Japanese and Non-Japanese Patients with Transient Ischemic Attack or Minor Stroke: A Five-Year Risk Analysis of Stroke and Vascular Events.
CONCLUSIONS: Recurrent stroke and intracranial hemorrhage were determined to be more prevalent at 5 years after TIA or minor stroke in Japanese patients than in non-Japanese patients. Strategies to mitigate the long-term risks of stroke, aside from adherence to current guidelines, should take Japanese-patient-specific residual risks into account. PMID: 32938836 [PubMed - as supplied by publisher] (Source: Journal of Atherosclerosis and Thrombosis)
Source: Journal of Atherosclerosis and Thrombosis - September 19, 2020 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research

Incidence, mortality, and cardiovascular diseases in pituitary adenoma in Korea: a nationwide population-based study
ConclusionSouth Korea had a relatively high incidence of NFPA. The incidence of stroke was highest for ACTH  + TSH and NFPA, which was directly related to mortality during long-term follow-up. Patients with these types of PA should receive stroke prevention measures to reduce their risk of mortality. (Source: Pituitary)
Source: Pituitary - September 19, 2020 Category: Endocrinology Source Type: research

An East Coast Perspective on Artificial Intelligence and Machine Learning: Part 1: Hemorrhagic Stroke Imaging and Triage
Publication date: Available online 17 September 2020Source: Neuroimaging Clinics of North AmericaAuthor(s): Rajiv Gupta, Sanjith Prahas Krishnam, Pamela W. Schaefer, Michael H. Lev, R. Gilberto Gonzalez (Source: Neuroimaging Clinics of North America)
Source: Neuroimaging Clinics of North America - September 18, 2020 Category: Radiology Source Type: research

Wnt Pathway: An Emerging Player in Vascular and Traumatic Mediated Brain Injuries
The Wnt pathway, which comprises the canonical and non-canonical pathways, is an evolutionarily conserved mechanism that regulates crucial biological aspects throughout the development and adulthood. Emergence and patterning of the nervous and vascular systems are intimately coordinated, a process in which Wnt pathway plays particularly important roles. In the brain, Wnt ligands activate a cell-specific surface receptor complex to induce intracellular signaling cascades regulating neurogenesis, synaptogenesis, neuronal plasticity, synaptic plasticity, angiogenesis, vascular stabilization, and inflammation. The Wnt pathway ...
Source: Frontiers in Physiology - September 18, 2020 Category: Physiology Source Type: research

Relationship of optic nerve sheath diameter and intracranial hypertension in patients with traumatic brain injury
Conclusions: ONSD is a simple noninvasive measurement on initial CT in patients with TBI that could be a surrogate for ICP monitoring. However, further studies are warranted. (Source: Journal of Emergencies, Trauma and Shock)
Source: Journal of Emergencies, Trauma and Shock - September 18, 2020 Category: Emergency Medicine Authors: Ammar Al-Hassani Gustav Strandvik Sheraz Abayazeed Khalid Ahmed Ayman El-Menyar Ismail Mahmood Suresh Kumar Arumugam Mohammad Asim Syed Nabir Nadeem Ahmed Zahoor Ahmed Hassan Al-Thani Source Type: research

RET/PTC3 translocation in a rare hemorrhagic brain metastasis of papillary thyroid cancer post Chernobyl radiation affects vessels ultrastructure
Publication date: March 2021Source: Interdisciplinary Neurosurgery, Volume 23Author(s): Michela Relucenti, Pietro Familiari, Giorgia Iacopino, Placido Bruzzaniti, Selenia Miglietta, Maurizio Salvati, Xiaobo Li, Rui Chen, Giancarlo D'Andrea, Alessandro Frati, Cira Di Gioia, Angelina Pernazza, Carlo Della Rocca, Giuseppe Familiari, Antonio Santoro (Source: Interdisciplinary Neurosurgery)
Source: Interdisciplinary Neurosurgery - September 17, 2020 Category: Neurosurgery Source Type: research

Emergency Carotid Endarterectomy Instead of Carotid Artery Stenting Reduces Delayed Hemorrhage in Thrombectomy Stroke Patients
ConclusionThe use of CEA is a  feasible alternative to CAS in acute stroke and has the advantage that DAPT/GpIIb/IIIa inhibitors are not needed. All PH2 in CEA patients occurred during the intervention, implying that hemorrhage in this group is likely to be caused by reperfusion injury, whereas delayed hemorrhage is likely to b e caused by DAPT/GpIIb/IIIa inhibitors. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - September 17, 2020 Category: Neurology Source Type: research

