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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

Pre-hospital Triage of Acute Ischemic Stroke Patients —Importance of Considering More Than Two Transport Options
Conclusion: Pre-hospital triage algorithms for AIS patients that only take into account the nearest CSC and the nearest PSC as transport destinations may be unable to identify the optimal transport destination for a significant proportion of patients. Introduction Background International guidelines recommend early administration of intravenous thrombolysis for eligible patients with acute ischemic stroke (AIS); in addition, patients with proximal large vessel occlusion (LVO) should receive mechanical thrombectomy (MT) as quickly as possible (1). As the clinical benefit of both thrombolysis (2–4) and MT (5&#...
Source: Frontiers in Neurology - April 26, 2019 Category: Neurology Source Type: research

Intravenous Thrombolysis in Posterior Circulation Stroke
Conclusions: Up to date, no data about PCIS and IVT are available from RTCs. Based on limited results from retrospective clinical studies and case series, IVT is safer for use in PCIS than in ACIS. Patients with brainstem ischemia, vertebral artery occlusion, and absence of basilar or posterior cerebral artery occlusion could be considered for treatment with IVT even in borderline cases. Time to IVT in PCIS seems to be a less crucial factor than in ACIS. IVT for PCIS may be beneficial even after 4.5 h from symptom onset. Introduction History of Intravenous Thrombolysis—The Most Relevant Studies Intravenous...
Source: Frontiers in Neurology - April 26, 2019 Category: Neurology Source Type: research

Analysis of the Association Between Polymorphisms within PAI-1 and ACE genes and Ischemic Stroke Outcome After rt-PA Therapy.
CONCLUSION: Results of our study suggest that stroke patients with ACE II genotype, treated with rt-PA, may be at risk of HT. PMID: 31013014 [PubMed - in process]
Source: Journal of Pharmacy and Pharmaceutical Sciences - April 24, 2019 Category: Drugs & Pharmacology Tags: J Pharm Pharm Sci Source Type: research

Paradoxical Brain Embolism Caused by Isolated Pulmonary Arteriovenous Fistula Successfully Treated with Recombinant Tissue Plasminogen Activator
Pulmonary arteriovenous fistula (PAVF), a vessel malformation connecting the pulmonary circulation to the systemic circulation while bypassing the pulmonary capillaries, can cause paradoxical cerebral infarction. It is often associated with hereditary hemorrhagic telangiectasia (HHT), a genetic disease characterized by multiple dermal, mucosal, and visceral telangiectasia causing recurrent bleeding. Paradoxical cerebral embolism caused by PAVF without HHT is rare. Here, we report a patient with isolated PAVF who experienced an ischemic stroke caused by a paradoxical embolism from deep venous thrombosis; the patient was suc...
Source: Journal of Stroke and Cerebrovascular Diseases - April 18, 2019 Category: Neurology Authors: Itsuki Hasegawa, Takato Abe, Toshikazu Mino, Kousuke Okamoto, Akitoshi Takeda, Yoshiaki Itoh Tags: Case Report Source Type: research

Influence of Sex on Stroke Prognosis: A Demographic, Clinical, and Molecular Analysis
Conclusion Our data suggest that women who suffer from IS present with a poorer functional outcome than men at 3-months, regardless of other preclinical and clinical factors during the acute phase. These relationships seem to be mediated by atrial dysfunction and inflammation. The inflammatory response is slightly higher in women; however, there are no sex differences in their functional behavior. There is a probable relationship between the molecular marker of atrial dysfunction NT-proBNP and worse functional outcome in women, and the connection seems to be more important in cardioembolic stroke patients. In patients wi...
Source: Frontiers in Neurology - April 17, 2019 Category: Neurology Source Type: research

Frequency of Hemorrhage on Follow Up Imaging in Stroke Patients Treated With rt-PA Depending on Clinical Course
Conclusions: Frequency of hemorrhagic transformation in Routine follow-up brain imaging and consecutive changes in therapeutic management were different depending on clinical course measured by NHISS score. Introduction Brain imaging 24–36 h after systemic thrombolysis for acute ischemic stroke is recommended in American Stroke Association and European Stroke Organization guidelines (1, 2). Brain imaging is performed to detect secondary bleeding or hemorrhagic transformation in order to adapt medical stroke prevention if necessary. Guideline recommendations are based on the results of the first study on rt-PA...
Source: Frontiers in Neurology - April 16, 2019 Category: Neurology Source Type: research

