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Cryptogenic Stroke: Diagnostic Workup and Management
AbstractPurpose of reviewCryptogenic stroke describes a subset of ischemic stroke for which no cause can be found despite a structured investigation. There are a number of putative mechanisms of cryptogenic ischemic stroke including a covert structural cardiac lesion, paroxysmal atrial fibrillation, hypercoagulable state or undiagnosed malignancy. Because many of these proposed mechanisms are embolic – and based on studies of thrombus history showing commonalities between thrombus composition between cardioembolic and cryptogenic strokes – the concept of embolic stroke of undetermined source (ESUS) (Hart et al. Lancet ...
Source: Current Treatment Options in Cardiovascular Medicine - December 3, 2019 Category: Cardiology Source Type: research
Subtype-Dependent Reporting of Stroke With SGLT2 Inhibitors: Implications From a Japanese Pharmacovigilance Study.
Abstract Volume depletion as an adverse events (AE) caused by sodium-glucose cotransporter-2 inhibitors (SGLT2i) because of their diuretic effect may raise the concern about the risk of lacunar stroke; however, an earlier meta-analysis reported no significant increase in the incidence of stroke without clearly distinguishing stroke subtypes. Here, aiming to investigate subtype-wise reporting of stroke potentially related to SGLT2i treatment, we conducted a disproportionality analysis using the Japanese Adverse Drug Event Report database, which contains approximately 500 000 cases recorded between April 2004 and M...
Source: The Journal of Clinical Pharmacology - December 2, 2019 Category: Drugs & Pharmacology Authors: Sato K, Mano T, Iwata A, Toda T Tags: J Clin Pharmacol Source Type: research
Multiple Administrations of Intravenous Thrombolytic Therapy to a Stroke Mimic
Patients who present emergently with focal neurological deficits concerning for acute ischemic stroke can be extremely challenging to diagnose and treat. Unnecessary administration of thrombolytics to potential stroke patients whose symptoms are not caused by an acute ischemic stroke —stroke mimics—may result in patient harm, although the overall risk of hemorrhagic complications among stroke mimics is low.
Source: The Journal of Emergency Medicine - December 2, 2019 Category: Emergency Medicine Authors: Ava L. Liberman, Daniel Antoniello, Steven Tversky, Michael G. Fara, Cen Zhang, Lindsey Gurin, Sara K. Rostanski Tags: Clinical Communications: Adult Source Type: research
An unusual cause of acute ischemic stroke: Adult Onset Still ’s Disease
We present a case where acute ischemic stroke secondary to a floating internal carotid artery thrombus was an early manifestation of AOSD. The patient also had prolonged high spiking fevers, sign ificant leucocytosis, arthralgias and transaminitis. He responded well to a high dose of oral corticosteroids and was eventually started on anticoagulation for secondary stroke prevention. To our knowledge, this is the first described case of arterial thrombosis associated with AOSD. We postulate th at thrombocytosis, vasculitis and hypercoagulability from the underlying inflammatory state may have contributed to the ischemic stroke.
Source: Journal of Thrombosis and Thrombolysis - December 2, 2019 Category: Hematology Source Type: research
Genetic Polymorphisms Associated with Thrombotic Disease Comparison of Two Territories: Myocardial Infarction and Ischemic Stroke.
Conclusions: The Thr325Ile polymorphism, but no Ala147Thr polymorphism, represents an independent risk factor for STEMI in the young Mexican population. PMID: 31781299 [PubMed - in process]
Source: Disease Markers - November 30, 2019 Category: Laboratory Medicine Tags: Dis Markers Source Type: research
ST-elevation myocardial infarction, pulmonary embolism, and cerebral ischemic stroke in a patient with critically low levels of natural anticoagulants
Publication date: Available online 22 November 2019Source: Journal of Cardiology CasesAuthor(s): Elena Vladimirovna Reznik, Ekaterina Sergeevna Shcherbakova, Svetlana Vasilievna Borisovskaya, Yurij Valerevich Gavrilov, Tatyana Mikhailovna Pajeva, Sergey Vladislavovich Lepkov, Aleksej Borisovich Mironkov, Eliso Murmanovna Dzhobava, Igor Gennadievich NikitinAbstractThis clinical case report describes the simultaneous development of an acute myocardial infarction, stroke, and a massive pulmonary thromboembolism in a 44-year-old patient — a carrier of the thrombophilia gene polymorphisms: MTHFR C677T, А1298C, PAI-1 4G/5G, I...
