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Recognizing cerebral venous thrombosis in adults
Abstract: Cerebral venous thrombosis is an underrecognized but serious thrombotic disorder that affects cerebral veins and sinuses. Clinical presentation varies based on extent and location of thrombosis within the cerebral venous system, and can include headache, focal neurologic deficits, focal or generalized seizures, stroke, and coma. Diagnosis is confirmed by brain and cerebral vascular imaging. Treatment focuses on anticoagulation, and outcomes are generally favorable.1,2
Source: Nursing Critical Care - May 1, 2018 Category: Nursing Tags: Feature: Stroke Spotlight Source Type: research

Tenecteplase: Thrombolytic of Choice in Stroke? Tenecteplase: Thrombolytic of Choice in Stroke?
The EXTEND-IA TNK trial suggesting better outcomes with tenecteplase than alteplase in the treatment of acute ischemic stroke has now been published in the New England Journal of Medicine.Medscape Medical News
Source: Medscape Critical Care Headlines - April 26, 2018 Category: Intensive Care Tags: Neurology & Neurosurgery News Source Type: news

Prevention and Management of Stroke in Obstetrics and Gynecology
The objective of this review is to provide an evidence-based summary of stroke incidence, risk factors, prevention, and treatment of stroke in pregnancy. The impact of postpartum contraceptive use can on stroke risk is summarized.
Source: Clinical Obstetrics and Gynecology - April 26, 2018 Category: OBGYN Tags: The Prevention and Management of Thrombosis in Obstetrics and Gynecology Source Type: research

tPA in Stroke: ' The Facts Are Clear ' tPA in Stroke: ' The Facts Are Clear '
Thrombolytic treatment for stroke remains controversial among specialties. Here, a neurologist argues for its use.Medscape Neurology
Source: Medscape Today Headlines - April 20, 2018 Category: Consumer Health News Tags: Neurology & Neurosurgery Expert Column Source Type: news

Understanding delays in acute stroke care: a systematic review of reviews
ConclusionThis review provides a wide overview of factors influencing acute stroke pathway. Since it was observed that the identified factors were interrelated, they needed to be analyzed in a systematic way. We hence created a synthetic framework that combines several categories of factors while assuming that factor weight varies from a study context to another. Better knowledge on underlying mechanisms between factors would provide crucial improvement of the interventions aiming at reducing delays in both pre-hospital and inhospital stages. For future research, we recommend adopting a systemic perspective on factors infl...
Source: The European Journal of Public Health - April 20, 2018 Category: General Medicine Source Type: research

Is von Willebrand factor associated with stroke and death at mid-term in patients with non-valvular atrial fibrillation?
CONCLUSIONS: High vWF plasma concentrations may discriminate patients with NVAF at greater risk of stroke or all-cause death. PMID: 29685722 [PubMed - as supplied by publisher]
Source: Archives of Cardiovascular Diseases - April 20, 2018 Category: Cardiology Authors: Ancedy Y, Berthelot E, Lang S, Ederhy S, Boyer-Chatenet L, Di Angelantonio E, Soulat-Dufour L, Etienney A, Adavane-Scheublé S, Boccara F, Cohen A Tags: Arch Cardiovasc Dis Source Type: research

Indications for the Performance of Intracranial Endovascular Neurointerventional Procedures: A Scientific Statement From the American Heart Association.
Abstract Intracranial endovascular interventions provide effective and minimally invasive treatment of a broad spectrum of diseases. This area of expertise has continued to gain both wider application and greater depth as new and better techniques are developed and as landmark clinical studies are performed to guide their use. Some of the greatest advances since the last American Heart Association scientific statement on this topic have been made in the treatment of ischemic stroke from large intracranial vessel occlusion, with more effective devices and large randomized clinical trials showing striking therapeuti...
Source: Circulation - April 19, 2018 Category: Cardiology Authors: Eskey CJ, Meyers PM, Nguyen TN, Ansari SA, Jayaraman M, McDougall CG, DeMarco JK, Gray WA, Hess DC, Higashida RT, Pandey DK, Peña C, Schumacher HC, American Heart Association Council on Cardiovascular Radiology and Intervention and Stroke Council Tags: Circulation Source Type: research

