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Safety and Effectiveness of Endovascular Treatment after 6 Hours of Symptom Onset in Patients with Anterior Circulation Ischemic Stroke: A Matched Case Control Study
Conclusions: We did not observe any evidence of benefit in halting neurologic worsening or improving outcomes among patients undergoing endovascular treatment for treatment of an anterior circulation ischemic stroke after 6 hours of symptom onset. Strong evidence of both the safety and efficacy of emergent endovascular treatment when administered to patients with stroke in the anterior circulation is needed.
Source: Journal of Stroke and Cerebrovascular Diseases - October 24, 2012 Category: Neurology Authors: Adnan I. Qureshi, Jefferson T. Miley, Saqib A. Chaudhry, Edouard Semaan, Gustavo J. Rodriguez, M.Fareed K. Suri, Harold P. Adams Tags: Original Articles Source Type: research

The Value of Whole-Brain Perfusion Parameters Combined with Multiphase Computed Tomography Angiography in Predicting Hemorrhagic Transformation in Ischemic Stroke
Objective: To explore the value of whole-brain perfusion parameters combined with multiphase computed tomography angiography (MP-CTA) in predicting the hemorrhagic transformation (HT) of ischemic stroke. Methods: A total of 64 patients with ischemic stroke who underwent noncontrast computed tomography, computed tomography perfusion imaging, and computed tomography angiography before treatment from August 2017 to June 2019 were included retrospectively. The perfusion parameters cerebral blood volume (CBV), cerebral blood flow (CBF), time to peak (TTP), mean transit time (MTT), time to maximum (Tmax), and permeability surfac...
Source: Journal of Stroke and Cerebrovascular Diseases - February 13, 2020 Category: Neurology Authors: Xiang Li, Huan Liu, Wenbing Zeng, Xinghua Liu, Yun Wen, Qiuxia Xiong, Ran Yang Source Type: research

CT Perfusion Maps Improve Detection of M2-MCA Occlusions in Acute Ischemic Stroke
A growing body of literature supports mechanical thrombectomy-based endovascular therapy for M2-MCA occlusions in eligible patients with acute ischemic stroke (AIS).1 –5 This is because endovascular treatment for M2-MCA occlusions is technically feasible and leads to improved patient outcomes, despite a potential increased risk of hemorrhage.4,5 Not uncommonly, these patients undergo a single or multi-phase CT angiogram (CTA) study for LVO detection. In patient s who present in the late stroke window (6–24 h since last known normal), the CT Perfusion (CTP) study is generally performed along with a CTA study to aid in patient triage.
Source: Journal of Stroke and Cerebrovascular Diseases - April 14, 2022 Category: Neurology Authors: Girish Bathla, Ravishankar Pillenahalli Maheshwarappa, Neetu Soni, Minako Hayakawa, Sarv Priya, Edgar Samaniego, Santiago Ortega-Gutierrez, Colin P. Derdeyn Source Type: research

Intra-arterial Administration of Papaverine during Mechanical Thrombectomy for Acute Ischemic Stroke
The use of stent retrievers for mechanical thrombectomy in acute ischemic stroke may induce significant vasospasm, which at the early phases of reperfusion may be crucial for rethrombosis of the recanalized vessel. We aimed to study whether the use of intra-arterial papaverine in selected cases of vasospasm was associated with improved cerebral perfusion, arterial reocclusion, or increased hemorrhagic complications.
Source: Journal of Stroke and Cerebrovascular Diseases - November 13, 2014 Category: Neurology Authors: Gerasimos Baltsavias, Susmitha Yella, Rahman Abdul Al Shameri, Andreas Luft, Anton Valavanis Source Type: research

