scholarly journals Case series demonstrating the value of computed tomography perfusion in differentiating ischemic strokes from seizures in patients with isolated aphasia

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Victoria Serven ◽  
Jonathan D. Clemente ◽  
Andrew W. Asimos
Keyword(s):  
Computed Tomography ◽  
Case Series ◽  
Computed Tomography Perfusion

The role of computed tomography perfusion in the diagnosis of brain ischaemic stroke

2008 ◽  
Vol 149 (23) ◽  
pp. 1059-1065 ◽  
Author(s):  
Szabolcs Halász ◽  
Tamás Puskás
Keyword(s):  
Computed Tomography ◽  
Ischaemic Stroke ◽  
Spiral Ct ◽  
Computed Tomography Perfusion

A többszeletes spirál-CT-berendezések széles körű alkalmazása és a perfúziós szoftverek bevezetése lehetővé tette az agyi véráramlás CT-vizsgálatát. Cél és módszerek: A szerzők ismertetik az agyi perfúziós CT-vizsgálatok elvét, technikáját, amelyet az elmúlt másfél évben 96 betegükön végzett vizsgálatuk tapasztalataival egészítenek ki. A folyamatos technikai fejlődés eredményeként a közeljövőben lehetővé válik a teljes agy perfúziós CT-vizsgálata. Következtetések: Az agy perfúziós CT-vizsgálata gyors, viszonylag olcsó és a stroke kórismézésében pontos diagnózist eredményez.

scholarly journals Value of Vascular and Non-Vascular Pattern on Computed Tomography Perfusion in Patients With Acute Isolated Aphasia

Stroke ◽  
2020 ◽  
Vol 51 (8) ◽  
pp. 2480-2487
Author(s):  
Salvatore Rudilosso ◽  
Alejandro Rodríguez ◽  
Sergio Amaro ◽  
Víctor Obach ◽  
Arturo Renú ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Predictive Value ◽  
Brain Perfusion ◽  
Complete Recovery ◽  
Vascular Perfusion ◽  
Computed Tomography Perfusion ◽  
Stroke Mimic ◽  
Ischemic Attack

Background and Purpose: Acute onset aphasia may be due to stroke but also to other causes, which are commonly referred to as stroke mimics. We hypothesized that, in patients with acute isolated aphasia, distinct brain perfusion patterns are related to the cause and the clinical outcome. Herein, we analyzed the prognostic yield and the diagnostic usefulness of computed tomography perfusion (CTP) in patients with acute isolated aphasia. Methods: From a single-center registry, we selected a cohort of 154 patients presenting with acute isolated aphasia who had a whole-brain CTP study available. We collected the main clinical and radiological data. We categorized brain perfusion studies on CTP into vascular and nonvascular perfusion patterns and the cause of aphasia as ischemic stroke, transient ischemic attack, stroke mimic, and undetermined cause. The primary clinical outcome was the persistence of aphasia at discharge. We analyzed the sensitivity, specificity, positive and negative predictive values of perfusion patterns to predict complete clinical recovery and ischemic stroke on follow-up imaging. Results: The cause of aphasia was an ischemic stroke in 58 patients (38%), transient ischemic attack in 3 (2%), stroke mimic in 68 (44%), and undetermined in 25 (16%). CTP showed vascular and nonvascular perfusion pattern in 62 (40%) and 92 (60%) patients, respectively. Overall, complete recovery occurred in 116 patients (75%). A nonvascular perfusion pattern predicted complete recovery (sensitivity 75.9%, specificity 89.5%, positive predictive value 95.7%, and negative predictive value 54.8%), and a vascular perfusion pattern was highly predictive of ischemic stroke (sensitivity 94.8%, specificity 92.7%, positive predictive value 88.7%, and negative predictive value 96.7%). The 3 patients with ischemic stroke without a vascular perfusion pattern fully recovered at discharge. Conclusions: CTP has prognostic value in the workup of patients with acute isolated aphasia. A nonvascular pattern is associated with higher odds of full recovery and may prompt the search for alternative causes of the symptoms.

scholarly journals A multicenter randomized controlled trial of endovascular therapy following imaging evaluation for ischemic stroke (DEFUSE 3)

2017 ◽  
Vol 12 (8) ◽  
pp. 896-905 ◽  
Author(s):  
Gregory W Albers ◽  
Maarten G Lansberg ◽  
Stephanie Kemp ◽  
Jenny P Tsai ◽  
Phil Lavori ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Primary Endpoint ◽  
Endovascular Therapy ◽  
Symptom Onset ◽  
Medical Management ◽  
Controlled Trial ◽  
Modified Rankin Scale ◽  
Computed Tomography Perfusion

