Is it dangerous to treat acute ischemic stroke by thrombolytic therapy in patients with comorbid intracranial aneurysms

The safety of cerebral ischemic stroke patients with comorbid intracranial aneurysms treated by thrombolysis is still an unsolved mystery. We aimed to perform a secondary analysis and review to provide evidence on whether stroke patients with intracranial aneurysms have worse outcomes following thrombolysis.
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research

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This study assesses the current practices of physicians in Lebanon routinely involved in ischemic stroke (IS) management. We conducted a prospective observational study of patients hospitalized at 8 different Lebanese hospitals in the period August 1, 2015 to July 31, 2016, with a diagnosis of acute stroke. Baseline characteristics and data on diagnostic studies, as well as treatments received during hospitalization and at discharge, were collected and analyzed. Two hundred and three strokes/transient ischemic attacks (TIAs) were recorded but only 173 patients (85%) with ischemic events were included in the study. The pati...
Source: Functional Neurology - Category: Neurology Tags: Funct Neurol Source Type: research
Future Neurology, Ahead of Print.
Source: Future Neurology - Category: Neurology Authors: Source Type: research
Specific clinical risk factors may contribute to improving or worsening neurological functions in acute ischemic stroke (AIS) patients pre-treated with a combined cholesterol reducer and recombinant tissue pla...
Source: Lipids in Health and Disease - Category: Lipidology Authors: Tags: Research Source Type: research
This study aimed to assess the relationship between baseline SBP and outcome. Materials and Methods: Studies that evaluated the association between the baseline SBP and the outcome of patients undergoing thrombolytic therapy were sought. Data were extracted according to a predefined data extraction form and then analyzed by STATA 12.0 software. The primary endpoint was the occurrence of good outcomes measured by a modified Rankin Scale score at 3 months, while the secondary endpoint was the occurrence of intracranial hemorrhage and death. Results: Eleven studies involving a total of 33,263 patients were included. Poo...
Source: The Neurologist - Category: Neurology Tags: Original Articles Source Type: research
ConclusionFurther integrated processes are required to maximise patient benefit from thrombolysis. Expansion of community education to incorporate less common symptoms and provision of alert pagers for patients may provide further reduction in thrombolysis times.
Source: Journal of Neurology - Category: Neurology Source Type: research
Abstract Thrombolytic therapy with recombinant tissue plasminogen activator (rtPA) in ischaemic stroke has been associated with neurotoxicity, blood brain barrier (BBB) disruption and intra-cerebral hemorrhage. To examine rtPA cellular toxicity we investigated the effects of rtPA on cell viability in neuronal, astrocyte and brain endothelial cell (bEnd.3) cultures with and without prior exposure to oxygen-glucose deprivation (OGD). In addition, the neuroprotective peptide poly-arginine-18 (R18D; 18-mer of D-arginine) was examined for its ability to reduce rtPA toxicity. Studies demonstrated that a 4- or 24-h expos...
Source: Neurochemical Research - Category: Neuroscience Authors: Tags: Neurochem Res Source Type: research
Conclusion: Previously undescribed, we suggest that tPA should be considered for post-TAVR AIS patients who otherwise satisfy inclusion and exclusion criteria.
Source: The Neurologist - Category: Neurology Tags: Case Report/Case Series Source Type: research
Background: Intravenous thrombolysis is the only approved pharmacological treatment for acute ischemic stroke (AIS) patients, but the immediate response to thrombolysis varies by patient. Objective: To investigate the factors associated with early neurological improvement (ENI) after the administration of intravenous recombinant tissue plasminogen activator (rt-PA) treatment to AIS patients within 4.5 hours of onset. Methods: Demographics, onset to treatment time, risk factors, and clinical and laboratory data of 209 AIS patients undergoing intravenous rt-PA therapy at a Chinese hospital between January 2013 and Au...
Source: The Neurologist - Category: Neurology Tags: Original Article Source Type: research
This study aimed to investigate the effects of rTPA in WUS patients during every day clinical scenarios, by measuring ischemic lesion volume and functional outcomes compared to non-treated WUS patients.MethodsWe retrospectively analyzed clinical and imaging data of 149 (75  rTPA; 74 non-rTPA) patients with acute ischemic WUS. Ischemic volume was calculated on follow-up CT and functional outcomes were the NIHSS and mRS comparing rTPA and non-rTPA WUS. Patients were selected using ASPECTS >  6 on CT and/or ischemic penumbra >  50% of hypoperfused tissue on CTP.ResultsA reduced volu...
Source: Journal of Neurology - Category: Neurology Source Type: research
This study aimed to assess the 3-month outcome of patients who underwent thrombolytic therapy following ischemic stroke. Methods: In the present prospective cohort study, the 3-month outcome of patients (mortality, disability) with acute ischemic stroke admitted to neurology department an educational hospital, Kermanshah, Iran, from 2016 to 2019, who had received thrombolytic therapy was assessed. National Institute of Health Stroke Scale (NIHSS) and Modified Rankin Score (MRS) were used for measuring the degree of disability (on admission, at the time of discharge and 3 months after thrombolytic therapy). Result...
Source: Accident and Emergency Nursing - Category: Emergency Medicine Authors: Tags: Arch Acad Emerg Med Source Type: research
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