Background and Purpose— As a reliable scoring system to detect the risk of symptomatic intracerebral hemorrhage after thrombectomy for ischemic stroke is not yet available, we developed a nomogram for predicting symptomatic intracerebral hemorrhage in patients with large vessel occlusion in the anterior circulation who received bridging of thrombectomy with intravenous thrombolysis (training set), and to validate the model by using a cohort of patients treated with direct thrombectomy (test set). Methods— We conducted a cohort study on prospectively collected data from 3714 patients enrolled in the IER (Italian Registry of Endovascular Stroke Treatment in Acute Stroke). Symptomatic intracerebral hemorrhage was defined as any type of intracerebral hemorrhage with increase of ≥4 National Institutes of Health Stroke Scale score points from baseline ≤24 hours or death. Based on multivariate logistic models, the nomogram was generated. We assessed the discriminative performance by using the area under the receiver operating characteristic curve. Results— National Institutes of Health Stroke Scale score, onset-to-end procedure time, age, unsuccessful recanalization, and Careggi collateral score composed the IER-SICH nomogram. After removing Careggi collateral score from the first model, a second model including Alberta Stroke Program Early CT Score was developed. The area under the receiver operating characteristic curve of the IER-SICH nomogram was 0.778 in the training set (n=492) and 0.709 in the test set (n=399). The area under the receiver operating characteristic curve of the second model was 0.733 in the training set (n=988) and 0.685 in the test set (n=779). Conclusions— The IER-SICH nomogram is the first model developed and validated for predicting symptomatic intracerebral hemorrhage after thrombectomy. It may provide indications on early identification of patients for more or less postprocedural intensive management.

Asterixis is not yet considered a common neurological sign of cerebellum infarction, and the pathogenic mechanism for asterixis remains elusive. We report a 58-year-old male with moderate hypertension who presented to our emergency department for acute headache in both cervical and occipital regions of the left side. About 2 hours later the patient developed ipsilateral asterixis in the upper left limb; 3 days later the asterixis disappeared. Magnetic resonance imaging of the brain disclosed cerebellar infarctions at the left superior cerebellar artery. In conclusion, we observed that a transitory asterixis associated with ipsilateral headache can be an initial clinical manifestation of ipsilateral cerebellar infarctions in the superior cerebellar artery area.

Purpose Intracranial carotid artery occlusion represents an underinvestigated cause of acute ischemic stroke as well as an indication for mechanical thrombectomy. We investigated baseline and procedural characteristics, outcomes and predictors of outcome in patients with acute ischemic stroke secondary to intracranial carotid artery occlusion. Methods A retrospective analysis of the Italian Registry of Endovascular Treatment in Acute Stroke was performed. Patients with intracranial carotid artery occlusion (infraclinoid and supraclinoid) with or without cervical artery occlusion but with patent intracranial arteries were included. The 3-month functional independence, mortality, successful reperfusion and symptomatic intracranial hemorrhage were evaluated. Results Intracranial carotid artery occlusion with patent intracranial arteries was diagnosed in 387 out of 4940 (7.8%) patients. The median age was 74 years and median baseline National Institute of Health Stroke Scale (NIHSS) was 18. Functional independence was achieved in 130 (34%) patients, successful reperfusion in 289 (75%) and symptomatic intracranial hemorrhage in 33 (9%), whereas mortality occurred in 111 (29%) patients. In univariate analysis functional independence was associated with lower age, lower NIHSS at presentation, higher rate of successful reperfusion and lower rate of symptomatic intracranial hemorrhage. Multivariable regression analysis found age (odds ratio, OR:1.03; P = 0.006), NIHSS at presentation (OR: 1.07; P < 0.001), diabetes (OR: 2.60; P = 0.002), successful reperfusion (OR:0.20; P < 0.001) and symptomatic intracranial hemorrhage (OR: 4.17; P < 0.001) as the best independent predictors of outcome. Conclusion Our study showed a not negligible rate of intracranial carotid artery occlusion with patent intracranial arteries, presenting mostly as severe stroke, with an acceptable rate of 3-month functional independence. Age, NIHSS at presentation and successful reperfusion were the best independent predictors of outcome. Keywords Circle of Willis • Large vessel occlusion • Stroke severity • Endovascular treatment • OutcomeAvailability of data and material Data supporting the findings of this study are available upon reasonable request

A robust methodology for mobile robot localisation, or relocation, is described, making use of airborne sonar. A linear array of three sequentially fired ultrasonic transducers is proposed for perfarming a full scan of the environment, whose map is assumed to be a priori given. A geometric approach to relocation is adopted: the segmentation algorithm is based on an Extended Kalman Filter for estimating the geometrical parameters of different targets and related uncertainty. The features characterised by minimal geometrical uncertainty are used by the matching algorithm to pelform a least squares search for the displacement and rotation that best take the sensor-based map into coincidence with the apriori reference map. A few heuristics are provided to enhance data robustness. An effective pruning strategy finally leads to solutions of the relocation problem with subcentimeterpositional accuracies andorientational accuracies within one degree. 1: IntroductionLocalisation is one of the fundamental skills required for a robot to autonomously navigate in its working environment. Different approaches have been proposed to address this paramount question: "Where am I?'. The procedure of structuring the environment with active beacons or passive markers as in commercially available Automated Guidance Vehicles (AGVs) aside, a widely used method consists of exploiting information from proprioceptive sensors to deduce the time history of all the previous movements. These deadreckoning systems, be they odometric or inertial guidance systems, are subjected to several sources of errors growing unbounded over time, unless the robot's configuration is fixed at appropriate times by matching readings from exteroceptive sensors to a known model of the outside world.Several sensing techniques have been used for determining the spatial relationships of arobot to its environment, ultrasonic [I], visual [2], infrared [3], laser-based [4]. Albeit the fusion of odometric data with information from other sensing modalities may result into cost-effective andreliable methods for short-term navigation in an indoor environment [5], it may be sometimes necessary that the localisation process starts from scratch.Relocation is intended henceforth as the ability of a mobile robot to fuc its configuration independently of any assumption about previous movements [6], and in the absence of any a priori information related to its current position. Therefore, we are not interested in this paper in dealing with the problem of integrating proprioceptive sensor data with exteroceptive sensor data. The extraction of information about navigation beacons naturally occurring in the environment is obtained by asimple active sensing technique; relocation results frommatching those features to someapriori given navigation maps.In spite of their shortcomings, we demonstrate in this paper that airbome ultrasonic (US) transducers are inexpensive and quite accurate source of information for successfully attacking the relocation problem, as previously stated. In-ai...

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