Varicella-Associated Stroke
A previously healthy, unimmunized 11-month-old boy presented with acute right-sided weakness. On the day of presentation, his mother noted that his right arm and leg seemed to be weak when she woke him from his usual afternoon nap. Evaluation at an urgent care center confirmed right-sided facial weakness, decreased strength and movement of his right upper and lower extremities, and a lack of right-sided support in a sitting position. Computed tomography of the head without contrast was normal. He was transferred to a regional care center where head magnetic resonance imaging and magnetic resonance angiography demonstrated ...
Source: The Journal of Pediatrics - April 19, 2018 Category: Pediatrics Authors: Surabhi B. Vora, Catherine Amlie-Lefond, Francisco A. Perez, Ann J. Melvin Tags: Insights and Images Source Type: research

The Case Against Thrombolytic Therapy in Stroke The Case Against Thrombolytic Therapy in Stroke
A New York Times article siding with neurologists in their debate with emergency medicine over the benefits of tPA in ischemic stroke prompted Dr Mandrola to take a closer look at the data.theheart.org on Medscape
Source: Medscape Today Headlines - April 13, 2018 Category: Consumer Health News Tags: Cardiology Expert Column Source Type: news

Reversal of dabigatran using idarucizumab: single center experience in four acute stroke patients
AbstractDabigatran is a direct thrombin inhibitor and a non-vitamin-K-antagonizing oral anticoagulant, approved for the prevention of stroke and systemic embolization in atrial fibrillation. Idarucizumab is a humanized monoclonal antibody that was recently approved for antagonizing the anticoagulant effects of dabigatran. Here, we report the use of idarucizumab in four acute stroke patients treated with dabigatran in order to enable intravenous thrombolysis in three patients and emergent trepanation in one patient with space occupying subdural hematoma. Since experience on the optimal management of acute stroke patients un...
Source: Journal of Thrombosis and Thrombolysis - April 9, 2018 Category: Hematology Source Type: research

Using light microscopy for diagnosing the cause of a case of acute stroke
A 60-year-old febrile man was transferred to the emergency department after being found alone and unconscious in a park. No medical history was available. Brain CT revealed a hyperdense lesion in the basilar artery (figure, A) suggesting a thromboembolic occlusion, which was subsequently thromboaspirated (figure, B and C). The fresh thrombus was retrieved (figure, D) and urgently analyzed using light microscopy, which revealed colonies of gram-positive bacilli (figure, E). A cardiac echogram showed severe mitral valve insufficiency and vegetations on its anterior leaflet (figure, F). After mitral valve repair and a long co...
Source: Neurology Clinical Practice - April 9, 2018 Category: Neurology Authors: Hajdu, S. D., Maillard, M., Antiochos, P., Saliou, G. Tags: Stroke in young adults, All Infections, Embolism Case Source Type: research

Abstract 205: Stroke Risk and Symptom Recognition Post Cardiac Catheterization Session Title: Poster Session PM
Over 1.4 million cardiac catheterization procedures (CCPs) take place yearly. CPP related stroke incidence in 1973 was reported as 0.23%. CCPs are invasive in nature with complications occurring due to unintentional trauma to preexisting atherosclerotic aortic plaques or thrombus formation at catheter/guidewire tips. Less common causes of ischemic stroke are air, left ventricular clot, hypotension, arterial dissection, fractured guidewire. Transient neurological deficits have been reported following high-osmolar contrast injection into carotid/vertebral arteries. With improved practice, current stroke incidence is 0.06%. P...
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Rivet, C., Schaefer, K., Strom, C. Tags: Session Title: Poster Session PM Source Type: research