Post-Stroke Blood-Brain Barrier Disruption and Poor Functional Outcome in Patients Receiving Thrombolytic Therapy
Conclusions: Post-stroke BBB disruption appears to be predictive of functional outcome irrespective of stroke size.Cerebrovasc Dis
Source: Cerebrovascular Diseases - April 15, 2019 Category: Neurology Source Type: research

The pleiotropic effect of rs7903146 on type 2 diabetes and ischemic stroke: a family-based study in a Chinese population
In conclusion, our study provided evidence that a T2D-independent path was identified out of the pleiotropic effect of rs7903146 on IS. However, further studies were needed to validate the biological mechanisms behind the pleiotropic effect and the modification by l ifestyle intervention.
Source: Journal of Thrombosis and Thrombolysis - April 12, 2019 Category: Hematology Source Type: research

Platelet Count Predicts Adverse Clinical Outcomes After Ischemic Stroke or TIA: Subgroup Analysis of CNSR II
Conclusion: In ischemic stroke or TIA patients with platelet count within normal range, platelet count may be a qualified predictor for long-term recurrent stroke, mortality, and poor functional outcome. Introduction Platelets exert a critical role in the pathogenesis of atherosclerotic complications of cardio-cerebrovascular disease, contributing to thrombus formation, and embolism (1, 2). Previous literature reported that platelets of various size and density are produced by megakaryocytes of different size and stages of maturation in different clinical conditions, suggesting various platelet patterns in differen...
Source: Frontiers in Neurology - April 12, 2019 Category: Neurology Source Type: research

Cardiac Imaging Within Emergency CT Angiography for Acute Stroke Can Detect Atrial Clots
This study was approved by the ethics committee of the medical faculty of the Ruhr University Bochum. FIGURE 1 Figure 1. Flow chart showing the selection of the study population. Results A total of 59 patients underwent emergency CCTA (Figure 2A) for suspected stroke, of which 44 received the final diagnosis ischemic stroke. There were 17 patients who had ischemic stroke or TIA and known or newly diagnosed atrial fibrillation (Table 1; mean age: 77.5 years, standard deviation: 8.4 years; 53% female). As hypothesized, intracardiac thrombi could be visualized: once in an artificially occluded left atrial appe...
Source: Frontiers in Neurology - April 10, 2019 Category: Neurology Source Type: research

Stroke prophylaxis in critically-ill patients with new-onset atrial fibrillation
AbstractDespite a high incidence of new onset atrial fibrillation (NOAF) in critically ill patients and its association with short and long-term incidence of stroke, there is limited data assessing anticoagulation on hospital discharge in these patients. We retrospectively reviewed electronic medical records of all adult patients admitted to non-cardiac ICUs at our institution between January 2009 and March 2016. Patients with NOAF were identified and CHA2DS2-VASc score of ICU survivors was calculated. Prescription of oral anticoagulant therapy on hospital discharge was analyzed. A total of 640 (1.7% [38,708 patients]; 95%...
Source: Journal of Thrombosis and Thrombolysis - April 8, 2019 Category: Hematology Source Type: research

Acute Management of Ischemic Stroke During Pregnancy.
Abstract Acute stroke in pregnancy can be devastating. Although neurologists will at some point be involved in the management, most of these patients are likely to first be evaluated by an obstetric care provider. It is, therefore, important for obstetric care providers to have an understanding of the presentation and management of stroke, particularly in the initial period when the window of opportunity for therapy is critical. Once suspected, a head computed tomography (CT) without contrast media should be performed without delay to rule out a hemorrhagic component. Patients presenting within 4.5 hours of sympto...
Source: Obstetrics and Gynecology - April 5, 2019 Category: OBGYN Authors: Pacheco LD, Hankins GDV, Saad AF, Saade GR Tags: Obstet Gynecol Source Type: research

Stroke: Insights into Thromboembolism Treatment and Prevention through the Decades.
PMID: 30947348 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - April 4, 2019 Category: Hematology Authors: Ntaios G, Lip GYH Tags: Thromb Haemost Source Type: research

