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Seasonal trend of cervical artery dissection in a Chilean cohort

2019 , RECULE GONZALEZ, FRANCISCA , MAZZON AGURTO, ENRICO , DIAZ TAPIA, VIOLETA DEL CARMEN , Rocha, Diego , BRUNSER RABOVICH, ALEJANDRO MICHEL , De La Barra, Camila , Zuniga, Paulo , Dominga Garcia, Maria , Gabriel Cavada , MUÑOZ VENTURELLI, PAULA ANDREA , Zeballos, Shirley , Charaf, Yusef

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Risk Factors and Diet Components Determining Adherence to the Mediterranean Diet in Acute Ischemic Stroke Patients: A Cross-Sectional Analysis of a Prospective Hospital Register Study

2022 , OLAVARRIA IANISZEWSKY, VERONICA VIVIANA , NAVIA GONZALEZ, VICTOR HUGO , MAZZON AGURTO, ENRICO , Alexis Rojo , BRUNSER, ALEJANDRO , LAVADOS GERMAIN, PABLO MANUEL

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A Chilean Experience of Telestroke in a COVID-19 Pandemic Year

2022 , Carlos Delfino , MAZZON AGURTO, ENRICO , Felipe Jurado Díaz , MUÑOZ VENTURELLI, PAULA ANDREA , BRUNSER, ALEJANDRO , Gabriel Cavada , Lorena Lara Cisternas , Diego Rocha Jiménez , Mirya Arévalo Valdivia , Diego Rojas Torres , Eloy Mansilla

<b><i>Background and Purpose:</i></b> Telemedicine for stroke patients’ care (telestroke [TS]) has grown notably in recent decades and may offer advantages during health crisis. Hospital admissions related to stroke have decreased globally during the COVID-19 pandemic, but scarce information is available regarding the effect of COVID-19 in TS. Using a population-based TS registry, we investigated the impact of the first year of the COVID-19 pandemic throughout our TS network in Santiago, Chile. <b><i>Methods:</i></b> Stroke codes evaluated after the onset of COVID-19 restrictions in Chile (defined as March 15, 2020) were compared with those evaluated in 2019. We analyzed differences between number of stroke codes, thrombolysis rate, stroke severity, and time from the stroke onset to hospital admission. <b><i>Results:</i></b> We observed that the number of stroke codes and the number of patients undergoing reperfusion therapy did not change significantly (<i>p</i> = 0.669 and 0.415, respectively). No differences were found with respect to the median time from the stroke onset to admission (<i>p</i> = 0.581) or in National Institutes of Health Stroke Scale (NIHSS) scores (<i>p</i> = 0.055). The decision-making-to-needle time was significantly shorter in the COVID-19 period (median 5 min [IQR 3–8], <i>p</i> &#x3c; 0.016), but no significant changes were found at the other times. <b><i>Conclusions:</i></b> This study demonstrates the potential of adapting TS to extreme situations such as the COVID-19 pandemic, as well as the importance of establishing networks that facilitate patient access to quality treatments.

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Cervical Artery Dissections with and without stroke, risk factors and prognosis: a Chilean prospective cohort

2020 , MAZZON AGURTO, ENRICO , D. Rocha , BRUNSER, ALEJANDRO , C. De la Barra , X. Stecher , T. Bernstein , P. Zúñiga , DIAZ TAPIA, VIOLETA DEL CARMEN , G. Martínez , MUÑOZ VENTURELLI, PAULA ANDREA

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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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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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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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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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Diffusion-weighted imaging as predictor of acute ischemic stroke etiology

2022 , Alejandro Michel Brunser , Eloy Mansilla , NAVIA GONZALEZ, VICTOR HUGO , MAZZON AGURTO, ENRICO , Alexis Rojo , Gabriel Cavada , OLAVARRIA IANISZEWSKY, VERONICA VIVIANA , LAVADOS GERMAIN, PABLO MANUEL , MUÑOZ VENTURELLI, PAULA ANDREA

Abstract Background: Topographic patterns may correlate with causes of ischemic stroke. Objective: To investigate the association between diffusion-weighted imaging (DWI) and Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification. Methods: We included 1019 ischemic stroke patients. DWI were classified as: i) negative; ii) DWI single lesion (cortico-subcortical, cortical, subcortical ≥20 mm, or subcortical <20 mm); iii) scattered lesions in one territory (small scattered lesions or confluent with additional lesions); and iv) multiple lesions (multiple unilateral anterior circulation [MAC], multiple posterior circulation [MPC], multiple bilateral anterior circulation [MBAC], and multiple anterior and posterior circulations [MAP]). Results: There was a relationship between DWI patterns and TOAST classification (p<0.001). Large artery atherosclerosis was associated with small, scattered lesions in one vascular territory (Odds Ratio [OR] 4.22, 95% confidence interval [95%CI] 2.61–6.8), MPC (OR 3.52; 95%CI 1.54–8.03), and subcortical lesions <20 mm (OR 3.47; 95%CI 1.76–6.85). Cardioembolic strokes correlated with MAP (OR 4.3; 95%CI 1.64–11.2), cortico-subcortical lesions (OR 3.24; 95%CI 1.9–5.5) and negative DWI (OR 2.46; 95%CI 1.1–5.49). Cryptogenic strokes correlated with negative DWI (OR 4.1; 95%CI 1,84–8.69), cortical strokes (OR 3.3; 95%CI 1.25–8.8), MAP (OR 3.33; 95%CI 1.25–8.81) and subcortical lesion ≥20 mm (OR 2.44; 95%CI 1,04–5.73). Lacunar strokes correlated with subcortical lesions diameter <20 mm (OR 42.9; 95%CI 22.7–81.1) and negative DWI (OR 8.87; 95%CI 4.03–19.5). Finally, MBAC (OR 9.25; 95%CI 1.12–76.2), MAP (OR 5.54; 95%CI 1.94–15.1), and MPC (OR 3.61; 95%CI 1.5–8.7) correlated with stroke of other etiologies. Conclusions: A relationship exists between DWI and stroke subtype.

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Effects of an Avocado-based Mediterranean Diet on Serum Lipids for Secondary Prevention after Ischemic Stroke Trial (ADD-SPISE)

2021 , Verónica V. Olavarría , CAMPODONICO GALDAMES, PAOLA ROSSANA , Valeska Vollrath , Paula von Geldern , Carolina Velásquez , Patricia Pavez , Barbara Valente , Pamela Donoso , Alexandra Ginesta , Gabriel Cavada , MAZZON AGURTO, ENRICO , NAVIA GONZALEZ, VICTOR HUGO , Matías Guzmán , Pablo Brinck , Pablo M. Lavados