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ESTUDIOS


18 junio 2015

AMERICAN JOURNAL OF NEURORADIOLOGY. A Comparison of 4D DSA with 2D and 3D DSA in the Analysis of Normal Vascular Structures in a Canine Model

C. Sandoval-Garcia, K. Royalty, B. Aagaard-Kienitz, S. Schafer, P. Yang and C. Strother

BACKGROUND AND PURPOSE: 4D DSA allows viewing of 3D DSA as a series of time-resolved volumes of a contrast bolus. There is no comparison of the accuracy of the anatomic information provided by 4D DSA with that available from conventional 2D and 3D DSA. Our purpose was to make this comparison by using a canine model.

04 junio 2015

AMERICAN JOURNAL OF NEURORADIOLOGY. Hot Topics in Research: Preventive Neuroradiology in Brain Aging and Cognitive Decline

C.A. Raji, H. Eyre, S.H. Wei, D.E. Bredesen, S. Moylan, M. Law, G. Small, P.M. Thompson, R.M. Friedlander, D.H. Silverman, B.T. Baune, T.A. Hoang, N. Salamon, A.W. Toga and M.W. Vernooij

SUMMARY: Preventive neuroradiology is a new concept supported by growing literature. The main rationale of preventive neuroradiology is the application of multimodal brain imaging toward early and subclinical detection of brain disease and subsequent preventive actions through identification of modifiable risk factors. An insightful example of this is in the area of age-related cognitive decline, mild cognitive impairment, and dementia with potentially modifiable risk factors such as obesity, diet, sleep, hypertension, diabetes, depression, supplementation, smoking, and physical activity. In studying this link between lifestyle and cognitive decline, brain imaging markers may be instrumental as quantitative measures or even indicators of early disease. The purpose of this article is to provide an overview of the major studies reflecting how lifestyle factors affect the brain and cognition aging. In this hot topics review, we will specifically focus on obesity and physical activity.

30 julio 2015

AMERICAN JOURNAL OF NEURORADIOLOGY. Outcome Differences between Intra-Arterial Iso- and Low-Osmolality Iodinated Radiographic Contrast Media in the Interventional Management of Stroke III Trial

T.A. Tomsick, L.D. Foster, D.S. Liebeskind, M.D. Hill, J. Carrozella, M. Goyal, R. von Kummer, A.M. Demchuk, I. Dzialowski, V. Puetz, T. Jovin, H. Morales, Y.Y. Palesch, J. Broderick, P. Khatri, S.D. Yeatts, for the IMS III Investigators

BACKGROUND AND PURPOSE: Intracarotid arterial infusion of nonionic, low-osmolal iohexol contrast medium has been associated with increased intracranial hemorrhage in a rat middle cerebral artery occlusion model compared with saline infusion. Iso-osmolal iodixanol (290 mOsm/kg H2O) infusion demonstrated smaller infarcts and less intracranial hemorrhage compared with low-osmolal iopamidol and saline. No studies comparing iodinated radiographic contrast media in human stroke have been performed, to our knowledge. We hypothesized that low-osmolal contrast media may be associated with worse outcomes compared with iodixanol in the Interventional Management of Stroke III Trial (IMS III).

13 agosto 2015

AMERICAN JOURNAL OF NEURORADIOLOGY. Could Statin Use Be Associated with Reduced Recurrence Rates following Coiling in Ruptured Intracranial Aneurysms?

W. Brinjikji, V. Shahi, H.J. Cloft, G. Lanzino, D.F. Kallmes and R. Kadirvel

BACKGROUND AND PURPOSE: A number of studies have examined the role of matrix metalloproteinases in aneurysm healing following endovascular coiling. Because ruptured aneurysms are known to express higher levels of matrix metalloproteinases, we hypothesized that patients with subarachnoid hemorrhage who were on a statin at the time of coil embolization would have lower aneurysm recanalization and retreatment rates than patients not on statins.

10 septiembre 2015

AMERICAN JOURNAL OF NEURORADIOLOGY. Dynamic 4D MRI for Characterization of Parathyroid Adenomas: Multiparametric Analysis

K. Nael, J. Hur, A. Bauer, R. Khan, A. Sepahdari, R. Inampudi and M. Guerrero

BACKGROUND AND PURPOSE: The hypervascular nature of parathyroid adenomas can be explored by proper dynamic imaging to narrow the target lesions for surgical exploration. The purpose of this study was to establish MR perfusion characteristics of parathyroid adenomas to differentiate them from their mimics, such as subjacent thyroid tissue and cervical lymph nodes.

