scholarly journals Cardio-Cerebral Infarction, Free-Floating Thrombosis and Hyperperfusion in COVID-19

2021 ◽  
Vol 13 (2) ◽  
pp. 266-268
Author(s):  
Sitara Koneru ◽  
Dinesh V. Jillella ◽  
Raul G. Nogueira
Keyword(s):  
Ischemic Stroke ◽  
Cerebral Infarction ◽  
Inflammatory Responses ◽  
Imaging Finding ◽  
Ct Perfusion ◽  
Hypercoagulable State ◽  
Left Internal Carotid Artery ◽  
Intraluminal Thrombus ◽  
Unique Case ◽  
Ct Perfusion Imaging

Cardio-cerebral infarction, which refers to an acute ischemic stroke (AIS) and acute myocardial infarction (AMI) that occur concurrently, is an uncommon phenomenon with a grave prognosis. Intraluminal carotid thrombus (ICT) is an infrequently encountered cause of ischemic stroke and can be associated with an underlying hypercoagulable state. One severe yet prevalent complication of infection with Coronavirus Disease 2019 (COVID-19) is thrombosis from multi-pathway inflammatory responses. Here, we present a unique case of cardio-cerebral infarction, with a free-floating intraluminal thrombus in the left internal carotid artery, in the setting of recent COVID-19 infection, and with the etiology of both events attributed to a COVID-19 hypercoagulable state. CT perfusion imaging also showed an interesting imaging finding of hyperperfusion, which is believed to be a form of dysfunctional cerebral autoregulation.

Automated CT perfusion imaging for acute ischemic stroke

Neurology ◽  
2019 ◽  
pp. 10.1212/WNL.0000000000008481 ◽  
Author(s):  
Achala Vagal ◽  
Max Wintermark ◽  
Kambiz Nael ◽  
Andrew Bivard ◽  
Mark Parsons ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Perfusion Imaging ◽  
Ct Perfusion ◽  
Ct Perfusion Imaging

scholarly journals Dynamic CT Perfusion Imaging for the Detection of Crossed Cerebellar Diaschisis in Acute Ischemic Stroke

2012 ◽  
Vol 13 (1) ◽  
pp. 12 ◽  
Author(s):  
Young Wook Jeon ◽  
Seo Hyun Kim ◽  
Ji Yong Lee ◽  
Kum Whang ◽  
Myung Soon Kim ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Perfusion Imaging ◽  
Ct Perfusion ◽  
Dynamic Ct ◽  
Crossed Cerebellar Diaschisis ◽  
Ct Perfusion Imaging ◽  
Cerebellar Diaschisis

scholarly journals Predictive Value of CT Perfusion Imaging on the Basis of Automatic Segmentation Algorithm to Evaluate the Collateral Blood Flow Status on the Outcome of Reperfusion Therapy for Ischemic Stroke

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Qingsong Gong ◽  
Botao Yu ◽  
Mengjie Wang ◽  
Min Chen ◽  
Haowen Xu ◽  
...  
Keyword(s):  
Blood Flow ◽  
Ischemic Stroke ◽  
Perfusion Imaging ◽  
Ct Perfusion ◽  
Automatic Segmentation ◽  
Reperfusion Therapy ◽  
Segmentation Algorithm ◽  
Collateral Flow ◽  
Collateral Blood Flow ◽  
Ct Perfusion Imaging

Our objective was to study the predictive value of CT perfusion imaging based on automatic segmentation algorithm for evaluating collateral blood flow status in the outcome of reperfusion therapy for ischemic stroke. All data of 30 patients with ischemic stroke reperfusion in our hospital were collected and examined by CT perfusion imaging. Convolutional neural network (CNN) algorithm was used to segment perfusion imaging map and evaluate the results. The patients were grouped by regional leptomeningeal collateral score (rLMCs). Binary logistic regression was used to analyze the independent influencing factors of collateral blood flow on brain CT perfusion. The modified Scandinavian Stroke Scale was used to evaluate the prognosis of patients, and the effects of different collateral flow conditions on prognosis were obtained. The accuracy of CNN segmentation image is 62.61%, the sensitivity is 87.42%, the similarity coefficient is 93.76%, and the segmentation result quality is higher. Blood glucose (95% CI = 0.943, P = 0.028 ) and ischemic stroke history (95% CI = 0.855, P = 0.003 ) were independent factors affecting the collateral blood flow status of stroke patients. CBF (95% CI = 0.818, P = 0.008 ) and CBV (95% CI = 0.796, P = 0.016 ) were independent influencing factors of CT perfusion parameters. After 3 weeks of onset, the prognostic function defect score of the good collateral flow group (11.11%) was lower than that of the poor group (41.67%) ( P < 0.05 ). The automatic segmentation algorithm has more accurate segmentation ability for stroke CT perfusion imaging and plays a good auxiliary role in the diagnosis of clinical stroke reperfusion therapy. The collateral blood flow state based on CT perfusion imaging is helpful to predict the treatment outcome of patients with ischemic stroke and further predict the prognosis of patients.

