scholarly journals Prognosis of ischemic stroke patients with or without collateralization after carotid stenosis

2018 ◽  
Vol 11 (4) ◽  
pp. 270-273
Author(s):  
Subash Kanti Dey ◽  
Md. Shahidullah ◽  
Anis Ahmed ◽  
Ahsan Habib ◽  
Abu Nasar Rizvi
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Carotid Stenosis ◽  
Digital Subtraction Angiography ◽  
P Value ◽  
Digital Subtraction ◽  
Stroke Patients

The objective of this study was to see the  association of the prognosis of ischemic stroke patients with or without collateralization after carotid stenosis. This study was conducted on 36 patients presenting with acute ischemic stroke who were going through digital subtraction angiography from March 2017 to March 2018. Collateralization status after unilateral or bilateral stenosis was evaluated. Modified ranking scale (mRS) score was  measured on the first day of the stroke and after three months. The disability of ischemic stroke patients was compared between patients who developed collateralization and who had not. Among them, 61.6% developed collateralization. Among the patients who developed collateralization after three months, 90.9% patients had mRS scale of ≤2 and who not developed collateralization, 85.7% patients had mRS scale of ≤2. In both the groups, the p value was <0.05. It can be concluded that carotid stenosed patients who suffered from ischemic stroke, most of the patients disability improved to some extents whether collateralization developed or not among the major vessels.

Clinical and radiological outcomes of acute ischemic stroke patients without angiographic occlusion on digital subtraction angiogram. A pooled analysis of case series

2008 ◽  
Vol 50 (11) ◽  
pp. 963-968 ◽  
Author(s):  
Qaisar A. Shah ◽  
Muhammad Zeeshan Memon ◽  
Gabriela Vazquez ◽  
M. Fareed K. Suri ◽  
Haitham M. Hussein ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Case Series ◽  
Pooled Analysis ◽  
Digital Subtraction ◽  
Stroke Patients ◽  
Digital Subtraction Angiogram

scholarly journals Characteristics of Cognitive Status in Sub-Population of Sub-Acute Stage of Ischemic Stroke Patients in West Nusa Tenggara, Indonesia

2021 ◽  
Vol 16 (3) ◽  
Author(s):  
Herpan Syafii Harahap ◽  
Muhammad Akbar ◽  
Jumraini Tammasse ◽  
Andi Kurnia Bintang ◽  
Andi Alfian Zainuddin
Keyword(s):  
Logistic Regression ◽  
Ischemic Stroke ◽  
Cognitive Decline ◽  
Acute Ischemic Stroke ◽  
Functional Outcomes ◽  
Cognitive Status ◽  
Acute Stage ◽  
P Value ◽  
Stroke Patients ◽  
Cross Sectional

Cognitive decline is a significant complication that affects most stroke survivors. Early detection of cognitive decline in ischemic stroke patients and identification of risk factors improves their clinical outcomes. This study aimed to determine the characteristics of cognitive status in the sub-acute phase of ischemic stroke. A cross-sectional study was conducted on 89 sub-acute ischemic stroke patients in three hospitals in West Nusa Tenggara recruited consecutively from August 2019 to April 2020. The data collected were demographic and clinical characteristics, cognitive status, and functional outcome. The association between clinical and demographic characteristics and cognitive decline was analyzed using logistic regression. In addition, the relationship between cognitive status and functional outcomes of these patients was examined using the chi-square test. This study revealed that the prevalence of cognitive decline in these subjects was 71.9%. Multiple logistic regression showed that age was the only characteristic associated with cognitive decline in the subjects (OR = 5.12,95% CI = 1.08-24.28). Furthermore, the frequency of cognitive decline in these subjects was significantly associated with functional outcomes (p-value =0.014). Thus, there was a high prevalence of cognitive decline in sub-acute ischemic stroke patients associated with increasing age and poor functional outcomes.

Arterial Spin Labeling Magnetic Resonance Imaging Can Identify the Occlusion Site and Collateral Perfusion in Patients with Acute Ischemic Stroke: Comparison with Digital Subtraction Angiography

2019 ◽  
Vol 48 (1-2) ◽  
pp. 70-76 ◽  
Author(s):  
Yoichi Morofuji ◽  
Nobutaka Horie ◽  
Yohei Tateishi ◽  
Minoru Morikawa ◽  
Susumu Yamaguchi ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Acute Ischemic Stroke ◽  
Digital Subtraction Angiography ◽  
Arterial Spin Labeling ◽  
Spin Labeling ◽  
Collateral Flow ◽  
Digital Subtraction ◽  
Resonance Imaging

