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Neuroradiology Stroke

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213 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/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
#1
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
#2
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...
June 2, 2017: Neurology
https://www.readbyqxmd.com/read/27161018/low-dose-versus-standard-dose-intravenous-alteplase-in-acute-ischemic-stroke
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28586894/association-between-cirrhosis-and-stroke-in-a-nationally-representative-cohort
#7
Neal S Parikh, Babak B Navi, Yecheskel Schneider, Arun Jesudian, Hooman Kamel
Importance: Cirrhosis is associated with hemorrhagic and thrombotic extrahepatic complications. The risk of cerebrovascular complications is less well understood. Objective: To investigate the association between cirrhosis and various stroke types. Design, Setting, and Participants: We performed a retrospective cohort study using inpatient and outpatient Medicare claims data from January 1, 2008, through December 31, 2014, for a random 5% sample of 1 618 059 Medicare beneficiaries older than 66 years...
June 5, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28495827/hyperbaric-oxygen-reduces-infarction-volume-and-hemorrhagic-transformation-through-atp-nad-sirt1-pathway-in-hyperglycemic-middle-cerebral-artery-occlusion-rats
#8
Qin Hu, Anatol Manaenko, Hetao Bian, Zongduo Guo, Jun-Long Huang, Zhen-Ni Guo, Peng Yang, Jiping Tang, John H Zhang
BACKGROUND AND PURPOSE: Energy depletion is a critical factor leading to cell death and brain dysfunction after ischemic stroke. In this study, we investigated whether energy depletion is involved in hyperglycemia-induced hemorrhagic transformation after ischemic stroke and determined the pathway underlying the beneficial effects of hyperbaric oxygen (HBO). METHODS: After 2-hour middle cerebral artery occlusion, hyperglycemia was induced by injecting 50% dextrose (6 mL/kg) intraperitoneally at the onset of reperfusion...
June 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28540482/linear-sign-in-cystic-brain-lesions-%C3%A2-5-mm-a-suggestive-feature-of-perivascular-space
#9
Jinkyeong Sung, Jinhee Jang, Hyun Seok Choi, So-Lyung Jung, Kook-Jin Ahn, Bum-Soo Kim
OBJECTIVE: To determine the prevalence of a linear sign within enlarged perivascular space (EPVS) and chronic lacunar infarction (CLI) ≥ 5 mm on T2-weighted imaging (T2WI) and time-of-flight (TOF) magnetic resonance angiography (MRA), and to evaluate the diagnostic value of the linear signs for EPVS over CLI. METHODS: This study included 101 patients with cystic lesions ≥ 5 mm on brain MRI including TOF MRA. After classification of cystic lesions into EPVS or CLI, two readers assessed linear signs on T2WI and TOF MRA...
May 24, 2017: European Radiology
https://www.readbyqxmd.com/read/28498930/risk-factors-for-intracranial-aneurysm-rupture-a-systematic-review
#10
Rachel Kleinloog, Nikki de Mul, Bon H Verweij, Jan Andries Post, Gabriel J E Rinkel, Ynte M Ruigrok
BACKGROUND: Intracranial aneurysm rupture prediction is poor, with only a few risk factors for rupture identified and used in clinical practice. OBJECTIVE: To provide an overview of all the risk factors (including genetic, molecular, morphological, and hemodynamic factors) that have potential for use in clinical practice. METHODS: We systematically searched PubMed and EMBASE and focused on factors that can be easily assessed in clinical practice, might be used for rupture prediction in clinical practice, and/or are potential targets for further research...
May 11, 2017: Neurosurgery
https://www.readbyqxmd.com/read/27302238/effect-of-baseline-alberta-stroke-program-early-ct-score-on-safety-and-efficacy-of-intra-arterial-treatment-a-subgroup-analysis-of-a-randomised-phase-3-trial-mr-clean
#11
RANDOMIZED CONTROLLED TRIAL
Albert J Yoo, Olvert A Berkhemer, Puck S S Fransen, Lucie A van den Berg, Debbie Beumer, Hester F Lingsma, Wouter J Schonewille, Marieke E S Sprengers, René van den Berg, Marianne A A van Walderveen, Ludo F M Beenen, Marieke J H Wermer, Geert J Lycklama À Nijeholt, Jelis Boiten, Sjoerd F M Jenniskens, Joseph C J Bot, Anna M M Boers, Henk A Marquering, Yvo B W E M Roos, Robert J van Oostenbrugge, Diederik W J Dippel, Aad van der Lugt, Wim H van Zwam, Charles B L M Majoie
BACKGROUND: Whether infarct size modifies intra-arterial treatment effect is not certain, particularly in patients with large infarcts. We examined the effect of the baseline Alberta Stroke Program Early CT Score (ASPECTS) on the safety and efficacy of intra-arterial treatment in a subgroup analysis of the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN). METHODS: MR CLEAN was a randomised, controlled, open-label, phase 3 trial of intra-arterial treatment in patients (aged ≥18 years from the Netherlands) with proximal arterial occlusion of the anterior circulation, given intra-arterial treatment within 6 h of stroke onset...
