Clinical feasibility of deep learning-driven magnetic resonance angiography collateral map in acute anterior circulation ischemic stroke.

To validate the clinical feasibility of deep learning-driven magnetic resonance angiography (DL-driven MRA) collateral map in acute ischemic stroke. We employed a 3D multitask regression and ordinal regression deep neural network, called as 3D-MROD-Net, to generate DL-driven MRA collateral maps. Two raters graded the collateral perfusion scores of both conventional and DL-driven MRA collateral maps and measured the grading time.

The CT collateral map: collateral perfusion estimation and baseline lesion assessment after acute anterior circulation ischemic stroke.

Purpose: To investigate the clinical feasibility of a CT collateral map compared with an MRA collateral map, focusing on collateral perfusion (CP) estimation and baseline lesion assessment in acute ischemic stroke (AIS).

Materials And Methods: This retrospective analysis used selected data from a prospectively collected database. We generated CT collateral maps derived from CT perfusion, encompassing images of arterial, capillary, early venous (CMEV), late venous, and delay phases.

Natural course of the acute unruptured intracranial vertebral artery dissections which show pearl-and-string sign.

Introduction: Ruptured vertebral artery dissections frequently exhibit pearl-and-string signs, a characteristic also observed in many unruptured dissections. This study examines the natural course of 50 unruptured acute vertebral artery dissections presenting with pearl-and-string signs and compares them to 10 ruptured dissections of the same morphological pattern.

Methods: We reviewed 633 radiology reports of head and neck imaging studies that included the keyword 'dissection'.

Using Artificial Intelligence to Diagnose Lacrimal Passage Obstructions Based on Dacryocystography Images.

Dacryocystography (DCG) has been used to illustrate the morphological and functional aspects of the lacrimal drainage system in the evaluation of patients with maxillofacial trauma and epiphora. This study developed deep-learning models for the automatic classification of the status of the lacrimal passage based on DCG. The authors collected 719 DCG images from 430 patients with nasolacrimal duct obstruction.

Efficacy of Coil Embolization in Small, Anterior Circulation Aneurysms in Patients Less Than 40 Years Old.

Ruptured and unruptured aneurysms are less common in younger individuals compared to older patients. Endovascular treatment has gained popularity over surgical options in the general population, but surgery remains the primary treatment for younger patients due to concerns about higher recurrence rates with endovascular procedures. This study compared the immediate and long-term outcomes of endovascular treatment in patients under 40 years with those aged 41-60.

3D mobile regression vision transformer for collateral imaging in acute ischemic stroke.

Purpose: The accurate and timely assessment of the collateral perfusion status is crucial in the diagnosis and treatment of patients with acute ischemic stroke. Previous works have shown that collateral imaging, derived from CT angiography, MR perfusion, and MR angiography, aids in evaluating the collateral status. However, such methods are time-consuming and/or sub-optimal due to the nature of manual processing and heuristics.

Prognostic value of collateral perfusion estimation by arterial spin labeling for acute anterior circulation ischemic stroke.

Purpose: This study aimed to verify the value of arterial spin labeling (ASL) collateral perfusion estimation for predicting functional outcomes in acute anterior circulation ischemic stroke.

Methods: This secondary analysis of an ongoing prospective observational study included data from participants with acute ischemic stroke due to steno-occlusion of the internal carotid artery and/or the middle cerebral artery within 8 h of symptom onset. We compared the collateral map, which is a 5-phase collateral imaging derived from dynamic contrast-enhanced magnetic resonance angiography, and ASL to validate the ASL collateral perfusion estimation.

The collateral map: prediction of lesion growth and penumbra after acute anterior circulation ischemic stroke.

Objectives: This study evaluated the collateral map's ability to predict lesion growth and penumbra after acute anterior circulation ischemic strokes.

Methods: This was a retrospective analysis of selected data from a prospectively collected database. The lesion growth ratio was the ratio of the follow-up lesion volume to the baseline lesion volume on diffusion-weighted imaging (DWI).

