The role of computed tomography in evaluation of the acute ischemic stroke

Vojinović, Radiša; Opančina, Valentina

doi:10.5937/mckg50-13426

Cited by 3 publications

(6 citation statements)

References 32 publications

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“…Generally, stroke can be divided into two major categories: ischaemic stroke and haemorrhagic stroke. Of the two, ischaemic stroke accounts for about 80% of all strokes (Vojinovic & Opancina, 2016). Up to now, the major clinical approaches for the treatment of ischaemic stroke can be divided into two types: ‐ recanalization and neuroprotection (Liberale et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Aberrant branched‐chain amino acid accumulation along the microbiota–gut–brain axis: Crucial targets affecting the occurrence and treatment of ischaemic stroke

Shen

Guo

Liu

et al. 2022

British J Pharmacology

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Background and Purpose Although increasing evidence illustrated that the bidirectional communication between the brain and the gut is closely related to the occurrence of various complex diseases. Limited effort has been made to explore the influence of intestinal flora on the risk of ischaemic stroke. The present study aims to identify microbiota and specialized microbiota metabolites related to the occurrence and treatment of ischaemic stroke. Experimental Approach The role of microbiota in the occurrence and the treatment of ischaemic stroke was evaluated on ischaemia/reperfusion (I/R), pseudo‐germ‐free and faecal transplantation animals. The target microbiota and specialized metabolites were identified by comparing their distribution in flora and metabolomic profiles in ischaemic stroke patients and animals with compared with healthy controls. The effects and mechanisms involved of the targeted metabolites in ischaemic stroke were explored in ischaemia/reperfusion rats, hypoxia/reoxygenation PC12 cells and LPS‐induced inflammatory BV2 cells. Key Results Both ischaemic stroke patients and I/R rats had significant accumulation of branched‐chain amino acids, which were closely associated with gut microflora dysbiosis and the development of ischaemic stroke. Lactobacillus helveticus (L.hel) and Lactobacillus brevis (L.bre) are identified as the microbiota most affected by ischaemia/reperfusion modelling and treatment. L.hel and L.bre colonization exhibited significant neuroprotective activity and could greatly alleviate the accumulation of branched‐chain amino acids. In addition, branched‐chain amino acid (BCAA) accumulation was shown to exacerbate microglia‐induced neuroinflammation by activating AKT/STAT3/NF‐κB signalling. Conclusion and Implications Our findings demonstrated the crucial role of intestinal flora and microbiota metabolites in the occurrence and treatment of ischaemic stroke.

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Section: Introductionmentioning

confidence: 99%

Aberrant branched‐chain amino acid accumulation along the microbiota–gut–brain axis: Crucial targets affecting the occurrence and treatment of ischaemic stroke

Shen

Guo

Liu

et al. 2022

British J Pharmacology

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“…Non-contrast computed tomography (NCCT) is a valuable tool for evaluating the initial stages of ischemic strokes. The presence of cytotoxic edema, thrombosis and cellular hypoperfusion during an ischemic event leads to observable signs on a CT scan [13][14][15][16][17][18]. These early signs are crucial for excluding intracranial hemorrhage, which is an absolute contraindication for thrombolytic therapy [14].…”

Section: Acute Ischemic Strokementioning

confidence: 99%

“…These early signs are crucial for excluding intracranial hemorrhage, which is an absolute contraindication for thrombolytic therapy [14]. The most commonly seen signs include focal hypodensity, hyperdense arteries, cortical effacement, the insular ribbon sign and the obscuration of the basal ganglia [13].…”

Section: Acute Ischemic Strokementioning

confidence: 99%

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Neuroimaging Modalities Used for Ischemic Stroke Diagnosis and Monitoring

