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Source: Medicine
Condition: Ischemic Stroke

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Total 352 results found since Jan 2013.

Rapid improvement of angiostenosis due to isolated middle cerebral artery dissection: A case report
AbstractRationale:Intracranial arterial dissection is a rare cause of ischemic stroke, and isolated middle cerebral artery dissection (MCAD) is extremely rare, having been described only in sparse case reports. The etiology, clinicoradiological features, and treatment strategies are not yet well understood.Patient concerns:A 49-year-old man presented with rapidly progressive aphasia and motor disturbance of the right limbs.Diagnoses:Neuroimaging evaluation confirmed a diagnosis of MCAD and cerebral infarction.Interventions:The patient underwent oral anti-platelet therapy (100 mg aspirin daily).Outcomes:The patient recove...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Can catheter ablation reduce the incidence of thromboembolic events in patients with atrial fibrillation?: Protocol for a systematic review and meta-analysis
Abstract Atrial fibrillation (AF), the most common cardiac arrhythmia, is a major risk factor for thromboembolic events, especially ischemic stroke. Catheter ablation is an effective method to maintain sinus rhythm in patients with AF. Although some observational studies have shown a relatively lower stroke rate after catheter ablation, whether catheter ablation can reduce the thromboembolic risk in patients with AF remains unclear. We aim to perform a systematic review to determine whether catheter ablation can prevent thromboembolism in patients with AF. PubMed, Embase, the Web of Science, and the Cochrane Library wil...
Source: Medicine - December 1, 2017 Category: Internal Medicine Tags: Research Article: Study Protocol Systematic Review Source Type: research

A possible synergistic effect of MTHFR C677T polymorphism on homocysteine level variations increased risk for ischemic stroke
AbstractBackground:Homocysteine (Hcy) plays an important role in vascular function and Hcy level contributes to pathogenesis of ischemic stroke (IS). MTHFR gene polymorphism may have effects on IS risks by influencing the Hcy metabolic pathway. In the present study, a case–control study was designed to evaluate the relationship among MTHFR C677Tpolymorphism, plasma Hcy level, and susceptibility of IS in Chinese population.Methods:A total of 300 patients with IS and 261 matched control subjects were recruited. Plasma Hcy concentration was determined using enzymatic cycling assay. MTHFR C677T polymorphisms were genotyped b...
Source: Medicine - December 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

The associations of stroke, transient ischemic attack, and/or stroke-related recurrent vascular events with Lipoprotein-associated phospholipase A2: A systematic review and meta-analysis
Conclusions:In patients with TIA and first ischemic stroke, elevated Lp-PLA2 activity levels were associated with recurrent vascular events. And in the general population elevated Lp-PLA2 levels were associated with the risk of stroke, although the association between Lp-PLA2 activity levels and the risk of stroke was less profound compared with the corresponding association of stroke risk with the Lp-PLA2 mass levels. Background: Studies on stroke and lipoprotein-associated phospholipase A2 (Lp-PLA2) have produced conflicting results. Objective: The aim of the study was to assess the associations of Lp-PLA2 levels ...
Source: Medicine - December 1, 2017 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

A case report of parenchymal hematoma after intravenous thrombolysis in a rivaroxaban-treated patient: Is it a true rivaroxaban hemorrhagic complication?
AbstractRationale:To date, the only treatment approved for acute ischemic strokes is thrombolysis. Whether intravenous thrombolysis may be safe in patients taking direct oral anticoagulants (DOACs) is currently a matter of debate.Patient concerns:A 74-year-old woman, who was on rivaroxaban 20 mg/d for nonvalvular atrial fibrillation, was admitted to our stroke unit with left-sided hemiparesis and aphasia. The onset of neurologic deficits had occurred 5 hours after the last rivaroxaban dose.Diagnosis:An acute ischemic stroke was diagnosed.Interventions:The patient was administered thrombolytic treatment with intravenous r...
Source: Medicine - December 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Association of apolipoprotein E genotype with outcome in hospitalized ischemic stroke patients
Abstract The aim of this study was to study the ability of the genotype to predict impairment and disability in hospitalized ischemic stroke (IS) patients after hospital discharge and 6 months after the onset of stroke symptoms. A total of 786 patients with a first IS were enrolled. Apolipoprotein E (ApoE) polymorphism was examined using polymerase chain reaction. Stroke subtype was classified using the Oxfordshire Community Stroke Project classification scheme and the Trial of Org 10172 in Acute Stroke Treatment criteria. Impairment as assessed using the National Institutes of Health Stroke Scale (NIHSS), and disabilit...
Source: Medicine - December 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Elevated serum lipoprotein(a) as a risk factor for combined intracranial and extracranial artery stenosis in a child with arterial ischemic stroke: A case report
Rationale: Stroke is an uncommon disease in childhood with an estimated incidence of 1 to 6 per 100,000 and stenoocclusive arteriopathy is the main risk factor of recurrent pediatric arterial ischemic stroke (AIS). Dyslipidemia may influence strongly before puberty and in late adolescence when plasma levels are naturally highest. Patient concerns: An 11-year-old male presented with acute onset seizure, a drowsy mentality, and right hemiplegia. Diagnoses: Magnetic resonance (MR) angiogram demonstrated occlusion of distal basilar artery and left vertebral arteries. Serum Lp(a) was significantly increased as 269 nmol/L (normal
Source: Medicine - December 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Chart validation of inpatient ICD-9-CM administrative diagnosis codes for ischemic stroke among IGIV users in the Sentinel Distributed Database
The Sentinel Distributed Database (SDD) is a large database of patient-level medical and prescription records, primarily derived from insurance claims and electronic health records, and is sponsored by the U.S. Food and Drug Administration for drug safety assessments. In this chart validation study, we report on the positive predictive value (PPV) of inpatient ICD-9-CM acute ischemic stroke (AIS) administrative diagnosis codes (433.x1, 434.xx, and 436) in the SDD. As part of an assessment of the risk of thromboembolic adverse events following treatment with intravenous immune globulin (IGIV), charts were obtained for 131 ...
Source: Medicine - December 1, 2017 Category: Internal Medicine Tags: Research Article: Diagnostic Accuracy Study Source Type: research

