Acute Infarct Core Volume Estimation on Noncontrast Computed Tomography With a Deep Learning Algorithm

 What good does this do to get survivors recovered? That's the whole point of stroke research! If you can't explain that you don't belong in stroke!

Send me hate mail on this: oc1dean@gmail.com. I'll print your complete statement with your name and my response in my blog. Or are you afraid to engage with my stroke-addled mind? I would like to know why you aren't solving stroke to 100% recovery, and what is your definition of competence in stroke? Swearing at me is allowed, I'll return the favor.

And you don't know about much faster ways to determine infarct or bleed?

Hats off to Helmet of Hope - stroke diagnosis in 30 seconds; February 2017 

Smart Brain-Wave Cap Recognises Stroke Before the Patient Reaches the Hospital

 October 2023

And then this to rule out a bleeder.

New Device Quickly Assesses Brain Bleeding in Head Injuries - 5-10 minutes April 2017

The latest here:

Acute Infarct Core Volume Estimation on Noncontrast Computed Tomography With a Deep Learning Algorithm

Santiago Ortega‐Gutierrez, MD, MSc https://orcid.org/0000-0002-3408-1297 santy-ortega@uiowa.edu, Juan Vivanco‐Suarez, MD, Aaron Rodriguez‐Calienes, MD, Victor Salvia, Milagros Galecio‐Castillo, MD, Mahmoud Dibas, MD, Yujing Lu, MS, … Show All … , and Marc Ribo, MDAuthor Info & Affiliations

Stroke: Vascular and Interventional Neurology

New online

https://doi.org/10.1161/SVIN.124.001509

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Abstract

BACKGROUND

A simplified patient selection paradigm with noncontrast computed tomography (NCCT) can reduce the time to reperfusion and widen the eligibility of acute ischemic stroke large vessel occlusions (LVOs) for endovascular therapy. The objectives of this article are (1) to develop, train, and internally validate a deep learning algorithm that estimates baseline infarct core volume (ICV) on NCCT in anterior circulation LVO patients, and (2) by using an external set, to ascertain how this algorithm's (aICV‐NCCT) predictive performance compares with Alberta Stroke Program Early Computed Tomography Score‐NCCT and ICV‐CT perfusion in its capacity to estimate the final infarct volume established on diffusion‐weighted magnetic resonance imaging at 24‐ to 48‐hour follow‐up.

METHODS

In the first phase, stroke activations with baseline NCCT and CT angiography were used to train an aICV‐NCCT. The algorithm was then internally validated using intraclass correlations and Intersection over Union. In the external set, patients with LVO treated with endovascular therapy achieving modified Thrombolysis in Cerebral Infarction score ≥2b and available baseline NCCT, CT angiography, and CT perfusion were included.

RESULTS

A total of 2858 studies of patients with stroke alerts were used for training (80%) and internal validation (20%). We obtained a high correlation (intraclass correlation coefficient, 0.78; CI, 0.73–0.83) and an acceptable Intersection over Union of 0.24 on the internal validation set. The external set consisted on 230 patients with an LVO. When predicting final infarct volume on the external set, our aICV‐NCCT was similar to ICV‐CT perfusion (intraclass correlation coefficient, 0.50 versus 0.54; P = 0.764) and Alberta Stroke Program Early Computed Tomography Score‐NCCT (r_s, −0.41; P = 0.436).

CONCLUSION

In this study, we developed and validated a deep learning algorithm that demonstrates an at least equivalent performance to CT perfusion in estimating core volume on acute stroke imaging studies in patients with suspected anterior circulation LVO strokes. The algorithm's robust performance holds significant potential in settings with limited access to advanced imaging technologies across diverse healthcare environments.

Graphical Abstract

More middle-aged adults have been dying from strokes. Experts cite 3 factors that might be to blame

 But you totally missed the fact that NOTHING is being done to identify and lower the 30-day death rate. Like stopping the 5 causes of the neuronal cascade of death in the first week thus saving millions to billions of neurons. If you don't understand recanalization is only the first step to recovery, you really don't belong in stroke!

In recent years, more adults between the ages of 45 and 64 have been dying from strokes, according to a new report from the Centers for Disease Control and Prevention (CDC). Stroke occurs when blood flow to the brain is blocked or there’s sudden bleeding in the brain. Unless treated quickly, it can lead to lasting brain damage, long-term disability or death.

After declining from 2002 to 2012, stroke death rates for middle-aged adults increased 7% between 2012 and 2019, and increased an additional 12% through 2021, the CDC found. The stroke death rate then fell slightly (by 2%) for men through 2022, and “did not change significantly” for women.

The CDC report didn’t explore possible reasons for the spike in stroke deaths. However, experts tell Yahoo Life there could be a few explanations.(Well, you need to talk  to better 'experts')

Reason #1: An increase in stroke risk factors — especially high blood pressure

Underlying conditions like diabetes, obesity and hyperlipidemia (aka high cholesterol) have increased among middle-aged adults, as have poor lifestyle habits such as alcohol use, unhealthy diets and physical inactivity — all of which are typical risk factors for stroke, experts say.

“These risk factors over time lead to atherosclerosis, which is a common cause of stroke in older patients. However, we have seen an increase in these same risk factors leading to stroke in our younger patient population,” Dr. Fan Caprio, a vascular neurologist at Northwestern Medicine and medical director for its Comprehensive Stroke Center, tells Yahoo Life.

An increase in risk factors, Caprio explains, can lead to more and bigger strokes — which in turn can lead to higher mortality and morbidity.

One of the most notable risk factors behind the rise is hypertension, or high blood pressure.

“Hypertension, which is the most important stroke risk factor, has increased among middle-aged adults,” Adam Vaughan, an epidemiologist with the CDC’s Division for Heart Disease and Stroke Prevention, tells Yahoo Life. Vaughan adds that more than half of middle-aged adults with hypertension have “uncontrolled hypertension” — meaning their high blood pressure is untreated or not responding to treatment.

Dr. Mona Bahouth, medical director of the Brain Rescue Unit at Johns Hopkins Medicine, adds that what can make high blood pressure so dangerous is the fact that it’s “fairly silent.”

“You don't really feel that you have high blood pressure until you've had it for a while and it's too late, unless you're measuring it,” she tells Yahoo Life.

Reason #2: Missing doctor appointments

Vaughan points out that socioeconomic disparities could also be at play. “Many people in this age group might have limited access to health care, leading to undiagnosed or not controlled risk factors, and delayed treatment in general,” he says.

It’s also possible that COVID-19 may have contributed to the rise. Rates in stroke deaths spiked 12% during the early years of the pandemic, which could be because more people missed doctor appointments and preventive screenings that would have identified some of those crucial risk factors. Still, Bahouth says we “can't really take that bait too easily”; although stroke deaths increased early in the pandemic, the study shows that rates were already on the rise before COVID came into the picture.

Reason #3: Not recognizing stroke symptoms

Stroke can be mistakenly viewed as a “disorder of the elderly.” As such, when a middle-aged person starts to develop symptoms of a stroke, those symptoms might be dismissed and medical attention delayed until it’s too late, Caprio says.

Experts say it’s imperative that people of all ages recognize the telltale signs of stroke, which include:

• sudden weakness or dizziness

• sudden numbness, especially on one side of the body

• sudden trouble speaking or understanding speech

• sudden severe headache

If you notice these symptoms, call 911 immediately. Fast treatment can not only be lifesaving but also lessen the likelihood of brain damage brought on by stroke and prevent another stroke from occurring