Source: Journal of Cardiology Cases - November 23, 2019 Category: Cardiology Source Type: research
Rosiglitazone ameliorates tissue plasminogen activator-induced brain hemorrhage after stroke.
CONCLUSIONS: RSG treatment protects against BBB damage and ameliorates HT in delayed tPA-treated stroke mice by activating PPAR-γ and favoring microglial polarization toward anti-inflammatory phenotype. PMID: 31756041 [PubMed - as supplied by publisher]
Source: CNS Neuroscience and Therapeutics - November 22, 2019 Category: Neuroscience Authors: Li Y, Zhu ZY, Lu BW, Huang TT, Zhang YM, Zhou NY, Xuan W, Chen ZA, Wen DX, Yu WF, Li PY Tags: CNS Neurosci Ther Source Type: research
Real-world Comparisons of Direct Oral Anticoagulants for Stroke Prevention in Asian Patients with Non-valvular Atrial Fibrillation: a Systematic Review and Meta-analysis
ConclusionsThe meta-analysis shows that the DOACs had greater effectiveness and safety compared to warfarin in real-world practice for stroke prevention, among Asian patients with NVAF.
Source: Cardiovascular Drugs and Therapy - November 19, 2019 Category: Cardiology Source Type: research
Modified diffusion-weighted imaging-Alberta Stroke Program Early Computed Tomography Score including deep white matter lesions predicts symptomatic intracerebral hemorrhage following intravenous thrombolysis
AbstractThe Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is widely used for the assessment of early ischemic changes (EICs) before thrombolysis. However, for symptomatic intracerebral hemorrhage (sICH) following intravenous recombinant tissue plasminogen activator (rt-PA), the prediction abilities of CT-ASPECTS, diffusion-weighted imaging (DWI)-ASPECTS, and DWI-ASPECTS including EICs in deep white matter (DWI-ASPECTS + W) are unclear. We investigated associations between each score and sICH following intravenous rt-PA. Data from consecutive patients who received intravenous rt-PA for acute ischemic...
Source: Journal of Thrombosis and Thrombolysis - November 19, 2019 Category: Hematology Source Type: research
Older age and duration of exposure to type 2 diabetes in selective screening of asymptomatic carotid artery stenosis for primary stroke prevention —A single institution experience
Carotid artery disease is a well-known cause of stroke. In Malaysia, stroke is the third most common cause of death . To our knowledge, there is still limited information regarding stroke and its associated risk factors. Strokes from ischemic infarction of the brain is due to narrowing or occlusion from local thrombosis or embolization of a proximal thrombus. The incidence of ischemic stroke from carotid artery stenosis in an asymptomatic western population is approximately 2.7% according to a report from Netherlands by Hartog et al.
Source: Primary Care Diabetes - November 17, 2019 Category: Primary Care Authors: Lenny Suryani Safri, Henry Tan Chor Lip, M. Iqbal Saripan, Tan Jih Huei, K. Krishna, Mohamad Azim Md Idris, Hanafiah Harunarashid Tags: Original research Source Type: research
Cost-effectiveness of warfarin care bundles and novel oral anticoagulants for stroke prevention in patients with atrial fibrillation in Thailand
Novel oral anticoagulants (NOACs) and warfarin care bundles (e.g. genotyping, patient self-testing or self-management) are alternatives to usual warfarin care for stroke prevention in patients with atrial fibrillation (AF). We aim to evaluate the cost-effectiveness of NOACs and warfarin care bundles in patients with AF in a middle-income country, Thailand.
