Differentiating intraparenchymal hemorrhage from contrast extravasation on post-procedural noncontrast CT scan in acute ischemic stroke patients undergoing endovascular treatment

Payabvash, Seyedmehdi; Qureshi, Mushtaq; Khan, Shayaan; Khan, Muhammad Taimoor; Majidi, Shahram; Pawar, Swaroop; Qureshi, Adnan I

doi:10.1007/s00234-014-1381-8

Cited by 71 publications

(65 citation statements)

References 20 publications

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“…Hyperdense phenomena without mass effect on CT that disappeared or weakened significantly within 24 hours of endovascular treatment were deemed as contrast extravasation 20. ICH was diagnosed and classified as SICH or aSICH following the Heidelberg Bleeding Classification (f igure 1 and online supplementary material) 11…”

Section: Methodsmentioning

confidence: 99%

Prognosis of asymptomatic intracranial hemorrhage after endovascular treatment

Hao

Liu

Wang

et al. 2018

J NeuroIntervent Surg

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Section: Methodsmentioning

confidence: 99%

Prognosis of asymptomatic intracranial hemorrhage after endovascular treatment

Hao

Liu

Wang

et al. 2018

J NeuroIntervent Surg

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“…11,12 All patients who (1) had unilateral M1 segment occlusion, (2) underwent endovascular treatment and (3) had follow-up MRI or CT scan from 48 h to 7 days after symptom onset were included in this study. Patients were excluded if they had (1) simultaneous occlusion of internal cerebral artery (ICA) or anterior cerebral artery; (2) developed post-procedural intraparenchymal haematoma on follow-up CT/MRI scans; or (3) had a prior or follow-up stroke within 3 months of the endovascular treatment.…”

Section: Methods and Materials Patientsmentioning

confidence: 99%

“…11,12 All patients who were eligible for receiving i.v. rt-PA, as per thencurrent treatment guideline, received i.v.…”

Section: Treatment and Angiographic Recanalization Assessmentmentioning

confidence: 99%

“…For endovascular treatment, patients received intra-arterial thrombolytic and/or underwent thrombectomy. 11,12 The recanalization success was assessed using the modified thrombolysis in cerebral infarction (mTICI) scoring system. 15 Successful recanalization was defined by achieving mTICI 2b (perfusion with .50% distal branch filling) or mTICI 3 (perfusion with filling in all distal branches).…”

Section: Treatment and Angiographic Recanalization Assessmentmentioning

confidence: 99%

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Cerebral regions preserved by successful endovascular recanalization of acute M1 segment occlusions: a voxel based analysis

Payabvash

Taleb

Qureshi

2017

BJR

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Objective: To identify cerebral regions preserved by successful recanalization of the middle cerebral artery M1 segment and their association with early clinical outcome. Methods: 47 patients who underwent endovascular treatment for acute unilateral M1 segment occlusion were included. Successful recanalization was defined by a modified thrombolysis in cerebral infarction score of 2b/3. Final infarct volumes were segmented on follow-up MRI/ CT, 2-7 days post-symptom onset. The differences in topography of infarct lesions associated with successful vs unsuccessful recanalization were assessed using voxelbased analysis. Favourable outcome was defined by a modified Rankin Scale score #2 at discharge, and disability/death by score .2. Results: Successful recanalization of M1 segment occlusion was achieved in 26/47 (55%) patients, which was associated with higher rate of favourable outcome (54% vs 9%, p 5 0.002) and smaller final infarct volumes (34.3 6 43.7 vs 98.1 6 47.7 ml, p , 0.001). In voxel-based analysis, patients with successful recanalization had a lower rate of infarction in precentral gyrus and posterior insular ribbon compared with those without recanalization. Favourable outcome was achieved in 16 (34%) patients, who were younger (62.2 6 13.9 vs 70.9 6 13.9, p 5 0.048), had higher rate of successful recanalization (88% vs 39%, p 5 0.002) and had smaller infarct volumes (25.2 6 23.6 vs 82.2 6 57.1 ml, p , 0.001) compared with those with disability/death. In voxel-based analysis, infarction of the insula, precentral gyrus, middle centrum semiovale and corona radiata were associated with disability/death. Conclusion: Successful endovascular recanalization of acute M1 segment occlusion tends to preserve posterior insular ribbon and precentral gyrus from infarction; and infarction of these regions was associated with higher rates of disability/death. Advances in knowledge: The knowledge of the topographic location of potentially salvageable cerebral tissue can provide additional information for treatment triage and selection of patients with acute stroke for endovascular treatment based on the "areas at risk" rather than the "volume at risk". Also, such knowledge can help with preferential recanalization, where the neurointerventionalist may choose to preferentially recanalize certain branches supplying salvageable and eloquent cerebral regions in favour of timely reperfusion treatment.

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“…One of the main techniques that is used to diagnose the clot is the brain computed tomography scan, or brain CT scan, which is a test that uses x rays to take clear, detailed pictures of the patient brain [3,4]. CT scan is mainly done immediately after stroke is suspected.…”

Section: Introductionmentioning

confidence: 99%

Classification of Ischemic Stroke using Machine Learning Algorithms

Adam¹,

Yousif²,

Bashir³

2016

IJCA

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Stroke is the third leading cause of death following diseases of heart and cancer. The majority of strokes are classified as ischemic which have two types: thrombotic and embolic. In thrombotic stroke, the blood clot (thrombus) forms in one of the arteries that supplies blood to brain. The embolic stroke happens when a blood clot that forms somewhere else in the body (embolus) break loose and travels to the brain through the bloodstream. Hemorrhagic stroke is considered another type of brain stroke by some researchers as it happen when an artery in the brain leaks blood or ruptures. As a reason of hemorrhagic stroke, the brain cells damages as result of the pressure from the leaked blood. There are many similarities between these types and it is difficult to classify the cases accurately using medical procedures. Furthermore, there are no clear boundaries between these types. This paper reviewed and analyzed the current studies on classification of ischemic stroke. Furthermore, the study has developed a classification model for ischemic stroke using decision tree algorithm and k nearest neighbor. The classification model is based on a dataset of 400 cases collected from different Sudanese hospitals. The results of the decision tree algorithm can be used by medical specialist to classify and diagnose ischemic stroke patients. Moreover, the study revealed that some features can be used directly to determine the type of ischemic stroke. These results help the medical doctors in the classification process of ischemic strokes. Furthermore, the results found that most of the ischemic stroke cases in Sudan are thrombotic ischemic stroke.

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Differentiating intraparenchymal hemorrhage from contrast extravasation on post-procedural noncontrast CT scan in acute ischemic stroke patients undergoing endovascular treatment

Abstract: An average attenuation <50 HU of the most hyperattenuating hyperdense parenchymal lesion on immediate post-procedural CT scan was very specific for differentiating contrast extravasation from intraparenchymal hemorrhage in acute ischemic stroke patients after endovascular treatment.

Cited by 71 publications

References 20 publications

Prognosis of asymptomatic intracranial hemorrhage after endovascular treatment

Prognosis of asymptomatic intracranial hemorrhage after endovascular treatment

Cerebral regions preserved by successful endovascular recanalization of acute M1 segment occlusions: a voxel based analysis

Classification of Ischemic Stroke using Machine Learning Algorithms

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