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The Impact of Comprehensive Stroke Care Capacity on the Hospital Volume of Stroke Interventions: A Nationwide Study in Japan: J-ASPECT Study
We examined the effect of hospital characteristics, having a t-PA protocol, and the number of fulfilled CSC items (total CSC score) on the hospital volume of t-PA infusion, removal of intracerebral hemorrhage, and coiling and clipping of intracranial aneurysms performed in 2009.Results: Approximately 55% of hospitals responded to the survey. Facilities with t-PA protocols (85%) had a significantly higher likelihood of having 23 CSC items, for example, personnel (eg, neurosurgeons: 97.3% versus 66.1% and neurologists: 51.3% versus 27.7%), diagnostic (eg, digital cerebral angiography: 87.4% versus 43.2%), specific expertise...
Source: Journal of Stroke and Cerebrovascular Diseases - October 7, 2013 Category: Neurology Authors: Koji Iihara, Kunihiro Nishimura, Akiko Kada, Jyoji Nakagawara, Kazunori Toyoda, Kuniaki Ogasawara, Junichi Ono, Yoshiaki Shiokawa, Toru Aruga, Shigeru Miyachi, Izumi Nagata, Shinya Matsuda, Koichi B. Ishikawa, Akifumi Suzuki, Hisae Mori, Fumiaki Nakamura, Tags: Original Articles Source Type: research

Long-Term Follow-up of Incidental Intracranial Aneurysms in Patients with Acute Ischemic Stroke
Conclusions: In our study, the prevalence of incidental aneurysm among acute ischemic stroke patients was 6.1%. After 2 years of follow-up, there was no aneurysm rupture or subarachnoid hemorrhage, and the diameter and shape of aneurysms did not change except for 1 patient in whom the aneurysm disappeared.
Source: Journal of Stroke and Cerebrovascular Diseases - October 21, 2011 Category: Neurology Authors: Yoon-Sang Oh, Young-Min Shon, Beum Saeng Kim, A-Hyun Cho Tags: Original Articles Source Type: research

Safety of Intravenous Thrombolysis in Acute Ischemic Stroke Patients with Saccular Intracranial Aneurysms
Conclusions: Intravenous thrombolysis was safe among our patients with acute ischemic stroke and incidental intracranial saccular aneurysm.
Source: Journal of Stroke and Cerebrovascular Diseases - February 17, 2012 Category: Neurology Authors: Manoj K. Mittal, Raymond C.S. Seet, Yi Zhang, Robert D. Brown, Alejandro A. Rabinstein Tags: Original Articles Source Type: research

Intravenous Alteplase at 0.6 mg/kg for Acute Stroke Patients with Basilar Artery Occlusion: The Stroke Acute Management with Urgent Risk Factor Assessment and Improvement (SAMURAI) Recombinant Tissue Plasminogen Activator Registry
Conclusions: The use of low-dose alteplase resulted in similar outcomes when comparing acute BAO and MCO patients.
Source: Journal of Stroke and Cerebrovascular Diseases - October 12, 2012 Category: Neurology Authors: Tetsuya Miyagi, Masatoshi Koga, Yoshiaki Shiokawa, Jyoji Nakagawara, Yasuhiro Hasegawa, Eisuke Furui, Kazumi Kimura, Kazuomi Kario, Satoshi Okuda, Hiroshi Yamagami, Yasushi Okada, Tomohisa Nezu, Koichiro Maeda, Kaoru Endo, Kazuo Minematsu, Kazunori Toyoda Tags: Original Articles Source Type: research

Evaluating Middle Cerebral Artery Atherosclerotic Lesions in Acute Ischemic Stroke Using Magnetic Resonance T1-weighted 3-Dimensional Vessel Wall Imaging
Background: Atherosclerotic lesions in intracranial arteries are a leading cause of ischemic stroke. Magnetic resonance angiography (MRA) is often used to assess atherosclerotic changes by detecting luminal narrowing, whereas it cannot directly visualize atherosclerotic lesions. Here, we used a 3-dimensional vessel wall imaging (3D-VWI) technique to evaluate intracranial arterial wall changes in acute stroke.Methods: Eighteen consecutive patients with acute noncardioembolic stroke in the middle cerebral artery (MCA) territory who were prospectively examined with a 1.5-T magnetic resonance scanner were studied. T1-weighted ...
Source: Journal of Stroke and Cerebrovascular Diseases - July 22, 2013 Category: Neurology Authors: Tatsunori Natori, Makoto Sasaki, Mitsuharu Miyoshi, Hideki Ohba, Noriyuki Katsura, Mao Yamaguchi, Shinsuke Narumi, Hiroyuki Kabasawa, Kohsuke Kudo, Kenji Ito, Yasuo Terayama Tags: Original Articles Source Type: research