Nukovic,

Opancina,

Ciceri

et al. 2023

Medicina

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Strokes are one of the global leading causes of physical or mental impairment and fatality, classified into hemorrhagic and ischemic strokes. Ischemic strokes happen when a thrombus blocks or plugs an artery and interrupts or reduces blood supply to the brain tissue. Deciding on the imaging modality which will be used for stroke detection depends on the expertise and availability of staff and the infrastructure of hospitals. Magnetic resonance imaging provides valuable information, and its sensitivity for smaller infarcts is greater, while computed tomography is more extensively used, since it can promptly exclude acute cerebral hemorrhages and is more favorable speed-wise. The aim of this article was to give information about the neuroimaging modalities used for the diagnosis and monitoring of ischemic strokes. We reviewed the available literature and presented the use of computed tomography, CT angiography, CT perfusion, magnetic resonance imaging, MR angiography and MR perfusion for the detection of ischemic strokes and their monitoring in different phases of stroke development.

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“…Within 3-6 h after the onset of infarction, CT early low-density changes (insular ribbon signs, obscuration of the lentiform nucleus) exceeded 50.0% of the area supplied by the MCA, with 61.0% sensitivity and 94.0% specificity in predicting massive infarction. The earlier the CT examination is performed, the higher specificity and the lower sensitivity of its findings (13)(14)(15)(16). In addition, obscuration of the lentiform nucleus appears within 4-6 h, and the HMCAS appears within 30 min of onset; these findings have a specificity of 85.0%−100.0% (12,17,18).…”

Section: Test Of the Nomogram Prediction Modelmentioning

confidence: 99%

Prediction model of early biomarkers of massive cerebral infarction caused by anterior circulation occlusion: Establishment and evaluation

Chen

et al. 2022

Front. Neurol.

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ObjectiveThe purpose of this study is to establish and evaluate an early biomarker prediction model of massive cerebral infarction caused by anterior circulation occlusion.MethodsOne hundred thirty-four patients with acute cerebral infarction from January 2018 to October 2020 were selected to establish the development cohort for the internal test of the nomogram. Ninety-one patients with acute cerebral infarction hospitalized in our hospital from December 2020 to December 2021 were constituted the validation cohort for the external validation. All patients underwent baseline computed tomography (CT) scans within 12 h of onset and early imaging signs (hyperdense middle cerebral artery sign, obscuration of the lentiform nucleus, insular ribbon sign) of acute cerebral infarction were identified on CT by two neurologists. Based on follow-up CT images, patients were then divided into a massive cerebral infarction group and a non-massive cerebral infarction group. The nomogram model was constructed based on logistic regression analysis with R language. The nomogram was subsequently validated in an independent external validation cohort. Accuracy and discrimination of the prediction model were evaluated by a calibration chart, receiver operating characteristic (ROC) curve, and decision curve.ResultsThe indicators, including insular ribbon sign, reperfusion therapy, National Institutes of Health Stroke Scale (NHISS) score, previous cerebral infarction, and atrial fibrillation, were entered into the prediction model through binary logistic regression analysis. The prediction model showed good predictive ability. The area under the ROC curve of the prediction model was 0.848. The specificity, sensitivity, and Youden index were 0.864, 0.733, and 0.597, respectively. This nomogram to the validation cohort also showed good discrimination (AUC = 0.940, 95% CI 0.894–0.985) and calibration.ConclusionDemonstrating favorable predictive efficacy and reproducibility, this study successfully established a prediction model of CT imaging signs and clinical data as early biomarkers of massive cerebral infarction caused by anterior circulation occlusion.

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The role of computed tomography in evaluation of the acute ischemic stroke

Cited by 3 publications

References 32 publications

Aberrant branched‐chain amino acid accumulation along the microbiota–gut–brain axis: Crucial targets affecting the occurrence and treatment of ischaemic stroke

Aberrant branched‐chain amino acid accumulation along the microbiota–gut–brain axis: Crucial targets affecting the occurrence and treatment of ischaemic stroke

Neuroimaging Modalities Used for Ischemic Stroke Diagnosis and Monitoring

Prediction model of early biomarkers of massive cerebral infarction caused by anterior circulation occlusion: Establishment and evaluation

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