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Condition: Stroke
Procedure: Perfusion

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CT perfusion can delineate lacunar infarcts in acute stroke calls
We present 4 patients in whom CT perfusion was performed using a 320-slice scanner (Aquilion ONE Vision, Toshiba, Japan) and Ultravist 370 (iopromide, Bayer, Switzerland) injected at 4 mL/s for 50 mL. Multiplanar reconstruction of perfusion data was performed using commercially available software (Vitrea 6.6.2036.1, Vital Images, Minnetonka, MN). Time from stroke onset to CT perfusion is presented in the table.
Source: Nature Clinical Practice - December 7, 2015 Category: Neurology Authors: Chiu, A. H., Hankey, G. J., Blacker, D. J., McAuliffe, W. Tags: CT, All Cerebrovascular disease/Stroke Cases Source Type: research

A Simple Geometric Assessment of Perfusion Lesion Volume at Hyperacute Stage of Ischemic Stroke in Patients with Symptomatic Steno-Occlusion of Major Cerebral Arteries and Risk of Subsequent Cerebral Ischemic Events
Our objective is to elucidate the association of baseline perfusion lesion volume on perfusion-weighted magnetic resonance imaging (PWI) obtained at hyperacute stage of ischemic stroke with subsequent cerebral ischemic events (SIEs) in patients with symptomatic steno-occlusion of major cerebral arteries. Using a prospective stroke registry database, patients arriving within 24 hours of onset with symptomatic steno-occlusion of major supratentorial cerebral arteries were identified. On baseline PWI, time-to-peak lesion volume (TTP-LV) was determined by a simple geometric method and dichotomized into the highest tertile (la...
Source: Journal of Stroke and Cerebrovascular Diseases - October 14, 2015 Category: Neurology Authors: Jihoon Kang, Cheolkyu Jung, Nayoung Kim, Yoo Ri Son, Byungse Choi, Jae-Hyoung Kim, Ji Sung Lee, Juneyoung Lee, Jun Lee, Myung Suk Jang, Mi Hwa Yang, Moon-Ku Han, Hee-Joon Bae Tags: Original Article Source Type: research

Prediction of Early Reperfusion From Repeated Arterial Spin Labeling Perfusion Magnetic Resonance Imaging During Intravenous Thrombolysis Brief Reports
Conclusions— The development of ATA during thrombolysis is associated with early reperfusion after thrombolysis. arterial spin labeling assessment during intravenous thrombolysis has the potential to guide subsequent therapeutic strategies in patients with acute stroke.
Source: Stroke - December 28, 2015 Category: Neurology Authors: Okazaki, S., Griebe, M., Gregori, J., Gunther, M., Sauter-Servaes, J., Wolf, M. E., Gass, A., Hennerici, M. G., Szabo, K., Kern, R. Tags: Computerized Tomography (CT), Magnetic Resonance Imaging (MRI), Cerebrovascular Disease/Stroke, Ischemic Stroke Brief Reports Source Type: research

Infarct growth despite full reperfusion in endovascular therapy for acute ischemic stroke
Conclusions Despite full reperfusion, infarct growth is relatively frequent and may explain poor clinical outcomes in this setting. Ethnicity was found to influence SIG. Use of IV t-PA and stent-retrievers were associated with less infarct core expansion.
Source: Journal of NeuroInterventional Surgery - January 13, 2016 Category: Neurosurgery Authors: Haussen, D. C., Nogueira, R. G., Elhammady, M. S., Yavagal, D. R., Aziz-Sultan, M. A., Johnson, J. N., Gaynor, B. G., Jen, S., Dehkharghani, S., Peterson, E. C. Tags: Ischemic stroke Source Type: research

Relative CBV ratio on perfusion-weighted MRI indicates the probability of early recanalization after IV t-PA administration for acute ischemic stroke
Conclusions The results of this study suggest that the rCBV ratio on PWI might serve as a useful indicator of ER after IV t-PA administration.
Source: Journal of NeuroInterventional Surgery - February 14, 2016 Category: Neurosurgery Authors: Sohn, S.-W., Park, H.-S., Cha, J.-K., Kim, D.-H., Kang, M.-J., Choi, J.-H., Nah, H.-W., Huh, J.-T. Tags: Ischemic stroke Source Type: research

