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Improving Acute Stroke Management With Ct Perfusion Imaging: Approaches To Treatment Guidance And Brain Tissue Salvage, Christopher D. D'Esterre

Electronic Thesis and Dissertation Repository

CT Perfusion (CTP) provides measurement of perfusion at the capillary level which can be used to characterize tissue viability, and blood-brain-barrier (BBB) compromise. Using CTP, the goals of this research are to: 1) select patients that will benefit from acute stroke treatment, and 2) determine if pre-stroke neuroprotection reduces stroke severity.

Chapter two investigates the cerebral blood volume (CBV) parameter in a small acute ischemic stroke (AIS) patient set. Overestimation of the acute CBV defect is caused by incomplete wash-out of the CT contrast due to a shortened CTP acquisition time (“truncation artifact”).

In chapter three we examine the prognostic …

Transcranial Sonothrombolysis Using High-Intensity Focused Ultrasound: Impact Of Increasing Output Power On Clot Fragmentation, Golnaz Ahadi, Christian S. Welch, Michele J. Grimm, David J. Fisher, Eyal Zadicario, Karin Ernström, Arne H. Voie, Thilo Hölscher

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

The primary goal of this study was to investigate the relationship between increasing output power levels and clot fragmentation during high-intensity focused ultrasound (HIFU)-induced thrombolysis.

Methods

A HIFU headsystem, designed for brain applications in humans, was used for this project. A human calvarium was mounted inside the water-filled hemispheric transducer. Artificial thrombi were placed inside the skull and located at the natural focus point of the transducer. Clots were exposed to a range of acoustic output power levels from 0 to 400 W. The other HIFU operating parameters remained constant. To assess clot fragmentation, three filters of different …

Multifactorial Modulation Of The Blood-Brain Barrier: Relationship To Stroke, Bei Zhang

Theses and Dissertations--Nutritional Sciences

The blood-brain barrier (BBB) is a dynamic interface, mainly consisting of highly specialized brain microvascular endothelial cells (BMECs) that segregate the central nervous system (CNS) from the peripheral circulation. Impairment of the BBB, due to disruption of tight junction (TJ) proteins and inflammatory responses, may initiate and/or contribute to the progress of CNS disorders, including stroke. Stroke is the second leading cause of death worldwide. It has been shown that aging and environmental pollutants can induce brain endothelium dysfunction, and are considered as risk factors for stroke.

Deficiency of telomerase is highly linked with aging-associated vascular diseases. Evidence indicates that …

Is Dabigatran Superior To Warfarin In Treating Patients With Atrial Fibrillation?, Kelly Higgins

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Dabigatran is superior to Warfarin in patients with atrial fibrillation.

STUDY DESIGN: Review of three English language primary studies published in 2007, 2009, and 2010.

DATA SOURCES: Three randomized control trials found using Cochrane Database.

OUTCOME(S) MEASURED: Outcomes measured were presence or absence of stroke or systolic embolism and intracranial hemorrhage. The absence of these events preserved neurologic function in patients with atrial fibrillation.

RESULTS: In both VKA-naïve and VKA-experienced patients, Dabigatran 150 mg was superior to Warfarin in both the prevention of stroke …

Left Atrial Dilatation In Undetermined Group According To Toast Classification: Echocardiographic Assessment Of Stroke Patients, Ahu Takoğlu, Ufuk Can

Turkish Journal of Medical Sciences

To investigate the left atrial dilatation in an undetermined etiological group according to Trial of Org 10172 in Acute Stroke Treatment (TOAST) and to evaluate the relationship between left atrial dilatation and stroke volume and localization. Materials and methods: Files of patients admitted to our hospital (2000-2010) with acute ischemic stroke diagnosis were investigated. The size of their left atrium was registered using the data from transthoracic echocardiogram. Lesion size and localization were registered using brain MRI. Stroke etiology was categorized according to TOAST classification. The relationship between left atrial dilatation and stroke volume and localization in the undetermined group …