Safety of Early Repeated Thrombolysis: A Case Report

Conclusion: This case report suggests that further randomized studies may evaluate whether repeated IVtPA may be safe and effective in ERS occurring shortly after a previous stroke when patients experience a period of complete neurological regression, minor disability, and a small infarct volume. Should the hypothesis be confirmed, small volume core and wide volume penumbra at perfusion CT may support the decision of adopting IVtPA repetition.
Source: The Neurologist - Category: Neurology Tags: Case Report/Case Series Source Type: research

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Publication date: Available online 7 January 2020Source: The Lancet Diabetes &EndocrinologyAuthor(s): Hertzel C Gerstein, Robert Hart, Helen M Colhoun, Rafael Diaz, Mark Lakshmanan, Fady T Botros, Jeffrey Probstfield, Matthew C Riddle, Lars Rydén, Charles Messan Atisso, Leanne Dyal, Stephanie Hall, Alvaro Avezum, Jan Basile, Ignacio Conget, William C Cushman, Nicolae Hancu, Markolf Hanefeld, Petr Jansky, Matyas KeltaiSummaryBackgroundCardiovascular outcome trials have suggested that glucagon-like peptide 1 (GLP-1) receptor agonists might reduce strokes. We analysed the effect of dulaglutide on stroke within the ...
Source: The Lancet Diabetes and Endocrinology - Category: Endocrinology Source Type: research
Publication date: Available online 24 December 2019Source: Journal of Clinical NeuroscienceAuthor(s): Paola Caruso, Miloš Ajčević, Giovanni Furlanis, Mariana Ridolfi, Carlo Lugnan, Tommaso Cillotto, Marcello Naccarato, Paolo ManganottiAbstractIntroductionRecombinant tissue plasminogen activator (rt-PA) is the first-line therapy demonstrated to be safe and effective in acute ischemic stroke. People with pre-existing severe dementia or physical disability are usually excluded from rt-PA. The aim of our study was to investigate rt-PA safety and effectiveness in acute stroke with pre-existing disability (mRS ≥ ...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
AbstractStroke remains one of the leading causes of long-term disability and mortality despite recent advances in acute thrombolytic therapies. In fact, the global lifetime risk of stroke in adults over the age of 25 is approximately 25%, with 24.9 million cases of ischemic stroke and 18.7 million cases of hemorrhagic stroke reported in 2015. One of the main challenges in developing effective new acute therapeutics and enhanced long-term interventions for stroke recovery is the heterogeneity of stroke, including etiology, comorbidities, and lifestyle factors that uniquely affect each individual stroke survivor. In this com...
Source: Translational Stroke Research - Category: Neurology Source Type: research
Publication date: Available online 12 December 2019Source: Anaesthesia &Intensive Care MedicineAuthor(s): Christopher J. TaylorAbstractIntracerebral haemorrhage (ICH) accounts for around 10–20% of all strokes and results from a variety of disorders. ICH is more likely to result in death or major disability than ischaemic stroke or subarachnoid haemorrhage. Rapid imaging allows early diagnosis and characterization of the localization and severity of the haemorrhage. Patients with significant acute ICH should be managed in a critical care unit. Treatment entails general supportive care, control of blood pressure an...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
CONCLUSIONS: We found no reliable evidence that SSRIs should be used routinely to promote recovery after stroke. Meta-analysis of the trials at low risk of bias indicate that SSRIs do not improve recovery from stroke. We identified potential improvements in disability only in the analyses which included trials at high risk of bias. A further meta-analysis of large ongoing trials will be required to determine the generalisability of these findings. PMID: 31769878 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Serum creatinine/cystatin C ratio could be used as a predictor of long ‐term poor prognosis in neurocritically ill patients, and it was associated with body mass index, the length of stay in neurocritical care unit, duration of mechanical ventilation, and risk of tracheotomy as well. AbstractObjectiveTo explore the predictive value of serum creatinine (Cr) to cystatin C (CysC) ratio in neurocritically ill patients.MethodsWe conducted a retrospectively observational study of adult patients admitted to a neurocritical care unit (NCU) between Jan 2013 and Jan 2017. Patients were excluded if
Source: Brain and Behavior - Category: Neurology Authors: Tags: ORIGINAL RESEARCH Source Type: research
Ischemic stroke is among the leading causes of disability and death worldwide. In acute ischemic stroke, the rapid recanalization of occluded cranial vessels is the primary therapeutic aim. However, experimental data (obtained using mostly the transient middle cerebral artery occlusion model) indicates that progressive stroke can still develop despite successful recanalization, a process termed “reperfusion injury.” Mounting experimental evidence suggests that platelets and T cells contribute to cerebral ischemia/reperfusion injury, and ischemic stroke is increasingly considered a thrombo-inflammatory disease. ...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
In this study, AT1-AAs were detected in the sera of patients with peripheral arterial disease (PAD) and the positive rate was 44.44% vs. 17.46% in non-PAD volunteers. In addition, analysis showed that AT1-AAs level was positively correlated with PAD. To reveal the causal relationship between AT1-AAs and vascular aging, an AT1-AAs-positive rat model was established by active immunization. The carotid pulse wave velocity was higher, and the aortic endothelium-dependent vasodilatation was attenuated significantly in the immunized rats. Morphological staining showed thickening of the aortic wall. Histological examination showe...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
AbstractThe optimal management of oral anticoagulation (OAC) in the acute phase of non valvular atrial fibrillation (NVAF)-related acute ischemic stroke (AIS) remains controversial, especially in very old patients. Therefore, the aim of our study was to evaluate the practical management of OAC in this context. We conducted an observational retrospective study on patients 85-years old and older admitted to two Italian hospitals for NVAF-related AIS. For each patient, clinical and brain computed tomography data were recorded. Type of OAC (vitamin K antagonists, VKAs or Direct Oral Anticoagulants, DOACs), dosage and starting ...
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
Publication date: Available online 11 October 2019Source: Life SciencesAuthor(s): Jenq-Lin Yang, Yun-Ru Yang, Shang-Der ChenAbstractStroke is the major cause of adult disability and the second or third leading cause of death in developed countries. The treatment options for stroke (thrombolysis or thrombectomy) are restricted to a small subset of patients with acute ischemic stroke because of the limited time for an efficacious response and the strict criteria applied to minimize the risk of cerebral hemorrhage. Attempts to develop new treatments, such as neuroprotectants, for acute ischemic stroke have been costly and tim...
Source: Life Sciences - Category: Biology Source Type: research
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