Final Results of Cilostazol-Aspirin Therapy against Recurrent Stroke with Intracranial Artery Stenosis (CATHARSIS)
Conclusion: Progression of IAS during the 2-year observation period appears to be less frequent than previously reported in stroke patients on antiplatelet agents after the acute phase, which could be due to the adequate control of risk factors, and because patients with stroke within 2 weeks after the onset were excluded. The results of the CATHARSIS trial suggest a potential utility of pharmacotherapies with cilostazol plus aspirin as well as of strict control of risk factors for the management of symptomatic IAS. Larger studies with higher statistical power are required to obtain conclusive results.Cerebrovasc Dis Extra...
Source: Cerebrovascular Diseases Extra - January 15, 2015 Category: Neurology Source Type: research
Endovascular Stroke Therapy Results Improve over Time: The ‘Learning Curve' at a New Comprehensive Stoke Center
Conclusions: At a new community-based CSC, improved outcome occurred from year 1 to year 2, and trends towards decreased mortality, fewer complications, and improved revascularization were observed. Furthermore, the data shows that improvement in NIHSS score after EST is associated with decreased mortality following stroke in this setting, implying a net benefit.Cerebrovasc Dis Extra 2014;4:235-242 (Source: Cerebrovascular Diseases Extra)
Source: Cerebrovascular Diseases Extra - January 13, 2015 Category: Neurology Source Type: research
Multifaceted Intervention Including Motivational Interviewing to Support Medication Adherence after Stroke/Transient Ischemic Attack: A Randomized Trial
The objective of this study was to investigate the effectiveness of a multifaceted intervention including MI in improving medication adherence for secondary stroke prevention. Methods: In this randomized controlled trial, TIA and stroke patients receiving a pharmacist intervention in a hospital setting were compared with patients receiving usual care. The intervention consisted of a focused medication review, an MI-approached consultation and 3 follow-up telephone calls and lasted for 6 months. The primary outcome was a composite medication possession ratio (MPR) for antiplatelets, anticoagulants and statins in the year af...
Source: Cerebrovascular Diseases Extra - December 11, 2014 Category: Neurology Source Type: research
Cerebral Microbleeds Are Associated with Worse Cognitive Function in the Nondemented Elderly with Small Vessel Disease
Conclusions: In nondemented elderly with SVD on MRI, the presence of CMBs was independently associated with worse executive and global cognitive functions. CMBs seemed to reflect hypertensive microangiopathy in this population, and CMBs in specific areas may play an important role in cognitive function.Cerebrovasc Dis Extra 2014;4:212-220 (Source: Cerebrovascular Diseases Extra)
Source: Cerebrovascular Diseases Extra - December 8, 2014 Category: Neurology Source Type: research
Evaluation of the Implementation of a Rapid Response Treatment Protocol for Patients with Acute Onset Stroke: Can We Increase the Number of Patients Treated and Shorten the Time Needed
Conclusions: The implementation of the rapid treatment protocol for acute onset ischemic stroke patients led to a significant decrease in the DTN time at our center. These improvements also produced an increase in the number of patients treated per year. The extension of the therapeutic window from 3 to 4.5 h for the use of intravenous recombinant tissue plasminogen activator also played a role in the increased treatment numbers.Cerebrovasc Dis Extra 2014;4:115-121 (Source: Cerebrovascular Diseases Extra)
Source: Cerebrovascular Diseases Extra - November 7, 2014 Category: Neurology Source Type: research
Preoperative White Matter Lesions Are Independent Predictors of Long-Term Survival after Internal Carotid Endarterectomy
Background: Cerebral white matter lesions (WMLs) predict long-term survival of conservatively treated acute stroke patients with etiology other than carotid stenosis. In carotid endarterectomy patients, WMLs are associated with severe carotid stenosis and unstable plaques, with the risk of perioperative complications and with increased 30-day perioperative risk of death. However, no data exist on their effect on postoperative long-term survival, a factor important when considering the net benefit from carotid endarterectomy. Whether this effect is independent of classical risk factors and indications for surgery is not kno...
Source: Cerebrovascular Diseases Extra - November 7, 2014 Category: Neurology Source Type: research
Measuring Quality Improvement in Acute Ischemic Stroke Care: Interrupted Time Series Analysis of Door-to-Needle Time
Conclusion and Implications: The DNT steadily improved from the first implementation of thrombolysis. Specific explanations for this improvement require further study, and may relate to the combined impact of a series of structural and logistic interventions. Our results support the use of performance measures for internal communication. Median DNT should be used on a monthly or quarterly basis to inform all professionals treating stroke patient of their achievements.Cerebrovasc Dis Extra 2014;4:149-155 (Source: Cerebrovascular Diseases Extra)
Source: Cerebrovascular Diseases Extra - November 7, 2014 Category: Neurology Source Type: research
Neurocognitive Functioning after Carotid Revascularization: A Systematic Review
The objective of this study was to review the recent literature regarding the neurocognitive consequences of carotid endarterectomy (CEA) and carotid stenting (CAS). Methods and Results: A PubMed and Web of Science search was conducted using the key words ‘carotid' in combination with ‘cognitive', ‘cognition', ‘neurocognition', ‘neurocognitive', ‘neuropsychology', and ‘neuropsychological'. Bibliographies of relevant articles were cross-referenced. We included 37 studies published since 2007 of which 18 examined CEA, 12 CAS, and 7 compared CEA to CAS. There is a wide variability in the reported neurocognitive ...