An East Coast Perspective on Artificial Intelligence and Machine Learning: Part 1
This article reviews the use of deep learning convolutional neural networks for managing hemorrhagic stroke. Such a capability may be used to alert appropriate care teams, make decisions about patient transport from a primary care center to a comprehensive stroke center, and assist in treatment selection. This article reviews artificial intelligence algorithms for intracranial hemorrhage detection, quantification, and prognostication. Multiple algorithms currently being explored are described and illustrated with the help of examples. (Source: Neuroimaging Clinics)
Source: Neuroimaging Clinics - September 17, 2020 Category: Radiology Authors: Rajiv Gupta, Sanjith Prahas Krishnam, Pamela W. Schaefer, Michael H. Lev, R. Gilberto Gonzalez Source Type: research

Hyperattenuating lesions after mechanical thrombectomy in acute ischaemic stroke: factors predicting symptomatic haemorrhage and clinical outcomes
To evaluate the clinical significance of hyperattenuating lesions on CT after mechanical thrombectomy for acute ischaemic stroke, and to identify imaging factors that predict symptomatic haemorrhage and unfavourable outcomes. (Source: Clinical Radiology)
Source: Clinical Radiology - September 17, 2020 Category: Radiology Authors: S. Bae, S.S. Ahn, B.M. Kim, D.J. Kim, Y.D. Kim, H.S. Nam, J.H. Heo, S.-K. Lee Source Type: research

Superficial Siderosis and Microbleed Restricted in Cortex Might Be Correlated to Atrophy and Cognitive Decline in Sneddon's Syndrome
Conclusions: This is the first report illustrating abundant cortical microbleeds and superficial siderosis mainly involved the anterior and posterior cortical watersheds in Sneddon's syndrome. The surprisingly identical topographic distribution of hemorrhagic lesions and the obvious atrophy suggest cerebral atrophy might be secondary to the microangiopathy related hemorrhagic lesions and further contribute to the neurological deficit, especially the early cognitive decline in Sneddon syndrome. (Source: Frontiers in Neurology)
Source: Frontiers in Neurology - September 16, 2020 Category: Neurology Source Type: research

Rules About Rules – The 6-h CT Rule For Subarachnoid Hemorrhage
In this issue of the Journal of Stroke and Cerebrovascular Diseases, Chakraborty and colleagues describe the cautionary tale of a patient who presented with a thunderclap headache concerning for a subarachnoid hemorrhage (SAH). A head computed tomographic scan (CT) done 4  h after the onset of the headache was interpreted as negative but the patient was ultimately found to have an aneurysmal SAH.1 (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 16, 2020 Category: Neurology Authors: Jonathan A. Edlow Source Type: research

Diverse Activities of von Willebrand Factor in Traumatic Brain Injury and Associated Coagulopathy.
Abstract Traumatic brain injury (TBI) is a leading cause of death and disability. Patients with isolated TBI lose a limited amount of blood to primary injury, but they often develop secondary coagulopathy, resulting in delayed or recurrent intracranial and intracerebral hematoma. TBI-induced coagulopathy is closely associated with poor outcomes for these patients, including death. This secondary coagulopathy is consumptive in nature, involving not only brain-derived molecules, coagulation factors, and platelets, but also endothelial cells in a complex process now called endotheliopathy. A key question is how a loc...
Source: Thrombosis and Haemostasis - September 15, 2020 Category: Hematology Authors: Xu X, Kozar R, Zhang J, Dong JF Tags: J Thromb Haemost Source Type: research

Statins Use and Outcome of Acute Ischemic Stroke Patients after Systemic Thrombolysis
Conclusion: Our study does not show any significant association between risk of sICH and poor outcome after IVT for patients on prior statin therapy. We also did not find significant association between the risk of sICH and poor outcome after IVT and the intensity of the stain used.Cerebrovasc Dis (Source: Cerebrovascular Diseases)
Source: Cerebrovascular Diseases - September 14, 2020 Category: Neurology Source Type: research

IJERPH, Vol. 17, Pages 6688: Neurological Complications of COVID-19 and Possible Neuroinvasion Pathways: A Systematic Review
Angelo Gemignani The Coronavirus Disease 2019 (COVID-19) outbreak has shocked the whole world with its unexpected rapid spread. The virus responsible for the disease, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), enters host cells by means of the envelope spike protein, which binds to angiotensin-converting enzyme 2 receptors. These receptors are highly expressed in heart, lungs, respiratory tract epithelium, endothelial cells and brain. Since an increasing body of significant evidence is highlighting a possible neuroinvasion related to SARS-CoV-2, a state of the art on the neurological complication...
Source: International Journal of Environmental Research and Public Health - September 14, 2020 Category: Environmental Health Authors: Graziella Orr ù Ciro Conversano Eleonora Malloggi Francesca Francesconi Rebecca Ciacchini Angelo Gemignani Tags: Review Source Type: research

