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Neuroradiology Stroke

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227 papers 100 to 500 followers Articles about stroke and vascular pathology for the neuroradiologist.
By Sebastian Bravo-Grau Neuroradiology Fellow - Radiologist
https://www.readbyqxmd.com/read/28666912/outcome-after-subarachnoid-hemorrhage-from-blood-blister-like-aneurysm-rupture-depends-on-age-and-aneurysm-morphology
#1
Juergen Konczalla, Florian Gessler, Markus Bruder, Joachim Berkefeld, Gerhard Marquardt, Volker Seifert
BACKGROUND: Blood blister-like aneurysms (BBLA) are rare, prone to rerupture and challenging to treat. OBJECTIVE: To report our results in relationship to the type of BBLA and other prognostic factors. METHODS: Data on patient and aneurysm characteristics, clinical course and treatment results were collected prospectively and analyzed retrospectively including data from patient records and review of imaging findings. RESULTS: Twenty-seven patients had subarachnoid hemorrhage (SAH) from BBLA...
June 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28428346/sugar-and-artificially-sweetened-beverages-and-the-risks-of-incident-stroke-and-dementia-a-prospective-cohort-study
#2
Matthew P Pase, Jayandra J Himali, Alexa S Beiser, Hugo J Aparicio, Claudia L Satizabal, Ramachandran S Vasan, Sudha Seshadri, Paul F Jacques
BACKGROUND AND PURPOSE: Sugar- and artificially-sweetened beverage intake have been linked to cardiometabolic risk factors, which increase the risk of cerebrovascular disease and dementia. We examined whether sugar- or artificially sweetened beverage consumption was associated with the prospective risks of incident stroke or dementia in the community-based Framingham Heart Study Offspring cohort. METHODS: We studied 2888 participants aged >45 years for incident stroke (mean age 62 [SD, 9] years; 45% men) and 1484 participants aged >60 years for incident dementia (mean age 69 [SD, 6] years; 46% men)...
May 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28681535/microbleeds-in-the-secondary-prevention-of-small-subcortical-strokes-trial-stroke-mortality-and-treatment-interactions
#3
Ashkan Shoamanesh, Lesly A Pearce, Carlos Bazan, Luciana Catanese, Leslie A McClure, Mukul Sharma, Joan Marti-Fabregas, David C Anderson, Carlos S Kase, Robert G Hart, Oscar R Benavente
OBJECTIVE: To characterize cerebral microbleeds (CMBs) in lacunar stroke patients in the Secondary Prevention of Small Subcortical Strokes (SPS3) trial and to assess their relationship with recurrent stroke and death, and response to assigned treatment. METHODS: SPS3 is a randomized, clinical trial conducted between 2003 and 2011. Patients with recent magnetic resonance imaging (MRI)-documented lacunar infarcts were randomly assigned in a factorial design to target levels of systolic blood pressure (130-149mmHg vs <130mmHg; open label) and to antiplatelet treatment (aspirin/clopidogrel vs aspirin/placebo; double-blinded)...
July 6, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28705890/mechanical-thrombectomy-of-m1-and-m2-middle-cerebral-artery-occlusions
#4
Hisham Salahuddin, Guru Ramaiah, Diana E Slawski, Julie Shawver, Mark Buehler, Syed F Zaidi, Mouhammad Jumaa
BACKGROUND: Over half of patients who receive intravenous tissue plasminogen activator for middle cerebral artery division (MCA-M2) occlusion do not recanalize, leaving a large percentage of patients who may need mechanical thrombectomy (MT). However, the outcomes of MT for M2 occlusion have not been well characterized. OBJECTIVE: To determine if MT of M2 occlusion is as safe and efficacious as current standard-of-care MT for M1 occlusions. METHODS: With institutional review board approval, we retrospectively reviewed records of 212 patients undergoing MT for isolated MCA M1 or M2 occlusions during a 36-month period (Sept 2013 to Sept 2016) at two centres...
July 13, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28410350/education-socioeconomic-status-and-intelligence-in-childhood-and-stroke-risk-in-later-life-a-meta-analysis
#5
Caroline A McHutchison, Ellen V Backhouse, Vera Cvoro, Susan D Shenkin, Joanna M Wardlaw
BACKGROUND: Stroke is the second most common cause of death, and a common cause of dependency and dementia. Adult vascular risk factors and socioeconomic status (SES) are associated with increased risk, but less is known about early life risk factors, such as education, childhood SES, or intelligence (IQ). METHODS: We comprehensively searched Medline, PsycINFO, and EMBASE from inception to November 2015. We included all studies reporting data on >50 strokes examining childhood/premorbid IQ, SES, and education...
