Diagnosis Of Cerebral Infarction Research Articles

Mediastinal and thoracic hematoma following transradial cerebral angiography: a case report

BackgroundCerebral angiography through the transradial approach (TRA) is associated with a low risk of complications, but in rare cases, these complications can be life-threatening.Case presentationA 56-year-old female patient was admitted for transradial cerebral angiography due to the complaint of right limb weakness and the diagnosis of cerebral infarction and cerebral artery stenosis. During the procedure, the patient coughed with expectoration and complained of throat discomfort, palpitations, and pains in the right shoulder and back. Emergency CT scan indicated hematoma in the middle mediastinum and the right thoracic cavity, and perforation of a branch of the subclavian artery was highly suspected. Subclavian artery angiography was conducted immediately, which revealed a patchy contrast medium overflow in a branch of the right costocervical trunk. Selective endovascular occlusion therapy was performed successfully with gelfoam particles and placement of 2 microcoils. At 12 days after cerebral angiography, the patient recovered well and was discharged from the hospital.ConclusionMediastinal and thoracic hematoma may occur due to vessel perforation during TRA cerebral angiography, in which guidewire advancement must be cautious. Early detection and appropriate countermeasures can reduce the severity of vascular perforation and subsequent hematoma.

ОЦЕНКА ЭФФЕКТИВНОСТИ ТРЕНИРОВКИ ДИНАМИЧЕСКОЙ КООРДИНАЦИИ У ПАЦИЕНТОВ С ИНФАРКТОМ ГОЛОВНОГО МОЗГА

The issues of medical rehabilitation of patients after the brain disaster remain relevant in a number of socio-economic aspects. The purpose of the study was to study the effect of complex treatment and medical rehabilitation of patients with a heart attack of the brain based on the new method of training dynamic coordination. The study was attended by 62 patients with a diagnosis of cerebral infarction, randomized in the control (n = 29) and the main (n = 33) research groups. All participants in the study before the start of treatment and after its completion, clinical testing using clinical scales was carried out. To perform a new rehabilitation technique for dynamic coordination training, a robotic exoplatform was used. As a result of clinical testing, it was established that the new method increases the effectiveness of the complex therapy program regulated by the standards of medical care by 37% (p = 0.008), due to significant effects on the state of walking and neuromuscular skeletal and associated movement functions (OR = 1.37; 95%CI: 1.1-1.78).

The effects of fibroblast growth factor-23 on diagnosis of cerebral infarction and vertebral basilar artery stenosis☆

ObjectivesThis study aimed to explore the correlation between Fibroblast Growth Factor-23 (FGF23) levels and Cerebral Infarction (CI), and to determine whether there is a significant relationship between FGF23 and the occurrence and severity of CI. MethodsThe study categorized Cerebral Infarction (CI) patients into severe and mild stenosis groups based on vertebrobasilar artery stenosis, using Digital Subtraction Angiography (DSA) and Magnetic Resonance Imaging (MRI). The study compared the levels of Fibroblast Growth Factor-23 (FGF23) in the serum of CI patients and healthy controls using a t-test and evaluated the diagnostic effectiveness of serum FGF23 using a Receiver Operating Characteristic (ROC) curve. Additionally, the study analyzed the correlation between FGF23 levels and CI severity after treatment using the National Institute of Health Stroke Scale score. ResultsThe study found a significant increase in serum Fibroblast Growth Factor-23 (FGF23) levels in patients with Cerebral Infarction (CI) compared to healthy volunteers, (p < 0.001). A higher serum FGF23 level was observed in the severe stenosis group than in the mild stenosis group (p < 0.001). Furthermore, the study showed that a high FGF23 level at admission was significantly related to more severe symptoms of CI as indicated by the National Institute of Health Stroke Scale (NIHSS) score on the 7th day after treatment (p < 0.001). ConclusionsThis study discovered a correlation between Fibroblast Growth Factor-23 (FGF23) levels, vertebrobasilar artery stenosis, and short-term prognosis in patients who had recently experienced acute Cerebral Infarction (CI).

