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Source: International Journal of Stroke
Condition: Ischemic Stroke
Procedure: CT Scan
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Total 21 results found since Jan 2013.
The Clinical Relevance of Microbleeds in Stroke study (CROMIS‐2): rationale, design, and methods
Background and rationaleThe increasing use of oral anticoagulants, mostly to prevent ischemic stroke due to atrial fibrillation in an ageing population, has been associated with a fivefold increased incidence of oral anticoagulant‐associated intracerebral hemorrhage: a rare, serious, and unpredictable complication. We hypothesize that cerebral microbleeds and other markers of cerebral small vessel disease on magnetic resonance imaging, and genetic polymorphisms (e.g. influencing cerebral small vessel integrity or anticoagulation stability), are associated with an increased risk of oral anticoagulant‐associated intracer...
Source: International Journal of Stroke - August 2, 2015 Category: Neurology Authors: Andreas Charidimou, Duncan Wilson, Clare Shakeshaft, Gareth Ambler, Mark White, Hannah Cohen, Tarek Yousry, Rustam Al‐Shahi Salman, Gregory Lip, Henry Houlden, Hans R. Jäger, Martin M. Brown, David J. Werring Tags: Protocol Source Type: research
Canadian Stroke Best Practice Recommendations: Hyperacute Stroke Care Guidelines, Update 2015
The 2015 update of the Canadian Stroke Best Practice Recommendations Hyperacute Stroke Care guideline highlights key elements involved in the initial assessment, stabilization, and treatment of patients with transient ischemic attack (TIA), ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and acute venous sinus thrombosis. The most notable change in this 5th edition is the addition of new recommendations for the use of endovascular therapy for patients with acute ischemic stroke and proximal intracranial arterial occlusion. This includes an overview of the infrastructure and resources required ...
Source: International Journal of Stroke - July 6, 2015 Category: Neurology Authors: Leanne K. Casaubon, Jean‐Martin Boulanger, Dylan Blacquiere, Scott Boucher, Kyla Brown, Tom Goddard, Jacqueline Gordon, Myles Horton, Jeffrey Lalonde, Christian LaRivière, Pascale Lavoie, Paul Leslie, Jeanne McNeill, Bijoy K. Menon, Brian Moses, Melani Tags: Guidelines Source Type: research
Thrombectomy in patients ineligible for iv tPA (THRILL)
DiscussionWhether mechanical thrombectomy in patients with acute ischemic stroke who are not eligible for intravenous thrombolysis with recombinant tissue plasminogen activator improves clinical outcomes is unclear. ‘Thrombectomy in patients ineligible for iv tPA’ may change clinical practice by providing evidence of an effective and safe treatment for such patients.
Source: International Journal of Stroke - June 4, 2015 Category: Neurology Authors: Martin Bendszus, Götz Thomalla, Michael Knauth, Werner Hacke, Susanne Bonekamp, Jens Fiehler Tags: Protocol Source Type: research
Acute nephropathy after contrast agent administration for computed tomography perfusion and computed tomography angiography in patients with acute ischemic stroke
Source: International Journal of Stroke - May 14, 2015 Category: Neurology Authors: Merel J. A. Luitse, Meenakshi Dauwan, Tom Seeters, Alexander D. Horsch, Joris M. Niesten, L. Jaap Kappelle, Geert Jan Biessels, Birgitta K. Velthuis, Tags: Letter to the editor Source Type: research
Imaging of occlusive thrombi in acute ischemic stroke
Thrombi, or clots, often occlude proximal segments of the cerebral arterial circulation in acute ischemic stroke. Thromboembolic occlusion or thrombi superimposed on atherosclerotic plaque are the principal focus of acute stroke therapies such as thrombolysis or thrombectomy. We review the imaging characteristics of thrombi on multimodal computed tomography and magnetic resonance imaging, angiography, and ultrasonography, summarizing recent studies that facilitate therapeutic decision‐making from these noninvasive studies. Information about the location, size, and imaging characteristics can be ascertained using these te...