Early thromboelastography in acute traumatic coagulopathy: an observational study focusing on pre-hospital trauma care
AbstractBackgroundMajor brain injury and uncontrolled blood loss remain the primary causes of early trauma-related mortality. One-quarter to one-third of trauma patients exhibit trauma-induced coagulopathy (TIC). Thromboelastometry (ROTEM) and thrombelastography (TEG) are valuable alternatives to standard coagulation testing, providing a more comprehensive overview of the coagulation process.PurposeEvaluating thromboelastographic profile, the incidence of fibrinolysis (defined as Ly30  >  3%) in severe trauma patients, and factors influencing pathological coagulation pattern.MethodsProspective observationa...
Source: European Journal of Trauma and Emergency Surgery - September 14, 2020 Category: Emergency Medicine Source Type: research

The Updated Role of the Blood Brain Barrier in Subarachnoid Hemorrhage: From Basic and Clinical Studies.
Abstract Subarachnoid hemorrhage (SAH) is a type of hemorrhagic stroke associated with high mortality and morbidity. The blood-brain-barrier (BBB) is a structure consisting primarily of cerebral microvascular endothelial cells, end feet of astrocytes, extracellular matrix, and pericytes. Post-SAH pathophysiology included early brain injury and delayed cerebral ischemia. BBB disruption was a critical mechanism of early brain injury, and was associated with other pathophysiological events. These pathophysiological events may propel the development of secondary brain injury, known as delayed cerebral ischemia. Imagin...
Source: Current Neuropharmacology - September 14, 2020 Category: Drugs & Pharmacology Authors: Chen S, Xu P, Fang Y, Lenahan C Tags: Curr Neuropharmacol Source Type: research

Mechanical injury and blood are drivers of spatial memory deficits after rapid intraventricular hemorrhage.
In conclusion, our results point to mechanical injury as the predominant mechanism of memory decline after intraventricular aneurysmal rupture. However, volume-matched pulsed injections of artificial CSF did not create a spatial memory deficit at 5 weeks. Therefore, whole blood itself must play a role in the mechanism. Further research is required to evaluate whether the viscosity of blood causes additional mechanical disruption and hydrocephalus through a primary injury mechanism or whether the toxicity of blood causes a secondary injury mechanism that leads to the observed spatial memory deficit after 5 weeks. P...
Source: Neurobiology of Disease - September 14, 2020 Category: Neurology Authors: Kamal K, Keiter JA, Binyamin TR, de la Cruz Dapula JN, Vergara AR, Hawk CW, Izadi A, Lyeth B, Gurkoff GG, Sharp FR, Waldau B Tags: Neurobiol Dis Source Type: research

Intracerebral hemorrhage alters circular RNA expression profiles in the rat brain.
Authors: Zhong Y, Li X, Li C, Li Y, He Y, Li F, Ling L Abstract Circular RNAs (circRNAs), formed from pre-messenger RNAs by back-splicing, are a novel class of evolutionarily-conserved endogenous non-coding RNAs. While circRNAs are involved in various diseases, the role of circRNAs in intracerebral hemorrhage (ICH) remains unknown. In the present study, we performed high-throughput sequencing to profile the expression of circRNAs in the rat brain at 24 and 48 hours after ICH onset, and utilized bioinformatics methods to make predictions about the function of dysregulated circRNAs. Compared with the sham group, 346 ...
Source: American Journal of Translational Research - September 13, 2020 Category: Research Tags: Am J Transl Res Source Type: research

MRI predictors of intracranial hemorrhage in acute ischemic stroke after endovascular thrombectomy therapy.
CONCLUSIONS: DWI volume, PWI volume and>3 passes with the retriever were able to predict the ICH in patients with AIS after EVT therapy. PMID: 32913526 [PubMed] (Source: American Journal of Translational Research)
Source: American Journal of Translational Research - September 13, 2020 Category: Research Tags: Am J Transl Res Source Type: research

Efficacy and safety of intravenous thrombolysis for acute ischemic stroke in cancer patients: a systemic review and meta-analysis.
Authors: Huang S, Lu X, Tang LV, Hu Y Abstract The efficacy and safety of intravenous thrombolysis (IVT) for acute ischemic stroke (AIS) in cancer patients remained uncertain due to low level evidence in the latest guideline for AIS. The aim of this study was to assess the efficacy and safety of IVT in cancer patients with stronger evidence. We searched Medline, Embase, CENTRAL and ClinicalTrials.gov until April 2020 for studies reporting outcomes of functional independence, hemorrhagic transformation (HT), symptomatic intracranial hemorrhage (SICH), major bleeding (MB), in-hospital mortality or 3-month mortality a...
Source: American Journal of Translational Research - September 13, 2020 Category: Research Tags: Am J Transl Res Source Type: research

