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Source: Stroke
Condition: Hemorrhagic Stroke
Therapy: Thrombolytic Therapy

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Total 21 results found since Jan 2013.

Low Levels of Caveolin-1 Predict Symptomatic Bleeding After Thrombolytic Therapy in Patients With Acute Ischemic Stroke Brief Report
Background and Purpose—Experimental models of cerebral ischemia demonstrate that the decrease in the caveolin-1 membrane protein results in an increase in endothelial permeability. Because this phenomenon is responsible for hemorrhagic transformation (HT) after cerebral ischemia, we aimed to determine whether caveolin-1 levels may predict bleeding after recombinant tissue-type plasminogen activator (r-tPA) administration in patients with acute stroke.Methods—We studied 133 patients with a first hemispheric stroke treated with r-tPA within 4.5 hours of symptom onset. HT was evaluated and classified on cranial computed t...
Source: Stroke - May 25, 2018 Category: Neurology Authors: Mar Castellanos, Cecile van Eendenburg, Carme Gubern, Elisabet Kadar, Gemma Huguet, Josep Puig, Tomas Sobrino, Gerard Blasco, Joaquin Serena, Juan Manuel Sanchez Tags: Biomarkers, Endothelium/Vascular Type/Nitric Oxide, Blood-Brain Barrier, Ischemic Stroke Brief Reports 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

Coexistent Sickle Cell Disease Has No Impact on the Safety or Outcome of Lytic Therapy in Acute Ischemic Stroke Clinical Sciences
Conclusions—Coexistent SCD had no significant impact on the safety or outcome of thrombolytic therapy in acute ischemic stroke. Although the sample size is relatively small, these data suggest that adults with SCD and acute ischemic stroke should be treated with thrombolysis, if they otherwise qualify. Addition studies, however, should track the intracranial hemorrhage rate and provide information on other SCD-related care such as transfusion.
Source: Stroke - February 26, 2017 Category: Neurology Authors: Robert J. Adams, Margueritte Cox, Shelly D. Ozark, Julie Kanter, Phillip J. Schulte, Ying Xian, Gregg C. Fonarow, Eric E. Smith, Lee H. Schwamm Tags: Ischemic Stroke, Transient Ischemic Attack (TIA) Original Contributions Source Type: research

Intravenous Thrombolysis in Unknown-Onset Stroke Clinical Sciences
Conclusions—Our data suggest no excess risk of symptomatic intracerebral hemorrhage but increased mortality and reduced favorable outcome in patients with UKO stroke compared with patients treated within the approved time window.
Source: Stroke - February 26, 2017 Category: Neurology Authors: Laura Dorado, Niaz Ahmed, Gotz Thomalla, Manuel Lozano, Branko Maloȷcic, Mushtaq Wani, Monica Millan, Ales Tomek, Antoni Davalos Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research

Identification of Reversible Disruption of the Human Blood-Brain Barrier Following Acute Ischemia Brief Reports
Conclusions— This study demonstrates that diffuse, mild BBB disruption in the acutely ischemic human brain is reversible with reperfusion. This study also confirms prior findings that focal severe BBB disruption confers an increased risk of hemorrhagic transformation in patients treated with intravenous tissue-type plasminogen activator.
Source: Stroke - August 21, 2016 Category: Neurology Authors: Simpkins, A. N., Dias, C., Leigh, R., on behalf of the National Institutes of Health Natural History of Stroke Investigators, Benson, Hsia, Latour, Luby, Lynch, Merino, Nadareishvili, Warach Tags: Magnetic Resonance Imaging (MRI), Blood-Brain Barrier, Intracranial Hemorrhage, Ischemic Stroke Brief Reports Source Type: research

Prognostic Significance of Short-Term Blood Pressure Variability in Acute Stroke: Systematic Review Clinical Sciences
Conclusions— This systematic review and meta-analysis suggest that greater systolic BPV, measured early from ischemic stroke or intracerebral hemorrhage onset, is associated with poor longer-term functional outcome. Future prospective studies should investigate how best to measure and define BPV in acute stroke, as well as to determine its prognostic significance.
Source: Stroke - August 24, 2015 Category: Neurology Authors: Manning, L. S., Rothwell, P. M., Potter, J. F., Robinson, T. G. Tags: Cerebrovascular disease/stroke, Acute Cerebral Hemorrhage, Acute Cerebral Infarction, Acute Stroke Syndromes Clinical Sciences Source Type: research

Drip and Ship Thrombolytic Therapy for Acute Ischemic Stroke: Use, Temporal Trends, and Outcomes Clinical Sciences
Conclusions— Drip and ship tPA is common, used in 1 in 4 patients treated with tPA in the United States. Modest differences in mortality and symptomatic intracranial hemorrhage may be because of patient selection bias, post-tPA care differences, or unmeasured confounding. The drip and ship paradigm may facilitate widespread tPA use in patients with acute stroke.
Source: Stroke - February 23, 2015 Category: Neurology Authors: Sheth, K. N., Smith, E. E., Grau-Sepulveda, M. V., Kleindorfer, D., Fonarow, G. C., Schwamm, L. H. Tags: Acute Cerebral Infarction, Acute Stroke Syndromes, Embolic stroke, Emergency treatment of Stroke, Thrombolysis Clinical Sciences Source Type: research

