3,144 results match your criteria Anterior Circulation Stroke


Predictors and Clinical Impact of Delayed Stent Thrombosis after Thrombectomy for Acute Stroke with Tandem Lesions.

AJNR Am J Neuroradiol 2019 Feb 14. Epub 2019 Feb 14.

From the Interventional Neuroradiology Department (R.P., D.M., M.M., J.S.R., R.B.).

Background And Purpose: There are very few published data on the patency of carotid stents implanted during thrombectomies for tandem lesions in the anterior circulation. We aimed to communicate our experience of stenting in the acute setting with systematic follow-up of stent patency and discuss predictors and clinical repercussions of delayed stent thrombosis.

Materials And Methods: We performed a retrospective study of stroke thrombectomies in a single center between January 2009 and April 2018. Read More

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http://dx.doi.org/10.3174/ajnr.A5976DOI Listing
February 2019

Bilateral cerebral infarction associated with severe arteriosclerosis in the A1 segment: a case report.

J Int Med Res 2019 Feb 14:300060519828930. Epub 2019 Feb 14.

1 Department of Neurology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

Large artery atherosclerosis and cardioembolism are the two major subtypes of ischemic stroke. We herein describe a 75-year-old man with acute complete cerebral infarction in the typical territories of the bilateral anterior cerebral artery (ACA) and left middle cerebral artery. Brain magnetic resonance angiography showed that the right A1 segment of the ACA was affected by severe arteriosclerosis and that the right ACA other than the A1 segment was compensated by the left ACA through the anterior communicating artery. Read More

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http://dx.doi.org/10.1177/0300060519828930DOI Listing
February 2019

Ultrasound identification of patients at increased risk of intracranial hemorrhage after successful endovascular recanalization for acute ischemic stroke.

World Neurosurg 2019 Feb 8. Epub 2019 Feb 8.

Neuroradiology Unit, University of Padua School of Medicine, Padua, Italy.

Background: Intracranial hemorrhage (ICH) is the most feared complication of endovascular treatment (EVT) for acute ischemic stroke due to anterior circulation large vessel occlusion (LVO). The purpose of this study was to identify cerebral hemodynamic predictors of ICH and poor outcome in patients with successful recanalization.

Materials And Methods: Serial transcranial color-coded sonography (TCCS) examinations assessed vessel status and cerebral hemodynamics of 226 [mean-age 69. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.01.198DOI Listing
February 2019
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Burden of large vessel occlusion stroke and the service gap of thrombectomy: A population-based study using a territory-wide public hospital system registry.

Int J Stroke 2019 Feb 11:1747493019830585. Epub 2019 Feb 11.

1 Division of Neurosurgery, Department of Surgery, The University of Hong Kong, Hong Kong.

Background: Ischemic stroke due to large vessel occlusion can be effectively treated with thrombectomy but access to this treatment is limited in many parts of the world. Local incidence of large vessel occlusion is critical in determining the development of thrombectomy service, but reliable data from Asian countries are lacking.

Aims: We performed a population-based study to estimate the burden of large vessel occlusion and the service gap for thrombectomy in Hong Kong. Read More

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http://journals.sagepub.com/doi/10.1177/1747493019830585
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http://dx.doi.org/10.1177/1747493019830585DOI Listing
February 2019
2 Reads

Early microvascular cerebral blood flow response to head-of-bed elevation is related to outcome in acute ischemic stroke.

J Neurol 2019 Feb 9. Epub 2019 Feb 9.

Department of Neurology, Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Background And Aims: Previously, microvascular cerebral blood flow (CBF) response to a mild head-of-bed (HOB) elevation has been shown to be altered in acute ischemic stroke (AIS) by diffuse correlation spectroscopy (DCS). We have hypothesized that early CBF response is related to the functional outcome.

Methods: Patients with a non-lacunar AIS in the anterior circulation were monitored by DCS to measure relative CBF (ΔrCBF) on the frontal lobes bilaterally during a 0°-30° HOB elevation at early (≤ 12) or late (> 12) hours from symptom onset. Read More

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http://dx.doi.org/10.1007/s00415-019-09226-yDOI Listing
February 2019

Revascularization surgery for symptomatic non-moyamoya intracranial arterial stenosis or occlusion.

J Neurosurg 2019 Feb 8:1-6. Epub 2019 Feb 8.

2Department of Clinical Medicine, Macquarie University; and.

OBJECTIVEPrevious trials rejected a role of extracranial-to-intracranial bypass surgery for managing symptomatic atheromatous disease. However, hemodynamic insufficiency may still be a rationale for surgery, provided the bypass can be performed with low morbidity and patency is robust.METHODSConsecutive patients undergoing bypass surgery for symptomatic non-moyamoya intracranial arterial stenosis or occlusion were retrospectively identified. Read More

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http://dx.doi.org/10.3171/2018.9.JNS181075DOI Listing
February 2019

Outcomes of Thrombectomy in Transferred Patients With Ischemic Stroke in the Late Window: A Subanalysis From the DEFUSE 3 Trial.

JAMA Neurol 2019 Feb 7. Epub 2019 Feb 7.

Departments of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California.

