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Procedure: Perfusion

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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

Solitaire™ with the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke (SWIFT PRIME) trial: protocol for a randomized, controlled, multicenter study comparing the Solitaire revascularization device with IV tPA with IV tPA alone in acute ischemic stroke
RationaleEarly reperfusion in patients experiencing acute ischemic stroke is critical, especially for patients with large vessel occlusion who have poor prognosis without revascularization. Solitaire™ stent retriever devices have been shown to immediately restore vascular perfusion safely, rapidly, and effectively in acute ischemic stroke patients with large vessel occlusions. AimThe aim of the study was to demonstrate that, among patients with large vessel, anterior circulation occlusion who have received intravenous tissue plasminogen activator, treatment with Solitaire revascularization devices reduces degree of disab...
Source: International Journal of Stroke - March 16, 2015 Category: Neurology Authors: Jeffrey L. Saver, Mayank Goyal, Alain Bonafe, Hans‐Christoph Diener, Elad I. Levy, Vitor M. Pereira, Gregory W. Albers, Christophe Cognard, David J. Cohen, Werner Hacke, Olav Jansen, Tudor G. Jovin, Heinrich P. Mattle, Raul G. Nogueira, Adnan H. Siddiqu Tags: Protocols Source Type: research

Additional Diagnostic Value of Computed Tomography Perfusion for Detection of Acute Ischemic Stroke in the Posterior Circulation Brief Reports
Conclusions— CT perfusion has significant additional diagnostic values to noncontrast CT and CT angiography source images for detecting ischemic changes in patients suspected of acute posterior circulation stroke.
Source: Stroke - March 23, 2015 Category: Neurology Authors: van der Hoeven, E. J. R. J., Dankbaar, J. W., Algra, A., Vos, J. A., Niesten, J. M., van Seeters, T., van der Schaaf, I. C., Schonewille, W. J., Kappelle, L. J., Velthuis, B. K., on behalf of the DUST Investigators Tags: Acute Cerebral Infarction, Computerized tomography and Magnetic Resonance Imaging Brief Reports Source Type: research

Incidence and mechanisms of stroke after permanent carotid artery occlusion following temporary occlusion testing
Conclusions The rate of ischemic stroke following carotid sacrifice remains high and most strokes are thromboembolic in nature. Our testing protocol did not eliminate the risk of hypoperfusion-related stroke. Delayed venous phase by angiography may be a better indicator of hemodynamic tolerance than perfusion imaging.
Source: Journal of NeuroInterventional Surgery - May 14, 2015 Category: Neurosurgery Authors: Whisenant, J. T., Kadkhodayan, Y., Cross, D. T., Moran, C. J., Derdeyn, C. P. Tags: Ischemic stroke Source Type: research

Cerebral collateral circulation in experimental ischemic stroke
Abstract Cerebral collateral circulation is a subsidiary vascular network, which is dynamically recruited after arterial occlusion, and represents a powerful determinant of ischemic stroke outcome. Although several methods may be used for assessing cerebral collaterals in the acute phase of ischemic stroke in humans and rodents, they are generally underutilized. Experimental stroke models may play a unique role in understanding the adaptive response of cerebral collaterals during ischemia and their potential for therapeutic modulation. The systematic assessment of collateral perfusion in experimental stroke model...
Source: Experimental and Translational Stroke Medicine - March 1, 2016 Category: Neurology Source Type: research

Change in CSF Dynamics Responsible for ICP Elevation After Ischemic Stroke in Rats: a New Mechanism for Unexplained END?
AbstractIt has been proposed that intracranial pressure (ICP) elevation and collateral failure are responsible for unexplained early neurological deterioration (END) in stroke. The study ’s aims were to investigate whether cerebral spinal fluid (CSF) dynamics, rather than edema, are responsible for elevation of ICP after ischemic stroke. Permanent middle cerebral artery occlusion (pMCAO) was induced with an intraluminal filament. At 24 h after stroke, baseline ICP was measured an d CSF dynamics were probed via a steady-state infusion method. Diffusion-weighted imaging (DWI) and T2-weighted magnetic resonance imaging wer...
Source: Translational Stroke Research - August 14, 2019 Category: Neurology Source Type: research

Best Practice Recommendations for Stroke Vascular Imaging During Iodinated Contrast Shortage
GE Healthcare© announced on April 19, 2022, that their main factory and distributor of iodinated contrast had experienced a temporary shutdown because of COVID-19 outbreak in Shanghai, China. This, along with other supply chain issues, led to a worldwide shortage of iodinated contrast agents, Omnipaque and Visipaque. Our Comprehensive Stroke Center was confronted with the cascading effect of this iodinated contrast material shortage. We took immediate steps to revise our protocols and processes to continue to provide high-quality care to our stroke patients. A multidisciplinary working group comprised of representativ...
Source: Neurology Clinical Practice - March 3, 2023 Category: Neurology Authors: Bhole, R., Solenski, N. J., Donahue, J. H., Kellogg, R. T., Roach, N. N., Chapman, S. N., Worrall, B. B., Evans, A. J., Patel, S. H., Mukherjee, S., Park, M. S., Southerland, A. M. Tags: Decision analysis, Medical care, All Cerebrovascular disease/Stroke, All Practice Management Commentary Source Type: research

