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Effect of Radiographic Contrast Media Shortage on Stroke Evaluation in the United States ADULT BRAIN
CONCLUSIONS: Our analysis reported changes in the use of CTA and CTP in patients with acute ischemic stroke during the contrast media shortage. Further research needs to identify effective strategies to reduce the reliance on contrast media–based studies such as CTA and CTP without compromising patient outcomes.
Source: American Journal of Neuroradiology - August 9, 2023 Category: Radiology Authors: Qureshi, A. I., Grintal, A., DeGaetano, A. C., Goren, M., Lodhi, A., Golan, D., Hassan, A. E. Tags: ADULT BRAIN Source Type: research

Endoluminal flow diverting stents for middle cerebral artery bifurcation aneurysms: multicenter cohort
Conclusion FDS treatment for MCA bifurcation aneurysms is feasible, with comparable safety and efficacy profiles to other available endovascular options when utilized in carefully selected aneurysms. Jailing of M2 branches was not associated with a higher risk of post-procedural ischemic complications.
Source: Journal of NeuroInterventional Surgery - October 14, 2022 Category: Neurosurgery Authors: Salem, M. M., Khorasanizadeh, M., Lay, S. V., Renieri, L., Kuhn, A. L., Sweid, A., Massari, F., Moore, J. M., Tjoumakaris, S. I., Jabbour, P., Puri, A. S., Ogilvy, C. S., Jankowitz, B. T., Burkhardt, J.-K., Kan, P., Limbucci, N., Cognard, C., Thomas, A. J Tags: Hemorrhagic stroke Source Type: research

Safety and efficacy of the surpass streamline for intracranial aneurysms (SESSIA): A multi-center US experience pooled analysis
CONCLUSION: This is the largest cohort study using a 72-96 wire flow diverter. The Surpass Streamline demonstrated a favorable safety and efficacy profile, making it a valuable option for treating not only large but also wide-necked small and medium-sized intracranial aneurysms.PMID:35934939 | DOI:10.1177/15910199221118148
Source: Interventional Neuroradiology - August 8, 2022 Category: Radiology Authors: Juan Vivanco-Suarez Alan Mendez-Ruiz Mudassir Farooqui Kimon Bekelis Justin A Singer Kainaat Javed David J Altschul Johanna T Fifi Stavros Matsoukas Jared Cooper Fawaz Al-Mufti Bradley Gross Brian Jankowitz Peter T Kan Muhammad Hafeez Emanuele Orru Andres Source Type: research

E-096 COVID status is related to clot burden during thrombectomy in acute stroke patients
ConclusionOf 230 patients included in this interim analysis across 24 centers in the United States, between 02/2021 and 01/2022, 16 patients had a history of COVID. Comparing COVID-positive to non-positive, patients with COVID were younger (median 66.5 years vs 71.5 years, p 0.042), and had more intracranial clot by weight (median 101.0 mg vs 42.0 mg, p 0.047). There was a trend toward COVID positive patients to have more clot volume (median 180 cc vs 77.5 cc p 0.08), suggesting the difference was a higher clot burden instead of more density to the thrombus. These results suggest different histopathological characteristics...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Fraser, J., Dabney, A., Vicari, J., Rivet, D., Woodward, B., Nanda, A., Fiorella, D., Baltan, S., Sohrabji, F., Pennypacker, K., Kellner, C. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

E-147 Ephrin receptor beta 1 single nucleotide polymorphisms in association with age in acute stroke patients undergoing thrombectomy
Conclusion193 patients were included in this interim analysis across 23 centers in the United States, between 02/2021 and 11/2021. For the EPHB1 SNP (rs13073658), Table 1 shows the numbers and proportions of patients with varying expressions of the SNP. While no patients 50 or older were homozygous for the SNP, 16% of those under 50 years old were. The potential relationship between EPHB1 SNP and stroke in younger patients requires further evaluation.Abstract E-147 Table 1Disclosures J. Fraser: 1; C; University of Kentucky, American Heart Association. 2; C; Stream Biomedical, Penumbra, Medtronic. 4; C; Fawkes Biotechnology...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Fraser, J., Dabney, A., Vicari, J., Rivet, D., Woodward, B., Nanda, A., Fiorella, D., Baltan, S., Sohrabji, F., Pennypacker, K., Kellner, C. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

