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BACKGROUND Intravenous alteplase is the only approved treatment for acute ischemic stroke. Tenecteplase, a genetically engineered mutant tissue plasminogen activator, is an alternative thrombolytic agent. METHODS In this phase 2B trial, we randomly assigned 75 patients to receive alteplase (0.9 mg per kilogram of body weight) or tenecteplase (0.1 mg per(More)
The use of perfusion imaging to guide selection of patients for stroke thrombolysis remains controversial because of lack of supportive phase three clinical trial evidence. We aimed to measure the outcomes for patients treated with intravenous recombinant tissue plasminogen activator (rtPA) at a comprehensive stroke care facility where perfusion computed(More)
Whole-brain dynamic time-resolved computed tomography angiography (CTA) is a technique developed on the new 320-detector row CT scanner capable of generating time-resolved cerebral angiograms from skull base to vertex. Unlike a conventional cerebral angiogram, this technique visualizes pial arterial filling in all vascular territories, thereby providing(More)
PURPOSE To perform a large-scale systematic comparison of the accuracy of all commonly used perfusion computed tomography (CT) data postprocessing methods in the definition of infarct core and penumbra in acute stroke. MATERIALS AND METHODS The collection of data for this study was approved by the institutional ethics committee, and all patients gave(More)
Computed tomography perfusion imaging in acute stroke requires further validation. We aimed to establish the optimal computed tomography perfusion parameters defining the infarct core and critically hypoperfused tissue. Sub-6-h computed tomography perfusion and 24-h magnetic resonance imaging were analysed from 314 consecutive patients with ischaemic(More)
BACKGROUND Perfusion computed tomography (PCT) shows promise in acute stroke assessment. However, the accuracy of CT perfusion thresholds in defining the acute infarct core remains uncertain. METHOD Concurrent PCT and MRI-DWI performed 3-6 h after symptoms onset were assessed in 57 ischemic stroke patients. PCT was compared to DWI images to define the(More)
BACKGROUND The role of brain CT perfusion (CTP) imaging in severe traumatic brain injury (STBI) is unclear. We hypothesised that in STBI early CTP may provide additional information beyond the non contrast CT (NCCT). METHODS Subset analysis of an ongoing prospective observational study on trauma patients with STBI who did not require craniectomy and(More)
BACKGROUND Remote structural and functional changes have been previously described after stroke and may have an impact on clinical outcome. We aimed to use multimodal MRI to investigate contralesional subcortical structural and functional changes 3 months after anterior circulation ischemic stroke. METHODS Fifteen patients with acute ischemic stroke had(More)
BACKGROUND AND PURPOSE Arterial spin labeling (ASL) is a perfusion magnetic resonance imaging (MRI) technique that does not require contrast administration and thus may be more practical in hyperacute stroke than susceptibility-weighted bolus-tracking perfusion-weighted imaging (PWI). However, a threshold for ASL measurement of the ischemic penumbra needs(More)
OBJECTIVE Arterial spin labeling (ASL) is a relatively new MR perfusion technique that requires validation. METHODS One hundred patients with an acute hemispheric ischemic stroke were imaged within 6 hours of symptom onset with perfusion CT (CTP), and at 24 hours with MRI perfusion imaging, including ASL and bolus dynamic susceptibility contrast (DSC)(More)