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Central nervous system
Published in David A Lisle, Imaging for Students, 2012
Transient ischaemic attack (TIA) is an acute neurological deficit that resolves completely within 24 hours. TIAs are thought to be caused by transient reduction of blood flow to the brain or eye due to emboli, and are associated with underlying stenosis of the internal carotid or cerebral arteries. Patients with TIA are usually investigated with CT of the brain and carotid Doppler US (see below).
Central nervous system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
The preferred imaging test for suspected TIA is MRI with DWI [29]. MRI is more sensitive than CT and for patients in the high-risk category for stroke (ABCD2 score of 4 or above, or crescendo TIA) it should be performed within 24 hours of onset of symptoms [3].
Conducting Polymers for Regenerative Medicine
Published in Ram K. Gupta, Conducting Polymers, 2022
Merve Çalışır, Nilay Bereli, İbrahim Vargel, Adil Denizli
When blood flow to part of your brain is reduced or interrupted, a stroke occurs that prevents brain tissue from getting oxygen and nutrients, and brain cells begin to die within minutes. Temporary or permanent loss of functions occurs in the area where the stroke occurred. Stroke (stroke) is a medical emergency and immediate treatment is of paramount importance. Early intervention can reduce brain damage and other complications. Effective treatments can also help prevent disability from stroke. There are two types of stroke: a blocked artery (ischemic stroke) or a blood vessel leaking or bursting (hemorrhagic stroke) [37]. Some people may suffer a stroke, known as a transient ischemic attack (TIA) that does not cause permanent symptoms and causes a temporary interruption in blood flow to the brain. This is the most common type of stroke. The brain's blood vessels become narrowed or blocked, causing severely reduced blood flow (ischemia). Clogged or narrowed blood vessels are caused by fat particles accumulating in the blood vessels, or by blood clots or other debris circulating in the bloodstream and lodged in the blood vessels in the brain. A hemorrhagic stroke occurs when a blood vessel in the brain leaks or ruptures. Brain hemorrhages can be caused by many conditions that affect your blood vessels. The treatment of stroke, which is a tough health problem for patients and caregivers, physiologically and psychologically, currently includes the most acute systematic treatments aimed at clot relieving. Poststroke brain tissue examination and possible treatments have not been implemented and remain in theory, and new ideas in medicine are needed to improve functional recovery after stroke [38]. It is noteworthy that conductive polymers can be very useful in poststroke recovery strategies that need to be established in the field of regenerative medicine. The ability to repair poststroke deformations and manipulate the environment makes conducting polymers stand out in this area. Some of the studies carried out in this context deserve to be presented in detail and it is necessary to see the opportunities that conductive polymers will provide in this field from a wide window.
Device profile of the Wingspan Stent System for the treatment of intracranial atherosclerotic disease: overview of its safety and efficacy
Published in Expert Review of Medical Devices, 2020
Zachary R. Barnard, Michael J. Alexander
The Wingspan received FDA approval as an HDE device following the results of the initial Wingspan safety trial of 45 patients. The trial included patients who presented with a 50% or greater intracranial atherosclerotic stenosis of a 2.0 mm to 4.5 mm artery, who presented with stroke, and had failed antithrombotic medical therapy, were modified Rankin score 3 or better, and were 22–80 years old. Two of the patients, however, presented with transient ischemic attack (TIA) only, and no history of stroke. The trial enrolled patients 7 days or greater following their qualifying stroke, and the mean time to stenting following stroke was 22 days. This trial was a prospective study performed across 12 centers with adjudication of events and core lab review of images. Of the 45 patient lesions, 44 were treated successfully, and one lesion could not be accessed with the microwire. The clinical results showed a 30-day composite ipsilateral stroke and death rate of 4.4% and 6-month composite ipsilateral stroke and death rate of 7.0%. In the follow-up evaluation of the patients, 40 patients had angiographic imaging at 6 months post-stent, and there was a 7.5% incidence of re-stenosis, defined as 50% or greater stenosis. None of these patients were symptomatic at the 6-month follow-up.
Antithrombotic therapy after transcatheter aortic valve implantation
Published in Expert Review of Medical Devices, 2022
Antonio Greco, Marco Spagnolo, Davide Capodanno
CVEs include transient ischemic attack (TIA) and stroke, which is one of the most feared and detrimental complications of TAVI [16]. In landmark RCTs of TAVI, the incidence of stroke ranged between 0.6% and 6.7% at 30 days (Figure 1) and reached up to 10.6% at one year (Figure 2) [3–11]. These figures likely underestimate the actual incidence of stroke and CVEs since the pivotal RCTs enrolled rather selected populations, excluding patients with serious comorbidities. Indeed, the risk for stroke is substantially increased in TAVI candidates at high versus lowsurgical risk, both at 30 days (4.7–6.7% vs. 0.6–3.4%; Figure 1) and one year (6.0–10.6% vs. 1.2–4.1%; Figure 2) [3–11].