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Background and Purpose Perfusion computerized tomography (PCT) has been used to assess the extent of blood brain barrier (BBB) breakdown. The purpose of this study was to determine the predictive value of (BBB) permeability (BBBP) measured using PCT for development of malignant middle cerebral artery infarction (MMCA) requiring hemicraniectomy (HC). Methods We retrospectively identified patients from our stroke registry that had MCA infarction and were evaluated with admission PCT. BBBP and cerebral blood volume (CBV) maps were generated and infarct volumes calculated. Clinical and radiographic characteristics were compared between those who underwent HC versus those who did not undergo hemicraniectomy (NHC). Results 122 patients (12 (HC), 110 (NHC)) were identified. 12 patients who underwent HC had developed edema, midline shift or infarct expansion. Infarct permeability area (IParea), infarct CBV area (ICBVarea), and infarct volumes were significantly different (p<0.018, p<0.0211, p<0.0001, p<0.0014) between HC and NHC groups. Age (p=0.03) and admission National Institutes of Health Stroke Scale (NIHSS) (p=0.0029) were found to be independent predictors for HC. Using logistic regression modeling, there was an association between increased IParea and HC. The odds ratio for HC based on a 5, 10, 15 or 20 cm2 increase in IParea were 1.179, 1.390, 1.638 or 1.932, respectively (95% CI 1.035-1.343, 1.071-1.804, 1.108-2.423, 1.146-3.255). Conclusion Increased IParea is associated with an increased likelihood for undergoing HC. Since early HC for MMCA has been associated with better outcomes, the IParea on admission PCT might be a useful tool to predict MMCA and need for HC.

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Recent studies have shown that oxidative stress is the one of the molecular changes underlying the pathogenesis of Alzheimer's disease. In this study, we have investigated the dynamic thiol-disulphide homeostasis in patients with Alzheimer's disease, using a novel method.

Background and Objective Patients with intracerebral hemorrhage (ICH) are at high risk for development of deep venous thrombosis (DVT). Current guidelines state that low dose subcutaneous (SQ) low-molecular weight heparin (LMWH) or unfractionated heparin (UH) may be considered at 3 to 4 days from onset. However, insufficient data exists on hematoma volume (HV) in patients with ICH before and after pharmacological DVT prophylaxis, leaving physicians with uncertainty regarding the safety of this practice. Methods We identified patients from our stroke registry (6/03 to 12/07) who presented with ICH only or ICH + intraventricular hemorrhage (IVH) and received either LMWH SQ or UH within 7 days of admission and had a repeat CT scan performed within 4 days of starting DVT prophylaxis. We calculated the change in hematoma volume (Δvol) from the admission and post treatment CTs. HV was calculated using the (ABC/2) method and IVH volumes were calculated using a published method of hand drawn regions of interest (ROI) Results We identified 73 patients with a mean age of 63 yo and median NIHSS 11.5. The mean baseline total HV was 25.8ml ± 23.2ml. There was an absolute Δvol from pre and posttreatment CT of −4.3ml ± 11.0ml. Two patients developed hematoma growth. Repeat analysis of patients given pharmacological DVT prophylaxis within 2 or 4 days after ICH found no increase in hematoma size. Conclusion Pharmacological DVT prophylaxis given SQ in patients with ICH and/or IVH in the subacute period is generally not associated with hematoma growth.