20 marzo 2014

AMERICAN JOURNAL OF NEURORADIOLOGY. Generalized versus Patient-Specific Inflow Boundary Conditions in Computational Fluid Dynamics Simulations of Cerebral Aneurysmal Hemodynamics

I.G.H. Jansen, J.J. Schneiders, W.V. Potters, P. van Ooij, R. van den Berg, E. van Bavel, H.A. Marquering and C.B.L.M. Majoie

Background and Purpose: Attempts have been made to associate intracranial aneurysmal hemodynamics with aneurysm growth and rupture status. Hemodynamics in aneurysms is traditionally determined with computational fluid dynamics by using generalized inflow boundary conditions in a parent artery. Recently, patient-specific inflow boundary conditions are being implemented more frequently. Our purpose was to compare intracranial aneurysm hemodynamics based on generalized versus patient-specific inflow boundary conditions.

01 noviembre 2012

AMERICAN JOURNAL OF NEURORADIOLOGY. Emergency Noninvasive Angiography for Acute Intracerebral Hemorrhage

H. Khosravani, S.A. Mayer, A. Demchuk, B.S. Jahromi, D.J. Gladstone, M. Flaherty, J. Broderick and R.I. Aviv

Summary: Spontaneous ICH is a devastating condition and is associated with significant mortality in the acute phase due to ongoing hemorrhage and hematoma expansion. A growing body of evidence suggests that there may be considerable utility in performing noninvasive vascular imaging during the acute-to-early phase of ICH. CTA has become widely available and is sensitive and specific for detecting vascular causes of secondary ICH such as aneurysms, arteriovenous malformations, dural arteriovenous fistulas, intracranial dissections, and neoplasm. CT venography can also diagnose dural sinus thrombosis presenting as hemorrhagic infarction. Recent data from stroke populations demonstrate a relatively low risk to patients when contrast is administered in the absence of a known serum creatinine. Detection of acute contrast extravasation within the hematoma (“spot sign”) with CT angiography is predictive of subsequent hematoma expansion and is associated with increased morbidity and mortality. Risk stratification based on acute CTA can inform and expedite decision-making regarding intensive care unit admission, blood pressure control, correction of coagulopathy, and neurosurgical consultation. Noninvasive vascular imaging should be considered as an important component of the initial diagnostic work-up for patients presenting with acute ICH.

09 mayo 2014

CIRCULATION. Stroke. Evaluation of Interval Times From Onset to Reperfusion in Patients Undergoing Endovascular Therapy in the Interventional Management of Stroke III Trial

Mayank Goyal, MD; Mohammed A. Almekhlafi, MD, MSc; Liqiong Fan, MS; Bijoy K. Menon, MD; Andrew M. Demchuk, MD; Sharon D. Yeatts, PhD; Michael D. Hill, MD, MSc; Thomas Tomsick, MD; Pooja Khatri, MD, MSc; Osama O. Zaidat, MD; Edward C. Jauch, MD; Muneer Eesa, MD; Tudor G. Jovin, MD; Joseph P. Broderick, MD

Background: Meaningful delays occurred in the Interventional Management of Stroke (IMS) III trial. Analysis of the work flow will identify factors contributing to the in-hospital delays.

14 octubre 2014

CIRCULATION. Cerebral and Sinus Vein Thrombosis

Stephan Moll, MD; Beth Waldron, MA

Introduction: A blood clot in the veins that drain the blood from the brain is called a sinus or cerebral vein thrombosis. It is an uncommon type of clot, affecting about 1500 people in the United States per year.

09 agosto 2013

CIRCULATION. Stroke. Long-Term Effects of Secondary Prevention on Cognitive Function in Stroke Patients

Abdel Douiri, PhD; Christopher McKevitt, PhD; Eva S. Emmett, MD; Anthony G. Rudd, MD, FRCP; Charles D.A. Wolfe, MD, FFPH

Background: Limited long-term follow-up data exist on the impact of appropriate secondary prevention therapies on cognitive function in patients after first-ever stroke. The aim of this study is to determine the effect of secondary prevention of vascular events on cognitive function after stroke.