Distinctive Patterns of Three-Dimensional Arterial Spin-Labeled Perfusion Magnetic Resonance Imaging in Subtypes of Acute Ischemic Stroke
Ischemic penumbra in acute ischemic stroke (AIS) can be evaluated using arterial spin-labeled (ASL) perfusion magnetic resonance imaging (MRI). We used three-dimensional ASL-MRI to examine patients with different stroke subtypes and the clinical utility of the method within 24 hours of AIS onset.
Source: Journal of Stroke and Cerebrovascular Diseases - April 20, 2016 Category: Neurology Authors: Naoto Kohno, Kazunori Okada, Shingo Yamagata, Hiroyuki Takayoshi, Shuhei Yamaguchi Source Type: research

Pial Collateral Reactivity During Hypertension and Aging: Understanding the Function of Collaterals for Stroke Therapy Basic Sciences
Conclusions— This study shows for the first time that LMAs from young and aged SHR are vasoconstricted and have impaired vasodilatory responses that may contribute to greater perfusion deficit and little penumbral tissue. These results also suggest that therapeutic opening of pial collaterals is possible during middle cerebral artery occlusion to create penumbral tissue and prevent infarct expansion.
Source: Stroke - May 22, 2016 Category: Neurology Authors: Chan, S.-L., Sweet, J. G., Bishop, N., Cipolla, M. J. Tags: Animal Models of Human Disease, Endothelium/Vascular Type/Nitric Oxide, Vascular Biology, Cerebrovascular Disease/Stroke, Ischemic Stroke Basic Sciences Source Type: research

Distinctive Patterns of Three-Dimensional Arterial Spin-Labeled Perfusion Magnetic Resonance Imaging in Subtypes of Acute Ischemic Stroke
Ischemic penumbra in acute ischemic stroke (AIS) can be evaluated using arterial spin-labeled (ASL) perfusion magnetic resonance imaging (MRI). We used three-dimensional ASL-MRI to examine patients with different stroke subtypes and the clinical utility of the method within 24 hours of AIS onset.
Source: Journal of Stroke and Cerebrovascular Diseases - April 20, 2016 Category: Neurology Authors: Naoto Kohno, Kazunori Okada, Shingo Yamagata, Hiroyuki Takayoshi, Shuhei Yamaguchi Source Type: research

Computed Tomography Perfusion-Based Decision Making for Acute Ischemic Stroke —Missing the Mismatch
We present a case of an 80-year-old man admitted because of acute ischemic stroke. CT angiography demonstrated left proximal M2 occlusion. As CTP demonstrated signs of large ischemic core with no significant penumbra, mechanical thrombectomy was not performed following tPA administration.
Source: Journal of Stroke and Cerebrovascular Diseases - March 17, 2017 Category: Neurology Authors: J.A. Molad, M. Findler, E. Auriel Tags: Case Studies Source Type: research

External Counterpulsation Increases Beat-to-Beat Heart Rate Variability in Patients with Ischemic Stroke
External counterpulsation (ECP) is a noninvasive method used to augment cerebral perfusion in ischemic stroke. However, the response of beat-to-beat heart rate variability (HRV) in patients with ischemic stroke during ECP remains unknown.
Source: Journal of Stroke and Cerebrovascular Diseases - April 7, 2017 Category: Neurology Authors: Li Xiong, Ge Tian, Li Wang, Wenhua Lin, Xiangyan Chen, Thomas Wai Hong Leung, Yannie Oi Yan Soo, Lawrence Ka Sing Wong Source Type: research