June 2016: Lancet Neurology
https://www.readbyqxmd.com/read/28432266/baseline-blood-pressure-effect-on-the-benefit-and-safety-of-intra-arterial-treatment-in-mr-clean-multicenter-randomized-clinical-trial-of-endovascular-treatment-of-acute-ischemic-stroke-in-the-netherlands
#12
Maxim J H L Mulder, Saliha Ergezen, Hester F Lingsma, Olvert A Berkhemer, Puck S S Fransen, Debbie Beumer, Lucie A van den Berg, Geert Lycklama À Nijeholt, Bart J Emmer, H Bart van der Worp, Paul J Nederkoorn, Yvo B W E M Roos, Robert J van Oostenbrugge, Wim H van Zwam, Charles B L M Majoie, Aad van der Lugt, Diederik W J Dippel
BACKGROUND AND PURPOSE: High blood pressure (BP) is associated with poor outcome and the occurrence of symptomatic intracranial hemorrhage in acute ischemic stroke. Whether BP influences the benefit or safety of intra-arterial treatment (IAT) is not known. We aimed to assess the relation of BP with functional outcome, occurrence of symptomatic intracranial hemorrhage and effect of IAT. METHODS: This is a post hoc analysis of the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands)...
April 21, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28500364/radiologists-need-to-be-aware-of-secondary-central-venous-stenosis-in-patients-with-sapho-syndrome
#13
Mizuho Suzuki, Hidenori Kanazawa, Takeshi Shinozaki, Hideharu Sugimoto
OBJECTIVES: We aimed to define central venous stenosis (CVS) caused by sternocostoclavicular hyperostosis as a feature of synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome on routine contrast-enhanced computed tomography (CT) images. The relationship between SAPHO syndrome and CVS without venous thrombosis caused by anterior chest wall compression has not been investigated. Therefore, the present study evaluated CVS in patients with SAPHO syndrome at our hospital. METHODS: We retrospectively reviewed contrast-enhanced CT images of ten patients with suspected or diagnosed SAPHO syndrome between January 2007 and November 2015...
May 12, 2017: European Radiology
https://www.readbyqxmd.com/read/28492918/association-of-a-primary-stroke-center-protocol-for-suspected-stroke-by-large-vessel-occlusion-with-efficiency-of-care-and-patient-outcomes
#14
Ryan A McTaggart, Shadi Yaghi, Shawna M Cutting, Morgan Hemendinger, Grayson L Baird, Richard A Haas, Karen L Furie, Mahesh V Jayaraman
Importance: While prehospital triage to the closest comprehensive stroke center (CSC) may improve the delivery of care for patients with suspected emergent large-vessel occlusion (ELVO), efficient systems of care must also exist for patients with ELVO who first present to a primary stroke center (PSC). Objective: To describe the association of a PSC protocol focused on 3 key steps (early CSC notification based on clinical severity, vessel imaging at the PSC, and cloud-based image sharing) with the efficiency of care and the outcomes of patients with suspected ELVO who first present to a PSC...
May 8, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28492932/population-based-prevalence-of-cerebral-cavernous-malformations-in-older-adults-mayo-clinic-study-of-aging
#15
Kelly D Flemming, Jonathan Graff-Radford, Jeremiah Aakre, Kejal Kantarci, Giuseppe Lanzino, Robert D Brown, Michelle M Mielke, Rosebud O Roberts, Walter Kremers, David S Knopman, Ronald C Petersen, Clifford R Jack
Importance: The prevalence of cerebral cavernous malformation (CCM) is unknown. Case ascertainment in most previous studies was based on autopsy data or clinical convenience samples, often without detailed clinical or radiologic information. Objective: To determine the prevalence of CCM in a population-based sample of older adults. Design, Setting, and Participants: This prospective imaging study included 4721 participants aged 50 to 89 years who were enrolled between January 1, 2004, and December 15, 2015, in the Mayo Clinic Study of Aging, a longitudinal, population-based study of residents of Olmsted County, Minnesota...
