Diffusion‐weighted imaging and diagnosis of transient ischaemic attack

Abstract Background: Magnetic resonance (MR) diffusion‐weighted imaging (DWI) is sensitive to small acute ischaemic lesions and might help diagnose transient ischaemic attack (TIA). Reclassification of patients with TIA and a DWI lesion as ‘stroke’ is under consideration. We assessed DWI positivity in TIA and implications for reclassification of stroke. Methods: We searched multiple sources, without language restriction, from January 1995 to July 2012. We used PRISMA guidelines, included studies that provided data on patients presenting with suspected TIA who underwent MR DWI and reported the proportion with an acute DWI lesion. We performed univariate random effects meta‐analysis to determine DWI positive rates and influencing factors. Results: We included 47 papers, 9,078 patients (range 18 to 1,693). Diagnosis was by a stroke specialist in 26/47 studies (55%); all studies excluded TIA mimics. The pooled proportion of TIA patients with an acute DWI lesion was 34.3% (95% CI 30.5%‐38.4%), range 9% to 67% (I2=89.3%). Larger studies (n>200) had lower DWI‐positive rates (29%, 95%CI 23.2‐34.6%) than smaller (n
Source: Annals of Neurology - Category: Neurology Authors: Tags: Research Article Source Type: research

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ConclusionDuring COVID-19 pandemic, TIA and minor stroke consistently reduced compared to the same timeframe in 2019. Longer stroke-to-call and door-to-scan times, attributable to change in citizen behavior and screening at hospital arrival, did not impact on stroke-to-treatment time. Mothership model might have minimized the effects of the pandemic on the stroke care organization.
Source: Neurological Sciences - Category: Neurology Source Type: research
AbstractPurposeTo evaluate a  novel flow-independent 3D isotropic REACT sequence compared with CE-MRA for the imaging of extracranial arteries in acute ischemic stroke (AIS).MethodsThis was a  retrospective study of 35 patients who underwent a stroke protocol at 3 T including REACT (fixed scan time: 2:46 min) and CE-MRA of the extracranial arteries. Three radiologists evaluated scans regarding vessel delineation, signal, and contrast and assessed overall image noise and artifacts using 5-point scales (5: excellent delineation/no artifacts). Apparent signal- and contrast-to-noise ratios (aS...
Source: Clinical Neuroradiology - Category: Neurology Source Type: research
CONCLUSIONS: In highly selected patients at very HBR, discontinuation of any antithrombotic therapy after LAAC appears safe and feasible. PMID: 32999093 [PubMed - in process]
Source: The Journal of Invasive Cardiology - Category: Cardiology Tags: J Invasive Cardiol Source Type: research
In this issue of the Journal, a group of distinguished Nordic researchers, led by Anne Helene Garde and including four of our Associated Editors, present a discussion paper that originated from a workshop and provides detailed recommendations on night shift work (1). The recommendations are very clear: to protect workers ’ health, night shift schedules should have: (i) ≤3 consecutive night shifts; (ii) shift intervals of ≥11 hours; and (iii) ≤9 hours shift duration. For pregnant women, night work should be limited to one shift per week. The authors acknowledge that under circumstances allowing better possibi...
Source: Scandinavian Journal of Work, Environment and Health - Category: Occupational Health Tags: Editorial Source Type: research
Systemic air embolism developed after CT ‐guided TTNB, leading to ST‐elevation, myocardial infarction and acute ischemic stroke. The patient recovered completely without sequelae and was diagnosed with adenocarcinoma harboring activatingEGFR mutation. Treatment with gefitinib showed a response. Air embolism is a rare, fatal complication of computed tomography (CT) ‐guided transthoracic needle biopsy (TTNB) of the lung. Here, we report a patient who developed an air embolism after CT‐guided TTNB, which led to ST‐elevation myocardial infarction and acute cerebral ischemia. The patient recovered completely without c...
Source: Thoracic Cancer - Category: Cancer & Oncology Authors: Tags: CASE REPORT Source Type: research
In conclusion, it remains unclear if brain-specific regional and temporal changes occur in the expression of the different APP variants during AD progression. Since APP is also found in blood cells, assessing the changes in APP mRNA expression in peripheral blood cells from AD patients has been considering an alternative. However, again the quantification of APP mRNA in peripheral blood cells has generated controversial results. Brain APP protein has been analyzed in only a few studies, probably as it is difficult to interpret the complex pattern of APP variants and fragments. We previously characterized the soluabl...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Authors: Banham ND, Saw J, Hankey GJ, Ghia D Abstract A 75 year-old male developed features of an acute stroke following bubble contrast echocardiography, which was shown on emergent computed tomography scanning to be a result of cerebral arterial gas embolism (CAGE) to the left middle cerebral artery. Ischaemic stroke symptoms have previously been reported as a rare complication of bubble contrast echocardiography. Radiologically proven CAGE from bubble contrast echocardiography had not been reported at the time this case occurred. Immediate provision of 100% oxygen and administration of hyperbaric oxygen are reco...
Source: Diving and Hyperbaric Medicine - Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research
Abstract Acute ischemic stroke is a neurological emergency with a high likelihood of morbidity, mortality, and long-term disability. Modern stroke care involves multidisciplinary management by neurologists, radiologists, neurosurgeons, and anesthesiologists. Current American Heart Association/American Stroke Association (AHA/ASA) guidelines recommend thrombolytic therapy with intravenous (IV) alteplase within the first 3-4.5 hours of initial stroke symptoms and endovascular mechanical thrombectomy within the first 16-24 hours depending on specific inclusion criteria. The anesthesia and critical care provider may b...
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research
ConclusionsRetinal diffusion restrictions were present in a  majority of CRAO patients and detectable with reasonable sensitivity, high specificity and substantial inter-rater reliability. Further studies are necessary to study time dependency of retinal diffusion restrictions, improve image quality and investigate the reliability of retinal DWI to discern CRAO from other causes of acute loss of vision.
Source: Klinische Neuroradiologie - Category: Radiology Source Type: research
Authors: Zhang S, Wang X, Cheng F, Ma C, Fan S, Xu W, Jin N, Liu S, Lv K, Wang Q Abstract Ischemic stroke is the most common type of cerebrovascular accident worldwide. It causes long-term disability and death. Qingkailing (QKL) injection is a traditional Chinese patent medicine which has been clinically applied in the treatment of ischemic stroke for nearly thirty years. In the present study, network pharmacology combined with experimentation was used to elucidate the mechanisms of QKL. ADME screening and target prediction identified 62 active compounds and 275 targets for QKL. Topological screening of the protein...
Source: Evidence-based Complementary and Alternative Medicine - Category: Complementary Medicine Tags: Evid Based Complement Alternat Med Source Type: research
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