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Specialty: Neurology
Therapy: Thrombolytic Therapy

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Total 551 results found since Jan 2013.

Improving door-to-reperfusion time in acute ischemic stroke during the COVID-19 pandemic: experience from a public comprehensive stroke center in Brazil
ConclusionAcute stroke care continued to be a priority despite the COVID-19 pandemic. The implementation of a thrombolytic bolus and the start of continuous infusion on the CT scan table was the main factor that contributed to the reduction of DNT. Continuous monitoring of service times is essential for improving the quality of the stroke center and achieving better functional outcomes for patients.
Source: Frontiers in Neurology - July 10, 2023 Category: Neurology Source Type: research

Unanswered Questions in Thrombolytic Therapy for Acute Ischemic Stroke
This article reviews some of the current literature in support or against extension of the intravenous tissue plasminogen activator window, use of intra-arterial therapy or devices, as well alternative pharmacologic therapies that may extend the window for treatment of patients with acute ischemic stroke, with consideration of the relative risk of thrombolytic complications, factors for worse outcomes, and unclear stroke onset, as seen in patients with wake-up stroke. The issue of newer concomitant antithrombotic therapies as they affect the decision for acute ischemic stroke thrombolytic therapy is also explored.
Source: Neurologic Clinics - May 13, 2013 Category: Neurology Authors: Adriana Sofia Ploneda Perilla, Michael J. Schneck Source Type: research

PKC-{delta} and Akt Signaling in Reduced Apoptosis by Ethanol after Transient Ischemic Stroke (P1.100)
CONCLUSIONS: Our study suggests that ethanol administration following ischemic stroke modulates the gene and protein profile by increasing expression of anti-apoptotic Akt and decreases the pro-apoptotic PKC-. This ultimately results in a decrease in neuronal apoptosis, thus conferring neuroprotection.Disclosure: Dr. Hafeez has nothing to disclose. Dr. Geng has nothing to disclose. Dr. Guthikonda has nothing to disclose. Dr. Ding has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Hafeez, A., Geng, X., Guthikonda, M., Ding, Y. Tags: Cerebrovascular Disease and Interventional Neurology: Translational Science Source Type: research

Prognostic Value of CT Angiography in the Hyperacute Phase of Middle Cerebral Artery Stroke. (P2.018)
CONCLUSION: CT and CTA hyperacute findings predicted volume of ischemic lesions and post stroke functional status in patients with MCAS.Disclosure: Dr. Santiago has nothing to disclose. Dr. Zurru has nothing to disclose. Dr. Luzzi has nothing to disclose. Dr. Brescacin has nothing to disclose. Dr. Alonzo has nothing to disclose. Dr. Camera has nothing to disclose. Dr. Waisman has nothing to disclose. Dr. Cristiano has received personal compensation for activities with Bayer Pharmaceuticals Corp., Biogen Idec, Merck & Co., Inc., and Novartis,
Source: Neurology - April 9, 2014 Category: Neurology Authors: Santiago, P., Zurru, M., Luzzi, A., Brescacin, L., Alonzo, C., Camera, L., Waisman, G., Cristiano, E. Tags: Cerebrovascular Disease and Interventional Neurology I Source Type: research

The Norwegian tenecteplase stroke trial (NOR-TEST): randomised controlled trial of tenecteplase vs. alteplase in acute ischaemic stroke
Background: Alteplase is the only approved thrombolytic agent for acute ischaemic stroke. The overall benefit from alteplase is substantial, but some evidence indicates that alteplase also has negative effects on the ischaemic brain. Tenecteplase may be more effective and less harmfull than alteplase, but large randomised controlled phase 3 trials are lacking. The Norwegian Tenecteplase Stroke Trial (NOR-TEST) aims to compare efficacy and safety of tenecteplase vs. alteplase. Methods: NOR-TEST is a multi-centre PROBE (prospective randomised, open-label, blinded endpoint) trial designed to establish superiority of tenectepl...
Source: BMC Neurology - May 15, 2014 Category: Neurology Authors: Nicola LogalloChristopher KvistadAliona NacuHalvor NaessUlrike Waje-AndreassenJörg AsmussAnne Hege AamodtChristian LundMartin KurzOle Morten RønningRolf SalvesenTitto IdiculaLars Thomassen Source Type: research

Prehospital Thrombolysis for Stroke An Idea Whose Golden Hour Has Arrived
Soon after thrombolytic therapy was established as a therapy for ischemic stroke, our colleague Anthony Furlan, MD, famously circulated a cartoon of a computed tomographic (CT) scanner visible through the back doors of an ambulance, where a happy stroke physician had hung a bottle dripping tissue plasminogen activator (tPA) into the scanned patient’s arm. Because the time interval from stroke onset to initiation of thrombolysis after ischemic stroke is inversely related to the probability of disability-free recovery, prehospital initiation of thrombolytic therapy seemed a compelling and logical ambition, if one could rul...
Source: JAMA Neurology - November 17, 2014 Category: Neurology Source Type: research

Reasons for low thrombolysis rate in a Norwegian ischemic stroke population
In conclusion, a large percentage of patients with AIS are not treated with thrombolysis because of mild or rapidly improving symptoms, and because patients arrive too late to the hospital. Absolute and relative contraindications account for a minor proportion of reasons for excluding patients.
Source: Neurological Sciences - November 25, 2014 Category: Neurology Source Type: research