July 2017: Epidemiology
https://www.readbyqxmd.com/read/28684458/influence-of-carotid-siphon-anatomy-on-brain-aneurysm-presentation
#6
E Waihrich, P Clavel, G A C Mendes, C Iosif, I Moraes Kessler, C Mounayer
BACKGROUND AND PURPOSE: Intracranial aneurysm is a devastating disease of complex etiology that is not fully understood. The purpose of this study was to assess the implications of carotid siphon anatomy for the formation and development of intracranial aneurysms. MATERIALS AND METHODS: Between January 2007 and May 2015, lateral view digital subtraction angiographic images of 692 consecutive patients with intracranial aneurysms treated in our department of interventional neuroradiology were reviewed and had their angles measured...
July 6, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28562210/lateral-sinus-dural-arteriovenous-fistulas-sinovenous-outflow-restriction-outweighs-cortical-venous-reflux-as-a-parameter-associated-with-hemorrhage
#7
Yong-Sin Hu, Chung-Jung Lin, Hsiu-Mei Wu, Wan-Yuo Guo, Chao-Bao Luo, Chih-Chun Wu, Wen-Yuh Chung, Kang-Du Liu, Huai-Che Yang, Cheng-Chia Lee
Purpose To investigate whether sinovenous outflow restriction (SOR) is more strongly associated with hemorrhage than cortical venous reflux (CVR) in patients with lateral sinus dural arteriovenous fistulas (DAVFs). Materials and Methods An institutional review board approved this retrospective study and waiver of informed consent was obtained. From 1995 to 2016, 163 cases of lateral sinus DAVFs were included and divided into hemorrhagic and nonhemorrhagic groups based on initial presentation. Their angiograms and magnetic resonance images were evaluated, with two evaluators independently grading CVR and SOR...
May 30, 2017: Radiology
https://www.readbyqxmd.com/read/28678670/multiphase-ct-angiography-improves-prediction-of-intracerebral-hemorrhage-expansion
#8
David Rodriguez-Luna, Pilar Coscojuela, Noelia Rodriguez-Villatoro, Jesús M Juega, Sandra Boned, Marián Muchada, Jorge Pagola, Marta Rubiera, Marc Ribo, Alejandro Tomasello, Andrew M Demchuk, Mayank Goyal, Carlos A Molina
Purpose To determine the prevalence of the spot sign and the accuracy of using the spot sign to predict intracerebral hemorrhage (ICH) expansion with standardized multiphase computed tomographic (CT) angiography. Materials and Methods This prospective observational cohort study included 123 consecutive patients with acute ICH (onset <6 hours). Patients underwent multiphase CT angiography in three automated phases after injection of contrast material. Patients were classified as having one of four patterns (pattern A, B, C, or D) according to the presence of the spot sign in the three phases...
July 3, 2017: Radiology
https://www.readbyqxmd.com/read/28652053/mr-imaging-in-hyperacute-ischemic-stroke
#9
Carla Vert, Carmen Parra Fariñas, Àlex Rovira
Brain and vascular imaging are required components of the emergency assessment of patients with suspected stroke. Either CT or MRI may be used as the initial imaging test. MRI is more sensitive to the presence of acute and chronic ischemic lesions, and chronic microbleeds, but CT remains the most practical and used initial brain imaging test. Although, a non-enhanced CT or T2* MRI sequence showing no haemorrhage is sufficient for deciding intravenous treatment eligibility within the first 4.5h after stroke onset, a non-invasive intracranial vascular study is strongly recommended during the initial imaging evaluation of the acute stroke patient, particularly if mechanical thrombectomy is contemplated...
June 19, 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28668406/vessel-shape-alterations-of-the-vertebrobasilar-arteries-in-mucopolysaccharidosis-type-iva-morquio-a-patients
#10
Yasemin Tanyildizi, Seyfullah Gökce, Federico Marini, Anna K Mayer, Stefanie Kirschner, Julia B Hennermann, Marc A Brockmann
PURPOSE: Main symptom of mucopolysaccharidosis type IVa (MPS IVa) is progressive systemic skeletal dysplasia. This is routinely monitored by cerebral and spinal MRI. The vascular system is generally not in the primary focus of interest. In our population of MPS IVa patients we observed vessel shape alterations of the vertebrobasilar arteries, which has not been described before. MATERIAL AND METHODS: MRI-datasets of 26 patients with MPS IVa acquired between 2008 and 2015 were eligible for retrospective analysis of the vertebrobasilar arteries...