Transoesophageal echocardiography prior to catheter ablation could be avoided in atrial fibrillation patients with a low risk of stroke and without filling defects in the late-phase MDCT scan: A retrospective analysis of 783 patients
ConclusionsFor AF patients with low risk of stroke, when MDCT images showed no filling defect in the late phase, TEE prior to catheter ablation can be avoided.Key Points•MDCT can help detect the presence of LAA thrombus.•TEE can be avoided when late-phase MDCT shows no filling defect.•TEE is required in patients whose MDCT images indicate thrombus.
Source: European Radiology - April 4, 2018 Category: Radiology Source Type: research

Cancer diagnosis as a risk factor of ischemic stroke in atrial fibrillation patients with low stroke risk score
Introduction: Atrial fibrillation (AF) is a well known risk factor of ischemic stroke (IS). Patients categorized as low risk according to stroke risk scores are not routinely recommended anticoagulation prophylaxis. Cancer is known to increase the risk of IS, but it is not clear to what extent cancer is a risk factor of IS in AF patients with low stroke risk score.
Source: Thrombosis Research - April 1, 2018 Category: Hematology Authors: A. Atterman, B. Gigante, K. Asplund, S. Aspberg Tags: PO-25 Source Type: research

Increased Aortic Stiffness is Associated with Higher Rates of Stroke, GI-bleeding and Pump Thrombosis in Continuous-Flow Left Ventricular Assist Device Patients
In the general population, increased aortic stiffness (kAo) is associated with risk of cardiovascular events. Continuous-flow left ventricular assist device (CF-LVAD) pts have been reported to have increased kAo. The association between kAo and common adverse events (AEs), including stroke, gastrointestinal bleed (GIB) and pump thrombosis (PT) are unknown in CF-LVAD pts.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: H. Rosenblum, A. Pinsino, R.T. Demmer, P.C. Colombo, M. Yuzefpolskaya, A.R. Garan, V.K. Topkara, A. Gaudig, M.T. Pineda, Y. Naka, H. Takayama, K. Takeda, F. Castagna, J.Z. Willey, B.J. McDonnell, J.R. Cockcroft, E.J. St öhr Source Type: research

Predictive Value of Mean Arterial Pressure Versus Systolic Blood Pressure and Visit-To-Visit Blood Pressure Variability for Stroke and Pump Thrombosis in HeartMate II Patients
Elevated blood pressure (BP) in pts on left ventricular assist device (LVAD) support is a risk factor for adverse events (AEs) such as stroke and pump thrombosis (PT). Current guidelines recommend a mean arterial pressure (MAP) ≤ 80mmHg. Above-median systolic BP (SBP) at discharge after HeartMate II (HMII) implant has been associated with an increased risk of stroke. We sought to 1) compare the predictive value of outpt MAP and SBP on AEs, 2) examine the association of visit-to-visit variability (VVV) of BP with AEs in H MII pts.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: A. Pinsino, F. Castagna, J.Z. Willey, A.M. Zuver, M.A. Flannery, B. Cagliostro, J.R. Cockroft, A.R. Garan, V.K. Topkara, H. Takayama, K. Takeda, Y. Naka, R.T. Demmer, P.C. Colombo, M. Yuzefpolskaya Source Type: research

Risk Predictors for Ischemic Stroke in CF-LVAD Patients by Pump Flow Type
Risk of stroke continues to be a major adverse event post-LVAD implantation, limiting wider application and utility of the device. Even with aggressive blood pressure control, patients with LVADs are at higher risk of stroke due to combination of pump-dependent factors including loss of natural pulsatility, anticoagulation, and thrombosis risk from blood-pump interaction. We used a Bayesian Network machine-learning approach to derive comparative risk factors for ischemic stroke in patients with axial versus centrifugal flow pumps at 3 months post LVAD implant.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: M. Kanwar, L. Lohmueller, R. Kormos, S. Bailey, C. Mcilvennan, S. Murali, J. Antaki Source Type: research

