Endovascular Therapy for Acute Ischemic Stroke

Patients with an occlusion of the distal internal carotid or proximal middle cerebral artery have among the most severe types of ischemic stroke that typically produce life-altering disabilities. Prior to a few months ago, the standard of care for such patients included intravenous (IV) alteplase and comprehensive peristroke care to avoid complications, including measures to prevent another stroke and comprehensive rehabilitation.
Source: JAMA Neurology - Category: Neurology Source Type: research

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Stroke is one of the major causes of chronic disability worldwide and increasing efforts have focused on studying brain repair and recovery after stroke. Following stroke, the primary injury site can disrupt functional connections in nearby and remotely connected brain regions, resulting in the development of secondary injuries that may impede long-term functional recovery. In particular, secondary degenerative injury occurs in the connected ipsilesional thalamus following a cortical stroke. Although secondary thalamic injury was first described decades ago, the underlying mechanisms still remain unclear. We performed a sy...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
ConclusionAs IV stimulates hippocampal neurogenesis after stroke, thus potentially facilitates brain to remodel and repair by downregulating IL-17 expression via Wnt pathway.
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
In this study, we explored the neuroprotective effects of miR-219a-5p on brain using an in vitro ischemia model (mouse neuroblastoma N2a cells treated with oxyglucose deprivation and reperfusion), and in vivo cerebral I/R model in mice.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
This article reviews the actual indications for mechanical thrombectomy in patients with acute ischemic stroke and how the opportunities for endovascular therapy can be expanded by using the concept of clinical-imaging or perfusion-imaging mismatch (as a surrogate for salvageable tissue) rather than time of ischemia. RECENT FINDINGS Six randomized controlled trials undoubtedly confirmed the benefits of using endovascular thrombectomy on the clinical outcome of patients with stroke with large vessel occlusion within 6 hours from symptom onset compared with those receiving only standard medical care. In a meta-analysis of...
Source: CONTINUUM: Lifelong Learning in Neurology - Category: Neurology Tags: REVIEW ARTICLES Source Type: research
Abstract INTRODUCTION: Stroke is a leading cause of death and disability, with the administration of reverse transcriptase-plasminogen activator (rtPA) improving outcomes in a time-dependent manner. Only 52.3% of our eligible stroke patients received rtPA within 60 minutes of arrival. We aimed to better the percentage of acute stroke patients receiving rtPA within 60 minutes of arrival at the emergency department (ED). METHODS: Results from the first year of a clinical practice improvement project, where quality improvement interventions were implemented, are presented. Primary outcome measure was percentage ...
Source: Singapore Medical Journal - Category: General Medicine Authors: Tags: Singapore Med J Source Type: research
Intracerebral hemorrhage (ICH) is a severe cerebrovascular disease with a high incidence, mortality and disability rate. Danhong injection (DHI) is beneficial for ischemic stroke, but is prohibited for ICH due to risk of bleeding. The present study aims to explore the potential therapeutic time window and molecular mechanism of DHI in a collagenase-induced ICH model in aged rats. DHI administration after ICH could significantly improve body weight and neurological deficits, and reduce the hematoma volume and brain water content when compared to the vehicle control. Furthermore, the protective effect of DHI administration o...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
ConclusionsPresent study illustrates effect of lercanidipine on neurometabolic alterations which might be mediated through its antioxidant, anti ‐inflammatory, vasodilatory and anti‐apoptotic property in MCAo model of stroke.
Source: Journal of Pharmacy and Pharmacology - Category: Drugs & Pharmacology Authors: Tags: Research Paper Source Type: research
CONCLUSION: The PSOM-SCS constitutes a valid tool for classifying overall neurological severity emphasizing function and encompassing the full range of severity in pediatric stroke. IMPACT: Arithmetic summing of the PSOM subscales scores to assess severity classification is inadequate.The prior severity classification using PSOM overestimates poor outcomes.Three distinct severity profiles using PSOM subscales are identified.The PSOM-SCS is in moderate to excellent agreement with other disability measures.PSOM-SCS offers a valid tool for classifying the overall neurological deficit severity. PMID: 32179868 [PubMed...
Source: Pediatric Research - Category: Pediatrics Authors: Tags: Pediatr Res Source Type: research
Conclusion: FD 3-6 months after ischemic stroke is a risk equivalent to comorbidity of conventional vascular risk factors for the incidence of cardiovascular events and mortality of all-cause death. PMID: 32172677 [PubMed - as supplied by publisher]
Source: Topics in Stroke Rehabilitation - Category: Neurology Authors: Tags: Top Stroke Rehabil Source Type: research
Despite the recent surge of therapeutic options in treating acute stroke, stroke remains a leading cause of adult mortality and disability.1,2 Late presentation beyond the therapeutic window poses the main obstacle to institute therapeutic reperfusion for acute ischaemic strokes with thrombolysis rates remaining as low as 1%-8% at most.3 Delay in presentation has been attributed to a lack of awareness among the general population of stroke, its risk factors, warning symptoms and treatment in both developed and developing countries.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
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