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Intravenous thrombolysis for acute ischemic stroke: why not?
Purpose of review The aim of this study was to summarize available evidence regarding the safety and efficacy of intravenous thrombolysis (IVT) using recombinant tissue-plasminogen activator (rt-PA) in acute ischemic stroke (AIS) patients with specific comorbidities and potential contraindications to systemic reperfusion therapy. Recent advances in IVT implementation in wake-up stroke and in extended time window using advanced neuroimaging will also be highlighted. Recent findings Despite theoretical concerns of a higher bleeding risk with IVT, there are no data showing increased risk of symptomatic intracerebra...
Source: Current Opinion in Neurology - January 19, 2022 Category: Neurology Tags: CEREBROVASCULAR DISEASE: Edited by Diana Aguiar de Sousa Source Type: research

Cerebral Autoregulation in Subarachnoid Hemorrhage
Subarachnoid hemorrhage (SAH) is a devastating stroke subtype with a high rate of mortality and morbidity. The poor clinical outcome can be attributed to the biphasic course of the disease: even if the patient survives the initial bleeding emergency, delayed cerebral ischemia (DCI) frequently follows within 2 weeks time and levies additional serious brain injury. Current therapeutic interventions do not specifically target the microvascular dysfunction underlying the ischemic event and as a consequence, provide only modest improvement in clinical outcome. SAH perturbs an extensive number of microvascular processes, includi...
Source: Frontiers in Neurology - July 23, 2021 Category: Neurology Source Type: research

Clinical and Radiological Outcomes After Revascularization of Hemorrhagic Moyamoya Disease
Conclusion: Direct revascularization may be superior to indirect revascularization for prevention of rebleeding and poor neurological outcome in adults with hemorrhagic MMD. The risk of postoperative rebleeding was higher in those with untreated aneurysms, repetitive bleeding episodes, normal perfusion status, and indirect revascularization. The regression of original collaterals and establishment of revascularization collaterals after revascularization were more significant in hemispheres with direct revascularization than those with indirect revascularization.
Source: Frontiers in Neurology - May 6, 2020 Category: Neurology Source Type: research

Intracranial Hemorrhage Diagnosed with Transcranial Ultrasound in a Comatose, Postliver Transplant Patient
We report a case of an intracranial hemorrhage first suspected during a trans-cranial Doppler assessment of a postorthotopic liver transplant patient. The patient was at considerable risk of bleeding, due to a primary graft nonfunction, but he had also elevated ammonium levels, justifying the comatose state, and no focal neurological deficits.
Source: Journal of Stroke and Cerebrovascular Diseases - September 4, 2019 Category: Neurology Authors: Amedeo Bianchini, Rocco D'Andrea, Berin Lepic, Lorenzo Querci, Cristiana Laici, Antonio Siniscalchi Tags: Case Report Source Type: research

Influence of Sex on Stroke Prognosis: A Demographic, Clinical, and Molecular Analysis
Conclusion Our data suggest that women who suffer from IS present with a poorer functional outcome than men at 3-months, regardless of other preclinical and clinical factors during the acute phase. These relationships seem to be mediated by atrial dysfunction and inflammation. The inflammatory response is slightly higher in women; however, there are no sex differences in their functional behavior. There is a probable relationship between the molecular marker of atrial dysfunction NT-proBNP and worse functional outcome in women, and the connection seems to be more important in cardioembolic stroke patients. In patients wi...
Source: Frontiers in Neurology - April 16, 2019 Category: Neurology Source Type: research

Combining Human Umbilical Cord Blood Cells With Erythropoietin Enhances Angiogenesis/Neurogenesis and Behavioral Recovery After Stroke
In conclusion, our results suggest that hUCBC infusion in combination with EPO administration demonstrates therapeutic efficacy in the treatment of stroke-induced injury by promoting neurogenesis and angiogenesis. Further research that delineates the therapeutic mechanism of systemically administered hUCBC and EPO is required. Ethics Statement All experimental procedures involving animals were performed in accordance with the Guide for the Care and Use of Laboratory Animals as adopted and promulgated by the U. S. National Institutes of Health and were approved by CHA University Institutional Animal Care & Use Com...
Source: Frontiers in Neurology - April 9, 2019 Category: Neurology Source Type: research

