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Procedure: Perfusion
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Perfusion Computed Tomography for the Evaluation of Acute Ischemic Stroke: Strengths and Pitfalls Topical Reviews
Source: Stroke - March 27, 2016 Category: Neurology Authors: Heit, J. J., Wintermark, M. Tags: Computerized Tomography (CT), Imaging, Revascularization, Cerebrovascular Procedures, Ischemic Stroke Topical Reviews Source Type: research
Susceptibility–Diffusion Mismatch in Hyperacute Stroke: Correlation with Perfusion–Diffusion Mismatch and Clinical Outcome
A prominent vein (PV) on susceptibility-weighted imaging (SWI) was recently proposed to be a marker of the penumbra. We aimed to compare the utility of SWI and perfusion-weighted imaging (PWI) sequences for the evaluation of the penumbra in hyperacute middle cerebral artery (MCA) stroke, and to determine whether SWI–DWI mismatch is a neuroimaging marker of clinical outcome.
Source: Journal of Stroke and Cerebrovascular Diseases - April 13, 2016 Category: Neurology Authors: Maelle Dejobert, Xavier Cazals, Mariam Annan, Séverine Debiais, Marie-Agnes Lauvin, Jean-Philippe Cottier Source Type: research
Patient selection for stroke thrombectomy: Is CT head good enough?
Six randomized controlled trials have established the substantial benefit of mechanical thrombectomy for acute ischemic stroke patients presenting with large vessel occlusive disease.1–6 Enrolling patients with large clinical deficit in the setting of small completed infarct and rapid, complete, or near complete recanalization, and treatment with the most recent generation of thrombectomy devices, contributed to this success. Efforts to generalize the results of these trials beyond select, experienced centers have focused attention on workflow and developing consensus on patient selection. Optimizing outcomes require...
Source: Neurology - July 17, 2016 Category: Neurology Authors: Jadhav, A. P., Wechsler, L. R. Tags: CT, All Cerebrovascular disease/Stroke, Infarction EDITORIALS Source Type: research
Susceptibility –Diffusion Mismatch in Hyperacute Stroke: Correlation with Perfusion–Diffusion Mismatch and Clinical Outcome
A prominent vein (PV) on susceptibility-weighted imaging (SWI) was recently proposed to be a marker of the penumbra. We aimed to compare the utility of SWI and perfusion-weighted imaging (PWI) sequences for the evaluation of the penumbra in hyperacute middle cerebral artery (MCA) stroke, and to determine whether SWI –DWI mismatch is a neuroimaging marker of clinical outcome.
Source: Journal of Stroke and Cerebrovascular Diseases - April 13, 2016 Category: Neurology Authors: Maelle Dejobert, Xavier Cazals, Mariam Annan, S éverine Debiais, Marie-Agnes Lauvin, Jean-Philippe Cottier Source Type: research
Different Perfusion Patterns in a Patient with Acute Ischemic Stroke
A 29-year-old male patient with aphasia and mild weakness of the right arm arrived at the emergency room 4 hours after symptom onset. The computed tomography perfusion showed a typical delay in the time-based maps in the left occipital lobe and another hyperperfused area in the left frontal lobe. The follow-up magnetic resonance imaging confirmed cortical ischemic lesions in both areas. This case shows that besides hypoperfusion, hyperperfusion can also be found in the first stages of acute stroke, and it is highly suggestive of established ischemic lesions.
Source: Journal of Stroke and Cerebrovascular Diseases - March 9, 2017 Category: Neurology Authors: Salvatore Rudilosso, Carlos Laredo, Xabier Urra, Ángel Chamorro Tags: Case Studies Source Type: research
Absent Filling of Ipsilateral Superficial Middle Cerebral Vein Is Associated With Poor Outcome After Reperfusion Therapy Clinical Sciences
Conclusions—Lack of SMCV filling contributed to poor outcome after thrombolysis, especially when reperfusion was not achieved. The main deleterious effect of poor venous filling appears related to the development of brain edema.
Source: Stroke - March 27, 2017 Category: Neurology Authors: Sheng Zhang, Yangxiao Lai, Xinfa Ding, Mark Parsons, John H. Zhang, Min Lou Tags: Cerebrovascular Disease/Stroke Original Contributions Source Type: research
Cerebral Near-Infrared Spectroscopy Brief Report
Background and Purpose—Regional brain oxygen saturation (rSO2) changes, assessed by cerebral near-infrared spectroscopy, are likely influenced by cerebral hemodynamic fluctuations induced by thrombectomy of acute proximal occlusion. We studied the correlations between rSO2 and baseline magnetic resonance imaging perfusion parameters and the relationship between rSO2 changes, recanalization, and clinical outcome.Methods—Seventeen acute ischemic stroke patients, treated with mechanical thrombectomy, were monitored using bilateral near-infrared spectroscopy before, during, and continuously for 24 hours after the procedure...
Source: Stroke - November 27, 2017 Category: Neurology Authors: Thomas Ritzenthaler, Tae–Hee Cho, Laura Mechtouff, Elodie Ong, Francis Turȷman, Philip Robinson, Yves Berthezene, Norbert Nighoghossian Tags: Diagnostic Testing, Magnetic Resonance Imaging (MRI), Revascularization, Ischemic Stroke Brief Reports Source Type: research
Staging Hemodynamic Failure With Blood Oxygen-Level-Dependent Functional Magnetic Resonance Imaging Cerebrovascular Reactivity Clinical Sciences
We examined the agreement between the 2 imaging modalities and hypothesized that quantitative CVR can be a surrogate imaging marker to assess hemodynamic failure.Methods—Nineteen data sets of subjects with chronic cerebrovascular steno-occlusive disease (age, 60±11 years; 4 women) and unilaterally impaired perfusion reserve on Diamox-challenged (15O-)H2O PET were studied and compared with a standardized BOLD functional magnetic resonance imaging+CO2 examination within 6 weeks (8±19 days). Agreement between quantitative CBF- and CVR-based perfusion reserve was assessed. Hemodynamic failure was staged according to PET fi...
