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Depressive symptoms in stroke patients treated and non-treated with intravenous thrombolytic therapy: a 1-year follow-up study
Conclusions(1) Thrombolysed and non-thrombolysed stroke survivors had similar frequency of depressive symptoms although the thrombolysed patients had more severe neurological deficits in the acute phase. It can be assumed that if thrombolysis had not been used, depressive symptoms would have been more frequent. (2) Lack of the rt-PA treatment was associated with three-time greater odds of screening for PSD at 3  months post-stroke, after adjustment for other PSD correlates. (3) Therefore, thrombolytic therapy seems to have a positive, but indirect, effect on patients’ mood, especially in the first months after stroke. (...
Source: Journal of Neurology - June 18, 2018 Category: Neurology Source Type: research

Applications of Liposomal Drug Delivery Systems to Develop Neuroprotective Agents for the Treatment of Ischemic Stroke.
Abstract Ischemic stroke is one of the leading causes of severe disability and death. In clinical settings, tissue plasminogen activator (t-PA) for thrombolytic therapy is the only globally approved drug for the treatment of ischemic stroke. However, the proportion of patients who receive t-PA therapy is extremely limited due to its narrow therapeutic time window (TTW) and the risk of cerebral hemorrhage. Cerebral ischemia-reperfusion (I/R) injury is also a serious problem for patients' outcomes. Hence, the development of more effective therapies has been desired to prolong the TTW of t-PA and prevent cerebral I/R...
Source: Biological and Pharmaceutical Bulletin - March 6, 2019 Category: Drugs & Pharmacology Authors: Fukuta T, Ishii T, Asai T, Oku N Tags: Biol Pharm Bull Source Type: research

Association of Neutrophil-to-Lymphocyte Ratio and Lymphocyte-to-Monocyte Ratio with Treatment Modalities of Acute Ischaemic Stroke: A Pilot Study.
Conclusions: The main finding of this pilot study was that NLR in IS patients treated using thrombectomy following thrombolysis was markedly higher than that in other treatment groups, which was associated with increased severity of the disease in these patients. Therefore, patients with higher NLR may be expected to have more severe stroke. The link between stroke severity and NLR deserves further study. PMID: 31284487 [PubMed - in process]
Source: Medicina (Kaunas) - July 4, 2019 Category: Universities & Medical Training Authors: Świtońska M, Słomka A, Korbal P, Piekuś-Słomka N, Sinkiewicz W, Sokal P, Żekanowska E Tags: Medicina (Kaunas) Source Type: research

Acute Ischemic Stroke With Mild Symptoms –To Thrombolyse or Not to Thrombolyse?
The objective of this review is to evaluate the current literature and evidence regarding the management of minor stroke, with a particular emphasis on the role of IV thrombolysis. Definition of minor stroke, pre-hospital recognition of minor stroke and stroke of unknown onset are discussed together with neuroimaging aspects and existing evidence for IV thrombolysis in minor strokes. Though current guidelines advise against the use of thrombolysis in those without clearly disabling symptoms due to a paucity of evidence, advanced imaging techniques may be able to identify those likely to benefit. Further research on this topic is ongoing.
Source: Frontiers in Neurology - November 18, 2021 Category: Neurology Source Type: research

Thrombolytic Agents for Acute Ischaemic Stroke Treatment: the Past, Present and Future.
Abstract Despite advances in the diagnosis and treatment of acute ischaemic stroke in the past two decades, stroke has remained the third cause of mortality and the single leading cause of disability worldwide. The immediate goal of acute ischaemic stroke therapy is to salvage the ischaemic penumbra through recanalisation of the occluded cerebral blood vessel. This is currently achieved through thrombolytics, which are pharmacological agents that can break up a clot blocking the flow of blood. To date, the only approved thrombolytic for treatment of acute ischaemic stroke is recombinant tissue plasminogen activato...
Source: CNS and Neurological Disorders Drug Targets - February 4, 2013 Category: Drugs & Pharmacology Authors: Balami JS, Chen R, Sutherland BA, Buchan AM Tags: CNS Neurol Disord Drug Targets Source Type: research

Routine serum C‐reactive protein and stroke outcome after intravenous thrombolysis
ConclusionsAccording to our findings, elevated routine serum CRP measured within 24 h after admission does not seem to independently affect the outcome in patients receiving intravenous thrombolysis for stroke. However, further studies of blood samples taken directly before the treatment are needed.
Source: Acta Neurologica Scandinavica - February 20, 2014 Category: Neurology Authors: M. Karlinski, J. Bembenek, K. Grabska, A. Kobayashi, A. Baranowska, T. Litwin, A. Czlonkowska Tags: Original Article Source Type: research

Thrombolysis ImPlementation in Stroke (TIPS): evaluating the effectiveness of a strategy to increase the adoption of best evidence practice - protocol for a cluster randomised controlled trial in acute stroke care
DiscussionTIPS will trial a comprehensive, multi-component and multidisciplinary collaborative approach to improving thrombolysis rates at multiple sites. The trial has the potential to identify methods for optimal care which can be implemented for stroke patients during the acute phase. Study findings will include barriers and solutions to effective thrombolysis implementation and trial outcomes will be published whether significant or not.Trial registration: Australian New Zealand Clinical Trials Registry: ACTRN12613000939796
Source: Implementation Science - March 25, 2014 Category: Health Management Authors: Christine PaulChristopher LeviCatherine D¿EsteMark ParsonsChristopher BladinRichard LindleyJohn AttiaFrans HenskensErin LalorMark LongworthSandy MiddletonAnnika RyanErin KerrRobert Sanson-Fisher Source Type: research