Hyperammonemia with impaired consciousness caused by continuous 5-fluorouracil infusion for colorectal cancer: A  case report.
Hyperammonemia with impaired consciousness caused by continuous 5-fluorouracil infusion for colorectal cancer: A case report. Int J Clin Pharmacol Ther. 2020 Sep 10;: Authors: Nakamura T, Shibata S, Miyatani Y, Matsubara H Abstract A 66-year-old woman was diagnosed with stage IVb sigmoid colon cancer. Modified FOLFOX-6 (mFOLFOX-6; levofolinate‒fluorouracil‒oxaliplatin) plus panitumumab was selected as the chemotherapeutic regimen, but she was administered a regimen without oxaliplatin (L-OHP) or bolus 5-fluorouracil (5-FU) because of her general condition and concern about adverse effects. The...
Source: International Journal of Clinical Pharmacology and Therapeutics - September 13, 2020 Category: Drugs & Pharmacology Tags: Int J Clin Pharmacol Ther Source Type: research

Long-Term Mortality Among ICU Patients With Stroke Compared With Other Critically Ill Patients
Conclusions: Stroke patients who need intensive care treatment have a high short-term mortality risk, but this alters favorably with increasing duration of survival time after ICU admission in patients with both ischemic stroke and intracerebral hemorrhage, especially compared with other populations of critically ill patients such as sepsis or severe community-acquired pneumonia patients. (Source: Critical Care Medicine)
Source: Critical Care Medicine - September 13, 2020 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Modifiable Risk Factors and Mortality From Ischemic and Hemorrhagic Strokes in Patients Receiving Venoarterial Extracorporeal Membrane Oxygenation: Results From the Extracorporeal Life Support Organization Registry
Objectives: Although acute brain injury is common in patients receiving extracorporeal membrane oxygenation, little is known regarding the mechanism and predictors of ischemic and hemorrhagic stroke. We aimed to determine the risk factors and outcomes of each ischemic and hemorrhagic stroke in patients with venoarterial extracorporeal membrane oxygenation support. Design: Retrospective analysis. Setting: Data reported to the Extracorporeal Life Support Organization by 310 extracorporeal membrane oxygenation centers from 2013 to 2017. Patients: Patients more than 18 years old supported with a single run of venoar...
Source: Critical Care Medicine - September 13, 2020 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Idarucizumab for dabigatran reversal in daily clinical practice: A case series
CONCLUSION Our first experiences with idarucizumab use in daily-care settings support a rapid and efficient decrease in the anticoagulant effect of dabigatran in emergency situations. Late re-occurrence of dabigatran effect was noted in a subset of patients with severe renal failure. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - September 12, 2020 Category: Anesthesiology Tags: Coagulation Source Type: research

Vascular PDGFR-alpha protects against BBB dysfunction after stroke in mice
AbstractBlood –brain barrier (BBB) dysfunction underlies the pathogenesis of many neurological diseases. Platelet-derived growth factor receptor-alpha (PDGFRα) induces hemorrhagic transformation (HT) downstream of tissue plasminogen activator in thrombolytic therapy of acute stroke. Thus, PDGFs are attractive therapeutic targets for BBB dysfunction. In the present study, we examined the role of PDGF signaling in the process of tissue remodeling after middle cerebral arterial occlusion (MCAO) in mice. Firstly, we found that imatinib increased lesion size after permanent MCAO in wild-type mice. Moreover, i matini...
Source: Angiogenesis - September 12, 2020 Category: Molecular Biology Source Type: research

Increased intracranial hemorrhage of mechanical thrombectomy in acute ischemic stroke patients with atrial fibrillation
This study aimed to investigate the potential association between AF and outcomes after MT in AIS patients. A post-hoc analysis of a multi-center prospective clinical trial was conducted. Before and after propensity score matching (PSM), the clinical features were compared between patients with and without AF. Multivariable logistic regression and mediation analyses were performed to assess the relationship between AF and ICH. Of the total 245 patients, 123 patients were included in the AF group. After PSM, the AF group showed more retrieval attempts (P = 0.004), comparable favorable outcome (P =&thins...
Source: Journal of Thrombosis and Thrombolysis - September 12, 2020 Category: Hematology Source Type: research