Importance: Although thrombectomy benefit was maintained in transfer patients with ischemic stroke in early-window trials, overall functional independence rates were lower in thrombectomy and medical management-only groups.

Objective: To evaluate whether the imaging-based selection criteria used in the Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3 (DEFUSE 3) trial would lead to comparable outcome rates and treatment benefits in transfer vs direct-admission patients.

Design, Setting, And Participants: Subgroup analysis of DEFUSE 3, a prospective, randomized, multicenter, blinded-end point trial. Read More

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http://dx.doi.org/10.1001/jamaneurol.2019.0118DOI Listing
February 2019

Results From DEFUSE 3.

Stroke 2019 Feb 6:STROKEAHA118023407. Epub 2019 Feb 6.

Department of Radiology, Stanford University, CA (M.P.M., J.J.H.).

Background and Purpose- The effect of leptomeningeal collaterals for acute ischemic stroke patients with large vessel occlusion in the late window (>6 hours from last known normal) remains unknown. We sought to determine if collateral status on baseline computed tomography angiography impacted neurological outcome, ischemic core growth, and moderated the effect of endovascular thrombectomy in the late window. Methods- This is a prespecified analysis of DEFUSE 3 (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke). Read More

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http://dx.doi.org/10.1161/STROKEAHA.118.023407DOI Listing
February 2019
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Effectiveness of Low-Dose Intravenous Tissue Plasminogen Activator before Stent Retriever or Aspiration Mechanical Thrombectomy.

J Vasc Interv Radiol 2019 Feb;30(2):134-140

Department of Neurosurgery, Kimitsu Chuo Hospital, 1010 Sakurai, Kisarazu 4-9-1 292-8535, Japan.

Purpose: To determine whether thrombolysis with a lower dose of intravenous recombinant tissue plasminogen activator before mechanical thrombectomy is beneficial for functional outcomes compared with mechanical thrombectomy alone.

Materials And Methods: Data for 100 Japanese patients who underwent mechanical thrombectomy between July 2014 and November 2017 were retrospectively reviewed. These patients were divided into groups according to whether they received intravenous thrombolysis before mechanical thrombectomy, and outcomes were compared. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10510443183168
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http://dx.doi.org/10.1016/j.jvir.2018.11.005DOI Listing
February 2019
4 Reads

Moyamoya syndrome and PHACE syndrome: clinical and radiographic characterization of the intracranial arteriopathy and response to surgical revascularization.

J Neurosurg Pediatr 2019 Feb 1:1-5. Epub 2019 Feb 1.

Departments of1Neurosurgery and.

OBJECTIVEPHACE syndrome (PHACES) has been linked to cervical and cerebral vascular anomalies, including persistent embryonic anastomoses and progressive steno-occlusive disease. However, no prior studies have documented the long-term response of PHACES patients with moyamoya disease to surgical revascularization with pial or myosynangiosis. The authors present their experience with 8 consecutive patients with PHACES and moyamoya disease. Read More

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http://dx.doi.org/10.3171/2018.10.PEDS18582DOI Listing
February 2019
1 Read

Ideal sedation for stroke thrombectomy: a prospective pilot single-center observational study.

Neurosurg Focus 2019 Feb;46(2):E16

1National Skull Base Foundation, Thousand Oaks.

OBJECTIVESeveral retrospective studies have supported the use of conscious sedation (CS) over general anesthesia (GA) as the preferred methods of sedation for stroke thrombectomy, but a recent randomized controlled trial showed no difference in outcomes after CS or GA. The purpose of the Ideal Sedation for Stroke Thrombectomy (ISST) study was to evaluate the difference in time and outcomes in the reperfusion of anterior circulation in ischemic stroke using GA and monitored anesthesia care (MAC).METHODSThe ISST study was a prospective, open-label registry. Read More

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http://dx.doi.org/10.3171/2018.11.FOCUS18522DOI Listing
February 2019
2 Reads

Complete Recanalization May Exert The Most Important Effect on Outcomes of Endovascular Treatment in Acute Ischemic Stroke With Small Infarct Core Beyond 6 Hours.

World Neurosurg 2019 Feb 1. Epub 2019 Feb 1.

Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province 210002, China. Electronic address:

Objective: To explore the differences among grades of recanalization on outcomes of endovascular treatment for acute anterior large vessel occlusion with small infarct core beyond 6 hours time window.

Methods: Patients beyond 6 hours time window with ASPECTS>7 were retrospectively enrolled from the endovascular treatment for acute anterior circulation ischemic stroke (ACTUAL) registry. They were divided into three groups according to the degree of recanalization: modified treatment in cerebral infarction (mTICI) 0-2a, 2b, and 3. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.01.131DOI Listing
February 2019
2.417 Impact Factor

Dysphagia Screening in Acute Ischemic Stroke.

Eur J Neurol 2019 Feb 3. Epub 2019 Feb 3.

Department of Neurology, University of Lübeck, Lübeck, Germany.

