Is CT perfusion helpful in the treatment allocation of patients with acute ischemic stroke? An expert-opinion analysis
| Autor: | Jonathan Y. Streifler, Antonio Castaldi, Matteo Puntoni, Bruno Del Sette, Laura Strada, Daria Bianchini, Massimo Del Sette |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Neurology medicine.medical_treatment Clinical Decision-Making Contrast Media Perfusion scanning Dermatology 030204 cardiovascular system & hematology Brain Ischemia 03 medical and health sciences Young Adult 0302 clinical medicine medicine Humans heterocyclic compounds Single-Blind Method Thrombolytic Therapy Prospective Studies Acute ischemic stroke Stroke Neuroradiology Aged Retrospective Studies Aged 80 and over business.industry Standard treatment Brain Reproducibility of Results General Medicine Thrombolysis Middle Aged medicine.disease Cerebral Angiography Psychiatry and Mental health Female Neurology (clinical) Neurosurgery Radiology business Tomography X-Ray Computed 030217 neurology & neurosurgery |
| Zdroj: | Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 38(10) |
| ISSN: | 1590-3478 |
| Popis: | Intravenous tPA is the standard treatment for acute ischemic stroke within 4.5 hours of symptom onset. Neuroradiological selection is currently based upon non-contrast- brain CT scan (NCCT). To verify, in an “expert-opinion setting”, the possible usefulness of CT perfusion (CTP) in decision-making toward i.v. thrombolysis. One hundred and three consecutive patients with acute ischemic stroke who underwent NCCT and CTP were re-evaluated by an expert in cerebrovascular disease, to verify if adding CTP information would have changed expert’s opinion. After CTP, a definitive decision was made for 20 more patients, changing the proportion of patients candidate to i.v. tPA from 44% to 51%, and reducing uncertainty from 29% to 10%. CTP results were useful inmilder stroke (p = 0.01). In a “real world” setting, CT perfusion could be useful for clinical decision, in particular for milder stroke. |
| Databáze: | OpenAIRE |
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