Impact of Collateral Circulation on Futile Endovascular Thrombectomy in Acute Anterior Circulation Ischemic Stroke.

Objective: Collateral circulation is associated with the differential treatment effect of endovascular thrombectomy (EVT) in acute ischemic stroke. We aimed to verify the ability of the collateral map to predict futile EVT in patients with acute anterior circulation ischemic stroke.

Methods: This secondary analysis of a prospective observational study included data from participants underwent EVT for acute ischemic stroke due to occlusion of the internal carotid artery and/or the middle cerebral artery within 8 hours of symptom onset.

Acute hemicranial pain accompanied with a pearl and string type dissection of intracranial vertebral artery: Consideration for the time when to finish the medical observation.

The International Classification of Headache Disorder (ICHD) clearly guides the suspicion of intracranial vertebral artery dissection (ICVAD) in headache patients, but guidelines on how observational or imaging studies should be performed to detect dangerous progression early are unclear. Fifty-six cases with pearl and string type intracranial vertebral artery dissection were divided into 3 groups: 39 in the headache group, 6 in the infarction group, and 11 in the hemorrhagic group. Clinical and angiographic data were analyzed and compared.

A 3D Multi-task Regression and Ordinal Regression Deep Neural Network for Collateral Imaging from Dynamic Susceptibility Contrast-Enhanced MR perfusion in Acute Ischemic Stroke.

Background And Objective: Cerebral collaterals have been identified as one of the primary determinants for treatment options in acute ischemic stroke. Several works have been proposed, but these have not been adopted for a routine clinical usage due to their manual and heuristic nature as well as inconsistency and instability of the assessment. Herein, we present an advanced deep learning-based method that can automatically generate a multiphase collateral imaging (collateral map) derived from dynamic susceptibility contrast-enhanced MR perfusion (DSC-MRP) in an accurate and robust manner.

Imaging in Acute Anterior Circulation Ischemic Stroke: Current and Future.

Clinical trials on acute ischemic stroke have demonstrated the clinical effectiveness of revascularization treatments within an appropriate time window after stroke onset: intravenous thrombolysis (NINDS and ECASS-III) through the administration of tissue plasminogen activator within a 4.5-hour time window, endovascular thrombectomy (ESCAPE, REVASCAT, SWIFT-PRIME, MR CLEAN, EXTEND-IA) within a 6-hour time window, and extending the treatment time window up to 24 hours for endovascular thrombectomy (DAWN and DEFUSE 3). However, a substantial number of patients in these trials were ineligible for revascularization treatment, and treatments of some patients were considerably futile or sometimes dangerous in the clinical trials.

Collateral estimation by susceptibility-weighted imaging and prediction of functional outcomes after acute anterior circulation ischemic stroke.

To determine the value of susceptibility-weighted imaging (SWI) for collateral estimation and for predicting functional outcomes after acute ischemic stroke. To identify independent predictors of favorable functional outcomes, age, sex, risk factors, baseline National Institutes of Health Stroke Scale (NIHSS) score, baseline diffusion-weighted imaging (DWI) lesion volume, site of steno-occlusion, SWI collateral grade, mode of treatment, and successful reperfusion were evaluated by multiple logistic regression analyses. A total of 152 participants were evaluated.

Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID-19 pandemic.

Background: During the COVID-19 pandemic, decreased volumes of stroke admissions and mechanical thrombectomy were reported. The study's objective was to examine whether subarachnoid haemorrhage (SAH) hospitalisations and ruptured aneurysm coiling interventions demonstrated similar declines.

Methods: We conducted a cross-sectional, retrospective, observational study across 6 continents, 37 countries and 140 comprehensive stroke centres.

Collateral and permeability imaging derived from dynamic contrast material-enhanced MR angiography in prediction of PH 2 hemorrhagic transformation after acute ischemic stroke: a pilot study.