Therapeutic strategy against ischemic stroke with the concept of neurovascular unit
Publication date: Available online 1 April 2019Source: Neurochemistry InternationalAuthor(s): Tomohiko Ozaki, Hajime Nakamura, Haruhiko KishimaAbstractStroke is one of the leading causes of death and disability globally. Although thrombolytic therapy by t-PA and mechanical thrombectomy have improved outcomes of ischemic stroke patients, both of these approaches are applicable to limited numbers of patients owing to their time constraints. Therefore, development of other treatment approaches such as developing neuroprotective drugs and nerve regeneration therapy is required to overcome ischemic stroke. The concept of the ne...
Source: Neurochemistry International - April 2, 2019 Category: Neuroscience Source Type: research

The Relevance of Vascular Endothelial Growth Factor, Hypoxia Inducible Factor-1 Alpha, and Clusterin in Carotid Plaque Instability
Background: Stroke is one of the leading causes of morbidity and mortality. Thromboembolism, as a major cause of carotid artery-related stroke, can be caused by plaque rupture which is associated with neoangiogenesis within the carotid plaque. Aim: We sought to investigate a possible correlation between angiogenesis-related factors and preoperative neurological manifestations in patients with internal carotid artery stenosis, for a better understanding of thromboembolism in internal carotid artery stenosis-related stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - April 2, 2019 Category: Neurology Authors: Jelena Basic, Stefan Stojkovic, Afshin Assadian, Sabine Rauscher, Nikolaus Duschek, Christoph Kaun, Johann Wojta, J ürgen Falkensammer Source Type: research

Thrombolysis for atlantoaxial dislocation mimicking acute ischemic stroke: Case report and review
The frequency of stroke mimics among stroke patients has been reported to be up to 30%, and that in patients who receive thrombolytic therapy ranges between 1% and 16%. Atlantoaxial dislocation with myelopathy mimicking stroke is extremely rare. An 83-year-old man with a history of old cerebellar infarction presented to the emergency department with acute left hemiplegia after a chiropractic manipulation of the neck and back several hours before symptom onset. Mild hypoesthesia was observed on his left limbs.
Source: The American Journal of Emergency Medicine - March 27, 2019 Category: Emergency Medicine Authors: Adam Tsou, Yu-Hsiu Juan, Tsu-Yi Chen, Shinn-Kuang Lin Source Type: research

Thrombolysis for atlantoaxial dislocation mimicking acute ischemic stroke
The frequency of stroke mimics among stroke patients has been reported to be up to 30%, and that in patients who receive thrombolytic therapy ranges between 1% and 16%. Atlantoaxial dislocation with myelopathy mimicking stroke is extremely rare. An 83-year-old man with a history of old cerebellar infarction presented to the emergency department with acute left hemiplegia after a chiropractic manipulation of the neck and back several hours before symptom onset. Mild hypoesthesia was observed on his left limbs.
Source: The American Journal of Emergency Medicine - March 27, 2019 Category: Emergency Medicine Authors: Adam Tsou, Yu-Hsiu Juan, Tsu-Yi Chen, Shinn-Kuang Lin Tags: Case Report Source Type: research

Features of Childhood Arterial Ischemic Stroke in China.
CONCLUSION: Infection was an important risk factor for children with AIS in China. Infection and thrombophilia risk factors were more likely to occur in isolation. The stroke lesions commonly occurred in the basal ganglia region. PMID: 30890011 [PubMed - as supplied by publisher]
Source: Fetal and Pediatric Pathology - March 22, 2019 Category: Pathology Tags: Fetal Pediatr Pathol Source Type: research

Calcium-dependent blood-brain barrier breakdown by NOX5 limits postreperfusion benefit in stroke
Ischemic stroke is a predominant cause of disability worldwide, with thrombolytic or mechanical removal of the occlusion being the only therapeutic option. Reperfusion bears the risk of an acute deleterious calcium-dependent breakdown of the blood-brain barrier. Its mechanism, however, is unknown. Here, we identified type 5 NADPH oxidase (NOX5), a calcium-activated, ROS-forming enzyme, as the missing link. Using a humanized knockin (KI) mouse model and in vitro organotypic cultures, we found that reoxygenation or calcium overload increased brain ROS levels in a NOX5-dependent manner. In vivo, postischemic ROS formation, in...
Source: Journal of Clinical Investigation - March 19, 2019 Category: Biomedical Science Authors: Ana I. Casas, Pamela W.M. Kleikers, Eva Geuss, Friederike Langhauser, Thure Adler, Dirk H. Busch, Valerie Gailus-Durner, Martin Hrabê de Angelis, Javier Egea, Manuela G. Lopez, Christoph Kleinschnitz, Harald H.H.W. Schmidt Source Type: research