Source: Cerebrovascular Diseases Extra - November 7, 2014 Category: Neurology Source Type: research
Gastrointestinal Bleeding in Acute Ischemic Stroke: Recent Trends from the Fukuoka Stroke Registry
Conclusions: GI bleeding infrequently occurred in patients with acute ischemic stroke, which was mostly due to etiologies other than peptic ulcer. GI bleeding was associated with poor clinical outcomes including neurologic deterioration, in-hospital mortality, and poor functional outcome.Cerebrovasc Dis Extra 2014;4:156-164 (Source: Cerebrovascular Diseases Extra)
Source: Cerebrovascular Diseases Extra - November 7, 2014 Category: Neurology Source Type: research
Is Isolated Aphasia Associated with Atrial Fibrillation A Prospective Study
Conclusions: A statistically significant relation between isolated aphasia and AF could not be established in this study. However, our results showed a tendency towards significance. Further studies, in which rhythm is observed for a longer period of time, may be required to confirm this hypothesis.Cerebrovasc Dis Extra 2014;4:165-173 (Source: Cerebrovascular Diseases Extra)
Source: Cerebrovascular Diseases Extra - November 7, 2014 Category: Neurology Source Type: research
Chronic Kidney Disease Is an Independent Predictor of Adverse Clinical Outcomes in Patients with Recent Small Subcortical Infarcts
Background: Chronic kidney disease (CKD) is associated with cerebral small vessel diseases (SVD) and predicts stroke, cardiovascular events and mortality. However, its association with recent small subcortical infarcts (RSSI), a novel subtype of cerebral SVD, has not yet been established in stroke patients. The aim of this longitudinal study was to clarify whether CKD can predict clinical outcome in patients with RSSI. Methods: We enrolled patients with first-ever RSSI (formerly categorized as acute lacunar stroke). CKD was defined as an estimated glomerular filtration rate of (Source: Cerebrovascular Diseases Extra)
Source: Cerebrovascular Diseases Extra - November 7, 2014 Category: Neurology Source Type: research
Acute Isolated Dysarthria Is Associated with a High Risk of Stroke
The objective of this study was to prospectively identify and follow a cohort of patients presenting to EDs with isolated dysarthria in order to explore their natural history and risk of recurrent cerebrovascular events. Specifically, we sought to determine early outcomes of individuals with this nonspecific and atypical presentation in order to appropriately expedite their management. Methods: Patients with isolated dysarthria having presented to 8 Canadian EDs between October 2006 and April 2009 were analyzed as part of a prospective multicenter cohort study of patients with acute neurological symptoms as assessed by eme...
Source: Cerebrovascular Diseases Extra - November 7, 2014 Category: Neurology Source Type: research
The Longitudinal Evolution of Cerebral Blood Flow Regulation after Acute Ischaemic Stroke
Background: Acute stroke is known to impair cerebral blood flow (CBF) regulation, but the longitudinal changes of these effects have been poorly reported. The main CBF regulatory mechanisms [cerebral autoregulation (CA) and neurovascular coupling (NVC)] were assessed over 3 months after acute ischaemic stroke. Methods: Recordings of CBF velocity (CBFv), blood pressure (BP), and end-tidal CO2 were performed during 5 min baseline and 1 min passive movement of the elbow. Stroke patients were assessed (Source: Cerebrovascular Diseases Extra)
Source: Cerebrovascular Diseases Extra - November 7, 2014 Category: Neurology Source Type: research
Arachidonic Acid and Cerebral Ischemia Risk: A Systematic Review of Observational Studies
Background: Arachidonic acid (ARA) is a precursor of various lipid mediators. ARA metabolites such as thromboxane A2 cause platelet aggregation and vasoconstriction, thus may lead to atherosclerotic disease. It is unclear whether dietary ARA influences the ARA-derived lipid mediator balance and the risk for atherosclerotic diseases, such as cerebral ischemia. Considering the function of ARA in atherosclerosis, it is reasonable to focus on the atherothrombotic type of cerebral ischemia risk. However, no systematic reviews or meta-analyses have been conducted to evaluate the effect of habitual ARA exposure on cerebral ischem...
Source: Cerebrovascular Diseases Extra - November 7, 2014 Category: Neurology Source Type: research
