A woman in her 20s presented with neck pain, slurred speech and left-sided weakness. She successfully underwent mechanical thrombectomy (MT) for total occlusion of the basilar artery and made full neurological recovery. Initial ultrasound Doppler of legs (USDL) did not show any deep vein thrombosis (DVT). However, 2 days later, a repeat USDL revealed an extensive proximal DVT in the right common femoral vein. CT scan confirmed a haematoma arising from the femoral access site causing compression of the adjacent common femoral vein. This may have initiated DVT formation or exacerbated extension of a previously undetected DVT. Echocardiogram revealed a patent foramen ovale. As the patient was asymptomatic, delayed or missed diagnosis of DVT would have put her at risk of life-threatening pulmonary embolism or further strokes. Clinicians should maintain a high index of suspicion of DVT as a direct procedural complication from MT so treatment can be initiated promptly.
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http://dx.doi.org/10.1136/bcr-2023-255391 | DOI Listing |
PeerJ
January 2025
Department of Medical Imaging, Guangzhou Hospital of Integrated Traditional and Western Medicine, Guangzhou, China.
Background: The 2019 American Heart Association/American Stroke Association (AHA/ASA) guidelines strongly advise using non-contrast CT (NCCT) of the head as a mandatory test for all patients with suspected acute ischemic stroke (AIS) due to CT's advantages of affordability and speed of imaging. Therefore, our objective was to combine patient clinical data with head CT signs to create a nomogram to predict poor outcomes in AIS patients.
Methods: A retrospective analysis was conducted on 161 patients with acute ischemic stroke who underwent mechanical thrombectomy at the Guangzhou Hospital of Integrated Traditional and Western Medicine from January 2019 to June 2023.
Neuroradiol J
January 2025
Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY, USA.
This study evaluates the efficacy of deep learning models in identifying infarct tissue on computed tomography perfusion (CTP) scans from patients with acute ischemic stroke due to large vessel occlusion, specifically addressing the potential influence of varying noise reduction techniques implemented by different vendors. We analyzed CTP scans from 60 patients who underwent mechanical thrombectomy achieving a modified thrombolysis in cerebral infarction (mTICI) score of 2c or 3, ensuring minimal changes in the infarct core between the initial CTP and follow-up MR imaging. Noise reduction techniques, including principal component analysis (PCA), wavelet, non-local means (NLM), and a no denoising approach, were employed to create hemodynamic parameter maps.
View Article and Find Full Text PDFJ Neuroimaging
January 2025
Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Maryland, USA.
Introduction: The venous outflow profile (VOP) is a crucial yet often overlooked aspect affecting stroke outcomes. It plays a major role in the physiopathology of acute cerebral ischemia, as it accounts for both the upstream arterial collaterals and cerebral microperfusion. This enables it to circumvent the limitations of various arterial collateral evaluation systems, which often fail to consider impaired autoregulation and its impact on cerebral blood flow at the microcirculatory levels.
View Article and Find Full Text PDFInt J Cerebrovasc Dis Stroke
August 2024
Department of Neurology, Neurosurgery, & Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA, United States.
Background: Cerebral Venous Sinus Thrombosis (CVST) is a relatively rare type of stroke, accounting for less than 3% of all stroke cases, and is associated with significant morbidity and mortality in young females. However, when promptly diagnosed and treated, it can have favorable outcomes. Several knowledge gaps remain regarding pathophysiology, diagnosis, and management of CVST, so critical assessment of past and present research could help close these gaps or establish targeted future research goals.
View Article and Find Full Text PDFCardiol Young
January 2025
Pediatric Cardiology, Rady Children's Hospital, University of California, San Diego, USA.
A 16-year-old male with newly diagnosed granulomatosis with polyangiitis presented to the emergency room with chest pain. He was found to have a myocardial infarction involving the right coronary artery and the left circumflex artery. He underwent mechanical thrombectomy and stent placement without significant sequelae.
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