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Dehydration Is Associated with More Severe Hemispatial Neglect after Stroke (S02.004)
CONCLUSIONS: Patients who are dehydrated at the time of presentation with stroke have more severe stroke symptoms, independent of stroke severity. This represents an opportunity to evaluate our hydration practices in patients with varying degrees of cardiac dysfunction during the acute stroke period in order to prescribe more precise fluid resuscitation algorithms. Future clinical trials designed to evaluate fluid resuscitation practices at the time of ischemic stroke are needed.Disclosure: Dr. Bahouth has nothing to disclose. Dr. Bahrainwala has nothing to disclose. Dr. Hillis has received personal compensation in an edit...
Source: Neurology - February 14, 2013 Category: Neurology Authors: Bahouth, M., Bahrainwala, Z., Hillis, A., Gottesman, R. Tags: S02 Acute Stroke Therapy Source Type: research

Routine troponin measurements are unnecessary in acute ischemic stroke evaluations (P4.285)
CONCLUSIONS: Troponin elevation in patients with ischemic stroke is not caused by acute myocardial ischemia unless iatrogenic in the setting of vasopressor administration. Serum troponins should be measured based on clinical context rather than routinely in all acute ischemic stroke patients.Disclosure: Dr. Ali has nothing to disclose. Dr. Young has nothing to disclose. Dr. Rabinstein has received royalty payments from Elsevier and Oxford University Press. Dr. Rabinstein has received research support from DJO Global. Dr. Flemming has nothing to disclose. Dr. Fugate has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Ali, F., Young, J., Rabinstein, A., Flemming, K., Fugate, J. Tags: Cerebrovascular Disease and Interventional Neurology: Acute Ischemic Stroke Care 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

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

Optical Bedside Monitoring of Cerebral Blood Flow in Acute Ischemic Stroke Patients during Head of Bed Manipulation (P4.216)
CONCLUSIONS: A lower HOB angle results in an increase in cortical CBF without a significant change in arterial flow velocity in the setting of acute stroke, but there is variability across patients in this response. Bedside CBF monitoring with DCS provides a potential means to individualize interventions designed to optimize CBF in acute ischemic stroke.Disclosure: Dr. Favilla has nothing to disclose. Dr. Mesquita has nothing to disclose. Dr. Mullen has nothing to disclose. Dr. Durduran has nothing to disclose. Dr. Kim has nothing to disclose. Dr. Minkoff has nothing to disclose. Dr. Kasner has received personal compensati...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Favilla, C., Mesquita, R., Mullen, M., Durduran, T., Kim, M., Minkoff, D., Kasner, S., Joel, G., Yodh, A., Detre, J. Tags: Cerebrovascular Disease and Interventional Neurology: Acute Stroke Endovascular Source Type: research

Ultra-acute CT perfusion imaging: A stroke in the scanner
A stroke patient with a mild right hemiparesis (NIH Stroke Scale score 4) underwent dual-slab CT perfusion (CTP). In the midst of acquiring the lower CTP slab, she became aphasic and developed a dense right hemiparesis (NIH Stroke Scale score 17). Reconstruction of the CTP into a dynamic CT angiogram demonstrates fragmentation of an internal carotid artery thrombus at the time of clinical worsening (figure 1; video on the Neurology® Web site at Neurology.org). The upper CTP slab, acquired 2 minutes later, provides the earliest known view of the hemodynamics of ischemic stroke in humans. It demonstrates total absence of...
Source: Neurology - November 9, 2015 Category: Neurology Authors: Christensen, S., Obi, C., Albers, G., Lansberg, M. Tags: CT, All Cerebrovascular disease/Stroke, Embolism, Infarction VIDEO NEUROIMAGES Source Type: research

Combined PET/MRI: Multimodality insights into acute stroke hemodynamics
A 61-year-old man underwent simultaneous PET/MRI 5.5 hours after sudden onset of aphasia (NIH Stroke Scale 4), which revealed a diffusion/perfusion mismatch of different extents as measured with pulsed arterial spin-labeling MRI (59 mL), perfusion-weighted MRI (27 mL), and [15O]H2O-PET (36 mL) (figure). Due to spontaneous recanalization, the penumbra tissue did not progress towards infarction. This demonstrates that the outcome of critically hypoperfused stroke brain tissue may be favorable even without sufficient collateral flow and without therapeutic intervention.1 Here, PET/MRI offers the chance to cross-evaluate MRI-b...
Source: Neurology - May 15, 2016 Category: Neurology Authors: Werner, P., Saur, D., Mildner, T., Moller, H., Classen, J., Sabri, O., Hoffmann, K.-T., Barthel, H. Tags: MRI, PET, DWI, All Cerebrovascular disease/Stroke NEUROIMAGES Source Type: research

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

Intervention Stroke Assessment Scale for Eligibility in Endovascular Therapy (ISAS-ET) (P4.213)
Conclusion:In conclusion, the ISAS scoring system might help with the assessment of patient qualification for further endovascular treatment. Further prospective studies are warranted.Disclosure: Dr. Haitham has nothing to disclose. Dr. Bashir has nothing to disclose. Dr. Hussain has nothing to disclose. Dr. Misthal has nothing to disclose. Dr. Moussavi has nothing to disclose. Dr. Kirmani has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Haitham, D., Bashir, A., Hussain, M., Misthal, S., Moussavi, M., Kirmani, J. Tags: Cerebrovascular Disease and Interventional Neurology: Acute Stroke Endovascular Source Type: research

