Endovascular stroke treatment using balloon guide catheters may reduce penumbral tissue damage and improve long-term outcome
ConclusionsThe lowered MD index early after mechanical recanalization without BGC usage can be interpreted as microstructural ischemic damage of the salvaged penumbra. It was shown that achieving complete reperfusion in a setting of BGC usage with proximal flow arrest minimizes penumbral damage and improves long-term outcomes.Key Points• Microstructural ischemic damage can be reduced by using proximal flow arrest during endovascular treatment with balloon guide catheter.• Complete reperfusion in a setting of balloon guide catheter minimizes penumbral damage and improves long-term outcome.
ConclusionIn our population, data suggest improved outcomes after EVT in carotid-I occlusion patients and provide no arguments to withhold EVT in these patients.
AbstractPurposeComputed tomography angiography (CTA) is routinely used to detect large-vessel occlusion (LVO) in patients with suspected acute ischemic stroke; however, visual analysis is time consuming and prone to error. To evaluate solutions to support imaging triage, we tested performance of automated analysis of CTA source images (CTASI) at identifying patients with LVO.MethodsStroke patients with LVO were selected from a prospectively acquired cohort. A control group was selected from consecutive patients with clinically suspected stroke without signs of ischemia on CT perfusion (CTP) or infarct on follow-...
Conclusions: Changes in retinal microvasculature identified using OCTA are associated with monogenic SVD and different stages of AD, but data are limited and partly confounded by methodological differences. Larger studies with risk factors adjustment and more consistent OCTA methods are needed to fully exploit this technology.PROSPERO registration number: CRD42020166929.
Conclusion: Prompt recognition of acute onset hemichorea-hemiballismus as the manifestation of acute ischemic stroke in appropriate clinical setting may reduce diagnostic delay. Multiple imaging techniques including cerebral digital subtraction angiography and HR-MRI can be applied to diagnosis and further clarify the mechanism of stroke, which facilitate in selection of secondary prevention therapies.
The management of acute ischemic stroke (AIS) has rapidly evolved over the last decade with the advancement in neuroimaging selection methods and endovascular treatment techniques. CT perfusion (CTP) with automated post-processing is the most widely used technique for extended-time window selection of patients for intra-arterial interventions based on recent clinical trials.1,2 CTP provides predictive information about stroke outcome, however the predictive ability remains moderate with area under the curve (AUC) approximately 0.6.
ConclusionsAlthough SPECT imaging still represents the gold standard for CBF assessment, our results suggest that data obtained using DSC perfusion technique, and in particular MTT maps, might be a very useful and noninvasive tool for evaluating hemodynamic status in MMS-NF1 patients.
The importance of quick door-to-needle times for patients with focal cerebral ischaemia who are candidates for thrombolysis, and the emergence of mechanical thrombectomy as an effective treatment for large vessel occlusion ischaemic stroke, underlines the importance of early imaging and timely intervention. In this article we cover the main imaging modalities, including computed tomography (CT), CT angiography, magnetic resonance imaging, digital subtraction angiography and perfusion imaging.
In this study, 5% of VF arrest was due to PE: V fib is initial rhythm in PE in 3 of 60 cases. On the other hand, if the presenting rhythm is PEA, then pulmonary embolism is likely. When there is VF in PE, it is not the initial rhythm, but occurs after prolonged PEA renders the myocardium ischemic.--Another study by Courtney and Kline found that, of cases of arrest that had autopsy and found that a presenting rhythm of VF/VT had an odds ratio of 0.02 for massive pulmonary embolism as the etiology, vs 41.9 for PEA. ===================================MY Comment by KEN ...
Conclusion: Direct compression of ICA is rare complication of pituitary apoplexy, which caused cerebral ischemia. Conventional angiography should be necessary for accurate diagnosis and prompt surgical decompression should be the treatment of choice. PMID: 32494388 [PubMed]
Conclusion: Compared to pCT, DECT within 36 h after IV thrombolysis for acute ischemic stroke, changes the radiological diagnosis of post-treatment ICH to “CS only” in a small proportion of patients. Studies are warranted of whether the altered radiological reports have an impact on patient management, for example initiation timing of antithrombotic secondary prevention.