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Acute Stroke Therapy in Infective Endocarditis - Case Series and Systematic Review (P6.295)
Conclusions:Endovascular thrombectomy alone appears to be safer than IV-tPA alone in the management of AIS in patients with IE.Disclosure: Dr. Marquardt has nothing to disclose. Dr. Cho has nothing to disclose. Dr. Zhang has nothing to disclose. Dr. Uchino has nothing to disclose. Dr. Wisco has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Marquardt, R., Cho, S.-M., Zhang, L., Uchino, K., Wisco, D. Tags: Cardiovascular Issues in Ischemic Stroke Source Type: research

Treatment and Outcome of Hemorrhagic Transformation After Intravenous Alteplase in Acute Ischemic Stroke: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association AHA/ASA Scientific Statement
Purpose—Symptomatic intracranial hemorrhage (sICH) is the most feared complication of intravenous thrombolytic therapy in acute ischemic stroke. Treatment of sICH is based on expert opinion and small case series, with the efficacy of such treatments not well established. This document aims to provide an overview of sICH with a focus on pathophysiology and treatment.Methods—A literature review was performed for randomized trials, prospective and retrospective studies, opinion papers, case series, and case reports on the definitions, epidemiology, risk factors, pathophysiology, treatment, and outcome of sICH. The documen...
Source: Stroke - November 27, 2017 Category: Neurology Authors: Shadi Yaghi, Joshua Z. Willey, Brett Cucchiara, Joshua N. Goldstein, Nicole R. Gonzales, Pooja Khatri, Louis J. Kim, Stephan A. Mayer, Kevin N. Sheth, Lee H. Schwamm Tags: Statements and Guidelines AHA/ASA Scientific Statement Source Type: research

Dynamic Detection of Thrombolysis in Embolic Stroke Rats by Synchrotron Radiation Angiography
AbstractA rodent model of embolic middle cerebral artery occlusion is used to mimic cerebral embolism in clinical patients. Thrombolytic therapy is the effective treatment for this ischemic injury. However, it is difficult to detect thrombolysis dynamically in living animals. Synchrotron radiation angiography may provide a novel approach to directly monitor the thrombolytic process and assess collateral circulation after embolic stroke. Thirty-six adult Sprague-Dawley rats underwent the embolic stroke model procedure and were then treated with tissue plasminogen activator. The angiographic images were obtained in vivo by s...
Source: Translational Stroke Research - January 24, 2019 Category: Neurology Source Type: research

More Studies Required to Understand Mortality Rates of Dialysis-Dependent Patients after Acute Thrombolysis for Stroke
I read with interest the article by Tariq et al in the Journal that details outcomes with thrombolytic therapy for acute ischemic stroke in over 1000 dialysis patients. They are to be commended for examining this important aspect of acute stroke care in dialysis cohorts. However, in their discussion, the authors state that a previous US study by Sozio et al reported a 30-day mortality rate of 35% after thrombolysis. This is inaccurate and can potentially cause confusion. In fact, careful review of the article reveals that the authors of that study do not report any thrombolysis-related outcomes and that this mortality ra...
Source: Journal of Stroke and Cerebrovascular Diseases - July 1, 2013 Category: Neurology Authors: Albert Power Tags: Letters to the Editor Source Type: research

Stroke in a young patient? Ask about synthetic cannabinoids
3 out of 5 stars Ischemic stroke after use of synthetic marijuana “spice”. Freeman MJ et al. Neurology 2013;81:1-4. Abstract This interesting paper, from the University of South Florida in Tampa, describes a brother and sister who at different times both developed ischemic strokes shortly after smoking a synthetic marijuana product. The 26-year-old brother presented with dysarthria, expressive aphasia, and right-sided weakness after smoking “Spice” a few hours previously. Head CT showed a clot in the proximal middle cerebral artery. His symptoms resolved after treatment with thrombolytics. The 19-y...
Source: The Poison Review - December 11, 2013 Category: Toxicology Authors: Leon Tags: Medical cerebral ischemia jwh-018 spice stroke synthetic cannabinoid Source Type: news

Massive Interventricular Septal Aneurysm and Stroke in a Healthy Young Patient: Guilt by Association?
We describe here the case of an otherwise healthy, 41-year-old man who presented to the hospital with acute-onset confusion and left-sided body weakness attributed to a right middle cerebral artery ischemic stroke. He experienced a nearly complete resolution of deficits following systemic thrombolytic therapy. After an extensive workup, the presumed mechanism of stroke was a thromboembolus that originated in a massive aneurysm of the patient's membranous interventricular septum. Due to a perceived risk of surgical morbidity, the patient was managed conservatively with anticoagulation. He denied further events and reported ...
Source: Journal of Stroke and Cerebrovascular Diseases - June 10, 2013 Category: Neurology Authors: John C. Stendahl, Amatul S. Hasan, Mengistu A. Simegn Tags: Case Reports Source Type: research

Predictive Factors for Early Clinical Improvement after Intra-arterial Thrombolytic Therapy in Acute Ischemic Stroke
This study aimed to identify clinical and radiological variables that are predictive of early improvement (EI) after IAT in acute ischemic stroke.Methods: This single-center retrospective cohort study included 141 consecutive patients who underwent IAT for terminal internal carotid and/or middle cerebral artery (MCA) occlusions. EI was defined as a National Institutes of Health Stroke Scale (NIHSS) score less than 3 or NIHSS score improvement of 8 points or more within 72 hours of IAT. The EI and non-EI groups were compared in terms of clinical and radiological findings before and after IAT.Results: Forty-nine patients sh...
Source: Journal of Stroke and Cerebrovascular Diseases - February 14, 2014 Category: Neurology Authors: Hye Seon Jeong, Hyun-Jo Kwon, Chang Woo Kang, Hee-Jung Song, Hyeon Song Koh, Sang Min Park, Jung Geol Lim, Ji Eun Shin, Suk Hoon Lee, Jei Kim Tags: Original Articles Source Type: research

