Association Between Neurologic Improvement With Decline in Blood Pressure and Recanalization in Stroke

Conclusions and RelevanceNeurologic improvement with concurrent decline in systolic blood pressure of 20 mm Hg or greater after intravenous tissue plasminogen activator may be a clinical sign of recanalization. This observation needs confirmation in a larger cohort.
Source: JAMA Neurology - Category: Neurology Source Type: research

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HeartFlow said yesterday that it won reimbursement coverage from the Japanese Ministry of Health, Labor and Welfare for its HeartFlow FFRct fractional flow reserve analysis. The Redwood City, Calif.-based company said that it has already received approval from the Japanese Pharmaceuticals and Medical Devices Agency, and that reimbursement will go into effect beginning on December 1. “When a patient presents with symptoms suggesting CAD, we want to be able to quickly and effectively diagnose patients while reducing the need for unnecessary tests or invasive procedures. In clinical studies, we were able to see fir...
Source: Mass Device - Category: Medical Devices Authors: Tags: Business/Financial News Cardiovascular Featured Imaging Software / IT HeartFlow Source Type: news
We present a case report of a 69-year-old man who on unenhanced PMCT scan showed an empty delta sign in the cerebral veins. The empty delta sign was able to be demonstrated in unenhanced PMCT which can be explained by hyper attenuation of the dural veins at postmortem forming an internal contrast highlighting the thrombus.
Source: The American Journal of Forensic Medicine and Pathology - Category: Forensic Medicine Tags: Case Reports Source Type: research
Conclusions: There are limited reports of protamine reversal of heparin before IV-tPA administration. To our knowledge, there are only 6 AIS cases including ours. Three cases received 0.6 mg/kg of tPA dose. All have favorable outcomes and no intracranial hemorrhage was reported. Protamine reversal of heparin for AIS after CC seems to be safe. Further studies are needed to confirm the therapeutic safety and efficacy of this strategy.
Source: The Neurologist - Category: Neurology Tags: Case Report/Case Series Source Type: research
AbstractPurpose of ReviewThis review provides an updated summary of blunt cerebrovascular injury (BCVI) to guide clinicians in its early diagnosis and prevention and treatment of stroke associated with such injury.Recent FindingsUntreated BCVI causes stroke in 10 –40% of patients, but more than half will not present with stroke symptoms initially. Risk of stroke is highest in the first 7 days, with a peak in the first 24 h. Computed tomography (CT) angiography is currently the screening modality of choice, although digital subtraction angiography may sti ll be required in some cases. Antithrombotic therapy ...
Source: Current Neurology and Neuroscience Reports - Category: Neuroscience Source Type: research
CONCLUSION: In LAO patients, directly proceeding EVT following IVT may not be hesitated. In addition, while LAO patients with incomplete IV-tPA treatment responses result in transient improvement of neurological symptoms but later reversed, EVT may be a potential rescue therapy in carefully selected patients. PMID: 30315557 [PubMed - in process]
Source: Acta Neurologica Taiwanica - Category: Neurology Tags: Acta Neurol Taiwan Source Type: research
There are three key characteristics evident on CT angiography (CTA) scans that...Read more on AuntMinnie.comRelated Reading: 5 risk factors help predict brain hemorrhage on CT AI algorithm can triage head CT exams for urgent review Perfusion imaging expands window for stroke treatment CTA helps direct use of clot removal for stroke patients Color mapping boosts vessel interpretation in stroke CT
Source: Headlines - Category: Radiology Source Type: news
Authors: Befera N, Griffin AS, Hauck EF Abstract A 48-year-old woman presented with an acute ischemic stroke (National Institutes of Health Stroke Scale (NIHSS) 21) six hours after symptom onset. Workup revealed a left cervical internal carotid artery (ICA) occlusive dissection, which was emergently reconstructed with a flow-diverting stent. A routine Duplex scan one hour later suggested reocclusion of the ICA, confirmed by angiography. The true lumen of the ICA could not be accessed and therefore the "false lumen" of the ICA dissection was entered proximally. The true lumen and ultimately the flow-divert...
Source: Interventional Neuroradiology - Category: Radiology Tags: Interv Neuroradiol Source Type: research
AbstractMultiphase CT angiography (CTA) in collateral assessment provides time-resolved cerebral angiograms of the intracranial vasculature, requiring a high-speed multidetector CT (MDCT) scanner with ≥ 64 slices. Unfortunately, many hospitals are equipped with lower speed MDCT scanners. Herein, we present our experience performing dual-phase CTA (d-CTA) on a 16 slice MDCT with a biphasic rate injection to grade intracranial collaterals as predictor of clinical outcome. 42 patients were evalu ated with both dual-phase CTA (d-CTA) and single-phase CTA (s-CTA) for occluded anterior intracranial circulation and coll...
Source: Acta Neurologica Belgica - Category: Neurology Source Type: research
Conclusions: Elevated parametric parenchymal blood flow wash-in rates after thrombectomy may be associated with increased risk of hemorrhagic events.Intervent Neurol 2018;7:522 –532
Source: Interventional Neurology - Category: Neurology Source Type: research
ConclusionNo association was found between pre-existing ICA stenosis and extent of CTP derived collateral filling in patients with an M1  occlusion.
Source: Clinical Neuroradiology - Category: Neurology Source Type: research
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