Computed Tomographic Angiography and Cerebral Blood Volume Can Predict Final Infarct Volume and Outcome After Recanalization

These idiots still don't have a clue that the neuronal cascade of death keeps on killing neurons even after recanalization.
Some day there are going to be dozens on researchers working on that and they'll wonder why they took so long to understand the etiology of stroke damage. 

Computed Tomographic Angiography and Cerebral Blood Volume Can Predict Final Infarct Volume and Outcome After Recanalization

1. Cheemun Lum, MD, FRCP;
2. Muhammad Ejaz Ahmed, MBBS;
3. Satya Patro, MBBS;
4. Rebecca Thornhill, PhD;
5. Matthew Hogan, MD, FRCP;
6. Daniela Iancu, MD;
7. Howard Lesiuk, MD, FRCS;
8. Marlise dos Santos, MD, MSc;
9. Dar Dowlatshahi, MD, PhD, FRCPC;
10. on behalf of the Ottawa Stroke Research Group (OSRG)

+ Author Affiliations

1. From the Interventional Neuroradiology Section, Department of Medical Imaging-Diagnostic (C.L., M.E.A., S.P., R.T., D.I., H.L., M.d.S.) and Division of Neurology, Department of Medicine (M.H., D.D.), The Ottawa Hospital, Ottawa Hospital Research Institute (OHRI), University of Ottawa, Ottawa, Ontario, Canada.

1. Correspondence to Cheemun Lum, MD, C1-Diagnostic Imaging, Civic Campus, The Ottawa Hospital, 1053 Carling Ave, Ottawa, Ontario, Canada K1Y 4E9. E-mail chlum@ottawahospital.on.ca

Abstract

Background and Purpose—Recanalization rates are higher in acute anterior stroke treated with stent-retrievers when compared with older techniques. However, some still have sizeable infarcts and poor outcome. This may be related to underestimation of core infarct on nonenhanced computed tomography (NECT). CT angiography (CTA) source images (CTASI) and CT perfusion may be more informative. We hypothesize that core infarct estimation with NECT, CTA, and CT perfusion predicts infarct at 24 hours and outcome after fast recanalization.

Methods—Consecutive good recanalization patients with proximal anterior circulation stroke were evaluated. We assessed Alberta Stroke Program Early CT Score (ASPECTs) on NECT for subtle early infarct, hypodensity, loss of gray–white (CTASI), and low cerebral blood volume (CBV; CT perfusion). Sensitivity and specificity for predicting infarct by region were calculated.

Results—Of 46 patients, 36 (78%) had successful thrombectomy. Median ASPECTS was 10 for NECT early infarct and frank hypodensity; for CBV, CTASI-ASPECTS was 8. CTASI had the highest sensitivity of 71% and specificity of 82% for 24 hours NECT infarct. There was moderate correlation and concordance between CBV/24-hour NECT (R_p=0.51; R_c=0.50) and CTASI/24-hour NECT (R_p=0.54 and R_c=0.53). Thirty-four patients (74%) had good outcomes. Median ASPECTS was higher on CTASI (8 versus 5; P=0.04) and CBV (9 versus 5; P=0.03) for patients with good versus bad outcome. There were better outcomes with increasing CTASI-ASPECTS (P=0.004) and CBV-ASPECTS (P=0.02).

Conclusions—CTASI and CBV were better at predicting 24-hour infarct and outcome than NECT. Appropriate advanced imaged guided selection may improve outcomes in large-vessel stroke treated with the newest techniques.

Cat Stroke Survivor Gets Water Therapy

I bet the cat recovers better than 99% of human stroke survivors.
http://www.myfoxphilly.com/story/25879369/cat-stroke-survivor-gets-water-therapy

Why a Cat's Purr Can Lower Heart Attack Risk

Something that came out of the Stroke research Center at the University of Minnesota. I'll have to further check them out to see if they need some expert help with this kind of stuff.
http://www.petside.com/article/why-cats-purr-can-lower-heart-attack-risk
Cats are such a calming presence in our lives that they reduce the risk of having a heart attack by 40 percent, according to a research study.
I’m not surprised. Burying my face in my cat’s warm, silky fur has helped me calm down numerous times.
She may even be saving my life.
The study, a 10-year endeavor from the Stroke Research Center at the University of Minnesota looked at 4,435 Americans aged 30 to 75, and also found that cats reduce the risk of dying from other heart diseases and stroke by 30 percent.
More specifically, it could be a cat’s purr that’s putting hearts at ease.
Animal behavior consultant Steve Dale told the Chicago Tribune that cats use their purr as a calming mechanism to communicate with their kittens. “They’ll purr when they’re content, but they’ll also purr when they’re about to be euthanized.”
In that way, they may be communicating with us as well.
This animal connection, Dale explained, "alters our neurochemistry.” Our cats are helping us relax just like they do their own kittens.
I’ve often dismissed the idea of my tiny black cat mothering me as being silly. But I have thought about it.
For instance, when I’m particularly stressed, I have the less than delightful habit of of shooting up out of a deep sleep, gasping for breath, caught somewhere between a bad dream and my warm bed.
At these times my cat shimmers into existence without fail. She hears me and hops up to my lap from her own warm sleeping spot, purring away. She anchors me in my safe reality then helps me quickly fall back to sleep.
Thinking about this simple, but vital ritual of ours makes that 40 percent seem a lot less astounding, and the fact that not everyone has a cat more so.
If you’ve been considering adopting a cat, you might be saving two lives

DRAGON Score Helps Predict Functional Outcomes in Stroke

They did at least talk about a CAT scan but no PET scan to show the penumbra. So I
don 't think this is really valid. And a three month outcome doesn't follow the normal 6-12 month spontaneous recovery.
http://www.doctorslounge.com/index.php/news/pb/26557
A new scoring method can aid clinicians in predicting functional outcomes for patients with ischemic stroke receiving intravenous alteplase, according to a study published in the Feb. 7 issue of Neurology.
MONDAY, Feb. 6 (HealthDay News) -- A new scoring method can aid clinicians in predicting functional outcomes for patients with ischemic stroke receiving intravenous (IV) alteplase, according to a study published in the Feb. 7 issue of Neurology.
Daniel Strbian, M.D., Ph.D., of Helsinki University Central Hospital, and colleagues developed a functional outcome prediction score by studying the immediate pretreatment parameters and three-month outcomes in 1,319 ischemic stroke patients treated with IV alteplase. The accuracy of the model was evaluated with bootstrapping. External validation was performed in a cohort of 330 patients treated at the University Hospital Basel in Switzerland.
The researchers developed the 10-point DRAGON scale based on (hyper)Dense cerebral artery sign or early infarct signs on admission computed tomography scan; prestroke modified Rankin Scale (mRS) score; Age; Glucose level at baseline; Onset-to-treatment time; and baseline National Institutes of Health Stroke Scale score. The area under the receiver operator characteristic curve was 0.84 in the original cohort and 0.80 in the validation cohort. For patients with a score of 0-1, 2, 3, and 8-10 points, the proportions of patients with good outcomes (mRS score, 0 to 2) were 96, 88, 74, and 0 percent, respectively. For patients with a score of 0-1, 2, 3, 8, and 9-10 points, the proportions with miserable outcomes (mRS score, 5 to 6) were 0, 2, 5, 70, and 100 percent, respectively. Similar results were seen with external validation.
"The DRAGON score is valid at our site and was reliable externally," the authors write.
Several authors disclosed financial ties to pharmaceutical companies. One author disclosed involvement with patents related to the study subject matter.