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Background Predicting clinical outcome based on either the postprocedural recanalization score (modified treatment in cerebral infarction) or the initial National Institute of Health Stroke Scale (NIHSS) clinical score performed immediately after the acute phase remains controversial. The gold standard to predict clinical outcome is the NIHSS score with diffusion weighted imaging. However, magnetic resonance spectroscopy could provide useful metabolic informations. Our study aimed to determine early metabolic factors predictive of long‐term clinical outcome after acute ischemic stroke in patients with middle cerebral artery occlusion successfully treated by mechanical thrombectomy. Methods Patients with proximal middle cerebral artery occlusion, an NIHSS score greater than 6 and successfully treated by mechanical thrombectomy with or without intravenous therapy were included. All patients underwent within 24 hours after mechanical thrombectomy, brain magnetic resonance imaging examination with multivoxel proton‐phosphorus‐magnetic resonance spectroscopy. Functional disability at 90 days with reference to pre‐stroke activities was categorized using the modified Rankin scale. Metabolite ratios were measured and confronted to modified Rankin scale. Results A total of 49 patients were included with initial mean NIHSS of 15.19±5.48. Time delay between: onset‐thrombectomy was 6.77 hours±3.22, thrombectomy‐magnetic resonance imaging was 29.83 hours±15.01. Results in the lesion compared with the contralateral area show an increase of Lac/Cr (0.88 versus 0.21; P

BackgroundThere is no consensus regarding the influence of infarct laterality in patients with acute ischemic stroke due to anterior large vessel occlusion (AIS-LVO) treated with mechanical thrombectomy (MT), particularly in low-ASPECT (0–5) patients who were excluded from the initial MT studies and that participated in dedicated randomized-controlled trials that do not consider the side of the occlusion. We aimed to evaluate the role of infarct laterality on the clinical outcome in low-ASPECT AIS patients treated with MT.Material and methodsWe retrospectively analyzed our institutional stroke database in our Thrombectomy-Capable Stroke Center (TCSC), including patient characteristics, procedural variables, and outcomes, between January 2015 and January 2022. Patients with acute intracranial ICA and/or proximal MCA occlusions with ASPECT ≤ 5 either on CT or MRI were included and divided into 2 groups according to the location of ischemia. The primary endpoint was a good clinical outcome at 90 days (modified Rankin Scale (mRS) score of 0–3).ResultsBetween January 2015 and November 2021, 817 MT were performed, of which 82 were low-ASPECT (10.0%): 41 left-sided and 41 right-sided strokes. The rates of good clinical outcome were 30.8% (12/41) for the left-sided group and 43.6% (17/41) for the right-sided group, with a p-value of 0.349. The morality rate showed no significant difference between the two groups: 39.0% (16/41) in the right stroke group and 36.6% (15/41) in the left stroke group.ConclusionThe clinical outcome was not significantly influenced by stroke laterality. The results of this single-center retrospective study indicate either a lack of strength or equal value in performing mechanical thrombectomy regardless of stroke laterality.

The analysis of Cerebral Angiographies are an essential tool for the assessment of the future of patients that underwent thrombolysis after a stroke event. Many semi-qualitative visual diagnostic scales have been developed for this purpose. Perfusion angiographies show essentially three phases: the arterial (early), the capillary (intermediate), and venous (late) phase. We call parenchymogram the image sequence corresponding to the capillary phase only. Unfortunately the parenchymogram is often under exploited in practice, despite containing many pertinent hints on the quality of reperfusion. In this paper we propose a set of methods for the extraction of the parenchymogram from raw Cerebral Angiographies. These methods rely on basis pursuit and on the representation of images with an over-complete basis arising from an redundant wavelet transform. We will show that the extraction of the parenchymogram by applying the aforementioned methods on real clinical data allows us to recover essential information for the comparison of blood flow before and after thrombolysis.

Abstract: Objective: To evaluate the clinical impact of diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) in staging of malignant lymphoma. Methods: Twenty-three patients with proven malignant lymphomas were prospectively enrolled. DWIBS (b =0, 1000s/mm2) examinations and PET-CT were performed respectively on an Intera 1.5T unit and a Gyroscan PET-CT scan (Philips Medical system, Best, the Netherland). The criteria for positive node involvement were a size over 10mm or an apparent diffusion coefficient (ADC) value under 0.7510−3 mm2/s for nodes under 10mm. For extranodal analysis, a high or heterogeneous signal on DWIBS was considered as positive. In cases of discordance, the reference standard for each region or organ was established at 6 months after the diagnosis according to all available clinical, biological information, as well as histological evidence or follow-up to prove or disprove the presence of disease. Results: DWIBS and PET-CT results were congruent in 333 node regions on the 345 areas analyzed, with excellent agreement (κ =0.97, P <0.0001). From 433 organs analyzed (one patient had splenectomy) extranodal disease was detected in 22 organs on DWIBS. The two imaging techniques agreed on 430 organs (κ =0.99, P <0.0001). Finally, Ann Arbor stages based on DWIBS and those of PET/CT were in agreement for 23 patients. Conclusions: For malignant lymphoma in a pre-therapeutic context, agreement between diffusion-weighted whole-body imaging and PET/CT is high for Ann Arbor staging. [Copyright &y& Elsevier]