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Which imaging before reperfusion strategy?

Which imaging before reperfusion strategy? Rev Neurol (Paris). 2017 Oct 13;: Authors: Olivot JM Abstract The ischemic penumbra is a transient and potentially reversible condition. Therefore, infarct progression and its counterpart penumbral salvage are highly variable and result from the interaction of 3 major factors: collateral flow, revascularization delay and success. Multimodal brain imaging now offers in clinical practice an exhaustive characterization of the acute ischemic injury: vessel site occlusion, infarction/critical hypoperfusion volume, and collateral flow. From 1995 to 2015, IV alteplase administered within 4.5hours after the onset of acute BI diagnosed by the absence of hemorrhage on a non-contrast head CT scan has been the only approved revascularization treatment. Over the past 2years, 6 randomized trials have confirmed the benefit of a thrombectomy performed within 6-8 hours after the onset of an acute anterior BI downstream of an ICA/M1 occlusion. The recommended imaging modality for such patients remains a NCCT to exclude an hemorrhage and a CTA to confirm the proximal vessel occlusion. As a consequence, in the absence of collateral or penumbral imaging, studies and meta-analyses, have emphasized the importance of treatment delay on the outcome of patient after a revascularisation treatment (tPA/thrombectomy). These findings have supported the development of mobile stroke unit for tPA administration and the direct transfer of the pat...
Source: Revue Neurologique - Category: Neurology Tags: Rev Neurol (Paris) Source Type: research

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This article reviews the epidemiological and clinical data concerning stroke incidence and burden around the globe. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: Seminars in Neurology - Category: Neurology Authors: Tags: Review Article Source Type: research
Authors: Funaki T, Takahashi JC, Miyamoto S Abstract In this article, the authors review the literature related to long-term outcome of pediatric moyamoya disease, focusing on late cerebrovascular events and social outcome of pediatric patients once they reach adulthood. Late-onset de novo hemorrhage is rare but more serious than recurrence of ischemic stroke. Long-term follow-up data on Asian populations suggest that the incidence of de novo hemorrhage might increase at age 20 or later, even more than 10 years after bypass surgery. Social adaptation difficulty, possibly related to cognitive impairment caused by fr...
Source: Neurologia Medico-Chirurgica - Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research
In this study however, they didn’t assess the risk of developing diabetes, which may be because diabetes is a newer disease in the Chinese population and there is not good documentation of who has it,” Richard said. Still, she noted, “this will be very important data for helping develop dietary prevention guidelines in China.” Cardiovascular disease, which takes the lives of 17.7 million people every year, is the leading cause of death and disability worldwide, according to the World Health Organization. Cardiovascular disease causes nearly a third — 31% — of all global deaths each year....
Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - Category: Consumer Health News Authors: Tags: Health News Eggs Heart Disease Local TV Source Type: news
AbstractPurpose of ReviewCerebral autoregulation (CA) is a mechanism that maintains cerebral blood flow constant despite fluctuations in systemic arterial blood pressure. This review will focus on recent studies that measured CA non-invasively in acute cerebrovascular events, a feature unique to the transcranial Doppler ultrasound. We will summarize the rationale for CA assessment in acute cerebrovascular disorders and specifically evaluate the existing data on the value of CA measures in relation to clinical severity, guiding management decisions, and prognostication.Recent FindingsExisting data suggest that CA is general...
Source: Current Atherosclerosis Reports - Category: Cardiology Source Type: research
AbstractPurpose of ReviewRecent advances in endovascular thrombectomy have made acute ischemic stroke due to a large vessel occlusion more treatable than ever. Rapid access to treatment remains paramount and multiple large vessel occlusion prediction scales have been created to enhance prehospital identification and triage of these patients. This review summarizes the current state of large vessel occlusion prediction scales, proposes a set of ideal scale features, and discusses the future of these scales and prehospital neurological emergency response systems.Recent FindingsA meta-analysis of the available data concluded ...
Source: Current Atherosclerosis Reports - Category: Cardiology Source Type: research
AbstractPurpose of reviewTreatment recommendations for pregnancy associated ischemic stroke are scarce. This may be due to the fact that, in general, obstetricians tend not to make recommendations for stroke patients and neurologists are not commonly involved in the care of pregnant women. Herein, we review the multiple etiologies of ischemic stroke during pregnancy, considerations for diagnostic testing, and acute treatment and prevention options, including associated risks specific to the pregnant and puerperal state.Recent findingsIntravenous tissue plasminogen activator (tPA) and endovascular thrombectomy have been use...
Source: Current Treatment Options in Neurology - Category: Neurology Source Type: research
Abstract OBJECTIVE Blunt traumatic extracranial carotid or vertebral artery injury (i.e., traumatic cerebrovascular injury [TCVI]) occurs in 1%-2% of all blunt trauma admissions, carries a 10% risk of thromboembolic ischemic stroke, and accounts for up to 9600 strokes annually in the US. Screening CT angiograms (CTAs) of patients with trauma has become ubiquitous in recent years, and patients with initially asymptomatic TCVI are commonly treated with antiplatelet agents to prevent stroke. Prophylaxis with antiplatelets is thought to be safer than anticoagulation, which carries a significant risk of hemorrhage in p...
Source: Journal of Neurosurgery - Category: Neurosurgery Authors: Tags: J Neurosurg Source Type: research
Endoscopic thoracic sympathectomy (ETS) was performed to cure palmar hyperhidrosis (PH). After ETS, blood pressure decreased, and cerebral flow velocity increased within 1 month. However, no studies distinguish between subsequent ischemic and hemorrhagic stroke following ETS for PH. The association between stroke type and PH after ETS must be evaluated.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
THURSDAY, May 17, 2018 -- The combination of clopidogrel and aspirin is associated with reduced risk of major ischemic events but increased risk of major hemorrhage among patients with minor ischemic stroke or high-risk transient ischemic attack...
Source: Drugs.com - Pharma News - Category: Pharmaceuticals Source Type: news
Markers of dispersion of myocardial repolarization have been proposed to identify the patients at higher risk of malignant arrhythmic events. The aim of the present study is to assess a possible association of the electrocardiografic (ECG) markers of the dispersion of repolarization with the type of stroke, involvement of insula, neurological severity (National Institutes of Health Stroke Scale, NIHSS score), and disability (modified Rankin Scale, mRS score) in patients with a cerebrovascular event.
Source: Journal of Electrocardiology - Category: Cardiology Authors: Source Type: research
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