Letter by Turc et al Regarding Article, "Defining Clinically Relevant Cerebral Hemorrhage After Thrombolytic Therapy for Stroke: Analysis of the National Institute of Neurological Disorders and Stroke Tissue-Type Plasminogen Activator Trials" Letters to the Editor
Source: Stroke - January 26, 2015 Category: Neurology Authors: Turc, G., Tisserand, M., Seners, P., Oppenheim, C., Baron, J.-C. Tags: Thrombolysis Letters to the Editor Source Type: research

Response to Letter Regarding Article, "Defining Clinically Relevant Cerebral Hemorrhage After Thrombolytic Therapy for Stroke: Analysis of the National Institute of Neurological Disorders and Stroke Tissue-Type Plasminogen Activator Trials" Letters to the Editor
Source: Stroke - January 26, 2015 Category: Neurology Authors: Rao, N. M., Levine, S. R., Saver, J. L. Tags: Acute Cerebral Hemorrhage, Acute Cerebral Infarction, Emergency treatment of Stroke, Intracerebral Hemorrhage, Thrombolysis Letters to the Editor Source Type: research

Impact of Living Alone on the Care and Outcomes of Patients With Acute Stroke Brief Reports
Conclusions— Patients living alone had delayed hospital arrival, less thrombolytic therapy, and were less likely to return home. Greater understanding of the inter-relationships among living alone, social isolation, access to stroke care, and outcomes is needed.
Source: Stroke - September 22, 2014 Category: Neurology Authors: Reeves, M. J., Prager, M., Fang, J., Stamplecoski, M., Kapral, M. K. Tags: Acute Stroke Syndromes Brief Reports Source Type: research

Thrombolysis in Ischemic Stroke Without Arterial Occlusion at Presentation Clinical Sciences
Conclusions— This study provides crucial data that patients with ischemic stroke who do not have visible arterial occlusion at presentation may benefit from thrombolysis.
Source: Stroke - August 25, 2014 Category: Neurology Authors: Lahoti, S., Gokhale, S., Caplan, L., Michel, P., Samson, Y., Rosso, C., Limaye, K., Hinduja, A., Singhal, A., Ali, S., Pettigrew, L. C., Kryscio, R., Dedhia, N., Hastak, S., Liebeskind, D. S. Tags: Cerebral Lacunes, Embolic stroke, Computerized tomography and Magnetic Resonance Imaging, Pathology of Stroke, Thrombolysis Clinical Sciences Source Type: research

Defining Clinically Relevant Cerebral Hemorrhage After Thrombolytic Therapy for Stroke: Analysis of the National Institute of Neurological Disorders and Stroke Tissue-Type Plasminogen Activator Trials Clinical Sciences
Conclusions— The ECASS2 and mSITS-MOST symptomatic intracerebral hemorrhage definitions, which combine radiological features and occurrence of substantial early neurological deterioration, best identify tPA hemorrhages that alter final patient outcome.
Source: Stroke - August 25, 2014 Category: Neurology Authors: Rao, N. M., Levine, S. R., Gornbein, J. A., Saver, J. L. Tags: Acute Cerebral Infarction, Emergency treatment of Stroke, Intracerebral Hemorrhage, Thrombolysis Clinical Sciences Source Type: research

Race/Ethnic Differences in the Risk of Hemorrhagic Complications Among Patients With Ischemic Stroke Receiving Thrombolytic Therapy Clinical Sciences
Conclusions— In patients with stroke receiving tPA, hemorrhagic complications were slightly higher in blacks and Asians, but not in Hispanics compared with whites. Asians also faced significantly higher risk for sICH relative to other race/ethnic groups. Future studies are needed to evaluate whether reduction in tPA dose similar to that used in many Asian countries could improve the safety of tPA therapy in Asians in the United States with acute ischemic strokes while maintaining efficacy.
Source: Stroke - July 28, 2014 Category: Neurology Authors: Mehta, R. H., Cox, M., Smith, E. E., Xian, Y., Bhatt, D. L., Fonarow, G. C., Peterson, E. D., for the Get With The Guidelines-Stroke Program Tags: Thrombolysis Clinical Sciences Source Type: research

Different Doses of Recombinant Tissue-Type Plasminogen Activator for Acute Stroke in Chinese Patients Clinical Sciences
Conclusions— These results did not support the dose of 0.9 mg/kg of r-tPA being optimal for all patients in the East Asian population. In elderly patients (71–80 years), a lower dose of 0.6 mg/kg is associated with a better outcome. Confirmation of the results through randomized trial is required.
Source: Stroke - July 28, 2014 Category: Neurology Authors: Chao, A.-C., Liu, C.-K., Chen, C.-H., Lin, H.-J., Liu, C.-H., Jeng, J.-S., Hu, C.-J., Chung, C.-P., Hsu, H.-Y., Sheng, W.-Y., Hu, H.-H., on behalf of the Taiwan Thrombolytic Therapy for Acute Ischemic Stroke (TTT-AIS) Study Group Tags: Thrombolysis Clinical Sciences Source Type: research

Totaled Health Risks in Vascular Events Score Predicts Clinical Outcomes in Patients With Cardioembolic and Other Subtypes of Ischemic Stroke Clinical Sciences
Conclusions— The THRIVE score is a simple tool that helps clinicians estimate good outcome and death after ischemic stroke.
Source: Stroke - May 27, 2014 Category: Neurology Authors: Lei, C., Wu, B., Liu, M., Chen, Y., Yang, H., Wang, D., Lin, S., Hao, Z. Tags: Acute Cerebral Infarction Clinical Sciences Source Type: research