scholarly journals Posterior circulation stroke: machine learning-based detection of early ischemic changes in acute non-contrast CT scans

2020 ◽  
Vol 267 (9) ◽  
pp. 2632-2641
Author(s):  
Helge C. Kniep ◽  
Peter B. Sporns ◽  
Gabriel Broocks ◽  
André Kemmling ◽  
Jawed Nawabi ◽  
...  
Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2781
Author(s):  
Mehdi Alilou ◽  
Prateek Prasanna ◽  
Kaustav Bera ◽  
Amit Gupta ◽  
Prabhakar Rajiah ◽  
...  

The aim of this study is to evaluate whether NIS radiomics can distinguish lung adenocarcinomas from granulomas on non-contrast CT scans, and also to improve the performance of Lung-RADS by reclassifying benign nodules that were initially assessed as suspicious. The screening or standard diagnostic non-contrast CT scans of 362 patients was divided into training (St, N = 145), validation (Sv, N = 145), and independent validation (Siv, N = 62) sets from different institutions. Nodules were identified and manually segmented on CT images by a radiologist. A series of 264 features relating to the edge sharpness transition from the inside to the outside of the nodule were extracted. The top 10 features were used to train a linear discriminant analysis (LDA) machine learning classifier on St. In conjunction with the LDA classifier, NIS radiomics classified nodules with an AUC of 0.82 ± 0.04, 0.77, and 0.71 respectively on St, Sv, and Siv. We evaluated the ability of the NIS classifier to determine the proportion of the patients in Sv that were identified initially as suspicious by Lung-RADS but were reclassified as benign by applying the NIS scores. The NIS classifier was able to correctly reclassify 46% of those lesions that were actually benign but deemed suspicious by Lung-RADS alone on Sv.


2020 ◽  
Vol 13 (8) ◽  
pp. e234661
Author(s):  
Tahir Nazir ◽  
Mohiuddin Sharief ◽  
James Farthing ◽  
Irfan M Ahmed

Catheter ablation of atrial fibrillation (AF) has established itself as a safe and proven rhythm control strategy for selected patients with AF over the past decade. Thromboembolic complications of catheter ablation are becoming rare in anticoagulated patients with a risk of stroke reported as 0.3%. A particular challenge is posed by clinical presentation due to ischaemic stroke involving the posterior circulation following catheter ablation because of its substantial differences from the carotid territory stroke, making the timely diagnosis and treatment very difficult. It is crucial to keep an index of clinical suspicion in patients presenting with neurological deficits related to vertebrobasilar circulation following ablation. We describe the case of a man who presented with dizziness and palpitations after radiofrequency catheter ablation of AF. He was found to be in AF with a rapid ventricular response. His dizziness was initially attributed to the cardiac dysrhythmia. As his symptoms continued despite heart rate control, he underwent further investigations and was eventually diagnosed with a posterior circulation stroke resulting in left cerebellar infarction. He was treated with antiplatelet therapy and improved significantly over the following few days. We review and present an up-to-date brief literature review on the complications of catheter ablation of AF and describe pathophysiology, clinical features, diagnosis and treatment options for posterior circulation stroke after AF ablation. This case aims to raise awareness among clinicians about posterior circulation stroke after AF ablation.


2021 ◽  
pp. 101154
Author(s):  
Y Muralidhar Reddy ◽  
Subhendu Parida ◽  
Premchand Gupta ◽  
Shyam K Jaiswal ◽  
Ganjisreenivasa Gnaneswar ◽  
...  

Author(s):  
Nourhan Abdelmohsen Taha ◽  
Hala El Khawas ◽  
Mohamed Amir Tork ◽  
Tamer M. Roushdy

Abstract Background Intravenous thrombolysis (IVT) with alteplase is the first-line therapy for acute ischemic anterior and posterior circulation strokes (ACS and PCS). Knowledge about safety and efficacy of IVT in posterior circulation stroke is deficient as most of the Egyptian studies either assessed IVT outcome in comparison to conservative therapy or its outcome in anterior circulation stroke only. Therefore, our aim was to compare the relative frequency and outcome after intravenous thrombolysis in anterior versus posterior circulation stroke patients presenting to stroke centers of Ain Shams University hospitals (ASUH). Results A total of 238 anterior circulation stroke and 61 posterior circulation strokes were enrolled, onset-to-door and door-to-needle time were statistically insignificant. NIHSS showed comparable difference at all time points despite higher scores along anterior circulation stroke; 90-day modified Rankin Scale (mRS) showed significant improvement in both groups from mRS >2 to ≤2 with a better percentage along posterior circulation stroke patients. There was insignificant difference for either incidence of death or intracranial hemorrhage (ICH) between the two groups. Conclusion IVT significantly reduced NIHSS for both anterior and posterior circulation stroke along different studied time points. Meanwhile, a higher percentage of patients with posterior circulation stroke had a better mRS outcome at 90 days.


Neurology ◽  
2017 ◽  
Vol 89 (18) ◽  
pp. e224-e225 ◽  
Author(s):  
Manchikanti Venkatesh ◽  
V.R. Shiva Prasad ◽  
S. Umar Basha ◽  
G.H. Jhansi Priya

2013 ◽  
Vol 10 (5) ◽  
pp. 672-678 ◽  
Author(s):  
Amrou Sarraj ◽  
Sarah Medrek ◽  
Karen Albright ◽  
Sheryl Martin-Schild ◽  
Wafi Bibars ◽  
...  

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