Increased Pump Speed is Associated with Reduced Rates of Stroke on HeartMate II LVAD Support
Higher pump speeds have recently been associated with reduced rates of pump thrombosis in the HeartMate II LVAD population. Whether pump speed is associated with stroke has not been well established. In this analysis we use a single center cohort to determine the association with discharge speed and all-cause stroke.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: J.N. Schultz, R. Cogswell, M. Prtizker, E. Missov, K. Liao, J. Misialek, R. John Source Type: research

High Cardiac Troponin I Is Associated With Transesophageal Echocardiographic Risk of Thromboembolism and Ischemic Stroke Events in Non-Valvular Atrial Fibrillation Patients.
CONCLUSIONS: Elevated hs-cTnI was independently associated with LA abnormality in NVAF patients. hs-cTnI level may be a useful biomarker for risk stratification of thromboembolism in NVAF patients. PMID: 29607894 [PubMed - as supplied by publisher]
Source: Circulation Journal - March 31, 2018 Category: Cardiology Authors: Tanaka S, Hirai T, Inao K, Fukuda N, Nakagawa K, Inoue H, Kinugawa K Tags: Circ J Source Type: research

Early and One-Year Outcomes of Acute Stroke in the Industrial Region of Poland During the Decade 2006 –2015: The Silesian Stroke Registry
Conclusions: In a large population of industrial province, we showed recent, positive trends in AS admissions, treatment and 1-year outcomes. Development of stroke unit networks and increase in thrombolytic treatment were at least in part responsible for survival improvement and reduction of recurrence of AS. However, case-fatality and stroke recurrence remain high compared to those of other developed countries.Neuroepidemiology 2018;50:183 –194
Source: Neuroepidemiology - March 27, 2018 Category: Epidemiology Source Type: research

Thrombosed Aneurysm of the Posterior Inferior Cerebellar Artery and Lateral Medullary Ischemia as the Initial Presentation of Polyarteritis Nodosa: Case Report and Literature Review
A 27-year-old woman with a previously undiagnosed polyarteritis nodosa (PAN) developed lateral medullary stroke related to a thrombosed posterior inferior cerebellar artery (PICA)-origin aneurysm. A concurrent thrombosis of the PICA was identified on high-resolution 3-dimensional CUBE T1 magnetic resonance imaging sequence at 3  T. Body computed tomography angiography, magnetic resonance imaging–magnetic resonance angiography, and digital angiography revealed multiple tiny aneurysms of the visceral arteries and bilateral kidney infarcts.
Source: Journal of Stroke and Cerebrovascular Diseases - March 27, 2018 Category: Neurology Authors: Monique Boukobza, Antoine Dossier, Jean-Pierre Laissy Tags: Case Studies Source Type: research

Beyond Stroke Prevention in Atrial Fibrillation: Exploring Further Unmet Needs with Rivaroxaban.
This article provides an update on three randomized controlled trials of rivaroxaban, a direct, oral factor Xa inhibitor, that are complete or are ongoing, in these unmet areas of stroke prevention: oPen-label, randomized, controlled, multicentre study explorIng twO treatmeNt stratEgiEs of Rivaroxaban and a dose-adjusted oral vitamin K antagonist treatment strategy in patients with Atrial Fibrillation who undergo Percutaneous Coronary Intervention (PIONEER AF-PCI) trial; the New Approach riVaroxaban Inhibition of factor Xa in a Global trial vs Aspirin to prevenT Embolism in Embolic Stroke of Undetermined Source (NAVIGATE E...
Source: Thrombosis and Haemostasis - March 22, 2018 Category: Hematology Authors: Gibson CM, Hankey GJ, Nafee T, Welsh RC Tags: Thromb Haemost Source Type: research

