BRUNSER RABOVICH, ALEJANDRO MICHEL
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BRUNSER RABOVICH, ALEJANDRO MICHEL
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Email
abrunser@alemana.cl
ORCID
Scopus Author ID
26644722200

Research Output

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Association between spontaneous internal carotid artery dissection and perivascular adipose tissue attenuation on computed tomography angiography

2023 , Kevin Cheng , Andrew Lin , STECHER GUZMAN, XIMENA PATRICIA , Tomas Bernstein , Paulo Zuñiga , Gonzalo Martinez , BRUNSER, ALEJANDRO , DIAZ TAPIA, VIOLETA DEL CARMEN , MAZZON AGURTO, ENRICO , William Cameron , Stephen J Nicholls , Sanjay Patel , Damini Dey , Dennis TL Wong , MUÑOZ VENTURELLI, PAULA ANDREA

Background: Spontaneous cervical artery dissection (sCAD) is a leading cause of ischemic stroke in young patients. Studies using high-resolution magnetic resonance imaging and positron emission tomography have suggested vessel wall inflammation to be a pathogenic factor in sCAD. Computed tomography (CT) attenuation of perivascular adipose tissue (PVAT) is an established non-invasive imaging biomarker of inflammation in coronary arteries, with higher attenuation values reflecting a greater degree of vascular inflammation. Objectives: We evaluate the CT attenuation of PVAT surrounding the internal carotid artery (PVATcarotid) with and without spontaneous dissection. Methods: Single-center prospective observational study of 56 consecutive patients with CT-verified spontaneous dissection of the internal carotid artery (ICA). Of these patients, six underwent follow-up computed tomography angiography (CTA). Twenty-two patients who underwent CTA for acute neurological symptoms but did not have dissection formed the control group. Using semi-automated research software, PVATcarotid was measured as the mean Hounsfield unit (HU) attenuation of adipose tissue within a defined volume of interest surrounding the ICA. Results: PVATcarotid was significantly higher around dissected ICA compared with non-dissected contralateral ICA in the same patients (−58.7 ± 10.2 vs −68.9 ± 8.1 HU, p < 0.0001) and ICA of patients without dissection (−58.7 ± 10.2 vs −69.3 ± 9.3 HU, p < 0.0001). After a median follow-up of 89 days, there was a significant reduction in PVATcarotid around dissected ICA (−57.5 ± 13.4 to −74.3 ± 10.5 HU, p < 0.05), while no change was observed around non-dissected contralateral ICA (−71.0 ± 4.4 to −74.1 ± 4.1 HU, p = 0.19). ICA dissection was an independent predictor of PVATcarotid following multivariable adjustment for age and the presence of ICA occlusion. Conclusion: PVATcarotid is elevated in the presence of sCAD and may decrease following the acute event.

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Transcranial Doppler as a Predictor of Ischemic Events in Carotid Artery Dissection

2017 , BRUNSER, ALEJANDRO , LAVADOS GERMAIN, PABLO MANUEL , HOPPE WIEGERING, ARNOLD JOHANNES GOTTLIEB , Emi Sujima , Javiera López , MUÑOZ VENTURELLI, PAULA ANDREA , Eloy Mansilla , Daniel Cárcamo , DIAZ TAPIA, VIOLETA DEL CARMEN

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Cluster-Randomized, Crossover Trial of Head Positioning in Acute Stroke

2017 , Craig S. Anderson , Hisatomi Arima , LAVADOS GERMAIN, PABLO MANUEL , Laurent Billot , Maree L. Hackett , OLAVARRIA IANISZEWSKY, VERONICA VIVIANA , MUÑOZ VENTURELLI, PAULA ANDREA , BRUNSER RABOVICH, ALEJANDRO MICHEL , Bin Peng , Liying Cui , Lily Song , Kris Rogers , Sandy Middleton , Joyce Y. Lim , Denise Forshaw , C. Elizabeth Lightbody , Mark Woodward , Octavio Pontes-Neto , H. Asita De Silva , Ruey-Tay Lin , Tsong-Hai Lee , Jeyaraj D. Pandian , Gillian E. Mead , Thompson Robinson , Caroline Watkins

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In-Hospital Acute Ischemic Stroke is Associated with Worse Outcome: Experience of a Single Center in Santiago Chile

2021 , BRUNSER RABOVICH, ALEJANDRO MICHEL , Patricia Araneda , NAVIA GONZALEZ, VICTOR HUGO , MAZZON AGURTO, ENRICO , Gabriel Cavada , MUÑOZ VENTURELLI, PAULA ANDREA , OLAVARRIA IANISZEWSKY, VERONICA VIVIANA , LAVADOS GERMAIN, PABLO MANUEL

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Incidence, risk factors, prognosis, and health-related quality of life after stroke in a low-resource community in Chile (ÑANDU): a prospective population-based study