Rationale Early reperfusion in patients experiencing acute ischemic stroke is effective in patients with large vessel occlusion. No randomized data are available regarding the safety and efficacy of endovascular therapy beyond 6 h from symptom onset. Aim The aim of the study is to demonstrate that, among patients with large vessel anterior circulation occlusion who have a favorable imaging profile on computed tomography perfusion or magnetic resonance imaging, endovascular therapy with a Food and Drug Administration 510 K-cleared mechanical thrombectomy device reduces the degree of disability three months post stroke. Design The study is a prospective, randomized, multicenter, phase III, adaptive, blinded endpoint, controlled trial. A maximum of 476 patients will be randomized and treated between 6 and 16 h of symptom onset. Procedures Patients undergo imaging with computed tomography perfusion or magnetic resonance diffusion/perfusion, and automated software (RAPID) determines if the Target Mismatch Profile is present. Patients who meet both clinical and imaging selection criteria are randomized 1:1 to endovascular therapy plus medical management or medical management alone. The individual endovascular therapist chooses the specific device (or devices) employed. Study outcomes The primary endpoint is the distribution of scores on the modified Rankin Scale at day 90. The secondary endpoint is the proportion of patients with modified Rankin Scale 0–2 at day 90 (indicating functional independence). Analysis Statistical analysis for the primary endpoint will be conducted using a normal approximation of the Wilcoxon–Mann–Whitney test (the generalized likelihood ratio test).

scholarly journals Serial Quantitative Computed Tomography Perfusion in Aneurysmal Subarachnoid Hemorrhage

2016 ◽  
Vol 43 (3) ◽  
pp. 375-380 ◽  
Author(s):  
Cheemun Lum ◽  
Matthew J. Hogan ◽  
John Sinclair ◽  
Shane English ◽  
Howard Lesiuk ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Middle Cerebral Artery ◽  
Transit Time ◽  
Cerebral Artery ◽  
Computed Tomography Angiography ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Mean Transit Time ◽  
Arterial Diameter ◽  
Computed Tomography Perfusion

AbstractPurpose: Computed tomography perfusion (CTP) has been performed to predict which patients with aneurysmal subarachnoid hemorrhage are at risk of developing delayed cerebral ischemia (DCI). Patients with severe arterial narrowing may have significant reduction in perfusion. However, many patients have less severe arterial narrowing. There is a paucity of literature evaluating perfusion changes which occur with mild to moderate narrowing. The purpose of our study was to investigate serial whole-brain CTP/computed tomography angiography in aneurysm-related subarachnoid hemorrhage (aSAH) patients with mild to moderate angiographic narrowing. Methods: We retrospectively studied 18 aSAH patients who had baseline and follow-up whole-brain CTP/computed tomography angiography. Thirty-one regions of interest/hemisphere at six levels were grouped by vascular territory. Arterial diameters were measured at the circle of Willis. The correlation between arterial diameter and change in CTP values, change in CTP in with and without DCI, and response to intra-arterial vasodilator therapy in DCI patients was evaluated. Results: There was correlation among the overall average cerebral blood flow (CBF; R=0.49, p<0.04), mean transit time (R=–0.48, p=0.04), and angiographic narrowing. In individual arterial territories, there was correlation between changes in CBF and arterial diameter in the middle cerebral artery (R=0.53, p=0.03), posterior cerebral artery (R=0.5, p=0.03), and anterior cerebral artery (R=0.54, p=0.02) territories. Prolonged mean transit time was correlated with arterial diameter narrowing in the middle cerebral artery territory (R=0.52, p=0.03). Patients with DCI tended to have serial worsening of CBF compared with those without DCI (p=0.055). Conclusions: Our preliminary study demonstrates there is a correlation between mild to moderate angiographic narrowing and serial changes in perfusion in patients with aSAH. Patients developing DCI tended to have progressively worsening CBF compared with those not developing DCI.

scholarly journals Computed Tomography Perfusion: A New Method to Evaluate Response to Therapy in Lung Cancer

2011 ◽  
Vol 6 (9) ◽  
pp. 1599-1600 ◽  
Author(s):  
Francesco Fraioli ◽  
Simone Vetere ◽  
Marco Anile ◽  
Federico Venuta
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Response To Therapy ◽  
New Method ◽  
Computed Tomography Perfusion
Sign in / Sign up

Export Citation Format

Share Document