Understanding the Value of Real-World Evidence: Focus on Stroke Prevention in Atrial Fibrillation with Rivaroxaban.
Abstract Real-world data are a well-recognized component within the drug lifecycle, and such data are generated from a range of sources and study designs, including claims databases, electronic health records, non-interventional studies (NIS) and registries. While this information can be of vital clinical importance, there may be challenges in understanding the relevance of the differing study designs, endpoints and populations. Here, we summarize the value of real-world evidence and considerations pertinent to their use in clinical research. Owing to the variety of analyses being conducted using real-world data, ...
Source: Thrombosis and Haemostasis - March 22, 2018 Category: Hematology Authors: Camm AJ, Coleman CI, Larsen TB, Nielsen PB, Tamayo CS Tags: Thromb Haemost Source Type: research

Cell Death Mechanisms in Stroke and Novel Molecular and Cellular Treatment Options.
Abstract As a result of ischemia or hemorrhage, blood supply to neurons is disrupted which subsequently promotes a cascade of pathophysiological responses resulting in cell loss. Many mechanisms are involved solely or in combination in this disorder including excitotoxicity, mitochondrial death pathways, and the release of free radicals, protein misfolding, apoptosis, necrosis, autophagy and inflammation. Besides neuronal cell loss, damage to and loss of astrocytes as well as injury to white matter contributes also to cerebral injury. The core problem in stroke is the loss of neuronal cells which makes recovery di...
Source: Current Neuropharmacology - March 20, 2018 Category: Drugs & Pharmacology Authors: Sekerdag E, Solaroglu I, Gursoy-Ozdemir Y Tags: Curr Neuropharmacol Source Type: research

Hyperglycemia predicts unfavorable outcomes in acute ischemic stroke patients treated with intravenous thrombolysis among a Chinese population: A prospective cohort study
In this study, we investigated whether an elevated admission serum glucose level in the 3-h time window of intravenous thrombolysis for acute ischemic stroke determined poor functional outcomes among Chinese population.
Source: Journal of the Neurological Sciences - March 16, 2018 Category: Neurology Authors: Sheng-Feng Lin, A-Ching Chao, Han-Hwa Hu, Ruey-Tay Lin, Chih-Hung Chen, Lung Chan, Huey-Juan Lin, Yu Sun, Yung-Yang Lin, Po-Lin Chen, Shinn-Kuang Lin, Ming-Hui Sun, Cheng-Yu Wei, Yu-Te Lin, Jiunn-Tay Lee, Chi-Huey Bai, Taiwan Thrombolytic Therapy for Acut Source Type: research

Influence of on-going treatment with angiotensin-converting enzyme inhibitor or angiotensin receptor blocker on the outcome of patients treated with intravenous rt-PA for ischemic stroke
ConclusionIn patients treated by intravenous thrombolytic therapy for ischemic stroke, on-going treatment with ACE-Is or ARBs does not influence on outcomes after adjustment on baseline characteristics and propensity scores.
Source: Journal of Neurology - March 16, 2018 Category: Neurology Source Type: research

Diverse roles of mitochondria in ischemic stroke
Publication date: June 2018 Source:Redox Biology, Volume 16 Author(s): Jenq-Lin Yang, Sujira Mukda, Shang-Der Chen Stroke is the leading cause of adult disability and mortality in most developing and developed countries. The current best practices for patients with acute ischemic stroke include intravenous tissue plasminogen activator and endovascular thrombectomy for large-vessel occlusion to improve clinical outcomes. However, only a limited portion of patients receive thrombolytic therapy or endovascular treatment because the therapeutic time window after ischemic stroke is narrow. To address the current shortage of st...
Source: Redox Biology - March 15, 2018 Category: Biology Source Type: research

Clinical and radiological factors associated with unfavorable outcome after intravenous thrombolysis in patients with mild ischemic stroke
A significant proportion of patients with mild ischemic stroke become disabled despite receiving intravenous thrombolytic therapy. The purpose of this study was to assess the clinical and radiological factors ...
Source: BMC Neurology - March 15, 2018 Category: Neurology Authors: Dae-Hyun Kim, Deok-Soo Lee, Hyun-Wook Nah and Jae-Kwan Cha Tags: Research article Source Type: research