Source: Thrombosis Research - November 15, 2019 Category: Hematology Authors: Siok Shen Ng, Surakit Nathisuwan, Arintaya Phrommintikul, Nathorn Chaiyakunapruk Tags: Full Length Article Source Type: research
Identification of genetic risk factors associated with ischaemic stroke in young Mexican patients
ConclusionThe polymorphisms Glu298Asp and C677T, affecting the eNOS and 5,10-MTHFR enzymes, respectively, and smoking, hypertension, and family history of stroke were associated with ischaemic stroke in young Mexican patients; this was not the case for the Thr325Ile, Ala147Thr, 4 G/5 G, and PLA1/A2 polymorphisms of the genes coding for fibrinolytic proteins and platelet receptors.ResumenIntroducciónDiversos polimorfismos en genes candidatos que codifican proteínas del sistema hemostático se han propuesto como factores de riesgo para el desarrollo de trombosis.MétodosCasos y controles, sobrevivientes de enferm...
Source: Neurologia - November 11, 2019 Category: Neurology Source Type: research
A Case of Wallenberg's Syndrome Presenting with Spontaneous Thrombosis of a Vertebral Artery Aneurysm
Complete spontaneous thrombosis of intracranial aneurysms is uncommon. Although this type of thrombosis is largely asymptomatic, in rare cases it can be accompanied by parent artery occlusion and ischemic stroke. There are limited reports of complete thrombosis of an unruptured aneurysm of the internal carotid artery and middle cerebral artery. Furthermore, there are no reports of occlusion of the vertebral artery caused by thrombosis of an aneurysm. The mechanisms of spontaneous thrombosis are not established.
Source: Journal of Stroke and Cerebrovascular Diseases - November 11, 2019 Category: Neurology Authors: Misaki Kamogawa, Takashi Koide, Ryogo Kikuchi, Akiyoshi Nakamura, Asako Tagawa, Hiromichi Miyazaki Tags: Case Report Source Type: research
Dual energy CT in the management of antiplatelet therapy in patients with acute ischemic stroke for carotid obstruction.
CONCLUSIONS: DE-CT may contribute to select antiplatelet regimen after acute carotid stenting in tandem occlusions. PMID: 31684785 [PubMed - as supplied by publisher]
Source: Interventional Neuroradiology - November 9, 2019 Category: Radiology Tags: Interv Neuroradiol Source Type: research
HFpEF Is the Substrate for Stroke in Obesity and Diabetes Independent of Atrial Fibrillation
Publication date: Available online 6 November 2019Source: JACC: Heart FailureAuthor(s): Milton PackerAbstractBoth obesity and type 2 diabetes are important risk factors for the development of heart failure with a preserved ejection fraction (HFpEF), and both disorders increase the risk of systemic thromboembolic events. Traditionally, the risk of stroke has been explained by the strong association of these disorders with atrial fibrillation (AF). However, adiposity and diabetes are risk factors for systemic thromboembolism, even in the absence of AF, because both can lead to the development of an inflammatory and fibrotic ...
Source: JACC: Heart Failure - November 8, 2019 Category: Cardiology Source Type: research
Timing of Initiation of Oral Anticoagulation after Acute Ischemic Stroke in Patients with Atrial Fibrillation
AbstractPatients with atrial fibrillation (AF) who suffer an acute ischemic stroke are at risk for both hemorrhagic transformation and recurrent ischemic stroke in the acute post ‐stroke period. Oral anticoagulants are recommended for secondary stroke prevention in patients with AF. The optimal time to initiate anticoagulant therapy after acute ischemic stroke in patients with AF is uncertain. There is concern that early initiation increases the risk of hemorrhagic transfo rmation, whereas delayed initiation leaves the patient at risk for recurrent ischemic stroke. In this article, we provide a review of the risk of hemo...
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - November 7, 2019 Category: Drugs & Pharmacology Authors: Maureen A. Smythe, Dennis Parker, Candice L. Garwood, Adam Cuker, Steve R. Mess é Tags: REVIEW OF THERAPEUTICS Source Type: research
Evaluation of sex differences in acid/base and electrolyte concentrations in acute large vessel stroke.
