Brain Computed Tomography Scan Research Articles

Feasibility study on the clinical application of CT-based synthetic brain T1-weighted MRI: comparison with conventional T1-weighted MRI.

This study aimed to examine the equivalence of computed tomography (CT)-based synthetic T1-weighted imaging (T1WI) to conventional T1WI for the quantitative assessment of brain morphology. This prospective study examined 35 adult patients undergoing brain magnetic resonance imaging (MRI) and CT scans. An image synthesis method based on a deep learning model was used to generate synthetic T1WI (sT1WI) from CT data. Two senior radiologists used sT1WI and conventional T1WI on separate occasions to independently measure clinically relevant brain morphological parameters. The reliability and consistency between conventional and synthetic T1WI were assessed using statistical consistency checks, comprising intra-reader, inter-reader, and inter-method agreement. The intra-reader, inter-reader, and inter-method reliability and variability mostly exhibited the desired performance, except for several poor agreements due to measurement differences between the radiologists. All the measurements of sT1WI were equivalent to that of T1WI at 5% equivalent intervals. This study demonstrated the equivalence of CT-based sT1WI to conventional T1WI for quantitatively assessing brain morphology, thereby providing more information on imaging diagnosis with a single CT scan. Real-time synthesis of MR images from CT scans reduces the time required to acquire MR signals, improving the efficiency of the treatment planning system and providing benefits in the clinical diagnosis of patients with contraindications such as presence of metal implants or claustrophobia. • Deep learning-based image synthesis methods generate synthetic T1-weighted imaging from CT scans. • The equivalence of synthetic T1-weighted imaging and conventional MRI for quantitative brain assessment was investigated. • Synthetic T1-weighted imaging can provide more information per scan and be used in preoperative diagnosis and radiotherapy.

Early Discharge versus 6-hour Observation in Mild Traumatic Brain Injury with Normal Brain CT Scan; a Comparative Pilot study of Outcomes.

Early discharge from the emergency department (ED) or a 6-hour observation in the ED are two methods for management of patients with mild traumatic brain injury (mTBI) with normal brain computed tomography (CT) scan. This study aimed to compare the outcomes of the two management options. This study is a single-center, open-label, pilot randomized case control study conducted in the ED of Ramathibodi Hospital from June 2022 to September 2023. Eligible participants included all individuals with mTBI who had negative findings on Brain CT scans. They were randomly assigned to either the early ED discharge or 6-hour ED observation group and compared regarding the outcomes (rate of 48-hour ED revisits; occurrence of post-concussion syndrome (PCS) 1 day, 1 month, and 3 months after the initial injury; and 3-month mortality). 122 patients with the mean age of 74.62 ± 14.96 (range: 25-99) years were consecutively enrolled (57.37% female). No significant differences were observed between the early discharge and observation groups regarding the severity of TBI (p=0.853), age (p=0.334), gender (p=0.588), triage level (p=0.456), Glasgow Coma Scale (GCS) score (p=0.806), comorbidities (p=0.768), medication usage (p=0.548), mechanism of injury (p=0.920), indication for brain CT scan (p=0.593), time from TBI onset to ED arrival (p=0.886), and time from ED triage to brain CT scan (p=0.333). Within 48 hours after randomization, the incidence of revisits was similar between the two groups (1.57% vs. 3.23%; p = 1.000). There were no statistically significant differences in the incidence of PCS between the early discharge and observation groups at 1 day (33.90% vs. 35.48%, p = 0.503), at 1 month (12.07% vs. 13.11%, p = 0.542), and at 3 months (1.92% vs. 5.56%, p = 0.323) after randomization. After a three-month follow-up period, four patients in the early discharge group, had expired (none of the deaths were associated with TBI). It seems that, in mTBI patients with normal initial brain CT scan and the absence of other injuries or neurological abnormalities, early discharge from the ED without requiring observation could be considered safe.

Determining the effect of hypertension and diabetes following stroke in tertiary hospital, Aljouf, Saudi Arabia.

