3 ms·
For those interested, the DAWN Trial (http://www.nejm.org/doi/full/10.1056/NEJMoa1706442 http://www.nejm.org/doi/full/10.1056/NEJMoa1706442) provides more detai
by ntenenz 8y ago
For those interested, the DAWN Trial (http://www.nejm.org/doi/full/10.1056/NEJMoa1706442 http://www.nejm.org/doi/full/10.1056/NEJMoa1706442) provides more detail on the value of thrombectomy, especially in cases where the collateral circulation is strong.
- _0ffh 8y agoVery interesting, thank you! Unfortunately I don't quite know what to make of the recurring phrase "mismatch between clinical deficit and infarct". Could anyone enlighten me, please?
- arkades 8y agoWhen a clot blocks off blood flow to an area of the brain you expect that area to die and, as a result, lose its function (“clinical deficit”). The blockage is an infarct; the downstream area suffocating is infarcted. When you look at the area of brain that should be downstream of a clot and therefore nonfunctional, that’s the “infarct volume”. It’s the volume of brain that we believe is infarcted. The “mismatch” is when we do a CT, find that, say, the chunk of your brain that moves your right hand is downstream from the infarct, but your right hand is still working. This suggests that that part of your brain has enough blood coming to it from other, less salient, arteries that it’s dying slowly instead of fast. That “mismatch” area is the one that, if we can go in and surgically pull out the clot, we can save.