CONCLUSION: Acid/base and electrolyte response to ischemic conditions differ between men and women, and these early changes could be used to predict local acid/base changes and how they develop differently in men and women during ischemia. These findings provide a novel insight into the pathology of large vessel stroke in humans, particularly potential variations based on sex. PMID: 31697942 [PubMed - as supplied by publisher]
Source: Experimental Neurology - November 4, 2019 Category: Neurology Authors: Martha SR, Collier LA, Davis SM, Erol A, Lukins D, Pennypacker KR, Fraser JF Tags: Exp Neurol Source Type: research
Caveolin-1 and MLRs: A potential target for neuronal growth and neuroplasticity after ischemic stroke.
Authors: Zhong W, Huang Q, Zeng L, Hu Z, Tang X Abstract Ischemic stroke is a leading cause of morbidity and mortality worldwide. Thrombolytic therapy, the only established treatment to reduce the neurological deficits caused by ischemic stroke, is limited by time window and potential complications. Therefore, it is necessary to develop new therapeutic strategies to improve neuronal growth and neurological function following ischemic stroke. Membrane lipid rafts (MLRs) are crucial structures for neuron survival and growth signaling pathways. Caveolin-1 (Cav-1), the main scaffold protein present in MLRs, targets man...
Source: International Journal of Medical Sciences - November 2, 2019 Category: Biomedical Science Tags: Int J Med Sci Source Type: research
Young male with syphilitic cerebral arteritis presents with signs of acute progressive stroke: A case report
Conclusion Progressive stroke was the initial symptom of the neurosyphilis. Disease progression is rapid and difficult to control with a single course of penicillin.
Source: Medicine - November 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Not all in your head (and neck): Stroke after blunt cerebrovascular injury is associated with systemic hypercoagulability
CONCLUSION Patients who suffer BCVI-related stroke are hypercoagulable compared with those with BCVI who remain asymptomatic. Increased angle or MA should be considered when assessing the risk of thrombosis and determining the optimal time to initiate antithrombotic therapy in patients with BCVI. LEVEL OF EVIDENCE Prognostic, Level III.
Source: The Journal of Trauma: Injury, Infection, and Critical Care - November 1, 2019 Category: Orthopaedics Tags: 2019 WTA PODIUM PAPERS Source Type: research
What Causes LVAD-Associated Ischemic Stroke? Surgery, Pump Thrombosis, Antithrombotics, and Infection
Acute ischemic stroke (AIS) is a major complication in left ventricular assist device (LVAD) population. A better understanding of clinical risk factors associated with AIS may help mitigate risk of stroke. We reviewed prospectively collected data of 477 LVAD patients from a tertiary center from October 1, 2004 to December 31, 2016. Supplemental data abstraction was performed on patients with AIS. Fifty-seven (12%) developed 61 AIS. Of 61, 17 (28%) AIS occurred perioperatively. The median time from implant to perioperative AIS was 5 days (interquartile range: 3–9). Pump thrombosis accounted for 19 (31%) of 61 AIS, and 7 ...
Source: ASAIO Journal - November 1, 2019 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research
Younger age at stroke onset but not thrombolytic treatment predicts poststroke epilepsy: An updated meta-analysis
ConclusionDespite limitations due to the uneven quality and design of the studies, the present meta-analysis confirms that cortical involvement, hemorrhagic component, and ES are associated with a higher risk of PSE. In this update, younger age at stroke onset but not thrombolytic treatment seems to increase the risk for PSE.This article is part of the Special Issue “Seizures & Stroke”.
Source: Epilepsy and Behavior - November 1, 2019 Category: Neurology Source Type: research
Chungkookjang, a soy food, fermented with Bacillus amyloliquefaciens protects gerbils against ishcmeic stroke injury, and post-stroke hyperglycemia
In conclusion, the daily intake of chungkookjang fermented with B. amyloliquefaciens improved the gut microbiome, increased blood flow to the brain, suppressed systemic inflammation, and may reduce the susceptibility to injury from ischemic stroke in gerbils subjected to ischemic injury.Graphical abstract
Source: Food Research International - October 31, 2019 Category: Food Science Source Type: research
Rivaroxaban Versus Warfarin for Stroke Prevention and Venous Thromboembolism Treatment in Extreme Obesity and High Body Weight.
