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stroke and CT perfusion

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https://www.readbyqxmd.com/read/29794101/reperfusion-injury-after-ischemic-stroke-study-risks-single-centre-florence-italy-prospective-observational-protocol-study
#1
Benedetta Piccardi, Francesco Arba, Mascia Nesi, Vanessa Palumbo, Patrizia Nencini, Betti Giusti, Alice Sereni, Davide Gadda, Marco Moretti, Enrico Fainardi, Salvatore Mangiafico, Giovanni Pracucci, Stefania Nannoni, Francesco Galmozzi, Alessandra Fanelli, Paola Pezzati, Simone Vanni, Stefano Grifoni, Cristina Sarti, Maria Lamassa, Anna Poggesi, Francesca Pescini, Leonardo Pantoni, Anna Maria Gori, Domenico Inzitari
INTRODUCTION: Treatments aiming at reperfusion of the acutely ischaemic brain tissue may result futile or even detrimental because of the so-called reperfusion injury. The processes contributing to reperfusion injury involve a number of factors, ranging from blood-brain barrier (BBB) disruption to circulating biomarkers. Our aim is to evaluate the relative effect of imaging and circulating biomarkers in relation to reperfusion injury. METHODS AND ANALYSIS: Observational hospital-based study that will include 140 patients who had ischaemic stroke, treated with systemic thrombolysis, endovascular treatment or both...
May 24, 2018: BMJ Open
https://www.readbyqxmd.com/read/29772576/wake-up-stroke-versus-stroke-with-known-onset-time-clinical-and-multimodality-ct-imaging-characteristics
#2
Jan W Dankbaar, Henri P Bienfait, Coen van den Berg, Edwin Bennink, Alexander D Horsch, Tom van Seeters, Irene C van der Schaaf, L Jaap Kappelle, Birgitta K Velthuis
BACKGROUND: Current guidelines for the treatment of acute ischemic stroke are mainly based on the time between symptom onset and initiation of treatment. This time is unknown in patients with wake-up stroke (WUS). We investigated clinical and multimodality CT imaging characteristics on admission in patients with WUS and in patients with a stroke with a known onset time. METHODS: All patients were selected from a large prospective cohort study (Dutch acute stroke study)...
May 17, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29746644/relationships-between-selective-neuronal-loss-and-microglial-activation-after-ischaemic-stroke-in-man
#3
Rhiannon S Morris, P Simon Jones, Josef A Alawneh, Young T Hong, Tim D Fryer, Franklin I Aigbirhio, Elizabeth A Warburton, Jean-Claude Baron
Modern ischaemic stroke management involves intravenous thrombolysis followed by mechanical thrombectomy, which allows markedly higher rates of recanalization and penumbral salvage than thrombolysis alone. However, <50% of treated patients eventually enjoy independent life. It is therefore important to identify complementary therapeutic targets. In rodent models, the salvaged penumbra is consistently affected by selective neuronal loss, which may hinder recovery by interfering with plastic processes, as well as by microglial activation, which may exacerbate neuronal death...
May 9, 2018: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29724764/clinical-outcomes-of-endovascular-treatment-within-24-hours-in-patients-with-mild-ischemic-stroke-and-perfusion-imaging-selection
#4
X Shang, M Lin, S Zhang, S Li, Y Guo, W Wang, M Zhang, Y Wan, Z Zhou, W Zi, X Liu
BACKGROUND AND PURPOSE: Endovascular thrombectomy has been accepted as the standard of care for patients with acute ischemic stroke. Our aim was to investigate the clinical outcomes of patients with mild ischemic stroke with acute proximal large-vessel occlusion after endovascular treatment within 24 hours of symptom onset. MATERIALS AND METHODS: Between January 2014 and August 2017, ninety-three Chinese patients with mild ischemic stroke (NIHSS scores, 0-8) and large-vessel occlusion with endovascular treatment were retrospectively enrolled from 7 comprehensive stroke centers...
June 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29714677/monitoring-cerebral-perfusion-changes-after-revascularization-in-patients-with-moyamoya-disease-by-using-arterial-spin-labeling-mr-imaging
#5
Seunghyun Lee, Tae Jin Yun, Roh-Eul Yoo, Byung-Woo Yoon, Koung Mi Kang, Seung Hong Choi, Ji-Hoon Kim, Jeong Eun Kim, Chul-Ho Sohn, Moon Hee Han
Purpose To determine whether arterial spin-labeling (ASL) magnetic resonance (MR) imaging could be used to identify changes in cerebral blood flow (CBF), collateral blood flow, and anastomosis site patency after revascularization in patients with moyamoya disease. Materials and Methods This retrospective study was conducted in 145 patients with moyamoya disease who underwent middle cerebral artery (MCA)-superficial temporal artery anastomosis. Preoperative, early postoperative, and late postoperative ASL and digital subtraction angiography images were analyzed...