01 octubre 2015

NEUROSURGERY. Randomized Clinical Trial of Balloon-Expandable Intracranial Stenting Versus Aggressive Medical Therapy for Symptomatic Intracranial Arterial Stenosis

Starke, Robert M. MD, MSc; Komotar, Ricardo J. MD; Connolly, E. Sander MD

Stroke is a leading worldwide cause of morbidity and mortality. Ischemia from intracranial athero-occlusive disease is a leading cause of stroke, and these patients are at a considerable risk of recurrent stroke. Despite the significant number of patients who suffer from intracranial atherosclerosis, a limited number of trials have been aimed at patient management.

24 noviembre 2015

STROKE. Clinical Sciences. An International Standard Set of Patient-Centered Outcome Measures After Stroke

Joel Salinas, MD, MBA; Sara M. Sprinkhuizen, PhD, MSc; Teri Ackerson, SCRN, BSN; Julie Bernhardt, PT, PhD; Charlie Davie, MD; Mary G. George, MD, MSPH; Stephanie Gething, Dip COT, MSc; Adam G. Kelly, MD; Patrice Lindsay, RN, PhD; Liping Liu, MD; Sheila C.O. Martins, MD, PhD; Louise Morgan, MSN, CPHQ; Bo Norrving, MD, PhD; Gerard M. Ribbers, MD, PhD; Frank L. Silver, MD; Eric E. Smith, MD, MPH; Linda S. Williams, MD; Lee H. Schwamm, MD

Background and Purpose: Value-based health care aims to bring together patients and health systems to maximize the ratio of quality over cost. To enable assessment of healthcare value in stroke management, an international standard set of patient-centered stroke outcome measures was defined for use in a variety of healthcare settings.

24 noviembre 2015

STROKE. Clinical Sciences. Different Antiplatelet Strategies in Patients With New Ischemic Stroke While Taking Aspirin

Joon-Tae Kim, MD, PhD; Man-Seok Park, MD, PhD; Kang-Ho Choi, MD, PhD; Ki-Hyun Cho, MD, PhD; Beom Joon Kim, MD, PhD; Moon-Ku Han, MD, PhD; Tai Hwan Park, MD, PhD; Sang-Soon Park, MD; Kyung Bok Lee, MD, PhD; Byung-Chul Lee, MD, PhD; Kyung-Ho Yu, MD, PhD; Mi Sun Oh, MD, PhD; Jae Kwan Cha, MD, PhD; Dae-Hyun Kim, MD, PhD; Hyun-Wook Nah, MD, PhD; Jun Lee, MD, PhD; Soo Joo Lee, MD, PhD; Young-Chai Ko, MD; Jae Guk Kim, MD; Jong-Moo Park, MD, PhD; Kyusik Kang, MD; Yong-Jin Cho, MD, PhD; Keun-Sik Hong, MD, PhD; Jay Chol Choi, MD, PhD; Dong-Eog Kim, MD, PhD; Wi-Sun Ryu, MD; Dong-Ick Shin, MD, PhD; Min-Ju Yeo, MD; Wook-Joo Kim, MD; Juneyoung Lee, PhD; Ji Sung Lee, PhD; Jeffrey L. Saver, MD, PhD; Hee-Joon Bae, MD, PhD

Background and Purpose—Selecting among different antiplatelet strategies when patients experience a new ischemic stroke while taking aspirin is a common clinical challenge, currently addressed by a paucity of data.

05 noviembre 2015

STROKE. Clinical Sciences. Impact of Collateral Status Evaluated by Dynamic Computed Tomographic Angiography on Clinical Outcome in Patients With Ischemic Stroke

Ido R. van den Wijngaard, MD; Jelis Boiten, MD, PhD; Ghislaine Holswilder, MSc; Ale Algra, MD, PhD; Diederik W.J. Dippel, MD, PhD; Birgitta K. Velthuis, MD, PhD; Marieke J.H. Wermer, MD, PhD*; Marianne A.A. van Walderveen, MD, PhD*

Background and Purpose: Status of collateral circulation is a strong predictor of outcome after acute ischemic stroke. Our aim was to compare the predictive value of strategies for collateral blood flow assessment with dynamic computed tomographic angiography (CTA) and conventional single-phase CT angiography.

06 octubre 2015

STROKE. Clinical Sciences. Differences in Common Genetic Predisposition to Ischemic Stroke by Age and Sex

Matthew Traylor, PhD; Loes C.A. Rutten-Jacobs, PhD; Elizabeth G. Holliday, PhD; Rainer Malik, PhD; Cathie Sudlow, FRCP(E); Peter M. Rothwell, FMedSci; Jane M. Maguire, PhD; Simon A. Koblar, MD; Steve Bevan, PhD; Giorgio Boncoraglio, MD; Martin Dichgans, MD; Chris Levi, MD; Cathryn M. Lewis, PhD; Hugh S. Markus, DM

Background and Purpose: Evidence from epidemiological studies points to differences in factors predisposing to stroke by age and sex. Whether these arise because of different genetic influences remained untested. Here, we use data from 4 genome-wide association data sets to study the relationship between genetic influence on stroke with both age and sex.

