Prognosis comparisons in acute ischemic stroke patients with thrombolysis and nonthrombolysis therapy: a retrospective study with larger sample size

We compared the short-term, middle-term and long-term primary outcomes between thrombolysis and nonthrombolysis therapy in acute ischemic stroke (AIS) patients. Medical records were collected from patients suffered from AIS between 2010 and 2013 and allocated into either the intravenous recombinant tissue plasminogen activator (as rt-PA group) treatment, or non-rt-PA treatment group (as control group). The primary outcomes included a proportion of patients with favorable outcome [as defined with a modified Rankin Scale (mRS) of 0–1], functional independence (mRS of 0–2) or with bad outcome (mRS of 5–6) at 3, 6 and 12 months and the overall mortality. The secondary outcome included the events of intracranial hemorrhage. A total of 357 patients from Xinhua Hospital were selected. At 3-month follow-up, 86 patients in rt-PA vs. 99 in control group had favorable outcome, 105 vs. 122 were independent and 23 vs. 27 had bad outcome. At 6-month follow-up, 101 patients in rt-PA vs. 104 in control group had favorable outcome, 114 vs. 124 were independent and 20 vs. 34 had bad outcome. At 12 months, 104 patients in rt-PA vs. 105 in control group had favorable outcome, 117 vs. 125 were independent and 12 vs. 32 had bad outcome. At the end of 12 months, more deaths occurred in control group (20) than in the rt-PA group (11), but it was not statistically significant. Alteplase treatment in AIS patients showed the superior primary outcomes compared with control group, espec...
Source: Blood Coagulation and Fibrinolysis - Category: Hematology Tags: Original Articles Source Type: research

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A pulmonary arteriovenous malformation (PAVM) is an anomalous connection between a pulmonary artery and a pulmonary vein that lacks a capillary bed. The most common symptoms of PAVM are dyspnea, exercise intolerance, migraine, stroke or transient ischemic attack, and lung hemorrhage. The treatment of choice is transcatheter embolization with the most common embolic devices being coils (multiple manufacturers) or Amplatzer plugs (AVP) (St. Jude Medical, Plymouth, MN) to occlude the malformation. The newest embolic device for PAVM occlusion is the microvascular plug (MVP) (Micro Vascular Plug System, Medtronic, Minneapolis, MN).
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Scientific Session 42: Need Some Inspiration Source Type: research
AbstractDebates regarding the most beneficial medical or surgical procedures for patients with spontaneous intracerebral hemorrhage (sICH) are still ongoing. We aimed to evaluate the risk of subsequent vascular disease and mortality in patients with sICH treated with and without surgical intervention, in a large-scale Asian population. Patients hospitalized within 2000 to 2013 who were newly diagnosed with sICH were identified using the National Health Insurance Research Database of Taiwan. Neuroendoscopy and craniotomy groups comprised patients who underwent surgical treatment within 1  week, while those in the contr...
Source: Neurotherapeutics - Category: Neurology Source Type: research
CONCLUSION: Our results suggest that cold temperature and snowfall are independent risk factors for death from hemorrhagic stroke in men. These findings imply that interventions to prevent fatal hemorrhagic stroke during winter should include both cold temperature exposure and snowfall in men. PMID: 30784804 [PubMed - as supplied by publisher]
Source: Environment International - Category: Environmental Health Authors: Tags: Environ Int Source Type: research
AbstractAccurate stroke recognition during triage can streamline care and afford patients earlier access to life-saving interventions. However, the tools currently available to clinicians for prehospital and early in-hospital identification of stroke are limited. The peripheral immune system is intricately involved in stroke pathology and thus may be targetable for the development of immunodiagnostics. In this preliminary study, we sought to determine whether the circulating antibody pool is altered early in stroke, and whether such alterations could be leveraged for diagnosis. One hundred microliters of peripheral whole b...
Source: Neurotherapeutics - Category: Neurology Source Type: research
ConclusionWake-up strokes and patients who are treated within a drip-and-ship concept are especially vulnerable for symptomatic ICH, while complete recanalization, contrary to subtotal recanalization only, was revealed as a protective factor against ICH.
Source: Neuroradiology - Category: Radiology Source Type: research
Publication date: Available online 14 February 2019Source: Journal of NeuroradiologyAuthor(s): Fabrizio Sallustio, Caterina Motta, Stefano Merolla, Giacomo Koch, Francesco Mori, Fana Alemseged, Daniele Morosetti, Valerio Ros Da, Roberto Gandini, Marina DiomediABSTRACTBackground and purpose: the effect of intravenous heparin during mechanical thrombectomy for acute ischemic stroke is not clear. We aimed to study efficacy and safety of heparin use during endovascular stroke treatment in a real-world setting.Materials and Methods: patients with anterior circulation stroke were divided, based on the use of intraprocedural hepa...
Source: Journal of Neuroradiology - Category: Radiology Source Type: research
This study aimed to determine the body mass index (BMI) of fatal stroke cases amongst young adults, their clinical characteristics and the association with BMI with risk factors. All cases aged 15-44 years where death was attributed to stroke for whom BMI was available were retrieved from the National Coronial Information System (1/1/2009-31/12/2016). 179 cases were identified: haemorrhagic (165), ischaemic (5), thrombotic (6), mycotic (3), embolic (0). Proportions in each BMI category were: underweight (5.6%), normal weight (37.4%), overweight (27.4%), obese (29.6%). There was a significant linear trend in the proportion ...
Source: Journal of Forensic and Legal Medicine - Category: Forensic Medicine Source Type: research
Conclusions: Patients with RD and acute vertebrobasilar stroke should be thoroughly monitored to prevent ICH after thrombectomy. Our results support performing mechanical thrombectomy in acute stroke patients with large vessel occlusions of the posterior circulation, irrespective of their renal function.Cerebrovasc Dis 2019;47:48 –56
Source: Cerebrovascular Diseases - Category: Neurology Source Type: research
ConclusionsTwenty-and-a-half syndrome is reported for the first time. It is due to posterior circulation stroke; in our case, it was due to lacunar infarcts in the pons and medulla, manifesting as one-and-a-half syndrome with bilateral seventh and right fifth nerve palsy.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Conclusion: DACs can safely be used for mechanical thrombectomy of acute M2 occlusions by the ADAPT approach. Their use alone can be a high efficacious treatment of distal intracranial thromboembolic occlusions.
Source: Journal of Neuroradiology - Category: Radiology Source Type: research
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