Systems and Care Process Parameters as Determinants of Onset-to-Treatment Times in Acute Ischemic Stroke: A Simulation Study (P1.018)
CONCLUSIONS: We employed a realistic simulation of AIS care to explore performance characteristics of proposed AIS care process configurations during the narrow window of opportunity to deliver thrombolytic therapy. This simulation methodology provides a model for prototyping process reengineering, in which essential details and assumptions in AIS care are identified for critical review by stakeholders. Study Supported by: Genentech, Inc.Disclosure: Dr. Levy has received personal compensation for activities with Genentech. Dr. Norris has received personal compensation for activities with Genentech. Dr. Tayama has received ...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Levy, D., Norris, D., Tayama, D. Tags: Cerebrovascular Disease and Interventional Neurology I ePosters Source Type: research

Successful Systemic Thrombolysis in an Adolescent With Acute Ischemic Stroke
Conclusions: Despite the lack of evidence regarding the safety and the efficacy of recombinant tissue plasminogen activator in pediatric stroke, this treatment option should be considered, especially in adolescents presenting within 3 hours from symptom onset in centers with consolidated experience in adult thrombolysis.
Source: The Neurologist - September 1, 2015 Category: Neurology Tags: Case Report/Case Series Source Type: research

DWI Lesion Patterns Predict Outcome in Stroke Patients with Thrombolysis
Background: Lesion patterns may predict prognosis after acute ischemic stroke within the middle cerebral artery (MCA) territory; yet it remains unclear whether such imaging prognostic factors are related to patient outcome after intravenous thrombolysis. Aims: The aim of this study is to investigate the clinical outcome after intravenous thrombolysis in acute MCA ischemic strokes with respect to diffusion-weighted imaging (DWI) lesion patterns. Methods: Consecutive acute ischemic stroke cases of the MCA territory treated over a 7-year period were retrospectively analyzed. All acute MCA stroke patients underwent a MRI scan ...
Source: Cerebrovascular Diseases - October 30, 2015 Category: Neurology Source Type: research

Cytoprotective Drug-Tissue Plasminogen Activator Protease Interaction Assays: Screening of Two Novel Cytoprotective Chromones
In conclusion, the results suggest that high concentrations of both cytoprotectives reduced 4-nitroaniline production in vitro, but the inhibition only occurs with concentrations 104 –1025-fold that of EC50 values in an efficacy assay. Thus, CSMC-19 and CSMC-140 should be further developed and evaluated in embolic stroke models in the absence or presence of a thrombolytic. If necessary, they could be administered once effective tPA thrombolysis has been confirmed to avoid the possibility that the chromone will reduce the efficacy of tPA in patients. Stroke investigator developing new cytoprotective small molecules should...
Source: Translational Stroke Research - April 12, 2017 Category: Neurology Source Type: research

Neutrophil extracellular traps in ischemic stroke thrombi
This study aimed at investigating the presence of neutrophils and more specifically NETs in ischemic stroke thrombi. Methods: Sixty‐eight thrombi retrieved from ischemic stroke patients undergoing endovascular treatment were characterized by immunostaining using neutrophil markers (CD66b and neutrophil elastase) and NETs markers (citrullinated histones H3 (H3Cit) and extracellular DNA). Neutrophils and NETs were quantified. In addition, extracellular DNA was targeted by performing ex vivo lysis of retrieved thrombi with DNase 1 and t‐PA. Results: Neutrophils were detected extensively throughout all thrombi. Citrullinat...
Source: Annals of Neurology - July 11, 2017 Category: Neurology Authors: Elodie Laridan, Frederik Denorme, Linda Desender, Olivier Fran çois, Tommy Andersson, Hans Deckmyn, Karen Vanhoorelbeke, Simon F. De Meyer Tags: Research Article Source Type: research

Pathophysiologic mechanisms, neuroimaging and treatment in wake-up stroke.
Abstract Wake-up stroke (WUS) or ischemic stroke occurring during sleep accounts for 14%-29.6% of all ischemic strokes. Management of WUS is complicated by its narrow therapeutic time window and attributable risk factors, which can affect the safety and efficacy of administering intravenous (IV) tissue plasminogen activator (t-PA). This manuscript will review risk factors of WUS, with a focus on obstructive sleep apnea, potential mechanisms of WUS, and evaluate studies assessing safety and efficacy of IV t-PA treatment in WUS patients guided by neuroimaging to estimate time of symptom onset. The authors used PubMe...
Source: CNS Spectrums - September 11, 2019 Category: Neurology Authors: Elfil M, Eldokmak M, Baratloo A, Ahmed N, Amin HP, Koo BB Tags: CNS Spectr Source Type: research

Plasmin Generation Potential and Recanalization in Acute Ischaemic Stroke; an Observational Cohort Study of Stroke Biobank Samples
This study will use historical samples from the Barcelona Stroke Thrombolysis Biobank, comprised of 350 pre-thrombolysis plasma samples from ischaemic stroke patients who received serial transcranial-Doppler (TCD) measurements before and after thrombolysis. The plasmin potential of each patient will be measured using the level of plasmin-antiplasmin complex (PAP) generated after in-vitro addition of rt-PA. Levels of antiplasmin, plasminogen, t-PA activity, and PAI-1 activity will also be determined. Association between plasmin potential variables and time to recanalization [assessed on serial TCD using the thrombolysis in ...
Source: Frontiers in Neurology - November 3, 2020 Category: Neurology Source Type: research