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Blood-brain barrier leakage increases with small vessel disease in acute ischemic stroke
Conclusions: Global SVD burden is associated with increased BBB leakage in both acutely ischemic and nonischemic area. Our results support that SVD score has construct validity, and confirm a relation between SVD and BBB disruption also in patients with acute stroke.
Source: Neurology - November 20, 2017 Category: Neurology Authors: Arba, F., Leigh, R., Inzitari, D., Warach, S. J., Luby, M., Lees, K. R., On behalf of the STIR/VISTA Imaging Collaboration Tags: MRI, All Cerebrovascular disease/Stroke ARTICLE Source Type: research

Imaging-based selection of patients for acute stroke treatment: Is it ready for prime time?
Historically, brain imaging in acute stroke has sought to exclude brain hemorrhage in order to allow therapy aiming at recanalization of the occluded intracranial artery. The National Institute of Neurological Disorders and Stroke study, published in 1995, found a clinical benefit of IV thrombolysis in acute stroke after exclusion of brain hemorrhage based on noncontrast CT (NCCT).1 More than 20 years later, the decision at most centers whether to give thrombolysis within the first 4.5 hours remains based on NCCT; often, the bolus of recombinant tissue plasminogen activator (rt-PA) is administered in the CT scanner suite e...
Source: Neurology - June 12, 2017 Category: Neurology Authors: Carrera, E., Wintermark, M. Tags: CT, MRI, Infarction EDITORIALS Source Type: research

Evaluation of hyperacute infarct volume using ASPECTS and brain CT perfusion core volume
Conclusions: We found no significant difference between the accuracy of CT perfusion and ASPECTS to predict hyperacute MRI lesion volume in ischemic stroke.
Source: Neurology - June 12, 2017 Category: Neurology Authors: Demeestere, J., Garcia-Esperon, C., Garcia-Bermejo, P., Ombelet, F., McElduff, P., Bivard, A., Parsons, M., Levi, C. Tags: CT, MRI, All Cerebrovascular disease/Stroke ARTICLE Source Type: research

MR perfusion lesions after TIA or minor stroke are associated with new infarction at 7 days
Conclusions: Our results showed that 30% of the acute focal PWI lesions detected after a TIA are associated with a new BI at 1 week. Those new BIs may result from the progression of the initial ischemic injury.
Source: Neurology - June 12, 2017 Category: Neurology Authors: Lee, J., Inoue, M., Mlynash, M., Mann, S. K., Cereda, C. W., Ke, M., Albers, G. W., Olivot, J. M. Tags: Stroke prevention, MRI ARTICLE Source Type: research

Feasibility of Near Infra-Red Spectroscopy in Blood Pressure Management Following Thrombectomy for Acute Large Vessel Occlusion Ischemic Stroke (P5.045)
Conclusions:NIRS monitoring is a feasible method of evaluating patients undergoing thrombectomy for LVO ischemic strokes. This study is continuing to enroll patients to help determine whether NIRS monitoring may help determine better blood pressure targets following thrombectomy.Disclosure: Dr. Saini has nothing to disclose. Dr. Mahapatra has nothing to disclose. Dr. O'Phelan has nothing to disclose. Dr. Kottapally has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Saini, V., Mahapatra, A., OPhelan, K., Kottapally, M. Tags: Neurocritical Care: Ischemic Injury Source Type: research

Real Eyes Realize Real Lies (P1.148)
Conclusions:In this case, CT Perfusion scanning was used to disprove vascular etiology and ultimately led to the appropriate diagnosis through further diagnostic testing.Disclosure: Dr. E-Ghanmh has nothing to disclose. Dr. Niazi has nothing to disclose. Dr. Ermak has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: El-Ghanem, M., Niazi, M., Ermak, D. Tags: General Neurology: The Eyes Have It and White Matter Matters Source Type: research