Early neurological deterioration during the acute phase as a predictor of long-term outcome after first-ever ischemic stroke
Early neurological deterioration (END) is associated with increased risk of functional disability and mortality. However, data are limited regarding the long-term risk of poor functional outcomes. Thus we explored the association between END and long-term outcomes in patients with acute ischemic stroke. A total of 1064 patients were enrolled with acute ischemic stroke who were consecutively admitted to the 3 stroke units of Huai-He Hospital, Kaifeng, China. END was defined as an increment change of at least one point in motor power or total National Institute of Health Stroke Scale (NIHSS) score deterioration ≥2 points ...
Source: Medicine - December 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Usefulness of multiphase computed tomography angiography in a patient with transient ischemic attack in the hyperacute phase: A case report
We present a case of TIA, the cause of which was identified using multiphase computed tomography angiography (MCTA) in the hyperacute phase of the disease.Patient Concerns:The patient was a 57-year-old man who was admitted to the emergency department for right-side weakness persisting for 1 hour.Diagnoses:Occlusion of the proximal M3 segment of the left middle cerebral artery territory was found on the initial MCTA.Outcomes:The weakness completely resolved at 2 hours after symptom onset, and there was no acute infarction on the initial diffusion-weighted magnetic resonance imaging (MRI) on the same day. Follow-up MCTA ...
Source: Medicine - December 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Ischemic stroke due to intracranial arterial dolichoectasia coexisting with spontaneous dissection of the basilar artery: A case report
Conclusion: We discuss in general terms the diagnosis of basilar artery dissection and its probable relationship with the occurrence of dolichoectasia.
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Prognostic value of glucose metabolism for non-ST-segment elevation infarction patients with diabetes mellitus and single concomitant chronic total occlusion following primary percutaneous coronary intervention
Abstract Glucose metabolism status may play a predictive role in the severity of the complications among patients with type 2 diabetes mellitus (DM). However, few studies have focused on the prognostic value of glycosylated hemoglobin (HbA1c) and Homeostatic Model Assessment 2 for Insulin Resistance (HOMA2-IR) in patients with DM, non-ST-segment elevation infarction (NSTEMI), and single concomitant chronic total occlusion (CTO) following primary percutaneous coronary intervention (PCI). Short- and long-term prognostic value of HbA1c and HOMA2-IR in patients with DM with NSTEMI and single CTO who received primary percutan...
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Prognostic value of high-resolution magnetic resonance imaging in evaluating carotid atherosclerotic plaque in patients with ischemic stroke
Conclusion: Our study conclusively intimated the promise of HRMRI as an evaluative tool for the determination of carotid atherosclerotic plaques in patients with IS.
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research

Low free triiodothyronine levels predict symptomatic intracranial hemorrhage and worse short-term outcome of thrombolysis in patients with acute ischemia stroke
Abstract The aim of the study was to determine whether thyroid hormones level on admission in patients with ischemic stroke, treated with intravenous recombinant tissue type plasminogen activator (rtPA), was associated with symptomatic intracranial hemorrhage (sICH) and worse outcomes at 3 months. Patients with acute ischemic stroke (AIS) receiving intravenous rtPA thrombolytic treatment on our stroke unit between January 2015 and June 2016 were included in this study. Serum-free triiodothyronine (fT3), free thyroxine (fT4), total triiodothyronine (tT3), total thyroxine (tT4), and thyroid-stimulating hormone (TSH) were ...
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Prognostic role of neutrophil–lymphocyte ratio in patients with acute ischemic stroke
Conclusion: For patients with AIS, higher NLR was associated with poorer functional outcome at 3 months and may be associated with a higher risk of developing sICH. This readily available and inexpensive marker may be helpful in future clinical and research work. However, due to the limited number of included studies, more well-designed studies are warranted to further clarify this issue.
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research