Conclusion and Relevance: Although not statistically significant, rivaroxaban trended toward a lower incidence of clinical failure while demonstrating a significantly shorter LOS when compared with warfarin for VTE treatment or atrial fibrillation in morbidly obese or high-body-weight patients. PMID: 31672028 [PubMed - as supplied by publisher]
Source: The Annals of Pharmacotherapy - October 31, 2019 Category: Drugs & Pharmacology Authors: Perales IJ, San Agustin K, DeAngelo J, Campbell AM Tags: Ann Pharmacother Source Type: research
Younger age at stroke onset but not thrombolytic treatment predicts poststroke epilepsy: An updated meta-analysis.
CONCLUSION: Despite limitations due to the uneven quality and design of the studies, the present meta-analysis confirms that cortical involvement, hemorrhagic component, and ES are associated with a higher risk of PSE. In this update, younger age at stroke onset but not thrombolytic treatment seems to increase the risk for PSE. This article is part of the Special Issue "Seizures & Stroke". PMID: 31677999 [PubMed - as supplied by publisher]
Source: Epilepsy and Behaviour - October 30, 2019 Category: Neurology Authors: Gasparini S, Ascoli M, Brigo F, Cianci V, Branca D, Arcudi L, Aguglia U, Belcastro V, Ferlazzo E Tags: Epilepsy Behav Source Type: research
A Visual Task Management Application for Acute Ischemic Stroke Care
Conclusions: TCS is a novel approach that uses ICT to support information sharing in a parallel CS workflow in AIS care. It shortens the processing times of critical tasks and lessens the communication burden among team members.
Source: Frontiers in Neurology - October 30, 2019 Category: Neurology Source Type: research
Antiplatelet therapy in secondary ischemic stroke prevention - a short review.
In conclusion, we can say that current recommendations focused primarily on the therapy with aspirin for the secondary prevention of stroke in patients that presented vascular events, such as ischemic stroke of non-cardioembolic cause or transient ischemic attack and, as appropriate, aspirin plus dipyridamol or clopidogrel. The new therapy with ticagrelor in secondary stroke prevention seems to be promising, but more randomized clinical trials are needed to accurately assess the safety and efficacy of this new antiplatelet drug. PMID: 31658310 [PubMed - in process]
Source: Romanian Journal of Morphology and Embryology - October 29, 2019 Category: General Medicine Tags: Rom J Morphol Embryol Source Type: research
Long Non-Coding RNA MEG3 Promotes Apoptosis of Vascular Cells and is Associated with Poor Prognosis in Ischemic Stroke.
CONCLUSIONS: This study suggested that MEG3 might be considered as an intervention point and potential prognostic indicator for IS. PMID: 31656272 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - October 29, 2019 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
Hand knob stroke from cancer-associated thromboembolism.
PMID: 31636165 [PubMed - in process]
Source: cmaj - October 21, 2019 Category: General Medicine Authors: Tomoda Y, Tanaka M, Tanaka K Tags: CMAJ Source Type: research
Intravenous thrombolysis in acute ischemic stroke due to intracranial artery dissection: a single-center case series and a review of literature
AbstractEfficacy and safety of intravenous thrombolysis (IVT) in acute ischemic stroke (AIS) due to intracranial artery dissection (IAD) are currently not established. We aimed to present a single-center experience on IAD-related AIS treated by IVT. We selected all consecutive patients with IAD-related AIS treated by IVT from a prospectively constructed single-center acute stroke registry from 2003 to 2017. We reviewed demographical, clinical and neuroimaging data and recorded hemorrhagic complications, mortality within 7 days and modified Rankin Scale at 3-months. Out of 181 AISs related to cervicocephalic dissections, ...
