Brain oscillatory activity and CT perfusion in hyper-acute ischemic stroke

ConclusionThe results of this preliminary study show that the combined use of EEG and CTP, as highly available techniques, in acute ischemic stroke may be helpful in clinical practice and provide information about functional and metabolic aspects of brain involvement. The joint use of these methodologies may give a better clinical insight of the functionality of injured area in the hyperacute phase.
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research

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AbstractThe RAPID © software is the most commonly used computed tomography perfusion (CTP) software in stroke centers. It is estimated that about 1300 hospitals in the world are using this software for decision-making in ischemic stroke. The software provides the estimated volume of infarction and ischemic penumbra, so it is the backbone of treatment planning in these patients. In this manuscript, we present two cases of subacute infarction with misleading CTP using RAPID© software. We believe that given the popularity of this software and increasing application of CTP in subacute infarction, this pitfall is like...
Source: Emergency Radiology - Category: Emergency Medicine Source Type: research
AbstractIt has been proposed that intracranial pressure (ICP) elevation and collateral failure are responsible for unexplained early neurological deterioration (END) in stroke. The study ’s aims were to investigate whether cerebral spinal fluid (CSF) dynamics, rather than edema, are responsible for elevation of ICP after ischemic stroke. Permanent middle cerebral artery occlusion (pMCAO) was induced with an intraluminal filament. At 24 h after stroke, baseline ICP was measured an d CSF dynamics were probed via a steady-state infusion method. Diffusion-weighted imaging (DWI) and T2-weighted magnetic resonance ima...
Source: Translational Stroke Research - Category: Neurology Source Type: research
In this study, we tried to translate this concept, the initiation of intraventricular NO application on top of continuous Molsidomine infusion, from awake to comatose patients who lack neurological –clinical monitoring but are primarily monitored using frequently applied transcranial Doppler (TCD).MethodsIn this observational, retrospective, nonrandomized feasibility study, 18 consecutive aSAH comatose/intubated patients (Hunt and Hess IV/V with/without pupil dilatation) whose poor clinical status precluded clinical monitoring received standard neuro-intensive care, frequent TCD monitoring, continuous intravenous Mol...
Source: Neurocritical Care - Category: Neurology Source Type: research
BACKGROUND AND PURPOSE: Leukoaraiosis frequently coexists in patients with acute stroke. We studied whether leukoaraiosis could confound the interpretation of CTP findings in patients treated with mechanical thrombectomy. MATERIALS AND METHODS: We analyzed 236 patients with stroke treated with mechanical thrombectomy and studied with CTP, of whom 127 (53.8%) achieved complete reperfusion. Periventricular white matter hyperintensities on MR imaging and hypodensities on NCCT were assessed through the Fazekas score. CTP-predicted nonviable tissue was defined as relative CBF
Source: American Journal of Neuroradiology - Category: Radiology Authors: Tags: INTERVENTIONAL Source Type: research
Conclusion: Our results suggest that the prevalence of perfusion abnormality is high as assessed by RAPID using the parametric Tmax  4 s. History of hypertension is a strong predictor of focal perfusion abnormality as calculated by RAPID on Tmax map of TIA patients with negative DWI findings.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Abstract Important milestones of acute ischemic stroke (AIS) treatment were achieved in recent years. The results of two randomized controlled trials revealed that intravenous thrombolysis is efficacious for treatment of AIS patients with a symptom onset
Source: Der Nervenarzt - Category: Neurology Authors: Tags: Nervenarzt 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
AbstractObjectivesTo compare collateral status on single-phase CT angiography (sCTA) and multiphase CT angiography (mCTA) and their ability to predict a target mismatch on CT perfusion (CTP) and clinical outcome in patients with acute ischemic stroke (AIS).MethodsSeventy-three AIS patients with stroke onset between 5 and 15  h or with unclear onset time and occlusions in the M1/M2 segment of the middle cerebral artery and/or intracranial internal carotid artery underwent head non-contrast CT and CTP. Simulated sCTA and mCTA were reconstructed from CTP data and were compared for collaterals assessment. The ability to p...
Source: European Radiology - Category: Radiology Source Type: research
AbstractPurposeTo determine the optimal combination of low b ‑values to generate perfusion information from intravoxel incoherent motion (IVIM) in patients with acute ischemic stroke (AIS) considering the time constraints for these patients.MethodsA retrospective cohort study of AIS patients with IVIM MRI was performed. A two-step voxel-by-voxel postprocessing was used to derive IVIM perfusion fraction maps with different combinations of b  values. Signal values within regions of ischemic core, non-infarcted ischemic hemisphere, and contralateral hemisphere were measured on IVIM (f, D*,fD*, D) parameter maps. Bland-...
Source: Clinical Neuroradiology - Category: Neurology Source Type: research
This article reviews PCT for the evaluation of AIS patients.
Source: Radiologic Clinics of North America - Category: Radiology Authors: Source Type: research
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