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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

Assessment of Irreversible Tissue Injury in Extensive Ischemic Stroke —Potential of Quantitative Cerebral Perfusion
AbstractComputed tomography perfusion (CTP) is used as a tool to select ischemic stroke patients for endovascular treatment (EVT) and is currently investigated in the setting of extensive stroke with low Alberta Stroke Program Early CT scores (ASPECTS). The purpose of this study was to perform a comprehensive quantitative analysis of cerebral blood flow within the ischemic lesion compared to threshold-derived core lesion volumes. We hypothesized that the degree of cerebral blood volume (CBV) reduction within the ischemic lesion is predictive of irreversible tissue injury and functional outcome in patients with low ASPECTS....
Source: Translational Stroke Research - June 29, 2023 Category: Neurology Source Type: research

Interaction of age with the ischaemic penumbra, leptomeningeal collateral circulation and haemodynamic variables in acute stroke: a pilot study
Conclusions These findings, described for the first time in a clinical cohort using whole brain CT perfusion and concomitant vascular imaging, suggest that age has a differential effect on acute tissue compartments in the wake of a preserved collateral vascular response and haemodynamic parameters. In agreement with the preclinical literature, the results point to a distinct tissue response to acute ischaemia in the ageing brain and merit validation studies in larger cohorts, particularly in relation to clinical outcomes.
Source: Journal of Neurology, Neurosurgery and Psychiatry - February 15, 2013 Category: Neurosurgery Authors: Agarwal, S., Scoffings, D. J., Jones, P. S., Marrapu, S. T., Barry, P. J., O'Brien, E. W., Baron, J.-C., Warburton, E. A. Tags: Stroke, Radiology, Radiology (diagnostics) Cerebrovascular disease Source Type: research

Incidence of Venous Thromboembolism in the Wake of the Clots in Legs Or sTockings after Stroke (CLOTS) Study Brief Reports
Conclusions— Discontinuation of compressive stockings did not increase venous thromboembolism incidence. There was a trend toward more deep vein thrombosis and fewer PEs after CLOTS, which might be because of increased clinical vigilance in the diagnosis of deep vein thrombosis, but a chance variation cannot be excluded.
Source: Stroke - September 23, 2013 Category: Neurology Authors: Jain, P., Ward, E., Nevatte, T., Roffe, C. Tags: Deep vein thrombosis Brief Reports Source Type: research

Large ct perfusion-defined mismatch predicts early improvement after iv thrombolysis in acute ischaemic stroke
Conclusions Acute CTP mismatch ratio predicted early neurological improvement after IV rtPA treatment, with large mismatch ratios yielding better prediction of favourable early response. The combination of NIHSS and CTP mismatch may improve prediction of poor outcome. Since all patients received rtPA, no conclusion can be made about the interaction between imaging variables and rtPA.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Collins, P. D., Dani, K. A., Moreton, F., Huang, X., MacDougall, N. J., McVerry, F., Macleod, M. J., Wardlaw, J. M., Muir, K. W. Tags: Stroke, Radiology, Radiology (diagnostics) Association of British Neurologists (ABN) joint meeting with the Royal College of Physicians (RCP), London, 23-24 October 2013 Source Type: research

The halifax acute stroke imaging study (hasis): does ct perfusion scanning in acute ischemic stroke predict final infarct volume?
Conclusions Results from HASIS suggest information from admission CTP and SI in suspected AIS patients can predict final infarct volume, where final volume of infarcted brain will not be smaller than that predicted by CTP CBV or CTA SI.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Langlands, G., Shankar, J., Simpkin, W., Christian, C., Phillips, S. Tags: Stroke, Radiology, Radiology (diagnostics) Association of British Neurologists (ABN) joint meeting with the Royal College of Physicians (RCP), London, 23-24 October 2013 Source Type: research

Prediction of Poststroke Hemorrhagic Transformation Using Computed Tomography Perfusion Clinical Sciences
Conclusions— Tmax >14 s was the CTP parameter most strongly associated with PH. This outperformed relative cerebral blood flow <30%, which closely equates to CTP estimates of ischemic core volume. Although ischemic core volume on CTP is useful in the pretreatment prediction of PH, severe hypoperfusion on Tmax is more strongly associated and may allow better prediction of the likely anatomic location of hemorrhage.
Source: Stroke - October 21, 2013 Category: Neurology Authors: Yassi, N., Parsons, M. W., Christensen, S., Sharma, G., Bivard, A., Donnan, G. A., Levi, C. R., Desmond, P. M., Davis, S. M., Campbell, B. C. V. Tags: Acute Cerebral Infarction, Emergency treatment of Stroke, Computerized tomography and Magnetic Resonance Imaging, Thrombolysis Clinical Sciences Source Type: research

Effects of Noninvasive Facial Nerve Stimulation in the Dog Middle Cerebral Artery Occlusion Model of Ischemic Stroke Basic Sciences
Conclusions— These results support the development and evaluation of a noninvasive facial nerve stimulator device as a treatment of ischemic stroke.
Source: Stroke - March 24, 2014 Category: Neurology Authors: Borsody, M. K., Yamada, C., Bielawski, D., Heaton, T., Castro Prado, F., Garcia, A., Azpiroz, J., Sacristan, E. Tags: Other Treatment Basic Sciences Source Type: research