Thrombolytic Therapy for Acute Ischemic Stroke: Past and Future.
CONCLUSION: Thrombolytic therapy is sometimes accompanied by harmful hemorrhagic insults; accordingly, a window of time wherein therapy can safely be performed has been established for this approach. Several basic and clinical studies are ongoing to develop next-generation thrombolytic drugs to expand the time window. PMID: 30892155 [PubMed - as supplied by publisher]
Source: Current Pharmaceutical Design - March 18, 2019 Category: Drugs & Pharmacology Authors: Shibata K, Hashimoto T, Miyazaki T, Miyazaki A, Nobe K Tags: Curr Pharm Des Source Type: research

The Implication of HeartWare HVAD Inflow Cannula Angle on Stroke and Thrombus Rate
Stroke and ventricular assist device (VAD) pump thrombus are serious complications that have previously been thought to be related to surgical placement - namely VAD inflow cannula angle. Our aim with this study was to better elucidate the impact of post-operative HeartWare HVAD (left VAD) cannula inflow angle on stroke and thrombus rate within a single centre in Sydney, Australia.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: S. Emmanuel, D. Aktuerk, A. Chowdhury, C. Hurwitz, L. Beiglari, P. Jansz, C. Hayward Tags: 1080 Source Type: research

Safety and efficacy of sonothrombolysis for acute ischaemic stroke: a multicentre, double-blind, phase 3, randomised controlled trial
Publication date: April 2019Source: The Lancet Neurology, Volume 18, Issue 4Author(s): Andrei V Alexandrov, Martin Köhrmann, Lauri Soinne, Georgios Tsivgoulis, Andrew D Barreto, Andrew M Demchuk, Vijay K Sharma, Robert Mikulik, Keith W Muir, Gordon Brandt, John Alleman, James C Grotta, Christopher R Levi, Carlos A Molina, Maher Saqqur, Dimitris Mavridis, Theodora Psaltopoulou, Milan Vosko, Jochen B Fiebach, Pitchaiah MandavaSummaryBackgroundPulsed-wave ultrasound increases the exposure of an intracranial thrombus to alteplase (recombinant tissue plasminogen activator), potentially facilitating early reperfusion. We aimed ...
Source: The Lancet Neurology - March 16, 2019 Category: Neurology Source Type: research

Thrombolytic Therapy in Cocaine Users with Ischemic Stroke: A Review of Current Practice.
Authors: Siniscalchi A, De Sarro G, Pacifici R, Pisani E, Sanguigni S, Gallelli L Abstract Alteplase is the main pharmacological treatment available for intravenous thrombolysis in patients with acute ischemic stroke. Endovascular treatment alone or add-on to intravenous thrombolysis is a valid approach in acute ischemic stroke with cerebral large vessel disease. The most common serious adverse reaction related to alteplase is the development of spontaneous intracerebral hemorrhage and the presence of cerebral small vessel disease may increase this risk, particularly in cocaine users, even if only few data have bee...
Source: Psychopharmacology Bulletin - March 16, 2019 Category: Psychiatry & Psychology Tags: Psychopharmacol Bull Source Type: research

Predictors and Clinical Impact of Delayed Stent Thrombosis after Thrombectomy for Acute Stroke with Tandem Lesions INTERVENTIONAL
CONCLUSIONS: We observed a non-negligible rate of delayed stent thrombosis with significant negative impact on clinical outcome. Future studies should systematically measure and report stent patency rates.
Source: American Journal of Neuroradiology - March 14, 2019 Category: Radiology Authors: Pop, R., Zinchenko, I., Quenardelle, V., Mihoc, D., Manisor, M., Richter, J. S., Severac, F., Simu, M., Chibbaro, S., Rouyer, O., Wolff, V., Beaujeux, R. Tags: INTERVENTIONAL Source Type: research

