Role of Computed Tomography Perfusion in Identification of Acute Lacunar Stroke Syndromes.

Abstract:

BACKGROUND AND PURPOSE:Lacunar syndromes correlate with a lacunar stroke on imaging in 50% to 60% of cases. Computed tomography perfusion (CTP) is becoming the preferred imaging modality for acute stroke triage. We aimed to estimate the sensitivity, specificity, and predictive values for noncontrast computed tomography and CTP in lacunar syndromes, and for cortical, subcortical, and posterior fossa regions. METHODS:A retrospective analysis of confirmed ischemic stroke patients who underwent acute CTP and follow-up magnetic resonance imaging between 2010 and 2018 was performed. Brain noncontrast computed tomography and CTP were assessed independently by 2 stroke neurologists. Receiver operating characteristic curve analysis was performed to estimate sensitivity, specificity, and area under the curve (AUC) for the detection of strokes in patients with lacunar syndromes using different CTP maps. RESULTS:We found 106 clinical lacunar syndromes, but on diffusion-weighted imaging, these consisted of 59 lacunar, 33 cortical, and 14 posterior fossa strokes. The discrimination of ischemia identification was very poor using noncontrast computed tomography in all 3 regions, but good for cortical (AUC, 0.82) and poor for subcortical and posterior regions (AUCs, 0.55 and 0.66) using automated core-penumbra maps. The addition of delay time and mean transient time maps substantially increased subcortical (AUC, 0.80) and slightly posterior stroke detection (AUC, 0.69). CONCLUSIONS:Analysis of mean transient time and delay time maps in combination with core-penumbra maps improves detection of subcortical and posterior strokes.

journal_name

Stroke

journal_title

Stroke

authors

Garcia-Esperon C,Visser M,Churilov L,Miteff F,Bivard A,Lillicrap T,Levi CR,Spratt NJ,Parsons MW

doi

10.1161/STROKEAHA.120.030455

subject

Has Abstract

pub_date

2021-01-01 00:00:00

pages

339-343

issue

1

eissn

0039-2499

issn

1524-4628

journal_volume

52

pub_type

杂志文章

相关文献

STROKE文献大全
  • Risk factors, clinical presentation, and neuroimaging findings of neonatal perforator stroke.

    abstract:BACKGROUND AND PURPOSE:To date, studies on neonatal stroke have mainly focused on cortical stroke. We have focused on perforator strokes, noncortical strokes in the arterial vascular perforator area. We sought to identify risk factors and evaluate clinical presentation and neuroimaging findings for neonatal perforator ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.113.001064

    authors: Ecury-Goossen GM,Raets MM,Lequin M,Feijen-Roon M,Govaert P,Dudink J

    更新日期:2013-08-01 00:00:00

  • Vertebrobasilar stenosis predicts high early recurrent stroke risk in posterior circulation stroke and TIA.

    abstract:BACKGROUND AND PURPOSE:20% of ischemic stroke is in the posterior circulation, but there is little prospective data on early recurrent stroke risk and whether vertebrobasilar stenosis predicts a high recurrence risk. This natural history data are important as it is technically possible to stent such lesions. Contrast e...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.109.553859

    authors: Gulli G,Khan S,Markus HS

    更新日期:2009-08-01 00:00:00

  • Association of apolipoprotein E polymorphism with outcome after aneurysmal subarachnoid hemorrhage: a preliminary study.

    abstract:BACKGROUND AND PURPOSE:Variation in the outcome after aneurysmal subarachnoid hemorrhage (SAH) is not fully explained by known prognostic factors. APOE genotype is the most important genetic determinant of susceptibility to Alzheimer's disease, and it is also shown to be associated with the outcome after traumatic brai...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.32.5.1181

    authors: Niskakangas T,Ohman J,Niemelä M,Ilveskoski E,Kunnas TA,Karhunen PJ

    更新日期:2001-05-01 00:00:00

  • Preexisting Heart Disease Underlies Newly Diagnosed Atrial Fibrillation After Acute Ischemic Stroke.

    abstract:BACKGROUND AND PURPOSE:Whether newly diagnosed atrial fibrillation (nAF) after stroke reflects underlying heart disease and represents an increased risk of cardioembolic stroke, or whether it is triggered by neurogenic mechanisms remains uncertain. We investigated, whether cardiovascular risk factors and echocardiograp...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.115.011465

    authors: Rizos T,Horstmann S,Dittgen F,Täger T,Jenetzky E,Heuschmann P,Veltkamp R