Dysphagia is a common neurological, often underdiagnosed symptom of an acute stroke, particularly, in patients suffering from a stroke in the posterior circulation, particularly brainstem infarction or a malign anterior circulation stroke, with altered consciousness. Up to 80% of acute stroke patients showed a dysfunction in swallowing, whereas the determined rate of dysphasia is depending on the stroke's severity, the type and timing of the dysphasia screening techniques. A quarter of the dysphasia patients developed a chronic swallowing dysfunction which severely affects the quality of life in addition to the malnutrition and dehydration risk . Read More

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http://dx.doi.org/10.1111/ene.13921DOI Listing
February 2019

Association Between Net Vertebral Artery Flow Volume and Non-AF Stroke: A Retrospective 2-Year Analysis.

Front Neurol 2018 18;9:1198. Epub 2019 Jan 18.

Department of Neurology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan.

Association between net vertebral artery flow volume (NVAFV) and stroke types remains unclear. We hypothesize NVAFV is low in patients with posterior circulation infarction (PCI) and an ideal cut-off value for discriminating PCI from anterior circulation infarction (ACI) and controls may be present. As study candidates, we retrospectively enrolled hospitalized patients with first-time non-AF stroke within 2-years period. Read More

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http://dx.doi.org/10.3389/fneur.2018.01198DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345680PMC
January 2019
1 Read

Effect of balloon guide catheter on clinical outcomes and reperfusion in Trevo thrombectomy.

J Neurointerv Surg 2019 Feb 2. Epub 2019 Feb 2.

Departments of Endovascular Neurosurgery and Stroke, St Vincent Mercy Medical Center, Toledo, Ohio, USA.

Introduction: The Solitaire stent retriever registry showed improved reperfusion, faster procedure times, and better outcome in acute stroke patients with large vessel occlusion treated with a balloon guide catheter (BGC) and Solitaire stent retriever compared with a conventional guide catheter. The goal of this study was to evaluate whether use of a BGC with the Trevo stent retriever improves outcomes compared with a conventional guide catheter.

Methods: The TRACK registry recruited 23 sites to submit demographic, clinical, and site adjudicated angiographic and outcome data on consecutive patients treated with the Trevo stent retriever. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014452DOI Listing
February 2019

Impact of Collateral Filling Delay on the Development of Subacute Complications After Acute Ischemic Stroke.

Clin Neuroradiol 2019 Feb 1. Epub 2019 Feb 1.

Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.

Purpose: Leptomeningeal collaterals play a pivotal role in acute ischemic stroke. While most collateral scores rely on subjective visual analysis, an objective quantification is possible using dynamic computed tomography (CT) angiography (dynCTA). The aim was to determine the value of collateral filling delay (CFD) as assessed by dynCTA for predicting subacute stroke complications. Read More

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http://dx.doi.org/10.1007/s00062-019-00760-wDOI Listing
February 2019
1 Read

Distribution Pattern of Atherosclerotic Stenosis in Chinese Patients with Stroke: A Multicenter Registry Study.

Aging Dis 2019 Feb 1;10(1):62-70. Epub 2019 Feb 1.

20Department of Ultrasonography, Brain Hospital of Hunan Province, China.

The aim of this multicenter study was to demonstrate the distribution pattern of atherosclerotic stenosis and its trend with aging between extracranial and intracranial arteries and its distribution between the anterior and posterior circulations in Chinese patients hospitalized with ischemic stroke. In addition, the risk factors for the distribution pattern were illustrated. From June 2015 to May 2016, 9,346 patients with ischemic stroke from 20 hospitals were enrolled. Read More

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http://dx.doi.org/10.14336/AD.2018.0602DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345329PMC
February 2019
1 Read

Evaluating patients for thrombectomy.

Brain Circ 2018 Oct-Dec;4(4):153-159. Epub 2018 Dec 31.

Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

The treatment of acute ischemic stroke patients with a proximal large vessel occlusion (LVO) in the anterior circulation has seen tremendous advances initially with the demonstration of the substantial benefit of thrombectomy within 6-h of stroke onset and then with the demonstration of thrombectomy in carefully selected patients up to 24-h from onset. In both the early and late time windows, imaging played an important role in patient selection, especially in the later time window trials where very strict imaging inclusion criteria were employed to identify patients with a small/moderate sized ischemic core on computed tomography perfusion scanning and diffusion-weighted magnetic resonance imaging. In clinical practice, it is important to identify LVO patients quickly so several scoring scales have been developed to help route appropriate patients to a thrombectomy capable center. Read More

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http://dx.doi.org/10.4103/bc.bc_27_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6329212PMC
December 2018

Transradial versus transfemoral access for anterior circulation mechanical thrombectomy: comparison of technical and clinical outcomes.

J Neurointerv Surg 2019 Jan 22. Epub 2019 Jan 22.

Department of Neurological Surgery, University of Miami School of Medicine, Miami, Florida, USA.

Background: A transradial approach (TRA) is associated with fewer access site complications than a transfemoral technique (TFA).However, there is concern that performing mechanical thrombectomy (MT) via TRA may lead to longer revascularization times and thus worse outcomes. Nonetheless, TRA may confer added benefits in MT since navigation of challenging aortic arch and carotid anatomy is often facilitated by a right radial artery trajectory. Read More

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http://jnis.bmj.com/lookup/doi/10.1136/neurintsurg-2018-0144
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http://dx.doi.org/10.1136/neurintsurg-2018-014485DOI Listing
January 2019
4 Reads

Association of Time From Stroke Onset to Groin Puncture With Quality of Reperfusion After Mechanical Thrombectomy: A Meta-analysis of Individual Patient Data From 7 Randomized Clinical Trials.

