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Condition: Stroke
Procedure: Perfusion

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Total 4550 results found since Jan 2013.

Interaction of Recanalization, Intracerebral Hemorrhage, and Cerebral Edema After Intravenous Thrombolysis Clinical Sciences
Conclusions— Large ischemic core was associated with poorer outcomes and both early vasogenic brain edema and ICH, but recanalization on 24-hour CT angiography was associated with clinically favorable outcome. There was no significant interaction of recanalization and large core volume for any outcomes. The association of hemorrhage or brain edema with post-thrombolysis reperfusion is unclear.
Source: Stroke - June 26, 2016 Category: Neurology Authors: Cheripelli, B. K., Huang, X., MacIsaac, R., Muir, K. W. Tags: Cerebrovascular Disease/Stroke, Intracranial Hemorrhage, Ischemic Stroke Clinical Sciences Source Type: research

How Patient Demographics, Imaging, and Beliefs Influence Tissue-Type Plasminogen Activator Use: A Survey of North American Neurologists Clinical Sciences
Conclusions— Diagnostic certainty and likelihood of treatment with tissue-type plasminogen activator increase with additional clinical data, with the history being the most important factor for diagnostic and treatment decisions. Respondents had difficulty in interpreting the results of CT perfusion scans although they had little impact on treatment decisions. We did not identify treatment bias based on patient age, race, or sex.
Source: Stroke - July 24, 2016 Category: Neurology Authors: Shamy, M. C. F., Pugliese, M., Meisel, K., Rodriguez, R., Kim, A. S., Stahnisch, F. W., Smith, E. E. Tags: Computerized Tomography (CT), Ethics and Policy, Quality and Outcomes, Ischemic Stroke Clinical Sciences Source Type: research

Venous imaging-based biomarkers in acute ischaemic stroke
Vascular neuroimaging plays a decisive role in selecting the best therapy in patients with acute ischaemic stroke. However, compared with the arterial system, the role of veins has not been thoroughly studied. In this review, we present the major venous imaging-based biomarkers in ischaemic stroke. First, the presence of hypodense veins in the monophasic CT angiography ipsilateral to the arterial occlusion. Second, the asymmetry of venous drainage in the pathological cerebral hemisphere on CT and MRI dynamic angiography. Finally, the presence of hypodense veins on T2* -based MRI. From the physiological point of view, the v...
Source: Journal of Neurology, Neurosurgery and Psychiatry - December 14, 2016 Category: Neurosurgery Authors: Munuera, J., Blasco, G., Hernandez-Perez, M., Daunis-i-Estadella, P., Davalos, A., Liebeskind, D. S., Wintermark, M., Demchuk, A., Menon, B. K., Thomalla, G., Nael, K., Pedraza, S., Puig, J. Tags: Stroke, Radiology, Radiology (diagnostics) Cerebrovascular disease Source Type: research

Primary acute stroke thrombectomy within 3 h for large artery occlusion (PAST3-LAO): a pilot study
Conclusions Our study demonstrates that primary SRT in AIS from LAO is safe and feasible and is associated with complete recanalization and good outcome. Further study is required.
Source: Journal of NeuroInterventional Surgery - March 15, 2017 Category: Neurosurgery Authors: Lodi, Y., Reddy, V., Petro, G., Devasenapathy, A., Hourani, A., Chou, C.-A. Tags: Ischemic stroke 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

Exacerbation of Thromboinflammation by Hyperglycemia Precipitates Cerebral Infarct Growth and Hemorrhagic Transformation Basic Sciences
Conclusions—We show that hyperglycemia primes the thromboinflammatory cascade, thus, amplifying middle cerebral artery occlusion–induced DMT. DMT exacerbation in hyperglycemic rats impaired reperfusion and precipitated neurovascular damage, blood–brain barrier disruption, and hemorrhagic transformation. Our results designate DMT as a possible target for reduction of the deleterious impact of hyperglycemia in acute ischemic stroke.
Source: Stroke - June 26, 2017 Category: Neurology Authors: Jean–Philippe Desilles, Varouna Syvannarath, Veronique Ollivier, Clement Journe, Sandrine Delbosc, Celina Ducroux, William Boisseau, Liliane Louedec, Lucas Di Meglio, Stephane Loyau, Martine Jandrot–Perrus, Louis Potier, Jean–Baptiste Mi Tags: Biomarkers, Inflammation, Pathophysiology, Blood-Brain Barrier, Ischemic Stroke Original Contributions Source Type: research

Influence of Penumbral Reperfusion on Clinical Outcome Depends on Baseline Ischemic Core Volume Clinical Sciences
This study included 1507 patients. Reperfused penumbral volume had moderate ability to predict 90-day mRS 0 to 1 (area under the curve, 0.77; R2, 0.28; P
Source: Stroke - September 25, 2017 Category: Neurology Authors: Chushuang Chen, Mark W. Parsons, Matthew Clapham, Christopher Oldmeadow, Christopher R. Levi, Longting Lin, Xin Cheng, Min Lou, Timothy J. Kleinig, Kenneth S. Butcher, Qiang Dong, Andrew Bivard Tags: Ischemic Stroke Original Contributions Source Type: research