Source: Journal of Thrombosis and Thrombolysis - October 20, 2019 Category: Hematology Source Type: research
Interhospital transfer on intravenous thrombolysis in patients with acute ischemic stroke in three chinese municipal stroke centers
AbstractWe included acute ischemic stroke (AIS) patients who received recombinant tissue plasminogen activator (rt-PA) at three stroke centers via either interhospital transfer or direct presentation and compared the clinical outcomes and time metrics to analyze the impact of interhospital transfer on intravenous thrombolysis (IVT). We retrospectively enrolled patients with AIS admitted to three stroke centers from October 1, 2016, to June 1, 2018. Patients treated with rt-PA were classified into the transfer and direct groups. We collected the patients ’ general information and time points. Statistical analyses were con...
Source: Journal of Thrombosis and Thrombolysis - October 20, 2019 Category: Hematology Source Type: research
Management of oral anticoagulation in very old patients with non valvular atrial fibrillation related acute ischemic stroke
AbstractThe optimal management of oral anticoagulation (OAC) in the acute phase of non valvular atrial fibrillation (NVAF)-related acute ischemic stroke (AIS) remains controversial, especially in very old patients. Therefore, the aim of our study was to evaluate the practical management of OAC in this context. We conducted an observational retrospective study on patients 85-years old and older admitted to two Italian hospitals for NVAF-related AIS. For each patient, clinical and brain computed tomography data were recorded. Type of OAC (vitamin K antagonists, VKAs or Direct Oral Anticoagulants, DOACs), dosage and starting ...
Source: Journal of Thrombosis and Thrombolysis - October 17, 2019 Category: Hematology Source Type: research
Predictors of prolonged hospital stay in a Comprehensive Stroke Unit.
CONCLUSION: this study showed that three complications delayed hospital discharge in patients admitted in a stroke unit, two preventable ones: pneumonia and urinary tract infection. More intense measures to avoid them should be included in the performance indicators to reduce the length of hospital stay in stroke units. PMID: 31618390 [PubMed - in process]
Source: Revista Latino-Americana de Enfermagem - October 14, 2019 Category: Nursing Authors: Gaspari AP, Cruz EDA, Batista J, Alpendre FT, Zétola V, Lange MC Tags: Rev Lat Am Enfermagem Source Type: research
Thrombolysis with rhPro-UK 3 to 6 hours after embolic stroke in rat.
Conclusions: RhPro-UK had an obvious therapeutic effect on ischemic stroke caused by thrombosis, and could be started within 4.5 h TTW with less side effects of cerebral hemorrhage than that of UK. PMID: 31584350 [PubMed - as supplied by publisher]
Source: Neurological Research - October 5, 2019 Category: Neurology Tags: Neurol Res Source Type: research
Thrombus Imaging in Acute Stroke: Are We Even Close? Thrombus Imaging in Acute Stroke: Are We Even Close?
Can imaging characteristics of thrombi provide predictive value or useful information for planning endovascular procedures?Stroke
Source: Medscape Today Headlines - October 4, 2019 Category: Consumer Health News Tags: Neurology & Neurosurgery Journal Article Source Type: news
Efficacy and Safety of Intravenous Thrombolysis in Patients with Unknown Onset Stroke: A Meta-Analysis.
Conclusions: Intravenous thrombolysis is a better choice for UOS patients for its efficacy and safety. In addition, pretreatment imaging assessment is beneficial for improving the efficacy of thrombolytic therapy. However, it needs more supporting evidences for clinical use in the future. PMID: 31565095 [PubMed - in process]
Source: Behavioural Neurology - October 2, 2019 Category: Neurology Authors: Luan D, Zhang Y, Yang Q, Zhou Z, Huang X, Zhao S, Yuan L Tags: Behav Neurol Source Type: research
Pediatric Stroke: A Single-Center Experience
The aim of this study was to evaluate the clinical characteristics, risk factors, treatment, and outcomes of pediatric stroke cases. A total of 118 patients diagnosed with arterial ischemic stroke (AIS), hemorrhagic stroke, and sinovenous thrombosis (SVT) between January 2000 and December 2011 were included. Neonatal cases were excluded. Demographic and clinical findings were retrospectively examined from medical records. We identified 118 patients with stroke. The age of the patients ranged from 1 to 215 months (17.92 y), with a mean age of 5.19±5.25 years. AIS accounted for the majority of cases (n=69, 58.5%), and the...
