台灣腦中風學會

Taiwan Stroke Society

2023 社團法人
台灣腦中風學會 學術研討會
2 0 2 3 A N N UA L M E E T I N G OF
TA I WA N S T R OK E S OC I E T Y

整合中風醫療 同步國際水準 DATE NOV. 4 Sat. 5 Sun.

WORKING SMARTER TOGETHER MAKES STROKE CARE BETTER!

VENUE
聯新國際醫院
LANDSEED INTERNATIONAL HOSPITAL

大會手冊
 目 錄

理事長的話 02

大會主席的話 03

主辦單位與承辦單位 05

會場配置圖 14

會議議程 16

學術演講 24

午餐會議 84

致謝 89

01
 理事長的話 大會主席的話

各位女士先生： 由社團法人台灣腦中風學會與聯新國際醫院共同主辦的 2023 年度學術研討會於今年 11 月

歡迎大家蒞臨桃園聯新國際醫院參加 2023 年的社團法人台灣腦中風學會年會，今年的年會
有三個特色，第一點：就是強調 AI 在腦中風診斷與治療上所佔的角色與日俱增，因此探討
如何透過 A I 的進步以縮短急性中風的診斷時間與正確性就是此次我們要努力的方向。第二
點就是強調今年健保署擴大給付晚時間窗的取栓的 2023 指引更新完成，因而促使各層級的
醫院去面對這樣的改變，同時學會也將協助各區域達成區域聯防網絡整合，以及如何讓救護
車把中風病人送到有治療能力 有治療能量的醫院，最後就是如何讓民眾了解到急性中風的
黃金救援將從 3 小時延長為 24 小時。第三點是更加強調急性中風的診斷與治療是一整個合
作無間的團隊才能完成的，因此支持團隊中每一種職類人員皆能獲得合理的尊重與報酬是我
們應該疾呼的！
有關學會的會務在本屆全體理監事與學會幹部支持下持續推動中，在中風公共政策部份，繼
晚時間窗的取栓溶栓納入健保，持續與健保署互動達成區域聯防網絡整合，未來將促成健保
投入中風個案管理，以降低國人中風風險與失能比率，達成三贏。在中風教育活動方面除了
各地區腦中風雙月會進行以外，今年也成功地舉辦台澳、台韓的雙邊教育研討會。在學會主
導的學術研究方面，除了持續支持已經進行三年有初步成果的台灣取栓登錄外，今年也將增
加中風後失能研究（post stroke disability)。有關本會的正式刊物台灣中風醫誌則持續運作，
維持每年發表 3 到 5 個腦中風治療相關的指引。此外今年本會也成功地與桃園市衛生局、中
風病友協會、聯新國際醫院共同主辦「2023 年世界中風日在桃園」活動。
最後敬祝本屆年會圓滿成功，各位與會貴賓身體健康萬事如意。
4~5 日假聯新國際醫院盛大舉辦。
本次大會依照三大主軸『區域整合』、『流程整合』及『團隊整合』來進行規劃，在學會與
聯新國際醫院通力合作的規劃下，透過各方專家在學術研討會的交流，達到『整合中風醫療，
同步國際水準』的目標。
本次大會有下列特色：
ㄧ、邀請國內及遠自美歐亞澳各國來訪跨領域的腦血管醫療專家，與各位教學醫研精英聚
會，加入專家辯論的形式，深入探討國際最新的醫療與創新研究。
二、全方位腦血管診療的議題探討，由醫藥開發、資訊輔助影像診斷，到臨床試驗、登錄研
究：急重症神經內外科及微創介入治療的實例影像展示；與團隊中不可或缺的護理師、
放射師及個管師等醫療團隊合作，議題齊全。
三、隨著健保署對急性腦中風延長溶栓及取栓時間窗的給付，整合公部門及各級醫療的部分
展現急性期的區域聯防以達到在地醫療、精準轉送；及急性後期的整合照顧以減少中風
後失能是近期努力的目標。
特別感謝社團法人台灣腦中風學會第 15 屆理監事會及各位前輩先進的指導，及聯新國際醫
院的全力支持，讓本次大會得以順利舉辦，謹代表主辦單位致上最誠摯的敬意和感謝！
敬祝大會圓滿成功，祝各位與會嘉賓身體健康、萬事如意

理事長 秘書長 大會主席 大會榮譽主席

連立明 蔡力凱 陳右緯 陳啟仁

02 03
 大會主席的話

主辦單位與承辦單位
The 2023 Annual Meeting of Taiwan Stroke Society, organized by Taiwan Stroke
Society and Landseed International Hospital is grandly held at Landseed International
Hospital, Taoyuan from November 4th to 5th.
This conference is organized according to Integration3 of "Regional Integration", "Process
Integration" and "Team Integration". We wish to achieve "Working smarter together makes
stroke care better!" through sharing of the expertise from all speakers and attendees in the
meeting.
This conference has the important features:
1. Invitation of distinguished cerebrovascular experts in Taiwan and from the United
States, Europe, Asia and Australia to have the speeches, expert debates, and in-depth
discussion on the latest international research.
2. Discussion to cover a full range topics, from pharmaceutical research, information-
assisted imaging to clinical trials and nation-wide registries; acute critical care and
interventions, including video demonstration; and the team work with specialized
nurses, radiographers and other members.
3. Integration of the public sectors and all-level hospitals as the National Health Insurance
Administration extending the time window for thrombolysis and thrombectomy for
acute ischemic stroke; and of post-acute care to reduce post-stroke disability. 台灣腦中風學會
主辦單位
Special thanks to the 15th Board of Directors and Supervisors of the Taiwan Stroke Taiwan Stroke Society
Society and all seniors for their advanced guidance, as well as the full support of Landseed
International Hospital to well organize the conference. On behalf of the Organizing
Committee, I would like to express my most sincere respect and gratitude!
I wish the conference a complete success and all the guests good health and all the best!

承辦單位
聯新國際醫院
Chairperson of Organizing Committee
LANDSEED INTERNATIONAL HOSPITAL

Honorary Chairperson of Organizing Committee

Neuroscience Center, Landseed International Hospital

04 05
13
 會場配置圖：桃園聯新國際醫院 門診大樓 會場配置圖：桃園聯新國際醫院 門診大樓

第一會場
國際會議廳

藝文
空間
1樓 12 樓
壁報區
報到處 大會議程

GSK
COFFE BERAK

麗 醫
生
寶
議程
大會
諾和諾德 諾和諾德 拜 Ａ
耳 輝瑞 輝瑞 Ｚ

第
一
三
VIP 共
1/2

Micro Vention
百靈佳 百靈佳 芝利

會場配置圖：桃園聯新國際醫院 醫療大樓

B1 樓

企建 艾伯維 聯銘盛

春
杏
大
塚

11 樓
COFFE BERAK 大會議程 賽諾菲 賽諾菲

韻律
教室
第二會場 試片室
第五 / 六會議室 秘書室
多功能會議室

14 15
 11/4 (SAT.) 12 樓國際會議廳 11/4 (SAT.) 12 樓國際會議廳
TIME TOPIC SPEAKER MODERATOR TIME TOPIC SPEAKER MODERATOR
0830-1000 Cerebral small vessel diseases and genetics- 鍾芷萍醫師、 宋碧姍醫師 Prof. Henry Ma
No! Perfusion imaging is not necessary for EVT 邱浩彰 醫師
湯頌君 醫師 尹居浩 醫師 1405-1425 Monash Health, Melbourne,
0830-0850 CADASIL : clinical & neuroimaging features in late time window 雙和醫院 神經內科
台大醫院 神經內科 北榮新竹 神經內科 Victoria, Australia

廖翊筑 醫師 林慧娟 醫師 陳龍 醫師 / 邱浩彰 醫師

0850-0910 CADASIL : genetic basis & pathophysiology 1425-1435 Panel discussion All attendee
台北榮總 神經內科 奇美醫院 神經內科 雙和醫院 / 雙和醫院

Prof. Hee-Joon Bae 1435-1445 Poster break

Prevalence of mutations in mendelian stroke Seoul National University 林瑞泰 醫師 1445-1650 Plenary speech
0910-0930
genes in early onset stroke patients Bundang Hospital, Seoul, 高醫附醫 神經內科
1445-1520 Plenary 1
Korea
Prof. Steven M. Greenberg
The roles of cerebral lymphatic system in 蔡欣熹醫師 蔡力凱 醫師
0930-0950 Cerebral amyloid angiography: current prog- Massachusetts General Hos- 陳右緯 醫師
stroke 台大醫院 神經內科 新竹台大 神經內科
ress and future perspectives pital and Harvard Medical 聯新國際 神經內科
林瑞泰 醫師 / 尹居浩 醫師 School, Boston, MA, USA
0950-1000 Panel discussion All attendee
高醫附醫 / 北榮新竹
1520-1555 Plenary 2
1000-1015 Poster break
Prof. S. Claiborne Johnston
Factor XIa inhibitor for secondary stroke pre- 鄭建興 醫師
1015-1145 EVT: TSS guideline and registry- 陳啟仁醫師、林浚仁醫師 Harbor Health, Austin, TX,
vention: current progress and future directions 台大醫院 神經內科
Introduction of 2023 update of TSS EVT guide- 林浚仁 醫師 USA
1015-1020
lines 台北榮總 神經內科 陳昌明 醫師 1555-1630 Plenary 3
紀乃方 醫師 恩主公醫院 神經內科 Prof. Stephanie Debette
1020-1035 Imaging examination before EVT
台北榮總 神經內科 Stroke genetics: discovery, insight into mecha- Epidemiology at University 李俊泰 醫師
黃虹瑜 醫師 nisms, and future perspectives of Bordeaux, Talence, Nou- 三軍總醫院 神經內科
1035-1050 EVT for posterior circulation stroke velle-Aquitaine, France
中國附醫 神經內科 林剛旭 醫師
郭怡敏 醫師 中國附醫 神經內科 1630-1645 台灣腦中風學會許重義教授論文講座
1050-1105 Sedation and anesthesia for EVT
台北榮總 神經內科 Targeting stroke to improve functional recov- 李怡慧 醫師 胡漢華 醫師
EVT for anterior circulation stroke in 6-24 陳仕軒 醫師 ery and unravel disease susceptibility 台北榮總 神經內科 雙和醫院 神經內科
1105-1120
hours from onset 高雄長庚 神經內科 賴達昌 醫師 1645-1650 台灣腦中風學會終身成就獎頒獎
湯頌君 醫師 振興醫院 神經內科 連立明 醫師
1120-1135 TSS EVT Registry (TREAT-AIS) 陳榮基 醫師、劉祥仁 醫師
台大醫院 神經內科 新光醫院 神經內科
陳昌明 醫師 / 林浚仁 醫師 1650-1825 Emerging therapy for stroke- 張谷州 醫師、李怡慧醫師
1135-1145 Panel discussion All attendee
恩主公醫院 / 台北榮總
Prof. Jeyaraj Pandian
Intensive care bundle for acute cerebral hem- 張谷州 醫師
1200-1300 Luncheon 1650-1710 Christian medical
orrhage 高雄長庚 神經內科
1305-1435 Stroke image and debate- 蔡元雄醫師、 李崇維醫師 college, Principal

Prof. Gregory W. Albers 楊懷哲 醫師 李政家 醫師

李怡慧 醫師 1710-1730 Update radiotherapy for cerebral AVM
1305-1335 Leveraging AI in the treatment of stroke. Stanford Stroke Center, Palo 台北榮總 神經外科 台北榮總 神經外科
台北榮總 神經內科
Alto, CA, USA 許世賓 博士 李怡慧 醫師
1730-1750 Bihemispheric tDCS in subacute stroke
Opening: Cases and challenges for patient 蔡元雄 醫師 李崇維 醫師 陽明交大 職能治療 台北榮總 神經內科
1335-1345
selection in late time window 嘉義長庚 放射診斷科 台大醫院 影像醫學部 The therapeutic role of neurotrophic factors in 張谷州 醫師
1750-1810
Prof. Manabu Inoue acute stroke 高雄長庚 神經內科 陳俊鴻 醫師
Yes! Perfusion imaging is essential for EVT in National Cerebral and Car- 陳龍 醫師 The therapeutic role of neurotrophic factors in 孫瑜 醫師 高雄小港醫院 神經內科
1345-1405 1810-1825
late time window diovascular Center, Suita, 雙和醫院 神經內科 vascualar dementia 恩主公醫院 神經內科
Osaka, Japan
1840-2100 Gala dinner 與頒獎

16 17
 11/4 (SAT.) B1 第五 / 六會議室 11/4 (SAT.) B1 第五 / 六會議室
TIME TOPIC SPEAKER MODERATOR TIME TOPIC SPEAKER MODERATOR
0830-1000 It's all about life quality: post-stroke disability- 蔡力凱醫師、 張庭瑜醫師 1650-1820 優秀論文報告 - 鄭建興醫師、 林雅如醫師
李俊泰 醫師 Early antiplatelet resumption and the risks
0830-0833 Opening 劉濟弘 醫師
三軍總醫院 神經內科 1650-1700 of major bleeding after intracerebral hemor-
林口長庚 神經內科
rhage
Empowering neurologists: dealing with post- 張庭瑜 醫師 劉嘉為 醫師
0833-0850
stroke spasticity 林口長庚 神經內科 孫穆乾 醫師 Augmenting hematoma-scavenging capacity 高雄長庚 神經內科
彰基醫院 神經內科 of innate immune cells by CDNF reduces brain 曾冠穎 醫師
宋碧姍 醫師 1700-1710
0850-0910 Post-stroke cognitive dysfunction: an update injury and promotes functional recovery after 三軍總醫院 神經外科
成大醫院 神經內科
intracerebral hemorrhage
周中興 醫師 李俊泰 醫師
0910-0925 Introduction to post-stroke depression Cerebral venous reflux and cerebral amyloid
三軍總醫院 神經內科 三軍總醫院 神經內科 李柏青 醫師 鄭建興 醫師
1710-1720 angiopathy: a magnetic resonance imaging/
About post-stroke dysphagia- what we have 蘇慧真 醫師 台大醫院 放射線科 台大醫院 神經內科
0925-0943 positron emission tomography study
done and what we have not ？ 成大醫院 神經內科
黃金安 醫師 Connectome-based predictive modeling for 彭徐鈞 博士 宋昇峯 醫師
Another story begins from stroke: post-stroke 董欣 醫師 1720-1730
0943-0958 台中榮總 神經內科 functional recovery of acute ischemic stroke 北醫大 碩士在職專班 嘉義基督 神經內科
seizure 台中榮總 神經內科
Cerebral venous reflux and dilated basal gan-
0958-1000 Panel discussion All attendee 蔡欣熹 醫師 林雅如 醫師
1730-1740 glia perivascular space in hypertensive intra-
台大醫院 神經內科 馬偕醫院 神經內科
1000-1005 Poster break cerebral hemorrhage