Background: Stroke is a common neurological disorder with a high prevalence. The aim of this study was to determine the risk factor, prevalence, and association of types of strokes among diabetes and hypertension patients.
 Methods: A retrospective study was conducted in King Abdul Aziz, Qurayyat, Sakaka, and Tubarjal hospitals among stroke patients including both sexes within the age > 40 years. Type of stroke was identified by brain computed tomography scans or magnetic resonance imaging and risk factors for stroke and other details were noted on a checklist.
 Results: Out of 226 stroke patients considered for the present study, in which 48% were males and 52% were females. All lived in the Aljouf region. Most of the patients had risk factors which included Hypertension 49 (21.68%), Diabetes Mellitus 44 (19.46%), Combined (Hypertension and diabetes) 111 (49.11%), and Hyperlipidemia 22 (9.75%). Stroke patients > 60 years of age group showed a higher prevalence of ischemic stroke (p=0.001). The combined risk factor group also showed more prevalence of ischemic stroke (49.11%).
 Conclusion: Patient having both risk factor Hypertension and diabetes mellitus were major association with ischemic stroke. Majority of the patients with ischemic stroke age at onset > 60 year and irrespectively affected both males and females were equally.
 Bangladesh Journal of Medical Science Vol. 23 No. 01 January’24 Page : 171-178

Motion Artifact Mimics Subdural Hemorrhage on CT Scans: A Case Series

The aim of this paper is to show a common phenomenon seen in brain computed tomography scans. This phenomenon is seen when the patient slightly moves during the brain scan which creates a motion artifact that appears like pathology and the radiologists might misdiagnose the case as a false positive case. A slight motion artifact appeared as a subdural hemorrhage in five cases. Some of these cases came to the hospital as road traffic accident cases, while others have only suffered a chronic headache. In this case series, five cases are presented, scanned again to rule out any pathology, and these cases are discussed in this paper to find any common pattern among these cases.

Unsupervised model for structure segmentation applied to brain computed tomography.

This article presents an unsupervised method for segmenting brain computed tomography scans. The proposed methodology involves image feature extraction and application of similarity and continuity constraints to generate segmentation maps of the anatomical head structures. Specifically designed for real-world datasets, this approach applies a spatial continuity scoring function tailored to the desired number of structures. The primary objective is to assist medical experts in diagnosis by identifying regions with specific abnormalities. Results indicate a simplified and accessible solution, reducing computational effort, training time, and financial costs. Moreover, the method presents potential for expediting the interpretation of abnormal scans, thereby impacting clinical practice. This proposed approach might serve as a practical tool for segmenting brain computed tomography scans, and make a significant contribution to the analysis of medical images in both research and clinical settings.

Successful Surgical Resection of an Ependymal Cyst in the Fourth Ventricle of a Dog.

Ependymal cysts represent congenital brain malformations rarely described in human medicine, where surgical resection is the treatment of choice. In veterinary medicine, only three cases have been previously reported, with one partially resected with surgery. A 6 yr old entire male American Staffordshire terrier was referred with a 4 mo history of incoordination and collapsing episodes with extensor rigidity. Neurological examination localized the lesion to the left central vestibular system and cerebellum. A brain computed tomography scan showed a hypoattenuating lesion with peripheral contrast enhancement in the fourth ventricle consistent with a cyst and secondary hydrocephalus. Treatment with prednisone was initiated, but despite an initial improvement, neurologic signs recurred and a suboccipital craniectomy to remove the cyst was performed. The cyst was first drained, and the capsule was carefully resected. The histopathological evaluation revealed a simple cubic to cylindrical epithelium with apical cilia and loose surrounding fibrillar tissue consistent with an intraventricular ependymal cyst. Four and a half years after surgery, the dog only shows short episodes of balance loss when turning abruptly but is otherwise neurologically normal. To the authors' knowledge, this is the first reported ependymal cyst in the fourth ventricle of a dog with successful surgical resection.

Hypo-attenuating Berry Sign as a Novel Imaging Marker of Ruptured Aneurysm in Patients with Subarachnoid Hemorrhage; a Diagnostic Accuracy Study.