Improved detection and characterization of arterial occlusion in acute ischemic stroke using Contrast Enhanced MRA
Conclusions:Our study showed that CEMRA imaging detected arterial occlusions better than TOF MRA in AIS patients and more precisely such that thrombus length and location could be known, which improves the patient’s management and care.
Source: Journal of Neuroradiology - March 8, 2019 Category: Radiology Source Type: research

Applications of Liposomal Drug Delivery Systems to Develop Neuroprotective Agents for the Treatment of Ischemic Stroke.
Abstract Ischemic stroke is one of the leading causes of severe disability and death. In clinical settings, tissue plasminogen activator (t-PA) for thrombolytic therapy is the only globally approved drug for the treatment of ischemic stroke. However, the proportion of patients who receive t-PA therapy is extremely limited due to its narrow therapeutic time window (TTW) and the risk of cerebral hemorrhage. Cerebral ischemia-reperfusion (I/R) injury is also a serious problem for patients' outcomes. Hence, the development of more effective therapies has been desired to prolong the TTW of t-PA and prevent cerebral I/R...
Source: Biological and Pharmaceutical Bulletin - March 6, 2019 Category: Drugs & Pharmacology Authors: Fukuta T, Ishii T, Asai T, Oku N Tags: Biol Pharm Bull Source Type: research

Interaction between an ATP-Binding Cassette A1 (ABCA1) Variant and Egg Consumption for the Risk of Ischemic Stroke and Carotid Atherosclerosis: a Family-Based Study in the Chinese Population.
CONCLUSION: rs2066715 was found to interact with egg consumption in modifying the risk of carotid plaque in the Chinese population. PMID: 30828007 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - March 6, 2019 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research

Platelet Glycoprotein IIb/IIIa Receptor Inhibitor Tirofiban in Acute Ischemic Stroke
AbstractTirofiban is a non-peptide selective glycoprotein (GP) IIb/IIIa receptor inhibitor that reversibly inhibits fibrinogen-dependent platelet aggregation and subsequent formation of thrombi, which contribute to the major atherosclerotic complications in the development, progression, and resolution of ischemic stroke. The adjunctive use of tirofiban has been extensively evaluated in progressive stroke, combined intravenous thrombolysis (IVT), and endovascular treatment (EVT) in both preclinical and clinical studies. A body of evidence has been accumulated on the risks and benefits associated with tirofiban in terms of p...
Source: Drugs - March 6, 2019 Category: Drugs & Pharmacology Source Type: research

Is lipoprotein(a) a  risk factor for ischemic stroke and venous thromboembolism?
AbstractThe structural similarity with plasminogen as well as thrombogenic and atherogenic in vitro functions raise the question if lipoprotein(a) (Lp(a)) is a  risk factor for venous thromboembolism (VTE) and ischemic stroke. Numerous case–control and prospective studies using different cut-off values to define high Lp(a) generated conflicting evidence for both VTE and ischemic stroke. Several meta-analyses demonstrated independent associations of elev ated Lp(a) with a history of VTE or ischemic stroke. However, the evidence of prospective studies for associations of Lp(a) with incident stroke or recurrent VTE remain...
Source: Clinical Research in Cardiology Supplements - March 5, 2019 Category: Cardiology Source Type: research

Relationship of stroke and bleeding risk profiles to efficacy and safety of dabigatran dual therapy versus warfarin triple therapy in atrial fibrillation after PCI: An ancillary analysis from the RE-DUAL PCI trial
ConclusionDabigatran dual therapy reduced bleeding events irrespective of bleeding risk category and demonstrated similar efficacy regardless of stroke risk category when compared with warfarin triple therapy.
Source: American Heart Journal - March 4, 2019 Category: Cardiology Source Type: research

Therapeutic Challenges in Patients With Noncardioembolic Acute Ischemic Stroke in Need of Double Antiplatelet Therapy for Coronary Artery Disease
Conclusions: In the acute phase of an IS, maintenance or initiation of DAPT therapy imposed by CHD relies, on one hand, on the risk of hemorrhagic transformation of the brain injury and, on the other hand, on the risk of stent thrombosis in the coronary arteries. The management of these patients must be carried on by a vascular team, on an individualized basis.
Source: American Journal of Therapeutics - March 1, 2019 Category: Drugs & Pharmacology Tags: Systematic Reviews Source Type: research