1015-1145 Large artery atherosclerosis- 張豐基醫師、 林信光醫師 Modeling of CADASIL in the Drosophila
湯頌君 醫師
1740-1746 trachea by a cysteine-altering mutation in
Carotid risk score for predicting moderate or 台大醫院 神經內科
蕭振倫 醫師 林信光 醫師 NOTCH
1015-1045 high degree of carotid atherosclerosis with
台北慈濟 神經內科 台北慈濟 神經內科 Risk of stroke or other thrombosis following
carotid ultrasound
the first dose of ChAdOx1 nCoV-19 vaccine in 謝鎮陽 醫師
Percutaneous angioplasty and stenting of 1746-1752
黃俊肇 醫師 張豐基 醫師 patients undergoing maintenance hemodialy- 台南新樓 神經內科
1045-1115 stenosis of subclavian artery: the influence on sis: a self-controlled case series study 劉嘉為 醫師
馬偕醫院 放射科 台北榮總 放射線部
dizziness 高雄長庚 神經內科
Diversified rehabilitation Strategies for im-
Intracranial artery stenosis: imaging and inter- 張豐基 醫師 鍾芷萍 醫師 江昇樺 職能治療師
1115-1145 1752-1758 proving the independence of activities of daily 鄭建興 醫師
vention 台北榮總 放射線部 台北榮總 神經內科 聯新國際 復健治療科
living in patients with stroke 台大醫院 神經內科
1200-1300 Luncheon Retrospective analysis in efficacy and safety of
1305-1435 Video demonstration and and teamwork of EVT- 湯頌君醫師、 王景益醫師 modified stroke protocol during the COVID-19 王偉昇 醫師 宋昇峯 醫師
1758-1804 嘉義基督 神經內科
epidemic: real-world experience from a single 彰基醫院 神經內科
王景益 醫師 / 陳啟仁 醫師 healthcare system
Video case demonstration and teamwork of
1305-1320 聯新國際 林雅如 醫師
endovascular treatment
神經內科 / 神經醫學中心 陳右緯 醫師 1804-1810
Activation of peripheral TRPM8 mitigates isch- 李薰華 醫師 馬偕醫院 神經內科
聯新國際 神經內科 emic stroke by topically applied menthol 中山附醫 神經內科
Sleep or not? Updated anesthesia by Anesthe- 陳柏瑞 醫師
1320-1335 Comparable efficiency and outcomes in pa-
siology team in EVT 聯新國際 麻醉科
tients with suspected large vessel occlusion
Sleep or not? Sedation assessment and medi- 李美貞 護理師 王淳民 醫師
1335-1350 1810-1816 between integrated Drip-and-Ship Model and
cation process in EVT 林口長庚 護理部 馬辛一 醫師 成大醫院 神經內科
Mothership Model: experience from Tainan
From beginning to end: The trusted supporter 黃逸君 放射師 三軍總醫院 神經外科 stroke network
1350-1405
Neurointervention Radioghrapher in EVT 雙和醫院 影像醫學部
鄭建興 醫師
The beginning after the end: Stroke nursing 程瓊嬅 護理師 湯頌君 醫師 1816-1820 Closing
1405-1420 台大醫院 神經內科
care after EVT 台大醫院 護理部 台大醫院 神經內科
湯頌君 醫師 / 王景益 醫師 1840-2100 Gala dinner 與頒獎
1420-1435 Panel discussion All attendee
台大醫院 / 聯新國際
1435-1445 Poster break

18 19
 11/4 (SAT.) 午餐研討會 12:00-13:00 11/5 (SUN.) 12 樓國際會議廳
TIME TOPIC SPEAKER MODERATOR
第五會議室 ( 門診大樓 B1 樓 ) 0830-1000 Cardiogenic stroke and debate- 王宗道 醫師、陳龍醫師
Prof. Richard Li
諾和諾德 0830-0850 The impact of ICH for anticoagulation in AF
Pamela Youde Nethersole 李宗海 醫師
Eastern Hospital, Hong- 林口長庚 神經內科
Kong
蔡力凱 醫師 傅維仁 醫師
0850-0905 Update of Taiwan AF in ESUS (T-AFESUS) Trial
新竹台大 神經內科 馬偕醫院 神經內科
多功能會議室 ( 醫療大樓 11 樓 ) Debate: Should patients on DOAC within the
last 48 hours be excluded from thrombolysis
暉致 if drug level testing and reversal unavailable?
(Stating/challenging/conclusion: 15/5/3 min)
陳志昊 醫師 陳龍 醫師
Yes! Should be excluded from thrombolysis.
台大醫院 神經內科 雙和醫院 神經內科
0905-0951
第六會議室 ( 門診大樓 B1 樓 ) No! Should not be excluded.
詹益欣 醫師 劉崇祥 醫師
林口長庚 心臟內科 中國附醫 神經內科
百靈佳 0951-1000 Panel discussion All attendee
劉崇祥 醫師 / 陳龍 醫師
中國附醫 / 雙和醫院
1000-1010 Poster break
1010-1130 Plenary speech
韻律教室 ( 門診大樓 B1 樓 ) 1010-1045 Plenary 4
Prof. Jeffrey L. Saver
大塚 Advanced acute stroke care and future per- David Geffen School of 葉守正 醫師
spectives Medicine, UCLA, Los Ange- 澄清醫院 神經內科
les, CA, USA
1045-1120 Plenary 5
Prof. Marc Fisher
VIP 1/2( 門診大樓 12 樓 ) Neuroprotection in the reperfusion era Harvard Medical School,
連立明 醫師
新光醫院 神經內科
Boston, MA, USA
拜耳 1120-1130 公部門長官政策演講
石崇良 署長 連立明 醫師
腦中風晚時間窗再灌流治療之健保政策
中央健康保險署 新光醫院 神經內科
1130-1150 會員大會
藝文空間 ( 門診大樓 1 樓 ) 1200-1300 Luncheon
1305-1420 Secondary stroke prevention- 李孟醫師、 劉濟弘醫師
安沛
Intensive blood pressure control in secondary 謝孟倉 醫師 林清煌 醫師
1305-1320
stroke prevention 奇美醫院 神經內科 高雄榮總 神經內科
Comparison of anti-diabetic drugs in stroke 謝鎮陽 醫師 趙雅琴 醫師
1320-1335
prevention according to data from trials 台南新樓 神經內科 高醫附醫 神經內科
Revisit old myth of lipid control: the lower the 許家瑜 醫師 巫錫霖 醫師
1335-1350
better 嘉義長庚 神經內科 彰基醫院 神經內科
Special consideration of anticoagulation in AF 黃彥筑 醫師 李孟 醫師
1350-1405
patients with special conditions 嘉義長庚 神經內科 嘉義長庚 神經內科
Management of patients with breakthrough 劉濟弘 醫師 吳秀娟 醫師
1405-1420
stroke under anti-PLT 林口長庚 神經內科 林口長庚 神經內科

20 21
 11/5 (SUN.) B1 第五 / 六會議室 11/5 (SUN.) 午餐研討會 12:00-13:00
TIME TOPIC SPEAKER MODERATOR
0830-1000 Intracranial hemorrhage- 劉偉修醫師、 周中興醫師 第五會議室 ( 門診大樓 B1 樓 )
TSS ICH guideline: diagnosis and supportive 林鈺凱 醫師 周中興 醫師
0830-0850 賽諾菲
care 三軍總醫院 神經內科 三軍總醫院 神經內科
黃博浩 醫師 陳廷耀 醫師
0850-0910 TSS ICH guideline: surgical management
台大醫院 神經外科 高雄長庚 神經內科
Asymptomatic intracranial aneurysm: to treat 許斯凱 醫師 陳晉誼 醫師
0910-0930
or be negligible? 國泰醫院 神經外科 萬芳醫院 神經內科 多功能會議室 ( 醫療大樓 11 樓 )
Refining postoperative care strategies for
patients receiving dual antiplatelet therapy for 蘇亦昌 醫師 魏誠佑 醫師 衛采
0930-0950
the endovascular treatment of ruptured cere- 雙和醫院 神經外科 彰濱秀傳 神經內科
bral aneurysms
周中興 醫師 / 魏誠佑 醫師
0950-1000 Panel discussion All attendee
三軍總醫院 / 彰濱秀傳 第六會議室 ( 門診大樓 B1 樓 )
1000-1010 Poster break
1200-1300 Luncheon 艾伯維
1305-1445 Artificial intelegence in stroke- 陳柏霖醫師、 陳志昊醫師
陳柏霖 醫師
1305-1310 Opening
台中榮總 神經內科
The impact and future of artificial intelligence 許凱程 醫師 陳柏霖 醫師
韻律教室 ( 門診大樓 B1 樓 )
1310-1330
on stroke treatment 中國附醫 神經內科 台中榮總 神經內科
阿斯特捷利康
Application of artificial intelligence in stroke 陳彥廷 醫師 陳志昊 醫師
1330-1350
imaging 雙和醫院 影像醫學部 台大醫院 神經內科
楊梵孛 教授
Reliability of tissue at risk by utilising an auto- 胡漢華 醫師
1350-1410 清華大學 人工智慧研發中
nomic DCNN workflow 雙和醫院 神經內科
心 VIP 1/2( 門診大樓 12 樓 )
1410-1415 Discussion (1) All attendee
葛蘭素史克
陳育群 醫師 謝鎮陽 醫師
1415-1435 CHATGPT in research & writing
台北榮總 家庭醫學科 台南新樓 神經內科
1435-1440 Discussion (2) All attendee
陳志昊 醫師
1440-1445 Closing
台大醫院 神經內科

22 23
 11/4 (SAT.) 12 樓國際會議廳 08:30-08:50 11/4 (SAT.) 12 樓國際會議廳 08:50-09:10

CADASIL: Clinical & Neuroimaging Features CADASIL: Genetic Basis & Pathophysiology
CADASIL 的臨床與影像特徵 CADASIL: 基因突變與致病機轉

Sung-Chun Tang 湯頌君 Yi-Chu Liao 廖翊筑

Department of Neurology, National Taiwan University Hospital Department of Neurology, Taipei Veterans General Hospital, Taiwan
台大醫院 神經部 台北榮民總醫院 神經醫學中心 周邊神經科 主治醫師

Abstract Abstract
Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy
(CADASIL) is a hereditary small vessel disease primarily affecting the central nervous system. The (CADASIL) is the most common monogenic disorder of the cerebral small blood vessels. It is caused by
underlying cause of CADASIL lies in mutations within the NOTCH3 gene, leading to the accumulation mutations in the NOTCH3 gene with most pathogenic variants leading to an odd number of cysteines
of granular osmiophilic material in the walls of small blood vessels. Traditionally, the condition within one of the 34 epidermal growth factor-like repeats (EGFRs) of NOTCH3 protein. CADASIL is
manifests with a broad spectrum of neurological symptoms, including migraine with aura, recurrent characterized by abnormal accumulation of the NOTCH3 extracellular domain (NECD) around vascular
strokes, cognitive impairment, and mood disturbances. The age of onset and the specific combination smooth muscle cells and pericyte. Toxic accumulation of NOTCH3 NECD accompany with various
of symptoms can vary significantly among affected individuals, making diagnosis a challenging extracellular matrix proteins has been suggested as the potential cause of small-vessel pathology.
endeavor. The role of neuroimaging is pivotal in the diagnosis and ongoing monitoring of CADASIL. However, impairment of canonical Notch signaling might also play a role in its disease process. In
Magnetic resonance imaging (MRI) unveils characteristic findings, such as subcortical white matter my presentation, I’ll briefly summarize the findings from animal studies and human proteomics/
hyperintensities, lacunar infarcts, and microbleeds, which not only assist in distinguishing CADASIL from transcriptomics data in literatures to illustrate the pathogenesis of CADASIL.
other small vessel diseases but also contribute to the diagnostic criteria. Recent clinical and imaging
studies focusing on the hotspot NOTCH3 variant R544C in Taiwan have revealed a notable prevalence
of stroke patients carrying this variant, particularly in cases of small vessel occlusion and intracerebral
hemorrhage. Moreover, individuals carrying NOTCH3 R544C presenting with intracerebral hemorrhage
had a higher risk of stroke recurrence and functional dependence. While no CADASIL-specific treatment
has been identified to date, there is growing evidence that the management of vascular risk factors,
particularly aggressive blood pressure control, may play a crucial role in potentially mitigating the
impact of the disease. This talk will offer an in-depth exploration of the clinical and neuroimaging
features of CADASIL, with a specific emphasis on Taiwanese stroke patients harboring the R544C variant.