Primary decompressive craniectomy in poor-grade aneurysmal subarachnoid hemorrhage: long-term outcome in a single-center study and systematic review of literature
AbstractPrimary decompressive craniectomy (PDC) in patients with poor-grade aneurysmal subarachnoid hemorrhage (aSAH) in order to decrease elevated intracranial pressure (ICP) is controversially discussed. The aim of this study was to analyze the effect of PDC on long-term clinical outcome in these patients in a single-center cohort and to perform a systematic review of literature. Eighty-seven consecutive poor-grade SAH patients (World Federation of Neurosurgical Societies (WFNS) grades IV and V) were analyzed between October 2012 and August 2017 at the author ’s institution. PDC was performed due to clinical signs ...
Source: Neurosurgical Review - September 12, 2020 Category: Neurosurgery Source Type: research

Hepcidin attenuates the iron-mediated secondary neuronal injury after intracerebral hemorrhage in rats.
Abstract Iron plays a key role in secondary neuronal injury after intracerebral hemorrhage (ICH), and hepcidin is able to reduce brain iron in iron-overloaded rats by down-regulating iron transport proteins including ferroportin 1 and transferrin receptor 1. These led us to hypothesize that hepcidin might reduce iron-mediated neurotoxicity by inhibiting iron accumulation in ICH brain. Here, we examined effects of Ad-hepcidin (hepcidin expression adenovirus) on the non-heme iron contents, expression of hepcidin, ferritin and iron transport proteins, neuronal cell survival, water contents in the brain and/or cerebro...
Source: Translational Research : the journal of laboratory and clinical medicine - September 12, 2020 Category: Laboratory Medicine Authors: Yang G, Qian C, Zhang C, Bao Y, Liu MY, Jiang F, Li W, Liu Y, Ke Y, Qian ZM Tags: Transl Res Source Type: research

Characteristics of a Diverse Cohort of Stroke Patients with SARS-CoV-2 and Outcome by Sex
Coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), usually presents as a respiratory illness. Neurological manifestations can be seen in 36.4% of patients.1 Patients with vascular risk factors (VRFs), including history of stroke, tend to have worse prognosis.2 COVID-19 triggers a robust inflammatory response which leads to hypercoagulability and thromboembolism.3 Reports of stroke in patients with COVID-19 are mostly limited to small case series or case reports of ischemic stroke (IS), though intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) have ...
Source: Journal of Stroke and Cerebrovascular Diseases - September 11, 2020 Category: Neurology Authors: G. Trifan, F.D. Goldenberg, F.C. Caprio, J. Biller, M. Schneck, A. Khaja, T. Terna, J. Brorson, C. Lazaridis, Z. Bulwa, R. Alvarado-Dyer, F.G. Saleh-Velez, S. Prabhakaran, E.M. Liotta, A. Batra, N.J. Reish, S. Ruland, M. Teitcher, W. Taylor, P. De la Pena Source Type: research

Pituitary Adenylate Cyclase-Activating Polypeptide Attenuates Brain Edema by Protecting Blood –Brain Barrier and Glymphatic System After Subarachnoid Hemorrhage in Rats
AbstractBrain edema is a vital contributor to early brain injury after subarachnoid hemorrhage (SAH), which is responsible for prolonged hospitalization and poor outcomes. Pharmacological therapeutic targets on edema formation have been the focus of research for decades. Pituitary adenylate cyclase-activating polypeptide (PACAP) has been shown to participate in neural development and brain injury. Here, we used PACAP knockout CRISPR to demonstrate that endogenous PACAP plays an endogenous neuroprotective role against brain edema formation after SAH in rats. The exogenous PACAP treatment provided both short- and long-term n...
Source: Neurotherapeutics - September 11, 2020 Category: Neurology Source Type: research

The Importance of P bt O 2 Probe Location for Data Interpretation in Patients with Intracerebral Hemorrhage
ConclusionsIn the acute phase, BTH was more common in the perilesional area compared to healthy brain tissue. The improvement of BTH in the perilesional area over time may be the result of targeted treatment interventions and tissue regeneration. Due to the localized measurement of invasive neuromonitoring devices, integration of probe location in the clinical management of ICH patients and in research protocols seems mandatory. (Source: Neurocritical Care)
Source: Neurocritical Care - September 11, 2020 Category: Neurology Source Type: research