JAMA Neurol 2019 Jan 22. Epub 2019 Jan 22.

University of Lorraine, and University Hospital of Nancy, Nancy, France.

Importance: Reperfusion is a key factor for clinical outcome in patients with acute ischemic stroke (AIS) treated with endovascular thrombectomy (EVT) for large-vessel intracranial occlusion. However, data are scarce on the association between the time from onset and reperfusion results.

Objective: To analyze the rate of reperfusion after EVT started at different intervals after symptom onset in patients with AIS. Read More

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http://dx.doi.org/10.1001/jamaneurol.2018.4510DOI Listing
January 2019

Noninvasive Collateral Flow Velocity Imaging in Acute Ischemic Stroke: Intraindividual Comparison of 4D-CT Angiography with Digital Subtraction Angiography.

Rofo 2019 Jan 21. Epub 2019 Jan 21.

Neuroradiology, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany.

Purpose:  The collateral status can be defined not only by its morphological extent but also by the velocity of collateral filling characterized by the relative filling time delay (rFTD). The aim of our study was to compare different methods of noninvasive visualization of rFTD derived from 4D-CT angiography (4D-CTA) with digital substraction angiography (DSA) and to investigate the correlation between functional and morphological collateral status on timing-invariant CTA.

Materials And Methods:  50 consecutive patients with acute occlusion in the M1 segment who underwent DSA for subsequent mechanical recanalization after multimodal CT were retrospectively analyzed. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/a-0825-6660
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http://dx.doi.org/10.1055/a-0825-6660DOI Listing
January 2019
6 Reads

Solitaire Stent Permanent Implantation as an Effective Rescue Treatment for Emergency Large Artery Occlusion.

World Neurosurg 2019 Jan 19. Epub 2019 Jan 19.

Department of Neurosurgery, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China. Electronic address:

Background: In this study, we present our experiences on the feasibility of rescue permanent Solitaire stent placement for failed mechanical thrombectomy (MT) and our protocol to avoid ineffective stent placement.

Methods: We retrospectively evaluated the data for consecutive patients admitted into the Second Affiliated Hospital of Wenzhou Medical University and 2 collaboration hospitals from August 2014 to May 2018 for emergency large artery occlusion. The baseline clinical characteristics and radiologic assessment, interventional data, clinical outcome, and angiographic follow-up data were assessed. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18788750193000
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http://dx.doi.org/10.1016/j.wneu.2018.12.145DOI Listing
January 2019
5 Reads

Cerebral Arterial Stiffness as A New Marker of Early Stage Atherosclerosis of The Cerebral Large Artery in Acute Stroke.

J Atheroscler Thromb 2019 Jan 19. Epub 2019 Jan 19.

Institute of Neuroscience and Department of Neurology, the Second Affiliated Hospital of Guangzhou Medical University.

Aim: Carotid-cerebral pulse wave velocity (ccPWV) reflects the segment (C-M segment) stiffness between the common carotid artery and ipsilateral middle cerebral artery. C-M segment atherosclerosis (CMSA) is regarded the most frequent cause of anterior circulation ischemic stroke. We aimed to evaluate the association of ccPWV with early stage CMSA in this study. Read More

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http://dx.doi.org/10.5551/jat.46573DOI Listing
January 2019
2 Reads

Contralateral Approach Based on a Preoperative 3-Dimensional Virtual Osteotomy Technique for Anterior Circulation Aneurysms.

J Stroke Cerebrovasc Dis 2019 Jan 16. Epub 2019 Jan 16.

Department of Neurosurgery, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China. Electronic address:

Objective: Our objective was to review 15 consecutive patients with anterior circulation aneurysms managed through a contralateral approach. Individualized surgical simulation using three-dimensional (3D) imaging was adopted to enable safe performance of clipping surgery.

Methods: Five patients had multiple intracranial aneurysms, and 10 patients had a single aneurysm on the contralateral side of the craniotomy. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2018.12.040DOI Listing
January 2019
1 Read

Predicting cerebral edema in ischemic stroke patients.

Neurol Sci 2019 Jan 19. Epub 2019 Jan 19.

Stroke Unit - Medical Department of Continuity of Care and Disability, S.Orsola-Malpighi Hospital, Bologna, Italy.

Objectives: To produce a scoring system for predicting the development of edema in ischemic stroke patients without edema on admission.

Methods: This retrospective study included 572 ischemic stroke patients (73.3 ± 13. Read More

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http://dx.doi.org/10.1007/s10072-019-3717-yDOI Listing
January 2019
1 Read

Catastrophic Secondary Infarctions with Onset Seizure Following Tissue Plasminogen Activator Therapy.

J Stroke Cerebrovasc Dis 2019 Jan 14. Epub 2019 Jan 14.

Division of Neurology, Department of Internal Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan.