24 25
 11/4 (SAT.) 12 樓國際會議廳 09:10-09:30
Prevalence of Mutations in Mendelian Stroke Genes in Early
Onset Stroke Patients
Hee-Joon Bae, M.D.
Seoul National University Bundang Hosipital, Seoul, Korea
Abstract
Objective: Heritability of stroke, particularly among the younger population, is postulated to be
significant. Nevertheless, prior genetic studies have largely zeroed in on individuals characterized by
distinct clinical or neuroimaging features. This study aims to evaluate the prevalence of 15 Mendelian
stroke-related genes and their correlation with clinical and neuroimaging characteristics within a
comprehensive and unbiased cohort of young stroke patients.
Methods: We enrolled patients aged ≤55 years diagnosed with stroke or transient ischemic attack
sourced from a prospective, nationwide, multicenter stroke registry (CRCS-K-NIH registry). Clinically
relevant genetic variants (CRGV) within 15 Mendelian stroke genes (GLA, NOTCH3, HTRA1, RNF213,
ACVRL1, ENG, CBS, TREX1, ABCC6, COL4A1, FBN1, NF1, COL3A1, MT-TL1, and APP) were pinpointed
using a customized, targeted next-generation sequencing panel.
Results: Out of 4,112 patients, 522 (12.7%) exhibited 78 CRGV, most frequently in RNF213 (n=270,
6.6%), followed by ABCC6 (n=119, 2.9%) and NOTCH3 (n=69, 1.7%). The distribution of CRGV varied
among ischemic stroke subtypes (p<0.01) with the peak in other determined etiology, then large artery
atherosclerosis. A mere 2 (0.05%) patients presented with CRGV in GLA. Notably, there was a difference
in CRGV distribution between patients aged ≤35 years and those aged 51–55 years (17.5% vs. 9.1%,
p=0.02). Variants of uncertain significance were found in one every seven patients. Only a quarter of
patients with RNF213 and NOTCH3 variants had typical neuroimaging features of the corresponding
disorders, respectively.
Interpretation: The presence of CRGV in 15 Mendelian stroke genes might not be rare among young
stroke population. The prevalence of pathogenic variants in GLA (Fabry disease) was marked below
that observed in the western stroke population. Clinical implications of having CRGV or VUS should be
explored.
26
11/4 (SAT.) 12 樓國際會議廳 09:30-09:50
The Roles of Cerebral Lymphatic System In Stroke
腦淋巴循環系統與腦中風
Hsin-Hsi Tsai 蔡欣熹
MD, PhD
Clinical assistant professor, Department of Neurology, National Taiwan University College of Medicine and
National Taiwan University Hospital
臨床助理教授 / 主治醫師 台大醫學院與台大醫院神經部
Abstract
The lymphatic system is an open-ended route that carries fluid from the peripheral to the cardiovascular
circulation, and is known to be a trafficking pathway for immune cells. The key component of brain
lymphatic drainage system is composed of (1) basement membrane-based intramural perivascular
pathway, (2) a brain-wide glymphatic pathway, through paravascular spaces coupling with the cerebral
circulation system, (3) sinus-associated meningeal lymphatic vessels, and (4) nasal route that surrounds
olfactory nerve through the cribiform plate. Advanced neuroimaging approach have provided
the opportunity to assess the lymphatic drainage function, including the visualization of enlarged
perivascular spaces, measuring the water motion along the perivascular spaces (DTI-ALPS) and the
assessment of tracer retention in the ventricles as a surrogate marker for CSF clearance function. In
this talk, I will discuss the role of glymphatics in the pathogenesis in small vessel disease (SVD), and
the clinical evidence showing the correlations between glymphatic dysfunction and SVDs. I will also
share our recent investigation for the functional change of meningeal lymphatics in experimental
intracerebral hemorrhage (ICH), which provides a potential novel treatment target in enhancing
recovery after ICH.
27
 11/4 (SAT.) 12 樓國際會議廳 10:15-10:20
Introduction of 2023 update of TSS EVT guidelines
動脈內血栓移除治療指引 2023 更新之背景簡介
Chun-Jen Lin 林浚仁
MD, PhD 台北榮總 神經內科
Abstract
動脈內血栓移除治療 (Endovascular thrombectomy, EVT) 是急性缺血性腦中風合併大動脈阻塞之標
準治療之一。隨著近年增加的許多研究實證，動脈內血栓移除治療的適應症逐漸放寬。本學會和台
灣神經血管外科與介入治療醫學會組成指引共識小組，針對 EVT 的進展，將 2019 年發表的急性缺
血中風動脈內血栓移除治療指引進行更新。本共識小組成員包含神經內科、神經放射科、神經外
科、麻醉科等專家，由各章節作者完成初稿後，招開多次共識會議，根據最新的文獻證據，針對各
個議題產出建議。本指引含蓋了五個近年有顯著進展的主題：(1) 動脈內血栓移除術前影像檢查；(2)
靜脈血栓溶解劑治療在血栓移除治療時的角色；(3) 前循環腦中風 6-24 小時內血栓移除治療；(4) 後
循環腦中風之血栓移除治療；(5) 血栓移除術中之鎮靜與麻醉。本指引經專家審查，提供台灣健保
署擴大給付腦中風 24 小時內血栓移除治療，讓更多的急性缺血性中風病人能接受適當的再灌流治
療受益。
28
11/4 (SAT.) 12 樓國際會議廳 10:20-10:35
Imaging examination before EVT
腦動脈血栓移除治療前的影像簡介
Chun-Jen Lin 紀乃方
Associated Professor and Director, Department of Neurology,
School of Medicine, National Yang Ming Chiao Tung University
陽明交通大學醫學系 副教授暨神經學科主任
Abstract
動脈內血栓移除治療 (Endovascular thrombectomy, EVT) 是急性缺血性腦中風合併大動脈阻塞之標
準治療之一。隨著近年增加的許多研究實證，動脈內血栓移除治療的適應症逐漸放寬。本學會和台
灣神經血管外科與介入治療醫學會組成指引共識小組，針對 EVT 的進展，將 2019 年發表的急性缺
血中風動脈內血栓移除治療指引進行更新。本共識小組成員包含神經內科、神經放射科、神經外
科、麻醉科等專家，由各章節作者完成初稿後，招開多次共識會議，根據最新的文獻證據，針對各
個議題產出建議。本指引含蓋了五個近年有顯著進展的主題：(1) 動脈內血栓移除術前影像檢查；(2)
靜脈血栓溶解劑治療在血栓移除治療時的角色；(3) 前循環腦中風 6-24 小時內血栓移除治療；(4) 後
循環腦中風之血栓移除治療；(5) 血栓移除術中之鎮靜與麻醉。本指引經專家審查，提供台灣健保
署擴大給付腦中風 24 小時內血栓移除治療，讓更多的急性缺血性中風病人能接受適當的再灌流治
療受益。
29
 11/4 (SAT.) 12 樓國際會議廳 10:35-10:50 11/4 (SAT.) 12 樓國際會議廳 10:50-11:05

EVT for posterior circulation stroke Sedation and anesthesia for EVT
後循環動脈內血栓移除術之最新進展 血栓移除術中之鎮靜與麻醉

Huang Hung-Yu 黃虹瑜 Yi-min Kuo 郭怡敏

Atttending physician, China Medical University, Attending doctor, Department of Anesthesiology, Taipei Veterans General Hospital, Taiwan
Neurology department 臺北榮民總醫院麻醉部主治醫師
中國醫藥大學附設醫院 神經部主治醫師 Assistant professor, School of Medicine, National Yang Ming Chiao Tung University, Taiwan.
陽明交通大學醫學系助理教授

Abstract
Posterior circulation large vessel occlusion stroke, referring to basilar artery and vertebral artery
occlusion, exhibited devastating outcomes. Endovascular therapy (EVT) has emerged as a crucial
treatment modality for posterior circulation strokes, offering minimally invasive options for
revascularization. Critical factors in the success of EVT for posterior circulation include patient selection,
advanced imaging techniques, and the interventional neuroradiology team's expertise. Understanding
the unique challenges associated with posterior circulation procedures is critical, given the complexity
and delicate nature of the anatomy involved. This section aims to provide a concise overview of EVT in
the context of posterior circulation pathology.
Abstract
Endovascular thrombectomy (EVT) for large vessel occlusion ischemic stroke is either performed under
general anesthesia (GA) or with non-GA techniques such as conscious sedation or local anesthesia
alone. Current guidelines give no formal recommendation owing to that the optimal anesthetic
strategy remains debated. It is reasonable to select an anesthetic technique during EVT for AIS on the
basis of individualized assessment of patient risk factors, technical performance of the procedure, and
other clinical characteristics. Furthermore, the predicting factors regarding functional outcome after
EVT includes time to reperfusion, rate of successful reperfusion, and hemodynamic change during the
procedure. All of the above should be taken into consideration while choosing anesthetic strategy.

大動脈阻塞的缺血性腦中風執行 EVT 時的麻醉方式大致可分為全身麻醉及包含鎮靜麻醉 (consciousness

sedation; CS) 和局部麻醉 (local anesthesia; LA) 的非全身麻醉。由於何者為最佳麻醉方式尚有爭議，
目前的指引沒有給出正式麻醉建議。在選擇麻醉術式時，應評估病人的整體狀況、危險因子、並考
量醫療機構的臨床特質等。由於血管打通時間、打通率、和血壓變化皆是接受 EVT 之中風病人功
能預後的預測因子，在選擇麻醉術式時應對上述因素做整體考量。

30 31
 11/4 (SAT.) 12 樓國際會議廳 11:05-11:20
EVT for anterior circulation stroke in 6-24 hours from onset
前循環腦中風 6-24 小時內血栓移除治療
Chen Shih-Hsuan 陳仕軒
Attending Physician, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
高雄長庚腦血管科主治醫師
Abstract
急性腦中風合併顱內大血管阻塞，在前循環發作 6 小時內，Endovascular thrombectomy (EVT) 已
是標準治療。在 DAWN、DEFUSE 3 試驗中，藉由灌流影像發展，使得 EVT 在特定病人治療時間窗
可延長至症狀發生 16 至 24 小時。近年來，晚時間窗 6-24 小時的大動脈阻塞中風研究，更包含
大面積梗塞 (large core) 的 RESCUE-Japan LIMIT、SELECT2、TESLA，ANGEL-ASPECT，以及使用 CTA
collateral score 篩選的 MR CLEAN-LATE，均顯示晚時間窗中，EVT 相較藥物治療對病患臨床有助
益，使得延長 EVT 治療時間窗是可行的。2023 年美國神經血管介入學會 (Society of Vascular and
Interventional Neurology) 指引中，也針對延長 EVT 治療時間窗討論治療指引。近期健保給付納入
晚時間窗，台灣腦中風學會也對 6-24 小時前循環更新治療指引。
32
11/4 (SAT.) 12 樓國際會議廳 11:20-11:35
TSS EVT Registry (TREAT-AIS)
台灣腦中風學會動脈血栓移除登錄計畫 (TREAT-AIS)
Sung-Chun Tang 湯頌君
Department of Neurology, National Taiwan University Hospital
台大醫院 神經部
Abstract
Endovascular thrombectomy (EVT) is the standard therapy for patients with acute ischemic stroke
(AIS) secondary to large-artery occlusion. In January 2019, the Taiwan Stroke Society established
a nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-
AIS). TREAT-AIS is a multicenter prospective registration program in Taiwan. Patients aged ≥ 20 years
who underwent EVT for AIS were recruited. The key items on the registration form were divided into
general stroke demographics and EVT-related sections. The clinical outcomes of the effectiveness and
safety include the functional status (modified Rankin Scale score) at three months and hemorrhagic
transformation. By the end of June 2022, ten medical centers and nine community hospitals were
participating in the TREAT-AIS registry. In our baseline paper published in August 2023 in Stroke:
Vascular and Interventional Neurology, the study included a total of 1522 patients (mean age 71.2
± 13.6 years, 55.6% male). The median National Institutes of Health Stroke Scale (NIHSS) score on
admission was 18 (interquartile range, 12–23). The major etiology of stroke was cardioembolism (43.6%),
followed by large artery atherosclerosis (36.8%), and an undetermined etiology (15.4%). Functional
independence at three months post-stroke was achieved in 36.2% of the patients. In summary, this
talk will provide an update on the current progress of the TREAT-AIS in capturing real-world EVT data in
Taiwan. TREAT-AIS will offer valuable insights into the real-world practice of EVT in patients with acute
stroke and the related quality of care in Taiwan.
33
 11/4 (SAT.) 12 樓國際會議廳 13:05-13:35
Leveraging AI in the Treatment of Stroke
Gregory W Albers
MD, Department of Neurology and the Stanford Stroke Center, Stanford University, USA
Abstract
The substantial clinical benefits of late window thrombectomy led to expansion of the treatment
window for thrombectomy from 6 to 24 hours in the 2018. Newer studies have now expanded the
indications to patients with larger infarct core volumes. The new clinical trial data and guidelines
have led many stroke centers to begin using applications of artificial intelligence (AI) and other
advanced imaging techniques with computed tomography (CT) CT perfusion (CTP) or magnetic
resonance imaging (MRI) to evaluate patients who present with a possible large vessel occlusion. These
techniques can provide quantitative estimates of ischemic core and penumbra without user input and
have excellent interobserver agreement. AI applications can identify large vessel occlusions, provide
automated ASPECTS scores and hypodensity volumes as well as identify ICH and cerebral aneurysms.
However, these techniques also have limitations, and therefore it is important to review all available
imaging data before making a clinical decision.
The lecture will discuss imaging options for selecting patients for thrombectomy and review how to
interpret AI outputs. Limitations of AI that will be discussed include:
false positives and false negatives, need for clinician/radiologist oversight, training on all protocols
encountered in practice, technical issues (bolus timing, FOV, slice thickness), as well as differences
between triage and notification vs. CAD products.
34
11/4 (SAT.) 12 樓國際會議廳 13:35-13:45
Opening: Cases and challenges for patient selection in late time window.
晚期時間窗中風患者取栓手術的選擇 : 案例和挑戰
Yuan-Hsiung Tsai 蔡元雄
Professor. Department of Diagnostic Radiology. Chiayi Chang-Gung Memorial Hospital.
嘉義長庚醫院 放射診斷科 教授
Abstract
Current stroke guidelines advocate the use of advanced imaging techniques, such as computed
tomography perfusion, diffusion-weighted imaging, and perfusion-weighted imaging, for selecting
suitable candidates with acute ischemic stroke (AIS) for endovascular treatment (EVT) within a 6 to
24-hour time window following symptom onset. These advanced imaging methods enable precise
quantification of infarct core and ischemic penumbra based on specific threshold values, collectively
referred to as "target mismatch." Target mismatch criteria encompass core volume, penumbra volume,
and the mismatch ratio, which is the ratio between total hypoperfusion and core volumes, each having
well-defined cutoff values.
Automated software packages are commonly employed to calculate these target mismatch parameters,
offering a rapid and standardized interpretation of advanced imaging results. Nevertheless, this
approach is not without limitations. Technical artifacts can influence automated software platforms,
and there is significant variability among these platforms due to vendor-dependent factors, resulting in
differing estimates of target mismatch parameters. Additionally, advanced imaging may not consistently
provide accurate assessments of the infarct core, potentially leading to both underestimation and
overestimation.
In real-world clinical practice, adherence to guidelines may be challenged by resource constraints or
delays in accessing advanced imaging. Consequently, the selection of candidates for EVT currently falls
short of optimal due to a high occurrence of ineffective reperfusion and overselection resulting from
overly stringent inclusion criteria. Consequently, some researchers have proposed replacing advanced
imaging with conventional imaging for EVT selection. Several studies have demonstrated that non-
contrast CT ASPECTS and collateral assessment using computed tomography angiography are not
inferior to advanced imaging in predicting outcomes in AIS patients undergoing EVT. However, other
recent researches suggest that advanced imaging, such as CTP and PWI/DWI, is superior to conventional
imaging in determining the eligibility of EVT candidates.
Therefore, the routine application of automatic advanced imaging assessment in EVT candidate
selection remains a topic of debate. This "stroke image and debate section" has invited Prof. Manabu
Inoue and Prof. Henry Ma as master speakers to discuss this ongoing controversy. In this brief opening
speech, I will present specific cases and outline the current challenges associated with employing
advanced imaging in the context of EVT within the extended time window for stroke treatment.
35
 11/4 (SAT.) 12 樓國際會議廳 13:45-14:05 11/4 (SAT.) 12 樓國際會議廳 14:05-14:25