Purpose: To evaluate the role of collateral and permeability imaging derived from dynamic contrast material-enhanced magnetic resonance angiography to predict PH 2 hemorrhagic transformation in acute ischemic stroke.

Methods: The secondary analysis of a published data from participants with acute ischemic stroke. The multiphase collateral map and permeability imaging were generated by using dynamic signals from dynamic contrast material-enhanced magnetic resonance angiography obtained at admission.

Global impact of COVID-19 on stroke care.

Background: The COVID-19 pandemic led to profound changes in the organization of health care systems worldwide.

Aims: We sought to measure the global impact of the COVID-19 pandemic on the volumes for mechanical thrombectomy, stroke, and intracranial hemorrhage hospitalizations over a three-month period at the height of the pandemic (1 March-31 May 2020) compared with two control three-month periods (immediately preceding and one year prior).

Methods: Retrospective, observational, international study, across 6 continents, 40 countries, and 187 comprehensive stroke centers.

Unusual clinicopathological presentation of nontraumatic cerebral fat embolism: Two-case report.

Rationale: Fat embolism syndrome (FES) is characterized by the classical triad of cerebral, respiratory, and cutaneous manifestations. In contrast, cerebral fat embolism (CFE), corresponding to incomplete pure type FES, is much rarer and usually follows trauma. CFE typically shows a "starfield" pattern on diffusion-weighted magnetic resonance imaging due to the involvement of multiple small arteries.

Multiphase MR Angiography Collateral Map: Functional Outcome after Acute Anterior Circulation Ischemic Stroke.

Background Collateral circulation determines tissue fate and affects treatment result in acute ischemic stroke. A precise method for collateral estimation in an optimal imaging protocol is necessary to make an appropriate treatment decision for acute ischemic stroke. Purpose To verify the value of multiphase collateral imaging data sets (MR angiography collateral map) derived from dynamic contrast material-enhanced MR angiography for predicting functional outcomes after acute ischemic stroke.

Migraine with Aura as a Stroke Mimic.

Migraine with aura is one of the causes of stroke mimics. We retrospectively reviewed the 10-year medical records of patients who were treated with acute stroke management protocol. We analyzed the frequency and characteristics of patients with a final diagnosis of migraine with aura.

Deep regression neural networks for collateral imaging from dynamic susceptibility contrast-enhanced magnetic resonance perfusion in acute ischemic stroke.

Purpose: Acute ischemic stroke is one of the primary causes of death worldwide. Recent studies have shown that the assessment of collateral status could aid in improving the treatment for patients with acute ischemic stroke. We present a 3D deep regression neural network to automatically generate the collateral images from dynamic susceptibility contrast-enhanced magnetic resonance perfusion (DSC-MRP) in acute ischemic stroke.

Facial Nerve Hematoma After Penetrating Middle Ear Trauma: A Cause of Delayed Facial Palsy.

Penetrating middle ear injury may cause hearing loss, vertigo, or facial nerve injury, although facial nerve paralysis followed by head trauma is a rare condition. In this study, we report a case of a 3-year-old patient with delayed facial palsy on the left side that developed 4 days after an accidental tympanic membrane perforation caused by a cotton-tipped swab. Otoendoscopic examination revealed a perforation in the posterosuperior quadrant of the tympanic membrane.

Balloon Guide Catheter Is Beneficial in Endovascular Treatment Regardless of Mechanical Recanalization Modality.

Background and Purpose- Based on its mechanism, the use of balloon guide catheters (BGCs) may be beneficial during endovascular treatment, regardless of the type of mechanical recanalization modality used-stent retriever thrombectomy or thrombaspiration. We evaluated whether the use of BGCs can be beneficial regardless of the first-line mechanical endovascular modality used. Methods- We retrospectively reviewed consecutive acute stroke patients who underwent stent retriever thrombectomy or thrombaspiration from the prospectively maintained registries of 17 stroke centers nationwide.