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Stroke Perfusion

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https://www.readbyqxmd.com/read/29449280/prediction-of-the-multisegment-clot-sign-on-dynamic-ct-angiography-of-cardioembolic-stroke
#1
Z Chen, F Shi, M Zhang, X Gong, L Lin, M Lou
BACKGROUND AND PURPOSE: The multisegment clot sign has been observed at the site of large-artery occlusion in patients with acute ischemic stroke. This study aimed to assess its occurrence rate and relationship with stroke etiologies in patients with acute intracranial large-artery occlusion. MATERIALS AND METHODS: We included consecutive patients with acute ischemic stroke who had acute intracranial large-artery occlusion and underwent perfusion CT within 8 hours after stroke onset...
February 15, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29448967/facial-nerve-stimulation-in-normal-pigs-and-healthy-human-volunteers-transitional-development-of-a-medical-device-for-the-emergency-treatment-of-ischemic-stroke
#2
Olivia Sanchez, Andrea García, Fernando Castro-Prado, Miriam Perez, Rafael Lara-Estrada, Martin Ramirez-Meza, Montserrat Godinez, Michael L Coco, Joaquín Azpiroz, Mark K Borsody, Emilio Sacristán
BACKGROUND: Magnetic stimulation of the facial nerve has been tested in preclinical studies as a new, non-invasive emergency treatment of ischemic stroke that acts by increasing cerebral blood flow (CBF). The objective of the studies reported herein was to identify minimal stimulation parameters that increase CBF in large animals and then test those stimulation parameters in healthy volunteers for safety, tolerability, and effectiveness at increasing CBF. This translational research is necessary preparation for clinical studies in ischemic stroke patients...
February 15, 2018: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29445434/primary-endovascular-treatment-of-acute-ischemic-stroke-using-stent-retrievers-initial-egyptian-experience
#3
Ossama Yassin Mansour, Abdulrahman Mostafa Ibrahim Ali, Mohamed Megahed
Background: Several mechanical thrombectomy (MT) devices have been designed with the goal of improving the recanalization rates of major intracranial artery occlusions. Objective: In this single-center experience, we analyzed the acute ischemic stroke (AIS) treatment with Primary MT; safety and efficacy and clinical results in our patients with large vessel occlusion (LVO). Methods: During a five-year period (from September 2011 to July 2016), out of 996 patients who presented to our center with a diagnosis of AIS, 113 (11...
December 2017: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/29435996/type-ii-minimal-invasive-extracorporeal-circuit-for-aortic-valve-replacement-a-randomized-controlled-trial
#4
Erich Gygax, Hans-Ulrich Kaeser, Mario Stalder, Brigitta Gahl, Robert Rieben, Thierry Carrel, Gabor Erdoes
Extracorporeal circulation triggers systemic inflammatory response and coagulation disorders which may lead to unfavorable clinical outcome. A type II minimally-invasive extracorporeal circuit (MiECC) is a closed system with markedly reduced artificial surface as compared to conventional extracorporeal circuits (CECC). The aim of this study was to investigate and compare inflammatory responses, complement activation and selected clinical end-points in isolated surgical aortic valve replacement (SAVR) performed with a type II MiECC circuit or a CECC...
February 12, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29434800/protective-effects-of-scopolamine-and-penehyclidine-hydrochloride-on-acute-cerebral-ischemia-reperfusion-injury-after-cardiopulmonary-resuscitation-and-effects-on-cytokines
#5
Dengqin Wang, Qi Jiang, Xiuling Du
The objective of this study was to investigate the protective effects of scopolamine and penehyclidine hydrochloride on acute cerebral ischemia-reperfusion injury after cardiopulmonary resuscitation, and the effect on cytokine levels. Eighty patients with cardiac arrest admitted to our hospital from June 2011 to December 2015 were recruited and randomly divided into two groups (n=40 each). Following cardiopulmonary resuscitation, scopolamine was administered in the control group, whereas penehyclidine hydrochloride was administered in the observation group...