Cerebral blood flow and auto-regulation in acute TIA patients from a general hospital in Qatar (P4.253)
Conclusions:Preliminary results indicate the feasibility of TCD and BHI in acute evaluation of TIA patients for purpose of prognosis and functional outcome. Further studies are necessary to confirm their clinical value.Study Supported by: This research was supported by QNRF (a member of Qatar foundation) and NPRP No. 6-565-3-141. The opinions expressed are the sole responsibility of the authors.Disclosure: Dr. Musthak has nothing to disclose. Dr. Dimassi has nothing to disclose. Dr. Akhtar has nothing to disclose. Dr. Kamran has nothing to disclose. Dr. Abbasi has nothing to disclose. Dr. Khattab has nothing to disclose. D...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Musthak, A., Dimassi, D., Akhtar, N., Kamran, S., Abbasi, S., Khattab, A., El Sotouhy, A., Haddad, N., Streletz, L. Tags: Acute and Diagnostic Imaging in Ischemic Stroke and TIA Source Type: research

High values of baseline and 24-hour Mean Arterial Pressure are associated with lower chance of early neurological improvement in acute stroke patients treated with thrombolysis (P4.286)
Conclusions:High baseline and 24-hr MAP values are associated with lower chance of achieving ENI after IV thrombolysis. Further studies are needed to better understand whether acute BP dysregulation can influence different clinical courses in the early phase of IV thrombolysis.Disclosure: Dr. Lorenzano has nothing to disclose. Dr. Caselli has nothing to disclose. Dr. Zingaro has nothing to disclose. Dr. Orlando has nothing to disclose. Dr. Toni has received research support from Bayer, Medtronic, and Boehriger Ingelheim.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Lorenzano, S., Caselli, M. C., Zingaro, A., Orlando, F., Toni, D. Tags: Thrombolysis and Acute Evaluation in Ischemic Stroke Source Type: research

Recurrent transient hemiparesis and a novel ATP1A2 mutation (P3.220)
Conclusions:This case identifies a novel, potentially pathogenic mutation of the ATP1A2 gene corresponding to a phenotype of a rare migraine variant and contributes to our evolving understanding of migraine molecular genetics and pathophysiology.Study Supported by:Disclosure: Dr. Stredny has nothing to disclose. Dr. Winden has nothing to disclose. Dr. Danehy has nothing to disclose. Dr. Robertson has nothing to disclose. Dr. Trenor has nothing to disclose. Dr. Rivkin has nothing to disclose. Dr. Lehman has nothing to disclose. Dr. Bernson-Leung has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Stredny, C., Winden, K., Danehy, A., Robertson, R., Trenor, C., Rivkin, M., Lehman, L., Bernson-Leung, M. Tags: Child Neurology I Source Type: research

Acute Ischemic Stroke as a Presenting Feature of Multiple Myeloma (P3.279)
Conclusions:Stroke is a leading and preventable cause of disability in the US adult population. The majority of strokes are due to atherosclerotic vascular or cardioembolic disease. Understanding the diagnostic work up of stroke and recognizing rare etiologies like MM is important for stroke prevention. This brings to light the importance of recognizing stroke as an initial presenting feature of multiple myeloma and of multiple myeloma as an important treatable etiology of stroke.Disclosure: Dr. Chung has nothing to disclose. Dr. Ramamoorthy has nothing to disclose. Dr. Kar has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Chung, S., Ramamoorthy, R., Kar, J. Tags: Cerebrovascular Disease Case Reports II Source Type: research

Brain Embolism in the Moyamoya Syndrome (P3.290)
Conclusions:Hemodynamic compromise may not be the only cause of brain infarction in patients with moyamoya syndrome. Observations from these two patients provide both direct visualization and TCD evidence of embolization, suggesting an alternative, or additional, etiology for brain ischemia in these patients. Future investigations into the role of antithrombotic agents should be considered.Disclosure: Dr. Grimes has nothing to disclose. Dr. Snider has nothing to disclose. Dr. Vaitkevicius has received personal compensation for activities with Sage therapeutics as an employee. Dr. Babikian has received personal compensation...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Grimes, J., Snider, S., Vaitkevicius, H., Babikian, V., Patel, N. Tags: Cerebrovascular Disease Case Reports II Source Type: research