Yes! Perfusion imaging is essential for EVT in late time window. No! Perfusion imaging is not necessary for EVT in late time window.

Prof. Manabu Inoue Prof. Henry Ma

National Cerebral and Cardiovascular Center, Suita, Osaka, Japan Monash Health, Melbourne, Victoria, Australia

Abstract Abstract
Reperfusion therapy has been established in acute ischemic stroke with large vessel occlusion in various Do we need commercial software for perfusion imaging assessment?
time window. Among these, mechanical thrombolysis has an overwhelmingly high recanalization rate The advances of perfusion neuroimaging has enabled the extension of both thrombolysis and
compared to intravenous thrombolysis and is also highly effective in normalizing perfusion in the brain thrombectomy time window which has allowed more stroke patients to receive reperfusion therapy.
tissue. The therapeutic effect is particularly pronounced in cases of large vessel occlusion, and it is However, most of the clinical trials utilised commercial software for the assessment of the perfusion
considered best to perform mechanical thrombectomy if possible. Prior to mechanical thrombectomy, imaging. To replicate the clinical trial results in the real world one would require the utilisation of the
appropriate imaging selection can be used for maximizing the safety and effectiveness. Although a same software. However, this requires significant investments. In addition, there are several software
wide variety of modalities and sequences currently exist, it would be ideal if they could be linked to available which has created further complexity to the issue. This debate will explore the necessity of
treatment with as little effort and time as possible, and without deviating from the usual course of commercial software against more generic software or even visual assessment of the perfusion maps.
medical treatment.
In this session I would like to refer to the beneficial use of perfusion imaging along with analysis
software.
Currently, evidence has established the usefulness of CT/MR perfusion imaging for acute reperfusion
therapy for onset up to 24 hours. In addition to obtaining mismatched images of the ischemic core and
penumbra, perfusion imaging software can be used to automatically determine ASPECTS, measure the
actual ischemic core, determine the rate of infarct progression, approximate classification, and rapidly
construct vascular images showing occlusion of the main artery as an accessory function of the analysis
software.
It is also possible to judge cases with little benefit from mechanical thrombectomy, such as cases with
large ischemic core cases with no perfusion mismatch (matched cases), as not being eligible for any
reperfusion therapy. I would like to discuss the advantages and disadvantages of each modality and
outline the shortest diagnostic imaging protocols available at each institution. The ongoing T-FLAVOR
trial using the novel thrombolytic agent tenecteplasein Japan will also be introduced.

36 37
 11/4 (SAT.) 12 樓國際會議廳 14:45-15:20
Cerebral amyloid angiography: current progress and future perspectives
Steven M. Greenberg
MD, PhD, Massachusetts General Hospital and Harvard Medical School, Boston USA
Abstract
Cerebral amyloid angiopathy (CAA) is one of two common age-related pathologies (along with
arteriolosclerosis) of the cerebral small vessels, occurring at moderate-to-severe grade in nearly one
quarter of autopsied brains from the general population. CAA is now widely recognized as a major
cause of spontaneous intracerebral hemorrhage (ICH) in the elderly as well as a substantial contributor
to age-related cognitive decline. The recently updated Boston Criteria v2.0 expanded the range of MRI
biomarkers that can be used to diagnose probable CAA to include not only hemorrhagic lesions such
as lobar ICH, microbleeds, and cortical superficial siderosis but also some non-hemorrhagic markers
such as severe visible perivascular spaces in the centrum semiovale and white matter hyperintensities
in a multispot pattern. The international validation study for the Boston Criteria v2.0 established the
usefulness of the updated criteria for both ICH and non-ICH clinical presentations and across multiple
medical centers and time epochs. Because of the high risk of CAA-related ICH recurrence, the diagnosis
of CAA weighs heavily on decisions related to antithrombotic treatment for conditions such as
nonvalvular atrial fibrillation; however specific decision-making in these situations remains challenging
and best performed through an individualized approach. CAA also appears to be the driver of Amyloid-
Related Imaging Abnormalities (ARIA) following anti-amyloid immunotherapy, a condition with close
ties to the syndrome of spontaneous CAA-related inflammation. Reducing production, enhancing
clearance, and inhibiting the vascular toxicity of ß-amyloid are reasonable approaches towards disease-
modifying therapies for this challenging disorder.
38
11/4 (SAT.) 12 樓國際會議廳 15:20-15:55
Factor XIa inhibitors for secondary stroke prevention:
Current progress and future directions
S. Claiborne Johnston
MD, PhD, Harbor Health, Austin, TX, USA
Abstract
Stroke risk is high after an initial non-cardioembolic ischemic stroke or transient ischemic attack.
Treatment with dual antiplatelet therapy (DAPT ) lowers this risk, whether the combination is
clopidogrel-aspirin or ticagrelor-aspirin. However, the risk of recurrence remains high on DAPT in
the acute period, and DAPT is more risky than beneficial after the first 21-90 days. Anticoagulation
with warfarin or direct oral anticoagulants is modestly effective at reducing ischemic events but is
accompanied by larger increases in major hemorrhage. Factor XIa is a new target for anticoagulation
that may unpair the benefit in reducing ischemic events from the harm due to increased hemorrhage
risk. It works through the intrinsic pathway of anticoagulation while leaving the extrinsic pathway,
critical for clotting with vessel injury, intact. Two new agents, asundexian and milvexian, have shown
some promise in Phase II trials and are now being tested in large-scale international randomized trials,
with participation at many sites in Taiwan.
39
 11/4 (SAT.) 12 樓國際會議廳 15:55-16:30
Stroke genetics: discovery, insight into mechanisms, and future perspectives
Prof. Stéphanie Debette
Epidemiology at University of Bordeaux, Talence, Nouvelle-Aquitaine, France
Abstract
In recent years large collaborative genomic studies have led to substantial progress in the identification
of genetic variants associated with vascular brain disease. In this presentation, we provide an overview
of such collaborative studies on stroke and brain MRI endophenotypes of stroke (covert cerebral
small vessel disease, cSVD), revealing over 150 independent loci associated with these conditions.
We will expose how cross-ancestry efforts have enhanced our power to detect associations. In silico
functional explorations of the observed genetic associations point to a major role of blood pressure-
related pathways, but also mechanisms independent of vascular risk factors, such as extracellular
matrix structure and function, membrane transport, vascular development, myelination, and blood-
brain barrier. Leveraging next-generation sequencing data these studies also shed new light on the
continuum between monogenic and multifactorial stroke, with several genes harboring both rare
mutations and common variants contributing to the disease. Intriguingly, we recently showed that cSVD
risk loci identified in middle- and older age are associated with brain white matter microstructure and
perivascular space burden already in young adulthood, suggesting that processes contributing to cSVD
and stroke risk may find their root much earlier in life than previously thought. We will further present
how GWAS summary statistics have been leveraged, in combination with other omics resources, for
genomics-driven drug discovery for stroke and cSVD. Moreover, we will present how the combination
of these new GWAS resources with innovative integrative polygenic score methodology has informed
stroke risk prediction, for the first time across ancestries. Finally, we will reflect on future perspectives
for stroke genetics.
40
11/4 (SAT.) 12 樓國際會議廳 16:30-16:45
Targeting stroke to improve functional recovery and unravel disease susceptibility
I-Hui Lee 李怡慧
臺北榮總 神經內科
Abstract
It's my great privilege to be given this award from the Taiwan Stroke Society and to present our work
alongside many talented colleagues and collaborators. Whatever honor we have had was due to our
attention to stroke patients and enthusiasm for advancing treatments.
In the first part of my presentation, I will review early rehabilitation in acute stroke patients. Additionally,
I will introduce the concept of bihemispheric transcranial direct current stimulation (tDCS) over
the primary motor cortex in subacute stroke patients. I will also explore the potential mechanisms
underlying the tDCS effects, which have shown promise even in patients lacking corticospinal tract
integrity.
In the latter part of my presentation, I will discuss the rationale of utilizing subtype-guided hotspot
screening and/or subsequent whole exome sequencing for identifying uncommon monogenic stroke
disorders. Notably, around 20% of our familial stroke probands had been identified with pathogenic/
likely pathogenic variants (PVs), including novel PVs. This is particularly prevalent among those
presenting with the subtypes of small vessel disease and intracerebral hemorrhage of structural
vasculopathy. As we move forward, further studies are warranted to better predict tDCS responsiveness
and uncover population-specific genetic risks in stroke.
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 11/4 (SAT.) 12 樓國際會議廳 16:50-17:10 11/4 (SAT.) 12 樓國際會議廳 17:10-17:30

Intensive care bundle for acute cerebral hemorrhage Update radiotherapy for cerebral AVM

Jeyaraj Durai Pandian Huai-che Yang 楊懷哲

Christian medical college, Principal 臺北榮總 神經外科

Abstract Abstract
Among the stroke sub-types intracerebral hemorrhage (ICH) has a very high in-hospital mortality. In 腦部動靜脈畸形 (Arterio-Venous Malformation, AVM) 是一種先天性腦部血管的發育異常，有可能造
certain parts of the world the proportion of ICH is very high, particularly in Asia. Care bundle concept in 成病患產生包括腦部出血、癲癇、頭痛等症狀。據統計腦部 AVM 的病人每年有 3~4% 風險會造成
stroke evolved from Stroke unit care. Nurse led intervention focusing on swallow assessment, control of 腦出血，目前在腦部 AVM 的治療選擇上包括手術、血管內導管栓塞和加馬刀立體定位放射線手術。
fever and blood sugar can improve stroke outcome (FeSS). 不論何種治療都有其治療風險，如何能預測 AVM 病患接受治療的風險與預測其不治療出血的風險，
Rapid blood pressure lowering in acute ICH (INTERACT 2) trial tested the hyperacute lowering of BP in 是所有臨床醫師與病患於選擇治療前都很關心的議題。台北榮總的加馬刀治療團隊自 1993 年開始
ICH patients withing 6 hrs. 2839 patients who had a spontaneous ICH within the previous 6 hours and 以加馬刀放射手術治療 AVM，目前已累積超過 1000 位病患的治療經驗，目前整合最新的放射手
who had elevated systolic BP to receive intensive treatment to lower their blood pressure (with a target 術技術與過去累積經驗的影像分析結果，我們也研究開發出已利用人工智慧以模糊 C 均值演算法
systolic level of <140 mm Hg within 1 hour) or guideline-recommended treatment (with a target systolic (Fuzzy C Means，FCM) 這種類神經網路 (Artificial Neural Network, ANN) 演算法自動分析 AVM 腦部核
level of <180 mm Hg) with the use of agents of the physician's choosing. There was no difference in 磁共振影像 (magnetic resonance imaging，MRI)，做影像腦部分割 ( Brain Segmentation)，其分析結
primary outcome at 3 months however there was improvement in quality of life in the intervention arm. 果可以預測病患接受放射手術治療後之預後，這項技術已經成功申請到台灣與美國的專利，結合新
The third Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial 的科技，讓放射手術治療 AVM 可以更進一步預測病人治療後的預後與減少併發症的發生。
(INTERACT3) tested implementing a goal-directed care bundle incorporating protocols for early
intensive blood pressure lowering and management algorithms for hyperglycaemia, pyrexia, and
abnormal anticoagulation, implemented in a hospital setting, could improve outcomes for patients
with acute spontaneous ICH. Care bundle protocol for intensive BP lowering and other management
algorithms for physiological control within several hours of the onset of symptoms resulted in improved
functional outcome for patients with acute ICH.
IMPROVIng Stroke carE in India (IMPROVISE) Collaboration is an India United Kingdom joint project
which studied the implementation of swallow assessment, neurological examination by nurses,
documentation of dehydration and empowering caregivers for post stroke care by the nurses. This care
bundle approach improves outcome in both ischemic stroke and ICH patients.
Evidence so far for care bundle approach in treating stroke patients is promising and should be
incorporated in the stroke unit care protocols.

