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Cta tia

Best Anyama, Daniela Treitl, Jeffery Wessell, Rachele Solomon, Andrew A Rosenthal
Blunt cerebrovascular injury (BCVI) to the carotid artery is a relatively rare injury that is difficult to identify even with imaging. Any symptoms or neurological deficits following blunt neck injury mandate evaluation and consideration of BCVI. In an effort to highlight this issue, we report the case of a 31-year-old male patient who presented with left-sided weakness consistent with transient ischemic attack (TIA) and concussion. The patient's symptoms occurred within 24 hours of a blunt neck injury sustained by a knee strike during a basketball game...
2017: Case Reports in Emergency Medicine
Moni Roy, Ashish Kumar Roy, Jeffrey R DeSanto, Murad Abdelsalam
We present a case of 72-year-old male with reported past medical history of recurrent transient ischemic attacks (TIAs) presenting with myriad of neurological symptoms. Patient was transferred from outlying hospital with complaints of right sided facial droop and dysarthria. Computed tomography angiography (CTA) showed high grade proximal left internal carotid artery (ICA) stenosis along with interesting finding of a free floating thrombus (FFT) in the left ICA. After discussion with the neurosurgical team, our case was treated conservatively with combination of antiplatelet therapy with Aspirin and anticoagulation with Warfarin without recurrence of TIAs or strokes on six-month follow-up...
2017: Case Reports in Medicine
S Sundaram, S Kannoth, B Thomas, P S Sarma, P N Sylaja
BACKGROUND AND PURPOSE: Cervical internal carotid artery occlusion can present with varied clinical manifestations such as transient ischemic attack, stroke, and chronic ocular ischemia, or can be asymptomatic. The outcome in these patients is considerably influenced by cerebral hemodynamic compensatory adaptation of the intracranial collateral pathways. Our aim was to study whether collateral circulation as assessed by CT angiography can predict 3-month outcome and initial stroke severity in patients with symptomatic cervical ICA occlusion...
October 20, 2016: AJNR. American Journal of Neuroradiology
Virginija Gaigalaite, Augenijus Vilimas, Violeta Ozeraitiene, Jurate Dementaviciene, Ricardas Janilionis, Danute Kalibatiene, Saulius Rocka
BACKGROUND: The clinical significance of vertebral artery (VA) hypoplasia is under discussion. The aim of this retrospective study is to evaluate a hypothesis of a possible causal link between VA hypoplasia (VAH) and the incidence of posterior circulation stroke (PCS) or TIA depending on the degree of VAH and vascular risk factors. METHODS: A total of 367 symptomatic (PCS or TIA) and 742 asymptomatic subjects, were selected to participate in the study. The extracranial arteries were examined by ultrasound...
July 26, 2016: BMC Neurology
Markus A Möhlenbruch, Johannes Pfaff, Christian Herweh, Julian Bösel, Timolaos Rizos, Simon Nagel, Peter A Ringleb, Martin Bendszus, Mirko Pham
INTRODUCTION: We present a novel endovascular technique to treat intracranial atherosclerotic stenosis (ICS) with the specific potential to reduce the procedure-related complications which so far limited safety and efficacy of endovascular ICS intervention. METHODS: Six consecutive patients were included in this study with the following criteria of inclusion: (1) failure of dual antiplatelet therapy defined as recurrent TIA or ischemic stroke, (2) presence of ICS of ≥70 %, and (3) endovascular accessibility of the target lesion as judged by CTA or MRA...
September 2016: Neuroradiology
Aike Qiao, Xuan Dai, Jing Niu, Liqun Jiao
Hemodynamic factors may affect the potential occurrence of in-stent restenosis (ISR) after intervention procedure of vertebral artery ostial stenosis (VAOS). The purpose of the present study is to investigate the influence of stent protrusion length in implantation strategy on the local hemodynamics of the VAOS. CTA images of a 58-year-old female patient with posterior circulation transient ischemic attack were used to perform a 3D reconstruction of the vertebral artery. Five models of the vertebral artery before and after the stent implantation were established...
2016: Computer Methods in Biomechanics and Biomedical Engineering
Kenneth C Bilchick, Augustus Mealor, Jorge Gonzalez, Patrick Norton, David Zhuo, Pamela Mason, John D Ferguson, Rohit Malhotra, J Michael Mangrum, Andrew E Darby, John DiMarco, Klaus Hagspiel, John Dent, Christopher M Kramer, George J Stukenborg, Michael Salerno
BACKGROUND: Computed tomography angiography (CTA) can identify and rule out left atrial appendage (LAA) thrombus when delayed imaging is also performed. OBJECTIVE: In patients referred for CTA to evaluate pulmonary vein anatomy before the ablation of atrial fibrillation (AF) or left atrial flutter (LAFL), we sought to determine the effectiveness of a novel clinical protocol for integrating results of CTA delayed LAA imaging into preprocedure care. METHODS: After making delayed imaging of the LAA part of our routine preablation CTA protocol, we integrated early reporting of preablation CTA LAA imaging results into clinical practice as part of a formal protocol in June 2013...
