1,721,025 research outputs found
White matter hyperintensities are not associated with cognitive decline in early Parkinson's disease - The DeNoPa cohort
No full textSmall vessel disease and white matter hyperintensities (WMH) as its surrogate marker are known to predict cognitive decline in the elderly. However, the influence of vascular lesions on cognitive impairment in Parkinson's disease (PD) has been discussed controversial so far. The Aim of this study was to evaluate the predictive role of volume and location of white matter hyperintensities (WMH) on cognitive decline in de novo PD patients
Early Prediction of Malignant Cerebellar Edema in Posterior Circulation Stroke Using Quantitative LesionWater Uptake
No full textOptimierte Modellentwicklung zur stratifizierten Prognosebestimmung bei posteriorem Apoplex in einem „Real World“ Datensatz– das pcBATASs–Prognosemodell
No full textMediation of the Relationship between Functional Outcome and the Degree of Recanalization by Penumbra Salvage Volume in Acute Ischemic Stroke
No full textThe main treatment target of mechanical thrombectomy in patients with acute ischemic stroke is to restore the blood supply to the region of brain tissue supplied by the occluded vessel. The ischemic penumbra regularly has persisting blood flow through collaterals but can be transformed into infarction in case no recanalization occurs within a sufficient time period. The role of CTP is the time-sensitive selection of patients, that can still benefit from mechanical thrombectomy. The so-called ischemic penumbra is metabolically viable brain tissue that can be salvage after blood flow restoration through thrombectomy. In this study, we hypothesized that the relation between recanalization degree after mechanical thrombectomy and penumbra salvage directly predicts functional outcome in acute stroke patients.
In summary, our results clearly demonstrate that every increase of recanalization has a direct impact on saved brain parenchyma called the salvaged penumbra, which is associated with improved functional outcomes in patients after 90 days of acute stroke. Every degree of recanalization (mTICI 2a to mTICI 3) estimates the salvage of 63 mL of the hypoperfused brain tissue at risk. The results even show the association of penumbra salvage with improved clinical outcomes in 90 days, even in patients with an extensive ischemic core at admission. This once again demonstrates the importance of higher degree of reperfusion after recanalization.Das Hauptziel einer Behandlung mit mechanischer Thrombektomie bei Patienten mit akutem Schlaganfall ist die Wiederherstellung der Blutversorgung der Region des Hirnparenchyms, deren Blutversorgung durch das verschlossene Gefäß vermindert wurde. Die ischämische Penumbra wird durch Kollateralen weiterhin mit Blut versorgt, kann aber irreversibel sein, wenn sie nicht in kurzer Zeit wiederhergestellt wird. Die Rolle der CTP ist die zeitabhängige Auswahl der Patienten, die noch von einer mechanischen Thrombektomie profitieren können. Die so genannte ischämische Penumbra ist metabolisch lebensfähiges Hirngewebe, das nach der Wiederherstellung des Blutflusses durch die Thrombektomie gerettet werden kann. In dieser Studie stellten wir die Hypothese auf, dass die Beziehung zwischen dem Rekanalisationsgrad nach mechanischer Thrombektomie und der Penumbra-Rettung eine direkte Vorhersage für das funktionelle Ergebnis bei akuten Schlaganfallpatienten hat.
Zusammenfassend zeigten unsere Ergebnisse deutlich, dass jede Zunahme der Rekanalisationsrate einen direkten Einfluss auf das gerettete Hirnparenchym, die sogenannte gerettete Penumbra, hat, die mit einem verbesserten funktionellen Ergebnis nach 90 Tagen bei Patienten mit akutem Schlaganfall assoziiert ist. Jeder Grad der Rekanalisation (mTICI 2a bis mTICI 3) schätzt die Rettung von 63 mL des hypoperfundierten, gefährdeten Hirngewebes. Die Ergebnisse zeigten sogar eine Assoziation der Penumbra-Rettung mit einem verbesserten klinischen Outcome nach 90 Tagen, was selbst bei Patienten mit einem ausgedehnten ischämischen Kern bei der Aufnahme deutlich identifiziert wurde. Dies demonstriert erneut die Bedeutung eines höheren Reperfusionsgrades nach der Rekanalisation
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Thrombectomy for secondary distal, medium vessel occlusions of the posterior circulation: seeking complete reperfusion
No full textBackground Whether to approach distal occlusions endovascularly or not in medium-sized vessels secondary to proximal large vessel occlusion stroke remains unanswered. Objective To investigates the technical feasibility and safety of thrombectomy for secondary posterior circulation distal, medium vessel occlusions (DMVO). Methods TOPMOST (Treatment fOr Primary Medium vessel Occlusion STroke) is an international, retrospective, multicenter, observational registry of patients treated for distal cerebral artery occlusions. This study subanalysis endovascularly treated occlusions of the posterior cerebral artery in the P2 and P3 segment secondary preprocedural or periprocedural thrombus migration between January 2014 and June 2020. Technical feasibility was evaluated