Fatalities following intravenous recombinant tissue-type plasminogen activator therapy have been reported. Major fatal complications following intravenous recombinant tissue-type plasminogen activator therapy include intracranial hemorrhage, aortic dissection, and extracranial bleeding. However, the possibility that intravenous recombinant tissue-type plasminogen activator therapy itself paradoxically induces synchronized multiple cerebral novel infarctions has never been considered. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10523057183074
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2018.12.045DOI Listing
January 2019
4 Reads

Single-Centre Experience with Patients Selection for Mechanical Thrombectomy Based on Automated Computed Tomography Perfusion Analysis-A Comparison with Computed TomographyCT Perfusion Thrombectomy Trials.

J Stroke Cerebrovasc Dis 2019 Jan 14. Epub 2019 Jan 14.

International Clinical Research Centre, Stroke Research Program, St. Anne´s University Hospital, Brno, Czech Republic; Departments of Clinical Neurosciences, Calgary Stroke Program, Cumming School of Medicine, University of Calgary, Calgary, Canada; Department of Neurology, St. Anne´s University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.

Background: In randomized clinical trials, mechanical thrombectomy (MT) was proved to be a highly effective treatment of acute ischemic stroke which improved clinical outcomes. Some of the trials used automated computed tomography perfusion (CTP) analysis for selection of participants. We present a single-center experience with CTP selection and comparison with CTP trials. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10523057183074
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2018.12.041DOI Listing
January 2019
3 Reads

Futile reperfusion and predicted therapeutic benefits after successful endovascular treatment according to initial stroke severity.

BMC Neurol 2019 Jan 15;19(1):11. Epub 2019 Jan 15.

Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.

Background: Futile reperfusion (poor functional status despite successful reperfusion) was observed in up to 67% of patients enrolled in recent endovascular treatment (EVT) clinical trials. We investigated the impact of baseline stroke severity on both futile reperfusion and therapeutic benefit of successful EVT.

Methods: Using a prospective multicenter stroke registry, we identified consecutive ischemic stroke patients with anterior circulation large artery occlusion, who were reperfused successfully by EVT (Thrombolysis in Cerebral Infarction grade 2b-3). Read More

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https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-
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http://dx.doi.org/10.1186/s12883-019-1237-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6332890PMC
January 2019
5 Reads

Relationship between normalized distributional pattern and functional outcome in patients with acute cardiogenic cerebral embolism.

PLoS One 2019 15;14(1):e0210709. Epub 2019 Jan 15.

Department of Neurosurgery, Osaka University Graduate School of Medicine, Osaka, Japan.

This study aimed to elucidate spatial characteristics for magnetic resonance imaging (MRI) of cardiogenic cerebral embolism, to determine imaging biomarkers predicting patient outcome and cerebral herniation in cardioembolic stroke. This retrospective study assessed 90 patients with cardiogenic cerebral embolism. All images from MRI were normalized using a voxel-based symptom lesion mapping technique. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0210709PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333406PMC
January 2019
5 Reads

Outcomes after coverage of lenticulostriate vessels by flow diverters: a multicenter experience.

J Neurosurg 2019 Jan 11:1-8. Epub 2019 Jan 11.

Departments of1Neurosurgery and.

OBJECTIVEWith the increasing use of flow diversion as treatment for intracranial aneurysms, there is a concomitant increased vigilance in monitoring complications. The low porosity of flow diverters is concerning when the origins of vessels are covered, whether large circle of Willis branches or critical perforators. In this study, the authors report their experience with flow diverter coverage of the lenticulostriate vessels and evaluate their safety and outcomes. Read More

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http://dx.doi.org/10.3171/2018.8.JNS18755DOI Listing
January 2019
1 Read
3.737 Impact Factor

Topographic correlation of infarct area on CT perfusion with functional outcome in acute ischemic stroke.

J Neurosurg 2019 Jan 11:1-9. Epub 2019 Jan 11.

1Department of Neurologic Surgery.

OBJECTIVEThe role of CT perfusion (CTP) in the management of patients with acute ischemic stroke (AIS) remains a matter of debate. The primary aim of this study was to evaluate the correlation between the areas of infarction and penumbra on CTP scans and functional outcome in patients with AIS.METHODSThis was a retrospective review of 100 consecutively treated patients with acute anterior circulation ischemic stroke who underwent CT angiography (CTA) and CTP at admission between February 2011 and October 2014. Read More

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http://dx.doi.org/10.3171/2018.8.JNS181095DOI Listing
January 2019

Are you suffering from a large arterial occlusion? Please raise your arm!

Stroke Vasc Neurol 2018 Dec 3;3(4):215-221. Epub 2018 Sep 3.

Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden.

Background And Purpose: Triage tools to identify candidates for thrombectomy are of utmost importance in acute stroke. No prognostic tool has yet gained any widespread use. We compared the predictive value of various models based on National Institutes of Health Stroke Scale (NIHSS) subitems, ranging from simple to more complex models, for predicting large artery occlusion (LAO) in anterior circulation stroke. Read More

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http://dx.doi.org/10.1136/svn-2018-000165DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312073PMC
December 2018

Endovascular treatment of acute ischaemic stroke under conscious sedation: Predictors of poor outcomes.