January 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Praful Dalal, Madhumita Bhattacharjee
TIA is a serious condition and a medical emergency requiring immediate evaluation and treatment to prevent a stroke. Confirmation of diagnosis is vital. Medical conditions like hypoglycaemia, migraine etc which mimic TIA should be identified. TIA syndrome in carotid territory needs special evaluation by Duplex sonography to detect significant stenosis (>70%) near bifurcation. Recurrent TIA in the same territory leaves neuro deficit and this needs prevention by appropriate therapy (platelet antiaggregants, anticoagulants, surgical intervention)...
December 2014: Journal of the Association of Physicians of India
J Borst, H A Marquering, M Kappelhof, T Zadi, A C van Dijk, P J Nederkoorn, R van den Berg, A van der Lugt, C B L M Majoie
BACKGROUND AND PURPOSE: Semiautomatic measurement of ICA stenosis potentially increases observer reproducibility. In this study, we assessed the diagnostic accuracy and interobserver reproducibility of a commercially available semiautomatic ICA stenosis measurement on CTA and estimated the agreement among different software packages. MATERIALS AND METHODS: We analyzed 141 arteries from 90 patients with TIA or ischemic stroke. Manual stenosis measurements were performed by 2 neuroradiologists...
October 2015: AJNR. American Journal of Neuroradiology
P-Q Wang, J-J Liu, A-P Wang, G-B Zhang, Z-H Cao, P Wang, P-Y Zhou
OBJECTIVE: To evaluate the recurrent ischemic events and risk factors in patients with symptomatic intracranial artery stenosis. PATIENTS AND METHODS: Patients with acute cerebral infarction or transient ischemia attach (TIA) and intracranial arterial stenosis confirmed through CTA examination, were enrolled from the Department of Neurology. All cases were followed-up regularly and divided into recurrent group and non-recurrent group according to occurrence of cerebrovascular events...
2015: European Review for Medical and Pharmacological Sciences
Leanne K Casaubon, Jean-Martin Boulanger, Dylan Blacquiere, Scott Boucher, Kyla Brown, Tom Goddard, Jacqueline Gordon, Myles Horton, Jeffrey Lalonde, Christian LaRivière, Pascale Lavoie, Paul Leslie, Jeanne McNeill, Bijoy K Menon, Brian Moses, Melanie Penn, Jeff Perry, Elizabeth Snieder, Dawn Tymianski, Norine Foley, Eric E Smith, Gord Gubitz, Michael D Hill, Ev Glasser, Patrice Lindsay
The 2015 update of the Canadian Stroke Best Practice Recommendations Hyperacute Stroke Care guideline highlights key elements involved in the initial assessment, stabilization, and treatment of patients with transient ischemic attack (TIA), ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and acute venous sinus thrombosis. The most notable change in this 5th edition is the addition of new recommendations for the use of endovascular therapy for patients with acute ischemic stroke and proximal intracranial arterial occlusion...
August 2015: International Journal of Stroke: Official Journal of the International Stroke Society
Ido R van den Wijngaard, Ale Algra, Geert J Lycklama À Nijeholt, Jelis Boiten, Marieke J H Wermer, Marianne A A van Walderveen
INTRODUCTION: About 15% of patients with transient ischemic attack (TIA) or minor ischemic stroke have functional impairment after 3 months. We studied the role of whole brain computed tomography perfusion (WB-CTP) in the emergency diagnosis of TIA or minor stroke in predicting disability at 3 months. METHODS: We included patients with ongoing symptoms of a TIA or minor stroke with a National Institutes of Health Stroke Scale (NIHSS) score less than 4 who were evaluated with noncontrast CT (NCCT), CT angiography (CTA), and WB-CTP within 24 hours of symptom onset...
September 2015: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Noritaka Sano, Tetsu Satow, Daisuke Maruyama, Hiroharu Kataoka, Ken-ichi Morita, Hatsue Ishibashi-Ueda, Koji Iihara
OBJECTIVE: This study aimed to elucidate the relationships between preoperative carotid imaging results, histologic characteristics, and surgical treatment outcomes of radiation-induced carotid stenosis (RICS), using control subjects without RICS for comparison. METHODS: We retrospectively reviewed records of 17 patients who underwent carotid revascularization for 22 instances of RICS, including 10 cases of carotid artery stenting (CAS), 11 cases of carotid endarterectomy (CEA), and 1 case of CEA with retrograde CAS, between July 2004 and April 2013...
August 2015: Journal of Vascular Surgery
Ajay Gupta, Hediyeh Baradaran, Edward E Mtui, Hooman Kamel, Ankur Pandya, Ashley Giambrone, Costantino Iadecola, Pina C Sanelli
BACKGROUND: Carotid plaque MRI has been a useful method to characterize vulnerable atherosclerotic plaque elements. Recent investigations have suggested that source images from CT angiography (CTA) and MR angiography (MRA) can identify the simple high-risk features of symptom-producing carotid artery plaque. We studied the correlation and relative diagnostic accuracies of CTA and MRA source images in detecting symptomatic carotid artery plaque. METHODS: Subjects were eligible if they had carotid stenosis between 50 and 99% and had MRA and CTA exams performed within 10 days of one another...