14 octubre 2014

CIRCULATION. Surgery for Aortic Disease. Stroke and Outcomes in Patients With Acute Type A Aortic Dissection

Eduardo Bossone, MD, PhD; David C. Corteville, MD; Kevin M. Harris, MD; Toru Suzuki, MD, PhD; Rossella Fattori, MD; Stuart Hutchison, MD; Marek P. Ehrlich, MD; Reed E. Pyeritz, MD, PhD; Philippe Gabriel Steg, MD; Kevin Greason, MD; Arturo Evangelista, MD; Eva Kline-Rogers, MS, RN, NP; Daniel G. Montgomery, BS; Eric M. Isselbacher, MD; Christoph A. Nienaber, MD; Kim A. Eagle, MD

Background: Stroke is a highly dreaded complication of type A acute aortic dissection (TAAAD). However, little data exist on its incidence and association with prognosis.

31 julio 2013

CIRCULATION. Stroke. Subclinical Left Ventricular Dysfunction and Silent Cerebrovascular Disease

Cesare Russo, MD; Zhezhen Jin, PhD; Shunichi Homma, MD; Mitchell S.V. Elkind, MD, MS; Tatjana Rundek, MD, PhD; Mitsuhiro Yoshita, MD, PhD; Charles DeCarli, MD; Clinton B. Wright, MD, MS; Ralph L. Sacco, MD, MS, FAHA; Marco R. Di Tullio, MD

Background: Silent brain infarcts (SBIs) and white matter hyperintensities are subclinical cerebrovascular lesions associated with incident stroke and cognitive decline. Left ventricular ejection fraction (LVEF) is a predictor of stroke in patients with heart failure, but its association with subclinical brain disease in the general population is unknown. Left ventricular global longitudinal strain (GLS) can detect subclinical cardiac dysfunction even when LVEF is normal. We investigated the relationship of LVEF and GLS with subclinical brain disease in a community-based cohort.

01 septiembre 2013

JACC. Meta-Analysis and Systematic Review of the Predictive Value of Carotid Plaque Hemorrhage on Cerebrovascular Events by Magnetic Resonance Imaging

Tobias Saam, MD∗; Holger Hetterich, MD∗; Verena Hoffmann, PhD†; Chun Yuan, MD‡; Martin Dichgans, MD§; Holger Poppert, MD‖; Thomas Koeppel, MD¶; Ulrich Hoffmann, MD#; Maximilian F. Reiser, MD∗; Fabian Bamberg, MD, MPH∗

Objectives: This study sought to conduct a systematic review and meta-analysis to determine precise estimates of the predictive value of carotid intraplaque hemorrhage (IPH) as determined by magnetic resonance imaging (MRI) for cerebrovascular events.

01 septiembre 2013

JACC: CARDIOVASCULAR INTERVENTIONS. Neurovascular Rescue for Thrombus-Related Embolic Stroke During Transcatheter Aortic Valve Implantation

Pablo Salinas, MD∗; Raul Moreno, MD, PhD∗; Remedios Frutos, MD†; Jose Luis Lopez-Sendon, MD, PhD∗

An 88-year-old woman with critical aortic stenosis was scheduled for transfemoral transcatheter aortic valve implantation (TAVI). She received pre-procedural aspirin plus clopidogrel, and 100 IU/kg of unfractionated heparin during the procedure. The procedure was uneventful, and the balloon-expandable valve was successfully deployed. After deflating the balloon, an echo-dense mobile mass was seen in the left ventricular outflow tract, probably attached to the intraventricular portion of the guidewire. This mass was not present after valvuloplasty, so torn leaflets from the native valve were unlikely. Activated clotting time was 270 s. When the balloon catheter and guidewire were withdrawn, the mass disappeared.

25 julio 2013

STROKE. Brief Report. Morphological and Functional Assessment of Carotid Plaques Have Similar Predictive Accuracy for Coronary Artery Disease

Konstantinos Toutouzas, MD; Georgios Benetos, MD; Maria Drakopoulou, MD; Archontoula Michelongona, MD; Charalampia Nikolaou, MD; Constantina Masoura, MD; Konstantinos Stathogiannis, MD; Constantina Aggeli, MD; Eleftherios Tsiamis, MD; Elias Siores, BSc, MSc, PhD; Christodoulos Stefanadis, MD

Background and Purpose: Microwave radiometry allows noninvasive in vivo measuring of internal temperature of tissues reflecting inflammation. In the present study, we evaluated the predictive accuracy of this method for the diagnosis of coronary artery disease (CAD).

