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The potential role of micro-RNA 125b-5p level in predicting outcome from thrombolytic therapy in patients with acute ischemic stroke
AbstractSeveral studies highlighted a significant role of specific miRNA as diagnostic and prognostic biomarkers for acute ischemic stroke. The aim of this work was to study micro-RNA 125b-5p level in patients with acute ischemic stroke in relation to stroke etiology, risk factors, severity and outcome. This case –control study was conducted on 40 patients with acute ischemic stroke eligible for receiving rt-PA and 40 age and sex matched healthy controls, Patients were submitted to neurological and radiological assessment. Functional outcome after 3 months was assessed using the modified Rankin Scale (mRS ). Plasma micr...
Source: Journal of Thrombosis and Thrombolysis - June 8, 2023 Category: Hematology Source Type: research

Predictors and long-term outcome of intracranial hemorrhage after thrombolytic therapy for acute ischemic stroke —A prospective single-center study
DiscussionOlder age, higher NIHSS, large vessel occlusion, and intra-arterial thrombolysis may correlate with ICH. The unfavorable outcome is more common in patients with ICH. Precise scoring of post-thrombolysis bleeding might be a useful tool in the evaluation of the patient's prognosis. Our findings may help to identify predictors and estimate the prognosis of ICH in patients with AIS treated with rt-PA.
Source: Frontiers in Neurology - February 1, 2023 Category: Neurology Source Type: research

Stroke severity modified the effect of chronic atrial fibrillation on the outcome of thrombolytic therapy
This study was designed to identify high-risk patients with chronic AF who had undergone thrombolysis treatment and to explore whether the baseline National Institutes of Health Stroke Scale (NIHSS) could be used to distinguish poor clinical outcomes in thrombolyzed patients.
Source: Medicine - July 1, 2022 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Outcomes and risk factors of perforating and non-perforating middle cerebral artery infarctions after intravenous thrombolysis
AbstractThe clinical symptoms of perforating arteries differ, and responses to intravenous thrombolytic therapy are heterogeneous. Here, we investigated the effect of intravenous thrombolytic therapy and the related factors influencing acute perforating and non-perforating middle cerebral artery infarctions. We analyzed 320 patients with acute middle cerebral artery infarction who received alteplase thrombolysis within 4.5  h of onset at two stroke centers from January 2016 to December 2019. Outcome measures included rates of a favorable functional outcome (modified Rankin Scale scores of 0–2), distribution of modified ...
Source: Journal of Thrombosis and Thrombolysis - January 14, 2022 Category: Hematology Source Type: research

Prognostic value of red blood cell distribution width in predicting 3-month functional outcome of patients undergoing thrombolysis treatment for acute ischemic stroke
This study was performed to determine whether red blood cell distribution width (RDW) is associated with 3-month poor functional outcome in patients undergoing thrombolytic therapy for acute ischemic stroke. RDW was measured in patients with thrombolytic therapy in emergency department. Functional outcome was assessed after 3 months and poor functional outcome was defined as modified Rankin scale 3 to 6. A total of 240 patients were enrolled, and 82 (34.2%) had a poor functional outcome. The median RDW was significantly elevated in patients with a poor functional outcome compare with those with a good outcome. RDW ...
Source: Medicine - September 17, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Clinical-CT mismatch defined NIHSS ≥ 8 and CT-ASPECTS ≥ 9 as a reliable marker of candidacy for intravenous thrombolytic therapy in acute ischemic stroke
by Hung-Ming Wu, I-Hui Lee, Chao-Bao Luo, Chih-Ping Chung, Yung-Yang Lin BackgroundClinical-diffusion mismatch between stroke severity and diffusion-weighted imaging lesion volume seems to identify stroke patients with penumbra. However, urgent magnetic resonance imaging is sometimes inaccessible or contraindicated. Thus, we hypothesized that using brain computed tomography (CT) to determine a baseline “clinical-CT mismatch” may also predict the responses to thrombolytic therapy. MethodsBrain CT lesions were measured using the Alberta Stroke Program Early CT Score (ASPECTS). A total of 104 patients were included: 79 pa...
Source: PLoS One - April 30, 2021 Category: Biomedical Science Authors: Hung-Ming Wu Source Type: research

Nonatrial Fibrillation was Associated With Early Neurological Improvement After Intravenous Thrombolysis With rt-PA in Patients With Acute Ischemic Stroke
Background: Intravenous thrombolysis is the only approved pharmacological treatment for acute ischemic stroke (AIS) patients, but the immediate response to thrombolysis varies by patient. Objective: To investigate the factors associated with early neurological improvement (ENI) after the administration of intravenous recombinant tissue plasminogen activator (rt-PA) treatment to AIS patients within 4.5 hours of onset. Methods: Demographics, onset to treatment time, risk factors, and clinical and laboratory data of 209 AIS patients undergoing intravenous rt-PA therapy at a Chinese hospital between January 2013 and Au...
Source: The Neurologist - March 1, 2020 Category: Neurology Tags: Original Article Source Type: research

Acute Ischemic Stroke.
Authors: Rossi UG, Ierardi AM, Cariati M Abstract A 77-year-old woman with a history of hypertension developed acute onset of aphasia and right hemiplegia and hemisensory loss. She was urgently referred to emergency department. Cerebral multidetector computed tomographic angiography (MD-CTA) revealed an acute ischemic stroke due to the occlusion of the left middle cerebral artery (Figure 1). Since the symptoms started three hours previously, the patient was candidate for mechanical thrombectomy. The patient then performed a selective digital subtraction angiography (DSA) of the left internal carotid artery that con...
Source: Acta Neurologica Taiwanica - February 1, 2020 Category: Neurology Tags: Acta Neurol Taiwan Source Type: research

