https://ogma.newcastle.edu.au/vital/access/ /manager/Index en-au 5 Perfusion computed tomography in patients with stroke thrombolysis https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:31435 P < 0.001). For every millilitre of penumbra salvaged, 7.2 days of disability-adjusted life-year days were saved (ß = -7.2, 95% confidence interval, -10.4 to -4.1 days, P < 0.001). Each minute of earlier onset-to-treatment time resulted in a saving of 4.4 disability-free days after stroke (1.3-7.5 days, P = 0.006). However, after adjustment for imaging variables, onset-to-treatment time was not significantly associated with savings in disability-adjusted life-year days. Pretreatment perfusion computed tomography can (independently of clinical variables) predict significant gains, or loss, of disability-free life in patients undergoing reperfusion therapy for stroke. The effect of earlier treatment on disability-free life appears explained by salvage of penumbra, particularly when the ischaemic core is not too large.]]> Thu 17 Feb 2022 09:30:10 AEDT ]]> The blood pressure paradox in acute ischemic stroke https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:44094 3 seconds perfusion lesion with severely delayed contrast transit (delay time >3 seconds/delay time >6 seconds). Results: There were 306 patients included in this study. With every increase of 10 mmHg in baseline systolic blood pressure, the odds of achieving an excellent functional outcome decreased by 12% in multivariate analysis (odds ratio = 0.88, p = 0.048). Conversely, increased baseline blood pressure was associated with better collateral flow. In subgroup analysis of patients with major reperfusion, higher blood pressure was associated with decreased infarct growth and a better clinical outcome, and vice versa in patients without reperfusion. Interpretation: Higher baseline blood pressure in acute ischemic stroke patients with large vessel occlusion/stenosis was associated with better collateral flow. However, for patients without reperfusion, higher baseline blood pressure was associated with increased infarct growth, leading to an unfavorable clinical outcome. The relationship between blood pressure and outcomes is highly dependent on reperfusion, and active blood pressure–lowering treatment may be inappropriate in acute ischemic stroke patients prior to reperfusion treatment.]]> Thu 06 Oct 2022 16:16:26 AEDT ]]>