2015: Cerebrovascular Diseases
Christopher P Gallati, Minal Jain, Dushyant Damania, Abhijit R Kanthala, Anunaya R Jain, George E Koch, Nancy T M Kung, Henry Z Wang, Robert E Replogle, Babak S Jahromi
OBJECT: Carotid endarterectomy (CEA) carries a small but not insignificant risk of stroke/transient ischemic attack (TIA), most frequently observed within 24 hours of surgery, which can lead to the need for urgent vascular imaging in the immediate postoperative period. However, distinguishing expected versus pathological postoperative changes may not be straightforward on imaging studies of the carotid artery early after CEA. The authors aimed to describe routine versus pathological anatomical findings on CTA performed within 24 hours of CEA, and to evaluate associations between these CTA findings and postoperative stroke/TIA...
March 2015: Journal of Neurosurgery
Amy Y X Yu, Michael D Hill, Shelagh B Coutts
Stroke is a leading cause of morbidity and mortality worldwide. Up to 80% of ischemic stroke patients may initially present with minor symptoms. Minor stroke and transient ischemic attack patients are typically treated conservatively with antiplatelet agents and general vascular prevention strategies. Yet a high proportion develop recurrent stroke or progression of stroke and up to one in four of these patients are disabled or dead at follow-up. Minor or rapidly improving symptoms are the top reasons for withholding thrombolytic therapy to time-eligible stroke patients as they are believed to be 'too good to treat'...
April 2015: International Journal of Stroke: Official Journal of the International Stroke Society
Vasileios Papavasileiou, Haralampos Milionis, Lorenz Hirt, Patrik Michel
The aim of the present study was to explore the prevalence of acute cerebrovascular symptoms temporally related to carotid Doppler examination (DEx), in order to increase the awareness and recording of such events and to discuss possible mechanisms. All adult patients who complained of acute onset neurologic symptoms during or shortly after a carotid DEx, between 01/2003 and 12/2011 in the University Hospital of Lausanne were prospectively collected. We identified four consecutive patients with acute onset neurologic symptoms during or shortly after a carotid DEx among approximately 13,500 patients who underwent carotid DEx in our facility during the nine-year period (0...
February 2015: Ultrasound in Medicine & Biology
Shelagh B Coutts, Theodore H Wein, M Patrice Lindsay, Brian Buck, Robert Cote, Paul Ellis, Norine Foley, Michael D Hill, Sharon Jaspers, Albert Y Jin, Brenda Kwiatkowski, Carolyn MacPhail, Dana McNamara-Morse, Michael S McMurtry, Tania Mysak, Andrew Pipe, Karen Silver, Eric E Smith, Gord Gubitz
Every year, approximately 62,000 people with stroke and transient ischemic attack are treated in Canadian hospitals. The 2014 update of the Canadian Secondary Prevention of Stroke guideline is a comprehensive summary of current evidence-based recommendations for clinicians in a range of settings, who provide care to patients following stroke. Notable changes in this 5th edition include an emphasis on treating the highest risk patients who present within 48 h of symptom onset with transient or persistent motor or speech symptoms, who need to be transported to the closest emergency department with capacity for advanced stroke care; a recommendation for brain and vascular imaging (of the intra- and extracranial vessels) to be completed urgently using computed tomography/computed tomography angiography; prolonged cardiac monitoring for patients with suspective cardioembolic stroke but without evidence for atrial fibrillation on electrocardiogram or holter monitoring; and de-emphasizing the need for routine echocardiogram...
April 2015: International Journal of Stroke: Official Journal of the International Stroke Society
P Vanacker, M Cordier, J Janbieh, C Federau, P Michel
BACKGROUND: The effects of intravenous thrombolysis on floating thrombi in cervical and intracranial arteries of acute ischemic stroke patients are unknown. Similarly, the best prevention methods of early recurrences remain controversial. This study aimed to describe the clinical and radiological outcome of thrombolyzed strokes with floating thrombi. METHODS: We retrospectively analyzed all thrombolyzed stroke patients in our institution between 2003 and 2010 with floating thrombi on acute CT-angiography before the intravenous thrombolysis...
2014: Cerebrovascular Diseases
Peter Vanacker, Gonçalo Matias, Patric Hagmann, Patrik Michel
BACKGROUND: PRES is a reversible neurotoxic state presenting with headache, altered mental status, visual loss, and seizures. Delayed diagnosis can be avoided if radiological patterns could distinguish PRES from cerebral ischemia. METHODS: Clinical and radiological data were collected on all hospitalized patients who had (1) discharge diagnosis of PRES and (2) acute CTP/CTA. Data were compared with 10 TIA patients with proven cytotoxic edema on MRI. RESULTS: Of the four PRES patients found, three were correlated with acute blood pressure and one with chemotherapy...
July 2015: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
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