Diversity of Stroke Presentation in CADASIL: Study from Patients Harboring the Predominant NOTCH3 Mutation R544C
This study investigated the clinical stroke presentation and cranial magnetic resonance imaging (MRI) findings in a group of patients with CADASIL. We reviewed the clinical stroke presentation and brain MRI findings in 73 consecutive Korean patients aged>18 years diagnosed with CADASIL between May 2004 and April 2009. Brain MRI images were also scored for lacunar infarction and cerebral microbleeds. Intracranial atherosclerosis (ICAS) was assessed by magnetic resonance angiography. Disability was measured with the modified Rankin scale (mRS) and classified as good (mRS score 0-2) or poor (mRS score 3-5). In this study, 65 ...
Source: Journal of Stroke and Cerebrovascular Diseases - August 19, 2011 Category: Neurology Authors: Jay Chol Choi, Sook-Keun Song, Jung Seok Lee, Sa-Yoon Kang, Ji-Hoon Kang Tags: Original Articles Source Type: research

The Value of Whole-Brain Perfusion Parameters Combined with Multiphase Computed Tomography Angiography in Predicting Hemorrhagic Transformation in Ischemic Stroke
Objective: To explore the value of whole-brain perfusion parameters combined with multiphase computed tomography angiography (MP-CTA) in predicting the hemorrhagic transformation (HT) of ischemic stroke. Methods: A total of 64 patients with ischemic stroke who underwent noncontrast computed tomography, computed tomography perfusion imaging, and computed tomography angiography before treatment from August 2017 to June 2019 were included retrospectively. The perfusion parameters cerebral blood volume (CBV), cerebral blood flow (CBF), time to peak (TTP), mean transit time (MTT), time to maximum (Tmax), and permeability surfac...
Source: Journal of Stroke and Cerebrovascular Diseases - February 13, 2020 Category: Neurology Authors: Xiang Li, Huan Liu, Wenbing Zeng, Xinghua Liu, Yun Wen, Qiuxia Xiong, Ran Yang Source Type: research

CT Perfusion Maps Improve Detection of M2-MCA Occlusions in Acute Ischemic Stroke
A growing body of literature supports mechanical thrombectomy-based endovascular therapy for M2-MCA occlusions in eligible patients with acute ischemic stroke (AIS).1 –5 This is because endovascular treatment for M2-MCA occlusions is technically feasible and leads to improved patient outcomes, despite a potential increased risk of hemorrhage.4,5 Not uncommonly, these patients undergo a single or multi-phase CT angiogram (CTA) study for LVO detection. In patient s who present in the late stroke window (6–24 h since last known normal), the CT Perfusion (CTP) study is generally performed along with a CTA study to aid in patient triage.
Source: Journal of Stroke and Cerebrovascular Diseases - April 14, 2022 Category: Neurology Authors: Girish Bathla, Ravishankar Pillenahalli Maheshwarappa, Neetu Soni, Minako Hayakawa, Sarv Priya, Edgar Samaniego, Santiago Ortega-Gutierrez, Colin P. Derdeyn Source Type: research

Intravenous Tissue Plasminogen Activator Therapy for an Acute Ischemic Stroke Patient with Later Diagnosed Unilateral Moyamoya Syndrome
We report the use of intravenous tissue plasminogen activator (t-PA) therapy in a 38-year-old patient who was later diagnosed with unilateral moyamoya syndrome. The patient had a sudden onset of unconsciousness, vomiting, dysarthria, and tetraparesis. A neurologic examination revealed consciousness disturbance, right central facial nerve palsy, dysarthria, and tetraparesis with bilateral exotropia and horizontal gaze palsy. A magnetic resonance imaging scan on admission did not reveal fresh cerebral infarction or hemorrhage, but magnetic resonance angiography revealed severe stenosis at the terminal portion of left interna...
Source: Journal of Stroke and Cerebrovascular Diseases - July 26, 2012 Category: Neurology Authors: Shota Yokoyama, Yasuhiro Manabe, Daiki Fujii, Yasuko Ikeda-Sakai, Hisashi Narai, Nobuhiko Omori, Koji Abe Tags: Case Reports Source Type: research

