NORMAL BASELINE CT PERFUSION PREDICTS SMALLER INFARCT VOLUMES AND BETTER FUNCTIONAL OUTCOME WITH INTRAVENOUS THROMBOLYSIS IN CLINICAL LACUNAR SYNDROME
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Bibliographic record
Abstract
Background and aim:Lacunar infarction accounts for approximately 25% of acute ischaemic strokes. Previous studies have shown patients with lacunar infarction treated with intravenous thrombolysis had a favourable clinical course. This case series tested the hypothesis that patients with clinical lacunar syndrome with normal baseline CT perfusion treated with intravenous thrombolysis had a better outcome compared to patients demonstrating hypoperfusion on CT. Methods:A retrospective analysis of patients with clinical lacunar syndrome with baseline CT perfusion treated with intravenous thrombolysis in Calgary from 2015 to 2018. Results:There were 15 patients [(47%) female; median age 67 (range: 36-83) years] included. 6 patients had normal CTP. The median baseline NIHSS was 8 (range 5-13). The median onset to needle time was 237 (range 60-305) minutes. The median 24-hour NIHSS was 4 (range 1-13). The median 24-hour DWI infarct volume was 0.20 (range 0.04-0.76) ml. 5 (83%) patients achieved functional independence (modified Rankin Scale, mRS: 0-2) at 90 days. 9 patients had hypoperfusion on CTP. The median baseline NIHSS was 12 (range 2-17). The median onset to needle time was 227 (range 55-482) minutes. The median 24 hour NIHSS was 6 (range 0-12). The median 24-hour DWI infarct volume was 1.05 (0.15-1.19) ml. 4 (44%) patients achieved functional independence at 90 days. No patient died or had symptomatic intracerebral hemorrhage. Conclusions: Normal baseline CT perfusion appears to predict better 90-day functional outcome and smaller infarct volumes with intravenous thrombolysis in patients with clinical lacunar syndrome.
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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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.008 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.008 |
| Open science | 0.003 | 0.004 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.006 | 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 it