The value of serum Lp-PLA2 combined with MPO in the diagnosis of cerebral infarction caused by large artery atherosclerosis

ObjectiveTo explore the value of serum lipoprotein-associated phospholipase A2（Lp-PLA2）combined with myeloperoxidase（MPO）for the diagnosis of large artery atherosclerosis(LAA) cerebral infarction. MethodsBaseline data were collected from patients with first-ever acute cerebral infarction, serum Lp-PLA2 and MPO levels were measured. The etiology of cerebral infarction was classified according to the Chinese Ischemic Stroke Subtype Classification Standard. The risk factors associated with LAA cerebral infarction were identified by univariate and multivariate regression analysis. The diagnostic value of serum Lp-PLA2 and MPO for LAA cerebral infarction was assessed by the area under the receiver-operating characteristic (ROC) curve. ResultsOverall 368 patients were involved, 148 patients (40.22 %) were LAA. The serum La-PLA2 and MPO levels were higher in the LAA group than those in non-LAA group (23.06 ± 3.39 ng/mL versus 17.48 ± 3.26 ng/mL; 93.60 ± 9.58 ng/mL versus 75.98 ± 15.53 ng/mL; P < 0.001 for both). Multivariate analysis showed that elevated levels of serum Lp-PLA2 (OR 1.742, 95 %CI 1.499–2.025; P < 0.001) and MPO (OR 1.060, 95 % CI 1.026–1.096; P = 0.001) were the independent risk factors of LAA cerebral infarction. The area under curve of the serum Lp-PLA2 combined with MPO for the diagnosis of LAA cerebral infarction was 0.896 [0.866 ∼ 0.927] (P < 0.001). ConclusionSerum Lp-PLA2 combined with MPO could be valued as a predictor of acute cerebral infarction caused by large artery atherosclerosis.

Infarto cerebral e meningoencefalite trombótica em um bezerro devido a candidíase

ABSTRACT: We described a case of cerebral infarction and thrombotic meningoencephalitis due to candidiasis in a seven-month-old calf. The death occurred three days after the onset of apathy, fever, and the head’s lateral deviation to the left. Macroscopic changes in the brain consisted of asymmetry of telencephalic hemispheres; the right hemisphere was enlarged, causing cerebellar herniation. A focally extensive red area was observed on the surface of the right occipital lobe. At cross-sections of the fixed brain, the lesions revealed to be extensive, red-brown, soft or cavitated areas affecting the white and grey matter from the level of the thalamus to the cerebellum and compressing subjacent structures. Histologically, there was acute, coalescent, multifocal necrosupurative meningoencephalitis, associated with vasculitis, congestion, thrombosis, edema, infarction, and intralesional fungal hyphae. The diagnosis of cerebral infarction and thrombotic meningoencephalitis due to candidiasis was made by the pathological changes, the staining and morphological characteristics of the agent, and immunohistochemistry. The cerebral infarction and thrombotic meningoencephalitis in cattle can result from vascular lesions due to infection by Candida sp.; although uncommon, this case demonstrated that candidiasis should be part of a list of differential diagnoses of severe brain injuries in cattle.

Clinical Study on CT Imaging Examination in the Diagnosis of Cerebral Infarction

Clinical Study on CT Imaging Examination in the Diagnosis of Cerebral Infarction

Value of Serum Adiponectin Combined with ABCD2 in Predicting Cerebral Infarction Among Patients with Acute Isolated Vertigo.

IntroductionPatients with acute isolated vertigo have a high risk for developing cerebral infarction (CI). Risk stratification for cerebral infarction in patients with acute isolated vertigo is critical for early treatment and preventative therapy. In the present study, we aim to characterize the diagnostic value of serum adiponectin (APN) combined with ABCD2 scoring in determining cerebral infarction risk.MethodsPatients with acute isolated vertigo admitted to the emergency room were recruited. Diagnosis of cerebral infarction was performed using diffusion-weighted MRI (DWI-MRI) and T2WI and T2Flair imaging. Blood was collected for analysis of APN levels using enzyme-linked immunosorbent assay (ELISA). Multivariate analysis was used to analyze diabetes, hypertension, serum APN, and ABCD2 in association with CI.ResultsCompared to non-CI patients (n = 185), patients with CI (n = 68) demonstrated significantly lower serum APN levels (p < 0.001) and higher ABCD2 score (p < 0.001). A strong negative correlation was found between serum APN levels and ABCD2 scores. Multivariate analysis and ROC analysis suggested that low serum APN and high ABCD2 are strong predictors of CI in patients with acute isolated vertigo. Notably, the combination of APN and ABCD2 had a much stronger predictive sensitivity and specificity.ConclusionOur analysis suggests that the combination of serum APN and ABCD2 analyses offers a significantly improved prediction sensitivity and specificity for CI among patients with acute and isolated vertigo, which supports the potential use of this new marker in clinics.