Six-Minute Magnetic Resonance Imaging Protocol for Evaluation of Acute Ischemic Stroke: Pushing the Boundaries Clinical Sciences
Conclusions— A 6-minute multimodal MR protocol with good diagnostic quality is feasible for the evaluation of patients with acute ischemic stroke and can result in significant reduction in scan time rivaling that of the multimodal computed tomographic protocol.
Source: Stroke - June 23, 2014 Category: Neurology Authors: Nael, K., Khan, R., Choudhary, G., Meshksar, A., Villablanca, P., Tay, J., Drake, K., Coull, B. M., Kidwell, C. S. Tags: CT and MRI, Acute Cerebral Infarction, Computerized tomography and Magnetic Resonance Imaging Clinical Sciences Source Type: research

International survey of acute Stroke imaging used to make revascularization treatment decisions
ConclusionThere were significant variations among sites and geographical areas in terms of stroke imaging work‐up used tomake decisions both for intravenous and endovascular revascularization. Clinical trials using advanced imaging as a selection tool for acute revascularization therapy should address the need for additional resources and technical support, and take into consideration the lack of routine use of such techniques in trial planning.
Source: International Journal of Stroke - April 1, 2015 Category: Neurology Authors: Max Wintermark, Marie Luby, Natan M. Bornstein, Andrew Demchuk, Jens Fiehler, Kohsuke Kudo, Kennedy R. Lees, David S. Liebeskind, Patrik Michel, Raul G. Nogueira, Mark W. Parsons, Makoto Sasaki, Joanna M. Wardlaw, Ona Wu, Weiwei Zhang, Guangming Zhu, Stev Tags: Research Source Type: research

Sulcal Effacement With Preserved Gray-White Junction: A Sign of Reversible Ischemia Brief Reports
Conclusions— Sulcal effacement with preserved gray–white delineation is occasionally visualized in patients with proximal occlusion strokes, relates to robust leptomeningeal collaterals, and indicates preserved underlying parenchyma. ISE should not be used to exclude patients from thrombectomy.
Source: Stroke - May 22, 2015 Category: Neurology Authors: Haussen, D. C., Lima, A., Frankel, M., Anderson, A., Belagaje, S., Nahab, F., Rangaraju, S., Nogueira, R. G. Tags: Acute Cerebral Infarction, Emergency treatment of Stroke, Angiography, Computerized tomography and Magnetic Resonance Imaging Brief Reports Source Type: research

Multi‐modal CT in acute stroke: wait for a serum creatinine before giving intravenous contrast? No!
ConclusionsThe incidence of CIN is low when MMCT is used routinely to assess acute stroke patients. In this population, CIN was a biochemical phenomenon that did not have clinical manifestations, cause chronic kidney disease, require dialysis, or negatively impact on 90‐day mRS outcomes. Renal profiling and waiting for a baseline serum‐creatinine are an unnecessary delay to emergency reperfusion treatment.
Source: International Journal of Stroke - August 26, 2015 Category: Neurology Authors: Timothy E. Ang, Andrew Bivard, Christopher Levi, Henry Ma, Chung Y. Hsu, Bruce Campbell, Geoffrey Donnan, Stephen M. Davis, Mark Parsons Tags: Research Source Type: research

Alteplase Reduces Downstream Microvascular Thrombosis and Improves the Benefit of Large Artery Recanalization in Stroke Basic Sciences
Conclusions— Our data demonstrate that DMT is an early phenomenon initiated before recanalization. We further show that alteplase-dependent maintenance of downstream perfusion during MCAO improves acute ischemic stroke outcome through a fibrinogen-dependent platelet aggregation reduction. Our results indicate that early targeting of DMT represents a therapeutic strategy to improve the benefit of large artery recanalization in acute ischemic stroke.
Source: Stroke - October 26, 2015 Category: Neurology Authors: Desilles, J.-P., Loyau, S., Syvannarath, V., Gonzalez-Valcarcel, J., Cantier, M., Louedec, L., Lapergue, B., Amarenco, P., Ajzenberg, N., Jandrot-Perrus, M., Michel, J.-B., Ho-Tin-Noe, B., Mazighi, M. Tags: Fibrinolysis, Fibrinogen/fibrin, Acute Cerebral Infarction, Brain Circulation and Metabolism, Thrombolysis Basic Sciences Source Type: research

Ultra-acute CT perfusion imaging: A stroke in the scanner
A stroke patient with a mild right hemiparesis (NIH Stroke Scale score 4) underwent dual-slab CT perfusion (CTP). In the midst of acquiring the lower CTP slab, she became aphasic and developed a dense right hemiparesis (NIH Stroke Scale score 17). Reconstruction of the CTP into a dynamic CT angiogram demonstrates fragmentation of an internal carotid artery thrombus at the time of clinical worsening (figure 1; video on the Neurology® Web site at Neurology.org). The upper CTP slab, acquired 2 minutes later, provides the earliest known view of the hemodynamics of ischemic stroke in humans. It demonstrates total absence of...
Source: Neurology - November 9, 2015 Category: Neurology Authors: Christensen, S., Obi, C., Albers, G., Lansberg, M. Tags: CT, All Cerebrovascular disease/Stroke, Embolism, Infarction VIDEO NEUROIMAGES Source Type: research

Effects of Acute Stroke Serum on Non-Ischemic Cerebral and Mesenteric Vascular Function
Abstract We investigated the effects of circulating factors in serum obtained from patients in the acute phase of different subtypes of ischemic stroke on non-ischemic cerebral and mesenteric arteries, as a potential mechanism involved in influencing regional perfusion and thus clinical evolution. Posterior cerebral arteries (PCAs) and mesentery arteries (MAs) isolated from Wistar Kyoto rats were perfused with serum from acute stroke patients with large vessel disease without (LVD) or with hypertension (LVD + HTN), cardioembolism with hypertension (CE + HTN), or physiologic saline as controls. Myogenic act...
Source: Translational Stroke Research - January 26, 2016 Category: Neurology Source Type: research