Small subcortical ischemic infarction and other DWI lesions establish predictive model for MES

Frontiers in Neurology, Год журнала: 2025, Номер 15

Опубликована: Янв. 13, 2025

The relationship between small subcortical ischemic infarction remains poorly characterized. Therefore, the present study aimed to investigate association artery-to-artery embolization and infarctions. This retrospective observational cross-sectional enrolling 230 patients with acute middle cerebral artery (MCA) stroke classified into microembolic signals-positive (MES+) MES-negative (MES-) groups. diffusion weighted imaging (DWI) patterns in MCA were divided territorial, border zone (BZ), cortical, infarcts. We set standard of (SCI) two levels: < 10 mm diameter <5 diameter. Relevant DWI parameters used build a nomogram for MES+, using free statistics. MES occurred 38 cases, yielding positivity rate 16.5%. BZ, SCI <10 mm, cortical ischemia (CI), stenosis, white blood cell count, gender compared MES+ MES- Multivariate analysis revealed that CI independently associated MES. Based on parameters, model was built MES+. area under curve 0.826 (95%CI 0.764 0.889). In internal cross-validation, slope calibration 1.000, indicating accurately predicted unsuccessful treatment outcomes. Small infarctions are study, we predictive based other parameters. demonstrated good performance clinical practice.

Язык: Английский

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Imaging patterns and prognosis of proximal and distal small subcortical infarcts

Neurological Sciences, Год журнала: 2025, Номер unknown

Опубликована: Апрель 15, 2025

Abstract Introduction Small subcortical infarcts (SSI) are one of the hallmarks cerebral small vessel disease and have been classified in two different imaging patterns: proximal-SSI (p-SSI) distal-SSI (d-SSI), according to shape, size location parent artery. We aimed investigate prognosis differences between p-SSI d-SSI. Methods retrospectively reviewed records consecutive patients with SSI admitted at Stroke Units. assessed location, shape axial diameter d-SSI computed tomography (CT) and/or magnetic resonance (MR) blinded clinical data. Outcomes were: Early Neurological Deterioration (END), length hospital stay, rehabilitation after discharge functional status 3 months modified Rankin Scale (mRS). independent associations type stroke outcomes logistic ordinal regression analysis. Results included 292 patients, mean (+ -SD) age 67.42 -12.41) years, 205 (70%) males, median (IQR) NIHSS = 4 (2–5); END occurred 57 (20%) patients. Compared d-SSI, was associated non-rounded (82%vs 65%,p 0.005), lesion > 15 mm (34% vs 10%,p < 0.001), infratentorial (39% 23%,p absence white matter changes (22% 12%,p 0.035). more frequently (44% 0.001; OR 7.23;95%CI 3.73–14.03). In p-SSI, stay longer than six days (58% 40%,p 0.005; 1.78;95%CI 1.04–3.07) a shift towards worse mRS (cOR 2.47;95%CI 1.46–4.18) observed. Conclusions prognostic characteristics that may suggest distinct etiological origin possibly therapeutic approach.

Язык: Английский

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CT Perfusion in Lacunar Stroke: A Systematic Review

Diagnostics, Год журнала: 2023, Номер 13(9), С. 1564 - 1564

Опубликована: Апрель 27, 2023

The main theory underlying the use of perfusion imaging in acute ischemic stroke is presence a hypoperfused volume brain downstream an occluded artery. Indeed, purpose to select patients for endovascular treatment. Computed Tomography Perfusion (CTP) more used technique because its wide availability but lacunar infarcts are theoretically outside CTP, and limited data available about CTP performance with stroke.

