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Value of routine echocardiography in the management of stroke.
Abstract BACKGROUND: Transthoracic echocardiography is routinely performed in patients with stroke or transient ischemic attack (TIA) to help plan secondary stroke management, but recent data evaluating its usefulness in this context are lacking. We sought to evaluate the value of echocardiography for identifying clinically actionable findings for secondary stroke prevention. METHODS: We conducted a multicentre cohort study of patients admitted to hospital with stroke or TIA between 2010 and 2015 at 2 academic hospitals in Toronto, Ontario, Canada. Clinically actionable echocardiographic findings for secondar...
Source: cmaj - August 6, 2019 Category: General Medicine Authors: Fralick M, Goldberg N, Rohailla S, Guo Y, Burke MJ, Lapointe-Shaw L, Kwan JL, Weinerman AS, Rawal S, Tang T, Razak F, Verma AA Tags: CMAJ Source Type: research
Recurrence Risk in Patients with Cryptogenic Stroke, Patent Foramen Ovale, and Thrombophilia: A Systematic Review and Meta-Analysis.
CONCLUSION: Thrombophilia is associated with an increased risk of recurrence in patients with PFO and cryptogenic stroke, which may persist after PFO closure. This suggests a need for antithrombotic therapy after PFO closure. Study heterogeneity precludes strong conclusions on antithrombotic treatment, but life-long antiplatelet therapy to patients without preexisting indication for anticoagulant therapy seems reasonable. PMID: 31378004 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - August 4, 2019 Category: Hematology Authors: Hviid CVB, Simonsen CZ, Hvas AM Tags: Thromb Haemost Source Type: research
Pacemaker-detected atrial fibrillation burden and risk of ischemic stroke or thromboembolic events—A cohort study
ConclusionIn patients with dual-chamber pacemakers and comparable CHA2DS2-VASc score, pacemaker-detected AF burden is associated with elevated risk for thromboembolism. Further research is needed to clarify how pacemaker-detected AF burden could incorporate with CHA2DS2-VASc score variables and help to guide anticoagulation.
Source: Heart and Lung: The Journal of Acute and Critical Care - August 1, 2019 Category: Respiratory Medicine Source Type: research
Predictive value of CHA2DS2-VASc scores regarding the risk of stroke and all-cause mortality in patients with atrial fibrillation (CONSORT compliant)
Background: Patients with atrial fibrillation (AF) have a higher risk of fatal complications (e.g., stroke). This investigation was performed as an observational retrospective cohort study includes 137 patients (age 61 ± 15; 34.3% women) with a primary diagnosis of AF (paroxysmal, persistent, and permanent). Methods: We collected information about the drug therapy, comorbidities and survival of AF patients and determined their congestive heart failure, hypertension, age, diabetes mellitus, prior stroke or TIA or thromboembolism, vascular disease, age, sex category (CHA2DS2-VASc) scores. Statistical analysis ident...
Source: Medicine - August 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research
Thrombolysis Guided by Perfusion Imaging up to 9 Hours after Onset of Stroke
This study hypothesized that extending the time window for thrombolytic therapy to 9 hours after onset of symptoms in patients with a small core of infarction and a larger area of hypoperfusion would be beneficial.
Source: The Journal of Emergency Medicine - August 1, 2019 Category: Emergency Medicine Authors: Matthew W. Harrison, Amanda Young Source Type: research
Respond, Intervene and Escalate: Acute Stroke Events in the Post Anesthesia Care Unit
In the post-anesthesia care unit (PACU) setting there can be challenges in differentiating between anesthesia-related versus thrombolytic neurologic deficits. The ability to accurately assess, differentiate and escalate care is imperative to improve outcomes. The occurrence of acute stroke events in the peri-operative setting at a comprehensive cancer center emphasized the need for an evidence-based and comprehensive approach to assessment, communication and documentation of risk factors for thrombotic complications.
Source: Journal of PeriAnesthesia Nursing - July 31, 2019 Category: Nursing Authors: Lisa Jiang, Heather Douglas, Miguel Laxa, Leena Mathew, Sharon Sarmiento, Kimberly Vanderhorst, Elizabeth Vogler Tags: ASPAN National Conference Abstract Source Type: research
CT-based Higher Thrombus Density is associated with Secondary Embolism during Mechanical Thrombectomy: A Preliminary Observation
This study addresses a potential relationship between thrombus density on preinterventional computed tomography (CT) and the occurrence of SE. Methods: We reviewed anterior circulation AIS patients who underwent MT from July 2015 to January 2019 in our center. Thrombus density was measured in Hounsfield Units (HU) on 1-mm and 5-mm preinterventional nonenhanced CT (NECT).