August 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28619838/state-of-practice-endovascular-treatment-of-acute-aneurysmal-sah-in-germany
#11
H Janssen, A Berlis, J Lutz, N Thon, H Brückmann
BACKGROUND AND PURPOSE: Acute aneurysmal SAH is a severe disease that requires prompt treatment. Endovascular coiling and neurosurgical clipping are established treatment options. Our intention was to determine the state of current practice in acute aneurysmal SAH treatment in Germany, with emphasis on logistic and temporal aspects. MATERIALS AND METHODS: We interviewed 74 German university and nonuniversity hospitals with an anonymous questionnaire comprising 15 questions concerning the practice of treatment and diagnostics of acute aneurysmal SAH at their respective institutions...
June 15, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28605486/aneurysm-morphology-and-prediction-of-rupture-an-international-study-of-unruptured-intracranial-aneurysms-analysis
#12
J Mocco, Robert D Brown, James C Torner, Ana W Capuano, Kyle M Fargen, Madhavan L Raghavan, David G Piepgras, Irene Meissner, John Huston Iii
BACKGROUND: There are conflicting data between natural history studies suggesting a very low risk of rupture for small, unruptured intracranial aneurysms and retrospective studies that have identified a much higher frequency of small, ruptured aneurysms than expected. OBJECTIVE: To use the prospective International Study of Unruptured Intracranial Aneurysms cohort to identify morphological characteristics predictive of unruptured intracranial aneurysm rupture. METHODS: A case-control design was used to analyze morphological characteristics associated with aneurysm rupture in the International Study of Unruptured Intracranial Aneurysms database...
June 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28654338/small-intracranial-aneurysms-diagnostic-accuracy-of-ct-angiography
#13
Zhen Lu Yang, Qian Qian Ni, U Joseph Schoepf, Carlo N De Cecco, Han Lin, Taylor M Duguay, Chang Sheng Zhou, Yan E Zhao, Guang Ming Lu, Long Jiang Zhang
Purpose To assess the accuracy of computed tomographic (CT) angiography for diagnosis of cerebral aneurysms 5 mm or smaller, with digital subtraction angiography (DSA) as the reference standard, in a large patient cohort Materials and Methods This retrospective study was approved by the local institutional review board with a waiver of written informed consent. A total of 1366 patients who underwent cerebral CT angiography followed by DSA were included. The performance of CT angiography for depiction of aneurysms was evaluated by two readers on a per-patient and per-aneurysm basis and based on size of aneurysm, location, and status of rupture...
June 26, 2017: Radiology
https://www.readbyqxmd.com/read/28634280/surgical-clipping-or-endovascular-coiling-for-unruptured-intracranial-aneurysms-a-pragmatic-randomised-trial
#14
Tim E Darsaut, J Max Findlay, Elsa Magro, Marc Kotowski, Daniel Roy, Alain Weill, Michel W Bojanowski, Chiraz Chaalala, Daniela Iancu, Howard Lesiuk, John Sinclair, Felix Scholtes, Didier Martin, Michael M Chow, Cian J O'Kelly, John H Wong, Ken Butcher, Allan J Fox, Adam S Arthur, Francois Guilbert, Lu Tian, Miguel Chagnon, Suzanne Nolet, Guylaine Gevry, Jean Raymond
BACKGROUND: Unruptured intracranial aneurysms (UIAs) are increasingly diagnosed and are commonly treated using endovascular treatment or microsurgical clipping. The safety and efficacy of treatments have not been compared in a randomised trial. How to treat patients with UIAs suitable for both options remains unknown. METHODS: We randomly allocated clipping or coiling to patients with one or more 3-25 mm UIAs judged treatable both ways. The primary outcome was treatment failure, defined as: initial failure of aneurysm treatment, intracranial haemorrhage or residual aneurysm on 1-year imaging...
August 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28465460/efficacy-of-stent-retriever-thrombectomy-in-magnetic-resonance-imaging-versus-computed-tomographic-perfusion-selected-patients-in-swift-prime-trial-solitaire-fr-with-the-intention-for-thrombectomy-as-primary-endovascular-treatment-for-acute-ischemic-stroke
#15
RANDOMIZED CONTROLLED TRIAL
Nicolas Menjot de Champfleur, Jeffrey L Saver, Mayank Goyal, Reza Jahan, Hans-Christoph Diener, Alain Bonafe, Elad I Levy, Vitor M Pereira, Christophe Cognard, Dileep R Yavagal, Gregory W Albers
BACKGROUND AND PURPOSE: The majority of patients enrolled in SWIFT PRIME trial (Solitaire FR With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke) had computed tomographic perfusion (CTP) imaging before randomization; 34 patients were randomized after magnetic resonance imaging (MRI). METHODS: Patients with middle cerebral artery and distal carotid occlusions were randomized to treatment with tPA (tissue-type plasminogen activator) alone or tPA+stentriever thrombectomy...
