Jorge Mario Gaspar-Toro
2.4K posts
@jmgaspart
Neurointerventionism Vascular Physiology 🧠 #InterventionalNeurologist #BrainHealth 🇨🇴
In EVT treated M2 occlusion stroke, larger Tmax >4 s perfusion deficit was associated with worse 90-day functional outcomes. Tmax >4 s volume >113 mL best discriminated outcomes. MAD-MT study by @vsyedavalli @NANConsortium doi.org/10.3174/ajnr.A…
🚨 New study in Clinical Neurology and Neurosurgery on aneurysmal subarachnoid hemorrhage (aSAH) management 🩸 🧠 Anticipatory initiation of Intrathecal Nicardipine (ITN)—given before clinical or imaging evidence of delayed cerebral ischemia (DCI)—significantly reduces DCI parenchymal infarcts compared to controls (31.3% vs 55.2%). Key findings: 📉 Starting ITN prior to intra-arterial (IA) spasmolytics significantly lowers the need for serial IA treatments for recalcitrant vasospasm from 71.4% down to 23.1%. 🛡️ It is a safe intervention with no increased risk of EVD-related complications or meningitis. ⚠️ Timing is everything, because reactionary ITN given after DCI onset did not reduce the rate of additional infarcts or the need for serial IA treatments. Question: Does this article change your practice? #NeuroTwitter #NeuroCriticalCare #SubarachnoidHemorrhage #Vasospasm #NeuroSurgery sciencedirect.com/science/articl…
Article Commentary: “PET Imaging of Carotid Atherosclerosis: Methodology, Implications, and Applications in Neurovascular Disease” In this #BloggingStroke post, Natalie Neale discusses #Stroke article by Bhakta et al. ahajournals.org/do/10.1161/blo…
📊 Meta-analysis of 612 pediatric stroke cases suggests mechanical thrombectomy is safe and effective, achieving high recanalization rates and better functional outcomes than medical management—highlighting its promise despite current off-label use. Read more here: bit.ly/41syz73 @ElekAlperen
🔎🧠In 298 aneurysms, jailing vs re-crossing in stent-assisted coiling showed similar procedure metrics, no significant difference in safety events at 12 months, and comparable occlusion rates (89.4% vs 83.9%). Read more: bit.ly/40NJOGX @AshuPJadhav @BrianJankowitz @_AdnanSiddiqui
Are arterial webs limited to the carotid? In our case series + systematic review, we describe extra-carotid webs and propose the term “cervical arterial web”—a unified entity that may represent an underrecognized cause of cryptogenic stroke. @ENossek @BellevueHosp @nyugrossman @nyulangone @svinsociety @SVINJournal @AHAScience doi.org/10.1161/SVIN.1…
Left Atrial Appendage Closure or Medical Therapy in Atrial Fibrillation @nejm “Among patients with atrial fibrillation at high risk for stroke and bleeding, left atrial appendage closure was not noninferior to medical care mgmt with regard to a composite end point of stroke, systemic embolism, major bleeding, or cardiovascular or unexplained death.” Translation: patients randomized to LAA closure did worse then those treated with anticoagulation nejm.org/doi/full/10.10…
🧠 Dyslipidemia Management in Stroke Prevention ✍ Current evidence and a phenotype-guided, individualized framework for dyslipidemia management across stroke subtypes Read the review here! 👇 journals.sagepub.com/doi/full/10.11…
Crossed cerebellar diaschisis (CCD) explains this phenomenon, where a unilateral supratentorial cortical lesion causes contralateral cerebellar hypometabolism or hypoperfusion. It is a functional disconnection of the cerebrum-ponto-cerebellar pathway, typically seen following acute stroke or seizure. This image compares cerebral blood flow patterns associated with Crossed Cerebellar Diaschisis (CCD). link.springer.com/article/10.100…
🧠🔬 Neuro-dedicated intravascular OCT is emerging as a promising tool for intracranial vascular imaging. By enabling microscopic, high-resolution visualization of vessel wall pathology and therapeutic devices, it may expand our understanding of cerebrovascular disease and improve neurointerventional diagnosis and treatment strategies. 📖 Read more (open access): bit.ly/4bwlEpA @Cure4Stroke @_AdnanSiddiqui @Fie0815 @vitorpereiraca
🧠Early (0–24 hrs) and delayed (24–72 hrs) surgery after aneurysmal subarachnoid hemorrhage showed comparable long-term outcomes Differed in: 🏥In-hospital mortality 🩸Hemorrhage-related complications Read more here👇 journals.sagepub.com/doi/abs/10.117…
🧠💉 In TNK-treated LVO stroke patients eligible for EVT, thrombus migration occurred in 36% and made EVT impossible in 26% vs 4% without migration. Thrombus migration significantly reduced rates of complete reperfusion but did not affect functional outcomes. Read more here: bit.ly/4lpk658 @jildazz
The economics of VSS Versus VPS for IIH : (propensity-weighted, cost lens) our superstar research fellow @VictorGabriel_H has some numbers for you in this recent paper in @JNIS_BMJ @SNISinfo : 💰 Initial costs = twins 😵💫 Complications = 3.5% vs 37.7% 🏥 30d readmissions = 1.3% vs 33% 🚑 30d ER visits = 11.1% vs 36.6% 🔧 Reops = 1.3% vs 30.9% All the extra 💰 goes on complications, readmissions and reoperations in the VPS arm! @TJUHospital @TJUHNeurosurg jnis.bmj.com/content/neurin…
"Feasibility and Safety of 8F Guiding Catheter Navigation in Transradial Neurointervention for Unruptured Intracranial Aneurysms: A Propensity Score–Matched Comparison of Sheath-Based versus Sheathless Approaches" doi.org/10.3174/ajnr.A… @Fuga_NeuroIR