Technical improvements in carotid revascularization based on the mechanism of procedural stroke.
In conclusion, this review provides an overview of the pathophysiological mechanism of stroke following carotid revascularization (both CAS and CEA) and of the technical improvements that have contributed to reducing this stroke risk. PMID: 30827087 [PubMed - as supplied by publisher]
Source: The Journal of Cardiovascular Surgery - March 1, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Fassaert LM, de Borst GJ Tags: J Cardiovasc Surg (Torino) Source Type: research

A genome-wide association study identifies new loci for factor VII and implicates factor VII in ischemic stroke etiology
Factor VII (FVII) is an important component of the coagulation cascade. Few genetic loci regulating FVII activity and/or levels have been discovered to date. We conducted a meta-analysis of 9 genome-wide association studies of plasma FVII levels (7 FVII activity and 2 FVII antigen) among 27 495 participants of European and African ancestry. Each study performed ancestry-specific association analyses. Inverse variance weighted meta-analysis was performed within each ancestry group and then combined for a trans-ancestry meta-analysis. Our primary analysis included the 7 studies that measured FVII activity, and a secondary an...
Source: Blood - February 28, 2019 Category: Hematology Authors: de Vries, P. S., Sabater-Lleal, M., Huffman, J. E., Marten, J., Song, C., Pankratz, N., Bartz, T. M., de Haan, H. G., Delgado, G. E., Eicher, J. D., Martinez-Perez, A., Ward-Caviness, C. K., Brody, J. A., Chen, M.-H., de Maat, M. P. M., Franberg, M., Gill Tags: Thrombosis and Hemostasis Source Type: research

Effect of antiplatelet pretreatment on safety and efficacy outcomes in acute ischemic stroke patients after intravenous thrombolysis: a systematic review and meta-analysis.
CONCLUSION: There was no significant difference in sICH and mortality between patients with and without antiplatelet pretreatment. Besides, antiplatelet pretreatment did not adversely affect the efficacy outcomes. The prevalence of sICH among Asians receiving antiplatelet pretreatment was relatively high. Additionally, it needs to be noticed that the effect of preexisting antiplatelet on clinical outcomes may be dependent on post thrombolytic antiplatelet regiments. PMID: 30807235 [PubMed - as supplied by publisher]
Source: Expert Review of Neurotherapeutics - February 27, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Cerebral Amyloid Angiopathy Limits Treatment of Stroke
Cerebral amyloid angiopathy (CAA) is a predominantly sporadic degenerative vasculopathy characterized by beta-amyloid deposition in the cerebral microvasculature, which may lead to lobar intracerebral and sulcal hemorrhage in older adults. Although relatively common after the 7th decade of life (>50% of persons), CAA rarely impacts the management of stroke in those living with CAA disease. In cases of severe CAA, reconsideration of traditional thrombolytic and antiplatelet therapies is warranted to reduce risk of CAA-related hemorrhage.
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Monica Gavaller, M. Gavaller, H. Oh Tags: Case Report Source Type: research

Characterisation of acute ischemic stroke in patients with left ventricular thrombi after myocardial infarction
AbstractAcute ischemic stroke (AIS) is a feared complication in post-acute myocardial infarction (AMI) patients who develop left ventricular (LV) thrombus. There is limited data available on the incidence of stroke in this population, and characterisation of stroke subtypes has not been previously reported. Our study aims to evaluate the incidence of AIS in post-AMI patients with LV thrombus and to characterise the pattern of stroke subtypes. We screened 5829 patients with echocardiogram reports containing the “thrombus” keyword from August 2006 to September 2017. AIS that occurred after LV thrombosis was captured and ...
Source: Journal of Thrombosis and Thrombolysis - February 25, 2019 Category: Hematology Source Type: research