Aneurysmal subarachnoid hemorrhage (SAH) constitutes a life-threatening condition, and identifying the ruptured aneurysm is essential for further therapy. This study aimed to evaluate the diagnostic accuracy of hypo-attenuating berry sign (HBS) observed on computed tomography (CT) scan in distinguishing ruptured aneurysms. In this diagnostic accuracy study, patients who had SAH and underwent non-enhanced brain CT scan were recruited. The HBS was defined as a hypo-attenuating area with an identifiable border in the blood-filled hyper-dense subarachnoid space. The screening performance characteristics of HBS in identifying ruptured aneurysms were calculated considering the digital subtraction angiography (DSA) as the gold standard. A total of 129 aneurysms in 131 patients were analyzed. The overall sensitivity and specificity of HBS in the diagnosis of aneurysms were determined to be 78.7% (95%CI: 73.1% - 83.4%) and 70.7% (95%CI: 54.3% - 83.4%), respectively. Notably, the sensitivity increased to 90.9% (95%CI: 84.3% - 95.0%) for aneurysms larger than 5mm. The level of inter-observer agreement for assessing the presence of HBS was found to be substantial (kappa=0.734). The diagnostic accuracy of HBS in individuals exhibited enhanced specificity, sensitivity, and reliability when evaluating patients with a solitary aneurysm or assessing ruptured aneurysms. The multivariate logistic regression analysis revealed a statistically significant relationship between aneurysm size and the presence of HBS (odds ratios of 1.667 (95%CI: 1.238 - 2.244; p < 0.001) and 1.696 (95%CI: 1.231 - 2.335; p = 0.001) for reader 1 and reader 2, respectively). The HBS can serve as a simple and easy-to-use indicator for identifying a ruptured aneurysm and estimating its size in SAH patients. .

Injudicious use of cranio-spinal imaging in Guillain-Barré syndrome in a low resource country.

Background: Many patients being investigated for Guillain-Barré syndrome (GBS) undergo unnecessary neuroimaging. The objective of this study was to determine the proportion of patients with GBS undergoing neuroimaging investigation, and to investigate any association with different GBS variants using the Brighton criteria. Methods: This cross-sectional observational study was conducted in the leading tertiary care hospital in Pakistan; 148 patients being investigated for, and subsequently diagnosed with GBS between January 2017 and March 2020 were enrolled. Participants were asked if they had undergone neuroimaging of the craniospinal axis before or during hospital admission, and the purpose of any computed tomography (CT) scan was investigated. We enquired whether fundoscopy had been performed before lumbar puncture (LP) and determined the level of certainty based on the Brighton criteria. Results: The majority of participants were men (n = 107, 73%), with a mean age of 42.85 ± 18.40 years. The mean waiting time to their first interaction with a neurologist was 5.20 ± 4.01 days, and the demyelinating variant of GBS was more common than the axonal variant (1.6:1). Most patients were diagnosed with level I certainty using the Brighton criteria (n = 113, 76%). Brain and spine magnetic resonance imaging (MRI) were performed ahead of admission in 48 (32%) and 59 (39%) patients, respectively. Brain CT scan was performed in 121 (82%) patients before LP, while 27 (18%) only underwent fundoscopic examination before LP. Conclusion: Clinical examination is fundamental in the diagnosis of GBS. Neuroimaging may be inappropriate and unnecessary, and may detract attention from crucial peripheral neuropathy measures while misusing limited resources.

Age-Dependent Changes in Effective Dose in Pediatric Brain CT: Comparisons of Estimation Methods.

The effective dose (ED) in computed tomography (CT) may be calculated by multiplying the dose-length product (DLP) by a conversion factor. As children grow, automatic exposure control increases the DLP, while the conversion factor decreases; these two changes affect the ED in opposite ways. The aim of this study was to investigate the methods of ED estimation according to age in pediatric brain CT. We retrospectively analyzed 980 brain CT scans performed for various clinical indications in children. The conversion factor at each age, in integer years, was determined based on the values at 0, 1, 5, and 10 years provided by the International Commission on Radiological Protection (ICRP), using a curve (curve method) or lines (linear method). In the simple method, the ED was estimated using the ICRP conversion factor for the closest age. We also analyzed the ED estimated by a radiation dose management system. Although the median DLP at each age increased with age, the median ED estimated by the curve method was highest at 0 years, decreased with age, and then plateaued at 9 years. The linear method yielded mildly different results, especially at 2 and 3 years. The ED estimated by the simple method or the radiation dose management system showed inconsistent, up-and-down changes with age. In conclusion, the ED in pediatric brain CT decreases with age despite increased DLP. Determination of the conversion factor at each age using a curve is expected to contribute to estimating the ED in pediatric CT according to age.