Source: Journal of Pediatric Hematology Oncology - October 1, 2019 Category: Hematology Tags: Original Articles Source Type: research
P5. Abstract Title: Characterization of Unfractionated Heparin Infusions in a Comprehensive Stroke Centre
Stroke patients with arterial or venous intraluminal thrombus (ILT) are at high risk of stroke recurrence and embolic or hemorrhagic complications. Treatment with anticoagulation remains challenging in this group of patients due to onset of action, efficacy, and risk of hemorrhage. Traditionally, unfractionated heparin (UFH) has been used due to its short half-life in the context of risk of hemorrhagic transformation of the infarct zone. Heparin nomograms and associated bolus dosing are not standardized in clinical practice across centres and patients can exhibit long epochs of time under or over the therapeutic PTT range.
Source: Thrombosis Research - October 1, 2019 Category: Hematology Authors: H. Khosravani, P. Pham, C. Shen, C. Wong Source Type: research
Effectiveness of emergency physician determinations of the need for thrombolytic therapy in acute stroke.
Abstract An increased emphasis on stroke care has led to a proliferation of specialized stroke teams despite relatively few trials demonstrating their efficacy. Our academic stroke center incorporated a unique setup allowing for the comparison between stroke teams and emergency physicians. During weekday working hours, a stroke team would respond to the emergency department for stroke activations. During all other times, the emergency physician caring for the patient would make all treatment decisions. We sought to determine whether there was any difference in treatment and outcomes between these two groups. We co...
Source: Baylor University Medical Center Proceedings - October 1, 2019 Category: Universities & Medical Training Authors: Juergens AL, Barney J, Julakanti M, Allen L, Shaver C Tags: Proc (Bayl Univ Med Cent) Source Type: research
Neutrophil –lymphocyte ratio predicts post‐thrombolysis early neurological deterioration in acute ischemic stroke patients
ConclusionsThis study showed that elevated level of NLR may predict post ‐thrombolysis END in ischemic stroke patients.
Source: Brain and Behavior - September 30, 2019 Category: Neurology Authors: Pengyu Gong, Yi Xie, Teng Jiang, Yukai Liu, Meng Wang, Huanhuan Sun, Shuting Zhang, Yingdong Zhang, Xiaohao Zhang, Junshan Zhou Tags: ORIGINAL RESEARCH Source Type: research
Poor enhancement pattern of left atrial appendage in cardiac computed tomography is associated with stroke in persistent atrial fibrillation patients.
Conclusions: The LAA enhancement pattern observed using cardiac CT is associated with the risk of stroke. Poor enhancement in the LAA suggests a potential high risk of stroke. PMID: 31559034 [PubMed]
Source: Journal of Thoracic Disease - September 28, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
Effect of Statin on Stroke Recurrence Prevention at Different Infarction Locations: A Post Hoc Analysis of The J-STARS Study.
CONCLUSIONS: Pravastatin significantly reduced the recurrence rate of all stroke among patients with PCS. Thus, the effect of statin on the recurrence of stroke may differ according to infarction location. PMID: 31554765 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - September 27, 2019 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
Reduced ADAMTS13 activity during TTP remission is associated with stroke in TTP survivors
In conclusion, stroke is common after recovery from TTP and is associated with reduced ADAMTS13 activity during remission.
Source: Blood - September 26, 2019 Category: Hematology Authors: Upreti, H., Kasmani, J., Dane, K., Braunstein, E. M., Streiff, M. B., Shanbhag, S., Moliterno, A. R., Sperati, C. J., Gottesman, R. F., Brodsky, R. A., Kickler, T. S., Chaturvedi, S. Tags: Thrombosis and Hemostasis, Clinical Trials and Observations Source Type: research
Urokinase Plasminogen Activator: A Potential Thrombolytic Agent for Ischaemic Stroke.