Effectiveness of emergency physician determinations of the need for thrombolytic therapy in acute stroke.
Abstract An increased emphasis on stroke care has led to a proliferation of specialized stroke teams despite relatively few trials demonstrating their efficacy. Our academic stroke center incorporated a unique setup allowing for the comparison between stroke teams and emergency physicians. During weekday working hours, a stroke team would respond to the emergency department for stroke activations. During all other times, the emergency physician caring for the patient would make all treatment decisions. We sought to determine whether there was any difference in treatment and outcomes between these two groups. We co...
Source: Baylor University Medical Center Proceedings - September 30, 2019 Category: Universities & Medical Training Authors: Juergens AL, Barney J, Julakanti M, Allen L, Shaver C Tags: Proc (Bayl Univ Med Cent) Source Type: research

Acute Ischemic Stroke in a Child Successfully Treated with Thrombolytic Therapy and Mechanical Thrombectomy
We present the case of a 4-year-old boy with complex congenital heart disease, admitted 30 min after sudden onset of an aphasia and right hemiplegia, scoring 14 on the Pediatric National Institutes of Health Stroke Scale (PedNIHSS). Non-contrast brain computed tomography (CT) showed no evidence of acute ischemia. CT angiogram demonstrated a thrombus in the M1 segment of the left middle cerebral artery. Intravenous recombinant tissue plasminogen activator (rTPA) was infused 3.5 h after onset of symptoms. An improvement was observed in the hour after rTPA, with a PedNIHSS score of 7. Digital subtraction angiography was perfo...
Source: Case Reports in Neurology - February 8, 2019 Category: Neurology Source Type: research

Thrombolytic Therapy in Severe Cardioembolic Stroke After Reversal of Dabigatran with Idarucizumab: Case Report and Literature Review
Whether idarucizumab, an antidote of dabigatran, can be used effectively and safely before thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) in patients with stroke undergoing treatment with dabigatran remains unknown. We herein describe a 57-year-old man who developed severe cardioembolic stroke with a National Institutes of Health Stroke Scale score of 22 in the left middle cerebral artery territory while undergoing treatment with dabigatran for nonvalvular atrial fibrillation and who was treated with rt-PA after the reversal of dabigatran with idarucizumab.
Source: Journal of Stroke and Cerebrovascular Diseases - March 16, 2018 Category: Neurology Authors: Yuichiro Ohya, Noriko Makihara, Kayo Wakisaka, Takao Morita, Tetsuro Ago, Takanari Kitazono, Hitonori Takaba Tags: Case Studies Source Type: research

Evaluation of the role of susceptibility-weighted imaging in thrombolytic therapy for acute ischemic stroke
Publication date: Available online 20 February 2017 Source:Journal of Clinical Neuroscience Author(s): Guangjian Zhao, Ling Sun, Ziran Wang, Liquan Wang, Zhongrong Cheng, Hongyan Lei, Daiqun Yang, Yansen Cui, Shirui Zhang We inspected low-intensity venous signals and microbleeds in patients with acute ischemic stroke (AIS) using susceptibility-weighted imaging (SWI) before and after administration of within-thrombolytic-time-window thrombolytic therapies, and observed their prognosis and safety, in order to guide individualized thrombolytic therapies. Patients with AIS were divided into groups A or B according to the pres...
Source: Journal of Clinical Neuroscience - February 20, 2017 Category: Neuroscience Source Type: research

MRI based thrombolysis for FLAIR-negative stroke patients within 4.5 –6h after symptom onset
To investigate the feasibility of DWI-FLAIR mismatch in identifying patients who might benefit from thrombolytic therapy within 4.5 –6h, we analyzed the data of 105 ischemic stroke patients with known time of symptom onset who underwent MRI within 6h of stroke and thrombolysis between December 2006 and December 2013. They were divided into three groups: symptom onset within 4.5h (n=66); 4.5–6h and FLAIR images negative (n=9) ; and 4.5–6h and FLAIR images positive (n=30). Outcome of thrombolysis was assessed for each group by recanalization rate, National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) scores.
Source: Journal of the Neurological Sciences - November 8, 2016 Category: Neurology Authors: Xiao-Er Wei, Jia Zhou, Wen-Bin Li, Yu-Wu Zhao, Ming-Hua Li, Yue-Hua Li Source Type: research

International benchmarking for acute thrombolytic therapy implementation in Australia and Japan
Publication date: July 2016 Source:Journal of Clinical Neuroscience, Volume 29 Author(s): Hiroyuki Kawano, Christopher Levi, Yuichiro Inatomi, Heather Pagram, Erin Kerr, Andrew Bivard, Neil Spratt, Ferdinand Miteff, Toshiro Yonehara, Yukio Ando, Mark Parsons Although a wide range of strategies have been established to improve intravenous tissue plasminogen activator (IV-tPA) treatment rates, international benchmarking has not been regularly used as a systems improvement tool. We compared acute stroke codes (ASC) between two hospitals in Australia and Japan to study the activation process and potentially improv...
Source: Journal of Clinical Neuroscience - May 29, 2016 Category: Neuroscience Source Type: research

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