Indian J Anaesth 2018 Dec;62(12):951-957

Department of Anaesthesiology and Neurological Surgery, Washington University, St. Louis, MO, USA.

Background And Aims: Though, many practitioners prefer conscious sedation (CS), it is unclear which factors most influence neurological outcome following mechanical thrombectomy under CS. The aim of this retrospective study is to identify these factors.

Methods: After institutional review board approval, data were collected for the patients >18 years of age who underwent endovascular treatment of AIS under CS at our comprehensive stroke centre between January 2009 and June 2015. Read More

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http://dx.doi.org/10.4103/ija.IJA_487_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6299765PMC
December 2018
1 Read

Brain Aneurysms in the Pediatric Population of Slovenia: A Case Series.

Neuropediatrics 2019 Jan 10. Epub 2019 Jan 10.

Department of Child, Adolescent and Developmental Neurology, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia.

Background:  Brain aneurysms are rare in the pediatric population. The diagnosis of a brain aneurysm in a child may be difficult because of its infrequency and often subtle or nonspecific clinical presentation. Endovascular therapy and microsurgical treatment are increasingly used approaches in treating children, possibly contributing to favorable outcomes if patients are treated in a timely manner. Read More

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http://dx.doi.org/10.1055/s-0038-1676767DOI Listing
January 2019
7 Reads

Impact of endovascular recanalization on quantitative lesion water uptake in ischemic anterior circulation strokes.

J Cereb Blood Flow Metab 2019 Jan 10:271678X18823601. Epub 2019 Jan 10.

3 Department of Clinical Radiology, University Hospital Münster, Münster, Germany.

Studies evaluating the effect of reperfusion on ischemic edema in acute stroke described conflicting results. Net water uptake (NWU) per brain volume is a new quantitative imaging biomarker of space-occupying ischemic edema, which can be measured in computed tomography (CT). We sought to investigate the effects of vessel recanalization on the formation of ischemic brain edema using quantitative NWU. Read More

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http://journals.sagepub.com/doi/10.1177/0271678X18823601
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http://dx.doi.org/10.1177/0271678X18823601DOI Listing
January 2019
3 Reads

Tetraparesis following an Anterior Circulation Stroke: A Case Report.

Case Rep Neurol 2018 Sep-Dec;10(3):342-345. Epub 2018 Dec 4.

REHAB Basel, Clinic for Neurorehabilitation and Paraplegiology, Basel, Switzerland.

The azygos anterior cerebral artery (AACA) is a large single anterior cerebral artery that supplies both medial territories of the anterior cerebral hemispheres. Occlusion of the AACA can result, therefore, in bifrontal infarction. We report a patient who suffered from a tetraparesis following a bilateral anterior cerebral artery territory infarction due to an occluded AACA and provide a brief review of the literature. Read More

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http://dx.doi.org/10.1159/000495457DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6323375PMC
December 2018

Endovascular Treatment of Atherosclerotic Tandem Occlusions in Anterior Circulation Stroke: Technical Aspects and Complications Compared to Isolated Intracranial Occlusions.

Front Neurol 2018 13;9:1046. Epub 2018 Dec 13.

University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, Bern, Switzerland.

Endovascular treatment of tandem occlusions is an emerging option. We describe our multicenter experience with endovascular management of atherosclerotic tandem occlusions in the anterior circulation, particularly the technical aspects and complications in comparison to isolated intracranial occlusions. Consecutive patients with tandem occlusions due to atherosclerotic causes who underwent mechanical thrombectomy at two major stroke centers between January 2010 and September 2015 were reviewed. Read More

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http://dx.doi.org/10.3389/fneur.2018.01046DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6300468PMC
December 2018
1 Read

Safety of Intra-Arterial Tirofiban Administration in Ischemic Stroke Patients after Unsuccessful Mechanical Thrombectomy.

J Vasc Interv Radiol 2019 Feb 2;30(2):141-147.e1. Epub 2019 Jan 2.

Department of Neurology, Jinling Clinical College of Nanjing Medical University, 305# East Zhongshan Road, Nanjing, 210002, Jiangsu, China. Electronic address:

Purpose: To assess the safety of low-dose intra-arterial (IA) tirofiban bolus after unsuccessful mechanical thrombectomy in patients with ischemic stroke due to large artery occlusion in anterior cerebral circulation.

Materials And Methods: Patients with ischemic stroke who were treated with mechanical thrombectomy were enrolled in a multicenter registry. Low-dose tirofiban was injected into the residual arterial thrombus in patients after unsuccessful mechanical thrombectomy. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10510443183144
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http://dx.doi.org/10.1016/j.jvir.2018.08.021DOI Listing
February 2019
7 Reads

Predictive Value of A2HD Scoring for Transient Symptoms Associated with Infarction.

Med Sci Monit 2019 Jan 2;25:52-60. Epub 2019 Jan 2.

Department of Neurology, Shanghai Tenth People's Hospital of Tongji University, Shanghai, China (mainland).