PAR1 biased signaling is required for activated protein C in vivo benefits in sepsis and stroke
Activated protein C (APC) cleaves protease-activated receptor 1 (PAR1) in vitro at R46 to initiate beneficial cell signaling; however, thrombin and APC can cleave at R41. To elucidate PAR1-dependent aspects of the pharmacologic in vivo mechanisms of APC, we generated C57BL/6 mouse strains carrying QQ41 or QQ46 point mutations in PAR1 (F2r gene). Using these strains, we determined whether or not recombinant murine signaling-selective APC mutants would reduce septic death or provide neuroprotection against ischemic stroke when mice carried PAR1-homozygous mutations that prevent cleavage at either R41 or R46. Intercrossing PA...
Source: Blood - March 15, 2018 Category: Hematology Authors: Sinha, R. K., Wang, Y., Zhao, Z., Xu, X., Burnier, L., Gupta, N., Fernandez, J. A., Martin, G., Kupriyanov, S., Mosnier, L. O., Zlokovic, B. V., Griffin, J. H. Tags: Plenary Papers, Thrombosis and Hemostasis, Vascular Biology Source Type: research

Role of the chemokine receptors CCR2 and CX3CR1 in an experimental model of thrombotic stroke
This study underlines a key role of CCR2- and CX3CR1-expressing immune cells in the neuropathology associated with ischemic injuries.
Source: Brain, Behavior, and Immunity - March 14, 2018 Category: Neurology Source Type: research

Cancer-associated ischemic stroke: A retrospective multicentre cohort study
The association between stroke and cancer is well-known but insufficiently investigated. Aim of this multicentre retrospective cohort study was to estimate the prevalence of cancer-associated ischemic stroke, describe clinical outcomes in patients with cancer-associated ischemic stroke and investigate independent factors associated with active cancer.
Source: Thrombosis Research - March 14, 2018 Category: Hematology Authors: Stefano Grazioli, Maurizio Paciaroni, Giancarlo Agnelli, Monica Acciarresi, Andrea Alberti, Cataldo D'Amore, Valeria Caso, Michele Venti, Luigina Guasti, Walter Ageno, Alessandro Squizzato Tags: Full Length Article Source Type: research

A clinical decision support tool for improving adherence to guidelines on anticoagulant therapy in patients with atrial fibrillation at risk of stroke: A cluster-randomized trial in a Swedish primary care setting (the CDS-AF study)
ConclusionsThe present study demonstrates that a CDS can increase guideline adherence for anticoagulant therapy in patients with AF. Even though the observed difference was small, this is the first randomized study to our knowledge indicating beneficial effects with a CDS in patients with AF. Trial registrationClinicalTrials.gov NCT02635685
Source: PLoS Medicine - March 13, 2018 Category: Internal Medicine Authors: Lars O. Karlsson Source Type: research

Role of the chemokine receptors CCR2 and CX3CR1 in an experimental model of thrombotic stroke.
This study underlines a key role of CCR2- and CX3CR1-expressing immune cells in the neuropathology associated with ischemic injuries. PMID: 29545116 [PubMed - as supplied by publisher]
Source: Brain, Behavior, and Immunity - March 12, 2018 Category: Neurology Authors: Cisbani G, Le Behot A, Plante MM, Préfontaine P, Lecordier M, Rivest S Tags: Brain Behav Immun Source Type: research

Intravenous thrombolysis for acute ischaemic stroke in patients on direct oral anticoagulants
ConclusionsIn this expert opinion paper, it is suggested that IVT can be performed in patients selected according to the time elapsed since the drug was last taken, renal function, type of hospital where the patient is admitted and plasma concentration of DOAC.
Source: European Journal of Neurology - March 9, 2018 Category: Neurology Authors: E. Touz é, Y. Gruel, I. Gouin‐Thibault, E. De Maistre, S. Susen, P. Sie, L. Derex Tags: Original Article Source Type: research

