Journal of the neurological sciences
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Comparative Study
Comparison between MRI screening and CT-plus-MRI screening for thrombolysis within 3 h of ischemic stroke.
Although MRI may provide much information on brain pathology to aid in patient selection for thrombolysis, the concern remains that MRI screening may increase time-to-treatment. We hypothesized that CT-plus-MRI screening might be a valuable time-efficient alternative for selection of patients requiring thrombolysis. ⋯ These results suggest that early patient selection using MRI may be more effective than reduction of times-to-treatment in improvement of thrombolytic outcomes.
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Multicenter Study
Predictive value of the NIHSS for ADL outcome after ischemic hemispheric stroke: does timing of early assessment matter?
Early prediction of future functional abilities is important for stroke management. The objective of the present study was to investigate the predictive value of the 13-item National Institutes of Health Stroke Scale (NIHSS), measured within 72 h after stroke, for the outcome in terms of activities of daily living (ADL) 6 months post stroke. The second aim was to examine if the timing of NIHSS assessment during the first days post stroke affects the accuracy of predicting ADL outcome 6 months post stroke. ⋯ When measured within 9 days, the 13-item NIHSS is highly associated with final outcome in terms of BI at 6 months post stroke. The moment of assessment beyond 2 days post stroke does not significantly affect the accuracy of prediction of ADL dependency at 6 months. The NIHSS can therefore be used at acute hospital stroke units for early rehabilitation management during the first 9 days post stroke, as the accuracy of prediction remained about 72%, irrespective of the moment of assessment.
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Blast-induced traumatic brain injury (TBI) has been the predominant cause of neurotrauma in current military conflicts, and it is also emerging as a potential threat in civilian terrorism. The etiology of TBI, however, is poorly understood. Further study on the mechanisms and treatment of blast injury is urgently needed. ⋯ Diffuse subarachnoid hemorrhage and edema could be seen within the brain parenchyma, which showed a loss of integrity. Capillary damage and enlarged intercellular and vascular space in the cortex, along with a tattered nerve fiber were observed. These findings demonstrate that we have provided a reliable and reproducible blast-induced TBI model in rats.
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The artery of Percheron is an uncommon anatomic variant in which a solitary trunk originates from either posterior cerebral artery and provides arterial supply to bilateral paramedian thalami and the rostral midbrain (Fig. 1). Recognition of this anatomical variant is essential in establishing the stroke mechanism in bilateral paramedian thalamic infarcts. We describe the clinical presentation and neuroimaging characteristics in a patient with bilateral thalamic infarctions due to occlusion of the artery of Percheron.
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The aim of the present study was to evaluate the usefulness of transcranial motor evoked potential (MEP) monitoring and its impact on morbidity after surgical clipping of unruptured intracranial aneurysms. ⋯ Transcranial MEP monitoring is a simple, safe, and reliable tool for the prediction of postoperative motor functions. The ischemic complications can be reduced via prompt corrective measures taken on the basis of MEP changes during aneurysm surgery.