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Cerebral artery signal intensity gradient from Time-of-Flight Magnetic Resonance Angiography and clinical outcome in lenticulostriate infarction: a retrospective cohort study
ConclusionCerebral artery SIG from TOF-MRA was significantly associated with short-term functional outcomes in patients with lenticulostriate infarction. Further studies are needed to investigate the temporal relationships of SIG in patients with cerebral infarction.
Source: Frontiers in Neurology - September 20, 2023 Category: Neurology Source Type: research

Case report: Retrograde endovascular recanalization of vertebral artery occlusion with non-tapered stump via the deep cervical collateral
ConclusionAntegrade endovascular recanalization of VA occlusion with a non-tapered stump is a challenge. The retrograde endovascular method via the cervical collateral may be an alternative for this type of VA occlusion, which requires further exploration.
Source: Frontiers in Neurology - September 20, 2023 Category: Neurology Source Type: research

Quantitative assessment of collateral time on perfusion computed tomography in acute ischemic stroke patients
ConclusionOur results indicate that perfusion computed tomography can accurately quantify the collateral time after acute ischemic stroke.
Source: Frontiers in Neurology - August 24, 2023 Category: Neurology Source Type: research

Thrombectomy with and without computed tomography perfusion imaging for large-vessel occlusion stroke in the extended time window: a meta-analysis of randomized clinical trials
ConclusionThese findings suggest that the choice of NCCT ± CTA (without CTP) for the assessment of mechanical thrombectomy within 6–24 h after LVO in the anterior circulation is not significantly different from CTP; instead, the choice of NCCT ± CTA significantly reduces the time from onset to arterial puncture.
Source: Frontiers in Neurology - August 17, 2023 Category: Neurology Source Type: research

Impact of ongoing intravenous thrombolysis until completion of endovascular treatment in large vessel occlusion stroke patients
ConclusionOur findings suggest that ongoing IVT until ET completion has a favorable impact on both clinical and angiographic outcomes, as well as on periprocedural conditions, regardless of the overall time intervals involved. Therefore, rapid ET after IVT should be sought in order to take advantage of the additive effect of ongoing IVT during ET. Future studies should consider IVT timing in the context of ET as a potential confounder and treatment target.
Source: Frontiers in Neurology - August 4, 2023 Category: Neurology Source Type: research

Case report: Mechanical thrombectomy for acute basilar artery occlusion via persistent hypoglossal artery
Persistent hypoglossal artery (PHA) is a rare carotid-vertebrobasilar anastomosis in adults. Here, we report a case of mechanical thrombectomy for acute basilar artery occlusion via the PHA. A 44-year-old man was admitted to our stroke unit with an unstable gait and aphasia for 2 h. The baseline National Institutes of Health Stroke Scale (NIHSS) score was 4, but the clinical symptoms continued to worsen. Computed tomography angiography showed the absence of the basilar artery and an abnormal anastomosis between the anterior and posterior circulation. Clinical symptoms continued to worsen, and endovascular treatment was sch...
Source: Frontiers in Neurology - July 27, 2023 Category: Neurology Source Type: research

Microsurgical revascularization of a symptomatic proximal vertebral artery: pilot experiences from a single center
ConclusionMicrosurgical reconstruction is an alternative option that can effectively treat refractory proximal VASO disease and in-stent stenosis, with a high rate of postoperative vascular recirculation. Prospective cohort studies with larger sample sizes must be conducted to validate the above conclusions.
Source: Frontiers in Neurology - July 7, 2023 Category: Neurology Source Type: research

Computed tomography angiography-based radiomics model for predicting carotid atherosclerotic plaque vulnerability
This study aimed to identify radiomic features associated with the neovascularization of CAP and construct a prediction model for CAP vulnerability based on radiomic features. CTA data and clinical data of patients with CAPs who underwent CTA and CEUS between January 2018 and December 2021 in Beijing Hospital were retrospectively collected. The data were divided into a training cohort and a testing cohort using a 7:3 split. According to the examination of CEUS, CAPs were dichotomized into vulnerable and stable groups. 3D Slicer software was used to delineate the region of interest in CTA images, and the Pyradiomics package...
Source: Frontiers in Neurology - June 16, 2023 Category: Neurology Source Type: research

Impact of an automated large vessel occlusion detection tool on clinical workflow and patient outcomes
ConclusionImplementation of an automated LVO detection tool improved radiology TAT but did not translate to improved stroke metrics and outcomes in a real-world setting.
Source: Frontiers in Neurology - May 25, 2023 Category: Neurology Source Type: research

Determinants of cerebral collateral circulation in acute ischemic stroke due to large vessel occlusion
DiscussionThe results of our study suggest that risk factors and demographics do not influence the development of collateral circles, except for a negative relation with previous ischemic events. We confirm an already reported observation of a possible protective effect of collaterals on tissue damage assuming NIHSS as its surrogate. The association between left hemispheric stroke and better collaterals deserves to be further explored. Further efforts are needed to identify the factors that favor the development of collaterals.
Source: Frontiers in Neurology - May 17, 2023 Category: Neurology Source Type: research

Capsular warning syndrome and its clinical awareness and therapeutic approach: two case reports and a systematic review of the literature
ConclusionOur cases fit with the description of patients with partial recovery and risk factors (hypertension, diabetes, and smoking) in male patients. There is a lack of evidence regarding the best treatment option; dual antiplatelet therapy and anticoagulation therapy are strong contenders for a favorable result.
Source: Frontiers in Neurology - May 16, 2023 Category: Neurology Source Type: research

Diagnostic potential of routine brain MRI and high-resolution, multi-contrast vessel wall imaging in the detection of internal carotid artery dissection
Conclusion: The combination of brain MRI and clinical information could be used for the diagnosis of CAD and hrVWI should be sought for uncertain cases.
Source: Frontiers in Neurology - May 11, 2023 Category: Neurology Source Type: research

Stroke recurrence is associated with unfavorable intracranial venous outflow in patients with symptomatic intracranial atherosclerotic large vessel severe stenosis or occlusion
ConclusionFor patients with sICAS-S/O of the anterior circulation, unfavorable intracranial venous outflow is a potential imaging indicator for predicting higher 1-year RCIE risk.
Source: Frontiers in Neurology - May 9, 2023 Category: Neurology Source Type: research

Case report: Medulla oblongata and cervical cord reperfusion injury after intracranial vertebral artery angioplasty and stenting
ConclusionConcomitant reperfusion injury in the medulla oblongata and cervical cord secondary to vertebral artery angioplasty and stenting is extremely rare. However, this potentially devastating complication requires early recognition and prompt treatment. Maintaining the antegrade flow during vertebral artery endovascular treatment is a precaution against reperfusion injury.
Source: Frontiers in Neurology - May 5, 2023 Category: Neurology Source Type: research

Is aspiration an effective acute stroke treatment in older adults?
ConclusionSuccessful aspiration-based recanalization rate decreased with increasing age; however, these differences were not significant. Clinical outcomes did not significantly differ with regard to carotid tortuosity, regardless of the time of assessment. Neither intracranial nor extracranial tortuosity was significantly associated with reperfusion-related complications in either of the age subgroups.
Source: Frontiers in Neurology - May 2, 2023 Category: Neurology Source Type: research

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