    更新日期:2016-02-01 00:00:00

  • Preliminary findings of external counterpulsation for ischemic stroke patient with large artery occlusive disease.

    abstract:BACKGROUND AND PURPOSE:We aimed to investigate the feasibility and therapeutic effect of external counterpulsation (ECP) in ischemic stroke. METHODS:The trial was a randomized, crossover, assessment-blinded, proof-of-concept trial. ECP treatment consisted of 35 daily 1-hour sessions. Patients were randomized to either...

    journal_title:Stroke

    pub_type: 杂志文章,随机对照试验

    doi:10.1161/STROKEAHA.107.500132

    authors: Han JH,Leung TW,Lam WW,Soo YO,Alexandrov AW,Mok V,Leung YF,Lo R,Wong KS

    更新日期:2008-04-01 00:00:00

  • Stroke Incidence and Outcomes in Northeastern Greece: The Evros Stroke Registry.

    abstract:BACKGROUND AND PURPOSE:Data are scarce on both stroke incidence rates and outcomes in Greece and in rural areas in particular. We performed a prospective population-based study evaluating the incidence of first-ever stroke in the Evros prefecture, a region of a total 147 947 residents located in North Eastern Greece. ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.117.019524

    authors: Tsivgoulis G,Patousi A,Pikilidou M,Birbilis T,Katsanos AH,Mantatzis M,Asimis A,Papanas N,Skendros P,Terzoudi A,Karamanli A,Kouroumichakis I,Zebekakis P,Maltezos E,Piperidou C,Vadikolias K,Heliopoulos I

    更新日期:2018-02-01 00:00:00

  • PROACT: a phase II randomized trial of recombinant pro-urokinase by direct arterial delivery in acute middle cerebral artery stroke. PROACT Investigators. Prolyse in Acute Cerebral Thromboembolism.

    abstract:BACKGROUND AND PURPOSE:To test the safety and recanalization efficacy of intra-arterial local delivery of plasminogen activators in acute ischemic stroke, a randomized trial of recombinant pro-urokinase (rpro-UK) versus placebo was undertaken in patients with angiographically documented proximal middle cerebral artery ...

    journal_title:Stroke

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1161/01.str.29.1.4

    authors: del Zoppo GJ,Higashida RT,Furlan AJ,Pessin MS,Rowley HA,Gent M

    更新日期:1998-01-01 00:00:00

  • Cerebral mast cells mediate blood-brain barrier disruption in acute experimental ischemic stroke through perivascular gelatinase activation.

    abstract:BACKGROUND AND PURPOSE:Perivascularly positioned cerebral mast cells (MC) have been shown to participate in acute blood-brain barrier disruption and expansive brain edema following experimental transient cerebral ischemia. However, the underlying molecular mechanisms remain unknown. Because proteolytic gelatinase enzym...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.111.632224

    authors: Mattila OS,Strbian D,Saksi J,Pikkarainen TO,Rantanen V,Tatlisumak T,Lindsberg PJ

    更新日期:2011-12-01 00:00:00

  • Thrombolysis in stroke mimics: frequency, clinical characteristics, and outcome.

    abstract:BACKGROUND AND PURPOSE:Intravenous thrombolysis for acute ischemic stroke is usually based on clinical assessment, blood test results, and CT findings. Intravenous thrombolysis of stroke mimics may occur but has not been studied in detail. METHODS:We determined frequency, clinical characteristics, and outcome of mimic...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.108.530352

    authors: Winkler DT,Fluri F,Fuhr P,Wetzel SG,Lyrer PA,Ruegg S,Engelter ST

    更新日期:2009-04-01 00:00:00

  • Hypertensive encephalopathy after bilateral carotid endarterectomy.

    abstract:BACKGROUND:Hypertension occurs frequently after carotid endarterectomy and may lead to cerebral vascular complications and myocardial infarction. Its pathophysiology has recently been related to surgically induced damage of carotid baroreceptors. CASE DESCRIPTION:A 45-year-old normotensive man with no history of epile...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.26.3.488

    authors: Ille O,Woimant F,Pruna A,Corabianu O,Idatte JM,Haguenau M

    更新日期:1995-03-01 00:00:00

  • Declining Incidence of Ischemic Stroke: What Is the Impact of Changing Risk Factors? The Tromsø Study 1995 to 2012.

