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Reperfusion after 4·5 hours reduces infarct growth and improves clinical outcomes
ConclusionsThrombolysis 4·5–6 h after stroke onset reduced infarct growth and increased the rate of reperfusion, which was associated with good neurological and functional outcome.
Source: International Journal of Stroke - November 21, 2013 Category: Neurology Authors: Miguel R. Picanço, Søren Christensen, Bruce C. V. Campbell, Leonid Churilov, Mark W. Parsons, Patricia M. Desmond, P. Alan Barber, Christopher R. Levi, Christopher F. Bladin, Geoffrey A. Donnan, Stephen M. Davis, Tags: Research Source Type: research

Profile of Patients with Cerebral Venous Sinus Thrombosis with Cerebellar Involvement
Conclusions: Cerebellar involvement in CVT is very rare, and high index of suspicion is required for diagnosis. Imaging with CT and MRI will help in confirming the diagnosis. Conventional anticoagulation is effective in treatment. Mortality was 33%, and there was no disability in survivors.
Source: Journal of Stroke and Cerebrovascular Diseases - November 14, 2013 Category: Neurology Authors: Girish B. Kulkarni, Veerendrakumar Mustare, Mirza M. Abbas Tags: Original Articles Source Type: research

Clot composition and treatment approach to acute ischemic stroke: The road so far
We present a review of recent studies on the histopathologic analysis of thrombi, studies of MRI, and CT imaging correlation with thrombus histology, and detailed structural analysis of thromboemboli retrieved by thrombectomy devices during an acute ischemic stroke.
Source: Annals of Indian Academy of Neurology - October 25, 2013 Category: Neurology Authors: Paramdeep SinghRupinderjeet KaurAmarpreet Kaur Source Type: research

Good Outcome Rate of 35% in IV-tPA-Treated Patients With Computed Tomography Angiography Confirmed Severe Anterior Circulation Occlusive Stroke Clinical Sciences
Conclusions— IV-tPA treatment resulted in significantly better outcomes in patients with severely symptomatic stroke with major anterior circulation occlusions. The 35% good outcome rate was similar to rates found in endovascular therapy trials. Vascular imaging may help in patient selection and stratification for trials of IV-thrombolytic and endovascular therapies.
Source: Stroke - October 21, 2013 Category: Neurology Authors: Gonzalez, R. G., Furie, K. L., Goldmacher, G. V., Smith, W. S., Kamalian, S., Payabvash, S., Harris, G. J., Halpern, E. F., Koroshetz, W. J., Camargo, E. C. S., Dillon, W. P., Lev, M. H. Tags: CT and MRI, Acute Cerebral Infarction, Computerized tomography and Magnetic Resonance Imaging, Thrombolysis, Other Stroke Treatment - Surgical Clinical Sciences Source Type: research

Thrombolytic Therapy Is an Only Determinant Factor for Stroke Evolution in Large Anterior Choroidal Artery Infarcts
Conclusions: Thrombolytic therapy is an only determinant factor for stroke evolution in large AChA infarcts, which reduced the risk of stroke evolution and improved functional outcome.
Source: Journal of Stroke and Cerebrovascular Diseases - October 16, 2013 Category: Neurology Authors: Meng-Chen Wu, Li-Kai Tsai, Chung-Chu Wu, Shin-Joe Yeh, Sung-Chun Tang, Yun-Ju Chen, Chien-Lin Chen, Jiann-Shing Jeng Tags: Original Articles Source Type: research

Translational perspectives on perfusion–diffusion mismatch in ischemic stroke
Magnetic resonance imaging has tremendous potential to illuminate ischemic stroke pathophysiology and guide rational treatment decisions. Clinical applications to date have been largely limited to trials. However, recent analyses of the major clinical studies have led to refinements in selection criteria and improved understanding of the potential implications for the risk vs. benefit of thrombolytic therapy. In parallel, preclinical studies have provided complementary information on the evolution of stroke that is difficult to obtain in humans due to the requirement for continuous or repeated imaging and pathological veri...
Source: International Journal of Stroke - October 1, 2013 Category: Neurology Authors: Bruce C. V. Campbell, I. Mhairi Macrae Tags: Review 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

Cerebral Infarction in a Case of Parry-Romberg Syndrome
Our objective is to report a rare coexistence of Parry-Romberg disease and ischemic stroke. Here, we report the case of a 34-year-old woman with Parry-Romberg syndrome who developed cerebral infarction. This patient developed sudden left-sided weakness and was admitted to our hospital. Magnetic resonance imaging revealed acute cerebral infarction in the posterior limb of the right internal capsule. The patient had been diagnosed with Parry-Romberg syndrome at the age of 12, and she had a history of migraine without aura. Transesophageal echocardiography revealed a patent foramen ovale, but no atrial septal aneurysm or deep...
Source: Journal of Stroke and Cerebrovascular Diseases - May 9, 2013 Category: Neurology Authors: Yuji Tomizawa, Ryota Tanaka, Kiyoshi Sekiguchi, Yutaka Oji, Yasutaka Tanaka, Kazuo Yamashiro, Nobutaka Hattori Tags: Case Reports Source Type: research

Evaluation of plasma d‐dimer plus fibrinogen in predicting acute CVST
Conclusionsd‐dimer may serve as an important screening tool to determine the urgency of obtaining magnetic resonance imaging/magnetic resonance venography or digital subtraction angiography in patients presenting with clinical symptoms that are suspected of cerebral venous sinus thrombosis. Furthermore, d‐dimer in combination with fibrinogen may increase the predictive value of acute cerebral venous sinus thrombosis.
Source: International Journal of Stroke - March 19, 2013 Category: Neurology Authors: Ran Meng, Xiaoying Wang, Mohammed Hussain, David Dornbos, Lu Meng, Yu Liu, Yan Wu, Mingming Ning, Buonanno Ferdinando S, Eng H. Lo, Yuchuan Ding, Xunming Ji Tags: Research Source Type: research