Source: Journal of Stroke and Cerebrovascular Diseases - July 31, 2019 Category: Neurology Authors: Gengfan Ye, Ruoyao Cao, Jun Lu, Peng Qi, Juan Chen, Daming Wang Source Type: research
Patient characteristics and stroke and bleeding events in nonvalvular atrial fibrillation patients treated with apixaban and vitamin K antagonists: a Spanish real-world study.
Conclusion: Patients prescribed apixaban for the treatment of nonvalvular atrial fibrillation had lower rates of thromboembolic events and minor/major bleeding than patients on acenocoumarol. PMID: 31333045 [PubMed - as supplied by publisher]
Source: Journal of Comparative Effectiveness Research - July 25, 2019 Category: General Medicine Tags: J Comp Eff Res Source Type: research
The ACTB Variants and Alcohol Drinking Confer Joint Effect to Ischemic Stroke in Chinese Han Population.
CONCLUSIONS: ACTB rs852426 was significantly associated with alcohol consumption on stroke risk, and the expression of ACTB mRNA in IS who had a drinking habit was significantly down-regulated. This finding will provide a novel insight into the prevention of stroke. PMID: 31327802 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - July 24, 2019 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
Platelet Indices as a Marker of Severity in Non-diabetic NonHypertensive Acute Ischemic Stroke Patients.
Conclusion: In patients of ischemic stroke platelet indices may be used for predicting severity of motor deficit. Although larger sample size and multivariate analysis is required before this can be used regularly in clinical practice. PMID: 31325260 [PubMed - in process]
Source: Journal of the Association of Physicians of India - July 22, 2019 Category: General Medicine Tags: J Assoc Physicians India Source Type: research
Level of motor, sensory and functional impairment from stroke at admission and hospital discharge in Brazil.
Conclusions: Clinical severity was softened along the hospitalization period. The clinical, motor, sensory and functional characterization enlarges the understanding of the stroke sequelae, besides monitoring the deficits and the level of disability in this population in Brazil. PMID: 31322001 [PubMed - as supplied by publisher]
Source: Brain Injury - July 20, 2019 Category: Neurology Tags: Brain Inj Source Type: research
Technical note on endovascular treatment of concomitant carotid occlusion in large vessel occlusion stroke: The "single-cross" technique.
CONCLUSIONS: The single-cross technique appears to be a safe and effective option for treating tandem occlusive lesions in the setting of ELVO. PMID: 31311374 [PubMed - as supplied by publisher]
Source: Interventional Neuroradiology - July 19, 2019 Category: Radiology Tags: Interv Neuroradiol Source Type: research
Anesthesiological management in endovascular stroke treatment.
Abstract Early recanalization of the closed cerebral arteries after acute ischemic stroke (AIS) is the only treatment to minimize long-term disability and to reduce the associated morbidity and mortality. For a long time the only proven causal treatment of AIS was intravenous thrombolysis; however, after the publication of a series of randomized prospective studies concerning endovascular mechanical thrombectomy using stent retriever systems after AIS, new guidelines were published. It was found that endovascular treatment (EVT) dramatically improves the outcome of eligible patients. The stent retriever enables ...
Source: Der Anaesthesist - July 19, 2019 Category: Anesthesiology Authors: Theilen HJ, Gerber JC Tags: Anaesthesist Source Type: research
ADAMTS13: An Emerging Target in Stroke Therapy
Thrombosis is the main pathogenesis of acute ischemic stroke (AIS). The main treatments for stroke either have limited efficacy or increase the risk of bleeding. ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) is a metal protease that can effectively break down VWF (Von Willebrand Factor, VWF), the key factor in thrombus formation. Previous studies have proven that the abnormality of its activity is associated with many diseases. In recent years, it has been found that ADAMTS13 is closely related to stroke. We focus on the relationship between ADAMTS13 and acute ischemic stroke,...
Source: Frontiers in Neurology - July 17, 2019 Category: Neurology Source Type: research
Temporal Trends and Predictors of Drug Utilization and Outcomes in First-Ever Stroke Patients: A Population-Based Study Using the Singapore Stroke Registry
ConclusionsPrescription of secondary stroke preventive medications (particularly in ischemic stroke) was associated with more favorable outcomes, highlighting the importance of physician adherence to evidence-based pharmacotherapy.