June 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28576782/tenecteplase-in-ischemic-stroke-offers-improved-recanalization-analysis-of-2-trials
#16
RANDOMIZED CONTROLLED TRIAL
Andrew Bivard, Xuya Huang, Christopher R Levi, Neil Spratt, Bruce C V Campbell, Bharath Kumar Cheripelli, Dheeraj Kalladka, Fiona Catherine Moreton, Ian Ford, Christopher F Bladin, Stephen M Davis, Geoffrey A Donnan, Keith W Muir, Mark W Parsons
OBJECTIVE: To test whether patients with complete vessel occlusion show greater recanalization at 24 hours and have improved clinical outcomes at 24 hours and 90 days when treated with tenecteplase compared to alteplase. METHODS: Pooled clinical and imaging data from 2 phase 2 randomized trials comparing tenecteplase with alteplase allowed CT angiography (CTA) scans to be assessed centrally for occlusion status at baseline and at 24 hours post thrombolysis using the modified thrombolysis in cerebral infarction (TICI) scale...
July 4, 2017: Neurology
https://www.readbyqxmd.com/read/27161018/low-dose-versus-standard-dose-intravenous-alteplase-in-acute-ischemic-stroke
#17
RANDOMIZED CONTROLLED TRIAL
Craig S Anderson, Thompson Robinson, Richard I Lindley, Hisatomi Arima, Pablo M Lavados, Tsong-Hai Lee, Joseph P Broderick, Xiaoying Chen, Guofang Chen, Vijay K Sharma, Jong S Kim, Nguyen H Thang, Yongjun Cao, Mark W Parsons, Christopher Levi, Yining Huang, Verónica V Olavarría, Andrew M Demchuk, Philip M Bath, Geoffrey A Donnan, Sheila Martins, Octavio M Pontes-Neto, Federico Silva, Stefano Ricci, Christine Roffe, Jeyaraj Pandian, Laurent Billot, Mark Woodward, Qiang Li, Xia Wang, Jiguang Wang, John Chalmers
BACKGROUND: Thrombolytic therapy for acute ischemic stroke with a lower-than-standard dose of intravenous alteplase may improve recovery along with a reduced risk of intracerebral hemorrhage. METHODS: Using a 2-by-2 quasi-factorial open-label design, we randomly assigned 3310 patients who were eligible for thrombolytic therapy (median age, 67 years; 63% Asian) to low-dose intravenous alteplase (0.6 mg per kilogram of body weight) or the standard dose (0.9 mg per kilogram); patients underwent randomization within 4...
June 16, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/28458385/recent-trends-in-neuro-endovascular-treatment-for-acute-ischemic-stroke-cerebral-aneurysms-carotid-stenosis-and-brain-arteriovenous-malformations
#18
Yuji Matsumaru, Eiichi Ishikawa, Tetsuya Yamamoto, Akira Matsumura
The efficacy of mechanical thrombectomy with stent retrievers for emergent large vessel occlusion has been proved by randomized trials. Mechanical thrombectomy is increasingly being adopted in Japan since stent retrievers were first approved in 2014. An urgent clinical task is to offer structured systems of care to provide this treatment in a timely fashion to all patients with emergent large vessel occlusion. Treatment with flow-diverting stents is currently a preferred treatment option worldwide for large and giant unruptured aneurysms...
May 1, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28555270/critical-review-of-brain-avm-surgery-surgical-results-and-natural-history-in-2017
#19
REVIEW
Michael Kerin Morgan, Andrew Stewart Davidson, Nazih N A Assaad, Marcus Andrew Stoodley
BACKGROUND: An understanding of the present standing of surgery, surgical results and the role in altering the future morbidity and mortality of untreated brain arteriovenous malformations (bAVMs) is appropriate considering the myriad alternative management pathways (including radiosurgery, embolization or some combination of treatments), varying risks and selection biases that have contributed to confusion regarding management. The purpose of this review is to clarify the link between the incidence of adverse outcomes that are reported from a management pathway of either surgery or no intervention with the projected risks of surgery or no intervention...
May 29, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28489992/arteriovenous-malformations-of-the-brain
#20
REVIEW
Robert A Solomon, E Sander Connolly
New England Journal of Medicine, Volume 376, Issue 19, Page 1859-1866, May 2017.
May 11, 2017: New England Journal of Medicine
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