Preoperatively estimated graft flow rate contributes to the improvement of hemodynamics in revascularization for Moyamoya disease
Moyamoya disease is a cerebrovascular disease that is characterized by chronic progressive stenosis of the terminal portion of the internal carotid artery (ICA) on both sides of the brain, which results in an abnormal vascular network of the collateral pathways at the base of the brain.1,2 Therefore, patients with Moyamoya disease have a decreased cerebral blood flow (CBF) and reduced cerebral perfusion pressure,3 which can result in ischemic and/or hemorrhagic stroke. This hemodynamic condition can be evaluated using positron emission tomography (PET) or single-photon emission computed tomography (SPECT) as the gold standard procedure.
Source: Journal of Stroke and Cerebrovascular Diseases - November 7, 2020 Category: Neurology Authors: Tomoyoshi Kuribara, Takeshi Mikami, Katsuya Komatsu, Yusuke Kimura, Sangnyon Kim, Kei Miyata, Yukinori Akiyama, Rei Enatsu, Toru Hirano, Nobuhiro Mikuni Source Type: research

123I-IMP-SPECT in a Patient with Cerebral Proliferative Angiopathy: A Case Report
We describe cerebral perfusion abnormalities in a patient with CPA by using N-isopropyl-p-[123I] iodoamphetamine single-photon emission computed tomography (123I-IMP-SPECT) and perfusion-weighted magnetic resonance imaging. The patient, a 13-year-old boy, had reversible focal neurological deficits unrelated to cerebral hemorrhage. 123I-IMP-SPECT at resting state showed preserved uptake within the vascular lesion, yet lower uptake in the area adjacent to the lesion. In addition, acetazolamide-stressed 123I-IMP-SPECT exhibited severely impaired cerebrovascular reactivity over the affected hemisphere, suggesting that his foca...
Source: Journal of Stroke and Cerebrovascular Diseases - July 8, 2013 Category: Neurology Authors: Tomomi Kimiwada, Toshiaki Hayashi, Reizo Shirane, Teiji Tominaga Tags: Case Reports Source Type: research

Cerebral Perfusion Change of Venous Hypertension on Near-Infrared Spectroscopy Signals after Operation for Dural Arteriovenous Fistula
We report 1 case of dural AVF with retrograde leptomeningeal venous drainage. Cerebral hemodynamics were monitored using near-infrared spectroscopy imaging before, during, and after the 2-stage operative treatment. Preoperative functional near-infrared spectroscopy (fNIRS) showed an increase in deoxyhemoglobin (HbR) during a motor task. After partial coil embolization of the shunt points (stage 1), HbR increased during the first half of the task and decreased later, whereas oxyhemoglobin (HbO2) decreased in the first half of the task and increased later. After complete embolization (stage 2), fNIRS showed a pattern similar...
Source: Journal of Stroke and Cerebrovascular Diseases - August 19, 2013 Category: Neurology Authors: Satoka Shidoh, Takenori Akiyama, Takayuki Ohira, Kazunari Yoshida Tags: Original Articles Source Type: research

Computed Tomography Perfusion Deficits during the Baseline Period in Aneurysmal Subarachnoid Hemorrhage Are Predictive of Delayed Cerebral Ischemia
Delayed cerebral ischemia (DCI) is a frequent and fearful complication following aneurysmal subarachnoid hemorrhage (aSAH). The aim of this study is to assess the diagnostic accuracy of computed tomography perfusion (CTP) during an admission baseline period for the prediction of DCI.
Source: Journal of Stroke and Cerebrovascular Diseases - October 31, 2016 Category: Neurology Authors: Yuxia Duan, Haoli Xu, Rui Li, Kuikui Zheng, Zilong Hu, Nan Wu, Yunjun Yang, Qichuan Zhuge, Weijian Chen Source Type: research

Intracranial Hemorrhage Diagnosed with Transcranial Ultrasound in a Comatose, Postliver Transplant Patient
We report a case of an intracranial hemorrhage first suspected during a trans-cranial Doppler assessment of a postorthotopic liver transplant patient. The patient was at considerable risk of bleeding, due to a primary graft nonfunction, but he had also elevated ammonium levels, justifying the comatose state, and no focal neurological deficits.
Source: Journal of Stroke and Cerebrovascular Diseases - September 4, 2019 Category: Neurology Authors: Amedeo Bianchini, Rocco D'Andrea, Berin Lepic, Lorenzo Querci, Cristiana Laici, Antonio Siniscalchi Tags: Case Report Source Type: research