Source: CNS Drugs - July 16, 2019 Category: Neurology Source Type: research
Efficacy of Combining Proximal Balloon Guiding Catheter and Distal Access Catheter in Thrombectomy with Stent Retriever for Anterior Circulation Ischemic Stroke.
CONCLUSION: The combined technique needs lesser attempts, decreases distal migration, increases TICI 3 reperfusion and achieves better clinical outcomes. PMID: 31290296 [PubMed]
Source: Journal of Korean Neurosurgical Society - July 12, 2019 Category: Neurosurgery Tags: J Korean Neurosurg Soc Source Type: research
Status of prehospital delay and intravenous thrombolysis in the management of acute ischemic stroke in Nepal
The objective of this...
Source: BMC Neurology - July 9, 2019 Category: Neurology Authors: Gaurav Nepal, Jayant Kumar Yadav, Babin Basnet, Tirtha Man Shrestha, Ghanshyam Kharel and Rajeev Ojha Tags: Research article Source Type: research
Acid –Base and Electrolyte Changes Drive Early Pathology in Ischemic Stroke
AbstractEmergent large vessel occlusion accounts for 20 –40% of ischemic strokes and is the most debilitating form of stroke. Some of the earliest changes in response to ischemic stroke occur in blood gases and electrolytes. These biochemical changes occur within minutes after occlusion in experimental models of stroke and can be utilized to predict st roke outcomes. The majority of ELVO stroke patients are middle-aged to elderly and are of both sexes, revealing that there is an age and sex mismatch between ischemic stroke patients and animal models, since most experimental studies use young male rats. Rethinking of the ...
Source: NeuroMolecular Medicine - July 6, 2019 Category: Neurology Source Type: research
Diffuse alveolar hemorrhage following intravenous thrombolytic treatment in acute ischemic stroke: a case series
AbstractDiffuse alveolar hemorrhage (DAH) following fibrinolytic therapy is a rare but a life-threatening complication. In acute ischemic stroke (AIS), DAH as a complication was not reported following intravenous thrombolytic therapy (ITT). The demographic, clinical, radiologic, and prognostic data of 4 patients with AIS who developed DAH after ITT are presented in this case series, along with a literature review.
Source: Neurological Sciences - July 6, 2019 Category: Neurology 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 5, 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
Multimode Computed-Tomography-Guided Thrombolysis under a Prolonged Time Window in Acute Ischemic Stroke Patients with Atrial Fibrillation.
Authors: Yang Y, Sun W, Li D, Li XY, Wang XT, Li SC, Zhao HJ, Zhang JB Abstract Atrial fibrillation (AF) is an independent risk factor for intracranial hemorrhage in patients receiving recombinant-tissue-type plasminogen activator (rt-PA) thrombolytic therapy. Research showed that patients with acute ischemic stroke (AIS) could benefit from multimode computed-tomography- (CT-) guided intravenous thrombolysis over 4.5 hours. The medical data of patients with AIS in our center were retrospectively reviewed, and the data of the multimode CT-guided thrombolytic therapy or nonthrombolytic therapy within different time w...
Source: International Heart Journal - July 3, 2019 Category: Cardiology Tags: Int Heart J Source Type: research
Clinical outcomes of stroke in hemodialysis patients: a retrospective single-center study
ConclusionsStroke outcome in these patients is dismal with prolonged hospital stay, poor functional status at discharge, very limited response to rehabilitation, and increased mortality.
Source: International Urology and Nephrology - July 1, 2019 Category: Urology & Nephrology Source Type: research
Does the administration of sonothrombolysis along with tissue plasminogen activator improve outcomes in acute ischemic stroke? A systematic review and meta-analysis
AbstractThis meta-analysis was conducted to assess the safety and efficacy of sonothrombolysis along with intravenous recombinant tissue plasminogen activator, alteplase (IV rtPA), in the management of acute ischemic stroke. Electronic databases were searched under different meSH terms without the restriction of time and language. 1415 studies were analyzed and seven studies that matched the inclusion criteria were selected. Multiple safety and efficacy outcomes were extracted. Our pooled analysis demonstrated that there is no significant difference between sonothrombolysis group and control group in preventing mortality (...