Hepcidin attenuates the iron-mediated secondary neuronal injury after intracerebral hemorrhage in rats
Iron plays a key role in secondary neuronal injury after intracerebral hemorrhage (ICH), and hepcidin is able to reduce brain iron in iron-overloaded rats by down-regulating iron transport proteins including ferroportin 1 and transferrin receptor 1. These led us to hypothesize that hepcidin might reduce iron-mediated neurotoxicity by inhibiting iron accumulation in ICH brain. Here, we examined effects of Ad-hepcidin (hepcidin expression adenovirus) on the non-heme iron contents, expression of hepcidin, ferritin and iron transport proteins, neuronal cell survival, water contents in the brain and/or cerebrospinal fluid (CSF)...
Source: Translational Research - September 11, 2020 Category: Research Authors: Guang Yang, Christopher Qian, Chao Zhang, Yong Bao, Meng-Yue Liu, Fei Jiang, Wei Li, Yong Liu, Ya Ke, Zhong-Ming Qian Tags: Original article Source Type: research

Arundic Acid (ONO-2506) Attenuates Neuroinflammation and Prevents Motor Impairment in Rats with Intracerebral Hemorrhage.
to CA Abstract Intracerebral hemorrhage (ICH) is a severe stroke subtype caused by the rupture of blood vessels within the brain. Increased levels of S100B protein may contribute to neuroinflammation after ICH through activation of astrocytes and resident microglia, with the consequent production of proinflammatory cytokines and reactive oxygen species (ROS). Inhibition of astrocytic synthesis of S100B by arundic acid (AA) has shown beneficial effects in experimental central nervous system disorders. In present study, we administered AA in a collagenase-induced ICH rodent model in order to evaluate its effects on ...
Source: Cellular and Molecular Neurobiology - September 11, 2020 Category: Cytology Authors: Cordeiro JL, Neves JD, Nicola F, Vizuete AF, Sanches EF, Gonçalves CA, Netto CA Tags: Cell Mol Neurobiol Source Type: research

Wake-Promoting Effect of Bloodletting Puncture at Hand Twelve Jing-Well Points in Acute Stroke Patients: A Multi-center Randomized Controlled Trial
AbstractObjectiveTo assess the effect and safety of bloodletting puncture at hand twelve Jing-Well points (HTWPs) in acute stroke patients with conscious disturbance.MethodsIn this multi-center and randomized controlled trial, 360 patients suffered from ischemic or hemorrhagic stroke with conscious disturbance within 48 h from the onset of symptom were divided into bloodletting (180 cases) and control (180 cases) groups using a block randomization. Patients in both groups received routine Western medicine, and patients in the bloodletting group received additional bloodletting puncture at HTWPs on admission immediately bef...
Source: Chinese Journal of Integrative Medicine - September 11, 2020 Category: Internal Medicine Source Type: research

Nationwide Patterns of Hemorrhagic Stroke among Patients Hospitalized with Brain Metastases: Influence of Primary Cancer Diagnosis and Anticoagulation
Brain metastases can contribute to a decreased quality of life for patients with cancer, often leading to malaise, neurologic dysfunction, or death. Intracerebral hemorrhage (ICH) is especially feared complication in patients with brain metastases given the potential for significant morbidity and mortality. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 10, 2020 Category: Radiology Authors: Henry Park, Victor Lee, Vikram Jairam, James Yu Source Type: research

Endovascular treatment of pediatric ischemic stroke: A single center experience and review of the literature.
We report our single-center experience with thrombectomy of LVO in a series of pediatric patients, and perform a review of the literature. METHODS: Retrospective review of consecutive pediatric thrombectomy cases between 2011 and 2018. Demographic variables, imaging data, technical aspects and clinical outcome were recorded. RESULTS: In a period of 7 years, 7 children were treated for LVO at our center. Median age was 13 (2-17), and median Ped-NIHSS was 15 (3-24), and the median ASPECTS was 8 (2-10). Five patients had cardiac disease, and 2 of them were under external cardiac assistance. Median time from ons...
Source: Interventional Neuroradiology - September 10, 2020 Category: Radiology Tags: Interv Neuroradiol Source Type: research

Hypertension-Related Cerebral Microbleeds
We describe a case of cerebellar hemorrhage with cerebral microbleeds secondary to chronic hypertension.Case Rep Neurol 2020;12:266 –269 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - September 10, 2020 Category: Neurology Source Type: research

Liver Fibrosis Is Associated With Hemorrhagic Transformation in Patients With Acute Ischemic Stroke
Conclusion: Liver fibrosis, measured by FIB-4 score, was independently associated with the risk of HT in AIS patients. (Source: Frontiers in Neurology)
Source: Frontiers in Neurology - September 10, 2020 Category: Neurology Source Type: research

