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Neuroradiology Stroke

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242 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/29129127/a-new-dawn-for-imaging-based-selection-in-the-treatment-of-acute-stroke
#1
Werner Hacke
No abstract text is available yet for this article.
November 11, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29129157/thrombectomy-6-to-24-hours-after-stroke-with-a-mismatch-between-deficit-and-infarct
#2
Raul G Nogueira, Ashutosh P Jadhav, Diogo C Haussen, Alain Bonafe, Ronald F Budzik, Parita Bhuva, Dileep R Yavagal, Marc Ribo, Christophe Cognard, Ricardo A Hanel, Cathy A Sila, Ameer E Hassan, Monica Millan, Elad I Levy, Peter Mitchell, Michael Chen, Joey D English, Qaisar A Shah, Frank L Silver, Vitor M Pereira, Brijesh P Mehta, Blaise W Baxter, Michael G Abraham, Pedro Cardona, Erol Veznedaroglu, Frank R Hellinger, Lei Feng, Jawad F Kirmani, Demetrius K Lopes, Brian T Jankowitz, Michael R Frankel, Vincent Costalat, Nirav A Vora, Albert J Yoo, Amer M Malik, Anthony J Furlan, Marta Rubiera, Amin Aghaebrahim, Jean-Marc Olivot, Wondwossen G Tekle, Ryan Shields, Todd Graves, Roger J Lewis, Wade S Smith, David S Liebeskind, Jeffrey L Saver, Tudor G Jovin
Background The effect of endovascular thrombectomy that is performed more than 6 hours after the onset of ischemic stroke is uncertain. Patients with a clinical deficit that is disproportionately severe relative to the infarct volume may benefit from late thrombectomy. Methods We enrolled patients with occlusion of the intracranial internal carotid artery or proximal middle cerebral artery who had last been known to be well 6 to 24 hours earlier and who had a mismatch between the severity of the clinical deficit and the infarct volume, with mismatch criteria defined according to age (<80 years or ≥80 years)...
November 11, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28959994/endovascular-thrombectomy-for-stroke-current-best-practice-and-future-goals
#3
REVIEW
Bruce C V Campbell, Geoffrey A Donnan, Peter J Mitchell, Stephen M Davis
Endovascular thrombectomy for large vessel ischaemic stroke substantially reduces disability, with recent positive randomised trials leading to guideline changes worldwide. This review discusses in detail the evidence provided by recent randomised trials and meta-analyses, the remaining areas of uncertainty and the future directions for research. The data from existing trials have demonstrated the robust benefit of endovascular thrombectomy for internal carotid and proximal middle cerebral artery occlusions...
March 2016: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28970244/pial-artery-supply-as-an-anatomic-risk-factor-for-ischemic-stroke-in-the-treatment-of-intracranial-dural-arteriovenous-fistulas
#4
S W Hetts, A Yen, D L Cooke, J Nelson, P Jolivalt, J Banaga, M R Amans, C F Dowd, R T Higashida, M T Lawton, H Kim, V V Halbach
BACKGROUND AND PURPOSE: Although intracranial dural arteriovenous fistulas are principally supplied by dural branches of the external carotid, internal carotid, and vertebral arteries, they can also be fed by pial arteries that supply the brain. We sought to determine the frequency of neurologic deficits following treatment of intracranial dural arteriovenous fistulas with and without pial artery supply. MATERIALS AND METHODS: One hundred twenty-two consecutive patients who underwent treatment for intracranial dural arteriovenous fistulas at our hospital from 2008 to 2015 were retrospectively reviewed...
September 28, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28994833/the-efficacy-and-safety-of-endovascular-recanalization-of-occluded-large-cerebral-arteries-during-the-subacute-phase-of-cerebral-infarction-a-case-series-report
#5
Kangning Chen, Xianhua Hou, Zhenhua Zhou, Guangjian Li, Qu Liu, Li Gui, Jun Hu, Shugui Shi
BACKGROUND: Intravenous tissue plasminogen activator with or without mechanical thrombectomy during the acute phase are approved therapies for ischaemic stroke. Due to the short treatment time window (<6 hours) and often treatment failure, these patients would still have an intracranial arterial occlusion (IAO). It is unclear whether these patients can benefit from subsequent interventional recanalizationof their occluded artery in the subacute phase. In this retrospective study, we have examined the efficacy and safety in patients who have received either percutaneous transluminal angioplasty (PTA) or percutaneous transluminal angioplasty and stenting (PTAS) for IAO in the subacute phase of their stroke...