Lp(a) Lipoprotein(a) and Risk of Ischemic Stroke in the REGARDS Study.
Conclusions- We confirm that Lp(a) is a risk factor for ischemic stroke. Further research is needed to confirm the role of racial differences of the Lp(a) risk multiplier in ischemic stroke. PMID: 30786745 [PubMed - as supplied by publisher]
Source: Arteriosclerosis, Thrombosis and Vascular Biology - February 21, 2019 Category: Cardiology Authors: Arora P, Kalra R, Callas PW, Alexander KS, Zakai NA, Wadley V, Arora G, Kissela BM, Judd SE, Cushman M Tags: Arterioscler Thromb Vasc Biol Source Type: research

Diagnostic of rare form of acute stroke (venous stroke) in early postpartum period
Introduction: Venous stroke (VS) is a rare form of acute ischemic stroke as a thrombosis of Trolard vein (the frequency 0.1% to 3 –5%) occurs when the outflow of blood from the superficial cortical veins of the brain along the large anastomotic vein of Trolard and the small anastomotic vein of Labbe in turn, flow into the large vein of Gallen, which collects blood from the deep cerebral veins and falls into a straight sinus. Verification of VS is difficult due to the following features: the defeat of the parieto-occipital region gives meagre focal neurologic symptoms and more pronounced cerebral symptoms.
Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology - February 19, 2019 Category: OBGYN Authors: Nataliia Chemer, Nadiia Ruda, Andrii Tkachenko Tags: Movies Case Reports 2 – PPH, Puerperium and Neurology Source Type: research

Effect of prothrombotic genotypes on the risk of venous thromboembolism in patients with and without ischemic stroke.The Troms Ø Study.
CONCLUSIONS: Prothrombotic genotypes increased the risk of VTE in stroke patients, and the risk increased with increasing number of risk alleles. This article is protected by copyright. All rights reserved. PMID: 30773804 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - February 18, 2019 Category: Hematology Authors: Rinde LB, Morelli VM, Småbrekke B, Mathiesen EB, Løchen ML, Njølstad I, Wilsgaard T, Smith E, Rosendaal FR, Frazer KA, Braekkan SK, Hansen JB Tags: J Thromb Haemost Source Type: research

Combination of hand-crafted and unsupervised learned features for ischemic stroke lesion detection from Magnetic Resonance Images
Publication date: Available online 14 February 2019Source: Biocybernetics and Biomedical EngineeringAuthor(s): G.B. Praveen, Anita Agrawal, Ponraj Sundaram, Sanjay SardesaiAbstractDetection of ischemic stroke lesions plays a vital role in the assessment of stroke treatments such as thrombolytic therapy and embolectomy. Manual detection and quantification of stroke lesions is a time-consuming and cumbersome process. In this paper, we present a novel automatic method to detect acute ischemic stroke lesions from Magnetic Resonance Image (MRI) volumes using textural and unsupervised learned features. The proposed method profic...
Source: Biocybernetics and Biomedical Engineering - February 15, 2019 Category: Biomedical Engineering Source Type: research

Deep Venous Thrombosis with Decreased Cerebral Blood Flow to the Thalamus was Completely Restored by Factor Xa Inhibitor
Background: Cerebral venous thrombosis is rare and an uncommon cause of stroke and has diverse etiologies and varied clinical presentations. Here, we report 2 cases of deep cerebral venous thrombosis. Case Description: A 64-year-old woman presented with cerebral venous thrombosis due to a hypercoagulable state associated with ovarian tumor. On initial fluid-attenuated inversion recovery and diffusion-weighted imaging, there was a diffuse high-intensity lesion in the bilateral thalamus. Computed tomography angiography showed occlusion of the straight sinus, vein of Galen, and internal cerebral vein.
Source: Journal of Stroke and Cerebrovascular Diseases - February 14, 2019 Category: Neurology Authors: Yu Shimizu, Katsuhiro Tsuchiya, Hironori Fujisawa Tags: Case Report Source Type: research

Atrial Fibrillation and Stroke in Patients with Hypertrophic Cardiomyopathy: Important New Insights.
Abstract PMID: 30759487 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - February 13, 2019 Category: Hematology Authors: Borer JS, Atar D, Marciniak T, Kim MH, Serebruany V Tags: Thromb Haemost Source Type: research