In search of subcortical and cortical morphologic alterations of a normal brain through aging: an investigation by computed tomography scan.

Morphologic changes in the brain through aging, as a physiologic process, may involve a wide range of variables including ventricular dilation, and sulcus widening. This study reports normal ranges of these changes as standard criteria. Normal brain computed tomography scans of 400 patients (200 males, 200 females) in every decade of life (20 groups each containing 20 participants) were investigated for subcortical/cortical atrophy (bicaudate width [BCW], third ventricle width [ThVW], maximum length of lateral ventricle at cella media [MLCM], bicaudate index [BCI], third ventricle index [ThVI], and cella media index 3 [CMI3], interhemispheric sulcus width [IHSW], right hemisphere sulci diameter [RHSD], and left hemisphere sulci diameter [LHSD]), ventricular symmetry. Distribution and correlation of all the variables were demonstrated with age and a multiple linear regression model was reported for age prediction. Among the various parameters of subcortical atrophy, BCW, ThVW, MLCM, and the corresponding indices of BCI, ThVI, and CMI3 demonstrated a significant correlation with age (R2≥0.62). All the cortical atrophy parameters including IHSW, RHSD, and LHSD demonstrated a significant correlation with age (R2≥0.63). This study is a thorough investigation of variables in a normal brain which can be affected by aging disclosing normal ranges of variables including major ventricular variables, derived ventricular indices, lateral ventricles asymmetry, cortical atrophy, in every decade of life introducing BW, ThVW, MLCM, BCI, ThVI, CMI3 as most significant ventricular parameters, and IHSW, RHSD, LHSD as significant cortical parameters associated with age.

Attempted Suicide with a Self-Inflicted Penetrating Stab Wound to the Medulla Oblongata Caused by a Pair of Scissors: Case Illustration

A 78-year-old male patient with a history of psychotic depression was found in the bathroom of his apartment with a pair of scissors driven deeply into the back of his neck. He presented with tetraparesis with residual control over the left lower limb movement. Immediate skull radiograph and brain computed tomography scans revealed the tip of the scissors passing into the foramen magnum. Emergent surgery with midline suboccipital craniectomy and resection of the posterior arch of C1 was performed. The scissors were spontaneously dislocated in the course of surgery. Thereafter, debridement, placement of external ventricular drain and primary closure of the dura and skin were achieved. Post-operatively, the patient was not able to follow any instructions. On the 22nd post-operative day, the patient passed away in palliation. To our knowledge, this is the first reported case of a suicide attempt involving the use of scissors reaching the medulla oblongata.

Association between Peripheral Arterial Lactate Levels and Malignant Brain Edema Following Endovascular Treatment for Ischemic Stroke.

To investigate the factors of postoperative malignant brain edema (MBE) in patients with acute ischemic stroke (AIS) treated with endovascular treatment (EVT). MBE is a severe complication following EVT for AIS, and it is essential to identify risk factors early. Peripheral arterial lactate (PAL) levels may serve as a potential predictive marker for MBE. To determine whether immediate postoperative PAL levels and the highest PAL level within 24 hours of EVT are independently associated with MBE development in AIS patients. We retrospectively analyzed patients with AIS who underwent EVT from October 2019 to October 2022. Arterial blood was collected every 8 h after EVT to measure PAL, and record the immediate postoperative PAL and the highest PAL level within 24 h. Brain edema was evaluated using brain computed tomography scans within 7 days of EVT. The study included 227 patients with a median age of 71 years, of whom 59.5% were male and MBE developed in 25.6% of patients (58/227). Multivariate logistic regression analysis showed that the immediate postoperative PAL (odds ratio, 1.809 [95% confidence interval (CI), 1.215-2.693]; p = 0.004) and the highest PAL level within 24 h of EVT (odds ratio, 2.259 [95% CI, 1.407-3.629]; p = 0.001) were independently associated with MBE. The area under the curve for predicting MBE based on the highest PAL level within 24 hours of EVT was 0.780 (95% CI, 0.711-0.849). Early increase in PAL levels is an independent predictor of MBE after EVT in AIS patients.