Demographic and Clinical Predictors of Leptomeningeal Collaterals in Stroke Patients
Background: Leptomeningeal collaterals improve outcome after stroke, including reduction of hemorrhagic complications after thrombolytic or endovascular therapy, smaller infarct size, and reduction in symptoms at follow-up evaluation. The purpose of this study was to determine the demographic and clinical variables that are associated with a greater degree of cerebral collaterals.Methods: Clinical data of patients presenting with M1 occlusions of the middle cerebral artery (MCA) and associated computed tomography angiography studies after admission from 3 separate institutions were retrospectively compiled (n = 82). Occl...
Source: Journal of Stroke and Cerebrovascular Diseases - August 4, 2014 Category: Neurology Authors: Nitin Malik, Qinghua Hou, Achala Vagal, James Patrie, Wenjun Xin, Patrik Michel, Ashraf Eskandari, Tudor Jovin, Max Wintermark Tags: Original Articles Source Type: research

Angiographic Blush after Mechanical Thrombectomy is Associated with Hemorrhagic Transformation of Ischemic Stroke
Risk factors for hemorrhagic transformation of ischemic stroke after mechanical thrombectomy (MT) are not well established. We conducted a study to determine if prominent angiographic cerebral vascularity following recanalization with thrombectomy (angiographic blush) is associated with hemorrhagic transformation.
Source: Journal of Stroke and Cerebrovascular Diseases - August 6, 2018 Category: Neurology Authors: Setareh Salehi Omran, Srikanth Reddy Boddu, Aaron M. Gusdon, Benjamin Kummer, Hediyeh Baradaran, Praneil Patel, Iv án Díaz, Babak B. Navi, Ajay Gupta, Hooman Kamel, Athos Patsalides Source Type: research

Isolated Cortical Vein Thrombosis Associated with Prothrombin Gene Mutation
We report a 47-year-old female patient who had a frontal hemorrhage with headache associated with contralateral hemiparesis and hemisensory deficit on presentation. This hemorrhagic stroke was localized in a nonarterial territory, and it was caused by ipsilateral and isolated thrombosis of the vein of Labbe found on catheter angiogram that demonstrated a filling defect of the vein of Labbe at its connection with the transverse sinus. There were no filling defects in the superficial middle cerebral veins. Our patient had a family history of cardiovascular disease, stroke, and factor V Leiden mutation and cigarette smoking a...
Source: Journal of Stroke and Cerebrovascular Diseases - July 8, 2013 Category: Neurology Authors: Elias A. Giraldo, Rohan Arora, Robert A. Koenigsberg Tags: Case Reports Source Type: research

Intracerebral Hemorrhage Associated with Oral Phenylephrine Use: A Case Report and Review of the Literature
Conclusions: It is scientifically plausible that phenylephrine may cause strokes, consistent with the pharmacologic properties and adverse event profiles of similar amphetamine-like sympathomimetics. As RCVS has been well described in association with over-the-counter sympathomimetics, a likely, although not definitive, causal relationship between phenylephrine and ICH is proposed.
Source: Journal of Stroke and Cerebrovascular Diseases - August 25, 2014 Category: Neurology Authors: Brian E. Tark, Steven R. Messe, Clotilde Balucani, Steven R. Levine Tags: Original Articles Source Type: research

Detection of Vessel Wall Lesions in Spontaneous Symptomatic Vertebrobasilar Artery Dissection Using T1-weighted 3-dimensional Imaging
Conclusions: The T1W 3D-VWI can directly visualize vessel wall iVBD lesions during the acute period of stroke compared with multisequence MRI.
Source: Journal of Stroke and Cerebrovascular Diseases - August 29, 2014 Category: Neurology Authors: Tatsunori Natori, Makoto Sasaki, Mitsuharu Miyoshi, Hideki Ohba, Mao Yamaguchi Oura, Shinsuke Narumi, Taisuke Harada, Hiroyuki Kabasawa, Yasuo Terayama Tags: Original Articles Source Type: research

Large Amount of Cannabis Ingestion Resulting in Spontaneous Intracerebral Hemorrhage: A Case Report
Although multiple cases of cannabis-associated ischemic stroke have been reported, there are only 2 reported cases of hemorrhagic stroke with an associated cerebral vasoconstriction. To our knowledge, we present the first case of basal ganglia hemorrhage after a large-volume oral ingestion of cannabis without other identified risk factors. In our case, cerebral digital subtraction angiography within 24 hours of presentation did not reveal vasoconstriction leading to a possible alternative explanation for hemorrhagic stroke, including cannabis-induced transient arterial hypertension and autoregulation disruption.
Source: Journal of Stroke and Cerebrovascular Diseases - May 15, 2017 Category: Neurology Authors: Kunakorn Atchaneeyasakul, Luis F. Torres, Amer M. Malik Tags: Case Studies Source Type: research

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