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Mashup Score: 56
Rationale: Whether endovascular therapy (EVT) in addition to best medical treatment (BMT) in people with acute ischemic stroke (AIS) due to a medium distal vess…
Source: journals.sagepub.comCategories: General Medicine News, NeurologyTweet
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Mashup Score: 5
This pooled cohort study clarifies the association between cumulative mean systolic blood pressure and incident stroke types and explores whether race and ethnicity modify these associations.
Source: jamanetwork.comCategories: General Medicine News, NeurologyTweet
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Mashup Score: 2Lesion-Filling Index from Quantitative DSA Correlates with Hemorrhage of Cerebral AVM - 7 day(s) ago
BACKGROUND AND PURPOSE: Rupture is the most life-threatening manifestation of cerebral AVMs. This study aimed to explore the hemodynamic mechanism of AVM rupture. We introduced a new quantitative DSA parameter that can reflect the degree of intranidal blood stasis, called the lesion-filling index. MATERIALS AND METHODS: This study examined patients with AVMs who had undergone both DSA and MR imaging between 2013 and 2014. Clinical presentations, angioarchitecture, and hemodynamic parameters generated from quantitative DSA were analyzed using univariate and multivariable logistic regression. The lesion-filling index was defined as the arterial diagnostic window divided by the volume of the AVM. To assess the correlation between the lesion-filling index and rupture, we incorporated the lesion-filling index into 2 published prediction models widely recognized for predicting AVM rupture risk, R2eD and VALE. The DeLong test was used to examine whether the addition of the lesion-filling inde
Source: www.ajnr.orgCategories: General Medicine News, NeurologyTweet
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Mashup Score: 21
BACKGROUND AND PURPOSE: Hemorrhagic transformation can occur as a complication of endovascular treatment for acute ischemic stroke. This study aimed to determine whether ischemia depth as measured by admission CTP metrics can predict the development of hemorrhagic transformation at 24 hours. MATERIALS AND METHODS: Patients with baseline CTP and 24-hour follow-up imaging from the ESCAPE-NA1 trial were included. RAPID software was used to generate CTP volume maps for relative CBF, CBV, and time-to-maximum at different thresholds. Hemorrhage on 24-hour imaging was classified according to the Heidelberg system, and volumes were calculated. Univariable and multivariable regression analyses assessed the association between CTP lesion volumes and hemorrhage/hemorrhage subtypes. RESULTS: Among 408 patients with baseline CTP, 142 (35%) had hemorrhagic transformation at 24-hour follow-up, with 89 (63%) classified as hemorrhagic infarction (HI1/HI2), and 53 (37%), as parenchymal hematoma (PH1/PH2
Source: www.ajnr.orgCategories: General Medicine News, NeurologyTweet
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Mashup Score: 11Improved Cerebral Glymphatic Flow after Transvenous Embolization of CSF-Venous Fistula - 7 day(s) ago
Spontaneous intracranial hypotension is characterized by symptoms of low intracranial CSF volume due to various mechanisms of CSF leakage. One such mechanism is a CSF-venous fistula, treatable with transvenous embolization resulting in substantial radiographic and clinical improvement. However, the exact mechanisms underlying these improvements, including the potential involvement of the glymphatic system, remain unclear. To noninvasively assess glymphatic clearance in spontaneous intracranial hypotension, we used an advanced MR imaging technique called the DTI along the perivascular spaces in 3 patients with CSF-venous fistula before and after embolization. All 3 patients with spontaneous intracranial hypotension initially had low glymphatic flow, which improved postembolization. Two patients with symptomatic improvement exhibited a more substantial increase in glymphatic flow compared with a patient with minimal improvement. These findings suggest a possible link between cerebral gly
Source: www.ajnr.orgCategories: General Medicine News, NeurologyTweet
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Mashup Score: 16
Adequate reperfusion after ischemic stroke is a major determinant of functional outcome yet remains unpredictable and insufficient for most survivors. In this issue of Neuron, Binder et al. identify leptomeningeal collaterals (LMCs) in mice and human patients as a key factor in regulating reperfusion and hemorrhagic transformation following stroke.
Source: www.cell.comCategories: General Medicine News, NeurologyTweet
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Mashup Score: 153Subjects with carotid webs demonstrate pro-thrombotic hemodynamics compared to subjects with carotid atherosclerosis - 7 day(s) ago
Scientific Reports – Subjects with carotid webs demonstrate pro-thrombotic hemodynamics compared to subjects with carotid atherosclerosis
Source: www.nature.comCategories: General Medicine News, NeurologyTweet
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Mashup Score: 1Racial Disparities in Blood Pressure at Time of Acute Ischemic Stroke Presentation: A Population Study - 7 day(s) ago
BackgroundHypertension is a stroke risk factor with known disparities in prevalence and management between Black and White patients. We sought to identify if racial differences in presenting blood …
Source: www.ahajournals.orgCategories: General Medicine News, NeurologyTweet
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Mashup Score: 58Behavior of Extracranial‐to‐Intracranial Extended Arterial Dissections of the Vertebral Artery - 7 day(s) ago
BackgroundVertebral artery dissections (VADs) may extend from the extracranial to the intracranial vasculature (e+iVAD). We evaluated how the characteristics of e+iVAD differed from those of intrac…
Source: www.ahajournals.orgCategories: General Medicine News, NeurologyTweet
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Mashup Score: 4Deep learning-based model for difficult transfemoral access prediction compared with human assessment in stroke thrombectomy - 8 day(s) ago
Background In mechanical thrombectomy (MT), extracranial vascular tortuosity is among the main determinants of procedure duration and success. Currently, no rapid and reliable method exists to identify the anatomical features precluding fast and stable access to the cervical vessels. Methods A retrospective sample of 513 patients were included in this study. Patients underwent first-line transfemoral MT following anterior circulation large vessel occlusion stroke. Difficult transfemoral access (DTFA) was defined as impossible common carotid catheterization or time from groin puncture to first carotid angiogram >30 min. A machine learning model based on 29 anatomical features automatically extracted from head-and-neck computed tomography angiography (CTA) was developed to predict DTFA. Three experienced raters independently assessed the likelihood of DTFA on a reduced cohort of 116 cases using a Likert scale as benchmark for the model, using preprocedural CTA as well as automatic 3D vas
Source: jnis.bmj.comCategories: General Medicine News, NeurologyTweet
EnDovascular Therapy Plus Best Medical Treatment (BMT) Versus BMT Alone for MedIum distal VeSsel Occlusion sTroke (DISTAL): An international, multicentre, randomized-controlled, two-arm, assessor-blinded trial https://t.co/dqrmAk9Oj6 https://t.co/9dm0xFBkt9