Evidence map›Paper›PMID 37801879›Full record

ArticleJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association2023

Larger ischemic cores and poor collaterals among large vessel occlusions presenting in the late evening.

Anirudh Sreekrishnan, Steffen Tiedt, Pierre Seners, Nicole Yuen, Jean-Marc Olivot, Michael Mlynash, Maarten G Lansberg, Jeremy J Heit, Sarah Lee, Patrik Michel and 5 more

Abstract read
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In one paragraph

Article in Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Anirudh SreekrishnanDepartment of Neurology, Stanford Hospital, Palo Alto, CA, United States. Electronic address: asreekri@stanford.edu.
Steffen TiedtInstitute for Stroke and Dementia Research, University Hospital, LMU Munich, Munich, Germany.
Pierre SenersDepartment of Neurology, Stanford Hospital, Palo Alto, CA, United States; Neurology Department, Hôpital Fondation A. de Rothschild, Paris, France; Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, INSERM, Paris, France.
Nicole YuenDepartment of Neurology, Stanford Hospital, Palo Alto, CA, United States.
Jean-Marc OlivotDepartment of Neurology and UMR Clinical investigating Center 1436 Centre Hospitalier Hospitalier Universitaire de Toulouse, Toulouse, France.
Michael MlynashDepartment of Neurology, Stanford Hospital, Palo Alto, CA, United States.
Maarten G LansbergDepartment of Neurology, Stanford Hospital, Palo Alto, CA, United States.
Jeremy J HeitDepartment of Neurosurgery, Stanford Hospital, Palo Alto, CA, United States.
Sarah LeeDepartment of Neurology, Stanford Hospital, Palo Alto, CA, United States.
Patrik MichelDepartment of Neurology, Lausanne University Hospital, Lausanne, Switzerland.
Davide StramboDepartment of Neurology, Lausanne University Hospital, Lausanne, Switzerland.
Alexander SalernoDepartment of Neurology, Lausanne University Hospital, Lausanne, Switzerland.
José Bernardo Escribano ParedesDepartment of Neurology, Geneva University Hospital, Geneva, Switzerland.
Emmanuel CarreraDepartment of Neurology, Geneva University Hospital, Geneva, Switzerland.
Gregory W AlbersDepartment of Neurology, Stanford Hospital, Palo Alto, CA, United States.

Funding

Stanford University Regional Coordinating Stroke Center for the NIH Stroke Trials NetworkU24NS107220 · NINDS · STANFORD UNIVERSITY · PI MAARTEN G LANSBERG · 2018 to 2026
$2.8M
NINDS NIH HHS U24 NS107220
6 · The paper itself

Abstract

backgroundComponents critical to cerebral perfusion have been noted to oscillate over a 24-h cycle. We previously reported that ischemic core volume has a diurnal relationship with stroke onset time when examined as dichotomized epochs (i.e. Day, Evening, Night) in a cohort of over 1,500 large vessel occlusion (LVO) patients. In this follow-up analysis, our goal was to explore if there is a sinusoidal relationship between ischemic core, collateral status (as measured by HIR), and stroke onset time.

methodsWe retrospectively examined collection of LVO patients with baseline perfusion imaging performed within 24 h of stroke onset from four international comprehensive stroke centers. Both ischemic core volume and HIR, were utilized as the primary radiographic parameters. To evaluate for differences in these parameters over a continuous 24-h cycle, we conducted a sinusoidal regression analysis after linearly regressing out the confounders age and time to imaging.

resultsA total of 1506 LVO cases were included, with a median ischemic core volume of 13.0 cc (IQR: 0.0-42.0) and median HIR of 0.4 (IQR: 0.2-0.6). Ischemic core volume varied by stroke onset time in the unadjusted (p = 0.001) and adjusted (p = 0.003) sinusoidal regression analysis with a peak in core volume around 7:45PM. HIR similarly varied by stroke onset time in the unadjusted (p = 0.004) and adjusted (p = 0.002) models with a peak in HIR values at around 8:18PM.

conclusionThe results suggest that critical factors to the development of the ischemic core vary by stroke onset time and peak around 8PM. When placed in the context of prior studies, strongly suggest a diurnal component to the development of the ischemic core.

Indexed as

Brain IschemiaStrokeHumansRetrospective StudiesThrombectomyCircadian rhythmIschemic strokeLarge vessel occlusionsPerfusion imaging

Identifiers

PMID37801879
PMCPMC10841643

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.