Worse stroke outcome in atrial fibrillation is explained by more severe hypoperfusion, infarct growth, and hemorrhagic transformation
ConclusionAtrial fibrillation is associated with greater volumes of more severe baseline hypoperfusion, leading to higher infarct growth, more frequent severe hemorrhagic transformation and worse stroke outcomes.
Source: International Journal of Stroke - March 12, 2013 Category: Neurology Authors: Hans T. H. Tu, Bruce C. V. Campbell, Soren Christensen, Patricia M. Desmond, Deidre A. De Silva, Mark W. Parsons, Leonid Churilov, Maarten G. Lansberg, Michael Mlynash, Jean‐Marc Olivot, Matus Straka, Roland Bammer, Gregory W. Albers, Geoffrey A. Donnan Tags: Research Source Type: research

Smoking-Thrombolysis Paradox: Recanalization and Reperfusion Rates After Intravenous Tissue Plasminogen Activator in Smokers With Ischemic Stroke Original Contributions
Conclusions— Smoking is independently associated with recanalization and reperfusion, indicating that thrombolytic therapy acts more effectively in smokers; because of small numbers, these results should be considered preliminary. Clinical Trial Registration— URL: http://clinicaltrials.gov. Unique Identifier: NCT00715533.
Source: Stroke - January 18, 2013 Category: Neurology Authors: Kufner, A., Nolte, C. H., Galinovic, I., Brunecker, P., Kufner, G. M., Endres, M., Fiebach, J. B., Ebinger, M. Tags: Fibrinolysis, Angiography, Computerized tomography and Magnetic Resonance Imaging, Risk Factors for Stroke, Thrombolysis Original Contributions Source Type: research

Thrombosis of a Developmental Venous Anomaly in Inflammatory Bowel Disease: Case Report and Radiologic Follow-up
We describe the clinical and neuroradiologic follow-up of a 62-year-old man with a history of inflammatory bowel disease (IBD) presenting with new onset epilepsy and intracranial hemorrhage caused by thrombosis of a DVA who fully recovered after treatment with oral anticoagulant therapy. Patients with IBD have an increased risk of thrombosis because of inflammatory activity and the hypercoagulable state. Here we describe the first case of DVA thrombosis in a patient with IBD, and we show clinical and neuroradiologic follow-up after anticoagulant therapy.
Source: Journal of Stroke and Cerebrovascular Diseases - January 3, 2013 Category: Neurology Authors: Fabio Pilato, Rosalinda Calandrelli, Simona Gaudino, Paolo Profice, Matia Martucci, Giuseppe Esposito, Cesare Colosimo, Vincenzo Di Lazzaro Tags: Case Reports Source Type: research

Density of Thrombus on Admission CT Predicts Revascularization Efficacy in Large Vessel Occlusion Acute Ischemic Stroke Brief Reports
Conclusions— Thrombi with lower HU on NECT appear to be more resistant to pharmacological lysis and mechanical thrombectomy. Measuring thrombus density on admission NECT provides a rapid method to analyze clot composition, a potentially useful discriminator in selecting the most appropriate reperfusion strategy for an individual patient.
Source: Stroke - December 24, 2012 Category: Neurology Authors: Moftakhar, P., English, J. D., Cooke, D. L., Kim, W. T., Stout, C., Smith, W. S., Dowd, C. F., Higashida, R. T., Halbach, V. V., Hetts, S. W. Tags: Acute Cerebral Infarction, Angiography, Computerized tomography and Magnetic Resonance Imaging Brief Reports Source Type: research

Safety and Effectiveness of Endovascular Treatment after 6 Hours of Symptom Onset in Patients with Anterior Circulation Ischemic Stroke: A Matched Case Control Study
Conclusions: We did not observe any evidence of benefit in halting neurologic worsening or improving outcomes among patients undergoing endovascular treatment for treatment of an anterior circulation ischemic stroke after 6 hours of symptom onset. Strong evidence of both the safety and efficacy of emergent endovascular treatment when administered to patients with stroke in the anterior circulation is needed.
Source: Journal of Stroke and Cerebrovascular Diseases - October 24, 2012 Category: Neurology Authors: Adnan I. Qureshi, Jefferson T. Miley, Saqib A. Chaudhry, Edouard Semaan, Gustavo J. Rodriguez, M.Fareed K. Suri, Harold P. Adams Tags: Original Articles Source Type: research

Clinical and Radiological Management and Outcome of Pregnancies Complicated by Cerebral Venous Thrombosis: A Review of 19 Cases
Conclusions: If magnetic resonance imaging is available, it should be used for the detection of CVT in all pregnant patients instead of computed tomography. Patients with parenchymal lesions, thrombophilia, and antiphospholipid syndrome had a greater risk of being left with neurologic sequelae. For pregnant patients with CVT, low molecular weight heparin in full anticoagulant doses should be continued throughout the pregnancy. Anticoagulant therapy did not appear to predispose patients to further intracranial hemorrhage.
Source: Journal of Stroke and Cerebrovascular Diseases - August 17, 2012 Category: Neurology Authors: Caner Feyzi Demir, Mehmet Fatih İnci, Fuat Özkan, Mustafa Yıldız, Hasan Özdemir Tags: Original Articles Source Type: research

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