11 junio 2013

STROKE. Clinical Sciences. Impact of Diffusion-Weighted Imaging Lesion Volume on the Success of Endovascular Reperfusion Therapy

Jean-Marc Olivot, MD, PhD; Pascal J. Mosimann, MD; Julien Labreuche, BST; Manabu Inoue, MD; Elena Meseguer, MD; Jean-Philippe Desilles, MD; Aymeric Rouchaud, MD; Isabelle F. Klein, MD, PhD; Matus Straka, MD, PhD; Roland Bammer, MD, PhD; Michael Mlynash, MD, MS; Pierre Amarenco, MD; Gregory W. Albers, MD; Mikael Mazighi, MD, PhD

Background and Purpose: Diffusion-weighted imaging (DWI) lesion volume is associated with poor outcome after thrombolysis, and it is unclear whether endovascular therapies are beneficial for large DWI lesion. Our aim was to assess the impact of pretreatment DWI lesion volume on outcomes after endovascular therapy, with a special emphasis on patients with complete recanalization.

28 mayo 2013

STROKE. Clinical Sciences. Alberta Stroke Program Early CT Scale Evaluation of Multimodal Computed Tomography in Predicting Clinical Outcomes of Stroke Patients Treated With Aspiration Thrombectomy

Marios-Nikos Psychogios, MD; Peter Schramm, MD, PhD; Andreas Maximilian Frölich, MD; Kai Kallenberg, MD; Katrin Wasser, MD; Lars Reinhardt, MS; Andreas S. Kreusch, MS; Klaus Jung, PhD; Michael Knauth, MD, PhD

Background and Purpose: Patient selection is crucial in the endovascular treatment of acute ischemic stroke patients. Baseline computed tomographic (CT) images, evaluated with the Alberta Stroke Program Early CT Scale (ASPECTS), are considered significant predictors of outcome. In this study, we evaluated CT images and perfusion parameters, analyzed with ASPECTS, as final outcome predictors after endovascular stroke treatment.

06 junio 2013

STROKE. Clinical Sciences. Size Ratio Can Highly Predict Rupture Risk in Intracranial Small (<5 mm) Aneurysms

Daina Kashiwazaki, MD; Satoshi Kuroda, MD, PhD on behalf of the Sapporo SAH Study Group

Background and Purpose: Management strategies for unruptured intracranial aneurysms (UIAs) are controversial. This study aimed to identify surrogate parameters that highly predict the rupture risk of small (<5 mm) UIAs.

30 mayo 2013

STROKE. Clinical Sciences. Comparison of Flow Diversion and Coiling in Large Unruptured Intracranial Saccular Aneurysms

Nohra Chalouhi, MD; Stavropoula Tjoumakaris, MD; Robert M. Starke, MD; L. Fernando Gonzalez, MD; Ciro Randazzo, MD; David Hasan, MD; Jeffrey F. McMahon, BS; Saurabh Singhal, MD; Lea A. Moukarzel, BA; Aaron S. Dumont, MD; Robert Rosenwasser, MD; Pascal Jabbour, MD

Background and Purpose: Flow diversion has emerged as an important tool for the management of intracranial aneurysms. The purpose of this study was to compare flow diversion and traditional embolization strategies in terms of safety, efficacy, and clinical outcomes in patients with unruptured, large saccular aneurysms (≥10 mm).

07 mayo 2014

SPRINGER. Computed tomographic angiography criteria in the diagnosis of brain death—comparison of sensitivity and interobserver reliability of different evaluation scales

Marcin Sawicki1, R. Bohatyrewicz2, K. Safranow3, A. Walecka1, J. Walecki4, O. Rowinski5, J. Solek-Pastuszka2, Z. Czajkowski6, M. Guzinski7, M. Burzynska8 and J. Wojczal9

Introduction: The standardized diagnostic criteria for computed tomographic angiography (CTA) in diagnosis of brain death (BD) are not yet established. The aim of the study was to compare the sensitivity and interobserver agreement of the three previously used scales of CTA for the diagnosis of BD.