Background and Objectives: Determining the occlusion site and collateral blood flow is important in acute ischemic stroke. The purpose of the current study was to test whether arterial spin labeling (ASL) magnetic resonance imaging (MRI) could be used to identify the occlusion site and collateral perfusion, using digital subtraction angiography (DSA) as a gold standard. Method: Data from 521 consecutive patients who presented with acute ischemic stroke at our institution from January 2012 to September 2014 were retrospectively reviewed. Image data were included in this study if: (1) the patient presented symptoms of acute ischemic stroke; (2) MRI was performed within 24 h of symptom onset; and (3) DSA following MRI was performed (n = 32 patients). We defined proximal intra-arterial sign (IAS) on ASL as enlarged circular or linear bright hyperintense signal within the occluded artery and distal IAS as enlarged circular or linear bright hyperintense signals within arteries inside or surrounding the affected region. The presence or absence of the proximal IAS and distal IAS were assessed, along with their inter-rater agreement and consistency with the presence of occlusion site and collateral flow on DSA images. Results: The sensitivity and specificity for identifying occlusion site with ASL were 82.8 and 100%, respectively. Those for identifying collateral flow with ASL were 96.7 and 50%, respectively. The inter-rater reliability was excellent for proximal IAS (κ = 0.92; 95% CI 0.76–1.00) and substantial for distal IAS detection (κ = 0.78; 95% CI 0.38–1.00). Conclusions: Proximal IAS and distal IAS on ASL imaging can provide important diagnostic clues for the detection of arterial occlusion sites and collateral perfusion in patients with acute ischemic stroke.

DWI Lesion Characteristics As A Predictor For Outcome In Acute Stroke Patients Treated By IV-tPA

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
H Aref ◽  
S Farag ◽  
S Helmy ◽  
H Mahmoud
Keyword(s):  
Ischemic Stroke ◽  
Acute Stroke ◽  
Acute Ischemic Stroke ◽  
Plasminogen Activator ◽  
Tissue Type ◽  
P Value ◽  
Stroke Patients ◽  
Tissue Type Plasminogen Activator ◽  
Type Plasminogen Activator ◽  
Iv Tpa

Abstract Background Thrombolysis with tissue-type plasminogen activator (IV-tPA) is a well-proved, widely used treatment in acute ischemic stroke patients, many predictors of functional outcome have been proposed as Age, vascular risk factors, initial clinical evaluation on admission using National institute of health stroke scale(NIHSS), functional state of patient(b.L) baseline before stroke and 3 months (3m) after stroke using modified Rankin stroke scale (MRS)and the most controversial Diffusion weighted image characteristics (volume, heterogeneity) Objective To evaluate DWI MRI characteristics (volume, heterogeneity) as a predictor for outcome in Acute stroke patients treated by IV-tPA Patients and Methods This study will be done on a sample of 100 acute ischemic stroke Egyptian patients receiving intra-venous tissue -type plasminogen activator presenting to Ain-Shams university hospitals Results Highly statistically significant (p-value &lt; 0.001) Positive correlation (r = 0.394) between volume (DWI) and MRS (3m) post discharge in studied patients, No statistically significant (pvalue &gt; 0.05) relation between heterogeneity and other studied parameters (MRS, NIHSS D & ADC values) in studied patients Conclusion DWI infarct volume is a predictor for outcome in acute ischemic stroke patients treated by tPA

scholarly journals The use of neurovascular ultrasound versus digital subtraction angiography in acute ischemic stroke

2015 ◽  
Vol 73 (3) ◽  
pp. 218-222 ◽  
Author(s):  
Marcos C. Lange ◽  
Tatiana P. Bruch ◽  
Jeff C. Pedrozo ◽  
Luana Maranha ◽  
Thiago Mamôru Sakae ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Hospital Admission ◽  
Acute Ischemic Stroke ◽  
Digital Subtraction Angiography ◽  
Sensitivity And Specificity ◽  
Transient Ischemic Attack ◽  
Ultrasound Examination ◽  
High Sensitivity ◽  
Digital Subtraction ◽  
Ischemic Attack

Cervical and intracranial arterial evaluation is an important issue for acute ischemic stroke (IS). Objective Compare the use of the neurovascular ultrasound examination (NVUE) to digital subtraction angiography (DSA) in acute IS patients for diagnosing significant extracranial and intracranial arteriopathy. Method Nonconsecutive patients with IS or transient ischemic attack admitted within 12 hours of the onset of symptoms were evaluated retrospectively. Standardized NVUE and DSA were done in all patients within the first 120 hours of hospital admission. Results Twenty-four patients were included in the study. Compared to DSA, the NVUE demonstrated 94.7% sensitivity and 100% specificity for identifying symptomatic extracranial and/or intracranial arteriopathy. Conclusion The standardized NVUE technique demonstrated high sensitivity and specificity compared to DSA for diagnosing arterial abnormalities in acute IS patients.

