Mapping the ischemic penumbra and predicting stroke progression in acute ischemic stroke: the overlooked role of susceptibility weighted imaging

ConclusionA positive DWI-SWI mismatch is an indicator of the ischemic penumbra and a predictor of infarct expansion if left untreated.
Source: Insights into Imaging - Category: Radiology Source Type: research

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When used together, non-contrast simple CT and CT perfusion have higher prediction rates
Source: Diagnostic Imaging - Category: Radiology Authors: Tags: CT Ischemic stroke Source Type: news
Publication date: February 2020Source: The Annals of Thoracic Surgery, Volume 109, Issue 2Author(s): Elizabeth L. Norton, Xiaoting Wu, Linda Farhat, Karen M. Kim, Himanshu J. Patel, G. Michael Deeb, Bo YangBackgroundIt is controversial if extension of aortic dissection into arch branches should be an indication for replacement of the arch and its branches in acute type A aortic dissection.MethodsFrom 2008 to April 2018, 399 patients underwent open repair for an acute type A aortic dissection, and 190 patients had known innominate and/or left common carotid artery dissection without malperfusion syndrome, including no arch ...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Abstract Stroke is one of the world's most deadly pathologies, and the rate of stroke recurrence is high. However, due to the complex nature of ischemia and reperfusion injury, there is presently no reliable treatment. The main factors driving brain damage from ischemic stroke are neuronal cell death resulting from oxidative stress, inflammation, and failure of the blood brain barrier. While under normal conditions, the blood brain barrier acts as a selectively permeable membrane allowing solutes and other substances to pass into the tissues of the central nervous system, ischemia and reperfusion alter the express...
Source: Archives of Biochemistry and Biophysics - Category: Biochemistry Authors: Tags: Arch Biochem Biophys Source Type: research
Authors: Sheen JJ, Kim YW Abstract Three randomized control trials (RCTs), published in 2013, investigated efficacy of mechanical thrombectomy in large vessel occlusions and did not show better results compared to intravenous (IV) recombinant tissue-type plasminogen activator (tPA) alone. However, most clinicians treating stroke consider mechanical thrombectomy as the standard treatment rather than using IV tPA alone. This paradigm shift was based on five RCTs investigating efficacy of mechanical thrombectomy in acute ischemic stroke conducted from 2010 to 2015. They demonstrated that mechanical thrombectomy was ef...
Source: Journal of Korean Neurosurgical Society - Category: Neurosurgery Tags: J Korean Neurosurg Soc Source Type: research
CONCLUSIONS: The collateral-based imaging paradigm using multiphase CTA compares well with CTP in selecting patients for endovascular thrombectomy in the late time window.
Source: American Journal of Neuroradiology - Category: Radiology Authors: Tags: INTERVENTIONAL Source Type: research
Conclusions: There is no justification for the use of reperfusion procedures in acute ischaemic stroke in the anterior circulation in patients with initially unfavourable multimodal computed tomography scores. PMID: 31908703 [PubMed]
Source: Videosurgery and Other Miniinvasive Techniques - Category: Surgery Tags: Wideochir Inne Tech Maloinwazyjne Source Type: research
Low-dose aspirin reduces the frequency of adverse vascular events in those at increased risk of occlusive cardiovascular disease (CVD). People who benefit include those: with a history of myocardial infarction, ischaemic stroke, unstable or stable angina, peripheral arterial disease, or atrial fibrillation (1). The pathophysiology of CVD risk contributes to cognitive decline through multiple pathways that include cerebral hypo-perfusion, hypoxia, hippocampal atrophy, emboli, or infarcts (2,3). However, the value of aspirin use in prevention of cognitive impairment remains uncertain since results relating to the influence o...
Source: Maturitas - Category: Primary Care Authors: Source Type: research
ConclusionAdding CTP and/or a delayed-phase CTA to NCCT with arterial-phase CTA improves the decision-maker ’s confidence level and creates a trend towards a lower threshold for mechanical thrombectomy.
Source: Neuroradiology - Category: Radiology Source Type: research
Conclusions: At least 27 pediatric neurocritical care centers use transcranial Doppler during clinical care. In the majority of centers, studies are performed and interpreted by credentialed personnel, and findings are used to guide clinical management. Further studies are needed to standardize these practices.
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Neurocritical Care Source Type: research
Computed tomography perfusion (CTP) is increasingly used to determine treatment eligibility for acute ischemic stroke patients. Automated postprocessing of raw CTP data is routinely used, but it can fail. In reviewing 176 consecutive acute ischemic stroke patients, failures occurred in 20 patients (11%) during automated postprocessing by the RAPID software. Failures were caused by motion (n = 11, 73%), streak artifacts (n = 2, 13%), and poor contrast bolus arrival (n = 2, 13%). Stroke physicians should review CTP results with care before they are being integrated in their decision-making process.
Source: Journal of Computer Assisted Tomography - Category: Radiology Tags: Neuroradiology Source Type: research
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