BACKGROUND Effective early management of cerebral infarction patients with transient ischemic attack (TIA) is undermined by an inability to predict who is at highest risk of stroke. MATERIAL AND METHODS A total of 577 TIA patients with symptoms lasting no more than 1 hour were prospectively investigated and divided into a TIA group and a transient symptoms associated with infarction (TSI) group based on diffusion-weighted magnetic resonance imaging findings after hospital admission. The baseline characteristics, symptoms of TIA, features of disease onset, and findings from clinical examinations were compared between the 2 groups. Read More

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http://dx.doi.org/10.12659/MSM.911941DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327777PMC
January 2019
2 Reads

Neurosonography After Mechanical Thrombectomy for Acute Stroke Treatment.

J Neuroimaging 2019 Jan 2. Epub 2019 Jan 2.

Neurologische Klinik und Poliklinik, Klinikum rechts der Isar, München, Germany.

Background And Purpose: Mechanical thrombectomy has been shown to be effective for acute stroke treatment, but lesions of cerebral vessels can develop thereafter. Such lesions of recanalized vessels and altered cerebral hemodynamics after mechanical thrombectomy are poorly investigated. In particular for neurosonography, data are sparse. Read More

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http://dx.doi.org/10.1111/jon.12592DOI Listing
January 2019

Large Vessel Occlusion Score: A Screening Tool to Detect Large Vessel Occlusion in the Acute Stroke Setting.

J Stroke Cerebrovasc Dis 2018 Dec 29. Epub 2018 Dec 29.

Department of Neurosciences and Behavioral Sciences, Hospital das Clínicas-Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil.

Background: The results of recent trials of mechanical thrombectomy for acute ischemic stroke have increased the demand for identification of patients with large vessel occlusion (LVO) at the primary stroke center, where a prompt detection may expedite transfer to a comprehensive stroke center for endovascular treatment. However, in developing countries, a noncontrast computed tomography (NCCT) may be the only neuroimaging modality available at the primary stroke center scenario, what calls for a screening strategy accurate enough to avoid unnecessary transfers of noneligible patients for endovascular therapy. Algorithms based on National Institute of Health Stroke Scale (NIHSS) and NCCT findings can be used to screen for LVO in patients with anterior circulation stroke (ACS). Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2018.12.003DOI Listing
December 2018
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Is Direct Endovascular Treatment as an Alternative of Bridging Therapy in Acute Stroke Patients with Large Vessel Occlusion?

J Stroke Cerebrovasc Dis 2019 Mar 28;28(3):531-541. Epub 2018 Dec 28.

Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Neurobiology, Chongqing, China. Electronic address:

Background: Although endovascular treatment (EVT) is very effective for acute ischemia stroke (AIS) patients with proximal large vessels occlusion (LVO), whether bridging rPA before EVT in stroke patients of LVO is of any benefit and is currently one of the most urgent unanswered questions. We aim to comprehensively determine the efficacy and safety of direct EVT (DEVT) in AIS patients with LVO versus bridging therapy (BT).

Methods: Clinical researches published in the Embase, PubMed, and Cochrane Library electronic databases up to May 2017 were identified for analysis. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2018.10.007DOI Listing

Infarct Volume Predicts Hospitalization Costs in Anterior Circulation Large-Vessel Occlusion Stroke.

AJNR Am J Neuroradiol 2019 Jan 27;40(1):51-58. Epub 2018 Dec 27.

Department of Neurology, Stroke Institute (C.D.S., S.L.P., B.T.J., A.P.J., T.G.J., S.R., D.T.C.), University of Pittsburgh Medical Center, Pittsburgh. Pennsylvania

Background And Purpose: Anterior circulation large-vessel occlusion stroke, one of the most devastating stroke subtypes, is associated with substantial economic burden. We aimed to identify predictors of increased acute care hospitalization costs associated with anterior circulation large-vessel occlusion stroke.

Materials And Methods: Comprehensive cost-tracking software was used to calculate acute care hospitalization costs for patients with anterior circulation large-vessel occlusion stroke admitted July 2012 to October 2014. Read More

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http://dx.doi.org/10.3174/ajnr.A5917DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348151PMC
January 2019
2 Reads

Hemorrhagic Transformation After Thrombectomy for Tandem Occlusions.

Stroke 2019 Feb;50(2):516-519

From the Department of Diagnostic and Therapeutic Neuroradiology, INSERM U1254 (F.Z., S.B., B.G.), University Hospital of Nancy, France.

Background and Purpose- Carotid artery stenting in tandem large vessel occlusion strokes is usually avoided because of the intracranial hemorrhagic risks induced by antiplatelet therapy during thrombectomy interventions. This study aimed to evaluate the incidence of hemorrhagic transformation following thrombectomy in large vessel occlusion strokes patients with atherosclerotic cervical carotid occlusion, associated factors, and clinical relevance. Methods- The TITAN (Thrombectomy in Tandem Lesions) collaboration pooled individual data of prospectively collected multicentric thrombectomy databases for consecutive anterior circulation tandem large vessel occlusion strokes patients who underwent thrombectomy. Read More

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https://www.ahajournals.org/doi/10.1161/STROKEAHA.118.023689
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http://dx.doi.org/10.1161/STROKEAHA.118.023689DOI Listing
February 2019
1 Read

Emergent Management of Tandem Lesions in Acute Ischemic Stroke.

Stroke 2019 Feb;50(2):428-433

From the Department of Neurology, University of Pittsburgh Medical Center, PA (A.P.J., T.G.J.).