Interatrial block in prediction of all-cause mortality after first-ever ischemic stroke
Interatrial block (IAB) is an ECG indicator of atrial fibrosis related to atrial remodeling and thrombus formation thus leading to embolic stroke and increasing mortality. We aimed to assess weather IAB predic...
Source: BMC Cardiovascular Disorders - February 11, 2019 Category: Cardiology Authors: M. A. Baturova, A. Lindgren, Y. V. Shubik, J. Carlson and P. G. Platonov Tags: Research article Source Type: research

Acute Ischemic Stroke in a Child Successfully Treated with Thrombolytic Therapy and Mechanical Thrombectomy
We present the case of a 4-year-old boy with complex congenital heart disease, admitted 30 min after sudden onset of an aphasia and right hemiplegia, scoring 14 on the Pediatric National Institutes of Health Stroke Scale (PedNIHSS). Non-contrast brain computed tomography (CT) showed no evidence of acute ischemia. CT angiogram demonstrated a thrombus in the M1 segment of the left middle cerebral artery. Intravenous recombinant tissue plasminogen activator (rTPA) was infused 3.5 h after onset of symptoms. An improvement was observed in the hour after rTPA, with a PedNIHSS score of 7. Digital subtraction angiography was perfo...
Source: Case Reports in Neurology - February 8, 2019 Category: Neurology Source Type: research

Intensive blood pressure reduction with intravenous thrombolysis therapy for acute ischaemic stroke (ENCHANTED): an international, randomised, open-label, blinded-endpoint, phase 3 trial
Publication date: Available online 7 February 2019Source: The LancetAuthor(s): Craig S Anderson, Yining Huang, Richard I Lindley, Xiaoying Chen, Hisatomi Arima, Guofang Chen, Qiang Li, Laurent Billot, Candice Delcourt, Philip M Bath, Joseph P Broderick, Andrew M Demchuk, Geoffrey A Donnan, Alice C Durham, Pablo M Lavados, Tsong-Hai Lee, Christopher Levi, Sheila O Martins, Veronica V Olavarria, Jeyaraj D PandianSummaryBackgroundSystolic blood pressure of more than 185 mm Hg is a contraindication to thrombolytic treatment with intravenous alteplase in patients with acute ischaemic stroke, but the target systolic blood pressu...
Source: The Lancet - February 8, 2019 Category: General Medicine Source Type: research

Hemorrhagic Transformation of Arterial Ischemic and Venous Stroke in Children
Hemorrhagic transformation can complicate both arterial ischemic stroke (AIS) and cerebral sinus venous thrombosis (CSVT). Risk factors for hemorrhagic transformation after adult AIS include larger infarct volume, cardioembolic stroke, and anticoagulation in the acute period. Large hemorrhagic transformation in adults is associated with poor outcome. Therefore, hemorrhagic transformation is used as a safety endpoint of most AIS acute treatment and secondary prevention trials. Up to 30% of children with AIS have hemorrhagic transformation, most of which is petechial.
Source: Pediatric Neurology - February 7, 2019 Category: Neurology Authors: Melissa L. Hutchinson, Lauren A. Beslow Tags: Topical Review Source Type: research

Association of platelet-derived microvesicles and their phenotypes with carotid atherosclerosis and recurrent vascular events in patients after ischemic stroke
Platelet-derived microvesicles (pMVs) exhibit procoagulant and proinflammatory properties and play a role in the development and progression of atherosclerosis. The study examined the association between the total number of pMVs and their phenotypes with carotid atherosclerosis and recurrent vascular events (VEs) in patients in the convalescent phase of ischemic stroke (IS).
Source: Thrombosis Research - February 2, 2019 Category: Hematology Authors: Justyna Rosi ńska, Wojciech Ambrosius, Joanna Maciejewska, Robert Narożny, Wojciech Kozubski, Maria Łukasik Tags: Full Length Article Source Type: research

Hormone therapy in postmenopausal women associated with risk of stroke and venous thromboembolism: a population-based cohort study in Taiwan
Conclusions: In postmenopausal Taiwanese women, HT may be associated with an increased risk of cardiovascular disease. Although the women in our population receiving HT were near menopausal age, their risk of cardiovascular disease was still higher than in the non-HT group.
Source: Menopause - January 29, 2019 Category: OBGYN Tags: Original Articles Source Type: research