    abstract:BACKGROUND AND PURPOSE:It is proposed that 20% to 40% of the decline in first-ever stroke incidence is attributed to the improvement of risk factor control. We estimated the impact of modifiable cardiovascular risk factors on the changing incidence of ischemic stroke (IS) between 1995 and 2012, using individual person ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.116.014377

    authors: Vangen-Lønne AM,Wilsgaard T,Johnsen SH,Løchen ML,Njølstad I,Mathiesen EB

    更新日期:2017-03-01 00:00:00

  • The relevance of in vitro smooth muscle experiments to cerebral vasospasm.

    abstract::An overview of the possible factors that might contribute to the development of cerebral vasospasm is presented, with particular emphasis on the possibility that spasm arises from a malfunction of the regulatory or contractile processes in smooth muscle cells. This possibility is emphasized because the evidence for ce...

    journal_title:Stroke

    pub_type: 杂志文章,评审

    doi:10.1161/01.str.16.4.573

    authors: Wellum GR,Peterson JW,Zervas NT

    更新日期:1985-07-01 00:00:00

  • Autonomic Dysfunction Predicts Clinical Outcomes After Acute Ischemic Stroke: A Prospective Observational Study.

    abstract:BACKGROUND AND PURPOSE:Central autonomic dysfunction increases stroke morbidity and mortality. We aimed to investigate whether poststroke autonomic dysfunction graded by Ewing battery can predict clinical outcome. METHODS:In this prospective observational study, we assessed autonomic function of ischemic stroke patien...

    journal_title:Stroke

    pub_type: 临床试验,杂志文章

    doi:10.1161/STROKEAHA.117.019312

    authors: Xiong L,Tian G,Leung H,Soo YOY,Chen X,Ip VHL,Mok VCT,Chu WCW,Wong KS,Leung TWH

    更新日期:2018-01-01 00:00:00

  • Etiologic Workup in Cases of Cryptogenic Stroke: A Systematic Review of International Clinical Practice Guidelines.

    abstract::Background and Purpose- Identifying the etiology of acute ischemic stroke is essential for effective secondary prevention. However, in at least one third of ischemic strokes, existing investigative protocols fail to determine the underlying cause. Establishing etiology is complicated by variation in clinical practice,...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.119.027123

    authors: McMahon NE,Bangee M,Benedetto V,Bray EP,Georgiou RF,Gibson JME,Lane DA,Al-Khalidi AH,Chatterjee K,Chauhan U,Clegg AJ,Lightbody CE,Lip GYH,Sekhar A,Watkins CL

    更新日期:2020-05-01 00:00:00

  • Monitoring of cerebral autoregulation in head-injured patients.

    abstract:BACKGROUND AND PURPOSE:Disturbed cerebral autoregulation has been reported to correlate with an unfavorable outcome after head injury. Using transcranial Doppler ultrasonography, we investigated whether hemodynamic responses to spontaneous variations of cerebral perfusion pressure (CPP) provide reliable information on ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.27.10.1829

    authors: Czosnyka M,Smielewski P,Kirkpatrick P,Menon DK,Pickard JD

    更新日期:1996-10-01 00:00:00

  • Stroke unit care and outcome: results from the 2001 National Sentinel Audit of Stroke (England, Wales, and Northern Ireland).

    abstract:BACKGROUND AND PURPOSE:Stroke unit care is one of the most powerful interventions available to help stroke patients. There are limited data available to assess the impact of stroke units in routine clinical practice outside randomized clinical trials. This article uses data from the 2001 to 2002 National Stroke Audit t...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.STR.0000149618.14922.8a

    authors: Rudd AG,Hoffman A,Irwin P,Lowe D,Pearson MG

    更新日期:2005-01-01 00:00:00

  • Comparison of transcranial Doppler ultrasonography and transesophageal echocardiography to monitor emboli during coronary artery bypass surgery.