May 1, 2018: Radiology
https://www.readbyqxmd.com/read/29678936/effect-of-stroke-thrombolysis-predicted-by-distal-vessel-occlusion-detection
#6
Wolfgang G Kunz, Matthias P Fabritius, Wieland H Sommer, Christopher Höhne, Pierre Scheffler, Lukas T Rotkopf, Wolfgang P Fendler, Bastian O Sabel, Felix G Meinel, Franziska Dorn, Birgit Ertl-Wagner, Maximilian F Reiser, Kolja M Thierfelder
OBJECTIVE: Among ischemic stroke patients with negative CT angiography (CTA), we aimed to determine the predictive value of enhanced distal vessel occlusion detection using CT perfusion postprocessing (waveletCTA) for the treatment effect of IV thrombolysis (IVT). METHODS: Patients were selected from 1,851 consecutive patients who had undergone CT perfusion. Inclusion criteria were (1) significant cerebral blood flow (CBF) deficit, (2) no occlusion on CTA, and (3) infarction confirmed on follow-up...
May 15, 2018: Neurology
https://www.readbyqxmd.com/read/29652229/a-useful-diagnostic-method-to-reduce-the-in-hospital-time-delay-for-mechanical-thrombectomy-volume-perfusion-computed-tomography-with-added-vessel-reconstruction
#7
Ho Jun Yi, Jae Hoon Sung, Dong Hoon Lee, Seung Ho Yang, Jae Taek Hong
OBJECTIVE Volume perfusion CT (VPCT) with added CT angiography (CTA)-like reconstruction from VPCT source data (VPCTA) can reveal multiple intracranial parameters. The authors examined the usefulness of VPCTA in terms of reducing the in-hospital time delay for mechanical thrombectomy. METHODS A total of 180 patients who underwent mechanical thrombectomy at the authors' institution between January 2014 and March 2017 were divided into 2 groups: a CTA-based thrombectomy decision group (group 1: CTA) and a VPCTA-based decision group (group 2: VPCTA)...
April 13, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29651557/higher-admission-fasting-plasma-glucose-levels-are-associated-with-a-poorer-short-term-neurologic-outcome-in-acute-ischemic-stroke-patients-with-good-collateral-circulation
#8
Feng Wang, Beisi Jiang, Lasheta Kanesan, Yuwu Zhao, Bernard Yan
AIMS: In this retrospective study, we sought to delineate the collateral circulation status of acute ischemic stroke patients by CT perfusion and evaluate 90-day modified Rankin Scale (mRS) scores of patients with good or poor collaterals and its correlation with admission fasting plasma glucose (FPG). METHODS: We enrolled acute ischemic stroke patients who presented to our hospital 4.5 h within an onset of the first episode between January 2009 and December 2015...
April 12, 2018: Acta Diabetologica
https://www.readbyqxmd.com/read/29649783/radiation-dose-reduction-in-perfusion-ct-imaging-of-the-brain-using-a-256-slice-ct-80-mas-versus-160-mas
#9
Isabelle Riederer, Claus Zimmer, Daniela Pfeiffer, Silke Wunderlich, Holger Poppert, Ernst J Rummeny, Armin Huber
PURPOSE: To examine CTP of the brain in real patient data after reducing tube current down to 80 mAs to decrease radiation dose. METHODS: CTP was acquired in 60 suspected stroke patients with 80 (n: 30) or 160 (n: 30) mAs. Data were analyzed retrospectively by two independent readers. SNR, perfusion maps and image quality were compared in hypoperfused and non-affected areas. RESULTS: SNR was significantly higher in CTP with 160 mAs compared to 80 mAs (p < 0...
April 5, 2018: Clinical Imaging
https://www.readbyqxmd.com/read/29643681/mismatch-in-brain-perfusion-and-metabolism-detected-with-99m-tc-hexamethyl-propylene-amine-oxime-single-photon-emission-computed-tomography-and-18-f-fluorodeoxyglucose-positron-emission-tomography-in-moyamoya-disease
#10
Justo Serrano Vicente, Luis Fernández Prudencio, José Rafael Infante Torre, Juan Ignacio Rayo Madrid
We report a 47-year-old woman who developed an ischemic stroke with diplopia and dysarthria. Emergency computed tomography (CT) showed no pathological findings, and magnetic resonance (MR) showed mild ischemic-degenerative lesions. MR angiography and angiogram showed severe stenosis of both internal carotid and main intracranial arteries with plenty collateral vessels with "puff of smoke" suggesting a moyamoya disease (MMD). Brain perfusion single-photon emission CT showed global diminished perfusion in the brain lobes and a marked relative hyperperfusion in the cerebellum...