Improvement in Rates of Thrombolytic Therapy in Acute Stroke by a Telestroke Program in Rural Northern Wisconsin (P1.011)
Conclusion: Following development of a Telestroke program in northern Wisconsin, rural stroke patients benefited from dramatic increases in access to neurological expertise and acute thrombolytic treatment. Patients and providers have embraced the program with plans to expand Telestroke to other remote access hospitals.Disclosure: Dr. Kartje has nothing to disclose. Dr. Klemm has nothing to disclose. Dr. Heil has nothing to disclose. Dr. Antoniotti has nothing to disclose. Dr. Martin has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Kartje, R., Klemm, S., Heil, L., Antoniotti, N., Martin, T. Tags: Cerebrovascular Disease and Interventional Neurology I ePosters Source Type: research

Combining transcranial ultrasound with intelligent communication methods to enhance the remote assessment and management of stroke patients: Framework for a technology demonstrator
With over 150,000 strokes in the United Kingdom every year, and more than 1 million living survivors, stroke is the third most common cause of death and the leading cause of severe physical disability among adults. A major challenge in administering timely treatment is determining whether the stroke is due to vascular blockage (ischaemic) or haemorrhage. For patients with ischaemic stroke, thrombolysis (i.e. pharmacological ‘clot-busting’) can improve outcomes when delivered swiftly after onset, and current National Health Service Quality Improvement Scotland guidelines are for thrombolytic therapy to be provid...
Source: Health Informatics Journal - August 8, 2016 Category: Information Technology Authors: Mort, A., Eadie, L., Regan, L., Macaden, A., Heaney, D., Bouamrane, M.-M., Rushworth, G., Wilson, P. Tags: Articles Source Type: research

Mimics of Acute Stroke: Tips and Tricks for Solving the Diagnostic Dilemma
Stroke affects approximately 800,000 people in the United States each year and is the fourth major leading cause of adult mortality.1 Rapid diagnostic evaluation and prompt treatment are important to prevent death and disability from a stroke. The literature suggests that up to 30% of patients who present with acute onset of neurologic symptoms were found to have a stroke misdiagnosis. In addition, the safety of thrombolytic therapy for stroke mimics has not been fully studied. Although patients with acute stroke can benefit substantially from thrombolytic therapy, misdiagnosis of acute stroke can carry serious implication...
Source: Contemporary Diagnostic Radiology - August 31, 2016 Category: Radiology Tags: Article Source Type: research

Therapeutic strategy against ischemic stroke with the concept of neurovascular unit
Publication date: Available online 1 April 2019Source: Neurochemistry InternationalAuthor(s): Tomohiko Ozaki, Hajime Nakamura, Haruhiko KishimaAbstractStroke is one of the leading causes of death and disability globally. Although thrombolytic therapy by t-PA and mechanical thrombectomy have improved outcomes of ischemic stroke patients, both of these approaches are applicable to limited numbers of patients owing to their time constraints. Therefore, development of other treatment approaches such as developing neuroprotective drugs and nerve regeneration therapy is required to overcome ischemic stroke. The concept of the ne...
Source: Neurochemistry International - April 2, 2019 Category: Neuroscience Source Type: research

3-Month Outcome of Ischemic Stroke Patients Underwent Thrombolytic Therapy; a Cohort Study.
Conclusion: There was no significant correlation between 3-month disabilities of stroke patients underwent thrombolytic therapy and age, sex, time from initiation of symptoms, or vital signs on admission. Patients with a blood sugar lower than 144 had better 3-month outcome. PMID: 32021987 [PubMed]
Source: Accident and Emergency Nursing - February 7, 2020 Category: Emergency Medicine Authors: Sari Aslani P, Rezaeian S, Safari E Tags: Arch Acad Emerg Med Source Type: research

PET Detection of Cerebral Necrosis Using an Infarct-Avid Agent 2-Deoxy-2- 18 FFluoro- d -Glucaric Acid (FGA) in a Mouse Model of the Brain Stroke
ConclusionsAccumulation of FGA correlated well with the perfusion defect and inflammatory injury. As a PET agent, FGA has potential to image infarcted core in the brain stroke injury with high sensitivity, resolution, and specificity.
Source: Molecular Imaging and Biology - June 15, 2020 Category: Molecular Biology Source Type: research

Thrombolysis beyond 4.5  h in Acute Ischemic Stroke
AbstractPurpose of ReviewThe purpose of this article is to review the current approaches using neuroimaging techniques to expand eligibility for intravenous thrombolytic therapy in acute ischemic stroke patients with stroke of unknown symptom onset.Recent FindingsIn recent years, several randomized, placebo-controlled trials have shown neuroimaging-guided approaches to be feasible in determining eligibility for alteplase beyond 4.5  h from last known well, and efficacious for reducing disability. DWI-FLAIR mismatch on MRI is an effective tool to identify stroke lesions less than 4.5 h in onset in patients with stroke of ...
Source: Current Neurology and Neuroscience Reports - June 29, 2020 Category: Neuroscience Source Type: research

Health-related quality of life after ischemic stroke: impact of sociodemographic and clinical factors
CONCLUSION: Stroke survivors have significantly reduced HR-QoL. Multiple interacting factors are associated with an unfavorable outcome after IS. Early detection of these factors would help to improve the care for IS patients, to reduce disabilities and improve HR-QoL.PMID:33637026 | DOI:10.1080/01616412.2021.1893563
Source: Neurological Research - February 27, 2021 Category: Neurology Authors: M Tsalta-Mladenov S Andonova Source Type: research

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