    abstract:BACKGROUND AND PURPOSE:Transcranial Doppler ultrasonography (TCD) is the standard technique for monitoring emboli in the cerebral circulation. Embolic signals have been detected with the use of this technique in most patients undergoing coronary artery bypass surgery. We previously reported that the majority of emboli ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.27.1.87

    authors: Barbut D,Yao FS,Hager DN,Kavanaugh P,Trifiletti RR,Gold JP

    更新日期:1996-01-01 00:00:00

  • Population-Based Study of Cerebral Microbleeds in Stroke-Free Older Adults Living in Rural Ecuador: The Atahualpa Project.

    abstract:BACKGROUND AND PURPOSE:Prevalence of cerebral microbleeds (CMB) in white and Asian populations range from 4% to 15%. However, there is no information from indigenous Latin American people. We aimed to assess prevalence and cerebrovascular correlates of CMB in stroke-free older adults living in rural Ecuador. METHODS:O...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.115.009594

    authors: Del Brutto VJ,Zambrano M,Mera RM,Del Brutto OH

    更新日期:2015-07-01 00:00:00

  • Costs of stroke using patient-level data: a critical review of the literature.

    abstract:BACKGROUND AND PURPOSE:With decision-analytic models becoming more popular to assess the cost-effectiveness of health care interventions, the need for robust estimates on the costs of cerebrovascular disease is paramount. This study reports the results from a literature review of the costs of cerebrovascular diseases, ...

    journal_title:Stroke

    pub_type: 杂志文章,meta分析,评审

    doi:10.1161/STROKEAHA.108.529776

    authors: Luengo-Fernandez R,Gray AM,Rothwell PM

    更新日期:2009-02-01 00:00:00

  • Pathogenetical subtypes of recurrent intracerebral hemorrhage: designations by SMASH-U classification system.

    abstract:BACKGROUND AND PURPOSE:Pathogenetic classification of intracerebral hemorrhage (ICH), using systems such as SMASH-U (structural vascular lesions, medication, cerebral amyloid angiopathy [CAA], systemic disease, hypertension, or undetermined), is important in predicting functional outcomes and mortality in patients with...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.114.005598

    authors: Yeh SJ,Tang SC,Tsai LK,Jeng JS

    更新日期:2014-09-01 00:00:00

  • Tumor necrosis factor-alpha-238G>A promoter polymorphism is associated with increased risk of new hemorrhage in the natural course of patients with brain arteriovenous malformations.

    abstract:BACKGROUND AND PURPOSE:Identification of single-nucleotide polymorphisms (SNPs) associated with increased risk of new intracranial hemorrhage (ICH) after brain arteriovenous malformation (BAVM) diagnosis would facilitate risk stratification and identify potential targets for therapeutic intervention. METHODS:Patients ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.STR.0000195133.98378.4b

    authors: Achrol AS,Pawlikowska L,McCulloch CE,Poon KY,Ha C,Zaroff JG,Johnston SC,Lee C,Lawton MT,Sidney S,Marchuk DA,Kwok PY,Young WL,UCSF BAVM Study Project.

    更新日期:2006-01-01 00:00:00

  • Anesthesia Technique and Outcomes of Mechanical Thrombectomy in Patients With Acute Ischemic Stroke.

    abstract:BACKGROUND AND PURPOSE:The impact of anesthesia technique on the outcomes of mechanical thrombectomy for acute ischemic stroke remains an issue of debate. We investigated the association of general anesthesia with outcomes in patients undergoing mechanical thrombectomy for ischemic stroke. METHODS:We performed a cohor...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.116.015343

    authors: Bekelis K,Missios S,MacKenzie TA,Tjoumakaris S,Jabbour P

    更新日期:2017-02-01 00:00:00

  • Transcranial Doppler sonography and magnetic resonance angiography in the assessment of collateral hemispheric flow in patients with carotid artery disease.

    abstract:BACKGROUND AND PURPOSE:The aim of this investigation was to compare the respective efficacy of transcranial Doppler sonography (TCD) and magnetic resonance angiography (MRA) for the assessment of intracranial hemodynamics in patients with extracranial occlusion or severe stenosis of the internal carotid artery (ICA). ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.26.2.214

    authors: Anzola GP,Gasparotti R,Magoni M,Prandini F

    更新日期:1995-02-01 00:00:00

  • Cerebral hemorrhage in neonates with coarctation of the aorta.