29 septiembre 2015

STROKE. Clinical Sciences. Differences Between US and UK Adults in Stroke Preparedness

Stephan U. Dombrowski, PhD; Gary A. Ford, FRCP; Lewis B. Morgenstern, MD; Martin White, MD; Falko F. Sniehotta, PhD; Joan E. Mackintosh, MSc; Paul Gellert, PhD; Lesli E. Skolarus, MD

Background and Purpose: Although time-dependent treatment is available, most people delay contacting emergency medical services for stroke. Given differences in the healthcare system and public health campaigns, exploring between-country differences in stroke preparedness may identify novel ways to increase acute stroke treatment.

18 noviembre 2014

STROKE. Improving Outcomes in Patients With Carotid Stenosis. Call for Better Research Opportunities and Standards

Anne L. Abbott, PhD, FRACP, MBBS; Andrew N. Nicolaides, MS, FRCS, PhD

Knowing how to best prevent stroke in patients with carotid artery stenosis is of major public health importance because carotid stenosis is common in older people and causes ≈10% of all strokes.1 For decades it has been thought that patients with carotid plaques showing a predominance of echolucent tissue by ultrasound imaging have higher stroke risk and are more likely to benefit from carotid procedures.2 The accompanying meta-analysis by Gupta et al3 is important because it demonstrates that predominantly echolucent asymptomatic carotid plaques carry ≈2.5× the risk of ipsilateral stroke over the next 2 years or so compared with predominantly echogenic plaques. The meta-analysis also shows that predominantly echolucent plaques are common, making up 23% of stenosing or nonstenosing plaques and 31% of plaques causing ≥50% stenosis.

09 diciembre 2014

STROKE. Clinical Sciences. Residual High-Grade Stenosis After Recanalization of Extracranial Carotid Occlusion in Acute Ischemic Stroke

Merel J.A. Luitse, MD; Birgitta K. Velthuis, MD; Meenakshi Dauwan, MD; Jan Willem Dankbaar, MD; Geert Jan Biessels, MD; L. Jaap Kappelle, MD; on behalf of the Dutch Acute Stroke Study Group

Background and Purpose: Residual stenosis after recanalization of an acute symptomatic extracranial occlusion of the internal carotid artery (ICA) might be an indication for carotid endarterectomy. We evaluated the proportion of residual high-grade stenosis (≥70%, near occlusions not included) on follow-up imaging in a consecutive series of patients with an acute symptomatic occlusion of the extracranial ICA.

18 noviembre 2014

STROKE. Clinical Sciences. Ischemic Stroke and Intracranial Hemorrhage With Aspirin, Dabigatran, and Warfarin

Chi-Wai Ho, MBBS*; Mei-Han Ho, MBBS*; Pak-Hei Chan, MBBS; Jo-Jo Hai, MBBS; Emmanuel Cheung, MBBS; Chun-Yip Yeung, MBBS; Kui-Kai Lau, MBBS; Koon-Ho Chan, MD; Chu-Pak Lau, MD; Gregory Y.H. Lip, MD; Gilberto Ka-Kit Leung, MS; Hung-Fat Tse, MD, PhD; Chung-Wah Siu, MD

Background and Purpose: Little is known about the impact of quality of anticoagulation control, as reflected by time in therapeutic range (TTR), on the effectiveness and safety of warfarin therapy in Chinese patients with atrial fibrillation. We investigated the risks of ischemic stroke and intracranial hemorrhage (ICH) in relation to warfarin at various TTRs in a real-world cohort of Chinese patients with atrial fibrillation receiving warfarin and compared with those on dabigatran, aspirin, and no therapy.

18 noviembre 2014

STROKE. Clinical Sciences. Plaque Echolucency and Stroke Risk in Asymptomatic Carotid Stenosis

Ajay Gupta, MD; Kartik Kesavabhotla, MD; Hediyeh Baradaran, MD; Hooman Kamel, MD; Ankur Pandya, PhD; Ashley E. Giambrone, PhD; Drew Wright, MS, MLS; Kevin J. Pain, BA; Edward E. Mtui, MD; Jasjit S. Suri, MS, MBA, PhD; Pina C. Sanelli, MD, MPH; Alvin I. Mushlin, MD, ScM

Background and Purpose: Ultrasonographic plaque echolucency has been studied as a stroke risk marker in carotid atherosclerotic disease. We performed a systematic review and meta-analysis to summarize the association between ultrasound-determined carotid plaque echolucency and future ipsilateral stroke risk.

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