Neuroscience
This week's free access full-text paper in the new issue of the Journal of the American Medical Association addresses the relative value of CT vs. MRI imaging in the initial evaluation of acute CVA symptoms. Click here for the full paper; the abstract follows:
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Validation of the language component of the Addenbrooke's Cognitive Examination - Revised (ACE-R) as a screening tool for aphasia in stroke patients. Australas J Ageing. 2011 Sep;30(3):156-8 Authors: Gaber TA, Parsons F, Gautam V Abstract Aim: ...
- Neuropsychology Abstract Of The Day: Donepezil And Aphasia
Chen Y, Li YS, Wang ZY, Xu Q, Shi GW, & Lin Y. [The efficacy of donepezil for post-stroke aphasia: a pilot case control study.] Zhonghua Nei Ke Za Zhi. 2010 Feb, 49(2), 115-118. OBJECTIVE: To evaluate the efficacy of donepezil for post-stroke aphasia....
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From the BBC:Test 'identifies new stroke risk' Doctors have developed a simple checklist to show if patients who have had a mini-stroke are at immediate risk of a more serious attack. The Oxford University team, writing in the Lancet, said it...
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This evening, the CBC news show The National reported on a study newly published in the New England Journal of Medicine. Part of the CBC website report follows, followed by a link to the study's abstract:Ultrasound may improve stroke treatment CBC ...
- Abstract Of The Day: Stroke And Cognition
VK Srikanth et al. Progressive dementia after first-ever stroke: A community-based follow-up study. Neurology 2004; 63:785-792. Address correspondence and reprint requests to Prof. Geoffrey A. Donnan, Director, National Stroke Research Institute, Neurosciences...
Neuroscience
Imaging in the Initial Evaluation of Acute Stroke Symptoms
This week's free access full-text paper in the new issue of the Journal of the American Medical Association addresses the relative value of CT vs. MRI imaging in the initial evaluation of acute CVA symptoms. Click here for the full paper; the abstract follows:
Chelsea S. Kidwell, MD; Julio A. Chalela, MD; Jeffrey L. Saver, MD; Sidney Starkman, MD; Michael D. Hill, MD; et al. Comparison of MRI and CT for Detection of Acute Intracerebral Hemorrhage. JAMA. 2004; 292: 1823-1830.
ABSTRACT
Context. Noncontrast computed tomography (CT) is the standard brain imaging study for the initial evaluation of patients with acute stroke symptoms. Multimodal magnetic resonance imaging (MRI) has been proposed as an alternative to CT in the emergency stroke setting. However, the accuracy of MRI relative to CT for the detection of hyperacute intracerebral hemorrhage has not been demonstrated.
Objective. To compare the accuracy of MRI and CT for detection of acute intracerebral hemorrhage in patients presenting with acute focal stroke symptoms.
Design, Setting, and Patients. A prospective, multicenter study was performed at 2 stroke centers (UCLA Medical Center and Suburban Hospital, Bethesda, Md), between October 2000 and February 2003. Patients presenting with focal stroke symptoms within 6 hours of onset underwent brain MRI followed by noncontrast CT.
Main Outcome Measures. Acute intracerebral hemorrhage and any intracerebral hemorrhage diagnosed on gradient recalled echo (GRE) MRI and CT scans by a consensus of 4 blinded readers.
Results. The study was stopped early, after 200 patients were enrolled, when it became apparent at the time of an unplanned interim analysis that MRI was detecting cases of hemorrhagic transformation not detected by CT. For the diagnosis of any hemorrhage, MRI was positive in 71 patients with CT positive in 29 (P less than .001). For the diagnosis of acute hemorrhage, MRI and CT were equivalent (96% concordance). Acute hemorrhage was diagnosed in 25 patients on both MRI and CT. In 4 other patients, acute hemorrhage was present on MRI but not on the corresponding CT—each of these 4 cases was interpreted as hemorrhagic transformation of an ischemic infarct. In 3 patients, regions interpreted as acute hemorrhage on CT were interpreted as chronic hemorrhage on MRI. In 1 patient, subarachnoid hemorrhage was diagnosed on CT but not on MRI. In 49 patients, chronic hemorrhage, most often microbleeds, was visualized on MRI but not on CT.
Conclusion. MRI may be as accurate as CT for the detection of acute hemorrhage in patients presenting with acute focal stroke symptoms and is more accurate than CT for the detection of chronic intracerebral hemorrhage.
- Neuropsychology Abstract Of The Day: Aphasia Screening For Stroke Patients
Validation of the language component of the Addenbrooke's Cognitive Examination - Revised (ACE-R) as a screening tool for aphasia in stroke patients. Australas J Ageing. 2011 Sep;30(3):156-8 Authors: Gaber TA, Parsons F, Gautam V Abstract Aim: ...
- Neuropsychology Abstract Of The Day: Donepezil And Aphasia
Chen Y, Li YS, Wang ZY, Xu Q, Shi GW, & Lin Y. [The efficacy of donepezil for post-stroke aphasia: a pilot case control study.] Zhonghua Nei Ke Za Zhi. 2010 Feb, 49(2), 115-118. OBJECTIVE: To evaluate the efficacy of donepezil for post-stroke aphasia....
- Transient Ischemic Attack (tia)
From the BBC:Test 'identifies new stroke risk' Doctors have developed a simple checklist to show if patients who have had a mini-stroke are at immediate risk of a more serious attack. The Oxford University team, writing in the Lancet, said it...
- Ultrasound And Tpa Combined Treatment For Stroke
This evening, the CBC news show The National reported on a study newly published in the New England Journal of Medicine. Part of the CBC website report follows, followed by a link to the study's abstract:Ultrasound may improve stroke treatment CBC ...
- Abstract Of The Day: Stroke And Cognition
VK Srikanth et al. Progressive dementia after first-ever stroke: A community-based follow-up study. Neurology 2004; 63:785-792. Address correspondence and reprint requests to Prof. Geoffrey A. Donnan, Director, National Stroke Research Institute, Neurosciences...