Extremely Early Computed Tomography Signs in Hyperacute Ischemic Stroke as a Predictor of Parenchymal Hematoma
Bibliographic record
Abstract
BACKGROUND: In acute ischemic stroke, thrombolysis with intravenous recombinant tissue plasminogen activator is more effective when given within 90 min of onset compared to that given later than 90 min. However, the significance of early CT signs (ECTs) during such early periods has not yet been fully clarified. We investigated the usefulness of ECTs within 90 min for predicting parenchymal hematoma (PH) in patients without thrombolysis. METHODS: We evaluated 212 consecutive patients with initial ischemic stroke in the anterior cerebral circulation who underwent the first CT within 6 h of onset. The patients were divided into 3 groups according to the interval from onset to CT: within 90 min (group A, n = 90), 91-180 min (group B, n = 76) and 181-360 min (group C, n = 46). Patients who had received thrombolytic therapy were excluded. ECTs were evaluated according to the Alberta Stroke Program Early CT Score (ASPECTS). The relationships between ECTs and the subsequent development of PH were compared among the groups. RESULTS: In patients with ASPECTS values between 0 and 7, PH was developed more frequently in group A (35%) than in groups B (14%) or C (15%) (group A vs. B: p = 0.036, group A vs. C: p = 0.094). In group A, atrial fibrillation, elevated pretreatment blood pressure and ASPECTS < or =7 were independent predictors of PH. CONCLUSIONS: The manifestation of ECTs as represented by ASPECTS < or =7 within 90 min after stroke appears to indicate a high risk of PH.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".