Application Value of CT and MRI in Diagnosis of Cerebral Infarction

Application Value of CT and MRI in Diagnosis of Cerebral Infarction

Abstract 559: Left Atrial Enlargement In Primary Cryptogenic Strokes Without Atrial Fibrillation

The relationship between left atrial enlargement (LAE) and primary cryptogenic stroke (PCS) remains a mystery. Previous literature found the severity of LAE to be an independent risk factor in cases of PCS, recurrent ischemic strokes, and paroxysmal atrial fibrillation. Our study seeks to further characterize potential risk factors for patients with PCS in the absence of atrial fibrillation. Our multi-center retrospective study constructed a database of 646 patients identified with a diagnosis of cerebral infarction over a three year period. Detailed chart review excluded all patients with known etiologies for PCS including: atrial fibrillation, atrial flutter, prior stroke, systolic heart failure, carotid artery stenosis, thromboembolic disease, previous anticoagulation, or an active cancer diagnosis. Diagnosis of LAE utilized a composite of criteria for transthoracic echocardiogram (TTE) measurements including left atrial diameter (LAD) and left atrial volume index (LAVI). All study criteria were met by 154 patients (24%) for analysis, where baseline characteristics included: 79 (51%) male, 104 (67.5%) Caucasian, 108 (70%) diagnosis of hypertension, 80 (52%) previous or current tobacco users, and 47 (31%) diagnosis of diabetes. Our preliminary analysis found 74 (48%) of patients met at least one criteria for LAE. The mean LAD for patients with and without LAE was 4.1cm and 3.4 cm, respectively (SD .87 vs .55, p&lt;.0001). The mean LAVI for patients with and without LAE was 29.68 mL/m 2 and 18.44 mL/m 2 , respectively (SD 7.37 vs 5.13, p&lt;.0001). Our findings support the significance of LAE as a risk factor for cases of PCS. Multiple risk factors were identified in our study population that reflect the importance of preventative counseling for patients with hypertension, hyperlipidemia, histories of tobacco use, and diabetes. Further research may elucidate whether LAE alone or in the setting of comorbidities warrant universal screening practices or prophylactic therapies to prevent cases of PCS.

Bihemispheric ischemic strokes in patients with COVID-19.

BACKGROUND:There is emerging evidence that COVID-19 can trigger thrombosis because of a hypercoagulable state, including large-vessel occlusion ischemic strokes. Bihemispheric ischemic stroke is uncommon and is thought to indicate an embolic source. Here, we examine the findings and outcomes of patients with bihemispheric stroke in the setting of COVID-19.METHODS:We performed a retrospective cohort study at a quaternary academic medical center between March 1, 2020, and April 30, 2020. We identified all patients with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who presented with simultaneous bihemispheric ischemic strokes.RESULTS:Of 637 COVID-19 admissions during the 2-month period, 13 had a diagnosis of acute ischemic stroke, including 5 who developed bihemispheric cerebral infarction. Three of those 5 (60%) were female, median age was 54 (range 41–67), and all five were being managed for severe COVID-19-related pneumonia complicated by acute kidney injury and liver failure before the diagnosis of cerebral infarction was established. Five presented with elevated ferritin, lactate dehydrogenase, and interleukin-6 (IL-6) levels, and four had lymphopenia and elevated D-dimer levels. All patients underwent neuroimaging with computed tomography for persistent depressed mentation, with or without a focal neurologic deficit, demonstrating multifocal ischemic strokes with bihemispheric involvement. Outcome was poor in all patients: two were discharged to a rehabilitation facility with moderate-to-severe disability and three (60%) patients died.CONCLUSIONS:Stroke is implicated in SARS-CoV-2 infection. Although causality cannot be established, we present the imaging and clinical findings of patients with COVID-19 and simultaneous bihemispheric ischemic strokes. Multifocal ischemic strokes with bihemispheric involvement should be considered in COVID-19 patients with severe infection and poor neurologic status and may be associated with poor outcomes.

