Journal of vascular and interventional neurology
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J Vasc Interv Neurol · May 2015
Can the World Federation of Neurosurgical Societies Classification Accurately Predict Outcomes in Intracerebral Hemorrhage?
Many scoring systems have been developed for the purpose of estimating of mortality and outcomes in intracerebral hemorrhage (ICH). However, the utility of the World Federation of Neurosurgical Society (WFNS) classification, which is routinely used in patients with subarachnoid hemorrhage, has never been specifically assessed in ICH. ⋯ The WFNS classification is as accurate as the ICH score in predicting discharge outcomes and in-hospital mortality. It is a simple clinical scale that can be used to predict outcomes in both ICH and subarachnoid hemorrhage patients.
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J Vasc Interv Neurol · Dec 2014
Internal carotid artery stenosis associated with giant cell arteritis: case report and discussion.
Cerebrovascular ischemic events associated with giant cell arteritis (GCA) are uncommon and have been reported in 3%-4% of patients. We describe a case report of GCA associated with intracranial stenosis and review various angiographic findings. ⋯ Bilateral internal carotid arteries stenosis may be seen in patients presenting with typical symptoms of GCA and may persist after steroid treatment despite resolution of clinical symptoms.
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J Vasc Interv Neurol · Dec 2014
Mean transit time on Aquilion ONE and its utilization in patients undergoing acute stroke intervention.
Neuroimaging techniques have been beneficial in identifying patients with salvageable penumbra. We sought to validate the mean transit time (MTT) map on computed tomography perfusion (CTP) imaging utilizing an Aquilion ONE computed tomography (CT) scanner running a singular value decomposition plus algorithm in patients with acute large vessel ischemic stroke who underwent endovascular therapy. ⋯ Although further studies are required to validate this retrospective study, preliminary data suggest that cMTT maps can be a valuable and accurate tool in the assessment of patients with acute stroke who may benefit from aggressive endovascular therapy.
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J Vasc Interv Neurol · Jun 2014
Case report: Intra-procedural aneurysm rupture during endovascular treatment causing immediate, transient angiographic vasospasm.
Cerebral vasospasm is a major cause of delayed ischemic cerebral injury, typically occurring 3-14 days after subarachnoid hemorrhage (SAH). Ultra-early vasospasm is defined as angiographic vasospasm observed within 48 h of SAH onset. Immediate vasospasm at the time of aneurysmal rupture has been suspected, but has not been previously reported. We describe a case of immediate, transient vasospasm following intra-procedural aneurysmal rupture. ⋯ We document a case of ultra-early cerebral vasospasm that occurred immediately after an intra-procedural aneurysmal rupture. Catheter-induced vasospasm from mechanical manipulation of extracranial vasculature is well described. However, immediate vasospasm related to extravascular blood has never before been reported. This finding suggests that extravascular blood can have a local direct effect (presumably mechanical) on cerebral blood vessels, and may be an important mechanism for vasospasm.
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J Vasc Interv Neurol · May 2014
Endovascular treatment for acute ischemic stroke patients: implications and interpretation of IMS III, MR RESCUE, and SYNTHESIS EXPANSION trials: A report from the Working Group of International Congress of Interventional Neurology.
The results of Interventional Management of Stroke (IMS) III, Magnetic Resonance and REcanalization of Stroke Clots Using Embolectomy (MR RESCUE), and SYNTHESIS EXPANSION trials are expected to affect the practice of endovascular treatment for acute ischemic stroke. The purpose of this report is to review the components of the designs and methods of these trials and to describe the influence of those components on the interpretation of trial results. ⋯ The results do not support a large magnitude benefit of endovascular treatment in subjects randomized in all the three trials. The possibility that benefits of a smaller magnitude exist in certain patient populations cannot be excluded. Large magnitude benefits can be expected with implementation of "parameter optimized endovascular treatment" in patients with ischemic stroke who are candidates for IV thrombolytics.