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Time is Brain: Standardized Neuro-Interventional Thrombectomy Protocols lead to Faster Recanalization Times (S47.007)
Conclusions:Our initiatives allowed us to refine our process of care, resulting in a significant reduction of time between patient arrival and CT imaging, CT imaging and femoral artery access, and groin puncture to recanalization.Disclosure: Dr. Frei has received personal compensation for activities with Microvention, Covidien, Stryker, Siemens, and Penumbra as a consultant. Dr. Caputo has nothing to disclose. Dr. McCarthy has nothing to disclose. Dr. Salottolo has nothing to disclose. Dr. Bar-Or has nothing to disclose.
Source: Neurology - February 7, 2016 Category: Neurology Authors: Frei, D., Caputo, L., McCarthy, K., Salottolo, K., Bar-Or, D. Tags: IV-tPA and Endovascular Therapy Source Type: research

Epidural Electrical Stimulation for Stroke Rehabilitation: Results of the Prospective, Multicenter, Randomized, Single-Blinded Everest Trial
Conclusions. The primary analysis pertaining to efficacy of EECS during upper limb motor rehabilitation in chronic stroke patients was negative at 4 weeks postrehabilitation. A better treatment response was observed in a subset of patients eliciting stimulation induced upper limb movements during motor threshold assessments performed prior to each rehabilitation session. Post hoc comparisons indicated treatment effect differences at 24 weeks, with the control group showing significant decline in the combined primary outcome measure relative to the investigational group. These results have the potential to inform future chr...
Source: Neurorehabilitation and Neural Repair - January 27, 2016 Category: Neurology Authors: Levy, R. M., Harvey, R. L., Kissela, B. M., Winstein, C. J., Lutsep, H. L., Parrish, T. B., Cramer, S. C., Venkatesan, L. Tags: Clinical Research Articles Source Type: research

Impact of Mechanical Thrombectomy on the Organization of the Management of Acute Ischemic Stroke
Background: Several trials and meta-analyses have recently demonstrated the superiority of endovascular therapy over standard medical treatment in patients presenting with acute ischemic stroke. In order to offer the best possible treatment to a maximum number of patients, many stroke care networks probably have to be reorganized. After analyzing the reliability of data in the literature, an algorithm is suggested for a pre-hospital and in-hospital alert system to improve the timeliness of subsequent treatment: a drip-and-ship approach. Summary: Five recent well-designed randomized studies have demonstrated the benefit of ...
Source: European Neurology - January 16, 2016 Category: Neurology Source Type: research

Combining carotid endarterectomy with off-pump coronary artery bypass graft surgery is safe and effective
Conclusion: Combining CEA along with CABG is a safe and effective procedure.
Source: Annals of Indian Academy of Neurology - November 17, 2015 Category: Neurology Authors: Arun GargAtma Ram BansalDilip SinghManisha MishraPooja SharmaRavi Ratan KasliwalNaresh Trehan Source Type: research

A Prospective Nonrandomized Study on Carotid Surgery Performed under General Anesthesia without Intraoperative Cerebral Monitoring
The purpose of this study was to assess our experience of carotid surgery habitually performed under general anesthesia without intraoperative intracerebral monitoring, and following a pre-established perioperative protocol, which includes extensive use of an intraoperative shunt (IOS).
Source: Journal of Stroke and Cerebrovascular Diseases - October 19, 2015 Category: Neurology Authors: Francesco De Santis, Cristina Margot Chaves Brait, Cristian Pattaro, Vladimiro Cesareo, Vincenzo Di Cintio Source Type: research

Anesthetic factors and outcome in children undergoing indirect revascularization procedure for moyamoya disease: An Indian perspective
Conclusion: In this study, anesthetic techniques or medications did not influence the occurrence of postoperative neurological deficits or prolonged hospital stay after an indirect revascularization procedure in children with MMD.
Source: Neurology India - October 6, 2015 Category: Neurology Authors: Sabina JagdevanKamath SriganeshParitosh PandeyMadhusudan ReddyGS Umamaheswara Rao Source Type: research

Mechanical Thrombectomy Is Now the Gold Standard for Acute Ischemic Stroke: Implications for Routine Clinical Practice
Background: This review aims to summarize the findings of the recently published randomized controlled studies which provide overwhelming evidence in support of mechanical thrombectomy for acute ischemic stroke with large artery occlusion. The five studies, Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN), Endovascular Revascularization with Solitaire Device versus Best Medical Therapy in Anterior Circulation Stroke within 8 h (REVASCAT), Endovascular Treatment for Small Core and Proximal Occlusion Ischemic Stroke (ESCAPE), Solitaire™ FR as Primary Tr...
Source: Interventional Neurology - September 18, 2015 Category: Neurology Source Type: research

