dwi | STROKE MANUAL

Bow Hunter´s syndrome

Bow-Hunter type I (atlanto-axial) - flow in the vertebral artery extra- and transcranially at rest (left) and after head rotation contralaterally (right). Reduced extracranial flow and flow reversal in the V4 segment are demonstrated).

NEUROIMAGING / NEUROSONOLOGY Bow Hunter's syndrome David Goldemund M.D.Updated on 12/12/2023, published on 09/12/2021 [toc] Definition Bow Hunter's syndrome (also known as Rotational vertebral artery occlusion syndrome) is a symptomatic vertebrobasilar insufficiency caused by mechanical compression of the vertebral artery (VA) at the level of the atlanto-axial joint during head rotation within the normal physiologic ... Read more

Contrast-induced encephalopathy (CIE)

NEUROIMAGING Contrast-induced encephalopathy (CIE) David Goldemund M.D.Updated on 05/01/2024, published on 08/12/2021 [toc] contrast-induced encephalopathy (CIE) is a rare neurological complication that occurs during or after the use of a contrast media in various angiographic procedures such as coronary angiography, diagnostic cerebral DSA, carotid angioplasty, and EVT in acute stroke patients (Chu, 2020) it ... Read more

Resistance to antiplatelet drugs

MEDICATION / ANTIPLATELET THERAPY Resistance to antiplatelet therapy David Goldemund M.D.Updated on 07/05/2024, published on 01/12/2021 [toc] stroke may occur despite antiplatelet therapy; the broader term clinical resistance should be used in this scenario if the exact cause of stroke has not yet been identified the term '"resistance to antiplatelet drugs" should be reserved for situations where ... Read more

Neurosonology and the brain death diagnosis

TCCD in cerebral circulatory arrest (CCA) detection

NEUROIMAGING / NEUROSONOLOGY Neurosonology and the brain death diagnosis David Goldemund M.D.Updated on 02/02/2024, published on 29/11/2021 [toc] Introduction brain death and cerebral circulatory arrest (CCA) are not identical conditions brain death is a clinical diagnosis characterized by the irreversible loss of all brain functions, including those of the brainstem several mechanisms lead to brain ... Read more

Antiplatelet therapy in stroke prevention

DRUGS / ANTIPLATELET THERAPY Antiplatelet therapy in stroke prevention David Goldemund M.D.Updated on 25/04/2024, published on 28/11/2021 [toc] → overview of antiplatelet agents Antiplatelet therapy in the primary stroke prevention General population aspirin in primary prevention in the general population leads to only a modest or no reduction in cardiovascular (CV) risk while increasing the ... Read more

Antiplatelet and anticoagulant therapy in acute stroke

ISCHEMIC STROKE / ACUTE THERAPY Antiplatelet and anticoagulant therapy in acute stroke David Goldemund M.D.Updated on 26/12/2023, published on 16/11/2021 [toc] Antithrombotic therapy in acute stroke antithrombotic medication is crucial in stroke prevention, as it significantly reduces the risk of both initial and recurrent strokes antiplatelet therapy is the preferred treatment for lesions characterized by ... Read more

Recanalization therapy in anticoagulated patients

M1 segment occlusion on CTA and NCCT (with a dense artery sign)

ISCHEMIC STROKE / ACUTE THERAPY Recanalization therapy in anticoagulated patients David Goldemund M.D.Updated on 21/12/2023, published on 11/11/2021 [toc] ischemic stroke may occur despite anticoagulation, either due to subtherapeutic anticoagulation, non-compliance, or a prothrombotic condition that increases the clotting risk despite anticoagulation anticoagulants complicate the decision-making process for thrombolysis and mechanical thrombectomy in acute ischemic ... Read more

Idarucizumab (PRAXBIND)

ADD-ONS / ANTICOAGULANT THERAPY Idarucizumab (PRAXBIND) David Goldemund M.D.Updated on 17/03/2024, published on 10/11/2021 [toc] the use of idarucizumab as an antidote to reverse the anticoagulant effects of dabigatran was approved by the FDA in October 2015 [Cassels, 2015] it has a 300-fold greater affinity for thrombin than does dabigatran indicated for adult patients ... Read more

Pulmonary A-V malformation

Pulmonary arteriovenous malformation (PAVM) on MR angiography (Schneider, 2008)

ISCHEMIC STROKE / CLASSIFICATION AND PATHOGENESIS Pulmonary A-V malformation David Goldemund M.D.Updated on 03/03/2024, published on 31/10/2021 [toc] pulmonary arteriovenous malformation (PAVM) comprises abnormal connections between pulmonary arteries and veins synonyms: pulmonary AVM, pulmonary arteriovenous fistula, pulmonary arteriovenous aneurysm PAVMs are rare in the general population it is estimated that 70-80% of PVAMs are related ... Read more

Fibrinolytic drugs

ISCHEMIC STROKE / RECANALIZATION THERAPY Fibrinolytic drugs David Goldemund M.D.Updated on 06/05/2024, published on 26/10/2021 [toc] Comments on hemostasis blood clotting is a fundamental homeostatic mechanism the participation of different systems is necessary: vascular wall (vasoconstriction) platelets (adhesion → activation → aggregation) with the formation of a primary plug plasma coagulation factors → thrombin formation ... Read more