Hypoperfusion, vascular pruning, and transient hemiparesis mimicking stroke in transient erythroblastopenia of childhood (P4.161)
Conclusions:The patient’s transient cerebrovascular and electrophysiologic abnormalities are consistent with those described in the literature for hemiplegic migraine. However, he did not meet International Headache Society criteria for hemiplegic migraine, such as headache with presentation or recurrent events. We hypothesize that transient vascular narrowing and resultant hypoperfusion, compounded by cerebral hypoxia from significant anemia, may explain the transient neurologic symptoms concurrent with anemia in TEC.Disclosure: Dr. Calahan has nothing to disclose. Dr. Lehman has nothing to disclose. Dr. Rivkin has ...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Calahan, C., Lehman, L., Rivkin, M., Lipton, J., Danehy, A., Robertson, R., Ozuah, N., Trenor, C., Bernson-Leung, M. Tags: Child Neurology II Source Type: research

Role of atherosclerosis, clot extent, and penumbra volume in headache during ischemic stroke
Conclusions: Headache in the early phase of ischemic stroke tends to occur less often in patients with atherosclerosis than in patients without atherosclerosis in the large cerebral arteries. This finding lends support to the hypothesis that vessel wall elasticity is a necessary contributing factor in the occurrence of headache during acute ischemic stroke.
Source: Neurology - September 11, 2016 Category: Neurology Authors: van Os, H. J. A., Mulder, I. A., van der Schaaf, I. C., Kappelle, L. J., Velthuis, B. K., Broersen, A., Vos, J. A., Terwindt, G. M., Schonewille, W., Ferrari, M. D., Algra, A., van Walderveen, M. A. A., Wermer, M. J. H. Tags: All Headache, CT, All Clinical Neurology, All Cerebrovascular disease/Stroke, Infarction ARTICLE Source Type: research

Patient selection for stroke thrombectomy: Is CT head good enough?
Six randomized controlled trials have established the substantial benefit of mechanical thrombectomy for acute ischemic stroke patients presenting with large vessel occlusive disease.1–6 Enrolling patients with large clinical deficit in the setting of small completed infarct and rapid, complete, or near complete recanalization, and treatment with the most recent generation of thrombectomy devices, contributed to this success. Efforts to generalize the results of these trials beyond select, experienced centers have focused attention on workflow and developing consensus on patient selection. Optimizing outcomes require...
Source: Neurology - July 17, 2016 Category: Neurology Authors: Jadhav, A. P., Wechsler, L. R. Tags: CT, All Cerebrovascular disease/Stroke, Infarction EDITORIALS Source Type: research

Prospective Late Endovascular Treatment in Acute Ischemic Stroke Evaluating Non-Contrast Head CT Versus CT Perfusion (PLEASE No CTP) (P1.198)
CONCLUSIONS: "Penumbra" pattern on CTP did not identify patients who would benefit from ET when patients were selected with a non-contrast CT ASPECTS >7. There was no correlation of CTP penumbra with good outcomes. Larger prospective trials are warranted to justify the wide use of CTP within 8 hours of symptom onset.Disclosure: Dr. Hassan has nothing to disclose. Dr. Chaudhry has nothing to disclose. Dr. Andrew has nothing to disclose. Dr. Afzal has nothing to disclose. Dr. Tekle has nothing to disclose. Dr. Sanchez has nothing to disclose. Dr. Abantao has nothing to disclose. Dr. Riaz has nothing to disclose. Dr. Qures...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Hassan, A., Chaudhry, S., Christina Sanchez, C., Afzal, M. R., Tekle, W., Sanchez, O., Abantao, E., Riaz, A., Qureshi, A. Tags: Acute Endovascular Therapy: Outcomes and Safety Source Type: research

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