Source: Journal of Thrombosis and Thrombolysis - June 29, 2019 Category: Hematology Source Type: research
Serum Proteome Alterations in Human Cystathionine β-Synthase Deficiency and Ischemic Stroke Subtypes.
Abstract Ischemic stroke induces brain injury via thrombotic or embolic mechanisms involving large or small vessels. Cystathionine β-synthase deficiency (CBS), an inborn error of metabolism, is associated with vascular thromboembolism, the major cause of morbidity and mortality in affected patients. Because thromboembolism involves the brain vasculature in these patients, we hypothesize that CBS deficiency and ischemic stroke have similar molecular phenotypes. We used label-free mass spectrometry for quantification of changes in serum proteomes in CBS-deficient patients (n = 10) and gender/age-matched unaffected ...
Source: Genomics Proteomics ... - June 25, 2019 Category: Genetics & Stem Cells Authors: Sikora M, Lewandowska I, Kupc M, Kubalska J, Graban A, Marczak Ł, Kaźmierski R, Jakubowski H Tags: Int J Mol Sci Source Type: research
Can imaging extend the thrombolytic time window after stroke?
Nature Reviews Neurology, Published online: 24 June 2019; doi:10.1038/s41582-019-0232-yA new trial has demonstrated the benefits of intravenous thrombolysis, guided by perfusion imaging, 4.5–9.0 h after stroke onset and in individuals with wake-up stroke. In addition to extending the time window for thrombolysis after acute ischaemic stroke, these findings could aid the refinement of imaging and thrombolytic protocols.
Source: Nature Reviews Neurology - June 24, 2019 Category: Neurology Authors: Min Lou Source Type: research
Markers of Coagulation and Fibrinolysis Predicting the Outcome of Acute Ischemic Stroke Thrombolysis Treatment: A Review of the Literature
Intravenous administration of recombinant tissue plasminogen activator (rt-PA) has been proven to be safe and effective in the treatment of acute ischemic stroke. Little is known, however, why this treatment is less effective in some patients while in others life-threatening side-effects, e.g. symptomatic intracerebral hemorrhage might occur. Clinical failure of thrombolysis related to absent or partial recanalization or reocclusion as well as hemorrhagic complications of thrombolysis are possibly related to hemostatic events. Data on markers of coagulation and/or fibrinolysis in acute stroke patients are numerous and may ...
Source: Frontiers in Neurology - June 21, 2019 Category: Neurology Source Type: research
Association of Non-LDL Indices with Recurrent Stroke Risk while on Lipid-Modifying Therapy.
CONCLUSIONS: Compared with the nonuse of LT, there may be a hierarchy of residual vascular risk after stroke by non-LDL type and target, while on LT. Particularly, stroke patients with low HDL-C levels on LT may benefit from additional therapeutic strategies to improve their outcomes. PMID: 31189759 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - June 15, 2019 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
Aortogenic Embolic Stroke Diagnosed by a Pathological Examination of Endovascularly Removed Thrombus: An Autopsy Report.
Authors: Usui G, Hashimoto H, Sugiura Y, Nishi Y, Kusakabe M, Horiuchi H, Okubo S, Morikawa T Abstract Complex aortic atheroma is a high-risk factor for recurrent embolic stroke. An accurate identification of stroke etiology is clinically important; however, it can be challenging. A 91-year-old man with atrial fibrillation was diagnosed with cardioembolic stroke and treated with mechanical thrombectomy. The removed thrombus microscopically contained foamy cells, suggesting an atheroembolism. An autopsy revealed an atherosclerotic lesion with ulceration, located in the aortic arch. At the lesion, the plaque had micr...
Source: Internal Medicine - June 12, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research
Proteomic analyses identify a potential mechanism by which extracellular vesicles aggravate ischemic stroke
Publication date: Available online 7 June 2019Source: Life SciencesAuthor(s): Xintong Wang, Jiaoqi Wang, Xiaohua Shi, Chengliang Pan, Hongyu Liu, Yue Dong, Rui Dong, Jing Mang, Zhongxin XuAbstractAimsExtracellular vesicles (EVs) are vital for information exchange between donor and recipient cells. When cells are stressed (e.g., by oxygen glucose deprivation, OGD), the complex information carried by the EVs is altered by the donor cells. Here, we aimed to analyze the proteomic differences between EVs derived from OGD-damaged cells and EVs derived from undamaged cells to explore the potential mechanisms by which EVs aggravat...