Perfusion Deficits and Association with Clinical Outcome in Patients with Anterior Choroidal Artery Stroke
This study aims to determine the frequency of perfusion abnormalities in AChA stroke and association with clinical outcome.
Source: Journal of Stroke and Cerebrovascular Diseases - April 27, 2017 Category: Neurology Authors: Saeed A. Alqahtani, Marie Luby, Zurab Nadareishvili, Richard T. Benson, Amie W. Hsia, Richard Leigh, John K. Lynch Source Type: research

Use of Noncontrast Computed Tomography and Computed Tomographic Perfusion in Predicting Intracerebral Hemorrhage After Intravenous Alteplase Therapy Clinical Sciences
Background and Purpose—Intracerebral hemorrhage is a feared complication of intravenous alteplase therapy in patients with acute ischemic stroke. We explore the use of multimodal computed tomography in predicting this complication.Methods—All patients were administered intravenous alteplase with/without intra-arterial therapy. An age- and sex-matched case–control design with classic and conditional logistic regression techniques was chosen for analyses. Outcome was parenchymal hemorrhage on 24- to 48-hour imaging. Exposure variables were imaging (noncontrast computed tomography hypoattenuation degree, relative volume...
Source: Stroke - May 22, 2017 Category: Neurology Authors: Connor Batchelor, Pooneh Pordeli, Christopher D. d’Esterre, Mohamed Naȷm, Fahad S. Al–Aȷlan, Mari E. Boesen, Connor McDougall, Lisa Hur, Enrico Fainardi, Jai Jai Shiva Shankar, Marta Rubiera, Alexander V. Khaw, Michael D. Hill, Tags: Blood-Brain Barrier, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

Cerebral Hypoperfusion and Other Shared Brain Pathologies in Ischemic Stroke and Alzheimer ’s Disease
AbstractNewly emerged evidence reveals that ischemic stroke and Alzheimer ’s disease (AD) share pathophysiological changes in brain tissue including hypoperfusion, oxidative stress, immune exhaustion, and inflammation. A mechanistic link between hypoperfusion and amyloid β accumulation can lead to cell damage as well as to motor and cognitive deficits. This review will discuss decreased cerebral perfusion and other related pathophysiological changes common to both ischemic stroke and AD, such as vascular damages, cerebral blood flow alteration, abnormal expression of amyloid β and tau proteins, as well as behavioral an...
Source: Translational Stroke Research - October 2, 2017 Category: Neurology Source Type: research

Modified Thrombolysis in Cerebral Infarction 2C/Thrombolysis in Cerebral Infarction 3 Reperfusion Should Be the Aim of Mechanical Thrombectomy Clinical Sciences
Conclusions—Combining mTICI 2C and TICI 3 grades helps to determine a subgroup of patients achieving better functional outcomes than mTICI 2B patients. Achieving mTICI 2C/3 reperfusion should be the new aim of mechanical thrombectomy for anterior circulation LVO.
Source: Stroke - April 23, 2018 Category: Neurology Authors: Cyril Dargazanli, Robert Fahed, Raphael Blanc, Benjamin Gory, Julien Labreuche, Alain Duhamel, Gaultier Marnat, Suzana Saleme, Vincent Costalat, Serge Bracard, Hubert Desal, Mikael Mazighi, Arturo Consoli, Michel Piotin, Bertrand Lapergue Tags: Cerebrovascular Disease/Stroke, Cerebrovascular Procedures, Ischemic Stroke Original Contributions Source Type: research

Improving Microcirculatory Reperfusion Reduces Parenchymal Oxygen Radical Formation and Provides Neuroprotection Basic Sciences
Conclusions—Promoting microvascular reperfusion by protecting vasculature can secondarily reduce parenchymal ROS formation and provide neuroprotection. The model presented can be used to directly assess pharmacological end points postulated in brain parenchyma and vasculature in vivo.
Source: Stroke - April 23, 2018 Category: Neurology Authors: Aslihan Taskiran-Sag, Muge Yemisci, Yasemin Gursoy-Ozdemir, Sefik Evren Erdener, Hulya Karatas, Deniz Yuce, Turgay Dalkara Tags: Ischemic Stroke, Neuroprotectants Original Contributions Source Type: research