Source: Stroke - February 26, 2018 Category: Neurology Authors: Jorn Fierstra, Christiaan van Niftrik, Geoffrey Warnock, Susanne Wegener, Marco Piccirelli, Athina Pangalu, Giuseppe Esposito, Antonios Valavanis, Alfred Buck, Andreas Luft, Oliver Bozinov, Luca Regli Tags: Functional Magnetic Resonance Imaging (fMRI), Cerebrovascular Disease/Stroke Original Contributions Source Type: research
Upper Limb Ischemic Postconditioning as Adjunct Therapy in Acute Stroke Patients: A Randomized Pilot
This study aims to observe the clinical effect of upper limb ischemic postconditioning (LIPostC) as an adjunct to treatment with acute stroke patients, possibly due to increased cerebral perfusion.
Source: Journal of Stroke and Cerebrovascular Diseases - September 7, 2018 Category: Neurology Authors: Yuejuan Li, Keke Liang, Long Zhang, Yamei Hu, Yunli Ge, Jianhua Zhao Source Type: research
Thrombectomy for Stroke at 6-24 hours without Perfusion CT Software for Patient Selection
This study aimed to elucidate the efficacy of thrombectomy 6-24 hours after onset in our patient cohort using conventional imaging mismatch.
Source: Journal of Stroke and Cerebrovascular Diseases - December 5, 2018 Category: Neurology Authors: Junya Tsurukiri, Takahiro Ota, Hiroyuki Jimbo, Eitaro Okumura, Keigo Shigeta, Tatsuo Amano, Masayuki Ueda, Yuji Matsumaru, Yoshiaki Shiokawa, Teruyuki Hirano Source Type: research
Transcranial Optical Monitoring of Cerebral Hemodynamics in Acute Stroke Patients during Mechanical Thrombectomy
Introduction: Mechanical thrombectomy is revolutionizing treatment of acute stroke due to large vessel occlusion (LVO). Unfortunately, use of the modified Thrombolysis in Cerebral Infarction score (mTICI) to characterize recanalization of the cerebral vasculature does not address microvascular perfusion of the distal parenchyma, nor provide more than a vascular “snapshot.” Thus, little is known about tissue-level hemodynamic consequences of LVO recanalization. Diffuse correlation spectroscopy (DCS) and diffuse optical spectroscopy (DOS) are promising methods for continuous, noninvasive, contrast-free transcranial monit...
Source: Journal of Stroke and Cerebrovascular Diseases - April 7, 2019 Category: Neurology Authors: Rodrigo M. Forti, Christopher G. Favilla, Jeffrey M. Cochran, Wesley B. Baker, John A. Detre, Scott E. Kasner, Michael T. Mullen, Steven R. Mess é, W. Andrew Kofke, Ramani Balu, David Kung, Bryan A. Pukenas, Neda I. Sedora-Roman, Robert W. Hurst, Omar A. Source Type: research
Comparison of Automated CT Perfusion Softwares in Evaluation of Acute Ischemic Stroke
Background and Purpose: Automated imaging software is integral to decision-making in acute ischemic stroke (AIS) during extended time windows. RAPID software is the most widely used and has been validated in landmark endovascular trials. Olea software is another commercially available and FDA-approved software, but has not been studied in AIS trials. We aimed to compare the diagnostic utility and accuracy of RAPID and Olea in everyday clinical practice outside of a clinical trial. Methods: We analyzed prospectively-collected data from a consecutive cohort of 141 patients with suspected AIS who underwent computed tomography...
Source: Journal of Stroke and Cerebrovascular Diseases - September 24, 2019 Category: Neurology Authors: Yunyun Xiong, Chiwen C. Huang, Marc Fisher, David B. Hackney, Rafeeque A. Bhadelia, Magdy H. Selim Source Type: research
Vascular Hyperintensity on Fluid-Attenuated Inversion Recovery Indicates the Severity of Hypoperfusion in Acute Stroke
Although fluid-attenuated inversion recovery vascular hyperintensities may be frequently seen in acute large-artery ischemic stroke, reports on their prognostic utility had been conflicting due to lack of quantitative evaluation of the perfusion status based on the signal intensity. We hypothesized that greater hyperintensity represents more severe hypoperfusion.
Source: Journal of Stroke and Cerebrovascular Diseases - November 21, 2019 Category: Neurology Authors: Toshiharu Nomura, Kouichirou Okamoto, Hironaka Igarashi, Masato Watanabe, Hitoshi Hasegawa, Makoto Oishi, Yukihiko Fujii Source Type: research
Quantitative collateral assessment evaluated by cerebral blood volume measured by CT perfusion in patients with acute ischemic stroke
The variability in the pre-existing collateral status (CS) is considered an independent determinant of clinical outcomes for patients with acute ischemic stroke (AIS).1,2 Among patients with acute anterior circulation large-vessel occlusion (LVO), those with a highly developed CS have a large area of salvageable brain tissue and respond well to reperfusion therapy (RT).1,3 Therefore, the evaluation of CS is essential in the selection of optimal candidates who would benefit from RT.
Source: Journal of Stroke and Cerebrovascular Diseases - April 17, 2021 Category: Neurology Authors: Sakyo Hirai, Yoji Tanaka, Hirotaka Sato, Koichi Kato, Yongson Kim, Toshihiro Yamamura, Kazutaka Sumita, Toshinari Arai Source Type: research