Source: Life Sciences - June 8, 2019 Category: Biology Source Type: research
Left atrial remodeling index is a feasible predictor of poor prognosis in patients with acute ischemic stroke
This study aimed to elucidate whether combined assessment of LA functional and structural remodeling can predict LAA dysfunction and recurrent cerebrovascular events in patients with acute ischemic stroke. We performed transthoracic and transesophageal echocardiography in 196 patients within 7 days after acute ischemic stroke. Peak systolic LA strain was evaluated using 2D speckle tracking imaging. We defined the ratio of LA peak systolic strain to LA volume index (LAVI) as the LA remodeling index (LARI). All patients were prospectively followed for recurrent cerebrovascular events. We divided patients into four groups a...
Source: Heart and Vessels - June 5, 2019 Category: Cardiology Source Type: research
Distinct plasma proteomic changes in male and female African American stroke patients.
CONCLUSION: Plasma proteins that differ in quantities between stroke patients and controls were readily detected using a simple proteomic approach. Sex-dependent changes and changes that have not been reported for African American stroke patients offer potentially novel biomarkers for stroke in this underserved population. PMID: 31149323 [PubMed]
Source: International Journal of Physiology, Pathophysiology and Pharmacology - June 4, 2019 Category: Physiology Tags: Int J Physiol Pathophysiol Pharmacol Source Type: research
Effect of Hyperhomocysteinemia on Clinical Outcome and Hemorrhagic Transformation After Thrombolysis in Ischemic Stroke Patients
Conclusion: We found that Hhcy was an independent risk factor for poor outcome, but not an independent risk factor for HT after thrombolysis in ischemic stroke patients. In addition, there was no significant interaction of Hhcy and hypertension on the clinical outcome or HT after thrombolysis.
Source: Frontiers in Neurology - June 4, 2019 Category: Neurology Source Type: research
Association between K469E polymorphism of ICAM ‐1 gene and susceptibility of ischemic stroke: An updated meta‐analysis
ConclusionK469E polymorphism of ICAM ‐1 gene might be a risk factor for ischemic stroke in Caucasians, which suggested that K469E polymorphism might help in early identification of those at risk and help in primary prevention of ischemic stroke.
Source: Molecular Genetics & Genomic Medicine - June 3, 2019 Category: Genetics & Stem Cells Authors: Gaurav Nepal, Jayant Kumar Yadav, YuHui Kong Tags: ORIGINAL ARTICLE Source Type: research
Association of Cerebral Arterial Stiffness with Initial Severity in Acute Ischemic Stroke.
CONCLUSIONS: Cerebral arterial stiffness was independently associated with initial severity in AIS patients, and may be more strongly correlated with the initial SVO severity than those of other subtypes. PMID: 31130556 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - May 29, 2019 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
An injectable implant to stimulate the sphenopalatine ganglion for treatment of acute ischaemic stroke up to 24 h from onset (ImpACT-24B): an international, randomised, double-blind, sham-controlled, pivotal trial
Publication date: Available online 24 May 2019Source: The LancetAuthor(s): Natan M Bornstein, Jeffrey L Saver, Hans Christoph Diener, Philip B Gorelick, Ashfaq Shuaib, Yoram Solberg, Lisa Thackeray, Milan Savic, Tamar Janelidze, Natia Zarqua, David Yarnitsky, Carlos A Molina, Ashfaq Shuaib, Michael Hill, Daniel Vaclavik, David Skoloudik, Jan Fiksa, Grethe Andersen, Pekka Jakala, Turgut TatlisumakSummaryBackgroundSphenopalatine ganglion stimulation increased cerebral collateral blood flow, stabilised the blood–brain barrier, and reduced infarct size, in preclinical models of acute ischaemic stroke, and showed potential be...
Source: The Lancet - May 25, 2019 Category: General Medicine Source Type: research
Meta-Regression to Identify Patients Deriving the Greatest Benefit from Dual Antiplatelet Therapy After Stroke or Transient Ischemic Attack Without Thrombolytic or Thrombectomy Treatment
The patient's profile drawing the greatest benefit from dual antiplatelet therapy (DAPT) after a non-cardioembolic, ischemic cerebrovascular event is not well characterized. Aim of this meta-regression analysis was to compare DAPT versus single antiplatelet therapy (SAPT) in patients with stroke or transient ischemic attack (TIA). We searched randomized trials evaluating clinical outcome with aspirin plus a P2Y12 inhibitor versus SAPT in patients with non-cardioembolic stroke or TIA. Primary endpoint was the incidence of recurrent stroke; safety outcome measure was major bleeding.