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 11/4 (SAT.) 12 樓國際會議廳 17:30-17:50
Bihemispheric tDCS in subacute stroke
Shih-Pin Hsu 許世賓
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital
臺大醫院復健部 博士後研究員
Abstract
Subacute stroke refers to a critical period in which neurorehabilitation interventions can significantly
impact motor recovery. While conventional rehabilitation therapies, such as physical and occupational
therapy, have made significant strides in aiding stroke recovery, clinicians and researchers are
continually exploring innovative techniques to expedite and enhance the recovery process. The
integration of non-invasive neuromodulation like bihemispheric transcranial direct current stimulation
(tDCS) into these regimens may offer new hope for patients seeking to regain lost motor skills. Unlike
conventional unihemispheric tDCS, which primarily targets one hemisphere of the brain, bihemispheric
tDCS simultaneously facilitates the ipsilesional primary motor cortex (M1) and inhibits the contralateral
M1. This dual-hemisphere approach is grounded in the concept of rebalancing the neural activity
across both hemispheres, with the ultimate aim of enhancing motor recovery. Recent clinical research
suggests that bihemispheric tDCS has the potential to augment the effects of neurorehabilitation
and then improve motor outcomes for stroke survivors. In this presentation, I will review the current
evidence regarding tDCS efficacy and present our work, shedding light on the promise and potential of
bihemispheric tDCS in the realm of subacute stroke rehabilitation.
44
11/4 (SAT.) 12 樓國際會議廳 17:50-18:10
The therapeutic role of neurotrophic factors in acute stroke
神經營養因子治療急性腦梗塞
Chang, Ku-Chou 張谷州
Attending Physician, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
高雄長庚醫院神經內科部腦血管科主治醫師
Abstract
Neurotrophic agents are thought to be of value in treating all stages of stroke with limited progress.
Cerebrolysin consists of neuropeptides and free amino acids with neurotrophic activities.
In Taiwan, Cerebrolysin is listed for use as a supplementary regimen for patients with insufficient
nutrient intake. Animal models and clinical studies have provided efficacy and safety data supporting
the use of Cerebrolysin in patients with stroke and vascular dementia. This article is a concise overview
of evidence which might be of value for patients in Taiwan.
For ischemic stroke patients, Cerebrolysin initiated within 72 hours intravenously by 30-50mg daily,
along with intensive rehabilitation program, offered better improvement assessed by National Institutes
of Health Stroke Scale (NIHSS) at 90 days (Mann-Whitney (MW) 0.60) and modified Rankin scale (mRS)
(MW 0.61). The number need to treat was 7.7. For moderate to severe ischemic stroke patients, NIHSS
improvement was reported at 90 days (MW 0.60). The use of Cerebrolysin has been recommended by
European guidelines.
For vascular dementia patients, Cerebrolysin infusion was associated with improvements in cognitive
function as early as 4 weeks after therapy.
Based on updated preclinical and clinical evidence from meta-analyses and recommendations by
certain guidelines, the use of Cerebrolysin might be considered in patients suffering from stroke and
vascular dementia.
Key words: Cerebrolysin, stroke, ischemic stroke, vascular dementia
45
 11/4 (SAT.) 12 樓國際會議廳 18:10-18:25
The therapeutic role of neurotrophic factors in vascular dementia
神經營養因子在血管性失智症的治療角色
Yu Sun 孫瑜
Director of Department of Neurology, En Chu Kong Hospital
恩主公醫院神經內科主任
Abstract
This lecture comprises 5 parts. 1. A brief introduction of the updates of biomarkers in the vascular
dementia, 2. A brief introduction of the most common neurotrophic factors which are involved in
the pathology of stroke and dementia as well as their contribution to brain pathology and potential
therapeutic use, 3. A review of a neuropeptide preparation Cerebrolysin focusing on the study results
of its mode of action for neuroprotection and neuro-recovery in animal studies, 4. The result of some
clinical trials of Cerebrolysin on the motor and cognition function in patients with stroke and dementia. 5.
The updated evidence of the efficacy of Cerebrolysin for vascular dementia by Cochrane Review.
46
11/4 (SAT.) B1 第五 / 六會議室 08:33-08:50
Empowering Neurologists: Dealing with Post-stroke Spasticity
神經科醫師如何處理中風後肢體痙攣：實戰分享
Ting-Yu Jill Chang 張庭瑜
Stroke Center, Department of Neurology, Linkou Chang Gung Memorial Hospital
林口長庚神經內科系腦血管科 / 主治醫師 / 腦中風病房主任
Abstract
Motor dysfunction is the most common cause of disability after stroke. Among various forms of motor
dysfunction, post-stroke spasticity (PSS) affects approximately 40% of stroke survivors, particularly
those with moderate to severe disability. In those cases, the prevalence of PSS can soar to 97%. PSS is
not restricted to the chronic phase after stroke; it can also develop since the acute or subacute stage.
Consequently, neurologists have a prime opportunity to detect the early signs of spasticity after a
stroke and address disabling spasticity promptly.
This talk will focus on raising awareness and assessing PSS in its early stages, providing effective
strategies for managing PSS from a neurologist’s perspective. Since most PSS patterns belong to focal
pr multi-focal spasticity, we will also delve into the fundamental concept of preparing for localized
treatment through botulinum toxin injections.
47
 11/4 (SAT.) B1 第五 / 六會議室 08:50-09:10 11/4 (SAT.) B1 第五 / 六會議室 09:10-09:25

Post-stroke cognitive dysfunction: an update Introduction to Post-Stroke Depression

中風後認知功能障礙 簡介腦中風後憂鬱症

Pi-Shan Sung 宋碧姍 Chung-Hsing Chou 周中興

Staff physicians / Clinical Associate professor, Department of Neurology, Director of Department of Neurology, Tri-Service General Hospital
National Cheng Kung University Hospital, Tainan, Taiwan 三軍總醫院 神經科部主任
成大醫院神經部主治醫師 / 臨床副教授

Abstract Abstract
Poststroke cognitive impairment and dementia (PSCID) is a major complications or consequences 中風後憂鬱症的病人預後較差，與功能恢復較差、重返社會生活的困難度較高、較差的生活品質、
after stroke and may induce higher morbidity and mortality. PSCID, even occurring after stroke, may 及再次腦中風的風險增加，都有相關性。過去的研究估計腦中風後憂鬱症影響 18% 至 33% 的中風
be the consequences of brain injury due to stroke, in combination with comorbid neurodegenerative 病人。曾有研究發現，中風後憂鬱症病人的死亡風險，是中風後沒有憂鬱症病人的三到四倍。既然
pathology, which is common in elderly peoples. Peoples with reduced cognitive reserves or brain 中風後憂鬱症的發生與病人預後有相關性，若能分析獲知中風後憂鬱症的發生率、相關原因、藥物
reserves before stroke may suffer from higher risk of PSCID even with small stroke lesion. Understanding 等治療的效果，將有助將來的研究發展，及時預防和治療中風後憂鬱症，以改善腦中風病人的預後。
the complex interaction between an acute stroke event and preexisting brain pathology remains a 腦中風後可能出現情感障礙，例如淡漠 (apathy)，其病情或嚴重度未必符合憂鬱症。中風後憂鬱症
priority and will be critical for developing strategies for personalized interventions and rehabilitation. 的症狀通常發生在中風後最初三個月內 ( 中風後早發性憂鬱症 )，儘管也可能隨時發生 ( 中風後遲
In this review, we will discuss the development of PSCID and the potential mechanisms of PSCID. In 發性憂鬱症 )，曾有研究指出淡漠與中風後憂鬱症的相異點，例如淡漠往往在中風後 12 個月的追
addition, we will discuss the potential management for PSCID development targeting on the aspects of 蹤期間持續存在。該研究也指出，急性基底核或腦室周圍白質疏鬆病變與中風後淡漠相關，而深部
underlying mechanisms. 白質疏鬆病變則與中風後憂鬱相關。中風後憂鬱症的最佳治療方法，大致包括藥物和心理社會等針
對中風病人的綜合措施。目前為止的回顧性研究分析，仍不建議所有中風的人都需常規使用預防性
抗憂鬱藥，而中風後被診斷患有憂鬱症的病人則應考慮嘗試抗憂鬱藥物治療。

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 11/4 (SAT.) B1 第五 / 六會議室 09:25-09:43 11/4 (SAT.) B1 第五 / 六會議室 09:43-09:58

About post-stroke dysphagia- what we have done and what we have not? Another story begins from stroke: poststroke epilepsy
中風後吞嚥障礙的現況與未來 中風後的另一個故事：中風後癲癇

Hui-Chen Su 蘇慧真 Hsin Tung 董欣

Visiting staff in Department of neurology, NCKUH 臺中榮總 教學部 / 神經醫學中心
Convenor of Chewing and swallowing team
成大醫院神經部主治醫師 / 咀嚼吞嚥整合照護小組召集人

Abstract Abstract
吞嚥障礙是中風後常見的併發症，在急性期盛行率可達 65%。根據統計在中風後六個月仍然有 11- Seizure after stroke or poststroke epilepsy (PSE) is not uncommon complication of stroke. It not
50% 的病人有吞嚥障礙問題，也發現吞嚥障礙是病患預後不良及機構化 (institutionalization) 的預測 only increases the morbidities and mortalities of the stroke patients, but also affects their function,
因子。長期追蹤中風病患的吞嚥功能並進行篩檢有助於減少吸入性肺炎、及死亡。也有研究發現 cognition, and life quality. It was estimated that around 10% of the patients with cerebrovascular
在急性中風前十天吞嚥功能尚未改善的病人，三個月之後得到改善而有安全的吞嚥。除了 FEES， disorders would develop epilepsy. However, the prevalence and incidence vary depending on the
VFSS 為吞嚥障礙的標準檢查，臨床人員應學習臨床篩檢評估的方式。歐洲中風學會建議在急性腦 stroke type, location, and other risk factors. It is categorized by the timing of seizure onset after stroke
中風的病患在住院後盡快接受吞嚥篩檢例如喝水測試；中風後吞嚥障礙之病患建議依照評估的結果 as early and late PSE. They possess different mechanisms and pathogeneses. Additionally, the choice of
進行飲食質地調整並添加增稠劑。 antiseizure medications is the other concern of PSE, because the potential drug-drug interaction with
中風後吞嚥障礙的篩檢評估目前在各家醫院各有不同的做法，但缺少科學證據強度和建議。常用 the medications used for stroke prevention.
的臨床吞嚥測試 (clinical swallow examination CSE) 包括口腔功能、管控吞嚥的低位顱神經功能、咳 In this talk, the epidemiology, pathogenesis, diagnosis, and the predictors of PSE will be introduced.
嗽反射反覆唾液吞嚥測試 (repetitive saliva swallowing test, RSST)、( 改良式 ) 三口水測試 、體積黏 Furthermore, how to manage such patients will also be discussed.
度吞嚥測試 (volume viscosity swallowing test, VVST)、喉嚨發聲吞嚥篩檢量表 (Gugging Swallowing
Screen) 等。更進一步利用儀器評估吞嚥障礙的方法如 FEES, VFSS 就可能有人力和設備的限制，但
卻又是重要的一環。及早介入治療和定期再次評估又是各家醫院的做法不一。吞嚥障礙的治療目標
必須減少吸入性肺炎、安全進食，包含營養介入、飲食質地調整、姿勢調整、復健策略、口腔衛生
介入、藥物治療周邊和中樞神經刺激等。飲食質地調整必須經由纖維內視鏡吞嚥檢查後決定安全質
地再由營養師進行營養諮詢給予配餐建議。由此可知，中風後吞嚥障礙的評估治療和照護，需要一
個跨領域跨專業的團隊，給予每一個病患個別化的診療計畫和目標，以達到病患安全營養兼顧的進
食方式。