Early predictive blood markers of hemorrhagic stroke - influence of cytoflavin therapy.
This study aimed to determine early changes in the parameters of oxidative stress and routine biochemistry blood tests in patients with HS and to assess their relationship with clinical outcome. The effects of early applied cytoflavin were also investigated. The prospective study included 151 patients with HS. 48% of patients in the standard conservative therapy was added cytoflavin antioxidant energy therapy from the first day of hospitalization. The neurological status, neuroimaging, biochemical blood tests and free radical processes were assessed on days 1, 5, 10, 20 of hospitalization. In patients with HS, an imbalance...
Source: Canadian Journal of Physiology and Pharmacology - September 10, 2020 Category: Drugs & Pharmacology Authors: Silina E, Rumyantceva SA, Stupin VA, Parfenov VA, Bolevich S Tags: Can J Physiol Pharmacol Source Type: research

Neuroimaging Appearance of Cerebral Malignant Epithelioid Glioneuronal Tumors in Children [PEDIATRICS]
SUMMARY: Malignant epithelioid glioneuronal tumor is a rare high-grade, aggressive brain tumor that shows both glial and neuronal differentiation on histopathology but is not included in the current World Health Organization classification. The neuroimaging appearance is variable but may be secondary to the size of the mass and/or location of the tumor. In our series, all epithelioid glioneuronal tumors were encountered in the supratentorial space and included pineal, temporal, and extratemporal lobar cerebral hemisphere locations. When large, the tumors demonstrate cystic degeneration and necrosis, hemorrhage, contrast en...
Source: American Journal of Neuroradiology - September 9, 2020 Category: Radiology Authors: Orman, G., Mohammed, S., Tran, H. D. B., Lin, F. Y., Meoded, A., Desai, N., Huisman, T. A. G. M., Kralik, S. F. Tags: PEDIATRICS Source Type: research

Leukoencephalopathy Associated with Severe COVID-19 Infection: Sequela of Hypoxemia? [ADULT BRAIN]
SUMMARY: There is increasing evidence to suggest that complications of coronavirus disease 2019 (COVID-19) infection are not only limited to the pulmonary system but can also involve the central nervous system. Here, we report 6 critically ill patients with COVID-19 infection and neuroimaging findings of leukoencephalopathy. While these findings are nonspecific, we postulate that they may be a delayed response to the profound hypoxemia the patients experienced due to the infection. No abnormal enhancement, hemorrhage, or perfusion abnormalities were noted on MR imaging. In addition, Severe Acute Respiratory Syndrome corona...
Source: American Journal of Neuroradiology - September 9, 2020 Category: Radiology Authors: Lang, M., Buch, K., Li, M. D., Mehan, W. A., Lang, A. L., Leslie-Mazwi, T. M., Rincon, S. P. Tags: ADULT BRAIN Source Type: research

Predictors and Outcomes of Neurological Deterioration in Intracerebral Hemorrhage: Results from the TICH-2 Randomized Controlled Trial
AbstractNeurological deterioration is common after intracerebral hemorrhage (ICH). We aimed to identify the predictors and effects of neurological deterioration and whether tranexamic acid reduced the risk of neurological deterioration. Data from the Tranexamic acid in IntraCerebral Hemorrhage-2 (TICH-2) randomized controlled trial were analyzed. Neurological deterioration was defined as an increase in National Institutes of Health Stroke Scale (NIHSS) of ≥ 4 or a decline in Glasgow Coma Scale of ≥ 2. Neurological deterioration was considered to be early if it started ≤ 48 h and late if c...
Source: Translational Stroke Research - September 9, 2020 Category: Neurology Source Type: research

Intra- and inter-observer variability in intracranial aneurysm segmentation: comparison between CT angiography (semi-automated segmentation software stroke VCAR) and digital subtraction angiography (3D rotational angiography)
ConclusionThe examined 3D-CTA segmentation system is a reproducible procedure for aneurysm morphologic characterization and, in particular, for assessment of aneurysm sac dimensions, but considerable carefulness is required in neck length interpretation. (Source: La Radiologia Medica)
Source: La Radiologia Medica - September 9, 2020 Category: Radiology Source Type: research

Outcomes of a novel ED observation pathway for mild traumatic brain injury and associated intracranial hemorrhage
Recent studies have shown that the majority of non-anticoagulated patients with small subdural or subarachnoid intracranial hemorrhage (ICH) in the setting of mild traumatic brain injury do not experience clinical deterioration or require neurosurgical intervention. We implemented a novel ED observation pathway to reduce unnecessary admissions among patients with ICH in the setting of mild TBI (complicated mild TBI, cmTBI). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - September 9, 2020 Category: Emergency Medicine Authors: Jennifer M. Singleton, Leslie A. Bilello, Tatiana Greige, Lakshman Balaji, Carrie D. Tibbles, Jonathan A. Edlow, Martina Stippler, Carlo L. Rosen Source Type: research