Recanalized Left Internal Carotid Artery Bifurcation Aneurysm with Adherent Thrombus at Aneurysm Neck and M1 Origin Diagnosed on 2-Dimensional Angiography —Cause of Embolic Stroke
We report a unique case of recanalized left internal carotid artery aneurysm with thrombus adherent to the aneurysm neck and M1 origin diagnosed on 2-dimensional angiography causing embolic stroke in a 66-year-old female who was successfully treated with stent-assisted coiling. This is important to recognize as a cause of embolic stroke.
Source: World Neurosurgery - March 7, 2018 Category: Neurosurgery Authors: Anshu Mahajan, Gaurav Goel, Biplab Das, Karanjit Singh Narang Tags: Clinical Images Source Type: research

Could the CHA2DS2-VASc schema help stratify risk of ischemic stroke for individual patients with congestive heart failure?
We read the article “Risk of stroke in congestive heart failure with and without atrial fibrillation” by Kang et al. [1] interestingly, which has great clinical significance in prevention of ischemic stroke during the management of congestive heart failure (CHF) patients. CHF has been shown to be associated with2 t o 3 times higher risk of stroke [2,3], also known as cardioembolism that is due to thrombus formation caused by atrial fibrillation (AF) or stagnation of blood in the left ventricle [4,5].
Source: International Journal of Cardiology - March 3, 2018 Category: Cardiology Authors: Jing Bai, Deliang Shen, Bo Wang, Qing Han, Peiwen Wang, Jinying Zhang Tags: Letter to the Editor Source Type: research

Matrix Metalloproteinase-9 Mediates the Deleterious Effects of α2-Antiplasmin on Blood–Brain Barrier Breakdown and Ischemic Brain Injury in Experimental Stroke
We examined the hypothesis that MMP-9 is an essential downstream mediator of α2-antiplasmin’s deleterious effects during brain ischemia. Middle cerebral artery thromboembolic stroke was induced in a randomized, blinded fashion in mice with increased blood levels of α2-antiplasmin. There was a robust increase in MMP-9 expression (immunofluorescence) in the ischemic vs. the non-ischemic hemisphere of MMP-9+/+ but not MMP-9−/− mice, 24 h after stroke. Brain swelling and hemorrhage were significantly increased in the ischemic vs. the non-ischemic hemisphere of MMP-9+/+ mice. By comparison to MMP-9+/+ mice, the ischem...
Source: Neuroscience - March 3, 2018 Category: Neuroscience Source Type: research

Thrombolytic therapies for ischemic stroke: Triumphs and future challenges.
Abstract Acute stroke therapy has significantly evolved over the last two decades. The two main advances have been the approval of intravenous chemical thrombolysis in 1995, and the approval of intra-arterial mechanical thrombectomy in 2015. This has lead to significant improvement of functional outcomes in a disease known to be the first cause of disability worldwide. Subsequent studies have focused on identifying pre-treatment predictors of good treatment candidates, by developing biochemical and imaging biomarkers. Different doses and agents of thrombolysis are also being tested. In this review article, we expl...
Source: Neuropharmacology - March 2, 2018 Category: Drugs & Pharmacology Authors: Moussaddy A, Demchuk AM, Hill MD Tags: Neuropharmacology Source Type: research

Patent foramen ovale closure or medical therapy for cryptogenic ischemic stroke: an updated meta-analysis of randomized controlled trials.
CONCLUSIONS: PFO-C after cryptogenic ischemic stroke is safe and effective to reduce the risk of recurrent stroke and recurrent stroke + TIA, albeit with an increased risk for NOAF. PMID: 29500568 [PubMed - as supplied by publisher]
Source: Clin Med Res - March 2, 2018 Category: Research Authors: Schulze V, Lin Y, Karathanos A, Brockmeyer M, Zeus T, Polzin A, Perings S, Kelm M, Wolff G Tags: Clin Res Cardiol Source Type: research

