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The syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis mimicking an acute stroke
ConclusionsThe decision to thrombolyse or perform an LP in HaNDL patients mimicking a stroke is difficult in the acute setting. Perfusion CT can provide misleading results and CTA may be useful in ruling out occlusion of a cerebral vessel.
Source: European Journal of Neurology - April 22, 2016 Category: Neurology Authors: M. Guillan, A. DeFelipe‐Mimbrera, A. Alonso‐Canovas, M. C. Matute, R. Vera, A. Cruz‐Culebras, N. Garcia‐Barragan, J. Masjuan Tags: Original Article Source Type: research

Risk of pneumonia associated with zero‐degree head positioning in acute ischemic stroke patients treated with intravenous tissue plasminogen activator
ConclusionsZero‐degree head of bed positioning in the first 24 h following an acute ischemic stroke treated with IV‐tPA was associated with acceptable rates of pneumonia. Rates for pneumonia may be further reduced by eliminating use of a 0° protocol in intubated/mechanically ventilated patients. A zero‐degree head of bed position is recommended to increase cerebral perfusion in nonhypoxic acute ischemic stroke patients able to tolerate lying flat. However, this is not uniformly applied in clinical practice, most likely due to concerns of aspiration pneumonia. In our retrospective descriptive study, zero‐degree p...
Source: Brain and Behavior - December 1, 2015 Category: Neurology Authors: Paola Palazzo, Amy Brooks, David James, Randy Moore, Andrei V. Alexandrov, Anne W. Alexandrov Tags: Original Research Source Type: research

Symptomatic intracranial hemorrhage in the ALIAS Multicenter Trial: relationship to endovascular thrombolytic therapy
ConclusionsEndovascular thrombolysis was the major factor predisposing to symptomatic intracranial hemorrhage, and albumin contributed to this predisposition. The latter may be mediated by albumin's influence on platelet aggregation or collateral perfusion.
Source: International Journal of Stroke - March 22, 2015 Category: Neurology Authors: Myron D. Ginsberg, Michael D. Hill Tags: Research Source Type: research

Combined thrombolysis in posterior circulation stroke caused by bilateral vertebral artery dissection in squash player.
CONCLUSIONS: Vertebral artery dissection should be taken into consideration in differential diagnosis of posterior circulation stroke or TIA in young patients with a history of even as subtle precipitating events as forceful head movements. Combined thrombolytic therapy may provide safe and effective treatment of stroke-complicated cases. This case report shows that expanded diagnostic protocol for acute ischemic stroke, including computed tomography perfusion study and angiography of cervical and cranial vessels, assures rapid and correct diagnosis. PMID: 25168332 [PubMed - indexed for MEDLINE]
Source: Neurologia i Neurochirurgia Polska - October 26, 2014 Category: Neurology Authors: Frankowska E, Brzozowski K, Staszewski J, Kolmaga N, Stępień A, Bogusławska-Walecka R Tags: Neurol Neurochir Pol Source Type: research

CT Perfusion Variables Within 4.5 Hours Of Stroke: Relating Physiology To Time Since Onset (S35.007)
ConclusionsA decremental relationship between penumbra and time since onset appears to be one physiological mechanism underlying decreasing benefit of thrombolysis with time within 4.5 hours. This may be used to inform treatment in the clinical setting of strokes of unknown onset time, particularly using a simple visual assessment of CTp maps.Disclosure: Dr. Agarwal has nothing to disclose. Dr. Matys has nothing to disclose. Dr. Marrapu has nothing to disclose. Dr. Mitchell has nothing to disclose. Dr. Jones has nothing to disclose. Dr. Baron has nothing to disclose. Dr. Warburton has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Agarwal, S., Matys, T., Marrapu, S. T., Mitchell, J., Jones, P. S., Baron, J.-C., Warburton, E. Tags: Cerebrovascular Disease and Interventional Neurology: Issues in Acute Treatment 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

Intravenous thrombolysis in ischemic stroke with unknown onset using CT perfusion
ConclusionDelayed stroke patients with unknown onset time were no different than patients >4.5 h regarding eligibility and response to CTP‐based i.v. thrombolysis.
Source: Acta Neurologica Scandinavica - July 15, 2013 Category: Neurology Authors: E. Cortijo, P. García‐Bermejo, A. I. Calleja, S. Pérez‐Fernández, R. Gómez, J. M. del Monte, J. Reyes, J. F. Arenillas Tags: Original Article 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

Early Insulin Glycemic Control Combined With tPA Thrombolysis Reduces Acute Brain Tissue Damages in a Focal Embolic Stroke Model of Diabetic Rats Brief Reports
Conclusions— Early insulin glycemic control may be beneficial in combination with tPA thrombolysis for ischemic stroke with diabetes mellitus or poststroke hyperglycemia.
Source: Stroke - December 24, 2012 Category: Neurology Authors: Fan, X., Ning, M., Lo, E. H., Wang, X. Tags: Animal models of human disease, Type 1 diabetes, Acute Cerebral Infarction, Embolic stroke, Emergency treatment of Stroke, Thrombolysis Brief Reports Source Type: research

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