Source: International Journal of Stroke - December 26, 2014 Category: Neurology Authors: Gregory G. Gasparian, Nerses Sanossian, Mark S. Shiroishi, David S. Liebeskind Tags: Review Source Type: research
Should minor stroke patients be thrombolyzed? A focused review and future directions
Stroke is a leading cause of morbidity and mortality worldwide. Up to 80% of ischemic stroke patients may initially present with minor symptoms. Minor stroke and transient ischemic attack patients are typically treated conservatively with antiplatelet agents and general vascular prevention strategies. Yet a high proportion develop recurrent stroke or progression of stroke and up to one in four of these patients are disabled or dead at follow‐up. Minor or rapidly improving symptoms are the top reasons for withholding thrombolytic therapy to time‐eligible stroke patients as they are believed to be ‘too good to treat’...
Source: International Journal of Stroke - December 25, 2014 Category: Neurology Authors: Amy Y. X. Yu, Michael D. Hill, Shelagh B. Coutts Tags: Review (invited) Source Type: research
Canadian Stroke Best Practice Recommendations: secondary prevention of stroke guidelines, update 2014
Every year, approximately 62 000 people with stroke and transient ischemic attack are treated in Canadian hospitals. The 2014 update of the Canadian Secondary Prevention of Stroke guideline is a comprehensive summary of current evidence‐based recommendations for clinicians in a range of settings, who provide care to patients following stroke. Notable changes in this 5th edition include an emphasis on treating the highest risk patients who present within 48 h of symptom onset with transient or persistent motor or speech symptoms, who need to be transported to the closest emergency department with capacity for advanced...
Source: International Journal of Stroke - December 23, 2014 Category: Neurology Authors: Shelagh B. Coutts, Theodore H. Wein, M. Patrice Lindsay, Brian Buck, Robert Cote, Paul Ellis, Norine Foley, Michael D. Hill, Sharon Jaspers, Albert Y. Jin, Brenda Kwiatkowski, Carolyn MacPhail, Dana McNamara‐Morse, Michael S. McMurtry, Tania Mysak, Andr Tags: Guidelines Source Type: research
Clinical characteristics and outcome of the capsular warning syndrome: a multicenter study
ConclusionsCapsular warning syndrome preceded an ischemic infarction in 71·2% of patients. In addition to the internal capsule, other locations were noted. The most effective treatment remains unclear. The functional prognosis is favorable in most patients and recurrences are rare.
Source: International Journal of Stroke - December 19, 2014 Category: Neurology Authors: Pol Camps‐Renom, Raquel Delgado‐Mederos, Alejandro Martínez‐Domeño, Luís Prats‐Sánchez, Elena Cortés‐Vicente, Manuel Simón‐Talero, Adrià Arboix, Ángel Ois, Francisco Purroy, Joan Martí‐Fàbregas Tags: Research Source Type: research
Factors affecting clinical outcome in large‐vessel occlusive ischemic strokes
Clinical outcome after large‐vessel occlusive strokes depends on admitting clinical condition, successful recanalization, and robust collateral circulation. However, predicting successful recanalization and quantifying collateral status in the acute setting remain elusive. Successful recanalization has many predictive factors. Strong evidence supports increasing clot length being associated with poor recanalization. Current imaging techniques completed in the acute setting suggest that clot length can be estimated with a clot burden score. In vitro evidence suggests that clots with more red blood cells and less thrombin ...
Source: International Journal of Stroke - December 3, 2014 Category: Neurology Authors: Michelle P. Lin, Georgios Tsivgoulis, Andrei V. Alexandrov, Jason J. Chang Tags: Review Source Type: research
Should DWI MRI be the primary screening test for stroke?
Patients presenting with focal neurological symptoms may suffer from ischemic stroke, intracerebral hemorrhage, or stroke mimics. Such patients are usually screened with a noncontrast‐enhanced computed tomography to rule out hemorrhage and to detect early signs of ischemia. However, the sensitivity of noncontrast‐enhanced computed tomography for acute stroke is far inferior to that of diffusion‐weighted magnetic resonance imaging and the latter is also very sensitive for identifying acute intracerebral hemorrhage. Most centers perform a magnetic resonance imaging stroke protocol that takes long to accomplish and may ...
Source: International Journal of Stroke - July 17, 2014 Category: Neurology Authors: Ronen R. Leker, Galina Keigler, Roni Eichel, Tamir Ben Hur, John M. Gomori, Jose E. Cohen Tags: Opinion Source Type: research
Prediction of recanalization in acute stroke patients receiving intravenous and endovascular revascularization therapy
ConclusionThe overall likelihood of recanalization was the highest in the endovascular group, and higher for intravenous thrombolysis compared with no revascularization therapy. However, our statistical models of recanalization for each individual patient indicate significant variability between treatment options, suggesting the need to include this prediction in the personalized treatment selection.