Methanol poisoning during the COVID-19 pandemic in Iran: A retrospective cross-sectional study of clinical, laboratory, and brain imaging characteristics and outcomes.

To evaluate the frequency and significance of brain imaging findings in methanol poisoning patients and to propose a criterion for prioritizing brain imaging. We retrospectively reviewed the data of 306 patients (286 men and 34 women, mean age 32.10 ± 9.9 years) with confirmed methanol poisoning who were admitted to two hospitals in Iran during the COVID-19 pandemic. We analyzed their demographic, clinical, laboratory, and brain imaging data. The main brain computed tomography(CT) scan findings were hypodensity in the putamen (11.1%), cerebellar nuclei (8.2%), diffuse cerebral edema (7.5%), and intracranial hemorrhage (ICH; 1.6%). These findings were associated with blood pH, Glasgow Coma Scale (GCS), renal failure, bicarbonate, oxygen, carbon dioxide, potassium, and glucose levels (p < 0.05). Poor prognosis was related to blindness, opium addiction, chronic alcohol use, hyperglycemia, and abnormal CT scans (p < 0.001 for all). The most predictive brain imaging findings for poor prognosis were hypodensity in the cerebellar nuclei, diffuse cerebral edema, and ICH. Brain imaging can provide valuable information for the diagnosis and management of methanol poisoning patients. We suggest that patients with severe acidosis, low GCS, low pH, low oxygen saturation, and high glucose levels should undergo brain CT scan as a priority.

Evaluation of Sella Turcica Morphology and Morphometry Based on Gender and Age in Our Population Using Computed Tomography.

In this study, it was aimed to determine the reference values for the healthy Turkish population by evaluating the age-related changes in the morphology and morphometry of Sella Turcica (ST) and the relationship with the body mass index. In addition, it has been investigated whether the morphology and morphometry of this structure vary in diabetes mellitus (DM) patients. The study group was consisted of a total of 524 individuals (266 females and 258 males) (426 healthy and 48 with DM) between the ages of 1 and 80, who applied to the Department of Radiology between January 2018 and February 2021. Axial brain computed tomography scans which have no pathology in ST were retrospectively examined. The ST length (STL), height (STH), diameter (STD), processus clinoideus anterior right-left (PCAR_L), processus clinoideus posterior right-left (PCPR_L) did not differ significantly in healthy individuals and individuals with DM (P>0.05). When the ST morphology according to the ST shape classification performed by Meyer Marcotti and colleagues and Axellson and colleagues was evaluated, it was observed that there was no statistically significant difference between the 2 groups (P>0.05). There was a significant difference in STL, STD values (P<0.05), however, there was no difference in STH, PCAR_L, PCPR_L values between genders (P>0.05). While the distance between STL, STD, PCAR_L showed a significant difference between the decades in all groups, there was no significant difference in the STH, PCPR_L in both classifications (P>0.05). When the relationship between the parameters and body mass index was evaluated, STL, STD, PCAR_L showed a significant difference between the groups (P<0.05). Detailed knowledge of the ST anatomy will be helpful in terms of early diagnosis of diseases that may be related and guiding surgical interventions in this region.

Unnecessary Brain CT Scan and MRI Prescriptions for Evaluation of Children Suffering from Headache Referring to Namazi Hospital of Shiraz

