2 research outputs found
Assessment of Tissue Injury in Severe Brain Trauma
International audienceWe report our methodological developments to investigate, in a multi-center study using mean diffusivity, the tissue damage caused by a severe traumatic brain injury (GSC<9) in the 10 days post-event. To assess the diffuse aspect of the injury, we fuse several atlases to parcel cortical, subcortical and WM structures into well identified regions where MD values are computed and compared to normative values. We used P-LOCUS to provide brain tissue segmentation and exclude voxels labeled as CSF, ventricles and hemorrhagic lesion and then automatically detect the lesion load. Preliminary results demonstrate that our method is coherent with expert opinion in the identification of lesions. We outline the challenges posed in automatic analysis for TBI
Successful Thrombectomy Improves Functional Outcome in Tandem Occlusions with a Large Ischemic Core
International audienceBackground: Emergent stenting in tandem occlusions and mechanical thrombectomy (MT) of acute ischemic stroke related to large vessel occlusion (LVO-AIS) with a large core are tested independently. We aim to assess the impact of reperfusion with MT in patients with LVO-AIS with a large core and a tandem occlusion and to compare the safety of reperfusion between large core with tandem and nontandem occlusions in current practice. Methods: We analyzed data of all consecutive patients included in the prospective Endovascular Treatment in Ischemic Stroke Registry in France between January 2015 and March 2023 who presented with a pretreatment ASPECTS (Alberta Stroke Program Early CT Score) of 0â5 and angiographically proven tandem occlusion. The primary end point was a favorable outcome defined by a modified Rankin Scale (mRS) score of 0â3 at 90 days. Results: Among 262 included patients with a tandem occlusion and ASPECTS 0â5, 203 patients (77.5%) had a successful reperfusion (modified Thrombolysis in Cerebral Infarction grade 2b-3). Reperfused patients had a favorable shift in the overall mRS score distribution (adjusted odds ratio [aOR], 1.57 [1.22â2.03]; P < 0.001), higher rates of mRS score 0â3 (aOR, 7.03 [2.60â19.01]; P < 0.001) and mRS score 0â2 at 90 days (aOR, 3.85 [1.39â10.68]; P = 0.009) compared with nonreperfused. There was a trend between the occurrence of successful reperfusion and a decreased rate of symptomatic intracranial hemorrhage (aOR, 0.5 [0.22â1.13]; P = 0.096). Similar safety outcomes were observed after large core reperfusion in tandem and nontandem occlusions. Conclusions: Successful reperfusion was associated with a higher rate of favorable outcome in large core LVO-AIS with a tandem occlusion, with a safety profile similar to nontandem occlusion