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ABSTRACT Objective: To evaluate and treat high-risk infants with cerebral palsy by using Alberta Infant Motor Scale, and to explore the evaluation method of early motor development of infants. Methods: Twenty-four high-risk children with cerebral palsy were randomly divided into treatment group and control group with 12 cases in each group from December 2017 to December 2018 in the general outpatient department of pediatric care and Rehabilitation Department of The International Peace Maternity & Child health Hospital. The parents in the treatment group were instructed to have family rehabilitation by the scale, while the parents in the control group were only followed up to evaluate the improvement of children's motor development after three months. Result: After three months of treatment, Alberta scale was used to evaluate the two groups of children. The Alberta score of the control group was higher after treatment than before treatment, and that of the treatment group was higher after treatment than before treatment, and that of the treatment group was better than that of the control group. There were significant differences in Alberta scores before and after treatment in each group (all P<0.01), and the treatment group was better than the control group. Conclusion: Using Alberta Infant Motor Scale to guide the evaluation and treatment of high-risk infants with cerebral palsy has a remarkable effect and is worthy of clinical promotion. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the safety and efficacy of endovascular thrombectomy (EVT) in acute anterior circulation large vessel occlusive stroke (ALVOS) and explore the related influencing factors for prognoses in patients with low Alberta Stroke Program Early Computed Tomography Score (ASPECT). Methods: Patients with acute ALVOS who underwent EVT in Yijishan Hospital of Wannan Medical College from January 2019 to June 2022 were sequentially enrolled. (1) Patients were divided into a low ASPECT group (0-5) and a non-low ASPECT group (6-10), and the differences between the two groups were compared with respect to incidence of perioperative complications and good prognosis rate [modified Rankin scale (mRS) score≤2] 90 days after onset. (2) According to the prognoses 90 days after onset, the low ASPECT group was divided into the good prognosis (mRS score≤2) and poor prognosis (mRS score>2) subgroup. Univariate analysis and multivariate logistic regression analysis were used to investigate the independent risk factors for prognoses of the low ASPECT patients after EVT. Results: A total of 582 patients [age 26-94(69±11) years, 345 male patients (59.3%)] were enrolled for analysis. The baseline ASPECT score was 8 (7, 10), and the baseline NIHSS score was 14 (11, 18). Among them, 102 (17.5%) patients were in the low ASPECT score group and 480 (82.5%) patients were in the non-low ASPECT score group. In the total cohort, patients in the low ASPECT score group had a higher incidence of symptomatic intracranial hemorrhage, lower 90-day good prognosis rate, and higher 90-day mortality rate. Further, propensity score matching statistical analysis showed that patients in the low ASPECT score group had a significantly higher incidence of malignant brain edema after EVT treatment (40.0% vs. 17.6%, χ 2 =9.13, P =0.003), and a significantly lower 90-day good prognosis rate (24.7% vs. 41.6%, χ 2 =4.96, P =0.026), but there was no significant difference in the incidence of symptomatic intracranial hemorrhage and 90-day mortality between the two groups (40.3% vs. 26.0%, χ 2 =3.55, P =0.060). Among 102 patients with low ASPECT score, 22 (21.6%) patients had good prognosis and 80 (78.4%) had poor prognosis. Multivariate logistic regression analysis showed that history of atrial fibrillation ( OR =4.478, 95% CI 1.186-16.913, P =0.027) was an independent risk factor for poor prognosis of EVT in patients with low ASPECT score, while good collateral circulation (grade 2 vs. grade 0: OR =0.206, 95% CI 0.051-0.842, P =0.028) was a protective factor for good prognosis of EVT in patients with low ASPECT score. Conclusions: Although the 90-day good prognosis rate of EVT treatment for patients with low ASPECT score was lower than that of the non-low ASPECT group, 21.6% patients still benefitted from EVT treatment, especially patients with non-atrial fibrillation and good collateral circulation. Future studies involving more patients are needed to validate our observations.

Clinically, non-contrastive computed tomography (NCCT) is used to quickly diagnose the type and area of ​​stroke, and the Alberta stroke program early computer tomography score (ASPECTS) is used to guide the next treatment. However, in the early stage of acute ischemic stroke (AIS), it's difficult to distinguish the mild cerebral infarction on NCCT with the naked eye, and there is no obvious boundary between brain regions, which makes clinical ASPECTS difficult to conduct. The method based on machine learning and deep learning can help physicians quickly and accurately identify cerebral infarction areas, segment brain areas, and operate ASPECTS quantitative scoring, which is of great significance for improving the inconsistency in clinical ASPECTS. This article describes current challenges in the field of AIS ASPECTS, and then summarizes the application of computer-aided technology in ASPECTS from two aspects including machine learning and deep learning. Finally, this article summarizes and prospects the research direction of AIS-assisted assessment, and proposes that the computer-aided system based on multi-modal images is of great value to improve the comprehensiveness and accuracy of AIS assessment, which has the potential to open up a new research field for AIS-assisted assessment.

Objective: To explore the significance of multi-parameter semiquantitative Alberta Stroke Program Early CT Score (ASPECTS) in detecting core infarction in acute ischemic stroke (AIS) patients. Methods: Twenty-one consecutive AIS patients from Beijing Hospital were retrospectively reviewed in this study from August 2016 to August 2017. All the patients presented within 6 hours since symptom onset.All the patients underwent one-stop dynamic whole brain 4D CTA-CTP scan before treatments (intravenous thrombolysis, mechanical thrombectomy, or other endovascular recanalization). MRI scan was performed in all patients 3 to 7 days after initial administration. Multi-parameter ASPECTS was calculated on the affected hemisphere regarding noncontrast CT (NCCT) map, cerebral blood flow (CBF) map, cerebral blood volume (CBV) map, mean transit time (MTT) map and MRI-DWI map by subtracting 1 point from 10 for any abnormalities visually detected. The evaluative consistency and diagnostic efficiency were analyzed by Pearson's χ(2) test, kappa identity test, and Kendall ' s coefficient of concordance using IBM SPSS statistics 22.0 software. Results: Compared with DWI-ASPECTS or follow-up NCCT-ASPECTS, CBV-ASPECTS had the best performance on both the kappa identity test ( kappa coefficient κ=0.74)and Kendall's coefficient of concordance (τ=0.70). All the values of sensitivity (77.8%), specificity (95.5%), positive likelihood ratio (17.27) and AUC(0.87)were the highest in CBV-ASPECTS, followed by dMTT-ASPECTS. Meanwhile, the misdiagnosis rate (4.5%), missed diagnosis rate (22.2%) and negative likelihood ratio were the lowest in CBV-ASPECTS, followed by dMTT-ASPECTS. dMTT-ASPECTS had the same specificity(95.5%) as CBV-ASPECTS did and it could reveal the infarction in the areas where CBV map showed normal. NCCT-ASPECTS had the lowest sensitivity (64.7%) and highest missed diagnosis rate (35.3%). The misdiagnosis rate of CBF-ASPECTS was the highest (25.2%) and AUC was the lowest (0.76). Conclusions: Multi-parameter semiquantitative ASPECTS may predict the infarction accurately in AIS patients. Compared with the single parameter of NCCT-ASPECTS, this new method may have better detectability and diagnostic performance.