2021 , LAVADOS GERMAIN, PABLO MANUEL , HOFFMEISTER ARCE, LORENA , Ana M Moraga , Angelica Vejar , Carolina Vidal , Constanza Gajardo , Daniela San Martín , Bernardita Portales , Eduardo Lopez , Alexis Rojo , Claudio Sacks , ALMEIDA TORO, JUAN MANUEL , BRUNSER, ALEJANDRO , MUÑOZ VENTURELLI, PAULA ANDREA , OLAVARRIA IANISZEWSKY, VERONICA VIVIANA , HOPPE WIEGERING, ARNOLD JOHANNES GOTTLIEB , DIAZ TAPIA, VIOLETA DEL CARMEN

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Sonothrombolysis for acute ischemic stroke

2014 , BRUNSER, ALEJANDRO , HOPPE WIEGERING, ARNOLD JOHANNES GOTTLIEB , MUÑOZ VENTURELLI, PAULA ANDREA , Daniel Cárcamo , LAVADOS GERMAIN, PABLO MANUEL , Javier Gaete , Andrés Roldán , Rodrigo Rivas

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Additional Information Given to a Multimodal Imaging Stroke Protocol by Transcranial Doppler Ultrasound in the Emergency Room: A Prospective Observational Study

2010 , BRUNSER, ALEJANDRO , LAVADOS GERMAIN, PABLO MANUEL , Daniel A. Cárcamo , HOPPE WIEGERING, ARNOLD JOHANNES GOTTLIEB , OLAVARRIA IANISZEWSKY, VERONICA VIVIANA , DIAZ TAPIA, VIOLETA DEL CARMEN , Rodrigo Rivas

<i>Background:</i> Transcranial Doppler (TCD) ultrasound can demonstrate dynamic information. We aimed to evaluate whether TCD generates useful additional information in the emergency room after a multimodal stroke imaging protocol and also whether this modified the management of patients with cerebral infarction. <i>Methods:</i> Patients admitted between April 2006 and June 2007 with ischemic stroke of less than 24 h were subjected to a protocol consisting of noncontrast brain CT, computed tomography angiography, diffusion-weighted magnetic resonance imaging and then TCD within the following 6 h by an observer blinded to the results of imaging studies. <i>Results:</i> Seventy-nine patients were included. The imaging protocol was performed 457 (±346) min after stroke symptoms and TCD after 572 (±376) min. TCD provided additional information in 28 cases (35.4%, 95% CI 25.7–46.4). More that one piece of additional information was obtained in 6 patients. The most frequent additional information was collateral pathways. Multivariate analysis demonstrated that intracranial vessel occlusion was the variable most associated with additional information. In 7 patients (8.8%, 95% CI 4.3–17.1), additional information changed management: in 4 an additional angiography was performed, in 2 patients angiography was suspended and in 1 aggressive neurocritical care was indicated. Patients with NIHSS >10 were significantly more likely to have their initial treatment changed (p = 0.004). <i>Conclusions:</i> TCD can provide additional information to a multimodal acute ischemic stroke imaging protocol in a third of patients. This can result in changes in the management in some of these patients.

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Accuracy of Diffusion-Weighted Imaging in the Diagnosis of Stroke in Patients With Suspected Cerebral Infarct

2013 , BRUNSER, ALEJANDRO , HOPPE WIEGERING, ARNOLD JOHANNES GOTTLIEB , Sergio Illanes , DIAZ TAPIA, VIOLETA DEL CARMEN , MUÑOZ VENTURELLI, PAULA , Daniel Cárcamo , OLAVARRIA IANISZEWSKY, VERONICA VIVIANA , Marcela Valenzuela , LAVADOS GERMAIN, PABLO MANUEL

Background and Purpose— The accuracy of diffusion-weighted imaging (DWI) for the diagnosis of acute cerebral ischemia among patients with suspected ischemic stroke arriving to an emergency room has not been studied in depth. Methods— DWI was performed in 712 patients with acute or subacute focal symptoms that suggested an acute ischemic stroke (AIS), 609 of them with AIS. Results— DWI demonstrated a sensitivity of 90% and specificity of 97%, a positive likelihood ratio of 31 and a negative likelihood ratio of 0.1 for detecting AIS. The overall accuracy was 95%. Of those patients who demonstrated abnormal DWI studies, 99.5% were AIS patients, and of those patients with normal DWI studies 63% were stroke mimics. Conclusions— DWI is accurate in detecting AIS in unselected patients with suspected AIS; a negative study should alert for nonischemic conditions.

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Cervical Artery Dissection in Postpartum Women after Cesarean and Vaginal Delivery

2022 , Francisca Urrutia , MAZZON AGURTO, ENRICO , BRUNSER, ALEJANDRO , DIAZ TAPIA, VIOLETA DEL CARMEN , CALDERON GIADROSIC, JUAN FRANCISCO , STECHER GUZMAN, XIMENA PATRICIA , Tomas Bernstein , Paulo Zuñiga , SCHILLING REDLICH, ANDREA INGRID , MUÑOZ VENTURELLI, PAULA

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Telestroke in Chile: 1 year experience at 7 hospitals

2019 , Eloy Mansilla , Enrico Mazzon , Daniel Cárcamo , Felipe Jurado , Lorena Lara , Mirya Arévalo , Diego Rojas , Gloria Stephens , Arnold Hoppe , BRUNSER, ALEJANDRO

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