scholarly journals Contrast Staining on CT after DSA in Ischemic Stroke Patients Progresses to Infarction and Rarely Hemorrhages

2014 ◽  
Vol 20 (1) ◽  
pp. 106-115 ◽  
Author(s):  
Matthew R. Amans ◽  
Daniel L. Cooke ◽  
Maya Vella ◽  
Christopher F. Dowd ◽  
Van V. Halbach ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Brain Injury ◽  
Cerebral Infarction ◽  
Imaging Finding ◽  
Hemorrhagic Transformation ◽  
Brain Parenchyma ◽  
Inclusion Criteria ◽  
Stroke Patients ◽  
Contrast Ct ◽  
Ct And Mri

Contrast staining of brain parenchyma identified on non-contrast CT performed after DSA in patients with acute ischemic stroke (AIS) is an incompletely understood imaging finding. We hypothesize contrast staining to be an indicator of brain injury and suspect the fate of involved parenchyma to be cerebral infarction. Seventeen years of AIS data were retrospectively analyzed for contrast staining. Charts were reviewed and outcomes of the stained parenchyma were identified on subsequent CT and MRI. Thirty-six of 67 patients meeting inclusion criteria (53.7%) had contrast staining on CT obtained within 72 hours after DSA. Brain parenchyma with contrast staining in patients with AIS most often evolved into cerebral infarction (81%). Hemorrhagic transformation was less likely in cases with staining compared with hemorrhagic transformation in the cohort that did not have contrast staining of the parenchyma on post DSA CT (6% versus 25%, respectively, OR 0.17, 95% CI 0.017–0.98, p = 0.02). Brain parenchyma with contrast staining on CT after DSA in AIS patients was likely to infarct and unlikely to hemorrhage.

Abstract 2851: Intravenous Heparin For The Treatment Of Intraluminal Thrombus In Patients With Acute Ischemic Stroke

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Maxim Mokin ◽  
Tareq Kass-Hout ◽  
Omar Kass-Hout ◽  
Peter Kan ◽  
Adnan Siddiqui ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Ct Perfusion ◽  
Heart Association ◽  
Bleeding Complications ◽  
Intraluminal Thrombus ◽  
Computed Tomographic ◽  
Increased Risk ◽  
Before And After ◽  
Complete Lysis

Background and objectives: Current American Stroke Association/American Heart Association recommendations on the management of acute ischemic stroke do not recommend early use of heparin owing to increased risk of bleeding complications. However, for select patients, such as those with strokes associated with intraluminal thrombus, intravenous (IV) heparin might prove to be beneficial. Methods: We conducted a retrospective analysis of acute ischemic stroke cases associated with intraluminal thrombus of intracranial and extracranial arteries in the corresponding vascular territories to identify patients in whom treatment with IV heparin resulted in near-complete or complete lysis of the thrombus. Imaging findings from computed tomographic (CT) perfusion and angiography, magnetic resonance imaging, and/or digital subtraction angiography were used to describe the location of intraluminal thrombus immediately before and after treatment with IV heparin. Results: Eighteen patients with confirmed intraluminal thrombus by CT angiography (CTA) received treatment with IV heparin alone (median duration 3.5 days; range 1-8 days). The median NIHSS score was 2.5 (range 0-15) on admission and 1 (range 0-9) at discharge. Nine patients had complete lysis, and 9 patients had partial lysis of the thrombus with improved flow distal to the location of the thrombus. None of the patients developed intracranial hemorrhage. Conclusion: For strokes associated with intraluminal thrombus, IV heparin might prove to be an effective treatment strategy. Further studies are necessary to evaluate the efficacy and safety of treatment with IV heparin in those patients.

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