BACKGROUND: We sought to assess the hypothesis that length and volumes of middle cerebral artery (MCA) thrombus were associated with disappearance of the hyperdense middle cerebral artery sign (HMCAS) in acute ischemic stroke. METHODS: This is a retrospective cohort study of acute ischemic stroke patients with MCA occlusion admitted to the University Hospital in Canada. The length and volumes of the HMCAS was measured on the plain CT by placing CTA images (CTA source images or MIP images) side-by-side. RESULTS: Seventy-six patients with acute stroke having HMCAS on noncontrast CT (NCCT) with M1 MCA occlusion confirmed by CT angiography or digital subtraction angiography and received tPA. The treatments received were: IV tPA 41(53.9%) and endovascular treatment ± IV tPA 35 (46.1%). In the IV tPA group, the rate of disappearance varied depending on the baseline HMCAS length. Short length HMCAS (<10 mm) disappeared in 6/7 (85.7%) (P < .001). Medium length HMCAS (10-20 mm) disappeared in 9/24 (37.5%). No cases of long length HMCAS (>20 mm) disappeared (0/10) (P = .05). Rate of disappearance of HMCAS was found to be volume dependent (P < .002). CONCLUSION: HMCAS length >10 mm infrequently disappears with IV tPA suggesting a potential need for ancillary therapy in this group.
BACKGROUND: We sought to assess the hypothesis that length and volumes of middle cerebral artery (MCA) thrombus were associated with disappearance of the hyperdense middle cerebral artery sign (HMCAS) in acute ischemic stroke. METHODS: This is a retrospective cohort study of acute ischemic strokepatients with MCA occlusion admitted to the University Hospital in Canada. The length and volumes of the HMCAS was measured on the plain CT by placing CTA images (CTA source images or MIP images) side-by-side. RESULTS: Seventy-six patients with acute stroke having HMCAS on noncontrast CT (NCCT) with M1 MCA occlusion confirmed by CT angiography or digital subtraction angiography and received tPA. The treatments received were: IV tPA 41(53.9%) and endovascular treatment ± IV tPA 35 (46.1%). In the IV tPA group, the rate of disappearance varied depending on the baseline HMCAS length. Short length HMCAS (<10 mm) disappeared in 6/7 (85.7%) (P < .001). Medium length HMCAS (10-20 mm) disappeared in 9/24 (37.5%). No cases of long length HMCAS (>20 mm) disappeared (0/10) (P = .05). Rate of disappearance of HMCAS was found to be volume dependent (P < .002). CONCLUSION:HMCAS length >10 mm infrequently disappears with IV tPA suggesting a potential need for ancillary therapy in this group.
Authors: I N Kaschka; S P Kloska; T Struffert; T Engelhorn; P Gölitz; N Kurka; M Köhrmann; S Schwab; A Doerfler Journal: Clin Neuroradiol Date: 2014-11-20 Impact factor: 3.649
Authors: S M Mishra; J Dykeman; T T Sajobi; A Trivedi; M Almekhlafi; S I Sohn; S Bal; E Qazi; A Calleja; M Eesa; M Goyal; A M Demchuk; B K Menon Journal: AJNR Am J Neuroradiol Date: 2014-07-24 Impact factor: 3.825
Authors: Rosanna Rossi; Seán Fitzgerald; Sara M Gil; Oana M Mereuta; Andrew Douglas; Abhay Pandit; Paul Brennan; Sarah Power; Jack Alderson; Alan O'Hare; Michael Gilvarry; Ray McCarthy; Klearchos Psychogios; Georgios Magoufis; Georgios Tsivgoulis; István Szikora; Katarina Jood; Petra Redfors; Annika Nordanstig; Erik Ceder; Turgut Tatlisumak; Alexandros Rentzos; John Thornton; Karen M Doyle Journal: Eur Stroke J Date: 2021-07-07