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Initial Experience with Upfront Arterial and Perfusion Imaging among Ischemic Stroke Patients Presenting within the 4.5-hour Time Window
Conclusions: An upfront CTA/CTP protocol aided stroke team decision-making in nearly half of cases. Implementation of a CTA/CTP protocol was associated with a learning curve of 6 months before door to needle time ≤60 minutes returned to similar rates as the pre-CTA/CTP protocol.
Source: Journal of Stroke and Cerebrovascular Diseases - January 24, 2013 Category: Neurology Authors: Ali Reza Noorian, Katja Bryant, Ashley Aiken, Andrew D. Nicholson, Adam B. Edwards, Mason P. Markowski, Seena Dehkharghani, Jemisha C. Bouloute, Jacquelyn Abney, Fadi Nahab Tags: Original Articles Source Type: research

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

Mechanism of Acute Ischemic Stroke in Patients with Severe Middle Cerebral Artery Atherosclerotic Disease
Conclusions: In patients with severe MCA ICAD, the mechanism of stroke is multifactorial, but hemodynamic insufficiency plays a significant role. This finding is important in selecting a subgroup of patients who may benefit from revascularization.
Source: Journal of Stroke and Cerebrovascular Diseases - January 13, 2014 Category: Neurology Authors: Jordan S. Dubow, Elliott Salamon, Edward Greenberg, Athos Patsalides Tags: Original Articles Source Type: research

Ischemic Volume and Neurological Deficit: Correlation of Computed Tomography Perfusion with the National Institutes of Health Stroke Scale Score in Acute Ischemic Stroke
The National Institutes of Health Stroke Scale (NIHSS) is the most adopted stroke patients' evaluation tool in emergency settings to assess the severity of stroke and to determine the patients' eligibility for specific treatments. Computed tomography perfusion (CTP) is crucial to identify salvageable tissue that can benefit from the reperfusion treatment. The aim of this study is to identify the relation between the NIHSS scores and the hypoperfused volumes evaluated by CTP in patients with hyperacute ischemic stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - April 30, 2018 Category: Neurology Authors: Giovanni Furlanis, Milo š Ajčević, Lara Stragapede, Carlo Lugnan, Mariana Ridolfi, Paola Caruso, Marcello Naccarato, Maja Ukmar, Paolo Manganotti Source Type: research

The Yield of Multimodal Computed Tomography among Emergency Department Patients with Suspected Large Vessel Occlusion Stroke
Objectives: Endovascular therapy (EVT) improves outcomes for appropriately selected acute ischemic stroke patients. Guidelines suggest rapid acquisition of noninvasive vascular imaging to screen suspected ischemic stroke patients for large vessel occlusion (LVO) and candidacy for EVT. We sought to quantify the yield of an LVO stroke screening process in an undifferentiated emergency department (ED) suspected stroke population as well as identify predictors of successful EVT. Methods: We identified a cohort of consecutive ED patients who received CT angiography and brain perfusion (CTA/P) imaging to determine candidacy for EVT during 2016.
Source: Journal of Stroke and Cerebrovascular Diseases - September 3, 2019 Category: Neurology Authors: Yalda Serena Dastmalchi, J. Adam Oostema Source Type: research

Image level detection of large vessel occlusion on 4D-CTA perfusion data using deep learning in acute stroke
Acute ischemic stroke (AIS) secondary to LVOs represent approximately 30-40% of all stroke cases and are associated with disproportionately higher morbidity and mortality.1, 2 The importance of endovascular thrombectomy (EVT) in patients with acute ischemic stroke (AIS) has been well established in multiple randomized controlled trials for patients in both early and late stroke windows.3-6 A critical aspect of the patient triage is the accurate and timely detection of underlying large vessel occlusion (LVO).
Source: Journal of Stroke and Cerebrovascular Diseases - September 10, 2022 Category: Neurology Authors: Girish Bathla, Dhruba Durjoy, Sarv Priya, Edgar Samaniego, Colin P. Derdeyn Source Type: research

Meta-analyses Indicate Associations between Neuroendocrine Activation, Deactivation in Neurotrophic and Neuroimaging Markers in Depression after Stroke
Conclusions: Cortisol-lowering therapies and those that increase blood flow and neurotrophic factors represent promising novel therapeutics for depression subtypes and may reduce the risk of depression in stroke patients.
Source: Journal of Stroke and Cerebrovascular Diseases - November 12, 2012 Category: Neurology Authors: Kate Noonan, Leeanne M. Carey, Sheila G. Crewther Tags: Original Articles Source Type: research

Ischemic Stroke in Evolution: Predictive Value of Perfusion Computed Tomography
Background: Various perfusion computed tomography (PCT) parameters have been used to identify tissue at risk of infarction in the setting of acute stroke. The purpose of this study was to examine predictive value of the PCT parameters commonly used in clinical practice to define ischemic penumbra. The patient selection criterion aimed to exclude the effect of thrombolysis from the imaging data.Methods: Consecutive acute stroke patients were screened and a total of 18 patients who initially underwent PCT and CT angiogram (CTA) on presentation but did not qualify to receive thrombolytic therapy were selected. The PCT images ...
Source: Journal of Stroke and Cerebrovascular Diseases - August 19, 2013 Category: Neurology Authors: Amir Kheradmand, Marc Fisher, David Paydarfar Tags: Original Articles Source Type: research

