson said in prepared remar...
Source: Mass Device - Category: Medical Devices Authors: Tags: Featured Funding Roundup Neurological Surgical Wall Street Beat Nico Corp. Source Type: news
ConclusionsPediatric stroke is associated with poor prognosis in a substantial number of patients in short term, with CSVT having the worst prognosis. Not only ischemic but also hemorrhagic stroke were presented with detailed patient characteristics, with a full thrombosis panel achieved for most ischemic stroke patients.This article is protected by copyright. All rights reserved.
Source: Pediatrics International - Category: Pediatrics Authors: Tags: Original Articles Source Type: research
This article is protected by copyright. All rights reserved.
Source: Annals of Neurology - Category: Neurology Authors: Tags: Research Article Source Type: research
CONCLUSIONS: PA use may reduce initial stroke severity in AT stroke and the risk of END, and can improve functional outcome at three months irrespective of stroke subtypes. PMID: 30429408 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
CONCLUSION:: Sentinel infrastructure generated preliminary data that supported planning and implementation of a large pragmatic trial embedded in health plans. This planning identified unanticipated challenges that must be addressed in similar trials. PMID: 30445835 [PubMed - as supplied by publisher]
Source: Clinical Trials - Category: Research Authors: Tags: Clin Trials Source Type: research
ConclusionsMore than three retriever passes may increase the rate of recanalization, but not the likelihood of favorable functional outcomes in ischemic stroke patients treated with mechanical thrombectomy. Notably, multiple retriever passes may also increase the risk of intracranial hemorrhage.Evidence-Based MedicineLevel of Evidence: Level 4, Case Series.
Source: CardioVascular and Interventional Radiology - Category: Radiology Source Type: research
AbstractPurposeThe aim of this study is to assess the feasibility of aspiration mechanical thrombectomy in patients with massive and submassive pulmonary embolism (PE) and contraindications to thrombolysis.Materials and MethodsEighteen patients presenting massive (8/18) or submassive (10/18) PE were prospectively enrolled between October 2016 and November 2017. All the patients enrolled had contraindications to thrombolysis (haemorrhagic stroken = 1, ischaemic stroke in the preceding 6 monthsn = 7, central nervous system damage or neoplasmsn = 1, recent major trauma/surgery/he...
Source: CardioVascular and Interventional Radiology - Category: Radiology Source Type: research
Publication date: December 2018Source: The Lancet Neurology, Volume 17, Issue 12Author(s): Audrey M Thiebaut, Maxime Gauberti, Carine Ali, Sara Martinez De Lizarrondo, Denis Vivien, Manuel Yepes, Benoit D RousselSummaryAlthough recent technical advances in thrombectomy have revolutionised acute stroke treatment, prevalence of disability and death related to stroke remain high. Therefore, plasminogen activators—eukaryotic, bacterial, or engineered forms that can promote fibrinolysis by converting plasminogen into active plasmin and facilitate clot breakdown—are still commonly used in the acute treatment of ischa...
Source: The Lancet Neurology - Category: Neurology Source Type: research
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