O-052 The pennsylvania post-market multicenter experience with flow re-direction endoluminal device (FRED)
ConclusionThe results of the early post-market experience with the FRED device show reasonable safety and adequate aneurysmal occlusion rates comparable to other flow diverters. However, more extensive multicenter studies with more extended follow-up data are needed to assess the long-term safety and durability of the device.Abstract O-052 Table 1Baseline descriptive statistics Number of patients n=61 Gender Male 11 (18%) Female 50 (82%) Age (Years: median; IQR) 58 (51 – 68) Multiple Intracranial Aneurysms 21 (34.4%) Family history of aneurysms 9 (14.8%) Smoking History Never smokers 26 (42.6%) Past smokers 13 (21.3...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Salem, M., Kvint, S., Hendrix, P., Al Saiegh, F., Gajjar, A., Goren, O., Gross, B., Jabbour, P., Lang, M., Schirmer, C., Tjoumakaris, S., Griessenauer, C., Burkhardt, J. Tags: SNIS 19th annual meeting oral abstracts Source Type: research

Acute Stroke Diagnosis
Am Fam Physician. 2022 Jun 1;105(6):616-624.ABSTRACTStroke accounts for significant morbidity and mortality and is the fifth leading cause of death in the United States, with direct and indirect costs of more than $100 billion annually. Expedient recognition of acute neurologic deficits with appropriate history, physical examination, and glucose testing will help diagnose stroke and rule out mimicking presentations. The National Institutes of Health Stroke Scale should be used to determine stroke severity and to monitor for evolving changes in clinical presentation. Initial neuroimaging is used to differentiate between isc...
Source: American Family Physician - June 15, 2022 Category: Primary Care Authors: Edwin Y Choi Gilberto A Nieves Darrell Edward Jones Source Type: research

New ERLEADA ® (apalutamide) Analysis Demonstrates Rapid, Deep Prostate-Specific Antigen (PSA) Response in Patients with Metastatic Castration-Sensitive Prostate Cancer (mCSPC)
SAN FRANCISCO, Feb. 14, 2022 – The Janssen Pharmaceutical Companies of Johnson & Johnson today announced new real-world evidence data showing the initiation of ERLEADA® (apalutamide) results in high rates of rapid and deep prostate-specific antigen (PSA) response among patients with metastatic castration-sensitive prostate cancer (mCSPC). In a separate post-hoc analysis of the registrational Phase 3 SPARTAN and TITAN studies, rapid and deep PSA responses with ERLEADA® were associated with improvement in patient-reported outcomes (PROs) related to quality of life, physical wellbeing, pain, and fatigue intensity. The...
Source: Johnson and Johnson - February 14, 2022 Category: Pharmaceuticals Tags: Innovation Source Type: news

Combination of Dexmedetomidine and Ketamine for Magnetic Resonance Imaging Sedation
Conclusions: The efficacy of DEX–KET sedation was comparable to that of midazolam for MRI examination. DEX–KET was related to shorter scan time and lower occurrence of complications compared to midazolam. Introduction Neurocritically ill patients often require brain magnetic resonance imaging (MRI) in addition to conventional neurological evaluations. Brain MRI can reveal structural lesions with a high sensitivity due to its excellent spatial resolution and enhanced soft tissue contrast (1–3). To acquire MRI images, patients' cooperation is imperative. However, keeping patients with ...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

Asymptomatic Carotid Stenosis Is Associated With Circadian and Other Variability in Embolus Detection
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this t...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research