scholarly journals Frequency of Hypoalbuminemia in Acute Ischemic Stroke patients Based on Stroke Severity

2021 ◽  
Vol 15 (6) ◽  
pp. 1335-1339
Author(s):  
E. U Haq ◽  
A. Qayyum ◽  
H. A. Qayyum ◽  
M. Anam ◽  
A. R. Khan ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Serum Albumin ◽  
Acute Ischemic Stroke ◽  
Public Health Issue ◽  
P Value ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Baseline Serum ◽  
Nihss Score ◽  
The Mean

Background: Stroke is a serious public health issue and third leading cause of death worldwide. Hypoalbuminemia is commonly found factor in patients of stroke and is also associated with severe disease as well as pro inflammatory patterns of serum protein electrophoresis. Therefore, further research for understanding the role of Hypoalbuminemia in stroke is important to devise strategies for better management of stroke. Aim : To determine the frequency of hypoalbuminemia in acute ischemic stroke patients based on stroke severity. Methods: This descriptive cross- sectional study was conducted in Shifa International hospital stroke unit for 6 months from May 15, 2018 till Nov 15, 2018. Data was collected from 100 patients using purposive sampling. After taking consent from patient or attendant, the demographic data was collected on a structured proforma. Baseline serum albumin and stroke severity using the NIHSS score was also assessed. All data was entered and analysed using SPSS 21. After descriptive analysis, post stratified Chi Square test was applied for gender and age categories. Results: The mean age of patients was 63.60 ± 11.87 years with 57(57%) male and 43(43%) female cases. The mean serum albumin level was 4.03 ± 0.94 with minimum and maximum values as 1.50 and 5.5. Among cases with minor, moderately severe and with severe stroke, 6(37.5%) cases, 18(25.7%) cases and 6(42.9%) cases had Hypoalbuminemia. The frequency of hypoalbuminemia was statistically same with respect to severity of stroke, p-value > 0.05. Conclusion: This study concludes that the frequency of hypoalbuminemia in acute ischemic stroke patients was diagnosed in almost one third cases, however, no statistical association could be found. Hence, screening for hypoalbuminemia should be done for better management of stroke patients. Keywords: Storke, NIHSS score, serum albumin, hypoalbuminemia, mortality

Abstract P494: Automatically Predicting Modified Treatment in Cerebral Ischemia Scores From Patient Digital Subtraction Angiography Using Deep Learning

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Ayush Lall ◽  
Fabien Scalzo ◽  
Henrik Ullman ◽  
David S Liebeskind ◽  
Aichi Chien
Keyword(s):  
Neural Networks ◽  
Ischemic Stroke ◽  
Deep Learning ◽  
Cerebral Ischemia ◽  
Acute Ischemic Stroke ◽  
Digital Subtraction Angiography ◽  
Endovascular Therapy ◽  
Imaging Biomarker ◽  
Digital Subtraction ◽  
Neural Network Models

Introduction: We propose a new method for quantifying the effect of endovascular therapy for acute ischemic stroke. Currently, an mTICI (modified treatment in cerebral ischemia) score is assigned manually to document the success of endovascular revascularization therapy. The mTICI score based on Digital Subtraction Angiography (DSA), due to visual assignment, has limitations in settings where standardization is pertinent. Methods: We hypothesize that mTICI scores can be classified successfully by deep learning and thus be used as a standardized imaging biomarker. We aim to develop a regression framework using classification models that can assign continuous score to patients depending on the success of therapy, resulting in a score that is more granular than the mTICI. We use deep learning and 3D Convolutional Neural Networks (CNN) to classify frontal post-intervention DSA 2D time series into the mTICI score categories of 0, 1, 2a, 2b, and 3. An mTICI score of 0 represents no perfusion and a score of 3 represents full perfusion. The DSA series serve as features where the time dimension is the third dimension for the CNN. For our preliminary research we have condensed our groupings into binary {0,1} (0 refers to mTICI of 0, 1, 2a while 1 refers to mTICI of 2b, 3) of frontal DSA to see if Deep Learning models can categorize between the different mTICI classes. Results: We reduced our original data size of 181 patients to 93 patients in binary group 0 and 88 patients in group 1. Using a train/test split of 0.2, we have achieved a test classification accuracy of 73%, and F1-Score of 72.2% on the binary dataset. This is a good statistical indication that neural networks are able to classify between DSA. Conclusion: Neural network models show promise as a method of distinguishing between DSA to be used as an automatic standardized scoring method for acute ischemic stroke procedures. We aim to expand this research to frontal and lateral DSA images to get more vascular information to improve model accuracies. We propose using the softmax score of the classifier as a new score which will be a standardized measurement for endovascular therapy success.

Sign in / Sign up

Export Citation Format

Share Document