    abstract::Coarctation of the aorta is an uncommon cause of cerebral hemorrhage in the full- or near-term infant. The clinical, radiologic, and neurologic findings of four infants with aortic coarctation and cerebral hemorrhage are presented. In all four infants, cerebral hemorrhage was associated with only moderate elevation of...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.13.4.491

    authors: Young RS,Liberthson RR,Zalneraitis EL

    更新日期:1982-07-01 00:00:00

  • Endothelial dysfunction and arterial stiffness in ischemic stroke: the role of sleep-disordered breathing.

    abstract:BACKGROUND AND PURPOSE:Sleep-disordered breathing (SDB) represents a risk factor for cardiovascular morbidity after a cerebral ischemic event (acute ischemic event, ischemic stroke, or transient ischemic attack). In the present study, endothelial function and arterial stiffness were analyzed in patients who experienced...

    journal_title:Stroke

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1161/STROKEAHA.111.000112

    authors: Cereda CW,Tamisier R,Manconi M,Andreotti J,Frangi J,Pifferini V,Bassetti CL

    更新日期:2013-04-01 00:00:00

  • Cortical photothrombotic infarcts impair the recall of previously acquired memories but spare the formation of new ones.

    abstract:BACKGROUND AND PURPOSE:Despite a high incidence of poststroke dementia, there is no specific treatment for this condition. Because the evaluation of poststroke cognitive deficits in animal models of stroke is exceedingly challenging, the preclinical evaluation of candidate drugs is limited. We aimed to explore the impa...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.113.001907

    authors: Diederich K,Schmidt A,Strecker JK,Schäbitz WR,Schilling M,Minnerup J

    更新日期:2014-02-01 00:00:00

  • Perimesencephalic subarachnoid hemorrhage. Additional perspectives from four cases.

    abstract:BACKGROUND:Nonaneurysmal perimesencephalic hemorrhage, a distinct form of subarachnoid hemorrhage, is a recently described variant of intracranial hemorrhage. We describe two patients who presented with unusual features of this type of subarachnoid hemorrhage and also two patients who had a perimesencephalic pattern of...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.25.7.1507

    authors: Schievink WI,Wijdicks EF,Piepgras DG,Nichols DA,Ebersold MJ

    更新日期:1994-07-01 00:00:00

  • Dynamic Regional Brain Atrophy Rates in the First Year After Ischemic Stroke.

    abstract:BACKGROUND AND PURPOSE:Brain atrophy can be regarded as an end-organ effect of cumulative cardiovascular risk factors. Accelerated brain atrophy is described following ischemic stroke, but it is not known whether atrophy rates vary over the poststroke period. Examining rates of brain atrophy allows the identification o...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.120.030256

    authors: Brodtmann A,Khlif MS,Egorova N,Veldsman M,Bird LJ,Werden E

    更新日期:2020-09-01 00:00:00

  • Change in perfusion in acute nondominant hemisphere stroke may be better estimated by tests of hemispatial neglect than by the National Institutes of Health Stroke Scale.

    abstract:BACKGROUND AND PURPOSE:It has been reported that National Institutes of Health Stroke Scale (NIHSS) scores correlate poorly with hypoperfused tissue measured by perfusion-weighted imaging (PWI) in nondominant hemisphere stroke. We conducted 2 studies to determine whether tests of hemispatial neglect provide a better me...

    journal_title:Stroke

    pub_type: 临床试验,杂志文章

    doi:10.1161/01.STR.0000089681.84041.69

    authors: Hillis AE,Wityk RJ,Barker PB,Ulatowski JA,Jacobs MA

    更新日期:2003-10-01 00:00:00

  • Cerebral small vessel disease and kidney function predict long-term survival in patients with acute stroke.

    abstract:BACKGROUND AND PURPOSE:Cerebral small vessel disease reflected by white matter lesions (WMLs) in MRI and kidney function reflected by estimated glomerular filtration rate (eGFR) is closely associated in patients without stroke. We studied whether eGFR and WMLs predict long-term survival in patients with acute stroke. ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.110.587352

    authors: Oksala NK,Salonen T,Strandberg T,Oksala A,Pohjasvaara T,Kaste M,Karhunen PJ,Erkinjuntti T

    更新日期:2010-09-01 00:00:00