September 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28882863/patient-outcomes-and-cerebral-infarction-after-ruptured-anterior-communicating-artery-aneurysm-treatment
#6
J J Heit, R L Ball, N A Telischak, H M Do, R L Dodd, G K Steinberg, S D Chang, M Wintermark, M P Marks
BACKGROUND AND PURPOSE: Anterior communicating artery aneurysm rupture and treatment is associated with high rates of dependency, which are more severe after clipping compared with coiling. To determine whether ischemic injury might account for these differences, we characterized cerebral infarction burden, infarction patterns, and patient outcomes after surgical or endovascular treatment of ruptured anterior communicating artery aneurysms. MATERIALS AND METHODS: We performed a retrospective cohort study of consecutive patients with ruptured anterior communicating artery aneurysms...
September 7, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28906578/ultra-early-hematoma-growth-in-antithrombotic-pretreated-patients-with-intracerebral-hemorrhage
#7
J Roquer, R M Vivanco-Hidalgo, J Capellades, A Ois, E Cuadrado-Godia, E Giralt-Steinhauer, C Soriano-Tárraga, M Mola-Caminal, M Serra-Martínez, C Avellaneda-Gómez, J Jiménez-Conde, A Rodríguez-Campello
BACKGROUND AND PURPOSE: Patients with acute intracerebral hemorrhage (ICH) pretreated with antithrombotic drugs may have increased early hematoma growth, which would increase mortality risk. The effect of antiplatelet (AP) and vitamin K antagonist (VKA) pretreatment on ultra-early hematoma growth (uHG) and its relationship with mortality in patients with acute supratentorial ICH was analyzed. METHODS: This is an observational retrospective study of a prospective register of 197 ICH patients with first computed tomography (CT) scan taken <6 h from ICH symptom onset...
September 14, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28848166/mechanical-thrombectomy-for-acute-basilar-artery-occlusion-in-early-therapeutic-time-window
#8
Junji Uno, Katsuharu Kameda, Ryosuke Otsuji, Nice Ren, Shintaro Nagaoka, Kazushi Maeda, Yoshiaki Ikai, Hidefuku Gi
BACKGROUND: The natural history of basilar artery occlusion (BAO) is devastating, with morbidity rates increasing up to 80%. However, the efficacy of recanalization therapy for BAO has not been established as yet. OBJECTIVE: We analyzed consecutive cases of BAO treated with mechanical thrombectomy (MT) to evaluate its safety and efficacy and to determine factors associated with the prognosis. METHODS: Between October 2011 and September 2016, MT was performed in 34 patients with BAO...
2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28906581/is-there-a-benefit-of-mechanical-thrombectomy-in-patients-with-large-stroke-dwi-aspects-%C3%A2-5
#9
P-F Manceau, S Soize, M Gawlitza, G Fabre, S Bakchine, C Durot, I Serre, G-E Metaxas, L Pierot
BACKGROUND AND PURPOSE: Whether to withhold mechanical thrombectomy when the diffusion-weighted imaging (DWI) lesion exceeds a given volume is undetermined. Our aim was to identify markers that will help to select patients with large DWI lesions [DWI-Alberta Stroke Program Early Computed Tomography Score (DWI-ASPECTS) ≤ 5] that may benefit from thrombectomy. METHODS: From May 2010 to November 2016, 82 acute ischaemic stroke patients with DWI-ASPECTS ≤5 (43 men, 64...
September 14, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28867523/drip-and-ship-thrombolytic-therapy-for-acute-ischemic-stroke
#10
Ichiro Deguchi, Satoko Mizuno, Shinya Kohyama, Norio Tanahashi, Masaki Takao
BACKGROUND: Neuroendovascular therapy is a common treatment for patients with acute ischemic stroke of the anterior circulation who fail to respond to recombinant tissue plasminogen activator. However, although most hospitals can provide recombinant tissue plasminogen activator therapy, many cannot perform neuroendovascular therapy. Thus, use of a drip-and-ship treatment-liaison system allowing recombinant tissue plasminogen activator-treated patients to be transferred to facilities offering neuroendovascular therapy is important...
August 31, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28799861/absence-of-cortical-vein-opacification-is-associated-with-lack-of-intra-arterial-therapy-benefit-in-stroke
#11
Ivo G H Jansen, Annemieke B van Vuuren, Wim H van Zwam, Ido R van den Wijngaard, Olvert A Berkhemer, Hester F Lingsma, Cornelis H Slump, Robert J van Oostenbrugge, Kilian M Treurniet, Diederik W J Dippel, Marianne A A van Walderveen, Aad van der Lugt, Yvo B W E M Roos, Henk A Marquering, Charles B L M Majoie, René van den Berg
Purpose To assess the degree of cortical vein opacification in patients with internal carotid artery or middle cerebral artery (MCA) stroke and to evaluate the relationship with treatment benefit from intra-arterial therapy (IAT). Materials and Methods Written informed consent was obtained from all patients in the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands. From the trial's database, all patients (recruited from December 2010 until March 2014) with baseline computed tomographic (CT) angiograms were retrospectively included...