Application of MRI in Early Imaging Diagnosis of Cerebral Infarction

Application of MRI in Early Imaging Diagnosis of Cerebral Infarction

Predictive serum biomarkers of patients with cerebral infarction

ABSTRACT Objectives Stroke is the third most common cause of death and also causes seizures and disability. Biomarkers are abnormal signal indicators at the biological level that are present before the organism is seriously affected and are more sensitive to early diagnosis than are traditional imaging methods. Early diagnosis of stroke can prevent the progression of the disease. However, there are currently no widely accepted biomarkers for stroke that have been applied clinically. Methods A serum metabonomics method based on ultra-high-performance liquid chromatography-quadrupole-time of flight tandem mass spectrometry (UPLC-Q-TOF/MS) was used to identify potential biomarkers and metabolic pathways of cerebral infarction. The receiver-operating characteristic (ROC) curve was used to verify the diagnostic and classification abilities of the biomarkers, and a support vector machine (SVM) model was developed for the prediction of cerebral infarction. Results Principal component analysis revealed a clear separation between the normal and cerebral infarction groups. A total of 13 potential serum biomarkers were identified, which were mainly involved in linoleic acid metabolism; phenylalanine, tyrosine, and tryptophan biosynthesis; tyrosine metabolism; arachidonic acid metabolism; and fatty acid biosynthesis. The ROC curve analysis showed that the potential biomarkers had high specificity and sensitivity for the diagnosis of cerebral infarction. The SVM model had good diagnostic ability and could accurately distinguish the control group from the cerebral infarction group. Discussion The metabonomics approach may be a useful bioanalytical method for understanding the pathophysiology of cerebral infarction and may provide an experimental basis for the development of clinical biomarkers for stroke.

Deep-learning-based MRI in the diagnosis of cerebral infarction and its correlation with the neutrophil to lymphocyte ratio.

Dizziness is a common symptom in clinic, but there lacks an effective treatment method. This study sought to examine the efficiency of deep learning (DL)-based magnetic resonance imaging (MRI) in the diagnosis of cerebral infarction mainly manifesting as vertigo using the neutrophil to lymphocyte ratio (NLR) and other routine blood indexes. An improved multiscale U-Net [MS (U-Net)] model, based on the U-net model, was proposed and applied in the segmentation of MRI of the brain. One hundred and fifteen vertiginous cerebral infarction (VCI) patients, admitted to the Department of Neurology at Huizhou Central People's Hospital from January 2016 to December 2020, were chosen as the research subjects. Based on the MRI segmentation results for the brain, the patients were allocated to the benign paroxysmal positional vertigo (BPPV) group or acute cerebral infarction (ACI) group. Additionally, 50 healthy individuals, whose venous blood was collected for routine blood analyses, were allocated to the control group. The MS (U-Net) model accomplishes MRI segmentation of the brain, and its segmentation results were much closer to the real results than those of the U-Net model. Compared to the control group, the monocyte count (MC), low-density lipoprotein/high-density lipoprotein (LDL/HDL) ratio, and NLR of patients in the BPPV and ACI groups showed an obvious increase (P<0.05), as did the white blood cell count, triglyceride (TG) level, and other indexes of ACI patients (P<0.05). In relation to the diagnosis, the areas under the curve for the TG level, LDL/HDL ratio, and NLR of the BPPV and ACI groups were 0.930 and 0.760, 0.900, and 0.770, 0.945 and 0.855, respectively (P<0.05). DL can accomplish MRI segmentation in cerebral infarction patients, and the TG level, LDL/HDL ratio and NLR can be used in the diagnosis of VCI.

Evaluation of the Imaging Process for a Novel Subtraction Method Using Apparent Diffusion Coefficient Values.

Diffusion-weighted imaging may be used to obtain the apparent diffusion coefficient (ADC), which aids the diagnosis of cerebral infarction and tumors. An ADC reflects elements of free diffusion. Diffusion kurtosis imaging (DKI) has attracted attention as a restricted diffusion imaging technique. The ADC subtraction method (ASM) was developed to visualize restricted diffusion with high resolution by using two ADC maps taken with different diffusion times. We conducted the present study to provide a bridge between the reported basic ASM research and clinical research. We developed new imaging software for clinical use and evaluated its performance herein. This software performs the imaging process automatically and continuously at the pixel level, using ImageJ software. The new software uses a macro or a plugin which is compatible with various operating systems via a Java Virtual Machine. We tested the new imaging software's performance by using a Jurkat cell bio-phantom, and the statistical evaluation of the performance clarified that the ASM values of 99.98% of the pixels in the bio-phantom and physiological saline were calculated accurately (p<0.001). The new software may serve as a useful tool for future clinical applications and restricted diffusion imaging research.