Collateral Changes in Various MR Sequences and Their Clinical Implcation in Acute Stroke Patients (P6.024)
CONCLUSION: FHVS and PCA laterality is arterial while SWIHV is venous component of collateral circulation. Patients with these MR changes have smaller stroke size. SWIHV was not seen within large strokes.Disclosure: Dr. Ibrahim has nothing to disclose. Dr. Kamran has nothing to disclose. Dr. SATTAR has nothing to disclose. Dr. Akhtar has nothing to disclose. Dr. Elkhider has nothing to disclose. Dr. BOURKE has nothing to disclose. Dr. Shuaib has received research support from Pharma R11; AstraZeneca, CoAxia, Pfizer, BI, Sanofi, Servier, Merck Frosst, Bayer, NTI, Allphase, BMS, and Aventis.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Ibrahim, F., Kamran, S., Sattar, H., Akhtar, N., Elkhider, H., Bourke, P., Shuaib, A. Tags: Ischemic Stroke Diagnosis Source Type: research

Intravenous Thrombolysis Resulting In Acute Ischemic Stroke Recanalization Can Lead To Cerebral Hyperperfusion Syndrome (P7.123)
Conclusion- Cerebral hyperperfusion syndrome after intravenous thrombolysis in acute ischemic stroke should be suspected in patients that achieve arterial recanalization and develop unexplained new neuropsychiatric manifestations.Disclosure: Dr. Ong has nothing to disclose. Dr. Yeo has nothing to disclose. Dr. Ting has nothing to disclose. Dr. Sinha has nothing to disclose. Dr. Teoh has nothing to disclose. Dr. Chan has nothing to disclose. Dr. Seet has nothing to disclose. Dr. Sharma has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Ong, J., Yeo, L., Ting, E., Sinha, A., Teoh, H. L., Chan, B., Seet, C. S., Sharma, V. Tags: Cerebrovascular Disease and Interventional Neurology: Issues in Acute Stroke Treatment Source Type: research

Primary Acute Stroke Thrombectomy In 3 Hours From Middle Cerebral Artery Occlusion- A pilot Study (P4.291)
Conclusion: Our pilot study demonstrates that primary AIS thrombectomy for MCA occlusion with LCB is not only feasible and safe, but associated with complete recanalization and good functional outcome. Larger randomized controlled studies are needed.Disclosure: Dr. Lodi has nothing to disclose. Dr. Reddy has nothing to disclose. Dr. Devasenapathy has nothing to disclose. Dr. Shehadeh has nothing to disclose. Dr. Hourini has nothing to disclose. Dr. Chou has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Lodi, Y., Reddy, V., Devasenapathy, A., Shehadeh, K., Hourini, A., Chou, C.-A. Tags: Cerebrovascular Disease and Interventional Neurology: Acute Ischemic Stroke Treatment Source Type: research

Clinical and radiologic reversal of stroke-like episodes in MELAS with high-dose L-arginine
Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome (MT-TL1 gene) is a progressive neurologic disorder with stroke-like episodes (SLEs), which are recurrent neurologic deficits resembling vasoocclusive strokes.1 However, SLEs are not restricted to vascular territories and have a predilection for the occipital and posterior parietal and temporal cortices,2 may evolve subacutely over hours to days,3 and have greater potential for reversibility.4 Their pathophysiology is incompletely understood. Current literature suggests a combination of neuronal mitochondrial energy failure and cereb...
Source: Neurology - July 13, 2015 Category: Neurology Authors: Siddiq, I., Widjaja, E., Tein, I. Tags: MRI, Other cerebrovascular disease/ Stroke, Mitochondrial disorders; see Genetics/Mitochondrial disorders, All Pediatric CLINICAL/SCIENTIFIC NOTES Source Type: research

Response to endovascular reperfusion is not time-dependent in patients with salvageable tissue
Conclusion: The association between endovascular reperfusion and improved functional and radiologic outcomes is not time-dependent in patients with a perfusion-diffusion mismatch. Proof that patients with mismatch benefit from endovascular therapy in the late time window should come from a randomized placebo-controlled trial.
Source: Neurology - August 24, 2015 Category: Neurology Authors: Lansberg, M. G., Cereda, C. W., Mlynash, M., Mishra, N. K., Inoue, M., Kemp, S., Christensen, S., Straka, M., Zaharchuk, G., Marks, M. P., Bammer, R., Albers, G. W., For the Diffusion and Perfusion Imaging Evaluation for Understanding Stroke Evolution 2 ( Tags: MRI, All Cerebrovascular disease/Stroke, Clinical trials Observational study (Cohort, Case control) ARTICLE Source Type: research

Why are most stroke patients deemed poor candidates for intraaterial therapy? A prospective study (P4.306)
Conclusion: The majority of patients presenting to a large tertiary referral center with AIS due to a large vessel occlusion were found to be poor IA candidates, with more than half excluded for a single reason. Such data addressing the volume and proportion of patients found ineligible for IA therapy in real-world practice can help target efforts to develop new interventional options and improve future clinical trial design.Disclosure: Dr. Damania has nothing to disclose. Dr. Noto has nothing to disclose. Dr. Kung has nothing to disclose. Dr. Liew has nothing to disclose. Dr. Finley has nothing to disclose. Dr. Mangla has...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Damania, D., Noto, A., Kung, N., Liew, J., Finley, H., Mangla, R., Miranpuri, A., Sahin, B., Jahromi, B. Tags: Cerebrovascular Disease and Interventional Neurology: Acute Interventional Treatment for Ischemic Stroke Source Type: research

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