Background: The rapid evaluation of non-contrast-enhanced computed tomography (NCCT) brain scans in patients with anterior stroke symptoms saves time and favors optimal and prompt treatment. e-ASPECTS is a tool that automatically calculates the Alberta Stroke Program Early CT Score (ASPECTS) values, leading to a more accurate and timely image evaluation. Objective: To determine the ability of e-ASPECTS in differentiating images with and without injury. Methods: One-hundred sixteen patients admitted to a stroke unit in a Brazilian tertiary hospital underwent a CT scan at admission and at least one control brain imaging (NCCT or magnetic resonance imaging - MRI) 24 hours after admission. ASPECTS evaluation was performed by three neuroradiologists, three neurologists, and three neurology residents, all blinded to the symptoms and the injury side. The scores were compared to the ground truth, and an ASPECTS score was provided by two independent non blinded evaluators. Sensitivity and specificity were analyzed, and receiver operating characteristic curves, Bland-Altman plots with mean error score, and Matthews correlation coefficients (MCCs) were obtained for ASPECTS scores, assuming values equal to 10 for images without injury and values other than 10 for images with ischemic injury. Results: e-ASPECTS demonstrated similar performance to that of neuroradiologists and neurologists, with an area under the curve of 0.78 and an MCC value of 0.48 in the dichotomous analysis. The sensitivity and specificity of e-ASPECTS were 75% and 73%, respectively. Conclusion: e-ASPECTS is a validated and reliable tool for determining early signs of ischemia in NCCT.

Background and Purpose: Precise evaluation of brain computerized tomography (CT) is a crucial step in acute ischemic stroke evaluation. Electronic Alberta Stroke Program Early CT Score (E-ASPECTS) helps in the selection of patients who may be eligible for thrombolysis. This paper seeks to assess the performance of emergency physicians (EPs) in the evaluation of ASPECTS scores with and without the use of E-ASPECTS and to compare their results with neuroradiologists.Methods: A total of 116 patients were selected. Initially, two EPs and two neuroradiologists evaluated the admission nonenhanced CT without E-ASPECTS. Then, after 30 days, they re-evaluated the images using E-ASPECTS. Sensitivity, specificity, Matthew's correlation coefficients (MCC), and receiver operating characteristic curves were generated for analysis before and after the software use.Results: Eps' performances improved when they used E-ASPECTS, with their results closer to those obtained by neuroradiologists. In the initial evaluation, MCC values for the two EPs were -0.01 and 0.04, respectively. After the software assistance, they obtained 0.38 and 0.43, respectively, which was closer to the scores obtained by the neuroradiologists (0.53 and 0.39, respectively).Discussion: This is the first study that has specifically compared neuroradiologists' and EPs' performances before and after using E-ASPECTS. E-ASPECTS assisted and improved the evaluation of the images of patients with acute ischemic stroke. Conclusion:Artificial intelligence in the emergency room may increase the number of patients treated with tissue-type plasminogen activators.

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Introdução Migrânea tem alta prevalência, incapacitante, periódica e acomete várias gerações em uma mesma família. Além das dores de cabeça, são prevalentes dores no pescoço e os pontos-gatilho associados. Objetivo Tratar os indivíduos com migrânea crônica e cervicalgia, através da técnica de liberação miofascial Fascial Manipulation (FM). Verificar a possibilidade em diminuir a frequência, duração e intensidade de dores de cabeça após a realização da terapia manual e a quantidade de consumo de analgésico após o tratamento. Método Estudo natural em ensaio clínico experimental, analítico - projeto piloto (n-36) em abordagem terapêutica no tratamento intervencionista da (FM) em voluntários. Randomizado, com três grupos (grupo tratamento com a técnica mais medicação preventiva, grupo massagem placebo mais medicação preventiva e grupo controle somente medicação preventiva). Optou-se pela padronização dos medicamentos, o fármaco succinato de sumatriptana (50 mg) mais naproxeno sódico (500 mg) e o topiramato com dose de ascensão, única e diária de 25mg, elevando-se para 100mg em duas doses dia, ou maior dose tolerável.  Longitudinal com avaliação independente e reavaliações com algometria. A inclusão é através do diagnóstico dado pelo neurologista, que selecionam voluntários conforme a classificação internacional das cefaleias da IHS 2018. Os desfechos primários serão reduzir as dores de cabeça através da diminuição da percepção da intensidade, frequência e duração da dor pelo diário de cefaleia, ficha (VAS) e ficha de controle de fármacos. Redução das dores cervicais miofasciais, pelo questionário Brasil-nbq e algometria de músculos e nervos por algômetro digital sueco Somedic Sales AB. Melhora na qualidade de vida pelo questionário Whoqol-bref, melhora do impacto na incapacidade pela migrânea pelo questionário MIDAS. Melhora do apertamento dentário (noturno e diurno) por inventário. Melhora das amplitudes de movimentos das articulações altas da coluna cervical pela avaliação de fleximetria (flexion rotation test). Resultados e Conclusões Estudo em andamento até o momento.