Effect of Early Normobaric Hyperoxia on Blast-Induced Traumatic Brain Injury in Rats.
Abstract Blast-induced traumatic brain injury (bTBI) is a leading cause of disability and mortality in soldiers during the conflicts in Iraq and Afghanistan. Although substantial clinical and animal studies have investigated the pathophysiology and treatments of bTBI, few effective therapies have been found, especially for the early rescue in the battlefield. The aim of this study is to evaluate neuroprotective effects of early normobaric hyperoxia (NBO) on bTBI. We established a rat model of bTBI caused by explosion in the cabin. It exhibited typical changes of mild bTBI, like impaired neurological function, brai...
Source: Neurochemical Research - September 9, 2020 Category: Neuroscience Authors: Li Y, Lv W, Cheng G, Wang S, Liu B, Zhao H, Wang H, Zhang L, Dong C, Zhang J Tags: Neurochem Res Source Type: research

ECMO support in SARS-CoV2 multisystem inflammatory syndrome in children in a child.
In this report, we describe the case of a 5-year-old male with SARS-CoV-2 associated MIS-C with progressive respiratory failure and vasoplegic shock requiring extracorporeal support. At presentation, reverse transcription-polymerase chain reaction (RT-PCR) testing for SARS-CoV-2 was negative, however, SARS-CoV2 antibody testing was positive. Multiple inflammatory markers and cardiac biomarkers were elevated. Echocardiogram demonstrated mildly depressed left ventricular function and no coronary anomalies noted. The patient required mechanical ventilation, vasopressors, and eventually extracorporeal membrane oxygenation (ECM...
Source: Perfusion - September 9, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Kaushik S, Ahluwalia N, Gangadharan S, Esperenza M, Murthy R, Ofori-Amanfo G, Aydin SI Tags: Perfusion Source Type: research

Clinical significance of FSTL 1, Bax, Bcl-2 in acute cerebral infarction and its relationship with hemorrhagic transformation.
This study is designed to investigate the clinical significance of Follistatin-like protein 1 (FSTL1), Bax and Bcl-2 in ACI. PATIENTS AND METHODS: A total of 84 cases of ACI patients admitted to our hospital from September 2017 to September 2019 and 90 cases of healthy subjects undergoing physical examination at the same time were selected as the research objects for prospective analysis. The concentrations of FSTL1, Bax and Bcl-2 in the peripheral blood of objects in the two groups were detected to analyze the diagnostic value of FSTL1, Bax and Bcl-2 for ACI, and the correlation of FSTL 1, Bax and Bcl-2 with the infar...
Source: European Review for Medical and Pharmacological Sciences - September 8, 2020 Category: Drugs & Pharmacology Tags: Eur Rev Med Pharmacol Sci Source Type: research

Left temporal hemorrhage caused by cerebral venous reflux of a brachio-brachial hemodialysis fistula
AbstractCentral vein disease (CVD) is a well-known complication of central venous cannulations, indwelling dialysis catheters, and arteriovenous grafts. Brachiocephalic vein (BCV) stenosis or thrombotic occlusion can occur in dialysis patients, and the presence of an ipsilateral arteriovenous fistula can cause cerebral venous hypertension due to retrograde flow in the ipsilateral jugular vein. A 53-year-old man receiving hemodialysis (left brachiocephalic hemodialysis fistula) presented with impaired consciousness and seizures related to status epilepticus due to left temporal multifocal hemorrhages. Brain computed tomogra...
Source: Neuroradiology - September 8, 2020 Category: Radiology Source Type: research

Acutely altered mental status as the main clinical presentation of multiple strokes in critically ill patients with COVID-19
ConclusionAcutely altered mental status might be the main manifestation of multiple brain infarctions in critically ill COVID-19 patients. It should be specially considered in those with suspected COVID-19-associated coagulopathy. Full-dose anticoagulation and clinical-radiological monitoring might reduce their neurological consequences. (Source: Neurological Sciences)
Source: Neurological Sciences - September 8, 2020 Category: Neurology Source Type: research

Identification of Predictors for Hemorrhagic Transformation in Patients with Acute Ischemic Stroke After Endovascular Therapy Using the Decision Tree Model
(Source: Clinical Interventions in Aging)
Source: Clinical Interventions in Aging - September 8, 2020 Category: Geriatrics Tags: Clinical Interventions in Aging Source Type: research