Assuntos
Astrocitoma , Neoplasias Encefálicas , Humanos , Adulto , Afasia de Wernicke , Fala , Neoplasias Encefálicas/patologiaAssuntos
Condrossarcoma , Cordoma , Doenças do Sistema Nervoso , Neoplasias da Base do Crânio , Humanos , Pessoa de Meia-Idade , Osso Petroso/diagnóstico por imagem , Osso Petroso/patologia , Epistaxe/patologia , Neoplasias da Base do Crânio/complicações , Neoplasias da Base do Crânio/diagnóstico por imagem , Condrossarcoma/complicações , Condrossarcoma/diagnóstico por imagem , Cefaleia/diagnóstico por imagem , Cefaleia/etiologiaAssuntos
Neoplasias Cerebelares , Cisto Epidérmico , Neuroma Acústico , Neoplasias Cerebelares/diagnóstico por imagem , Neoplasias Cerebelares/cirurgia , Ângulo Cerebelopontino/diagnóstico por imagem , Ângulo Cerebelopontino/patologia , Cisto Epidérmico/patologia , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Neuroma Acústico/patologia , NeuropatologiaAssuntos
Paralisia Facial , Tumor Rabdoide , Teratoma , Criança , Paralisia Facial/diagnóstico por imagem , Feminino , Humanos , Neuropatologia , Vômito/etiologiaRESUMO
BACKGROUND AND PURPOSE: The modified TICI Infarction grading system is a metric currently used to evaluate angiographic results of thrombectomy for large-vessel occlusion in ischemic stroke. Originally designed for evaluating MCA territories, it is currently used for other vessel occlusions, including the posterior circulation. We postulate that the modified TICI use for the posterior circulation is not accurate due to the different vascular territories supplied by vertebrobasilar vasculature, making grading more complex. MATERIALS AND METHODS: We collected angiographic results from 30 patients who presented with acute posterior circulation occlusions between 2015 and 2018 and underwent thrombectomy in our institution. Eight observers were asked to evaluate the TICI scores before and after thrombectomy. The multirater statistics were computed using Fleiss κ analysis. Further data were collected regarding the potential brain territories at risk and the existence of atherosclerotic disease in the basilar artery. RESULTS: The overall agreement κ reached 0.277 (SD, 0.013), which suggests a "fair" agreement among the raters. On average, 45% of observers achieved a high accuracy in predicting brain areas at risk of ischemia. As for the existence of basilar atherosclerotic disease, a high agreement (defined as at least 5 of 6 observers) was seen in 20 of the 30 patients. CONCLUSIONS: Despite TICI being ubiquitous in stroke diagnostics, the high variability of posterior circulation TICI scores calls into question its use in these strokes. Other methods should be developed to assess recanalization in the posterior circulation.