Abstract Stroke continues to be one of the leading causes of mortality and morbidity worldwide. Restoration of cerebral blood flow by recombinant plasminogen activator (rtPA) with or without mechanical thrombectomy is considered the most effective therapy for rescuing brain tissue from ischaemic damage, but this requires advanced facilities and highly skilled professionals, entailing high costs, thus in resource-limited contexts urokinase plasminogen activator (uPA) is commonly used as an alternative. This literature review summarises the existing studies relating to the potential clinical application of uPA in is...
Source: Cellular and Molecular Neurobiology - September 24, 2019 Category: Cytology Authors: Kadir RRA, Bayraktutan U Tags: Cell Mol Neurobiol Source Type: research
Role of Biological Markers for Cerebral Bleeding Risk STRATification in Patients with Atrial Fibrillation on Oral Anticoagulants for Primary or Secondary Prevention of Ischemic Stroke (Strat-AF Study): Study Design and Methodology.
Conclusions: The Strat-AF study may be an essential step towards the exploration of the role of a combined clinical biomarker or multiple biomarker models in predicting stroke risk in AF, and might sustain the incorporation of such new markers in the existing stroke prediction schemes by the demonstration of a greater incremental value in predicting stroke risk and improvement in clinical outcomes in a cost-effective fashion. PMID: 31548494 [PubMed - in process]
Source: Medicina (Kaunas) - September 23, 2019 Category: Universities & Medical Training Authors: Poggesi A, Barbato C, Galmozzi F, Camilleri E, Cesari F, Chiti S, Diciotti S, Galora S, Giusti B, Gori AM, Marzi C, Melone A, Mistri D, Pescini F, Pracucci G, Rinnoci V, Sarti C, Fainardi E, Marcucci R, Salvadori E Tags: Medicina (Kaunas) Source Type: research
Non-High-Density Lipoprotein Cholesterol and Risk of Stroke Subtypes and Coronary Heart Disease: The Japan Public Health Center-Based Prospective (JPHC) Study.
CONCLUSIONS: In Japanese men, lower non-HDL-C levels were associated with a decreased risk of large-artery occlusive infarction and an increased risk of ICH, particularly lobar ICH. PMID: 31534078 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - September 20, 2019 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
Different Influences of Statin Treatment in Preventing At-Risk Stroke Subtypes: A Post Hoc Analysis of J-STARS.
CONCLUSIONS: Statins showed different influences on the risks of atherothromobotic and lacunar stroke according to postrandomized LDL cholesterol levels. PMID: 31534062 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - September 20, 2019 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
Infectious Etiologies of Stroke
Semin Neurol 2019; 39: 482-494 DOI: 10.1055/s-0039-1687915Central nervous system (CNS) infections are a frequently underappreciated potential etiology of cerebrovascular disease. Highlighted in this review are a selection of infectious agents that lead to cerebrovascular complications through various mechanisms including multifocal vasculopathy, focal infiltrative vasculitis and vasospasm, and direct vessel wall invasion and thrombus formation. Diagnosis of stroke due to underlying CNS infection requires a high index of clinical suspicion and careful consideration of neuroimaging, serum, and cerebrospinal fluid studies in ...
Source: Seminars in Neurology - September 18, 2019 Category: Neurology Authors: Shulman, Julie G. Cervantes-Arslanian, Anna M. Tags: Review Article Source Type: research
Endothelial Targets in Stroke: Translating Animal Models to Human.
Abstract Cerebral ischemia (stroke) induces injury to the cerebral endothelium that may contribute to parenchymal injury and worsen outcome. This review focuses on current preclinical studies examining how to prevent ischemia-induced endothelial dysfunction. It particularly focuses on targets at the endothelium itself. Those include endothelial tight junctions, transcytosis, endothelial cell death, and adhesion molecule expression. It also examines how such studies are being translated to the clinic, especially as adjunct therapies for preventing intracerebral hemorrhage during reperfusion of the ischemic brain. I...
Source: Arteriosclerosis, Thrombosis and Vascular Biology - September 12, 2019 Category: Cardiology Authors: Andjelkovic AV, Xiang J, Stamatovic SM, Hua Y, Xi G, Wang MM, Keep RF Tags: Arterioscler Thromb Vasc Biol Source Type: research