Source: The American Journal of Cardiology - May 25, 2019 Category: Cardiology Authors: Giuseppe Patti, Alessandro Sticchi, Antonio Bisignani, Francesco Pelliccia, Vincenzo Pasceri, Giulio Speciale, Maria Penco Source Type: research
Using CT left atrial appendage imaging to identify patients at higher risk of stroke
More than the last 5 –10 years, the left atrial appendage (LAA) has become an increasingly important anatomic site for cardiologists, especially in the prevention and management of stroke.1 Once felt to be a relatively benign entity, its role as a nidus for thrombus (especially in those with atrial fibrillation (AF)) has long been recognised, but with the advent of LAA exclusion devices, which may be internal (such as Watchman, Wavecrest and Amplatz devices), or external (such as the Lariat laso or Atriclip), the need to accurately assess the morphology of left atrial appendage has become increasingly important, both in ...
Source: Journal of Cardiovascular Computed Tomography - May 25, 2019 Category: Radiology Authors: E. Nicol Tags: Editorial Source Type: research
Jefferson Health and Bensalem Rescue Squad Unveil Mobile Stroke Unit
BENSALEM, PA — On Thursday, May 16, the Vickie and Jack Farber Institute for Neuroscience at Jefferson and the Bensalem Rescue Squad introduced during a formal ribbon-cutting ceremony a new Mobile Stroke Unit (MSU) that will serve stroke patients in Bucks County. The event was hosted by leaders from Jefferson Health and Bensalem Township, who touted the unit’s unique capabilities to aid victims of stroke. The MSU will be based in Bucks County and is the region’s first university-based, high-tech Mobile Stroke Unit. It will work with emergency medical services, Jefferson Expert Telestroke (JET) physician team, and med...
Source: JEMS Operations - May 24, 2019 Category: Emergency Medicine Tags: Ambulances & Vehicle Ops News Press Releases Source Type: news
Independent ischemic stroke risk factors in older Americans: a systematic review.
Abstract The Framingham Stroke Risk Profile (FSRP) is a validated model for predicting 10-year ischemic stroke risk in middle-aged adults, yet has not been demonstrated to consistently translate in older populations. This is a systematic review of independent risk factors measured among > 65 year olds, with subsequent first ischemic stroke, using PRISMA guidelines. We appraised peer-reviewed publications that included participants > 65 years old at risk assessment. Combined with other criteria, results were abstracted from 28 papers reporting six types of stroke risk factors: Serologic/Diagnostic, Convention...
Source: Aging - May 24, 2019 Category: Biomedical Science Authors: Singer J, Gustafson D, Cummings C, Egelko A, Mlabasati J, Conigliaro A, Levine SR Tags: Aging (Albany NY) Source Type: research
Left Atrial Appendage Occlusion for Secondary Stroke Prevention in Patients with Atrial Fibrillation: Long-Term Results
Conclusion: Patients with prior stroke may be the preferred group for LAAC regardless of the presence or absence of contraindications for anticoagulant therapy.
Source: Cerebrovascular Diseases - May 23, 2019 Category: Neurology Source Type: research
Left Atrial Appendage Occlusion as Adjunctive Therapy to Anticoagulation for Stroke Recurrence.
CONCLUSIONS: LAAO as an adjunctive therapy to OAC seems to be feasible and safe in patients with previous cardioembolic events despite optimal OAC. In our series, this strategy was associated with a low rate of cerebrovascular events after LAAO. PMID: 31088992 [PubMed - as supplied by publisher]
Source: The Journal of Invasive Cardiology - May 16, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research
Atrial fibrillation, not atrial cardiopathy, is associated with stroke: A single center retrospective study
Atrial fibrillation (AF) increases the risk of thromboembolism. Atrial cardiopathy, defined as structural left atrial enlargement (LAE), has been proposed to be a unifying risk factor for stroke, with or without atrial fibrillation (AF). We sought to understand the relative importance of LAE and AF as risk factors for stroke.
Source: Journal of the Neurological Sciences - May 15, 2019 Category: Neurology Authors: Muhammad Affan, Abhimanyu Mahajan, Sumul Modi, Lonni Schultz, Angelos Katramados, Stephan A. Mayer, Daniel Miller Source Type: research
Preference and Values of Stroke Interventions, Kingdom of Saudi Arabia.