February 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29432248/neurologic-complications-in-the-pediatric-intensive-care-unit
#6
Mark S Wainwright
PURPOSE OF REVIEW: All critical care is directed at maintaining brain health, but recognizing neurologic complications of critical illness in children is difficult, and limited data exist to guide practice. This article discusses an approach to the recognition and management of seizures, stroke, and cardiac arrest as complications of other critical illnesses in the pediatric intensive care unit. RECENT FINDINGS: Convulsive and nonconvulsive seizures occur frequently in children after cardiac arrest or traumatic brain injury and during extracorporeal membrane oxygenation...
February 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29432237/hypoxic-ischemic-encephalopathy-and-other-neonatal-encephalopathies
#7
Hannah C Glass
PURPOSE OF REVIEW: Neonatal encephalopathy is the most common condition in neonates encountered by child neurologists. The etiology is most often global hypoxia-ischemia due to failure of cerebral perfusion to the fetus caused by uterine, placental, or umbilical cord compromise prior to or during delivery. Other etiologies of neonatal encephalopathy include ischemic stroke and intracranial hemorrhage, infection, developmental anomalies, and inborn errors of metabolism. RECENT FINDINGS: Therapeutic hypothermia is standard of care for the treatment of neonatal encephalopathy presumed to be caused by hypoxia-ischemia...
February 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29414151/migrainous-aura-as-stroke-mimic-the-role-of-perfusion-computed-tomography
#8
Mariana Ridolfi, Antonio Granato, Paola Polverino, Giovanni Furlanis, Maja Ukmar, Irene Zorzenon, Paolo Manganotti
OBJECTIVES: The acute-onset of migrainuos aura (MA) can be erroneously diagnosed in Emergency Department (ED) as acute stroke (AS) and it can be classified as "stroke mimic" (SM). Perfusion computer tomography (PCT) may be useful to improve detection of infarcts. The aim of the study was to investigate the role in ED of PCT in improving diagnosis of migrainous aura. Data were compared with the well-defined perfusion patterns in patients with acute ischemic stroke. PATIENTS AND METHODS: A standardized Stroke Protocol was planned...
January 31, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29410099/repeat-robotic-endoscopic-mitral-valve-surgery-a-safe-and-effective-strategy
#9
Douglas A Murphy, Emmanuel Moss, Jeffrey Miller, Michael E Halkos
BACKGROUND: Mitral valve reoperation is necessary in a finite percent of patients. With growth in robotic mitral valve surgery, reoperative strategies need to be developed. A review of institutional mitral valve re-operations after a previous robotic approach was undertaken. METHODS: From January 2006 through April 2017, 1853 patients underwent an initial robotic mitral valve surgery by a dedicated robotic team. Fifty-four (2.9%) of these patients required mitral reoperation at our institution over this time period...
February 2, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29402765/computed-tomography-perfusion-derived-blood-brain-barrier-permeability-does-not-yet-improve-prediction-of-hemorrhagic-transformation
#10
Alexander D Horsch, Edwin Bennink, Tom van Seeters, L Jaap Kappelle, Yolanda van der Graaf, Willem P T M Mali, Hugo W A M de Jong, Birgitta K Velthuis, Jan Willem Dankbaar
INTRODUCTION: Hemorrhagic transformation (HT) in acute ischemic stroke can occur as a result of reperfusion treatment. While withholding treatment may be warranted in patients with increased risk of HT, prediction of HT remains difficult. Nonlinear regression analysis can be used to estimate blood-brain barrier permeability (BBBP). The aim of this study was to identify a combination of clinical and imaging variables, including BBBP estimations, that can predict HT. MATERIALS AND METHODS: From the Dutch acute stroke study, 545 patients treated with intravenous recombinant tissue plasminogen activator and/or intra-arterial treatment were selected, with available admission extended computed tomography (CT) perfusion and follow-up imaging...
January 8, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29402060/penumbral-imaging-based-thrombolysis-with-tenecteplase-is-feasible-up-to-24-hours-after-symptom-onset
#11
Mahesh Kate, Robert Wannamaker, Harsha Kamble, Parnian Riaz, Laura C Gioia, Brian Buck, Thomas Jeerakathil, Penelope Smyth, Ashfaq Shuaib, Kenneth Butcher, Derek Emery
BACKGROUND AND PURPOSE: Thrombolysis >4.5 hours after ischemic stroke onset is unproven. We assessed the feasibility of tenecteplase (TNK) treatment in patients with evidence of an ischemic penumbra 4.5 to 24 hours after onset. METHODS: Acute ischemic stroke patients underwent perfusion computed tomography (CT)/magnetic resonance imaging. Patients with cerebral blood volume (CBV) or diffusion weighted imaging Alberta Stroke Program Early CT Scores (ASPECTS) >6 and mismatch score >2 (defined as >2 ASPECTS regions with delay on mean transit time maps and normal CBV) were eligible for treatment with TNK (0...