August 11, 2017: Radiology
https://www.readbyqxmd.com/read/28792246/assessing-the-efficacy-of-endovascular-therapy-in-stroke-treatments-updates-from-the-new-generation-of-trials
#12
Gregory B Walker, Ashutosh P Jadhav, Tudor G Jovin
For the past 20 years, intravenous recombinant tissue plasminogen activator (rt-PA) has been the only proven treatment for acute ischemic stroke. Large arteries such as the internal carotid artery, the middle cerebral artery and the basilar artery supply blood to large volumes of brain tissue. When occluded, these vessels may have low response rates to rt-PA resulting in devastating injury and death. Areas covered: In 2013, three trials evaluating the efficacy of mechanical thrombectomy in acute stroke were neutral, however, lessons learned from these trials resulted in a second generation of five trials in 2015 and a sixth in 2016 which all demonstrated significant benefit for select patients...
October 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28751517/packing-density-necessary-to-reach-a-high-complete-occlusion-rate-in-circumferential-unruptured-intracranial-aneurysms-treated-with-stent-assisted-coil-embolization
#13
R T Tosello, U C Batista, B J A Pereira, R L Piske
BACKGROUND AND PURPOSE: This study is a homogeneous series of circumferential unruptured intracranial aneurysms with large necks treated with stent-assisted coil embolization. Our purpose was to demonstrate which value of packing density is required to produce a durable occlusion. MATERIALS AND METHODS: We retrospectively evaluated all patients with unruptured intracranial aneurysms who were treated with stent-assisted coil embolization having late angiographic control between 2004 and 2014, in a single large cerebrovascular referral center...
July 27, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28751519/value-of-thrombus-ct-characteristics-in-patients-with-acute-ischemic-stroke
#14
J Borst, O A Berkhemer, E M M Santos, A J Yoo, M den Blanken, Y B W E M Roos, E van Bavel, W H van Zwam, R J van Oostenbrugge, H F Lingsma, A van der Lugt, D W J Dippel, H A Marquering, C B L M Majoie
BACKGROUND AND PURPOSE: Thrombus CT characteristics might be useful for patient selection for intra-arterial treatment. Our objective was to study the association of thrombus CT characteristics with outcome and treatment effect in patients with acute ischemic stroke. MATERIALS AND METHODS: We included 199 patients for whom thin-section NCCT and CTA within 30 minutes from each other were available in the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute ischemic stroke in the Netherlands (MR CLEAN) study...
July 27, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28747462/mechanical-thrombectomy-outcomes-with-and-without-intravenous-thrombolysis-in-stroke-patients-a-meta-analysis
#15
Eva A Mistry, Akshitkumar M Mistry, Mohammad Obadah Nakawah, Rohan V Chitale, Robert F James, John J Volpi, Matthew R Fusco
BACKGROUND AND PURPOSE: Whether prior intravenous thrombolysis provides any additional benefits to the patients undergoing mechanical thrombectomy for large vessel, acute ischemic stroke remains unclear. METHODS: We conducted a meta-analysis of 13 studies obtained through PubMed and EMBASE database searches to determine whether functional outcome (modified Rankin Scale) at 90 days, successful recanalization rate, and symptomatic intracerebral hemorrhage rate differed between patients who underwent mechanical thrombectomy with (MT+IVT) and without (MT-IVT) pre-treatment with intravenous thrombolysis...
September 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28666912/outcome-after-subarachnoid-hemorrhage-from-blood-blister-like-aneurysm-rupture-depends-on-age-and-aneurysm-morphology
#16
Juergen Konczalla, Florian Gessler, Markus Bruder, Joachim Berkefeld, Gerhard Marquardt, Volker Seifert
BACKGROUND: Blood blister-like aneurysms (BBLA) are rare, challenging to treat, and prone to rerupture. We analyzed our results in relationship to type of BBLA and other prognostic factors. METHODS: Data on patient and aneurysm characteristics, clinical course, and treatment results, including data from patient records and review of imaging findings, were collected prospectively and analyzed retrospectively. RESULTS: There were 27 patients (mean age 56 years) with subarachnoid hemorrhage from BBLA...
September 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
#17
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
#18
RANDOMIZED CONTROLLED TRIAL
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)...
August 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28705890/mechanical-thrombectomy-of-m1-and-m2-middle-cerebral-artery-occlusions
#19
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
#20
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
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