Background and Objectives Despite the significant role of brain magnetic resonance imaging (MRI) and computed tomography (CT) scans in diagnosing diseases, unnecessary prescriptions of these imaging techniques may lead to adverse consequences, imposing a heavy financial burden on patients and health systems. The present study aimed to assess the unnecessary use of imaging services for the evaluation of children suffering from headaches in Namazi Hospital in Shiraz in 2020.. Subjects and Methods The research population of this retrospective study included all children who were referred to Namazi Hospital with the chief complaint of headache in 2019. Since the research sample was equal to the research population, no sampling was performed, and all individuals were surveyed through the census method. The data were analyzed in SPSS software (version 19) using statistical methods. Results Of the 54 brain MRIs performed, 7.4% were necessary, and 92.5% were unnecessary. Moreover, regarding 81 brain CT scans performed, 8.6% were necessary and 91.3% were not. The indication and insurance status had a significant positive relationship with the necessity of brain MRI and CT scan prescriptions (P&lt;0.05). The total financial burden imposed by unnecessary brain MRIs and brain CT scans of the studied patients in Shiraz Namazi Hospital was 158,298,588 Iranian Rials in 2020. Conclusion The results pointed out that over 90% of the brain MRIs and CT scans prescribed for children with headaches were unnecessary, which could impose unnecessary patient costs. Therefore, it seems essential to use effective clinical guidelines for the proper administration of brain MRI and CT scans.

Bilateral Abducens Nerve Palsy and Nystagmus Resolved Upon Intravenous Dextrose Administration in Hypoglycemic Young Female: A Case Report and Review of the Literature

Hypoglycemia can cause a variety of neurological symptoms ranging from mild confusion to seizures and coma. The brain depends heavily on glucose as its main energetic resource, and a decrease in glucose levels can lead to impaired cerebral function. A 38-year-old female presented to the Emergency department with a history of headache, dizziness and asymmetric reactive pupils in addition to bilateral medial strabismus, nystagmus and photophobia. A non-contrast brain Computed Tomography scan was performed showed no significant radiological findings. Laboratory tests were within normal ranges except for a clinically significant hypoglycemia (level II). Intravenous dextrose was administered and strabismus gradually resolved, and headache subsided gradually within an hour. Hypoglycemic state should be investigated first in any patient with sudden neurological deficit.

Üçüncü Basamak Bir Hastanede Acil Servis Nöroşirurji Konsültasyonları

Objective: To reveal the characteristics of patients needing neurosurgery by examining neurosurgery consultations within the emergency department (ED) admissions of a tertiary academic hospital.&#x0D; Method: This is a retrospective, single-centre observational study. Patients admitted to the ED between 01.01.2022 and 31.12.2022 and consulted to the neurosurgery department were identified through the hospital computer system and included in the study. The demographic information of the patients, mode of admission to the ED, the reasons for admission, the time of admission, the number of brain computed tomography (CT) scans, whether they underwent surgery or not, and the mortality results were recorded. &#x0D; Results: A total of 441 neurosurgery consultations were examined. Fall 35.6% (n=157) and traffic accident 16.6% (n=73) were the most common reasons for consultation. It was observed that 92.5% (n=408) of the patients had a brain CT scan, and 19.5% (n=86) had two or more brain CTs. It was determined that 12.7% (n=56) of the patients consulted for neurosurgery were operated on, and 4.1% (n=18) of the patients' hospital admissions resulted in death. Only 53.7% (n=237) of the patients who underwent neurosurgery consultation were discharged from the ED. It was determined that significantly more Neurosurgery consultations were requested during working hours (p = 0.013)&#x0D; Conclusion: Most consultation calls from the ED to neurosurgery are for trauma patients. Brain CT examination is frequently used in neurosurgical patient evaluation. As a result of the consultations, almost half of the patients are hospitalized. Emergency physicians can select patients who need neurosurgery well.

High Plasma Fibrinogen Level Elevates the Risk of Cardiac Complications Following Spontaneous Intracerebral Hemorrhage

