A Systemized Stroke Code Significantly Reduced Time Intervals for using Intravenous Tissue Plasminogen Activator under Magnetic Resonance Imaging Screening

A stroke code can shorten time intervals until intravenous tissue plasminogen activator (IV t-PA) treatment in acute ischemic stroke (AIS). Recently, several reports demonstrated that magnetic resonance imaging (MRI)–based thrombolysis had reduced complications and improved outcomes in AIS despite longer processing compared with computed tomography (CT)–based thrombolysis.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research

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This study aimed to identify the minimal degree of midline shift (MLS) that predicts outcome in a cohort encompassing a broad range of patients with acute stroke.MethodsPatient-level data from six acute stroke clinical trials were combined with endovascular thrombectomy registries from two academic referral centers, generating a combined cohort of 1977 patients. MLS was extracted from the original trial data or measured on computed tomography or magnetic resonance imaging that was obtained a median of 47.0  h (interquartile range 27.0–75.1 h) after stroke onset. Logistic regression was performed to identify...
Source: Neurocritical Care - Category: Neurology Source Type: research
Conclusion: Intraplaque enhancement and intracranial vertebral artery plaques seem to be more closely associated with A-to-A embolism than parent artery disease in patients with symptomatic intracranial vertebrobasilar disease.Clinical Trial Registration:http://www.clinicaltrials.gov, identifier: NCT02705599.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Objective: Asymmetrical cortical vein sign (ACVS) shown on susceptibility-weighted imaging (SWI) can reflect regional hypoperfusion. We investigated if ACVS could predict the cerebral collateral circulation (CC) as assessed by digital subtraction angiography (DSA) in acute ischemic stroke patients with ipsilateral severe stenosis/occlusion of the anterior circulation.Methods: Clinical data and imaging data of 62 acute ischemic stroke patients with ipsilateral severe stenosis or occlusion of the anterior circulation confirmed by DSA were collected retrospectively. Participants underwent magnetic resonance imaging, including...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conclusion: This report suggests that patients with MMD may be susceptible to PRES. It highlights the importance of considering PRES as a differential diagnosis while providing care to MMD patients with concurrent acute neurological symptoms and a prompt intervention contributes to a favorable clinical prognosis.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Rupture of a vulnerable carotid plaque is an important cause of ischemic stroke. Prediction models can support medical decision-making by estimating individual probabilities of future events, while magnetic resonance imaging (MRI) can provide detailed information on plaque vulnerability. In this review, prediction models for medium to long-term (>90 days) prediction of recurrent ischemic stroke among patients on best medical treatment for carotid stenosis are evaluated, and the emerging role of MRI of the carotid plaque for personalized ischemic stroke prediction is discussed. A systematic search identified two models; ...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Stroke is a leading cause of disability and mortality, and the incidence of ischemic stroke is projected to continue to rise in coming decades. These projections emphasize the need for improved imaging techniques for accurate diagnosis allowing effective treatments for ischemic stroke. Ischemic stroke is commonly evaluated with computed tomography (CT) or magnetic resonance imaging (MRI). Noncontrast CT is typically used within 4.5 hours of symptom onset to identify candidates for thrombolysis. Beyond this time window, thrombolytic therapy may lead to poor outcomes if patients are not optimally selected using appropriate...
Source: Topics in Magnetic Resonance Imaging - Category: Radiology Tags: Review Articles Source Type: research
Intravenous thrombolysis is the cornerstone of acute ischemic stroke treatment. However, the benefits of recanalization and reperfusion must be balanced against the risk of intracranial hemorrhage. Time from symptom onset was previously the most important selection tool for identifying patients who would benefit from treatment without prohibitive risk for secondary hemorrhage. Enhanced techniques in noncontrast computed tomography followed by computed tomography and magnetic resonance perfusion imaging led to the expansion of treatment eligibility for intravenous thrombolysis. Perfusion imaging allows for more precise eval...
Source: Topics in Magnetic Resonance Imaging - Category: Radiology Tags: Review Articles Source Type: research
Int Angiol. 2021 Jul 27. doi: 10.23736/S0392-9590.21.04751-9. Online ahead of print.ABSTRACTThe optimal management of patients with asymptomatic carotid stenosis (ACS) is the subject of extensive debate. According to the 2017 European Society for Vascular Surgery guidelines, carotid endarterectomy should (Class IIa; Level of Evidence: B) or carotid artery stenting may be considered (Class IIb; Level of Evidence: B) in the presence of one or more clinical/imaging characteristics that may be associated with an increased risk of late ipsilateral stroke (e.g. silent embolic infarcts on brain computed tomography/magnetic resona...
Source: International Angiology - Category: Cardiology Authors: Source Type: research
Int Angiol. 2021 Jul 27. doi: 10.23736/S0392-9590.21.04751-9. Online ahead of print.ABSTRACTThe optimal management of patients with asymptomatic carotid stenosis (ACS) is the subject of extensive debate. According to the 2017 European Society for Vascular Surgery guidelines, carotid endarterectomy should (Class IIa; Level of Evidence: B) or carotid artery stenting may be considered (Class IIb; Level of Evidence: B) in the presence of one or more clinical/imaging characteristics that may be associated with an increased risk of late ipsilateral stroke (e.g. silent embolic infarcts on brain computed tomography/magnetic resona...
Source: International Angiology - Category: Cardiology Authors: Source Type: research
Int Angiol. 2021 Jul 27. doi: 10.23736/S0392-9590.21.04751-9. Online ahead of print.ABSTRACTThe optimal management of patients with asymptomatic carotid stenosis (ACS) is the subject of extensive debate. According to the 2017 European Society for Vascular Surgery guidelines, carotid endarterectomy should (Class IIa; Level of Evidence: B) or carotid artery stenting may be considered (Class IIb; Level of Evidence: B) in the presence of one or more clinical/imaging characteristics that may be associated with an increased risk of late ipsilateral stroke (e.g. silent embolic infarcts on brain computed tomography/magnetic resona...
Source: International Angiology - Category: Cardiology Authors: Source Type: research
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