Application of Quantitative CT Imaging in Rehabilitation Nursing of Cerebral Apoplexy Patients.

Objectives:Electronic computed tomography (CT) is an important imaging method for the diagnosis of cerebral infarction. This paper explores the preventive effects of quantitative CT imaging and early rehabilitation nursing on patients with cerebral apoplexy and shoulder-hand syndrome.Methods:Sixty cerebral apoplexy patients treated were included as control group and given routine care from September 2018 to May 2020. Sixty cerebral apoplexy patients were included as observation group, and early rehabilitation nursing intervention was given based on control group. The incidence of shoulder-hand syndrome and upper limb function were compared between the two groups, to explore the effectiveness of the CT examination in promoting the physical function restoration.Results:The incidence of shoulder-hand syndrome in observation group after three months of intervention was lower than that in control group, and the severity was less than that in control group (P<0.05); The Ashworth score of muscle tension in observation group after three months of intervention was lower than that in control group, and the simplified FMA score of the upper limbs was higher than that in control group.Conclusion:Early rehabilitation nursing intervention after CT examination can prevent the occurrence of cerebral apoplexy and shoulder-hand syndrome and improve upper limb function, which is worthy of promotion.

Acute vascular dementia with bi‐thalamic infarction due to the artery of Percheron occlusion

AbstractBackgroundPrevious studies reported the altered mental status and behavioral amnesic impairment were the dominated clinical findings in patients with bi‐thalamic paramedian infarction only due to the occlusion of the artery of Percheron(AOP). However, the clinical features of multidomain cognitive impairment because of bi‐thalamic paramedian infarction need to be clarified.MethodWe report a 72 year old male with a history of hypertension who presented an acute vascular dementia with a multidomain cognitive impairment including memory, attention, orientation. Laboratory test results were not remarkable. Brain magnetic resonance imaging (MRI) revealed a bi‐thalamic symmetrical paramedian infarction. Large arterial computed tomography angiography (CTA) showed the thinner right vertebrobasilar artery and atherosclerotic plaques in the beginning of both internal carotid arteries and the right subclavain artery. Transthoratic echocardiograp‐ ‐hy revealed left ventricular diaslolic dysfunction with ejection fraction of 60%. 24‐hour dynamic eletrocardiogram(Holter) revealed paroxymol atrial tachycardia. However, there was no evidence of cardioembolism.ResultThe diagnosis of cerebral infarction that causes vascular dementia with a presumed occlusion of the artery of Percheron resulting from atherosclerosis was made and the treatment of antiplatelate and improving cognition was provided.ConclusionThis case illustrates vascular dementia resulting from bi‐thalamic paramedian infarction deserves clinical attention.

The values of AHCY and CBS promoter methylation on the diagnosis of cerebral infarction in Chinese Han population

BackgroundThe goal of our study is to investigate whether the methylation levels of AHCY and CBS promoters are related to the risk of cerebral infarction by detecting the methylation level of AHCY and CBS genes.MethodsWe extracted peripheral venous blood from 152 patients with cerebral infarction and 152 gender- and age-matched healthy controls, and determined methylation levels of AHCY and CBS promoters using quantitative methylation-specific polymerase chain reaction. We used the percentage of methylation reference (PMR) to indicate gene methylation level.ResultsWe compared the promoter methylation levels of two genes (AHCY and CBS) in peripheral blood DNA between the cerebral infarction case group and the control group. Our study showed no significant difference in AHCY promoter methylation between case and control. Subgroup analysis by gender showed that the methylation level of AHCY in males in the case group was lower than that in the control group, but the difference was not statistically significant in females. In a subgroup analysis by age, there was no significant difference in the AHCY methylation level between the case and control in the young group (≤44 years old). However, the level of AHCY gene methylation in the middle-aged group (45–59 years old) was significantly higher and the aged group (≥60 years old) was significantly lower than that in the control groups. However, CBS promoter methylation levels were significantly lower in the case group than in the control group (median PMR: 70.20% vs 104.10%, P = 3.71E-10). In addition, the CBS methylation levels of males and females in the case group were significantly lower than those in the control group (male: 64.33% vs 105%, P = 2.667E-08; female: 78.05% vs 102.8%, P = 0.003). We also found that the CBS levels in the young (23–44), middle-aged (45–59), and older (60–90) groups were significantly lower than those in the control group (young group: 69.97% vs 114.71%; P = 0.015; middle-aged group: 56.04% vs 91.71%; P = 6.744E-06; older group: 81.6% vs 119.35%; P = 2.644E-04). Our ROC curve analysis of CBS hypomethylation showed an area under the curve of 0.713, a sensitivity of 67.4%, and a specificity of 74.0%.ConclusionOur study suggests that hypomethylation of the CBS promoter may be closely related to the risk of cerebral infarction and may be used as a non-invasive diagnostic biomarker for cerebral infarction.

