Performance of e-ASPECTS software in comparison to that of stroke physicians on assessing CT scans of acute ischemic stroke patients

2016 ◽  
Vol 11 (4) ◽  
pp. 438-445 ◽  
Author(s):  
Christian Herweh ◽  
Peter A Ringleb ◽  
Geraldine Rauch ◽  
Steven Gerry ◽  
Lars Behrens ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Ct Scans ◽  
Stroke Patients

Abstract WMP23: Automated ASPECTS Scoring of CT Scans for Acute Ischemic Stroke Patients Using Machine Learning

Stroke ◽  
2018 ◽  
Vol 49 (Suppl_1) ◽  
Author(s):  
Hulin Kuang ◽  
Ericka Teleg ◽  
Mohamed Najm ◽  
Alexis T Wilson ◽  
Sung I Sohn ◽  
...  
Keyword(s):  
Machine Learning ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Ct Scans ◽  
Stroke Patients

Abstract WP54: Evaluation of the e-ASPECTS Automated Software for Detection of Acute Ischemic Stroke

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Iris Q Grunwald ◽  
Devesh Sinha ◽  
Christine Roffe ◽  
Silke Walter
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Ct Perfusion ◽  
Ct Scans ◽  
Ischemic Damage ◽  
Stroke Patients ◽  
Infarct Core ◽  
Ischemic Change ◽  
Scoring Tool ◽  
Automated Software

Objective: The Alberta Stroke Program Early CT score (ASPECTS)method is a validated score for identifying patients more likely to benefit from either thrombolytic or endovascular therapy. The e-ASPECTS software is a new, commercially available, standardized and fully automated ASPECTS scoring tool. e-ASPECTS assesses signs of early ischemic change on plain CT scans of stroke patients by applying the ASPECTS method. We compared the performance of e-ASPECTS to CT perfusion in detecting early ischemic signs. Methods: e-ASPECTS was run on the plain CT scans of 20 patients with acute ischemic stroke. CT perfusion, CT angiography and 24h CT was also available. The ischemic damage identified by e-ASPECTS was compared to the ischemic core as depicted on CBV on CT perfusion and the established infarct core on plain CT at 24h. Findings: e-ASPECTS reliably depicted established ischemic damage as compared to CT-Perfusion, both on an region-based and ASPECTS-based analysis. Conclusion: This is the first report demonstrating that e-ASPECTS correctly identified infarct on plain CT, similar to CT perfusion.

scholarly journals Management of acute ischemic stroke in patients with COVID-19 infection: Report of an international panel

2020 ◽  
Vol 15 (5) ◽  
pp. 540-554 ◽  
Author(s):  
Adnan I Qureshi ◽  
Foad Abd-Allah ◽  
Fahmi Al-Senani ◽  
Emrah Aytac ◽  
Afshin Borhani-Haghighi ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Current Knowledge ◽  
Intravenous Thrombolysis ◽  
Adult Patients ◽  
World Health ◽  
Stroke Patients ◽  
International Panel ◽  
Health Organization ◽  
Tract Infections

Background and purpose On 11 March 2020, World Health Organization (WHO) declared the COVID-19 infection a pandemic. The risk of ischemic stroke may be higher in patients with COVID-19 infection similar to those with other respiratory tract infections. We present a comprehensive set of practice implications in a single document for clinicians caring for adult patients with acute ischemic stroke with confirmed or suspected COVID-19 infection. Methods The practice implications were prepared after review of data to reach the consensus among stroke experts from 18 countries. The writers used systematic literature reviews, reference to previously published stroke guidelines, personal files, and expert opinion to summarize existing evidence, indicate gaps in current knowledge, and when appropriate, formulate practice implications. All members of the writing group had opportunities to comment in writing on the practice implications and approved the final version of this document. Results This document with consensus is divided into 18 sections. A total of 41 conclusions and practice implications have been developed. The document includes practice implications for evaluation of stroke patients with caution for stroke team members to avoid COVID-19 exposure, during clinical evaluation and performance of imaging and laboratory procedures with special considerations of intravenous thrombolysis and mechanical thrombectomy in stroke patients with suspected or confirmed COVID-19 infection. Conclusions These practice implications with consensus based on the currently available evidence aim to guide clinicians caring for adult patients with acute ischemic stroke who are suspected of, or confirmed, with COVID-19 infection. Under certain circumstances, however, only limited evidence is available to support these practice implications, suggesting an urgent need for establishing procedures for the management of stroke patients with suspected or confirmed COVID-19 infection.

scholarly journals Acute reperfusion therapies for acute ischemic stroke patients with unknown time of symptom onset or in extended time windows: an individualized approach

2021 ◽  
Vol 14 ◽  
pp. 175628642110211
Author(s):  
Georgios Magoufis ◽  
Apostolos Safouris ◽  
Guy Raphaeli ◽  
Odysseas Kargiotis ◽  
Klearchos Psychogios ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Endovascular Treatment ◽  
Acute Ischemic Stroke ◽  
Symptom Onset ◽  
Time Windows ◽  
Intravenous Thrombolysis ◽  
Inclusion Criteria ◽  
Stroke Patients ◽  
Treatment Algorithms ◽  
Late Presenters

Recent randomized controlled clinical trials (RCTs) have revolutionized acute ischemic stroke care by extending the use of intravenous thrombolysis and endovascular reperfusion therapies in time windows that have been originally considered futile or even unsafe. Both systemic and endovascular reperfusion therapies have been shown to improve outcome in patients with wake-up strokes or symptom onset beyond 4.5 h for intravenous thrombolysis and beyond 6 h for endovascular treatment; however, they require advanced neuroimaging to select stroke patients safely. Experts have proposed simpler imaging algorithms but high-quality data on safety and efficacy are currently missing. RCTs used diverse imaging and clinical inclusion criteria for patient selection during the dawn of this novel stroke treatment paradigm. After taking into consideration the dismal prognosis of nonrecanalized ischemic stroke patients and the substantial clinical benefit of reperfusion therapies in selected late presenters, we propose rescue reperfusion therapies for acute ischemic stroke patients not fulfilling all clinical and imaging inclusion criteria as an option in a subgroup of patients with clinical and radiological profiles suggesting low risk for complications, notably hemorrhagic transformation as well as local or remote parenchymal hemorrhage. Incorporating new data to treatment algorithms may seem perplexing to stroke physicians, since treatment and imaging capabilities of each stroke center may dictate diverse treatment pathways. This narrative review will summarize current data that will assist clinicians in the selection of those late presenters that will most likely benefit from acute reperfusion therapies. Different treatment algorithms are provided according to available neuroimaging and endovascular treatment capabilities.

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