Conclusion. Researchers found that the high percentage of participants had favorable response and positive perception toward providing acute stroke intervention and mechanical thrombectomy without informed consent. However, the study showed skeptical acceptance among participants regarding invasive surgical measures. PMID: 31057967 [PubMed]
Source: Neurology Research International - May 7, 2019 Category: Neurology Tags: Neurol Res Int Source Type: research
Patent Foramen Ovale and Ischemic Stroke in Patients With Pulmonary Embolism: A Prospective Cohort Study.
Conclusion: Frequency of recent ischemic stroke in patients with symptomatic PE was higher in patients with PFO than in those without PFO. This finding supports the hypothesis that paradoxical embolism is an important mechanism of ischemic stroke in patients with PFO. Primary Funding Source: French Ministry of Health. PMID: 31060047 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - May 7, 2019 Category: Internal Medicine Authors: Le Moigne E, Timsit S, Ben Salem D, Didier R, Jobic Y, Paleiron N, Le Mao R, Joseph T, Hoffmann C, Dion A, Rousset J, Le Gal G, Lacut K, Leroyer C, Mottier D, Couturaud F Tags: Ann Intern Med Source Type: research
Fatal intracranial aneurysm rupture after thrombolytic treatment for ischemic stroke: a case report and literature review
We present a case report of a patient who suffered fatal subarachnoid hemorrhage after thrombolysis from a known aneurysm. A history of recent previously inexperienced headaches was revealed retrospectively, suggestive of sentinel bleedings. A similar patient was identified in the literature; we thus propose that this history should be excluded in patients harboring an aneurysm considered for thrombolytic treatment.
Source: Acta Neurochirurgica - May 7, 2019 Category: Neurosurgery Source Type: research
Structural analysis of ischemic stroke thrombi: histological indications for therapy resistance.
Abstract Ischemic stroke is caused by a thromboembolic occlusion of cerebral arteries. Treatment is focused on fast and efficient removal of the occluding thrombus, either via intravenous thrombolysis or via endovascular thrombectomy. Recanalization, however, is not always successful and factors contributing to failure are not completely understood. Although the occluding thrombus is the primary target of acute treatment, little is known about its internal organization and composition. The aim of this study, therefore, was to better understand the internal organization of ischemic stroke thrombi on a molecular and...
Source: Haematologica - May 2, 2019 Category: Hematology Authors: Staessens S, Denorme F, François O, Desender L, Dewaele T, Vanacker P, Deckmyn H, Vanhoorelbeke K, Andersson T, De Meyer SF Tags: Haematologica Source Type: research
Specific mechanisms of subarachnoid hemorrhage accompanied by ischemic stroke in essential thrombocythemia: two case reports and a literature review
ConclusionsThe current study describes rare cases of SAH accompanied by ischemic stroke secondary to ET along with a review of the current literature, implying specific mechanisms for cerebral artery disorders associated withJAK2 V617F mutation.
Source: Journal of Neurology - May 2, 2019 Category: Neurology Source Type: research
Protease-independent action of tissue plasminogen activator in brain plasticity and neurological recovery after ischemic stroke Neuroscience
In this study, we investigated the role of tPA on primary neurons in culture and on brain recovery and plasticity after ischemic...
Source: Proceedings of the National Academy of Sciences - April 30, 2019 Category: Science Authors: Hongjian Pu, Yejie Shi, Lili Zhang, Zhengyu Lu, Qing Ye, Rehana K. Leak, Fei Xu, Shubei Ma, Hongfeng Mu, Zhishuo Wei, Na Xu, Yuguo Xia, Xiaoming Hu, T. Kevin Hitchens, Michael V. L. Bennett, Jun Chen Tags: PNAS Plus Source Type: research
Using Dental Pulp Stem Cells for Stroke Therapy
Conclusion and Future Perspectives Stem cell-based therapy is a promising alternative for stroke treatment. While stem cells from different sources, including induced PSC, ESC, MSC, and NSC, have been investigated, using NSC and enhancing the natural mechanisms is most appropriate for brain repair. In preclinical models of stroke, stem cell transplantation has led to positive outcomes through a variety of cellular and molecular mechanisms, many being mediated by the array of beneficial factors produced by the cells. Recent advances in cellular reprogramming have provided alternative sources of NSC to be investigated, allo...
Source: Frontiers in Neurology - April 29, 2019 Category: Neurology Source Type: research