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Introduction We evaluated the safety and efficacy of a new stent retriever-Tigertriever-after failed aspiration. Materials and Methods Patients with acute ischemic stroke treated with Tigertriever between January 2018 and March 2020 were included in the study. Treatment results of Tigertriever in rescue therapy (after failed aspiration) were evaluated. Periprocedural data were retrospectively analyzed. Results Thirty patients were treated with Tigertriever (14M/16F). There were 20 rescue thrombectomies after failed aspiration. Tigertriver successful recanalization rate (mTICI ≥ 2B) was 70% 65% in rescue therapy and 80% in first-line therapy. The type of first line treatment had no impact on mRS after 1 month and 3 months (ns). There was significant improvement in NIHSS in all patients (mean NIHSS 17 vs. 10, p = 0.028), in rescue treatment (mean NIHSS 17 vs. 11, p = 0.048) and in first line treatment (mean NIHSS 16 vs. 8, p = 0.0005). Better results in NIHSS at discharge were linked with first pass success (p = 0.002), better mTICI at the end of the procedure (p = 0.0006), and administration of rtPA (p = 0.013). Conclusions The new stent retriever Tigertriever is an efficient and safe tool to be used as a rescue device after an unsuccessful first line aspiration technique.Background In rare circumstances, brain arteriovenous malformations (BAVMs) can recruit a transdural blood supply (TBS). The clinical and radiologic characteristics of BAVMs with a TBS are poorly understood. Androgen Receptor activity Methods A retrospective review of the medical records was conducted for adult patients who were admitted for BAVMs from Jan 2013 to Dec 2019. TBSs for BAVMs were divided into 3 types (1) unilateral TBSs from the external carotid artery (ECA) and/or meningeal branch of the vertebral artery (VA); (2) bilateral TBSs from the ECA and/or meningeal branch of the VA; and (3) meningohypophyseal trunk TBSs of the internal carotid artery. Results Four hundred and twenty-eight patients were diagnosed with BAVMs during the study period, of whom 30 (7.0%, 30/428) were identified as having a TBS. Type 1, type 2, and type 3 TBSs were identified in 21 (70%, 21/30), 7 (23.3%, 7/30), and 2 (6.7%, 2/30) patients, respectively. Six (20%, 6/30) patients were conservatively managed. Twelve (40%, 12/30) patients underwent endovascular treatment (EVT) of the BAVM through non-TBS feeders. Eight (26.8%, 8/30) patients underwent EVT of the BAVM both through the TBS and non-TBS feeders. The modified Rankin Scale scores at the 3-month follow-up were 0, 1, 2, 4, and 5 in 24 (80%, 24/30), 2 (6.7%, 2/30), 2 (6.7%, 2/30), 1 (3.3%, 1/30), and 1 (3.3%, 1/30) patients, respectively. Good short-term recovery was achieved in 86.7% (26/30) of the patients. The size of the BAVMs with a TBS was larger than that of BAVMs without a TBS. Patients with higher Spetzler-Martin grades tended to have a TBS. No statistical difference was noted between the patients with and without a TBS with regard to age, sex, location, or concurrent aneurysms. Conclusions This study showed that a TBS was likely to develop in patients with larger BAVMs and that a TBS was likely to be located in the temporal lobe in patients BAVMs with higher SM grades. Weak structures were the primary targets of management. In addition, a BAVM could be embolized via the TBS.Objective To propose a novel scale for the assessment of stroke severity at symptom onset and to investigate whether it is associated with ultra-early neurological deterioration (UND) and functional outcomes. Methods The Chongqing Stroke Scale (CQSS) was constructed based on key aspects of history, emphasizing language, motor function, and level of consciousness to yield a total 0-11 scale. The diagnostic performance of the CQSS was assessed in 215 ischemic stroke patients between June 2017 and October 2017 in a tertiary hospital. Patients were included if they presented within 24 h after onset of symptoms and they or their witness can recall the scenario at symptom onset. UND was defined as an increase ≥2 points on the CQSS between symptom onset and admission. Functional outcomes were assessed using the 3-month modified Rankin scale. The correlation between the CQSS score and baseline National Institutes of Health Stroke Scale (NIHSS) score was assessed. The sensitivity, specificity, and positive and negativ The newly developed CQSS is a simple and easy-to-perform scale that allows a quantitative evaluation of the stroke severity at symptom onset and an assessment of UND before hospital admission. It is associated with NIHSS and predicts functional outcome in patients with acute ischemic stroke.Objectives (1) To assess whether neuroticism, state anxiety, and body vigilance are higher in patients with persistent postural-perceptual dizziness (PPPD) compared to a recovered vestibular patient group and a non-dizzy patient group; (2) To gather pilot data on illness perceptions of patients with PPPD. Materials and Methods 15 cases with PPPD and two control groups (1) recovered vestibular patients (n = 12) and (2) non-dizzy patients (no previous vestibular insult, n = 12). Main outcome measures Scores from the Big Five Inventory (BFI) of personality traits, Generalized Anxiety Disorder - 7 (GAD-7) scale, Body Vigilance Scale (BVS), Dizziness Handicap Inventory (DHI), modified Vertigo Symptom Scale (VSS) and Brief Illness Perception Questionnaire (BIPQ). Results Compared to non-dizzy patients, PPPD cases had higher neuroticism (p = 0.02), higher introversion (p = 0.008), lower conscientiousness (p = 0.03) and higher anxiety (p = 0.02). There were no differences between PPPD cases and recovered vestibular patients in BFI and GAD-7. PPPD cases had higher body vigilance to dizziness than both control groups and their illness perceptions indicated higher levels of threat than recovered vestibular patients. Conclusion PPPD patients showed statistically significant differences to non-dizzy patients, but not recovered vestibular controls in areas such as neuroticism and anxiety. Body vigilance was increased in PPPD patients when compared with both recovered vestibular and non-dizzy patient groups. PPPD patients also exhibited elements of negative illness perception suggesting that this may be the key element driving the development of PPPD. Large scale studies focusing on this area in the early stages following vestibular insult are needed.
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