Thrombolytic Outcomes for Acute Ischemic Stroke in Patients with Primary Brain Tumors in the United States (P4.220)
Conclusions: Thrombolytic therapy is an independent predictor of ICH in patients with primary brain tumors. Thrombolysis outcomes are less favorable in malignant brain tumors compared to benign tumors.Disclosure: Dr. Murthy has nothing to disclose. Dr. Moradiya has nothing to disclose. Dr. Shah has nothing to disclose. Dr. Shastri has nothing to disclose. Dr. Bershad has nothing to disclose. Dr. Suarez has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Murthy, S., Moradiya, Y., Shah, S., Shastri, A., Bershad, E., Suarez, J. Tags: Cerebrovascular Disease and Interventional Neurology: Acute Stroke Thrombolysis Source Type: research

Why Ischemic Stroke Patients Do Not Receive Thrombolytic Treatment? (P7.122)
CONCLUSIONS:This retrospective analysis suggests that less than half of the patients presenting within 4 hours of symptom onset receive rt-PA. The most common reason was minor or rapidly improving symptoms. A significant proportion of patients did not receive rt-PA because patient or family refused. Minority of patients had absolute contraindication. More patient and family education is needed to allay fears of rt-PA use.Disclosure: Dr. Lee has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Lahoti, S., Lee, J. Tags: Cerebrovascular Disease and Interventional Neurology: Issues in Acute Stroke Treatment Source Type: research

Ischemic Stroke in Evolution: Predictive Value of Perfusion Computed Tomography
Background: Various perfusion computed tomography (PCT) parameters have been used to identify tissue at risk of infarction in the setting of acute stroke. The purpose of this study was to examine predictive value of the PCT parameters commonly used in clinical practice to define ischemic penumbra. The patient selection criterion aimed to exclude the effect of thrombolysis from the imaging data.Methods: Consecutive acute stroke patients were screened and a total of 18 patients who initially underwent PCT and CT angiogram (CTA) on presentation but did not qualify to receive thrombolytic therapy were selected. The PCT images ...
Source: Journal of Stroke and Cerebrovascular Diseases - August 19, 2013 Category: Neurology Authors: Amir Kheradmand, Marc Fisher, David Paydarfar Tags: Original Articles Source Type: research

Platelet rich clots are resistant to lysis by thrombolytic therapy in a rat model of embolic stroke
Conclusions Site specific delivery of platelet rich clots to the MCA origin resulted in high rates of MCA occlusion, low rates of spontaneous clot lysis and large infarction. These platelet rich clots were highly resistant to tPA with or without microbubble-enhanced sonothrombolysis. This resistance of platelet rich clots to enhanced thrombolysis may explain recanalization failures clinically and should be an impetus to better clot-type identification and alternative recanalization methods.
Source: Experimental and Translational Stroke Medicine - January 27, 2015 Category: Neurology Source Type: research

Validity of Shape as a Predictive Biomarker of Final Infarct Volume in Acute Ischemic Stroke Clinical Sciences
Conclusions— Our findings suggest that lesion shape contains important predictive information and reflects important environmental factors that might determine the progression of ischemia from the core.
Source: Stroke - March 23, 2015 Category: Neurology Authors: Frindel, C., Rouanet, A., Giacalone, M., Cho, T.-H., Ostergaard, L., Fiehler, J., Pedraza, S., Baron, J.-C., Wiart, M., Berthezene, Y., Nighoghossian, N., Rousseau, D. Tags: Acute Cerebral Infarction, Brain Circulation and Metabolism Clinical Sciences Source Type: research

Perception Versus Actual Performance in Timely Tissue Plasminogen Activation Administration in the Management of Acute Ischemic Stroke Stroke
Conclusions Hospitals often overestimate their ability to deliver timely tPA to treated patients. Our findings indicate the need to routinely provide comparative provider performance rates as a key step to improving the quality of acute stroke care.
Source: JAHA:Journal of the American Heart Association - July 22, 2015 Category: Cardiology Authors: Lin, C. B., Cox, M., Olson, D. M., Britz, G. W., Constable, M., Fonarow, G. C., Schwamm, L., Peterson, E. D., Shah, B. R. Tags: Stroke Source Type: research

Rapidly improving neurological deficit of stroke; case series in Academic institute, KAUH, Jeddah (P4.283)
Conclusions:Rapidly improving patient represent a challenge to whether tPA should be given. However, the good outcome with thrombolytic therapy observed in our study, will hopfuly support the decision to treat.Study Supported by: nonDisclosure: Dr. khoja has nothing to disclose. Dr. Alshaer has nothing to disclose. Dr. al-Turkistani has nothing to disclose. Dr. Al-Mekhalfi has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: khoja, a., Al-Shaer, D., al-Turkistani, a., Al-Mekhalfi, M. Tags: Thrombolysis and Acute Evaluation in Ischemic Stroke Source Type: research

Thrombolytic Therapy of Acute Ischemic Stroke during Early Pregnancy
Thrombolytic treatment (recombinant tissue plasminogen activator [rt-PA]) has established efficacy in acute ischemic stroke, but pregnancy has been an exclusion criterion for all clinical trials that validated alteplase in acute stroke, so our knowledge about its use in this condition is limited.Herein we report the successful use of intravenous rt-PA thrombolysis, uncomplicated by neither hemorrhage development nor other complication in a woman who was 13 weeks pregnant with acute ischemic stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - November 28, 2017 Category: Neurology Authors: Anne Landais, Hugo Chaumont, Rachel Dellis Tags: Case Studies Source Type: research

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