Patent foramen ovale closure or medical therapy for cryptogenic ischemic stroke: an updated meta-analysis of randomized controlled trials
ConclusionsPFO-C after cryptogenic ischemic stroke is safe and effective to reduce the risk of recurrent stroke and recurrent stroke  + TIA, albeit with an increased risk for NOAF.
Source: Clinical Research in Cardiology - March 2, 2018 Category: Cardiology Source Type: research

Cell Death Mechanisms in Stroke and Novel Molecular and Cellular Treatment Options.
Abstract As a result of ischemia or hemorrhage, blood supply to neurons is disrupted which subsequently promotes a cascade of pathophysiological responses resulting in cell loss. Many mechanisms are involved solely or in combination in this disorder including excitotoxicity, mitochondrial death pathways, and the release of free radicals, protein misfolding, apoptosis, necrosis, autophagy and inflammation. Besides neuronal cell loss, damage to and loss of astrocytes as well as injury to white matter contributes also to cerebral injury. The core problem in stroke is the loss of neuronal cells which makes recovery di...
Source: Current Neuropharmacology - March 1, 2018 Category: Drugs & Pharmacology Authors: Sekerdag E, Solaroglu I, Gursoy-Ozdemir Y Tags: Curr Neuropharmacol Source Type: research

Paradoxical Cerebral Embolism after Gastrointestinal Endoscopy in a Patient with Crohn's Disease
We describe a patient with Crohn's disease who developed paradoxical cerebral embolism after GE. Both an unstable venous thrombus in the superior vena cava and RLS through patent foramen ovale were thought to be responsible for the stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - February 28, 2018 Category: Neurology Authors: Hajime Ikenouchi, Naoto Sugeno, Takaaki Nakamura, Junpei Kobayashi, Ryuji Oshima, Hiroshi Kuroda, Masashi Aoki Tags: Case Studies Source Type: research

4:21 PM Abstract No. 360 Impact of catheter size, balloon occlusion, and presence of posterior communicating artery during aspiration from internal carotid artery: stroke model of middle cerebral artery (M1 segment) using 3D printing cerebrovascular flow model
To clarify the impact of following factors during suction from large-bore catheter at internal carotid artery (ICA) using 3D printing circulation model simulating stroke due to middle cerebral artery (MCA) occlusion. 1. Catheter size, 8F vs. 9F 2. Balloon occlusion (BO) at cervical ICA, (+) vs. (-) 3. Presence of posterior communicating artery (PCOM), (+) vs. (-).
Source: Journal of Vascular and Interventional Radiology : JVIR - February 27, 2018 Category: Radiology Authors: M. Horikawa, T. Nakanishi, K. Hashimoto, R. Priest, K. Farsad, H. Bozorgchami Tags: Scientific Session 36: Venous: Thrombus Management Source Type: research

Prothrombotic factors do not increase the risk of recurrent ischemic events after cryptogenic stroke at young age: the FUTURE study
ConclusionsThe prevalence of prothrombotic factors and preceding infections did not significantly differ between stroke patients with a cryptogenic versus an identified cause of stroke and neither is significantly associated with an increased risk of recurrent ischemic events after cryptogenic stroke.
Source: Journal of Thrombosis and Thrombolysis - February 26, 2018 Category: Hematology Source Type: research

Impact of pre-admission treatment with non-vitamin K oral anticoagulants on stroke severity in patients with acute ischemic stroke
ConclusionsWe report a positive impact of pre-admission NOAC on ischemic stroke severity, which is particularly remarkable in light of the increased prevalence of prior stroke and lower rates of thrombolysis in this patient population.
Source: Journal of Thrombosis and Thrombolysis - February 23, 2018 Category: Hematology Source Type: research