PURPOSE: Cerebral hyperdensities can appear on head computed tomography (CT) images performed early after endovascular treatment (EVT) in patients with acute ischemic stroke and may be secondary to contrast staining or hemorrhagic transformation. The aim of this study was to determine how the high-density sign on CT affects mortality and clinical outcome and whether CT parameters predict hemorrhagic conversion or unfavorable outcome. METHODS: We retrospectively reviewed a database of patients who underwent EVT with mechanical thrombectomy for acute ischemic stroke over 7 years. Included were acute stroke patients with a CT examination within 24 h post-EVT with mechanical thrombectomy, demonstrating areas of hyperdensity. We evaluated morphologic characteristics of these lesions, location, CT Hounsfield units and largest area, as well as patient demographics, EVT methods and patient outcome. RESULTS: A total of 29 patients met the strict inclusion criteria. Complete recanalization was achieved in 58.6% (17/29). Seventeen (58.6%) cases of post-intervention cerebral hyperdensities were related to contrast staining and 12 (41.4%) cases to contrast staining and hemorrhage. Patient mortality was significantly higher in the hemorrhagic group (50.0% versus 5.9%, p = 0.003). The increased density on CT was associated with higher hemorrhagic risk (odds ratio 1.05, p = 0.036). CONCLUSION: Patients with the high-density sign on CT images after mechanical thrombectomy for acute ischemic stroke demonstrated increased mortality and worse clinical outcome, primarily when these hyperdensities were related to hemorrhage. CT imaging parameters as higher density areas can help in the differentiation of hemorrhage from contrast staining.
PURPOSE: Cerebral hyperdensities can appear on head computed tomography (CT) images performed early after endovascular treatment (EVT) in patients with acute ischemic stroke and may be secondary to contrast staining or hemorrhagic transformation. The aim of this study was to determine how the high-density sign on CT affects mortality and clinical outcome and whether CT parameters predict hemorrhagic conversion or unfavorable outcome. METHODS: We retrospectively reviewed a database of patients who underwent EVT with mechanical thrombectomy for acute ischemic stroke over 7 years. Included were acute stroke patients with a CT examination within 24 h post-EVT with mechanical thrombectomy, demonstrating areas of hyperdensity. We evaluated morphologic characteristics of these lesions, location, CT Hounsfield units and largest area, as well as patient demographics, EVT methods and patient outcome. RESULTS: A total of 29 patients met the strict inclusion criteria. Complete recanalization was achieved in 58.6% (17/29). Seventeen (58.6%) cases of post-intervention cerebral hyperdensities were related to contrast staining and 12 (41.4%) cases to contrast staining and hemorrhage. Patient mortality was significantly higher in the hemorrhagic group (50.0% versus 5.9%, p = 0.003). The increased density on CT was associated with higher hemorrhagic risk (odds ratio 1.05, p = 0.036). CONCLUSION: Patients with the high-density sign on CT images after mechanical thrombectomy for acute ischemic stroke demonstrated increased mortality and worse clinical outcome, primarily when these hyperdensities were related to hemorrhage. CT imaging parameters as higher density areas can help in the differentiation of hemorrhage from contrast staining.
Authors: G Parrilla; B García-Villalba; M Espinosa de Rueda; J Zamarro; E Carrión; F Hernández-Fernández; J Martín; R Hernández-Clares; A Morales; A Moreno Journal: AJNR Am J Neuroradiol Date: 2012-04-26 Impact factor: 3.825
Authors: J Hom; J W Dankbaar; B P Soares; T Schneider; S-C Cheng; J Bredno; B C Lau; W Smith; W P Dillon; M Wintermark Journal: AJNR Am J Neuroradiol Date: 2010-10-14 Impact factor: 3.825
Authors: Jeffrey L Saver; Mayank Goyal; Aad van der Lugt; Bijoy K Menon; Charles B L M Majoie; Diederik W Dippel; Bruce C Campbell; Raul G Nogueira; Andrew M Demchuk; Alejandro Tomasello; Pere Cardona; Thomas G Devlin; Donald F Frei; Richard du Mesnil de Rochemont; Olvert A Berkhemer; Tudor G Jovin; Adnan H Siddiqui; Wim H van Zwam; Stephen M Davis; Carlos Castaño; Biggya L Sapkota; Puck S Fransen; Carlos Molina; Robert J van Oostenbrugge; Ángel Chamorro; Hester Lingsma; Frank L Silver; Geoffrey A Donnan; Ashfaq Shuaib; Scott Brown; Bruce Stouch; Peter J Mitchell; Antoni Davalos; Yvo B W E M Roos; Michael D Hill Journal: JAMA Date: 2016-09-27 Impact factor: 56.272
Authors: Rüdiger von Kummer; Joseph P Broderick; Bruce C V Campbell; Andrew Demchuk; Mayank Goyal; Michael D Hill; Kilian M Treurniet; Charles B L M Majoie; Henk A Marquering; Michael V Mazya; Luis San Román; Jeffrey L Saver; Daniel Strbian; William Whiteley; Werner Hacke Journal: Stroke Date: 2015-09-01 Impact factor: 7.914