with the modified Thrombolysis in Cerebral Infarction (mTICI) scale. Procedural safety was assessed by the occurrence of symptomatic intracranial hemorrhage (sICH) and intervention-related serious adverse events. Results Among 71 patients with secondary posterior circulation DMVO who met the inclusion criteria, occlusions were present in 80.3% (57/71) located in the P2 segment and in 19.7% (14/71) in the P3 segment. Periprocedural migration occurred in 54.9% (39/71) and preprocedural migration in 45.1% (32/71) of cases. The first reperfusion attempt led in 38% (27/71) of all cases to mTICI 3. On multivariable logistic regression analysis, increased numbers of reperfusion attempts (adjusted odds ratio (aOR)=0.39, 95% CI 0.29 to 0.88, p=0.009) and preprocedural migration (aOR=4.70, 95% CI,1.35 to 16.35, p=0.015) were significantly associated with mTICI 3. sICH occurred in 2.8% (2/71). Conclusion Thrombectomy for secondary posterior circulation DMVO seems to be safe and technically feasible. Even though thrombi that have migrated preprocedurally may be easier to retract, successful reperfusion can be achieved in the majority of patients with secondary DMVO of the P2 and P3 segment.Background Whether to approach distal occlusions endovascularly or not in medium-sized vessels secondary to proximal large vessel occlusion stroke remains unanswered. Objective To investigates the technical feasibility and safety of thrombectomy for secondary posterior circulation distal, medium vessel occlusions (DMVO). Methods TOPMOST (Treatment fOr Primary Medium vessel Occlusion STroke) is an international, retrospective, multicenter, observational registry of patients treated for distal cerebral artery occlusions. This study subanalysis endovascularly treated occlusions of the posterior cerebral artery in the P2 and P3 segment secondary preprocedural or periprocedural thrombus migration between January 2014 and June 2020. Technical feasibility was evaluated with the modified Thrombolysis in Cerebral Infarction (mTICI) scale. Procedural safety was assessed by the occurrence of symptomatic intracranial hemorrhage (sICH) and intervention-related serious adverse events. Results Among 71 patients with secondary posterior circulation DMVO who met the inclusion criteria, occlusions were present in 80.3% (57/71) located in the P2 segment and in 19.7% (14/71) in the P3 segment. Periprocedural migration occurred in 54.9% (39/71) and preprocedural migration in 45.1% (32/71) of cases. The first reperfusion attempt led in 38% (27/71) of all cases to mTICI 3. On multivariable logistic regression analysis, increased numbers of reperfusion attempts (adjusted odds ratio (aOR)=0.39, 95% CI 0.29 to 0.88, p=0.009) and preprocedural migration (aOR=4.70, 95% CI,1.35 to 16.35, p=0.015) were significantly associated with mTICI 3. sICH occurred in 2.8% (2/71). Conclusion Thrombectomy for secondary posterior circulation DMVO seems to be safe and technically feasible. Even though thrombi that have migrated preprocedurally may be easier to retract, successful reperfusion can be achieved in the majority of patients with secondary DMVO of the P2 and P3 segment
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Effect of anesthetic strategies on distal stroke thrombectomy in the anterior and posterior cerebral artery
No full textBackground Numerous questions regarding procedural details of distal stroke thrombectomy remain unanswered. This study assesses the effect of anesthetic strategies on procedural, clinical and safety outcomes following thrombectomy for distal medium vessel occlusions (DMVOs). Methods Patients with isolated DMVO stroke from the TOPMOST registry were analyzed with regard to anesthetic strategies (ie, conscious sedation (CS), local (LA) or general anesthesia (GA)). Occlusions were in the P2/P3 or A2–A4 segments of the posterior and anterior cerebral arteries (PCA and ACA), respectively. The primary endpoint was the rate of complete reperfusion (modified Thrombolysis in Cerebral Infarction score 3) and the secondary endpoint was the rate of modified Rankin Scale score 0–1. Safety endpoints were the occurrence of symptomatic intracranial hemorrhage and mortality. Results Overall, 233 patients were included. The median age was 75 years (range 64–82), 50.6% (n=118) were female, and the baseline National Institutes of Health Stroke Scale score was 8 (IQR 4–12). DMVOs were in the PCA in 59.7% (n=139) and in the ACA in 40.3% (n=94). Thrombectomy was performed under LA±CS (51.1%, n=119) and GA (48.9%, n=114). Complete reperfusion was reached in 73.9% (n=88) and 71.9% (n=82) in the LA±CS and GA groups, respectively (P=0.729). In subgroup analysis, thrombectomy for ACA DMVO favored GA over LA±CS (aOR 3.07, 95% CI 1.24 to 7.57, P=0.015). Rates of secondary and safety outcomes were similar in the LA±CS and GA groups. Conclusion LA±CS compared with GA resulted in similar reperfusion rates after thrombectomy for DMVO stroke of the ACA and PCA. GA may facilitate achieving complete reperfusion in DMVO stroke of the ACA. Safety and functional long-term outcomes were comparable in both groups
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