January 2018: Journal of Stroke
https://www.readbyqxmd.com/read/29397311/cerebral-neuromonitoring-during-carotid-endarterectomy-and-impact-of-contralateral-internal-carotid-occlusion
#12
Davorin Sef, Andrija Skopljanac-Macina, Milan Milosevic, Anita Skrtic, Vinko Vidjak
BACKGROUND: The aim of this study was to identify the reliability of carotid artery stump pressure (SP) in predicting the neurologic changes and correlation with contralateral internal carotid artery (ICA) occlusion in patients undergoing eversion carotid endarterectomy (CEA). The optimal method for monitoring cerebral perfusion during CEA, performed under either local or general anesthesia, is still controversial. METHODS: We prospectively analyzed 118 consecutive patients undergoing eversion CEA under local anesthesia...
January 31, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29395757/standardized-model-of-porcine-resuscitation-using-a-custom-made-resuscitation-board-results-in-optimal-hemodynamic-management
#13
Jakob Wollborn, Eva Ruetten, Bjoern Schlueter, Joerg Haberstroh, Ulrich Goebel, Martin A Schick
AIM: Standardized modeling of cardiac arrest and cardiopulmonary resuscitation (CPR) is crucial to evaluate new treatment options. Experimental porcine models are ideal, closely mimicking human-like physiology. However, anteroposterior chest diameter differs significantly, being larger in pigs and thus poses a challenge to achieve adequate perfusion pressures and consequently hemodynamics during CPR, which are commonly achieved during human resuscitation. The aim was to prove that standardized resuscitation is feasible and renders adequate hemodynamics and perfusion in pigs, using a specifically designed resuscitation board for a pneumatic chest compression device...
January 22, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29388057/utility-of-radionuclide-bone-scintigraphy-in-complex-regional-pain-syndrome
#14
REVIEW
Brandon A Howard, Lance Roy, Alan David Kaye, Srinivas Pyati
PURPOSE OF REVIEW: To describe the current understanding of the role of three-phase bone scintigraphy (TPBS) in the diagnosis and management of complex regional pain syndrome (CRPS), discuss its advantages and limitations, and present three examples of TPBS patterns typically seen in CRPS patients. RECENT FINDINGS: CRPS is a debilitating disorder frequently presenting with pain to ordinarily non-painful stimuli, redness, swelling, following fractures, stroke, myocardial infarction, surgery, or even minor trauma, and its diagnosis, based on clinical criteria and supportive imaging findings, is difficult...
February 1, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29387626/clinical-results-of-the-intra-arterial-thrombolysis-with-stent-retriever-device-weather-perfusion-diffusion-mismatching-and-intravenous-tissue-plasminogen-activator-administration
#15
Young-Jin Kim, Kwang-Wook Cho, Seong-Rim Kim, Do-Sung Yoo, Hae-Kwan Park, Cheol Ji
Objective: Intraarterial thrombolysis (IA-Tx) with stent retriever is accepted as an additional treatment for selected patients and the clinical benefit is well reported. Each intravenous tissue plasminogen activator administration (IV-tPA) and perfusion diffusion mismatching (P/D-mismatching) is well known the beneficial effects for recanalization and clinical outcomes. In this report, authors analyzed the clinical outcomes of additional IA-Tx with retrieval stent device, according to the combined IV-tPA and P/D-mismatching or not...
