How should we treat patients who wake up with a stroke? A review of recent advances in management of acute ischemic stroke

Acute ischemic strokes account for 85% of all strokes and are the fifth leading cause of mortality in the United States. About one in five of all ischemic strokes occur during sleep and are not noticed until the patient wakes up with neurological deficits. There is growing evidence to support that a significantly higher number of stroke patients could benefit from more aggressive care, especially those patients who wake up with strokes. There is increasing research to support a physiologically-based approach based on advanced imaging rather than simply a time-based determination of whether or not a patient would benefit from reperfusion.
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research

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This study will be a single-blinded, randomized controlled trial with 2 parallel groups. It will be conducted at North China University of science and technology affiliated hospital. Discussion: There is no consistent conclusion about the pathogenesis of wake up stroke. Wake up stroke is more likely to manifest as small vessel disease. The incidence of wake up stroke patients is relatively high, and the effectiveness and safety of intravenous thrombolysis under the guidance of multimode imaging therapy in wake up stroke need to be further explored by prospective, large-scale studies. Trial registration: ClinicalTrial...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research
ConclusionIschemic stroke patients with OSA have higher disability, higher need of rehabilitation, and longer hospitalization length. Prescreening tools for recognizing these stroke patients in acute phase could be valuable. That could result in earlier initiation of treatment and might prevent worse recovery from stroke.
Source: Brain and Behavior - Category: Neurology Authors: Tags: ORIGINAL RESEARCH Source Type: research
The objectives of the present study were to determine the incidence of the composite endpoint postoperative MPCs and to identify predictors for postoperative MPCs in patients without SDB, with obstructive sleep apnea (OSA) and with central sleep apnea (CSA) undergoing cardiac surgery. STUDY DESIGN: and methods: In this sub-analysis of the ongoing prospective observational study CONSIDER AF, preoperative risk factors for postoperative MPCs were examined in 250 patients undergoing cardiac surgery. Postoperative MPCs, including respiratory failure, acute respiratory distress syndrome, pneumonia, or pulmonary embolism, we...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
The objective of this article is to investigate the differences of carotid atherosclerosis patients with or without OSAHS by a cross-sectional research. MATERIALS AND METHODS: Patients diagnosed with carotid atherosclerosis by ultrasonography were recruited. They were requested to fill the primary screening OSAHS questionnaire. Patients with high tendency of OSAHS underwent polysomnography (PSG) tests into OSAHS group, and patients without OSAHS were into non-OSAHS group. Blood tests and medical history were collected. Carotid atherosclerosis severity was analyzed by carotid artery intima-media thickness (IMT), c...
Source: Sleep and Breathing - Category: Sleep Medicine Authors: Tags: Sleep Breath Source Type: research
The objective of this article is to investigate the differences of carotid atherosclerosis patients with or without OSAHS by a cross-sectional research.Materials and methodsPatients diagnosed with carotid atherosclerosis by ultrasonography were recruited. They were requested to fill the primary screening OSAHS questionnaire. Patients with high tendency of  OSAHS underwent polysomnography (PSG) tests into OSAHS group, and patients without OSAHS were into non-OSAHS group. Blood tests and medical history were collected. Carotid atherosclerosis severity was analyzed by carotid artery intima-media thickness (IMT), carotid ...
Source: Sleep and Breathing - Category: Respiratory Medicine Source Type: research
Conclusion: Patients with BPH who had these risk factors had an increased risk of one-year recurrent IS. The modification of risk factors may prevent recurrent IS.
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
Wow, that was a couple of very insightful discussions, via social media no less. #1. The first one was about whether heads of state and candidates to high office should pass a cognitive/ mental fitness test. Click HERE to read and discuss some of the sharpest comments, such as… “I wonder what brought this up.” “Definitely. We routinely screen applicants for a wide range of jobs.” “Then the balance of political power would shift towards the designers of those tests.” “That’s what debates are for.” “Yes, but probably nobody would pass it.” “...
Source: SharpBrains - Category: Neuroscience Authors: Tags: Cognitive Neuroscience Education & Lifelong Learning Health & Wellness Technology Alzheimer's disease prevention Alzheimers-disease amyloid artificial intelligence Bill Gates brain health brain-teaser cognitive behavioral therapies Source Type: blogs
Abstract BACKGROUND: The relation of snoring to risks of stroke and other major cardiovascular (CV) events is uncertain. RESEARCH QUESTION: We aimed to determine associations of snoring patterns and major CV events in relation to the obstructive sleep apnea (OSA), among participants of the international Sleep Apnea cardiovascular Endpoints (SAVE) trial. STUDY DESIGN: and Methods: Post-hoc analyses of the SAVE trial, which involved 2687 patients with co-existing moderate-severe OSA and established coronary or cerebral CV disease, who were randomly allocated to continuous positive airway pressure (CPAP) tr...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
Abstract A 52-year-old man with paroxysmal atrial fibrillation presented with spontaneous confabulation, working memory deficits, and frontal release signs. MR scan of brain showed bifrontal mesial ischaemic strokes and angiography demonstrated that both anterior cerebral arteries were supplied by the left internal carotid artery. Isolated spontaneous confabulation is a rare presentation of stroke and may be associated with orbitofrontal cortex lesions. Interestingly, functional imaging during rapid-eye-movement sleep may show bilateral medial frontal lobe hypometabolism, suggesting anatomical overlap between drea...
Source: Practical Neurology - Category: Neurology Authors: Tags: Pract Neurol Source Type: research
Background: Nonalcoholic fatty liver disease (NAFLD) and HIV are independently associated with cardiovascular disease (CVD). However, the factors associated with NAFLD in persons living with HIV (PWH) and whether CVD is more frequent in PWH with NAFLD are currently unknown. Methods: From the Partners HealthCare Research Patient Data Registry, we identified PWH with and without NAFLD between 2010 and 2017. NAFLD was defined using validated histological or radiographic criteria. CVD was defined by an ICD-9 diagnosis of coronary artery disease, myocardial infarction, coronary revascularization, peripheral vascular diseas...
Source: JAIDS Journal of Acquired Immune Deficiency Syndromes - Category: Infectious Diseases Tags: Clinical Science Source Type: research
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