Intravenous Thrombolysis Outcomes in Patients Presenting with Large Vessel Acute Ischemic Strokes—CT Angiography‐Based Prognosis

ABSTRACT BACKGROUND AND PURPOSETo establish outcome rates for patients receiving intravenous thrombolysis based on vascular occlusion site. METHODSThis is a retrospective analysis of 225 patients who had received intravenous‐rt‐PA for anterior circulation strokes. The occlusion‐site was prospectively determined on the admission computed tomographic angiography (CTA) and divided into: large vessel occlusion (LVO) including patients with an internal carotid artery terminus or middle cerebral artery (M1/proximal M2) occlusions and no large vessel occlusion (No‐LVO; distal M2/M3/ACA) including patients with either distal or no occlusions. The primary outcome was the modified Rankin score (mRS) at 90‐days with a good outcome defined by mRS of 0‐2.000. RESULTSThere were 114 (50.7%) patients in the LVO and 111 (49.3%) in the No‐LVO group. A good outcome was seen in 28 (24.6%) patients in the LVO and 77 (69.4%) patients in the No‐LVO group (OR .14; 95% CI: .08‐.26; P
Source: Journal of Neuroimaging - Category: Radiology Authors: Tags: Clinical Investigative Study Source Type: research

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ConclusionsTwenty-and-a-half syndrome is reported for the first time. It is due to posterior circulation stroke; in our case, it was due to lacunar infarcts in the pons and medulla, manifesting as one-and-a-half syndrome with bilateral seventh and right fifth nerve palsy.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Publication date: Available online 7 February 2019Source: Interdisciplinary NeurosurgeryAuthor(s): Kamil Zeleňák, Martin Vorčák, Ján Sýkora, Zuzana Trabalková, Jana Zeleňáková, Ema Kantorová, Vladimír NosáľAbstractA 55-year-old woman with acute ischaemic stroke was referred for endovascular treatment after unsuccessful intravenous thrombolysis. Her initial National Institutes of Health Stroke Score (NIHSS) was 20. The right carotid artery stenting was performed because of the inappropriate result of angioplasty of the right internal carotid artery st...
Source: Interdisciplinary Neurosurgery - Category: Neurosurgery Source Type: research
Conclusions: AIS caused by small branches occlusion could benefit from intra-arterial urokinase thrombolysis, and the risk of intracerebral hemorrhage was not significantly higher.Eur Neurol 2018;80:277 –282
Source: European Neurology - Category: Neurology Source Type: research
ConclusionA  high CFD may serve as reproducible measure for collateralization and indicate development of increased risk of space-occupying infarction.
Source: Clinical Neuroradiology - Category: Neurology Source Type: research
AbstractBackground and PurposeRuptured blister-like aneurysms (BLAs) are challenging lesions to treat, without any consensus on their management. Few studies have evaluated the safety and effectiveness of flow diverter stents (FDS) for this indication, with promising results. The goal was to evaluate the safety and effectiveness of a  delayed (≥5 days) flow diversion strategy for the treatment of ruptured intracranial BLAs.Material and MethodsA  monocentric retrospective analysis of a prospectively collected database of intracranial aneurysms was performed. Eight consecutive patients with 9 ruptured ...
Source: Clinical Neuroradiology - Category: Neurology Source Type: research
AbstractPurpose of ReviewHere, we describe the four primary imaging modalities for identification of carotid artery dissection, advantages, limitations, and clinical considerations. In addition, imaging characteristics of carotid dissection associated with each modality will be described.Recent FindingsRecent advances in etiopathogenesis describe the genetic factors implicated in cervical artery dissection. MRI/MRA (magnetic resonance angiography) with fat suppression is regarded as the best initial screening test to detect dissection. Advances in magnetic resonance imaging for the diagnosis of dissection include the use o...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research
Publication date: Available online 19 December 2018Source: Journal of Clinical NeuroscienceAuthor(s): Nattaphol Uransilp, Pornpatr A. Dharmasaroja, Arvemas Watcharakorn, Sombat MuengtaweepongsaAbstractMultiphase computed tomography angiography (CTA) provides information on the status of major cranial arteries and extent of brain collateralization. The purpose of the study was to determine whether implementation of multiphase CTA in routine clinical practice was feasible, safe and useful. Patients with acute ischemic stroke (NIHSS ≥ 6) were included. Multiphase CTA was performed. Duration of performing multiphase CTA...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
Conclusions: In-hospital strokes and acute LVOs are common in LVAD-associated AIS. Prompt evaluation with CTA and endovascular therapy should be pursued for these critically ill patients.Cerebrovasc Dis 2018;46:213 –217
Source: Cerebrovascular Diseases - Category: Neurology 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
This study aimed to assess the evolution of imaging patterns over time in patients with neurological complications caused by reversible cerebral vasoconstriction syndrome.MethodsA  total of 24 consecutive patients with reversible cerebral vasoconstriction syndrome presenting between 2009 and 2016 were included, whose disease course was complicated by intracranial hemorrhage and/or ischemic events. In total 55 angiographic studies were carried out. The nature of the intracran ial complication and location of vasoconstriction on the angiograms in relation to the time interval since symptom-onset were assessed.ResultsCom...
Source: Clinical Neuroradiology - Category: Neurology Source Type: research
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