Stroke and Vascular Neurology
Real-world evaluation of Brainomix e-Stroke software
Brainomix e-Stroke is an artificial intelligence-based decision support tool that aids the interpretation of CT imaging in the context of acute stroke. While e-Stroke has the potential to improve the speed and accuracy of diagnosis, real-world validation is essential. The aim of this study was to prospectively evaluate the performance of Brainomix e-Stroke in an unselected cohort of patients with suspected acute ischaemic stroke. Brainomix e-Stroke software provides rapid and reliable analysis of CT imaging in the acute stroke setting although, in line with the manufacturer's guidance, it should be used as an adjunct to expert interpretation rather than a standalone decision-making tool.
Brainomix e-Stroke是一个基于人工智能的决策支持工具，在急性中风的情况下帮助解释CT成像。虽然e-Stroke有可能提高诊断的速度和准确性，但现实世界的验证是必不可少的。这项研究的目的是前瞻性地评估Brainomix e-Stroke在一组疑似急性缺血性中风患者中的表现。Brainomix e-Stroke软件可为急性中风患者提供快速可靠的CT成像分析，但根据制造商的指导，该软件应作为专家解释的辅助工具，而不是独立的决策工具。
REF: Mallon D, Fallon M, Blana E, et al. Real-world evaluation of Brainomix e-Stroke software. Stroke Vasc Neurol. Published online December 22, 2023. doi:10.1136/svn-2023-002859 PMID: 38164621
When treating acute ischaemic stroke of LVO type, time window prevails over tissue window
Time is brain. How fast an occluded cerebral artery can be reopened is directly related to how many brain cells can be saved. The identification of a tissue window as indicated by the presence of a penumbra on multimodality imaging study has opened the time window of treatment to 24 hours after the onset.1 From 2019 to 2022, the issue of direct intra-arterial (IA) mechanical thrombectomy (MT) is non-inferior to bridging therapy or not has been settled.2 Bridging therapy may have slight advantage in re-opening the occluded arteries than direct IA MT.3 Recently published data on IA MT to treat acute ischaemic stroke (AIS) from a large vessel occlusion but with a low Alberta Stroke Programme Early CT (ASPECT) score indicated that in these patients, performing a multimodality imaging study may not be necessary...
时间就是大脑。闭塞的脑动脉能多快重新开放，直接关系到能挽救多少脑细胞。多模态成像研究中存在半影所指示的组织窗的识别将治疗时间窗打开到发病后24小时。1从2019年到2022年，直接动脉内（IA）机械血栓切除术（MT）是否不劣于桥接治疗的问题已经得到解决。2桥接治疗在再狭窄方面可能略有优势。开放闭塞动脉比直接IA MT。3最近发表的关于IA MT治疗大血管闭塞但阿尔伯塔卒中项目早期CT（ASPECT）评分较低的急性缺血性卒中（AIS）的数据表明，在这些患者中，可能不需要进行多模态成像研究。
REF: Huo X, Jin A, Miao Z, Wang Y, Wang D. When treating acute ischaemic stroke of LVO type, time window prevails over tissue window. Stroke Vasc Neurol. Published online December 21, 2023. doi:10.1136/svn-2023-003007 PMID: 38164603
Treatment practice of vasospasm during endovascular thrombectomy: an international survey
The clinical importance and management of vasospasm as a complication during endovascular stroke treatment (EVT) has not been well studied. We sought to investigate current expert opinions in neurointervention and therapeutic strategies of iatrogenic vasospasm during EVT. There is disagreement among NIs about the clinical relevance of vasospasm during EVT and its management. There was a higher likelihood of use of preventive and active vasodilator treatment in the group that perceived vasospasm as a relevant complication as well as differing interventional strategies for continuing an EVT in the presence of a large-vessel vasospasm.
REF: Jesser J, Nguyen T, Dmytriw AA, et al. Treatment practice of vasospasm during endovascular thrombectomy: an international survey. Stroke Vasc Neurol. Published online December 19, 2023. doi:10.1136/svn-2023-002788 PMID: 38164618