White Matter Hypoperfusion Associated with Leukoaraiosis Predicts Intracranial Hemorrhage after Intravenous Thrombolysis
White matter hyperintensity is common in patients receiving intravenous thrombolysis. Some studies have expressed concern about the increased risk of hemorrhagic transformation and poor prognosis for those patients with pre-existing leukoaraiosis. The purpose of this study was to evaluate hypoperfusion associated with leukoaraiosis before thrombolysis using CT perfusion and to explore whether chronic white matter hypoperfusion increases risks of intracranial hemorrhage and poor clinical prognosis.
Source: Journal of Stroke and Cerebrovascular Diseases - December 9, 2020 Category: Neurology Authors: Fengzhen Qiu, Cuiping Chen, Zijian Fan, Jiayou Qiu, Qitao Chen, Bei Shao Source Type: research

The Predictive Accuracy of the Delayed Spot Sign for Haematoma Expansion in Spontaneous Supratentorial Intracerebral Haemorrhage: A Systematic Review and Meta-Analysis
Previous studies have shown that spot signs on imaging modalities such as CT perfusion, delayed phase CTA or post contrast CT imaging reportedly have greater ability to predict haematoma expansion (HE) than the traditional CT angiography spot sign. We performed a systematic review and meta-analysis of the diagnostic accuracy of the spot sign on delayed imaging modalities in predicting haematoma expansion.Pubmed, Excerpta Medica Database, and the Cochrane library were searched on the 11 November 2019.
Source: Journal of Stroke and Cerebrovascular Diseases - February 18, 2022 Category: Neurology Authors: Christopher Dillon Ovenden, Abhiram Hiwase, Aye-Aye Gyi, Amal Abou-Hamden, Timothy Kleinig Source Type: research

An unusual neurological presentation in a patient with primary hypereosinophilic syndrome
Hypereosinophilic syndromes are characterized by an increased number of blood eosinophils (usually more than 1.5  × 109) infiltrating tissues and causing organ damage through over-production of pro-inflammatory cytokines with heterogeneous clinical presentation. Here we present a case of a 47 years old male, with an unremarkable previous medical history, with a sudden onset of subungual hemorrhage and low b ack pain. Admitted for right arm weakness and vomiting, was raised the suspicion of acute cerebrovascular syndrome, but a brain CT scan with angiogram and perfusion sequences did not show any signs of early ischaemic...
Source: Journal of Stroke and Cerebrovascular Diseases - September 5, 2022 Category: Neurology Authors: E. Spina, G.T. Maniscalco, A. Petraroli, A. Detoraki, G. Servillo, A. Ranieri, A. De Mase, R. Renna, P. Candelaresi, A. De Paulis, V. Andreone Tags: Case Report Source Type: research

Radiographic risk factors for intracranial hemorrhage in patients with left ventricular assist devices
Patients with end-stage cardiomyopathy may require the use of mechanical circulatory support to maintain perfusion of the vital organs. This is most commonly achieved using an implantable left ventricular assist device (LVAD), typically used as a bridge to orthotopic heart transplant (BTT) or as destination therapy (DT) for those who are not transplant candidates. An LVAD is usually considered for those patients whose disease and symptoms meet INTERMACS Levels 2-4 criteria, indicating a significant decrease in functionality.
Source: Journal of Stroke and Cerebrovascular Diseases - November 1, 2022 Category: Neurology Authors: Nicholas S. Hernandez, Matthew Kanter, Vaishnavi Sharma, Andy Wang, Michael Kiernan, Delia Kryzanski, Robert Heller, Tara Nail, Ron I. Riesenburger, James T. Kryzanski Source Type: research