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Carotid risk score for predicting moderate or high degree carotid
依據頸動脈風險分數以超音波預測無症狀年長者中度以上頸動脈硬化
蕭振倫
Department of Neurology, Taipei Tzu Chi Hospital, Taiwan
台北慈濟醫院神經科主治醫師
Abstract
頸動脈粥樣硬化與心腦血管事件相關，我們探索了一種合適的方法來選擇出沒有缺血性腦血管疾
病，但有不同血管疾病危險因子的參與者符合頸動脈超音檢查條件。這個研究是延續之前一項社
區年長環保志工針對血管和認知功能的健康檢查研究，做進一步頸動脈斑塊負荷的分析，共有 956
位年長者（778 位女性和 178 位男性；平均年齡：70.8 歲）無腦中風病史的參與者被納入分析，
我們用頸動脈超音波檢查頸動脈斑塊並計算頸動脈斑塊分數（CPS）。中度或高度頸動脈粥樣硬化
(MHCA) 定義為 CPS > 5，共有 22% 參與者被發現有 MHCA，CPS 與年齡、收縮壓、和空腹血糖呈
正線性相關，我們將參與者分為四個年齡組：60-69、70-74、75-79 及 ≥80 歲，多變量分析顯示，
MHCA 的重要預測因素是年齡、男性、高血壓、糖尿病、高脂血症、冠狀動脈疾病和非素食者飲食。
冠狀動脈疾病和高齡是兩個最強的預測因子，我們選擇上述七個重要的預測因子來建立預測 MHCA
的列線圖。此列線圖之 10 倍交叉內部驗證的 ROC 曲線下面積以及分類精確度分別為 0.785 和 0.797，
我們推測有 MHCA 的機率 ≥50% 的人需要進行頸動脈超音檢查，經由此列線圖發展出一個包含所
有可能機率模組的危險因子流程表，以找出符合有 MHCA 機率 ≥ 50% 的參與者（相對於總線圖總
分 ≥15 分）。我們更進一步建立了頸動脈風險指數，分數範圍從 0 到 17，包括七個危險因子。頸
動脈風險指數 ≥ 7 是最佳判斷有 MHCA ≥ 50% 機率的臨界值。不論是列線圖流程表總分 ≥15 分或頸
動脈風險指數 ≥7，二者都有助於快速識別出無症狀但有 MHCA 機率 ≥50% 的人—這些人應該給予
安排頸動脈超音檢查。
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Percutaneous angioplasty and stenting of stenosis of subclavian artery: the influence on dizziness
鎖骨下動脈支架置放術對頭暈的影響
Chun-Chao, Huang 黃俊肇
Medical Staff, Department of Radiology, MacKay Memorial Hospital, Taipei
台北馬偕紀念醫院 放射科主治醫師
Abstract
Dizziness is a frequent symptom and usually due to vestibular or psychiatric causes. Subclavian artery
(SA) stenosis is a possible cause of dizziness. Percutaneous transluminal angioplasty and stenting (PTAS)
has been found to be effective in treating SA stenosis and associated dizziness but it is still unknown
the treatment effect of PTAS on the dizziness-related daily disability and quality of life (QoL).
There were 32 subjects enrolled in this study. The baseline Dizziness Handicap Inventory (DHI) score
was 23.2 ± 14.4, which improved to 8.4 ± 9.4 6 months after PTAS for SA (p-value < 0.001). The
baseline score of SF-36 in all 32 cases was 415.6 ± 87.8, which was not significantly different from the
postprocedural 6-month score of 419.1 ± 62.2 (p-value = 0.678). The SF-36 subscores of vitality (VT) and
mental health (MH) showed significant improvement from the baseline 53.4 ± 14.1 and 51.5 ± 11.0
to postprocedural 6-month 60.0 ± 11.3 and 55.6 ± 10.4 (p-values = 0.009 and 0.036). The responders
showed significantly higher scores of total and all the three subscales of DHI as well as in the role
limitation due to physical problems (RP) and bodily pain (BP) subscales of SF-36. Significantly higher
incidence of biphasic or decreased VA flow was noted in the responders as referring to improvement of
emotional well-being and functional activity subscales of DHI.
PTAS is effective management on patients with SA stenosis to improve dizziness-related disability and
QoL, especially on patients with worse baseline dizziness-related disability, better baseline QoL, and
decreased or biphasic ipsilateral VA flow.
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Intracranial artery stenosis: imaging and intervention Video case demonstration and teamwork of endovascular treatment
顱內動脈狹窄的影像與介入治 血栓移除術的案例示範與團隊合作

Feng-Chi Chang 張豐基 Ching-Yi Wang 王景益

Chief, Division of Neuroradiology, Dept. of Radiology, Taipei Veterans General Hospital Dept. of Neurology, Landseed International Hospital, Taiwan
台北榮民總醫院放射線部神科放射科主任 聯新國際醫院神經部主治醫師

Abstract Abstract
Intracranial artery stenosis (ICAS) accounts for 25-30% of ischemic stroke in Asian. For those of Starting from a video, the procedure of endovascular thrombectomy, cooperation and integration of
medically refractory case, endovascular management (angioplasty and stenting) is crucial to restore the whole team will be demonstrated. The value of each member will be highlighted.
hypoperfused status. 用影片的方式呈現在血栓移除治療的流程，其中包含跟團隊的整合合作，與優化，介紹各角色在團
In this speech, we are going to present the following: 隊中的重要功能。
1. Application of MR high resolution vessel wall imaging (HR-VWI) to diagnose the etiology of ICAS.
2. Application of MR HR-VWI to predict the outcome of endovascular management of ICAS.
3. Preliminary experience of endovascular management of ICAS with a new stent system: Credo stent.

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Sleep or not? Updated anesthesia by Anesthesiology team in EVT Sleep or not? Sedation assessment and medication process for acute stroke patients
麻醉科在緊急取栓治療中的角色與革新 腦中風病患鎮靜評估及用藥流程

Chen, Po-Jui 陳柏瑞 Mei-Jen Li 李美貞

Dept. of Anesthesia, Landseed International Hospital, Taiwan 林口長庚紀念醫院 專業照護師
聯新國際醫院 麻醉科 主治醫師

Abstract Abstract
・Recent meta-analysis report that compared with local anesthesia, general anesthesia during 1. 病患評估及術前準備
thrombectomy was associated with similar, or even better, outcome and recanalization rate. 2. 檢查過程前中後鎮靜評估及記錄
・Advantages of general anesthesia include Immobilization, secure airway and improved patient 3. 用藥安全步驟
and neuro-interventionalist comfort. Disadvantages include fluctuation of periprocedural blood 4. 鎮靜後注意事項及電子交接班確認
pressure, potential time delay, postoperative respiratory complications, and interfere with neurologic
assessment.
・Video laryngoscopy reduce the time of intubation, and lessen postoperative complications. It also
improve first-time success rate in patient with difficult airways.
・Sugammadex use was associated with a significantly faster neuromuscular blockade reversal, lower
incidence of major pulmonary complications, and lower risk of PONV.
・Bispectral index can monitor the anesthetic depth. It help us to optimized the dosage of anaesthetic
drug and reduce postoperative recovery time.
・The most important is having effective communication and well cooperation with neuro-
interventionalist.

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From beginning to end: The trusted supporter Neurointervention Radioghrapher in EVT The beginning after the end: Stroke nursing care after EVT
從始至終：EVT 可信賴的支持者 - 神經介入放射師 護理於急性腦中風病人動脈取栓後的角色功能

Yi-Chun Huang 黃逸君 Chiung-Hua Cheng 程瓊嬅

Dept. of Medical Imaging, Shuang-Ho Hospital, Taiwan Dept. of Neurology, Landseed International Hospital, Taiwan
雙和醫院 影像醫學部 放射師 臺大醫院腦中風中心加護病房 護理長

Abstract
神經介入治療的方式日新月異，近年來，隨著健保給付條件放寬，介入治療的需求量逐年提高，
治療團隊的訓練及值班人力備受挑戰，尤其在住院醫師的培養，通常有熟悉業務的銜接期，除了
EVT，住院醫師也同時背負了許多臨床業務，加上有勞基法的限制，以至於沒辦法一起協助執行
EVT，這時候，如果有一組人員經過適當的訓練，可以穩定的提供取栓動作以外的協助工作，讓取
栓的過程更順利，也能加快 EVT 的速度，爭取更多病人的恢復程度，這群可以協助的人，就是神
經介入放射師。
神經放射師的訓練過程與一般住院醫師的訓練大同小異，經過適當的訓練之後可以提供穩定的手術
協助、跟台教學甚至是外院支援。同時，放射師對於機器及原理也相當熟悉，更是法律規範中不可
或缺的角色，培養一個技術熟練的介入放射師，可多方面的提供醫療協助，是一個可信賴的好幫手。
Abstract
Endovascular thrombectomy is a therapeutic procedure that enables rapid perfusion of cerebral
blood flow for patients with acute ischemic stroke. It requires a multidisciplinary team of professionals
collaborating together to ensure the success of the treatment and the safety of the patients. Throughout
this entire process, nurses assume a multifaceted role, with proper post-procedural care emerging
as a pivotal aspect. This encompassing care involves the management of the patient's puncture site,
monitoring for potential complications, documenting and communicating essential information,
providing nursing guidance and mental support. These efforts collectively ensure that patients receive
comprehensive care, thereby enhancing both the success rate of treatment and the quality of recovery.

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12樓國際會議廳
樓國際會議廳 08:30-08:50
The impact of ICH on anticoagulation in atrial fibrillation
Richard Li 李梓強
Department of Medicine
Pamela Youde Nethersole Eastern Hospital
Abstract
There has been a paradigm shift from using vitamin-K dependent anticoagulants (VKA) to direct oral
anticoagulants (DOAC) in patients with atrial fibrillation (AF) due to their superior efficacy in preventing
thromboembolic events and better safety profiles. DOAC use has led to a reduction in the annual
rate of anticoagulation-related intracranial hemorrhage (ICH) from 0.6% to 0.2%. Despite its rare
occurrence, DOAC-related ICH remains the most disastrous complication of anticoagulation. Specific
reversal agents for direct-thrombin inhibitors and factor-Xa inhibitors have become available and were
increasingly used worldwide, which resulted in better mortality and morbidity. However, survivors of
DOAC-related ICH remained at risk of recurrent ischaemic events. So far, there are no clear guidelines on
anticoagulation resumption as they are usually excluded from randomised-controlled studies. This talk
will evaluate the efficacy of reversal agents on DOAC-related ICH, risk stratification for anticoagulation
resumption in DOAC-related ICH survivors, and real-world data on the benefits and timing of DOAC
resumption.
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12樓國際會議廳
樓國際會議廳 08:50-09:05
Update of Taiwan AF in ESUS (T-AFESUS) Trial
Li-Kai Tsai 蔡力凱
Department of Neurology, National Taiwan Universityd Hospital Hsinchu branch, Hsinchu City
新竹臺大分院 神經部
Abstract
Subclinical atrial fibrillation (AF) is one of the most important etiologies for embolic stroke of
undermined source (ESUS). Selecting high-risk patients for cardiac rhythm monitoring potentially
detects more AF. Taiwan AF in ESUS (T-AFESUS) trial aims to test the detection rats of AF using 24-hour
Holter ECG and 14-day EZYPRO® monitoring in patients with selected ESUS. T-AFESUS is a prospective
multicenter open-label clinical trial, which will enroll 500 subjects older than 50-year-old with ESUS
features at MR imaging. Each patient received both 24-hour Holter ECG and 14-day EZYPRO® monitoring
simultaneously within 2 weeks after index stroke. Patients who were detected to have paroxysmal AF
(more than 30 seconds of duration) will receive anticoagulants. Any vascular outcome within 6 months
will be recorded. The primary endpoint is to compare the AF detection rates between 24-hour Holter
and 14-day EZYPRO® in selected patients with ESUS. Preliminarily, 196 patients (mean age, 68.4±9.9
years; men, 63.8%) have completed cardiac monitoring. Among them, 20 (10.2%) were noted to have
paroxysmal AF by 14-day monitoring, while 24-hour Holter detected 10 (5.1%)(p<0.01). Patients with AF
showed higher systolic blood pressure, higher left ventricular ejection fraction, larger atrium diameter,
and lower initial glucose level than those without detected AF. None of patients with AF developed
recurrent stroke while 2 subjects (1.1%) without AF detection experienced recurrent ischemic stroke.
In conclusion, more patients were detected to have AF using 14-day than 24-hour monitoring for ESUS
patients with age more than 50 years, early monitoring and MR imaging selection. The study is ongoing,
and the features and outcome of patients will be investigated.
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樓國際會議廳 09:05-09:51 11/4 (SUN.)
11/5 (SAT.) 12
12樓國際會議廳
樓國際會議廳 09:05-09:51

Debate: Should patients on DOAC within the last 48 hours be excluded Debate: Should patients on DOAC within the last 48 hours be excluded
from thrombolysis if drug level testing and reversal unavailable? from thrombolysis if drug level testing and reversal unavailable?
Yes! Should be excluded from thrombolysis No! Should not be excluded.

Chih-Hao Chen 陳志昊 Yi-Hsin Chan 詹益欣

Attending physician, Department of Neurology, NTUH Professor of Internal Medicine and Cardiology, Chang Gung Memorial Hospital, Linkou
台大醫院神經部主治醫師 林口長庚 心臟內科

Abstract
過去 48 小時內有服用 DOAC、且藥物濃度及反轉劑無法取得之下，照目前臨床規範應被排除接受
施打靜脈血栓溶解劑 (rt-PA)。本場辯論我將回顧相關文獻，說明為何目前這規範是有道理的；但也
會告訴大家，這場辯論並沒有絕對的是與非，希望能透過雙方提出證據，帶給臨床醫師更多思考的
切入點。
Abstract
In patients with nonvalvular atrial fibrillation (AF), the use of non-vitamin K antagonist oral
anticoagulants (NOACs), such as apixaban, dabigatran, edoxaban, and rivaroxaban, has emerged as
the primary stroke prevention option. Since the transition from vitamin K antagonists (VKA) to NOACs,
it is estimated that every sixth patient with stroke who would otherwise qualify for intravenous
thrombolysis (IVT) has been prescribed NOACs. Regarding VKA with an international normalized
ratio (INR) greater than 1.7, guidelines recommend excluding patients who have recently consumed
NOACs (within 48 hours) from receiving IVT in the event of an ischemic stroke. This recommendation is
predicated on the assumption of an increased risk of symptomatic intracranial hemorrhage (sICH), but
there are insufficient data to support or refute this assumption. Studies on VKA cannot be extrapolated
to NOACs, which have a 50% lower risk of ICH than warfarin. In experimental ischemic stroke, NOACs
did not increase the risk of bleeding following IVT, whereas warfarin did. Diverse strategies for selection,
including the use of NOAC reversal agents prior to IVF selection of patients with low anticoagulant
activity at DOAC plasma level measurement or point-of-care coagulation assays has been proposed.
However, the available evidence comes from comparably small case series with single-center
experience and measuring NOAC plasma levels is not possible in many hospitals around the world,
calling into question the feasibility of this approach.
Prior administration of NOACs did not appear to increase the risk of sICH in patients with ischemic stroke
treated with IVT, according to a meta-analysis in 2020. Consistent with this observation, an analysis of
the United States-based Get With the Guidelines–Stroke Registry on 2020 found no association between
NOAC consumption within the previous 7 days prior to the onset of stroke and sICH. However, the
most significant limitation of these studies was the inclusion of only a small proportion of patients with
confirmed ingestion within the preceding 48 hours, which is the timeframe within which international
guidelines advise against IVT. According to the Get With the Guidelines report, only two of twenty-five
(8%) patients whose last NOAC ingestion occurred within 48 hours and none of eight patients whose
last NOAC ingestion occurred within 24 hours prior to hospital admission developed sICH. In addition,
no information was provided regarding selection strategies, including plasma level measurements, for
these patients. In one recent large international cohort study, the author found insufficient evidence of
excess harm associated with IVT in selected patients with ischemic stroke with recent DOAC ingestion.
This was true regardless of the selection strategy and is likely consistent with net benefit of IVT in those
patients. Given the established benefits of IVT and the absence of any signal for harm in recent clinical
studies or preclinical investigations, future guideline updates need to reconsider recent NOAC ingestion
as a contraindication to IVT for acute ischemic stroke.

