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Analyzing classroom teacher-student consultations: a systemic-multimodal perspective ...
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Analyzing classroom teacher-student consultations: a systemic-multimodal perspective ...
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Non-routine Mathematical Problem-Solving: Creativity, Engagement, and Intuition of STEM Tertiary Students
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The anesthetic approach for endovascular recanalization therapy depends on the lesion site in acute ischemic stroke
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Fröhlich, Kilian; Siedler, Gabriela; Stoll, Svenja; Macha, Kosmas; Kinfe, Thomas M.; Doerfler, Arnd; Eisenhut, Felix; Engelhorn, Tobias; Hoelter, Philip; Lang, Stefan; Muehlen, Iris; Schmidt, Manuel; Kallmünzer, Bernd; Schwab, Stefan; Seifert, Frank; Winder, Klemens; Knott, Michael
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In: Neuroradiology (2021)
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Abstract:
PURPOSE: Endovascular therapy (EVT) of large-vessel occlusion in acute ischemic stroke (AIS) may be performed in general anesthesia (GA) or conscious sedation (CS). We intended to determine the contribution of ischemic cerebral lesion sites on the physician’s decision between GA and CS using voxel-based lesion symptom mapping (VLSM). METHODS: In a prospective local database, we sought patients with documented AIS and EVT. Age, stroke severity, lesion volume, vigilance, and aphasia scores were compared between EVT patients with GA and CS. The ischemic lesions were analyzed on CT or MRI scans and transformed into stereotaxic space. We determined the lesion overlap and assessed whether GA or CS is associated with specific cerebral lesion sites using the voxel-wise Liebermeister test. RESULTS: One hundred seventy-nine patients with AIS and EVT were included in the analysis. The VLSM analysis yielded associations between GA and ischemic lesions in the left hemispheric middle cerebral artery territory and posterior circulation areas. Stroke severity and lesion volume were significantly higher in the GA group. The prevalence of aphasia and aphasia severity was significantly higher and parameters of vigilance lower in the GA group. CONCLUSIONS: The VLSM analysis showed associations between GA and ischemic lesions in the left hemispheric middle cerebral artery territory and posterior circulation areas including the thalamus that are known to cause neurologic deficits, such as aphasia or compromised vigilance, in AIS-patients with EVT. Our data suggest that higher disability, clinical impairment due to neurological deficits like aphasia, or reduced alertness of affected patients may influence the physician’s decision on using GA in EVT.
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Keyword:
Interventional Neuroradiology
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URL: https://doi.org/10.1007/s00234-021-02762-3
http://www.ncbi.nlm.nih.gov/pubmed/34244817
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8589787/
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Lesion site and therapy time predict responses to a therapy for anomia after stroke: a prognostic model development study
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In: Sci Rep (2021)
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Lesion site and therapy time predict responses to a therapy for anomia after stroke: a prognostic model development study
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Lesions that do or do not impair digit span: a study of 816 stroke survivors
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In: Brain Commun (2021)
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Damage to Broca’s area does not contribute to long-term speech production outcome after stroke
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In: Brain (2021)
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Changes in Community Clinicians’ Attitudes and Competence following a Transdiagnostic Cognitive Behavioral Therapy Training
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In: Implement Res Pract (2021)
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Brain regions that support accurate speech production after damage to Broca’s area
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In: Brain Commun (2021)
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Evaluating the Impact of Puzzle-based Learning on Creativity, Engagement and Intuition of STEM Tertiary Students
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CorCenCC: Corpws Cenedlaethol Cymraeg Cyfoes – the National Corpus of Contemporary Welsh ...
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Novel Computational Linguistic Measures, Dialogue System and the Development of SOPHIE: Standardized Online Patient for Healthcare Interaction Education ...
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Multimodal estimation and communication of latent semantic knowledge for robust execution of robot instructions
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In: Prof. Roy (2020)
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Patterns of Multidisciplinary Care of Head and Neck Squamous Cell Carcinoma in Medicare Patients
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In: JAMA Otolaryngol Head Neck Surg (2020)
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Black holes, gravitational waves and fundamental physics: a roadmap
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In: Class.Quant.Grav. ; https://hal.archives-ouvertes.fr/hal-01833690 ; Class.Quant.Grav., 2019, 36 (14), pp.143001. ⟨10.1088/1361-6382/ab0587⟩ (2019)
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Pathogenic variants in USP7 cause a neurodevelopmental disorder with speech delays, altered behavior, and neurologic anomalies.
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In: Genetics in medicine : official journal of the American College of Medical Genetics, vol 21, iss 8 (2019)
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Black holes, gravitational waves and fundamental physics: a roadmap
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