Source: International Journal of Stroke - June 30, 2014 Category: Neurology Authors: Guangming Zhu, Patrik Michel, Tudor Jovin, James T. Patrie, Wenjun Xin, Ashraf Eskandari, Weiwei Zhang, Max Wintermark Tags: Research Source Type: research
Trimming the fat in acute ischemic stroke: an assessment of 24‐h CT scans in tPA patients
ConclusionsOur results demonstrate that routine 24‐h computed tomography scan in patients without 24‐h National Institute of Health Stroke Scale worsening (especially those with baseline National Institute of Health Stroke Scale ≤10) is less likely to yield information that results in a deviation from standard acute stroke care. No patient without worsening and baseline National Institute of Health Stroke Scale ≤10 had parenchymal hematoma on 24‐h computed tomography. Application of the National Institute of Health Stroke Scale to distinguish patients who should have 24‐h follow‐up imaging from those who will...
Source: International Journal of Stroke - June 3, 2014 Category: Neurology Authors: Alexander J. George, Amelia K. Boehme, Casey R. Dunn, T. Beasley, James E. Siegler, Karen C. Albright, Ramy El Khoury, Sheryl Martin‐Schild Tags: Research Source Type: research
Acute imaging does not improve ASTRAL score's accuracy despite having a prognostic value
ConclusionsThe addition of information derived from multimodal imaging does not increase ASTRAL score's accuracy to predict functional outcome despite having an independent prognostic value. More selected radiological parameters applied in specific subgroups of stroke patients may add prognostic value of multimodal imaging.
Source: International Journal of Stroke - June 1, 2014 Category: Neurology Authors: George Ntaios, Vasileios Papavasileiou, Mohamed Faouzi, Peter Vanacker, Max Wintermark, Patrik Michel Tags: Research Source Type: research
Current status of acute stroke management in Korea: a report on a multicenter, comprehensive acute stroke registry
There are limited data on the utilization of diagnostics and the variation of treatments at the national level in acute stroke care. Clinical Research Center for Stroke – 5th division stroke registry aimed to describe stroke statistics and quality of care in Korea and to implement quality indicators. Clinical Research Center for Stroke – 5th division registry was established in April 2008 and covers pretreatment demographics, medical and stroke severity measures, diagnostic evaluation, hyperacute revascularization, in‐hospital management, discharge disposition, quality indicators, and long‐term functional outcomes....
Source: International Journal of Stroke - November 21, 2013 Category: Neurology Authors: Beom Joon Kim, Moon‐Ku Han, Tai Hwan Park, Sang‐Soon Park, Kyung Bok Lee, Byung‐Chul Lee, Kyung‐Ho Yu, Jae Kwan Cha, Dae‐Hyun Kim, Jun Lee, Soo Joo Lee, Youngchai Ko, Jong‐Moo Park, Kyusik Kang, Yong‐Jin Cho, Keun‐Sik Hong, Ki‐Hyun Cho, Tags: Panorama Source Type: research
A multicenter, randomized, controlled study to investigate EXtending the time for Thrombolysis in Emergency Neurological Deficits with Intra‐Arterial therapy (EXTEND‐IA)
Background and HypothesisThrombolysis with tissue plasminogen activator is proven to reduce disability when given within 4·5 h of ischemic stroke onset. However, tissue plasminogen activator only succeeds in recanalizing large vessel arterial occlusion in a minority of patients. We hypothesized that anterior circulation ischemic stroke patients, selected with ‘dual target’ vessel occlusion and evidence of salvageable brain using computed tomography or magnetic resonance imaging ‘mismatch’ within 4·5 h of onset, would have improved reperfusion and early neurological improvement when treated with intra‐arteri...
Source: International Journal of Stroke - November 10, 2013 Category: Neurology Authors: Bruce C. V. Campbell, Peter J. Mitchell, Bernard Yan, Mark W. Parsons, Søren Christensen, Leonid Churilov, Richard J. Dowling, Helen Dewey, Mark Brooks, Ferdinand Miteff, Christopher Levi, Martin Krause, Timothy J. Harrington, Kenneth C. Faulder, Brendan Tags: Protocols Source Type: research