Can cervical vascular ultrasound combined with transcranial Doppler ultrasound accurately diagnose cerebral infarction?: A protocol for a systematic review and meta-analysis.

The purpose of this study is to investigate the impact of cervical vascular ultrasound (CVU) combined transcranial Doppler ultrasound (TDU) in the diagnosis of cerebral infarction (CI). The following electronic databases will be sought from PUBMED, EMBASE, Cochrane Library, PSYCINFO, Web of Science, Allied and Complementary Medicine Database, WANGFANG, VIP database, and China National Knowledge Infrastructure. The search period will cover from the initial indexing to March 1, 2020 without restrictions of language and publication status. All case-controlled studies which identifying the impact of CVU combined TDU in the diagnosis of CI will be considered. Two authors will independently perform the whole process of study selection, data extraction, and quality assessment, respectively. If any disagreements occur between two authors, we will invite a third experienced author to help solve them through discussion. Quality Assessment of Diagnostic Accuracy Studies tool will be used to check study quality, and RevMan V.5.3 software and Stata V.12.0 software will be utilized to carry out statistical analysis. This study will summarize the most recent evidence that focusing on the impact of CVU combined TDU in the diagnosis of CI. This study will provide helpful evidence to determine whether CVU combined TDU is an accurate diagnosis tool for CI or not. PROSPERO CRD42020171367.

The design of a homocysteine fluorescent probe based on Rhodamine B and its responsiveness in the serum of cerebral infarction patients.

High levels of homocysteine (Hcy) is closely associated with the onset of cerebral infarction. The present study aimed to synthesize a novel Hcy probe based on Rhodamine B, named S1-4, a new compound that has not been previously reported. This probe exhibited good linear range under physiological fluid viscosity and pH; it has good selectivity for Hcy, and is able to avoid interference from other amino acids and metal ions. This probe can effectively measure the level of Hcy in the blood sera of healthy people and in patients with transient cerebral ischemia and cerebral infarction. However, satisfactory specificity and sensitivity to Hcy was not achieved according to receiver operating characteristic curve analysis. Overall, results from the present study suggested that following further optimization, this probe may be potentially applied in the diagnosis of cerebral infarction.

Abstract TP58: A Novel Deep Learning Approach for Automated Diagnosis of Cerebral Infarction on Computed Tomography

Introduction: Deep learning is a novel machine learning approach that enables automated extraction and classification of imaging features. We aimed to use deep learning to enhance detection of brain infarction. Methods: Patients with acute ischemic stroke admitted to our institution between 2011-2015 were prospectively registered in an IRB-approved database. On a subset of these patients, radiologists annotated the images by marking infarct area. Data was split randomly into a training set and test set (80:20). Deep learning models, including a 3D multi-scale fully convolutional neural network, were developed and trained on the training set and independently tested on the test set. The performance of this model was compared to the expert consensus interpretation. Diagnostic test characteristics including the area under the curve (AUC) for the deep learning algorithm were calculated both at a voxel and imaging-study level. Computer-generated heat maps were created to denote the possibility of infarct. Results: The study group included 114 patients (training set n = 92, test set n = 22). In the training set of 5,888 images, infarction was present in 602 (10.2%) images. In the testing set of 920 images, infarction was present in 130 (14.1%) images. A total of 1.5 billion voxels were used to train the model. The AUC for the deep learning algorithm for voxel accuracy was 0.973 (95% CI 0.972-0.974). Voxel accuracy, sensitivity, and specificity were 92%, 93%, and 92%, respectively. Positive predictive value (PPV) and negative predictive value (NPV) were 86% and 92%, respectively. The AUC for the deep learning algorithm for automated diagnosis of infarction at the imaging-study level was 0.91 (95% CI 0.90-0.94). Diagnostic accuracy, sensitivity, and specificity were 88%, 65%, and 91%, respectively. PPV and NPV were 49% and 95%, respectively. Conclusions: A machine-learned algorithm employing a novel deep learning algorithm enabled accurate diagnosis of brain infarction.