Cardiac complications are related to poor prognosis after spontaneous intracerebral hemorrhage (ICH). This study aims to predict the cardiac complications arising from small intracranial hematoma at ultraearly stage. The data of this work were derived from the Risk Stratification and Minimally Invasive Surgery in Acute ICH Patients study (ClinicalTrials.gov Identifier: NCT03862729). This work included patients with ICH but without brain herniation, as confirmed by a brain computed tomography scan within 48hours of symptom onset. Every Patient's information recorded at the emergent department, including clinical, laboratory, electrocardiogram, and medical records, was derived from the electronic data capture. Cardiac complications were defined as the occurrence of myocardial damage, arrhythmias, and ischemic electrocardiogram changes during hospitalization. Variables associated with cardiac complications were filtrated by univariate and multivariate regression analyses. Independent risk factors were used to form the early predictive model. The restricted cubic splines were employed to investigate the nonlinear associations in a more sophisticated and scholarly manner. A total of 587 ICH patients were enrolled in this work, including 72 patients who suffered from cardiac complications after ICH. Out of the 78 variables, 24 were found to be statistically significant in the univariate logistic regression analysis. These significant variables were then subjected to multivariate logistic regression analysis and utilized for constructing risk models. Multivariate logistic regression analysis showed high plasma fibrinogen (FIB) level [odds ratio (OR) per standard deviation (SD) 1.327, 95% confidence intervals (CI) 1.037-1.697; P=0. 024)] and older age (OR per SD 1.777, 95% CI 1.344-2.349; P ＜0.001) were associated with a higher incidence of cardiac complications after ICH. High admission pulse rate (OR 0.620, 95% CI 0.451-0.853; P=0. 003) was considered a protective factor for cardiac complications after ICH. In the restricted cubic spline regression model, FIB and cardiac complications following ICH were positively correlated and almost linearly (P for nonlinearity=0.073). The reference point for FIB in predicting cardiac complications after ICH was 2.64g/L. Emergent factors, including plasma FIB level, age, and pulse rate, might be independently associated with cardiac complications after ICH, which warrants attention in the context of treatment.

Intraventricular Hemorrhage Score as a Robust Predictor for Shunt-Dependent Hydrocephalus After Spontaneous Supratentorial Intracerebral Hemorrhage

Spontaneous intracerebral hemorrhage (ICH) is a common stroke subtype, and patients often develop intraventricular hemorrhage (IVH) and hydrocephalus (H). It is essential to promptly recognize factors that can predict the need for permanent cerebrospinal fluid shunt. This study aims to assess the potential of the IVH score as a predictor for shunt-dependent H in ICH patients. We retrospectively reviewed data from 296 patients with spontaneous supratentorial ICH. Clinical and radiographic data were analyzed. IVH scores were calculated based on initial brain computed tomography scans. A multivariable logistic regression analysis was performed to identify independent predictors of shunt-dependent H, and a receiver operating characteristic curve was generated for the IVH score. Among the 296 ICH patients, 25 (8.4%) required permanent cerebrospinal fluid shunt placement. The IVH score was identified as the sole significant independent predictor of shunt-dependent H (P<0.01), with an odds ratio of 1.13 and a 95% confidence interval between 1.04 and 1.22. With each unit increase in the IVH score, the likelihood of shunt dependence rises by 13%. The area under the curve for the IVH score as a predictor of shunt-dependent H was 0.818. With an IVH score threshold of 6.5, the sensitivity was 80.0%, and the specificity was 26.6%. The IVH score is a valuable predictor of shunt-dependent H in patients with spontaneous supratentorial ICH. Its simplicity allows for easy integration into routine clinical practice, aiding in better patient risk stratification and informed decision-making regarding permanent CSF shunt placement.

Investigating Cerebrovascular Events in Brain CT Scan of COVID-19 Patients

Background and Aim: The present study was conducted to investigate cerebrovascular accidents in brain computerized tomography (CT) scans of COVID-19 patients during 6 months in Ali Ibn Abi Talib Hospital in Rafsanjan City, Iran. Materials and Methods: The present research was descriptive and correlational. The statistical population of this research included the records of all patients referred to Ali Ibn Abi Taleb Hospital from October 2019 to March 2020, whose corona test results were positive and they underwent brain imaging (computerized tomography [CT] scan). The results were obtained from the patient’s files and the census sampling method. After collecting the data, SPSS software was used to analyze the data. Results: The results showed no relationship between the variables of age, sex, medical and drug history, disease severity, and outcome (death, recovery) with the occurrence of acute cerebral hemorrhage (P&gt;0.05). However, a relationship is observed between the variable of medical and drug history, disease severity, and outcome (death, recovery) with the incidence of ischemia (P&lt;0.05) Conclusion: Considering the relationship between the patient’s medical and drug history, the severity of the patient’s disease, and the outcome (death, improvement) of the disease on the patient with the occurrence of acute ischemia, it is suggested that the results of this research be investigated more precisely.