Leukoaraiosis as an outcome predictor in the acute and subacute phases of stroke.
Authors: Fierini F, Poggesi A, Pantoni L Abstract INTRODUCTION: Leukoaraiosis (LA) is one of the neuroimaging features of cerebral small vessel disease and is associated with poor long-term prognosis. Areas covered: This narrative review focuses on the predictive role of LA on the evolution of the ischemic brain damage and on the clinical outcome in the subacute phase of stroke and in the short-term period afterwards. Expert commentary: In acute stroke, LA is associated with a less favorable fate of brain infarct and is a marker of increased risk of thrombolysis-related hemorrhagic transformation. The impaired cerebra...
Source: Expert Review of Neurotherapeutics - August 23, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Atypical presentation of Sturge-Weber Syndrome. (P3.289)
Conclusions:This is an unusual presentation of SWS. Commonly, patients present at early age with seizure and unlike our case patient presented with SAH and stroke like symptoms.Disclosure: Dr. Lee has nothing to disclose. Dr. E-Ghanmh has nothing to disclose. Dr. Said Said has nothing to disclose. Dr. Wu has nothing to disclose. Dr. Muhammad has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Lee, A., E-Ghanmh, M., Said, S. S., Wu, N., Muhammad, I. Tags: Cerebrovascular Disease Case Reports II Source Type: research

Pathophysiological Role of Global Cerebral Ischemia following Subarachnoid Hemorrhage: The Current Experimental Evidence.
Authors: Plesnila N Abstract Subarachnoid hemorrhage (SAH) is the subtype of stroke with one of the highest mortality rates and the least well-understood pathophysiologies. One of the very early events which may occur after SAH is a significant decrease of cerebral perfusion pressure (CPP) caused by the excessive increase of intracranial pressure during the initial bleeding. A severely decreased CPP results in global cerebral ischemia, an event also occurring after cardiac arrest. The aim of the current paper is to review the pathophysiological events occurring in experimental models of SAH and global cerebral isch...
Source: Stroke Research and Treatment - December 2, 2014 Category: Neurology Tags: Stroke Res Treat Source Type: research

The Rabbit Shunt Model of Subarachnoid Haemorrhage
Abstract Aneurysmal subarachnoid haemorrhage (SAH) is a disease with devastating complications that leads to stroke, permanent neurological deficits and death. Clinical and ex-perimental work has demonstrated the importance of the contribution of delayed cerebral vasospasm (DCVS) indepen-dent early events to mortality, morbidity and functional out-come after SAH. In order to elucidate processes involved in early brain injury (EBI), animal models that reflect acute events of aneurysmal bleeding, such as increase in intracranial pressure (ICP) and decrease in cerebral perfusion pressure, are needed. In the presented...
Source: Translational Stroke Research - October 19, 2014 Category: Neurology Source Type: research

Cerebral CT perfusion in patients with perimesencephalic and those with aneurysmal subarachnoid hemorrhage
ConclusionsPerimesencephalic hemorrhage patients have a higher cerebral blood flow than aneurysmal subarachnoid hemorrhage patients. The findings of this study further support a venous origin of bleeding in perimesencephalic hemorrhage patients. Future studies should further elaborate on cerebral blood flow in posterior circulation aneurysms.
Source: International Journal of Stroke - March 21, 2013 Category: Neurology Authors: Charlotte H. P. Cremers, Irene C. Schaaf, Jan Willem Dankbaar, Birgitta K. Velthuis, Gabriel J. E. Rinkel Tags: Research Source Type: research