May 8, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28363976/elapss-score-for-prediction-of-risk-of-growth-of-unruptured-intracranial-aneurysms
#16
MULTICENTER STUDY
Daan Backes, Gabriel J E Rinkel, Jacoba P Greving, Birgitta K Velthuis, Yuichi Murayama, Hiroyuki Takao, Toshihiro Ishibashi, Michiya Igase, Karel G terBrugge, Ronit Agid, Juha E Jääskeläinen, Antti E Lindgren, Timo Koivisto, Mikael von Und Zu Fraunberg, Shunji Matsubara, Junta Moroi, George K C Wong, Jill M Abrigo, Keiji Igase, Katsumi Matsumoto, Marieke J H Wermer, Marianne A A van Walderveen, Ale Algra, Mervyn D I Vergouwen
OBJECTIVE: To develop a risk score that estimates 3-year and 5-year absolute risks for aneurysm growth. METHODS: From 10 cohorts of patients with unruptured intracranial aneurysms and follow-up imaging, we pooled individual data on sex, population, age, hypertension, history of subarachnoid hemorrhage, and aneurysm location, size, aspect ratio, and shape but not on smoking during follow-up and family history of intracranial aneurysms in 1,507 patients with 1,909 unruptured intracranial aneurysms and used aneurysm growth as outcome...
April 25, 2017: Neurology
https://www.readbyqxmd.com/read/28424275/outcomes-after-intracerebral-hemorrhage-from-arteriovenous-malformations
#17
Santosh B Murthy, Alexander E Merkler, Setareh Salehi Omran, Gino Gialdini, Aaron Gusdon, Benjamin Hartley, David Roh, Halinder S Mangat, Costantino Iadecola, Babak B Navi, Hooman Kamel
OBJECTIVE: To compare outcomes after intracerebral hemorrhage (ICH) from cerebral arteriovenous malformation (AVM) rupture and other causes of ICH. METHODS: We performed a retrospective population-based study using data from the Nationwide Inpatient Sample. We used standard diagnosis codes to identify ICH cases from 2002 to 2011. Our predictor variable was cerebral AVM. Our primary outcomes were inpatient mortality and home discharge. We used logistic regression to compare outcomes between patients with ICH with and without AVM while adjusting for demographics, comorbidities, and hospital characteristics...
May 16, 2017: Neurology
https://www.readbyqxmd.com/read/28446657/alcohol-use-and-risk-of-intracerebral-hemorrhage
#18
MULTICENTER STUDY
Ching-Jen Chen, W Mark Brown, Charles J Moomaw, Carl D Langefeld, Jennifer Osborne, Bradford B Worrall, Daniel Woo, Sebastian Koch
OBJECTIVE: To analyze the dose-risk relationship for alcohol consumption and intracerebral hemorrhage (ICH) in the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study. METHODS: ERICH is a multicenter, prospective, case-control study, designed to recruit 1,000 non-Hispanic white patients, 1,000 non-Hispanic black patients, and 1,000 Hispanic patients with ICH. Cases were matched 1:1 to ICH-free controls by age, sex, race/ethnicity, and geographic area...
May 23, 2017: Neurology
https://www.readbyqxmd.com/read/28455382/endovascular-therapy-for-ischemic-stroke-save-a-minute-save-a-week
#19
Atte Meretoja, Mahsa Keshtkaran, Turgut Tatlisumak, Geoffrey A Donnan, Leonid Churilov
OBJECTIVE: To quantify the patient lifetime benefits gained from reduced delays in endovascular therapy for acute ischemic stroke. METHODS: We used observational prospective data of consecutive stroke patients treated with IV thrombolysis in Helsinki (1998-2014; n = 2,474) to describe distributions of age, sex, stroke severity, onset-to-treatment times, and 3-month modified Rankin Scale (mRS) in routine clinical practice. We used treatment effects by time of endovascular therapy in large vessel occlusion over and above thrombolysis as reported by the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) study to model the shift in 3-month mRS distributions with reducing treatment delays...
May 30, 2017: Neurology
https://www.readbyqxmd.com/read/28384632/is-reperfusion-useful-in-ischaemic-stroke-patients-presenting-with-a-low-national-institutes-of-health-stroke-scale-and-a-proximal-large-vessel-occlusion-of-the-anterior-circulation
#20
Cyril Dargazanli, Arturo Consoli, Benjamin Gory, Raphaël Blanc, Julien Labreuche, Cristian Preda, Frédéric Bourdain, Jean-Pierre Decroix, Hocine Redjem, Gabriele Ciccio, Mikael Mazighi, Stanislas Smajda, Jean-Philippe Desilles, Roberto Riva, Paul-Emile Labeyrie, Oguzhan Coskun, Georges Rodesch, Francis Turjman, Michel Piotin, Bertrand Lapergue
BACKGROUND: In population-based studies, patients presenting with minor or mild stroke symptoms represent about two-thirds of stroke patients, and almost one-third of these patients are unable to ambulate independently at the time of discharge. Although mechanical thrombectomy (MT) has become the standard of care for acute ischaemic stroke with proximal large vessel occlusion (LVO) in the anterior circulation, the management of patients harbouring proximal occlusion and minor-to-mild stroke symptoms has not yet been determined by recent trials...
2017: Cerebrovascular Diseases
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