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12樓國際會議廳
樓國際會議廳 10:10-10:45
Advanced acute stroke care and future perspectives
Jeffrey L. Saver
David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
Abstract
With successful reperfusion now achieved in more than 90% of acute thrombectomy patients, the
opportunity to importantly advance acute stroke by innovation in mechanical thrombectomy devices is
narrowing. This forward-looking lecture will survey five emerging areas of potential dramatic advance.
1. Accelerated Stroke Onset Detection by Wearable Monitors
2. Devices to improve Paramedic Identification of Stroke and Stroke Subtypes
3. Novel Thrombolytic Agents Including DNase and von Willebrand Factor Targeting Molecutes
4. Neuroprotection Including Acute Neuromodulation Therapies
5. The New NIH STEP Stroke Platform Trial
Continued transformative advance is the future of acute stroke care.
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12樓國際會議廳
樓國際會議廳 10:45-11:20
Neuroprotection in the reperfusion era
Marc Fisher
Harvard Medical School, Boston, MA, USA
Abstract
Stroke is an urgent public health issue with millions of patients worldwide living with its devastating
effects. The advent of thrombolysis and endovascular thrombectomy has transformed the hyperacute
care of these patients. However, a significant proportion of patients receiving these therapies still go
on to have unfavourable outcomes and many more remain ineligible for these therapies based on our
current guidelines. The future of stroke care will depend on an expansion of the scope of thrombolysis
and endovascular thrombectomy to patients outside traditional time windows, more distal occlusions,
and large vessel occlusions with mild clinical deficits, for whom clinical trial results have not proven
therapeutic efficacy. Novel cytoprotective therapies targeting the ischemic cascade and reperfusion
injury therapy, in combination with our existing treatment modalities, should be explored to further
improve outcomes for these patients with acute ischemic stroke. We will discuss how cytoprotection
might be combined with thrombectomy and thrombolysis.
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樓國際會議廳 11:20-11:30 11/4 (SUN.)
11/5 (SAT.) 12
12樓國際會議廳
樓國際會議廳 13:05-13:20

腦中風晚時間窗再灌流治療之健保政策 Intensive blood pressure control in secondary stroke prevention

腦中風次級預防的血壓控制

石崇良 Hsieh Meng-Tsang 謝孟倉

中央健康保險署 署長 Department of Neurology, Chi-Mei Medical Center, attending physician
奇美醫學中心 神經內科主治醫師

Abstract Abstract
2023 年社團法人台灣腦中風學會學術研討會 Controlling risk factors for stroke is one of the crucial elements in the treatment and prevention of
社團法人台灣腦中風學會連理事長 / 蔡秘書長、大會陳榮譽主席 / 陳主席及與會的貴賓大家好，很 recurrent strokes, with high blood pressure being the most common risk factor for stroke. Blood
高興今天能夠受邀參與「2023 年社團法人台灣腦中風學會學術研討會」。首先，非常感謝主辦單 pressure management has new guidelines for both ischemic and hemorrhagic strokes, with varying
位對健康與醫療議題的關心，邀集各界專家透過今日的學術研討會，就台灣腦中風防治議題進行經 treatment goals in different phases after a stroke, presenting challenges for healthcare professionals in
驗與意見的交流。 their decision-making. In addition to the target for blood pressure, factors such as how blood pressure
腦中風是造成全球人口死亡及失能的主要原因之一，若可於疾病發作初期及早介入治療，可大幅改 is measured and recorded, as well as the blood pressure variability, can also influence prescription
善預後，也避免病人後續因失能而需仰賴家屬照顧、無法歸復社會工作之遺憾。各種治療方式中， decisions.
動脈取栓手術可明顯改善對於急性缺血性腦中風的治療效果，依據國際實證和臨床指引建議急性缺
血性腦中風病人於發作後 6 至 24 小時進行取栓，較未執行者仍具有明顯療效；另建議發作後 4.5
小時內使用血栓溶解劑 (rt-PA) 藥物，把握再灌流治療機會。
為保障民眾就醫權益，健保署與台灣腦中風學會合作，參考國際臨床治療指引，挹注約 1.82 億元
預算，修訂「急性缺血性腦中風機械取栓術」醫療服務及特材之適應症，由腦血管前循環發生阻塞
8 小時內，放寬至發作後 24 小時內；並修訂 rt-PA 藥品及處置費之給付規定，由腦中風病人發作
3 小時內靜脈注射，延長至 4.5 小時內注射，增進病人預後，減少病人自費負擔，預計分別新增加
565 位及 1,600 位中風病人得以受惠，亦可有效減少病人中風失能及後續長照負擔。
本署將持續努力，與相關學會合作，期透過政策滾動修正，與時俱進，提升醫療照護及病人生活品
質，以降低腦中風之發生率及失能為最終目標。最後，希望透過今日的活動，呼籲民眾重視腦中風
風險，並能強化健保署與醫衛專業團體的合作。並敬祝活動順利成功，祝福各位身體健康，謝謝大
家！

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11/5 (SAT.) 12
12樓國際會議廳
樓國際會議廳 13:20-13:35 11/4 (SUN.)
11/5 (SAT.) 12
12樓國際會議廳
樓國際會議廳 13:35-13:50

Comparison of anti-diabetic drugs in stroke prevention according to data from trials Revisit old myth of lipid control: the lower the better
根據臨床試驗資料比較糖尿病藥物於預防中風 重新探討血脂控制：越低越好？

Cheng-Yang Hsieh 謝鎮陽 Chia-Yu Hsu 許家瑜

Visting staff, Tainan Sin Lau Hospital Attending staff, Neurology department, Chang Gung Memorial Hospital, Chia-Yi Center
台南新樓醫院 神經內科主治醫師 嘉義長庚醫院 神經內科系主治醫師

Abstract
Diabetes can increase the risk for many health conditions, including stroke. People with diabetes are
twice as likely to have a stroke as people without diabetes. Diabetes affects around 30% of patients with
ischemic stroke and doubles their risk for recurrence. Like stroke, diabetes case management should
be provided by an interdisciplinary team. Notably, there are great advances in pharmacotherapy for
diabetes in recent years, such as sodium glucose co-transporter inhibitor and glucagon-like peptide-1
receptor agonist. In addition to glucose control, those novel anti-diabetic therapy can also reduce
major adverse cardiovascular events, such as stroke. Finally, I will also address the management of
hyperglycemia during the acute phase of stroke.
Abstract
Dyslipidemia is a major modifiable risk factor for ischemic stroke. Treatment with statins reduces the
incidence of recurrent ischemic stroke in patients with a history of ischemic stroke. Therefore, statins
represent an important component of secondary prevention of ischemic stroke. In patients who do
not achieve low-density lipoprotein cholesterol (LDL-C) targets despite treatment with the maximal
tolerated dose of a potent statin, ezetimibe should be added to their lipid-lowering treatment. Selected
patients who do not achieve LDL-C targets despite statin/ezetimibe combination are candidates for
receiving proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors. More intensive compared
with less intensive LDL-C lowering statin-based therapies are associated with a reduced risk of recurrent
stroke among patients with ischemic stroke, but this reduced risk might be confined to patients with
evidence of atherosclerosis. It should be mentioned that more intensive compared with less intensive
LDL-C lowering statin-based therapies are also associated with an increased risk of hemorrhagic stroke
and new-onset diabetes. For patients without evidence of atherosclerosis, intensive LDL-C–lowering
statin-based therapies might not be needed in most situations considering the uncertain benefits of
secondary stroke prevention and the increased risk of hemorrhagic stroke associated with intensive
LDL-C lower- ing.

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12樓國際會議廳
樓國際會議廳 13:50-14:05 11/4 (SUN.)
11/5 (SAT.) 12
12樓國際會議廳
樓國際會議廳 14:05-14:20

Special consideration of anticoagulation in AF patients with special conditions Management of patients with breakthrough stroke under anti-PLT
抗凝血劑使用於心房顫動之特殊狀況考量 已使用抗血小板藥物治療患者仍再發生中風之處置

Yenchu Huang 黃彥筑 Chi-Hung Liu 劉濟弘

Director, Department of Neurology, Stroke Center, Chang Gung Memorial Hospital at Chiayi Professor, Stroke Center and Department of Neurology, Chang-Gung Memorial Hospital, Linkou
嘉義長庚神經內科主任 / 腦中風中心主任 Vise Chair and Assistant Professor, School of Medicine, Chang Gung University
林口長庚醫院腦血管科教授
長庚大學醫學系副主任

Abstract Abstract
In the realm of anticoagulation therapy for patients with atrial fibrillation (AF), special consideration Antiplatelet treatment is the cornerstone of non-cardioembolic stroke. The same as DOAC failure in
is paramount when dealing with individuals who have specific medical histories or conditions. atrial fibrillation patients, antiplatelet failure may also occur in non-cardioembolic stroke patients,
Patients with a prior history of intracranial hemorrhage pose a unique challenge, as anticoagulation leading to breakthrough stroke. In this session, we’ll review the possible causes and management
must be managed cautiously to prevent recurrent bleeding episodes. Microbleeds, often detected strategies in patients with breakthrough stroke under antiplatelet use.
through advanced imaging techniques, raise concerns about potential bleeding risks associated with
anticoagulation. Understanding the location and significance of these microbleeds is vital in making
informed decisions about anticoagulant therapies. Furthermore, elderly AF patients, who are already at
an increased risk of both AF-related strokes and bleeding complications, demand specialized attention.
Similarly, individuals with end-stage renal disease, altered hemostasis complicates the application of
anticoagulants, which remains a topic of debate. Balancing the benefits of stroke prevention with the
risks of bleeding events becomes even more crucial in this demographic.

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B1第五
第五/ /六會議室
六會議室 08:30-08:50 11/4 (SUN.)
11/5 (SAT.) B1
B1第五
第五//六會議室
六會議室 08:50-09:10

TSS ICH guideline: diagnosis and supportive care TSS ICH guideline: surgical management
台灣腦中風學會自發性腦出血處置指引 : 診斷及內科治療

Yu-Kai Lin 林鈺凱 Abel Po-Hao Huang 黃博浩

Department of Neurology, Tri-Service General Hospital, National Defense Medical Center National Taiwan University Hospital, Neurosurgeon
Assistant professor: National Defense Medical Center 台大醫院 神經外科
三軍總醫院神經科部主治醫師
國防醫學院神經學科助理教授

Abstract
The Ministry of Health and Welfare in Taiwan has released statistics on the top 10 causes of death for the
last year (2022). Among these statistics, cerebrovascular diseases ranked as the fifth leading cause of
death. Within the category of cerebrovascular diseases, non-traumatic intracerebral hemorrhage (ICH)
was mentioned as a particularly deadly subtype of acute stroke, with an early mortality rate ranging
from approximately 30% to 40%. Today, I will introduce 2013 TSS ICH guideline, focusing on diagnosis
and supportive care.
Abstract
Background and Aims:
Intracerebral hemorrhage (ICH) is a highly prevalent disease with high mortality and morbidity. The
practice of surgery for ICH has been widely variable nationally and internationally. We aim to come up
with a practical guideline for our country.
Methods:
We reviewed all pertinent literature for MIS ICH treatment, including the AHA/ASA guideline and ICH
guideline of Japan, Korea, and China. We also formed a committee consisted of neurologist, critical
care experts, and neurosurgeons to review these. A detailed interview and questionaire was performed
to the neurosurgeon and stroke team of different hospitals; including medical center and regional
hospitals. Taking these into account, Taiwanese ICH Surgery Guideline was finalized.

Results:
MIS for evacuation of supratentorial ICHs and intraventricular hemorrhages (IVH), compared
with medical management alone, have demonstrated reductions in mortality. For patients with
supratentorial ICH of >20-mL volume with GCS scores in the moderate range 5-12 being considered for
evacuation, it may be reasonable to select minimally invasive hematoma evacuation over conventional
craniotomy to improve functional outcomes. MIS ICH evacuation was best done early, for deep
hemorrhages, for spot sign positive cases one must have ability to secure the bleeder during MIS, ICP
monitor implantation was suggested after surgical evacuation of ICH.