Background and Purpose- Although intracranial thrombectomy represents the standard treatment approach for anterior circulation tandem occlusions, whether the extracranial lesion requires acute stenting remains unclear. Our aim was to investigate differences in clinical and procedural outcomes related to stenting extracranial lesions in a registry of patients undergoing thrombectomy for acute stroke. Methods- Data were analyzed from the STRATIS registry (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke)-a prospective, nonrandomized study of patients undergoing neurothrombectomy with the Solitaire device. Read More

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http://dx.doi.org/10.1161/STROKEAHA.118.021893DOI Listing
February 2019
12 Reads

Hemodynamic Markers in the Anterior Circulation as Predictors of Recurrent Stroke in Patients With Intracranial Stenosis.

Stroke 2018 Dec 11:STROKEAHA118020840. Epub 2018 Dec 11.

From the Department of Neurology, Medical University of South Carolina, Charleston (A.M.W., T.N.T., M.I.C.).

Background and Purpose- Although aggressive medical therapy was superior to stenting in the SAMMPRIS trial (Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis), the stroke rate in the medical arm was still high. The aim of this study was to determine the association between hemodynamic markers (borderzone infarct pattern and impaired collateral flow on baseline imaging) and rates of recurrent stroke in patients treated medically in SAMMPRIS. Methods- This was a post hoc analysis of patients whose qualifying event for SAMMPRIS was an infarct in the territory of a stenotic middle cerebral artery or intracranial carotid artery. Read More

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http://dx.doi.org/10.1161/STROKEAHA.118.020840DOI Listing
December 2018

Increased Success of Single-Pass Large Vessel Recanalization Using a Combined Stentriever and Aspiration Technique: A Single Institution Study.

World Neurosurg 2018 Dec 19. Epub 2018 Dec 19.

Department of Radiology, University of California, Los Angeles, California, USA.

Background: Extensive evidence supports mechanical thrombectomy using stentrievers (SR) for acute large vessel occlusion (aLVO). Aspiration is also used as a first pass or adjunct technique during clot removal. Here we report technical results from mechanical thrombectomy cases using SR alone, aspiration alone (AD), or a combination of SR and aspiration (SA) as a first pass for aLVO. Read More

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http://dx.doi.org/10.1016/j.wneu.2018.12.023DOI Listing
December 2018
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Comparison of Mechanical Thrombectomy with Contact Aspiration, Stent Retriever, and Combined Procedures in Patients with Large-Vessel Occlusion in Acute Ischemic Stroke.

Med Sci Monit 2018 Dec 22;24:9342-9353. Epub 2018 Dec 22.

Department of Applied Mathematics, VŠB-Technical University of Ostrava, Ostrava, Czech Republic.

BACKGROUND We investigated the properties and effects of 5 mechanical thrombectomy procedures in patients with acute ischemic stroke. The relationships between the type of procedure, the time required, the success of recanalization, and the clinical outcome were analyzed. MATERIAL AND METHODS This prospective comparative analysis included 500 patients with acute ischemic stroke and large-vessel occlusion. Read More

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http://dx.doi.org/10.12659/MSM.913458DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320656PMC
December 2018
2 Reads

Clinical Outcome after Thrombectomy in Patients with Stroke with Premorbid Modified Rankin Scale Scores of 3 and 4: A Cohort Study with 136 Patients.

AJNR Am J Neuroradiol 2019 Feb 20;40(2):283-286. Epub 2018 Dec 20.

From the Departments of Neuroradiology (F.S., J.P., C.H., M.B., M.A.M.)

Background And Purpose: We aimed to analyze the clinical outcome after mechanical thrombectomy in patients with premorbid mRS 3 and 4 because there are currently no data on this patient group.

Materials And Methods: Between January 2009 and November 2017, all patients with premorbid mRS 3 or 4 undergoing mechanical thrombectomy due to anterior circulation stroke were selected. Good outcome was defined as a clinical recovery to the status before stroke onset (ie, equal premorbid mRS and mRS at 90 days). Read More

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http://dx.doi.org/10.3174/ajnr.A5920DOI Listing
February 2019
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Door-in-Door-Out Time at Primary Stroke Centers May Predict Outcome for Emergent Large Vessel Occlusion Patients.

Stroke 2018 Dec;49(12):2969-2974

From the Department of Diagnostic Imaging (R.A.M., E.L.D., G.L.B., R.A.H., M.V.J.), Rhode Island Hospital, Providence.

Background and Purpose- Interfacility transfers for thrombectomy in stroke patients with emergent large vessel occlusion (ELVO) are associated with longer treatment times and worse outcomes. In this series, we examined the association between Primary Stroke Center (PSC) door-in to door-out (DIDO) times and outcomes for confirmed ELVO stroke transfers and factors that may modify the interaction. Methods- We retrospectively identified 160 patients transferred to a single Comprehensive Stroke Center (CSC) with anterior circulation ELVO between July 1, 2015 and May 30, 2017. Read More

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http://dx.doi.org/10.1161/STROKEAHA.118.021936DOI Listing
December 2018
2 Reads
5.723 Impact Factor