Vulnerability to Infarction During Cerebral Ischemia in Migraine Sufferers Clinical Sciences
Conclusions—Migraine is likely to increase individual vulnerability to ischemic stroke during the process of acute brain ischemia and might represent, therefore, a potential new therapeutic target against occurrence and progression of the ischemic damage.
Source: Stroke - February 26, 2018 Category: Neurology Authors: Alessandro Pezzini, Giorgio Busto, Marialuisa Zedde, Massimo Gamba, Andrea Zini, Loris Poli, Filomena Caria, Valeria De Giuli, Anna Maria Simone, Rosario Pascarella, Alessandro Padovani, Marina Padroni, Roberto Gasparotti, Stefano Colagrande, Enrico Faina Tags: Epidemiology, Risk Factors, Cerebrovascular Disease/Stroke, Ischemic Stroke, Vascular Disease Original Contributions 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

Implications of Post-recanalization Perfusion Deficit After Acute Ischemic Stroke: a Scoping Review of Clinical and Preclinical Imaging Studies
AbstractThe goal of reperfusion therapy for acute ischemic stroke (AIS) is to restore cerebral blood flow through recanalization of the occluded vessel. Unfortunately, successful recanalization does not always result in favorable clinical outcome. Post-recanalization perfusion deficits (PRPDs), constituted by cerebral hypo- or hyperperfusion, may contribute to lagging patient recovery rates, but its clinical significance remains unclear. This scoping review provides an overview of clinical and preclinical findings on post-ischemic reperfusion, aiming to elucidate the pattern and consequences of PRPD from a translational pe...
Source: Translational Stroke Research - January 19, 2023 Category: Neurology Source Type: research

Endovascular thrombectomy beyond 24 hours from ischemic stroke onset: a propensity score matched cohort study
Conclusion In this real world study, EVT beyond 24 hours from stroke onset or last known well appeared to be feasible, with comparable safety and functional outcomes to EVT initiation between 6 and 24 hours. Randomized trials assessing the efficacy of EVT in the VL window are warranted, but may only be feasible with a large international collaborative approach.
Source: Journal of NeuroInterventional Surgery - February 14, 2023 Category: Neurosurgery Authors: Dhillon, P. S., Butt, W., Podlasek, A., Barrett, E., McConachie, N., Lenthall, R., Nair, S., Malik, L., James, M. A., Dineen, R. A., England, T. J. Tags: Ischemic stroke Source Type: research

Contrast conservation measures during the global iohexol contrast shortage crisis did not affect stroke thrombectomy outcomes
Conclusions Modifying stroke workflow to adapt to the current global shortage in iohexol is feasible. Using diluted iohexol (50% contrast mixed with 50% heparinized saline) did not affect MT outcomes.
Source: Journal of NeuroInterventional Surgery - August 29, 2023 Category: Neurosurgery Authors: Almallouhi, E., Sattur, M., Lajthia, O., Kicielinski, K. P., Holmstedt, C., Lena, J. R., Al Kasab, S., Spiotta, A. M. Tags: Ischemic stroke Source Type: research

The Effects of Alteplase 3 to 6 Hours After Stroke in the EPITHET-DEFUSE Combined Dataset: Post Hoc Case-Control Study Original Contributions
Conclusions— The data provide further evidence that alteplase significantly attenuates infarct growth and increases reperfusion compared with placebo in the 3- to 6- hour time window in patients selected based on MR penumbral imaging. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00238537
Source: Stroke - December 24, 2012 Category: Neurology Authors: Ogata, T., Christensen, S., Nagakane, Y., Ma, H., Campbell, B. C. V., Churilov, L., Lansberg, M. G., Straka, M., De Silva, D. A., Mlynash, M., Bammer, R., Olivot, J.-M., Desmond, P. M., Albers, G. W., Davis, S. M., Donnan, G. A., for the EPITHET and DEFUS Tags: CT and MRI, Other imaging, Thrombolysis Original Contributions Source Type: research

Clinical Outcomes Strongly Associated With the Degree of Reperfusion Achieved in Target Mismatch Patients: Pooled Data from the Diffusion and Perfusion Imaging Evaluation for Understanding Stroke Evolution Studies Clinical Sciences
Conclusion— The degree of reperfusion documented on perfusion-weighted imaging after reperfusion therapies corresponds closely with clinical outcomes in TMM patients. Reperfusion of ≥90% of the perfusion lesion is an appropriate goal for reperfusion therapies to aspire to.
Source: Stroke - June 24, 2013 Category: Neurology Authors: Inoue, M., Mlynash, M., Straka, M., Kemp, S., Jovin, T. G., Tipirneni, A., Hamilton, S. A., Marks, M. P., Bammer, R., Lansberg, M. G., Albers, G. W., for the DEFUSE 1 and 2 Investigators Tags: Acute Cerebral Infarction, Computerized tomography and Magnetic Resonance Imaging, Thrombolysis Clinical Sciences Source Type: research