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B1第五
第五/ /六會議室
六會議室 09:10-09:30
Asymptomatic intracranial aneurysm: to treat or be negligible?
無症狀之顱內動脈瘤 : 治療或忽略 ?
Szu-Kai Hsu 許斯凱
Visting staff, Department of Neurosurgery, Cathay General Hospital
國泰醫院神經外科 主治醫師醫師
Abstract
Unruptured intracranial aneurysms (UIA) are a common finding, occurring in about 2% of the
population and presenting in a variety of ways, from sudden death following subarachnoid hemorrhage
to an incidental finding on cerebral imaging. Making them very likely to be seen, and present a
challenge in the recommendations for optimal management and screening.
UIAs are common in the general population and, with the increase in detection on noninvasive
imaging, are likely to be encountered by all clinicians. Many UIAs may have a benign course, but
carry a risk for rupture, with potentially catastrophic SAH. Currently, there are 2 effective methods for
treatment, including surgical clipping and endovascular management, but such treatments carry a risk
of morbidity and mortality. When an unruptured aneurysm is detected, the aneurysm's natural history
is compared to interventional risks, with a consideration of numerous aneurysm and patient factors.
These include aneurysm size, location, morphology, and presentation and patient factors including age,
family history of SAH, personal history of SAH, presence of medical comorbidities, and their perspective
regarding an interventional procedure.
We addresses the challenges of screening and management of UIAs after reviewing the current articles.
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11/4 (SUN.)
11/5 (SAT.) B1
B1第五
第五//六會議室
六會議室 09:30-09:50
Refining Postoperative Care Strategies for Patients Receiving Dual Antiplatelet Therapy
in the Endovascular Treatment of Ruptured Cerebral Aneurysms
蘇亦昌
雙和醫院 神經外科
Abstract
Introduction
Endovascular treatment is pivotal for managing ruptured cerebral aneurysms. Complex or wide-
neck aneurysms often necessitate stent or flow diverter-assisted coiling, which typically entails
dual antiplatelet therapy (DAPT), including aspirin and clopidogrel. This introduces challenges in
postoperative care, particularly regarding hemorrhagic complications. This presentation offers insights
from our institutional experience and presents refined strategies tailored to patients undergoing
endovascular treatment for ruptured cerebral aneurysms on DAPT.
Materials and Methods
Over the past three years, we treated 36 cases of ruptured cerebral aneurysms with stent or flow
diverter-assisted coiling. Data included baseline demographics, subarachnoid hemorrhage (SAH)
severity, external ventricular drainage (EVD) status, specific stent or flow diverter details, and
hemorrhagic complication profiles.
Results
Among the 36 patients, 15 experienced new bleeding events: 6 asymptomatic and 9 symptomatic.
Spontaneous hemorrhagic events numbered 8, with 5 occurring around the EVD and 3 in distant
parenchyma. Approximately 75% of spontaneous bleeding events occurred within the first 5
postoperative days. Seven hemorrhagic events were procedure-related, including 2 tract bleeds
post-EVD removal, 3 post-ventriculoperitoneal shunt placement, 1 chronic subdural hematoma
post-ventriculoperitoneal shunt placement, and 1 acute subdural hematoma post-chronic subdural
hematoma surgery.
Discussion
Hemorrhagic events post-DAPT in endovascular treatment of ruptured cerebral aneurysms fall into
procedural and non-procedural categories, with incidence rates of 16.7% and 19.4%, respectively. To
mitigate procedure-related hemorrhagic complications, we recommend reducing DAPT before surgical
procedures. For non-procedural complications, we suggest minimizing patient transfers, especially
within the first 5 postoperative days, and promptly adjusting DAPT in response to hemorrhagic
complications.
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(SAT.) B1
B1第五
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六會議室 13:10-13:30 11/4 (SUN.)
11/5 (SAT.) B1
B1第五
第五//六會議室
六會議室 13:30-13:50

The impact and future of artificial intelligence on stroke treatment Clinical Applications of Artificial Intelligence in Stroke Imaging
人工智慧對中風治療的影響與未來 人工智慧於臨床中風影像應用

Kai-Cheng Hsu 許凱程 David Yen-Ting Chen 陳彥廷

Director of Artificial Intelligent Center/Attending Physician Attending physician, Dept. of Radiology, Shuang-Ho Hospital, Taiwan
人工智慧中心主任 / 醫師 雙和醫院影像醫學部主治醫師

Abstract
In the advancing landscape of stroke diagnosis, Artificial Intelligence (AI) has emerged as a pivotal
tool. Historically, Non-Contrast CT (NCCT) primarily differentiated hemorrhagic from ischemic strokes.
Now, with AI integration, particularly through the iBRS platform, ischemic strokes can be pinpointed
from NCCT images in roughly 90 seconds. Further, when AI algorithms augment CT Perfusion (CTP)
imaging, which emphasizes cerebral blood flow, there's an enhanced capacity for automatic delineation
of ischemic regions, including the ischemic core and penumbral zones. This fusion of technology
and medical imaging not only streamlines clinical decision-making but also magnifies its accuracy.
As highlighted in select clinical cases, these AI models demonstrate marked precision in real-world
scenarios, underscoring the promising horizon for improved patient outcomes in stroke diagnosis.
Abstract
Stroke is one of the leading causes of mortality and disability worldwide, imposing a significant
socioeconomic burden to the society. Imaging studies play a pivotal role in the diagnosis, management
and prognostication of stroke patients in the clinical practice. Recent advances in artificial intelligence
(AI) technologies have brought rapid progress in the field. In the presentation, I will first introduce an
overview of the potential roles of AI in stroke imaging from a neuroradiologist’s view. Then, I will delve
into some of the most impactful AI applications on stroke imaging, from imaging processing, disease
diagnosis, lesion quantification, to outcome prediction, which will be valuable to improve patient care
and provide insights for future stroke research.

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B1第五
第五/ /六會議室
六會議室 13:50-14:10 11/4 (SUN.)
11/5 (SAT.) B1
B1第五
第五//六會議室
六會議室 14:15-14:35

Reliability of tissue at risk by utilising an autonomic DCNN workflow CHATGPT in research & writing

Fan-pei Gloria Yang 楊梵孛 Yu-Chun Chen 陳育群

AI Center, National Tsing Hua University Chief, Division of Community Health, Department of Family Medicine, Taipei Veterans General Hospital
清華大學 人工智慧研發中心 台北榮總家庭醫學部 社區醫學科主任

Abstract Abstract
The tissue at risk of infarction, also known as penumbra, is where perfusion is insufficient for neuronal 大型語言模型，如 ChatGPT 帶來許多令人驚豔的應用。在本次演講中，我們將深入探討如何充分
function, but capable of cell growth and development. Identifying this dysfunctional yet salvageable 利用 ChatGPT 在各個研究階段的優勢，包括：進行文獻分析和探討、研究資料的統計與動態分析、
tissue is crucial for all acute stroke therapies, such as intravenous thrombolysis using t-PA (3) and 擬定研究草稿以及統計數據的解讀。更為重要的是，我們會探討如何利用 ChatGPT 增強研究的原
thrombectoy. MR sequences, including diffusion-weighted imaging (DWI) and perfusion-weighted 創性，並避免過度依賴 AI 生成重複內容，以確保研究的真實性和獨特性。透過這些策略，研究者
imaging (PWI) MR and CT perfusion (CTp), have been employed to rapidly identify stroke patients with 不僅可以提高工作效率，還能確保研究的品質與影響力。
still present penumbra. However, some remaining questions surround the optimal modality for imaging
the penumbra, the reliability of each modality, and potential of identification of penumbra with artificial
intelligence. This talk will introduce the advancement of artificial intelligence in segmenting the tissue
at risk and the pilot test results of a DCNN workflow.

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諾和諾德 百靈佳
時間 主題 演講者 座長 時間 主題 演講者 座長
連立明 醫師 李俊泰 醫師
1200-1205 Opening Remarks 1200-1205 Opening Remarks
新光醫院 三軍總醫院
GLP-1 RA in DiabetesManagement : Addressing 陳龍 醫師 連立明 醫師 黃虹瑜 醫師
1205-1240 1205-1230 Complete the Circle of Stroke Prevention
the link between Diabetes and Stroke 雙和醫院 新光醫院 中國附醫
李俊泰 醫師
1240-1300 Panel Discussion ALL The Simple Way to Solve Clinical Concerns: Dose 湯頌君 醫師
1230-1255 三軍總醫院
Selection and Net Clinical Benefit Among 4 NOACs 台大醫院
連立明 醫師
1300 Closing Remarks
新光醫院 1255-1300 Panel Discussion & Closing Remarks All Faculties

11/4 (SAT.) 多功能會議室 ( 醫療大樓 11 樓 ) 12:00-13:00 11/4 (SAT.) 韻律教室 ( 門診大樓 B1 樓 ) 12:00-13:00

暉致 大塚
時間 主題 演講者 座長 時間 主題 演講者 座長
鄭建興 醫師 劉崇祥 醫師
1200-1205 Opening Remarks 1200-1210 Opening Remarks
台大醫院 中國醫藥大學附設醫院
Better Strategy for Stroke Patients with 陳柏霖 醫師 鄭建興 醫師 劉崇祥 醫師
1205-1245 Modernized stroke treatment pathway to improve 施懿恩 醫師
Dyslipidemia 台中榮總 台大醫院 1210-1240 中國醫藥大學
patient outcomes 清泉醫院
1245-1255 Panel Discussion All 附設醫院

鄭建興 醫師 劉崇祥 醫師
1255-1300 Closing Remarks 1240-1250 Panel Discussion ALL 中國醫藥大學
台大醫院
附設醫院
劉崇祥 醫師
1250-1300 Closing Remarks
中國醫藥大學附設醫院

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 11/4 (SAT.) VIP 1/2 ( 門診大樓 12 樓 ) 12:00-13:00 11/5 (SUN.) 第五會議室 ( 門診大樓 B1 樓 ) 12:00-13:00

拜耳 賽諾菲
時間 主題 演講者 座長 時間 主題 演講者 座長
周中興 醫師 陳右緯 副院長
1200-1205 Opening 1200-1205 Opening Remarks
三軍總醫院 聯新國際醫院
How to Protect Elderly AF Patients with 詹益欣 醫師 周中興 醫師 Modernized stroke treatment pathway to improve 陳彥中 醫師 陳右緯 副院長
1205-1225 1205-1225
Appropriate Asian Dosage of NOACs? 林口長庚 三軍總醫院 patient outcomes 彰化基督教醫院 聯新國際醫院
Beyond Single Vessel:Escalate Systemic Protection 劉崇祥 醫師
陳彥中 醫師 宋碧姍 醫師 Optimal choice of antiplatelet monotherapy for 陳柏霖 醫師
1225-1245 of Chronic Coronary Syndrome (CCS) with Dual 1225-1245 中國醫藥大學
彰化基督教醫院 成大醫院 long-term patient care 台中榮民總醫院
Pathway Inhibition (DPI) 附設醫院
1245-1255 Panel Discussion All 1245-1255 Discussion All
宋碧姍 醫師 劉崇祥 醫師
1255-1300 Closing 1255-1300 Closing Remarks
成大醫院 中國醫藥大學附設醫院

11/4 (SAT.) 藝文空間 ( 門診大樓 1 樓 ) 12:00-13:00 11/5 (SUN.) 多功能會議室 ( 醫療大樓 11 樓 ) 12:00-13:00

安沛 衛采
時間 主題 演講者 座長 時間 主題 演講者 座長
湯頌君 教授 李俊泰 醫師
1200-1210 Opening 1200-1210 Opening Remarks
台大醫院 三軍總醫院
Try Everything – Tirofiban in Acute Ischemic 陳志昊 醫師 Opportunities of AEDS in Elderly Patient with 江星逸 醫師 李俊泰 醫師
1210-1230 湯頌君 教授 1210-1250
Stroke 台大醫院 Epilepsy 林口長庚醫院 三軍總醫院
台大醫院
1230-1235 Panel Discussion ALL 李俊泰 醫師
1250-1300 Panel Discussion
三軍總醫院
Unlocking the Potential: Endovascular Therapy 朱海瑞 主任
1235-1250 蔡力凱 教授
with Tirofiban in Acute Ischemic Stroke 恩主公醫院
台大醫院
1250-1255 Panel Discussion ALL
蔡力凱 教授
1255-1300 Closing
台大醫院

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致 謝
艾伯維
時間 主題 演講者 座長
連立明 理事長 鑽石級
1200-1205 Opening Remarks
台灣腦中風學會
Reduce Post-Stroke Disability Burden
蔡欣熹 醫師
1205-1240 - The Clinical Benefits of BOTOX on Post-Stroke 連立明 理事長
臺大醫院
Spasticity Management 台灣腦中風學會 白金級
1240-1255 Discussion ALL
連立明 理事長
1255-1300 Closing Remarks
台灣腦中風學會
金 級

11/5 (SUN.) 韻律教室 ( 門診大樓 B1 樓 ) 12:00-13:00

阿斯特捷利康 銀 級
時間 主題 演講者 座長
巫錫霖 醫師
1200-1205 Opening
彰基醫院
P2Y12i's role in acute ischemic stroke and TIA 湯頌君 醫師 巫錫霖 醫師 單 項
1205-1240
management 台大醫院 彰基醫院
巫錫霖 醫師
1240-1300 QA & Closing
彰基醫院

11/5 (SUN.) VIP 1/2 ( 門診大樓 12 樓 ) 12:00-13:00 ™

葛蘭素史克
時間 主題 演講者 座長
陳龍 醫師
1200-1205 Opening
雙和醫院
Elevating Post-Stroke Epilepsy Management in the 周建成 醫師 陳龍 醫師
1205-1240
Elderly: Why KEPPRA Reigns Supreme 台北榮總 雙和醫院
陳龍 醫師 UTRONIC

1240-1300 QA & Closing TECHTRONIC

雙和醫院

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