Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, November 11, 2019

Incremental Value of Computed Tomography Perfusion for Final Infarct Prediction in Acute Ischemic Cerebellar Stroke

Will you stop the prognostic crapola. Survivors want protocols that deliver 100% recovery, NOT this crap. 

Incremental Value of Computed Tomography Perfusion for Final Infarct Prediction in Acute Ischemic Cerebellar Stroke

Author information

1
Department ot Radiology University Hospital, LMU Munich Munich Germany.
2
Department of Neuroradiology University Hospital LMU Munich Germany.
3
Department of Neurology University Hospital LMU Munich Germany.
4
Department of Neurology University Hospital Heidelberg Germany.
5
German Center for Vertigo and Balance Disorders University Hospital LMU Munich Germany.
6
Institute for Stroke and Dementia Research University Hospital LMU Munich Germany.
7
Institute of Diagnostic and Interventional Radiology Pediatric Radiology and Neuroradiology University Medical Center Rostock Germany.

Abstract

Background 
The diagnosis of ischemic cerebellar stroke is challenging because of nonspecific symptoms and very limited accuracy of commonly applied computed tomography (CT) imaging. Advances in CT perfusion imaging provide increasing value in the detection of posterior circulation stroke, but the prognostic value remains unclear. We aimed to identify imaging parameters that predict morphologic outcome in cerebellar stroke patients using advanced CT including whole-brain CT perfusion (WB-CTP).
Methods and Results 
We selected all subjects with cerebellar WB-CTP perfusion deficits and follow-up-confirmed cerebellar infarction from a consecutive cohort with suspected stroke who underwent WB-CTP. Posterior-circulation-Acute-Stroke-Prognosis-Early-CT-Score (pc-ASPECTS) was determined on noncontrast CT, CT angiography source images, and on parametric WB-CTP maps. Cerebellar perfusion deficit volumes on all maps and the final infarction volume on follow-up imaging were quantified. Uni- and multivariate regression analyses were performed. Sixty patients fulfilled the inclusion criteria. pc-ASPECTS on CT angiography source images (ß, -9.239; 95% CI, -14.220 to -4.259; P<0.001) and cerebral blood flow deficit volume (ß, 0.886; 95% CI, 0.684 to 1.089; P<0.001) were significantly associated with final infarction volume in univariate linear regression analysis. The association of cerebral blood flow deficit volume (ß, 0.830; 95% CI, 0.605-1.055; P<0.001) was confirmed in a multivariate linear regression model adjusted for age, sex, pc-ASPECTS on noncontrast CT, and CT angiography source images and the National Institutes of Health Stroke Scale score on admission. No other clinical or imaging parameters were associated with cerebellar stroke final infarction volume (P>0.05).
Conclusions 
In contrast to noncontrast CT and CT angiography, WB-CTP imaging contains prognostic information for morphologic outcome in patients with acute cerebellar stroke.

KEYWORDS:

CT perfusion imaging; ischemic stroke; perfusion imaging; posterior circulation
PMID:
31631729
DOI:
10.1161/JAHA.119.013069
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