Advances in Neuro-Imaging for Clinical Neurology

Date/Time: Monday, October 24, 2022 - 12:00 PM – 1:00 PM
Track: Interactive Lunch Workshop
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Description:

This session will review the recent advances in sophisticated imaging platforms to manage neurological disease. Aneurysmal subarachnoid hemorrhage (aSAH) is associated with an unacceptably high mortality and chronic disability in survivors, underscoring a need to validate new approaches for treatment and prognosis. This session will review the use of advanced imaging, magnetic resonance imaging (MRI) to help address this gap given its versatile capacity to quantitatively evaluate and map changes in brain anatomy, physiology and functional activation.  Recent advances in CT and MR imaging in acute ischemic stroke reperfusion therapies have been centered on the ability to rapidly and accurately assess large vessel occlusions and stroke burden. Since the publication of pivotal randomized clinical trials in 2015, endovascular thrombectomy has become part of the standard of care in selected cases of AIS from large-vessel occlusions up to 6 hours after the onset of symptoms. However, the association between endovascular reperfusion and improved functional outcome is not strictly time dependent. Advances in imaging-based management of AIS provide crucial information about vessel occlusion, infarct core, ischemic penumbra, and degree of collaterals. This information is invaluable in identifying patients who are likely to benefit from reperfusion therapies and excluding those who are unlikely to benefit or are at risk of adverse effects. Malignant cerebral edema develops in a small subset of patients with hemispheric strokes, precipitating deterioration and death if decompressive hemicraniectomy (DHC) is not performed in a timely manner. Predicting which stroke patients will develop malignant edema is imprecise based on clinical data alone. Head computed tomography (CT) imaging is often performed at baseline and 24-h. Utilizing quantitative imaging features from baseline and follow-up CTs, including CSF volume, intracranial reserve (CSF/cranial volume), as well as midline shift (MLS) and infarct-related hypodensity volume may aid in the accurate identification of potentially lethal malignant edema.  

Chair: Neeraj Badjatia, MD, MS, FANA

Co-ChairSarah Nelson, MD

Objectives:

  • Understand the utility of advanced MRI techniques in the acute management of SAH.
  • Recognize the importance of advanced vessel imaging and stroke burden prediction on outcomes for acute ischemic stroke patients undergoing reperfusion therapies.
  • Recognize the emerging importance of machine learning techniques on identifying clinically relevant endpoints after ischemic stroke

Advances in Neuroimaging in Subarachnoid Hemorrhage

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Artificial Intelligence Approach Towards Imaging Cerebral Edema After Ischemic Stroke

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Mechanical Stroke Thrombectomy: Advanced Imaging Selection

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