April 2018: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/29625153/brain-ct-perfusion-improves-intracranial-vessel-occlusion-detection-on-ct-angiography
#11
Marinus J Becks, Rashindra Manniesing, Jeroen Vister, Sjoert A H Pegge, Stefan C A Steens, Ewoud J van Dijk, Mathias Prokop, Frederick J A Meijer
BACKGROUND AND PURPOSE: To evaluate whether brain CT perfusion (CTP) aids in the detection of intracranial vessel occlusion on CT angiography (CTA) in acute ischemic stroke. MATERIALS AND METHODS: Medical-ethical committee approval of our hospital was obtained and informed consent was waived. Patients suspected of acute ischemic stroke who underwent non-contrast CT(NCCT), CTA and whole-brain CTP in our center in the year 2015 were included. Three observers with different levels of experience evaluated the imaging data of 110 patients for the presence or absence of intracranial arterial vessel occlusion with two strategies...
April 3, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/29622554/slow-collateral-flow-is-associated-with-thrombus-extension-in-patients-with-acute-large-artery-occlusion
#12
R Zhang, Y Zhou, S Yan, S Zhang, X Ding, M Lou
BACKGROUND AND PURPOSE: It is still poorly understood about the dynamic changes of the thrombus after intravenous thrombolysis and how the remaining thrombus affects clinical outcome in human stroke. Collateral flow was assumed to help to deliver endo/exogenous tissue-type plasminogen activator to the clot. We aimed to analyze the impact of collateral flow on the dynamic changes of the thrombus in patients with acute large-artery occlusion who received intravenous thrombolysis. MATERIALS AND METHODS: We reviewed consecutive patients with acute ischemic stroke with M1 segment or distal internal carotid artery occlusion who underwent multimodal MR imaging or CT perfusion before and 24 hours after intravenous thrombolysis without recanalization...
April 5, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29581341/time-from-imaging-to-endovascular-reperfusion-predicts-outcome-in-acute-stroke
#13
Jenny P Tsai, Michael Mlynash, Soren Christensen, Stephanie Kemp, Sun Kim, Nishant K Mishra, Christian Federau, Raul G Nogueira, Tudor G Jovin, Thomas G Devlin, Naveed Akhtar, Dileep R Yavagal, Roland Bammer, Matus Straka, Gregory Zaharchuk, Michael P Marks, Gregory W Albers, Maarten G Lansberg
BACKGROUND AND PURPOSE: This study aims to describe the relationship between computed tomographic (CT) perfusion (CTP)-to-reperfusion time and clinical and radiological outcomes, in a cohort of patients who achieve successful reperfusion for acute ischemic stroke. METHODS: We included data from the CRISP (Computed Tomographic Perfusion to Predict Response in Ischemic Stroke Project) in which all patients underwent a baseline CTP scan before endovascular therapy...
April 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29557515/susceptibility-weighted-imaging-predicts-infarct-size-and-early-stage-clinical-prognosis-in-acute-ischemic-stroke
#14
Song Luo, Lijuan Yang, Yanfei Luo
Susceptibility-weighted imaging (SWI) is a non-invasive technique that can reveal venous structures and iron in the brain. This retrospective study evaluated SWI, relative to other imaging techniques, for determining cerebral infarct size and early-stage clinical prognosis in patients with acute ischemic stroke. Within 3 days after onset, 22 patients with acute ischemic stroke underwent SWI, diffusion-weighted imaging (DWI), perfusion-weighted imaging (PWI), fluid-attenuated inversion recovery (FLAIR), and magnetic resonance angiography (MRA)...
June 2018: Neurological Sciences
https://www.readbyqxmd.com/read/29536243/presence-of-multi-segment-clot-sign-on-dynamic-ct-angiography-a-predictive-imaging-marker-of-recanalisation-and-good-outcome-in-acute-ischaemic-stroke-patients
#15
Feina Shi, Zhicai Chen, Xiaoxian Gong, Meixia Zhang, David S Liebeskind, Min Lou
OBJECTIVE: To investigate the value of multi-segment clot (MSC) sign on dynamic CT angiography (CTA) in predicting recanalisation and outcome after reperfusion therapy in acute ischaemic stroke (AIS) with large artery occlusion (LAO). METHODS: We retrospectively reviewed data of anterior circulation LAO patients from a prospectively collected database for consecutive AIS patients who underwent perfusion CT (CTP) before treatment. MSC sign was defined as the presence of multiple segments on dynamic CTA derived from CTP data...
