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Acquisition of Prehospital Stroke Severity Scale is associated with shorter door-to-puncture times in patients with prehospital notifications transported directly to a thrombectomy center.
J Neurointerv Surg
September 2024
Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
Background: We sought to identify systemic factors influencing door-to-puncture times (DTP) among patients with pre-arrival notifications presenting directly to a comprehensive stroke center (CSC) and undergoing emergent mechanical thrombectomy (MT).
Methods: In this retrospective analysis of a prospectively maintained registry of acute ischemic stroke (AIS) patients undergoing MT at two CSCs between January 2021 and October 2023, we included consecutive AIS patients presenting directly to the CSC with pre-arrival notifications via emergency medical services (EMS) and who underwent emergent MT. We excluded patients with known confounders to DTP and divided this cohort into two groups: DTP ≤75 min and >75 min.
Primary Angiitis of the CNS: Differences in the Profile Between Subtypes and Outcomes From an Indian Cohort.
Neurol Neuroimmunol Neuroinflamm
July 2024
From the Department of Neurology (N.K.P., S.M.K.M., S.S., S.E.S., P.S.); Imaging Sciences and Interventional Radiology (D.P.S.); Comprehensive Stroke Care Program (S.E.S., P.S.); and Achutha Menon Centre for Health Science Studies (P.S.S.), Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
Background And Objectives: Primary angiitis of the CNS (PACNS) is a rare disease that has significant morbidity and mortality. Subtypes of PACNS can have different presentations that could be missed with certain diagnostic modalities, further increasing diagnostic complexity. We sought to distinguish the subtypes of PACNS and describe their outcomes in an Indian cohort.
View Article and Find Full Text PDFTime From Hospital Arrival Until Endovascular Thrombectomy and Patient-Reported Outcomes in Acute Ischemic Stroke.
JAMA Neurol
July 2024
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary and Foothills Medical Centre, Calgary, Alberta, Canada.
Article Synopsis
- The study investigates how the timing of endovascular thrombectomy (EVT) affects the quality of life reported by patients who have experienced an ischemic stroke.
- Using data from an international clinical trial, it evaluates the relationship between the time from hospital arrival to treatment and self-reported health outcomes 90 days post-stroke.
- Findings indicate that quicker EVT may lead to better patient-reported quality of life, but further analysis is necessary to fully understand the implications of timing on symptoms across various health domains.
Persistent intracranial steno-occlusion from calcified embolism: a treatment challenge.
Neurol Sci
August 2024
Neuroradiology Unit, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy.
Article Synopsis
- - Calcified arterial cerebral embolism is a rare type of ischemic stroke typically arising from calcific atheromas or heart valve diseases, with poor prognosis and potential underdiagnosis during acute episodes.
- - The study presents two cases of acute stroke due to calcified embolism in the middle cerebral artery, both showing no need for thrombolysis but achieving favorable outcomes after antiplatelet treatment and managing vascular risk factors.
- - Despite representing a small percentage of acute ischemic strokes, the challenges in identifying and treating calcified embolism remain, with most patients experiencing poor functional independence after standard treatments like endovascular thrombectomy.
Diagnostic accuracy of large and medium vessel occlusions in acute stroke imaging by neurology residents and stroke fellows: A comparison of CT angiography alone and CT angiography with CT perfusion.
Eur Stroke J
June 2024
Neuroscience Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Introduction: Neurology senior residents and stroke fellows are first to clinically assess and interpret imaging studies of patients presenting to the emergency department with acute stroke. The aim of this study was to compare the diagnostic accuracy of brain CT angiography (CTA) with and without CT perfusion (CTP) between neurology senior residents and stroke fellows.
Methods: In this neuroimaging study, nine practitioners (four senior neurology residents (SNRs) and five stroke fellows (SFs)) clinically assessed and interpreted the imaging data of 50 cases (15 normal images, 21 large vessel occlusions (LVOs) and 14 medium vessel occlusions (MeVOs) in two sessions, 1 week apart in comparison to final diagnosis of experienced neuroradiologist and experienced stroke neurologist consensus.
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