Human Urinary Kallidinogenase Improves Outcome of Stroke Patients by Shortening Mean Transit Time of Perfusion Magnetic Resonance Imaging
Improving cerebral perfusion remains a good option for ischemic stroke for restoring cerebral blood flow. Human urinary kallidinogenase has been shown promising in treating stroke patients. To investigate whether human urinary kallidinogenase's efficacy in treating stroke patients has relationship with improving cerebral perfusion and possible mechanism.
Source: Journal of Stroke and Cerebrovascular Diseases - June 29, 2015 Category: Neurology Authors: Jingwei Li, Yan Chen, Xin Zhang, Bing Zhang, Meijuan Zhang, Yun Xu Source Type: research

Thrombolysis, Complete Recanalization, Diffusion Reversal, and Luxury Perfusion in Hyperacute Stroke
A 59-year old man was admitted to our stroke care unit 1.8 hours after onset of cardioembolic stroke. Administration of issue-plasminogen activator achieved complete recanalization, and his lesion on diffusion-weighted imaging (DWI) disappeared and single photon emission computed tomography showed luxury perfusion. DWI reversal and luxury perfusion were sometimes observed in hyperacute stroke patients, especially timely reperfusion was achieved. However, the relationships between DWI reversal and luxury perfusion were not well known.
Source: Journal of Stroke and Cerebrovascular Diseases - October 28, 2015 Category: Neurology Authors: Yuki Sakamoto, Takahiro Ouchi, Seiji Okubo, Arata Abe, Junya Aoki, Akane Nogami, Takahiro Sato, Hiroyuki Hokama, Yutaro Ogawa, Shizuka Suzuki, Masahiro Mishina, Kazumi Kimura Tags: Case Report Source Type: research

Differentiating Stroke and Seizure in Acute Setting —Perfusion Computed Tomography?
Perfusion computed tomography (PCT) is part of acute stroke protocol in many hospitals; however, its clinical utility is still being disputed. Beyond its use in core and penumbra estimation, there is also a question about PCT role in stroke mimics diagnosis. Case series or small, retrospective studies showed equivocal results. This is the first published prospective, comparative study on PCT in differentiating stroke and seizure in acute setting.
Source: Journal of Stroke and Cerebrovascular Diseases - April 13, 2017 Category: Neurology Authors: Katarzyna Kubiak-Balcerewicz, Urszula Fiszer, Ewa Naga ńska, Cezary Siemianowski, Aleksander Sobieszek, Agnieszka Witak-Grzybowska, Aldona Kosińska-Szot Source Type: research

Stroke in Pregnancy and Review of Current Literature: Arterial Spin-Labeling MRI Can Identify the Presence and Intensity of Collateral Circle
We present a diagnostic strategy in a pregnant woman with suspect of acute stroke. We perform magnetic resonance with arterial spin labeling sequence, an X-ray and contrast medium safe perfusion technique. Arterial spin labeling can detects collateral vessels in patient with acute ischemic stroke. Demonstrating collateral vessels is relevant for better understanding prognosis and for improving the diagnostic assessment in pregnancy.
Source: Journal of Stroke and Cerebrovascular Diseases - September 15, 2018 Category: Neurology Authors: Agnese Morello, Tommaso Casseri, Maurizio Acampa, Paolo Galluzzi, Alfonso Cerase, Lucia Monti Source Type: research

Role of Non-Perfusion Factors in Mildly Symptomatic Large Vessel Occlusion Stroke
Recent reperfusion trials after acute large vessel occlusion (LVO) stroke did not include patients with low national institute of health stroke scale (NIHSS) except for MR CLEAN trial in which they enrolled subjects with NIHSS ranging between 3 and 38. Very few subjects had NIHSS ≤5. Other trials like REVASCAT, ESCAPE, SWIFT PRIME, EXTEND-IA, DAWN, and DIFFUSE 3 had their enrolled patients’ NIHSS at ≥6, interquartile range (IQR) 12-20, IQR 13-20, IQR 9-20, IQR 13-21, and IQR 10-21 respectively.1–3 The most likely rationale is that these low-NIHSS stroke patients have well-developed collateral circulations that allo...
Source: Journal of Stroke and Cerebrovascular Diseases - August 11, 2020 Category: Neurology Authors: Omar Hussein, Ahmed Abd Elazim, Khalid Sawalha, Smeer Salam, Kasser Saba, Mohammad Hamed, Juan Peng, Archana Hinduja Source Type: research

Clinical Use of Computed Tomographic Perfusion for the Diagnosis and Prediction of Lesion Growth in Acute Ischemic Stroke
Conclusions: In real-world use, acute imaging with CTP did not predict stroke or DWI lesions with sufficient accuracy. Our findings argue against the use of CTP for screening AIS patients until real-world implementations match the accuracy reported from specialized research centers.
Source: Journal of Stroke and Cerebrovascular Diseases - December 17, 2012 Category: Neurology Authors: Branko N. Huisa, William P. Neil, Ronald Schrader, Marcel Maya, Benedict Pereira, Nhu T. Bruce, Patrick D. Lyden Tags: Original Articles Source Type: research

Physical Activity Correlates with Arterial Stiffness in Community-dwelling Individuals with Stroke
Conclusions: We found that arterial stiffness is elevated in community-dwelling, ambulatory individuals with stroke relative to healthy people. Multivariable regression analysis suggests that aerobic capacity (VO2 peak) may contribute to the variance of cfPWV after accounting for the effects of age and medication use. Whether intense risk modification and augmented physical activity will improve arterial stiffness in this population remains to be determined.
Source: Journal of Stroke and Cerebrovascular Diseases - March 8, 2013 Category: Neurology Authors: Ada Tang, Janice J. Eng, Penelope M. Brasher, Kenneth M. Madden, Azam Mohammadi, Andrei V. Krassioukov, Teresa S.M. Tsang Tags: Original Articles Source Type: research

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