March 13, 2018: European Radiology
https://www.readbyqxmd.com/read/29525081/effects-of-pretreatment-cerebral-blood-volume-and-time-to-recanalization-on-clinical-outcomes-in-endovascular-thrombectomy-for-acute-ischemic-stroke
#16
Tomohide Yoshie, Toshihiro Ueda, Tatsuro Takada, Shinji Nogoshi, Fumio Miyashita, Satoshi Takaishi, Takayuki Fukano, Daiki Tokuura, Yasuhiro Hasegawa
BACKGROUND: Faster time to recanalization leads to better clinical outcomes in patients treated with endovascular thrombectomy. Whether the association between time to recanalization and clinical outcomes depends on cerebral blood volume (CBV) obtained from pretreatment computed tomography (CT) perfusion (CTP) imaging was investigated. METHODS: In consecutive patients with acute ischemic stroke who achieved recanalization by endovascular thrombectomy for intracranial internal carotid artery or M1 occlusion, the effects on clinical outcome of time to recanalization and the relative CBV value (rCBV) assessed by pretreatment CTP were evaluated...
March 7, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29523650/thalamic-diaschisis-in-acute-ischemic-stroke-occurrence-perfusion-characteristics-and-impact-on-outcome
#17
Paul Reidler, Kolja M Thierfelder, Matthias P Fabritius, Wieland H Sommer, Felix G Meinel, Franziska Dorn, Frank A Wollenweber, Marco Duering, Wolfgang G Kunz
BACKGROUND AND PURPOSE: Ipsilateral thalamic diaschisis (ITD) describes the reduction of thalamic function, metabolism, and perfusion resulting from a distant lesion of the ipsilateral hemisphere. Our aim was to evaluate the perfusion characteristics and clinical impact of ITD in acute middle cerebral artery stroke, which does not directly affect the thalamus. METHODS: One hundred twenty-four patients with middle cerebral artery infarction were selected from a prospectively acquired cohort of 1644 patients who underwent multiparametric computed tomography (CT), including CT perfusion for suspected stroke...
April 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29490322/updates-in-stroke-treatment
#18
Brian Mac Grory, Shadi Yaghi
In this article, we discuss major advances in the treatment and prevention of ischemic stroke that have taken placed in the past 3 years. The most important advance in acute stroke treatment is the validation and widespread adoption of intra-arterial therapies for the treatment of acute ischemic stroke. Five clinical trials spanning multiple continents were published in early 2015 that proved that intra-arterial treatment - both with and without tPA - is beneficial in improving functional recovery after stroke...
March 1, 2018: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/29489691/preliminary-study-of-time-maximum-intensity-projection-computed-tomography-imaging-for-the-detection-of-early-ischemic-change-in-patient-with-acute-ischemic-stroke
#19
Kazuhiro Murayama, Shigetaka Suzuki, Ryo Matsukiyo, Akinori Takenaka, Motoharu Hayakawa, Takashi Tsutsumi, Kenji Fujii, Kazuhiro Katada, Hiroshi Toyama
Noncontrast computed tomography (NCCT) has been used for the detection of early ischemic change (EIC); however, correct interpretation of NCCT findings requires much clinical experience. This study aimed to assess the accuracy of time maximum intensity projection computed tomography technique (tMIP), which reflects the maximum value for the time phase direction from the dynamic volume data for each projected plane, for detection of EIC, against that of NCCT.Retrospective review of NCCT, cerebral blood volume in CT perfusion (CTP-CBV), and tMIP of 186 lesions from 280 regions evaluated by Alberta Stroke Program Early CT Score (ASPECTS) in 14 patients with acute middle cerebral artery stroke who had undergone whole-brain CTP using 320-row area detector CT was performed...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29472890/severe-blood-brain-barrier-disruption-in-cardioembolic-stroke
#20
Chang Liu, Feina Shi, Zhicai Chen, Shenqiang Yan, Xinfa Ding, Min Lou
Background: Previous studies demonstrated that cardioembolism (CE) was prone to develop hemorrhagic transformation (HT), whereas hyper-permeability of blood-brain barrier (BBB) might be one reason for the development of HT. We, thus, aimed to investigate whether the BBB permeability (BBBP) was higher in CE stroke than other stroke subtypes in acute ischemic stroke (AIS) patients. Methods: This study was a retrospective review of prospectively collected clinical and imaging database of AIS patients who underwent CT perfusion...
2018: Frontiers in Neurology
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