Association of 24‐Hour Computed Tomography Infarct Density on Functional Outcomes in Stroke: Secondary Analysis From the AcT Trial

Background The final infarct volume has been historically considered the most critical radiological outcome in ischemic stroke. Yet, discrepancies between final infarct volume and functional outcomes occur frequently. We aim to evaluate whether 24-hour computed tomography (CT) infarct density modifies the relationship between 24-hour CT infarct volume and functional outcomes and is associated with outcomes in acute ischemic stroke. Methods Data are from the AcT (Alteplase Versus Tenecteplase ...

CT Angiography-for-All: Beyond “Diagnostic Nihilism” in Acute Intracerebral Hemorrhage Care – A Personal View

Introduction: The role of CTA in acute intracerebral hemorrhage (ICH) remains debated, yet its benefits are clear. In this viewpoint, we provide a case for the routine use of CTA in the initial assessment of patients with acute ICH. Method: To argue for the clinical value of immediate CTA in acute ICH, six key domains were considered: (i) diagnostic performance (does it improve diagnosis?), (ii) prognostic performance (does it improve prognosis?), (iii) predictive performance (does it predict...

Perhaps fewer, but faster: should we rethink the 90% stroke unit admission standard?

Spreading depolarization: A wave that precedes and drives cerebral ischemic cell death—Target for neuroprotection

Spreading depolarization (SD) is an all-or-none response of gray matter, evolutionarily conserved from insects to mammals and characterized by near-complete breakdown of transmembrane ion gradients and cytotoxic edema. In humans, SD has been recorded in diverse neurological conditions, including cerebral ischemia and hemorrhage, traumatic brain injury (TBI), and even during whole-brain death following cardiac arrest or during continued systemic circulation. During migraine aura, initial hyper...