Peri-interventional management of acute endovascular stroke treatment.
Abstract Due to the ground breaking consistent evidence that supports the effect of endovascular stroke treatment (EST), many acute care hospitals and stroke centers will have to be prepared to provide this treatment in an optimal way within the coming years. In addition to the intervention itself, patient preparation, stabilization and monitoring during the treatment as well as the aftercare represent significant challenges and have mostly not yet been sufficiently investigated. Under these aspects, the questions of optimal sedation and airway management have received the highest attention. Based on retrospective...
Source: Der Nervenarzt - August 28, 2015 Category: Neurology Authors: Schönenberger S, Bösel J Tags: Nervenarzt Source Type: research

Hypotension During Endovascular Treatment of Ischemic Stroke Is a Risk Factor for Poor Neurological Outcome Brief Reports
Conclusions— Profound intraprocedural hypotension is an independent predictor for poor neurological outcome in patients with acute ischemic stroke undergoing endovascular therapy in general anesthesia.
Source: Stroke - August 24, 2015 Category: Neurology Authors: Lowhagen Henden, P., Rentzos, A., Karlsson, J.-E., Rosengren, L., Sundeman, H., Reinsfelt, B., Ricksten, S.-E. Tags: Acute Cerebral Infarction, Emergency treatment of Stroke, Other Stroke Treatment - Surgical Brief Reports Source Type: research

Refractory status epilepticus due to SMART syndrome
Conclusions Taking into account clinical evolution and ictal neuroimaging studies, status epilepticus could explain the origin of these episodes in SMART syndrome. Although most patients have reversible symptoms, in some cases, aggressive treatment to avoid sequelae is needed. This article is part of a Special Issue entitled “Status Epilepticus”.
Source: Epilepsy and Behavior - June 12, 2015 Category: Neurology Source Type: research

Refractory status epilepticus due to SMART syndrome.
CONCLUSIONS: Taking into account clinical evolution and ictal neuroimaging studies, status epilepticus could explain the origin of these episodes in SMART syndrome. Although most patients have reversible symptoms, in some cases, aggressive treatment to avoid sequelae is needed. This article is part of a Special Issue entitled "Status Epilepticus". PMID: 26071996 [PubMed - as supplied by publisher]
Source: Epilepsy and Behaviour - June 11, 2015 Category: Neurology Authors: Jaraba S, Puig O, Miró J, Velasco R, Castañer S, Rodríguez L, Izquierdo C, Simó M, Veciana M, Falip M Tags: Epilepsy Behav Source Type: research

Stroke Neurologist's Perspective on the New Endovascular Trials Understanding and Applying the Endovascular Trials
In conclusion, stroke teams, including practicing neurologists caring for patients with stroke should now provide the option for intra-arterial thrombectomy for a subset of patients with acute stroke.
Source: Stroke - May 22, 2015 Category: Neurology Authors: Grotta, J. C., Hacke, W. Tags: Acute Cerebral Infarction, Emergency treatment of Stroke, Thrombolysis Understanding and Applying the Endovascular Trials Source Type: research

Methodology of Motor Evoked Potentials in a Rabbit Model
This study provides the basis for a reproducible model of SCI to be used for novel therapeutic drug development.
Source: Translational Stroke Research - May 20, 2015 Category: Neurology Source Type: research

Type of Anesthesia and Differences in Clinical Outcome After Intra-Arterial Treatment for Ischemic Stroke Clinical Sciences
Conclusions— Our study suggests that patients with AIS of the anterior circulation undergoing IAT without GA have a higher probability of good clinical outcome compared with patients treated with general anesthesia.
Source: Stroke - April 27, 2015 Category: Neurology Authors: van den Berg, L. A., Koelman, D. L. H., Berkhemer, O. A., Rozeman, A. D., Fransen, P. S. S., Beumer, D., Dippel, D. W., van der Lugt, A., van Oostenbrugge, R. J., van Zwam, W. H., Brouwer, P. A., Jenniskens, S., Boiten, J., Lycklama a Nijeholt, G. A., Vos Tags: Acute Cerebral Infarction, Emergency treatment of Stroke Clinical Sciences Source Type: research

Circulatory and Respiratory Parameters during Acute Endovascular Stroke Therapy in Conscious Sedation or General Anesthesia
Whether patients suffering from acute ischemic stroke and undergoing endovascular recanalization should be treated under general anesthesia (GA) or conscious sedation (CS) is a matter of debate. According to retrospective studies, GA appears to be associated with a worse outcome than CS. The underlying mechanisms are unknown, but hypotension and hypocapnia during GA have been suggested. There are no prospective data on this question.
Source: Journal of Stroke and Cerebrovascular Diseases - April 20, 2015 Category: Neurology Authors: Sibu Mundiyanapurath, Silvia Schönenberger, Maritoni L. Rosales, Ana M. Carrilho Romeiro, Markus Möhlenbruch, Martin Bendszus, Werner Hacke, Julian Bösel Source Type: research

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