December 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29381701/the-ratio-between-cerebral-blood-flow-and-tmax-predicts-the-quality-of-collaterals-in-acute-ischemic-stroke
#16
Ivana Galinovic, Elena Kochova, Ahmed Khalil, Kersten Villringer, Sophie K Piper, Jochen B Fiebach
BACKGROUND: In acute ischemic stroke the status of collateral circulation is a critical factor in determining outcome. We propose a less invasive alternative to digital subtraction angiography for evaluating collaterals based on dynamic-susceptibility contrast magnetic resonance imaging. METHODS: Perfusion maps of Tmax and cerebral blood flow (CBF) were created for 35 patients with baseline occlusion of a major cerebral artery. Volumes of hypoperfusion were defined as having a Tmax delay of > 4 seconds (Tmax4s) and > 6 seconds (Tmax6s) and a CBF drop below 80% of healthy, contralateral tissue...
2018: PloS One
https://www.readbyqxmd.com/read/29371433/staging-hemodynamic-failure-with-blood-oxygen-level-dependent-functional-magnetic-resonance-imaging-cerebrovascular-reactivity-a-comparison-versus-gold-standard-15o-h2o-positron-emission-tomography
#17
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
BACKGROUND AND PURPOSE: Increased stroke risk correlates with hemodynamic failure, which can be assessed with (15O-)H2O positron emission tomography (PET) cerebral blood flow (CBF) measurements. This gold standard technique, however, is not established for routine clinical imaging. Standardized blood oxygen-level-dependent (BOLD) functional magnetic resonance imaging+CO2 is a noninvasive and potentially widely applicable tool to assess whole-brain quantitative cerebrovascular reactivity (CVR)...
January 25, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29366619/encephaloduroateriosynangiosis-versus-conservative-treatment-for-patients-with-moyamoya-disease-at-late-suzuki-stage
#18
Peicong Ge, Xun Ye, Qian Zhang, Dong Zhang, Shuo Wang, Jizong Zhao
The purpose of this study is to investigate the long-term outcomes after conservative and encephaloduroateriosynangiosis procedures for patients with moyamoya disease at late Suzuki stage. We retrospectively reviewed 64 patients (128 hemispheres) with moyamoya disease at late Suzuki Stage at Beijing Tiantan Hospital. Clinical features, radiologic findings, and outcomes were analyzed. The mean age at diagnosis was 29.0 ± 14.9 years. The distribution of the initial Suzuki stage of MMD was as follows: stage 4, n = 75; stage 5, n = 46; stage 6, n = 7, PCA involvement was observed in 4 (37...
January 20, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29364767/thrombectomy-for-stroke-at-6-to-16-hours-with-selection-by-perfusion-imaging
#19
Gregory W Albers, Michael P Marks, Stephanie Kemp, Soren Christensen, Jenny P Tsai, Santiago Ortega-Gutierrez, Ryan A McTaggart, Michel T Torbey, May Kim-Tenser, Thabele Leslie-Mazwi, Amrou Sarraj, Scott E Kasner, Sameer A Ansari, Sharon D Yeatts, Scott Hamilton, Michael Mlynash, Jeremy J Heit, Greg Zaharchuk, Sun Kim, Janice Carrozzella, Yuko Y Palesch, Andrew M Demchuk, Roland Bammer, Philip W Lavori, Joseph P Broderick, Maarten G Lansberg
Background Thrombectomy is currently recommended for eligible patients with stroke who are treated within 6 hours after the onset of symptoms. Methods We conducted a multicenter, randomized, open-label trial, with blinded outcome assessment, of thrombectomy in patients 6 to 16 hours after they were last known to be well and who had remaining ischemic brain tissue that was not yet infarcted. Patients with proximal middle-cerebral-artery or internal-carotid-artery occlusion, an initial infarct size of less than 70 ml, and a ratio of the volume of ischemic tissue on perfusion imaging to infarct volume of 1...
January 24, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29364529/time-separation-technique-accurate-solution-for-4-d-c-arm-ct-perfusion-imaging-using-a-temporal-decomposition-model
#20
Sebastian Bannasch, Robert Frysch, Tim Pfeiffer, Gerald Warnecke, Georg Rose
PURPOSE: The issue of perfusion imaging using a temporal decomposition model is to enable the reconstruction of undersampled measurements acquired with a slowly rotating X-ray-based imaging system e. g. a C-arm-based cone beam computed tomography (CB-CT). Aim of this work is to integrate prior knowledge into the dynamic CT task in order to reduce the required number of views and the computational effort as well as to save dose. The prior knowledge comprises of a mathematical model and clinical perfusion data...
January 24, 2018: Medical Physics
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