Perfusion computed tomography thresholds defining ischemic penumbra and infarct core: studies in a rat stroke model
ConclusionsThe data provide perfusion computed tomography defined relative cerebral blood flow thresholds for infarct core and ischemic penumbra within the first two hours after experimental stroke in rats. These thresholds were shown to be stable to define the volume of infarct core and penumbra within this time window.
Source: International Journal of Stroke - October 21, 2013 Category: Neurology Authors: D. D. McLeod, M. W. Parsons, R. Hood, B. Hiles, J. Allen, S. K. McCann, L. Murtha, M. B. Calford, C. R. Levi, N. J. Spratt Tags: Research Source Type: research

Relative Cerebral Blood Volume as a Marker of Durable Tissue-at-Risk Viability in Hyperacute Ischemic Stroke Clinical Sciences
Conclusions— High rCBV was the strongest marker of good collaterals and may characterize durable tissue-at-risk viability in hyperacute MCA ischemic stroke.
Source: Stroke - December 23, 2013 Category: Neurology Authors: Cortijo, E., Calleja, A. I., Garcia-Bermejo, P., Mulero, P., Perez-Fernandez, S., Reyes, J., Munoz, M. F., Martinez-Galdamez, M., Arenillas, J. F. Tags: Acute Cerebral Infarction, Other imaging Clinical Sciences 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

Brain Edema Predicts Outcome After Nonlacunar Ischemic Stroke Clinical Sciences
Conclusions— Swelling and infarct growth each contribute to total stroke lesion growth in the days after stroke. Swelling is an independent predictor of poor outcome, with a brain swelling volume of ≥11 mL identified as the threshold with greatest sensitivity and specificity for predicting poor outcome.
Source: Stroke - November 24, 2014 Category: Neurology Authors: Battey, T. W. K., Karki, M., Singhal, A. B., Wu, O., Sadaghiani, S., Campbell, B. C. V., Davis, S. M., Donnan, G. A., Sheth, K. N., Kimberly, W. T. Tags: Acute Cerebral Infarction, Computerized tomography and Magnetic Resonance Imaging Clinical Sciences Source Type: research

Correlation between cerebral blood volume values and outcomes in endovascular therapy for acute ischemic stroke
Conclusions We found that cortical CBV loss is predictive of poor clinical outcomes, whereas basal ganglia CBV loss is predictive of hemorrhagic transformation but without translation into poor clinical outcomes. Our study findings support published results of baseline preintervention CBV as a predictor of outcomes in patients undergoing intra-arterial stroke therapies.
Source: Journal of NeuroInterventional Surgery - September 13, 2015 Category: Neurosurgery Authors: Mokin, M., Morr, S., Fanous, A. A., Shallwani, H., Natarajan, S. K., Levy, E. I., Snyder, K. V., Siddiqui, A. H. Tags: Ischemic stroke Source Type: research

Sodium Tanshinone IIA Sulfonate Enhances Effectiveness Rt-PA Treatment in Acute Ischemic Stroke Patients Associated with Ameliorating Blood-Brain Barrier Damage
AbstractTreatment with sodium tanshinone IIA sulfonate (STS) may ameliorate blood-brain barrier (BBB) damage in acute ischemic stroke patients receiving recombinant tissue plasminogen activator (rt-PA) thrombolysis and improve stroke patients ’ outcome. This randomized, single-center, placebo-controlled clinical trial investigated the potential effects and underlying mechanisms of STS. Forty-two acute ischemic stroke patients receiving intravenous rt-PA thrombolysis were randomized to intravenous administration either with STS (60 mg/ day) (n = 21) or with equivalent volume of saline as a placebo (n = 21) after rand...
Source: Translational Stroke Research - February 26, 2017 Category: Neurology Source Type: research

Acute Transient Vestibular Syndrome Clinical Sciences
Conclusions—Bedside examination and routine magnetic resonance imagings have a limitation in diagnosing strokes presenting with ATVS, and perfusion imaging may help to identify strokes in ATVS of unknown cause. Associated craniocervical pain and focal neurological symptoms/signs are the useful clues for strokes in ATVS.
Source: Stroke - February 26, 2017 Category: Neurology Authors: Jae-Hwan Choi, Min-Gyu Park, Seo Young Choi, Kyung-Pil Park, Seung Kug Baik, Ji-Soo Kim, Kwang-Dong Choi Tags: Cerebrovascular Disease/Stroke, Transient Ischemic Attack (TIA) Original Contributions Source Type: research