Язык: Английский

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MRI in older Patients – A focused Review

Seizure, Год журнала: 2024, Номер unknown

Опубликована: Ноя. 1, 2024

Язык: Английский

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Posterior reversible encephalopathy syndrome and acute ischemic stroke: an underreported association

Neurological Sciences, Год журнала: 2023, Номер 45(3), С. 1249 - 1254

Опубликована: Дек. 4, 2023

Язык: Английский

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Progression of enlarged perivascular spaces contributes to occurrence of silent lacunar infarction in the elderly

Neurological Sciences, Год журнала: 2023, Номер 45(4), С. 1529 - 1535

Опубликована: Ноя. 9, 2023

Язык: Английский

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The value of computed tomography perfusion deficit volumes in acute isolated brainstem infarction

Frontiers in Neurology, Год журнала: 2023, Номер 14

Опубликована: Окт. 19, 2023

Diagnosis of acute isolated brainstem infarction is challenging owing to non-specific, variable symptoms, and the effectiveness non-contrast computed tomography (NCCT) poor limited spatial resolution artifacts. Computed perfusion (CTP) imaging parameters are significantly associated with functional outcomes in posterior circulation ischemic stroke; however, role CTP remains unclear. We aimed determine value predicting for affected patients.In total, 116 consecutive patients pontine/midbrain hypoperfusion who underwent follow-up by magnetic resonance (MRI) between January 2018 March 2022, were retrospectively analyzed. Perfusion deficit volumes on all maps, final volume (FIV) MRI quantified. "Good" outcome was defined as a 90-day modified Rankin Scale score 0 1. Statistical analysis included uni- multivariate regression analyses, binary logistic regressions, receiver operating characteristics (ROC) analyses.In 113 had confirmed MRI. Onset-to-scan time, visibility lesions NCCT, baseline National Institutes Health Stroke (NIHSS) score, maps FIV (p < 0.05). In linear model, adjusted age, sex, NIHSS onset-to-scan remained FIV. independent predictors good outcome. ROC cerebral blood flow showed slightly higher discriminatory largest area under curve being 0.683 [(95% CI, 0.587-0.780), p = 0.001].Perfusion could reflect contain prognostic information infarction.

Язык: Английский

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Computed tomography perfusion imaging-guided intravenous thrombolysis in acute minor ischemic stroke

Frontiers in Neurology, Год журнала: 2023, Номер 14

Опубликована: Ноя. 27, 2023

Background Over 50% of acute ischemic stroke (AIS) patients present with minor neurological deficits, and optimal treatment is still debated. The randomized PRISMS trial did not show beneficial effects intravenous thrombolysis (IVT) in unselected non-disabling deficits. Purpose study aimed to evaluate if AIS may benefit from computed-tomography-perfusion (CTP)-guided IVT. primary endpoint was good functional outcomes, defined as a modified Rankin Scale score 0–2 at 90 days. Methods NIHSS ≤5 presenting within 4.5 h underwent multimodal CT-imaging including CTP. CTP mismatch hypoperfusion on time-to-peak delay &gt;6 s without corresponding cerebral blood volume. IVT decision left the attending physicians. Patients large vessel occlusion (LVO) absolute contraindications were excluded. Results In total, 267 consecutive included [mean age: 72 ± 14 years, 45.3% female patients, 75.3% received IVT, median admission: 3 (IQR 2, 4)]. detected 41.8% IVT− treated (IVT+) 28.8% standard (IVT−) ( p = 0.06). IVT+ had favorable outcomes days compared 0.006), but no interaction an existing (OR adj : 1.676; 95% CI: 0.644–4.364). No symptomatic intracranial hemorrhage according ECASS-III criteria occurred. Conclusion Although selected does correlate outcomes. guiding LVO

Язык: Английский

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Lenticulostriate arteries (LSA) sign in T occlusion A transient vasomotor phenomenon

Neurological Sciences, Год журнала: 2024, Номер unknown

Опубликована: Сен. 19, 2024

Язык: Английский

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CT Perfusion imaging as prognostic factor for outcome of lacunar stroke

Neuroradiology, Год журнала: 2024, Номер unknown

Опубликована: Окт. 10, 2024

Язык: Английский

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