Query: stroke

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Condition: Thrombosis

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Total 5726 results found since Jan 2013.

Modified DWI-FLAIR mismatch guided thrombolysis in unknown onset stroke
AbstractDWI-FLAIR mismatch has been recently proven to identify patients with unknown onset stroke (UOS) eligible for thrombolysis. However, this concept may exclude patients from thrombolysis who may eventually benefit as well. We aimed to examine the feasibility, safety and potential efficacy of thrombolysis in wake-up stroke (WUS) and UOS patients using a modified DWI-FLAIR mismatch allowing for partial FLAIR positivity. WUS/UOS patients fulfilling the modified DWI-FLAIR mismatch and treated with intravenous thrombolysis (IVT) were compared to propensity score matched WUS/UOS patients excluded from IVT due to FLAIR posi...
Source: Journal of Thrombosis and Thrombolysis - November 10, 2018 Category: Hematology Source Type: research

Ninety-day prognosis of patients receiving direct oral anticoagulants in the early phase of non valvular atrial fibrillation-related acute ischemic stroke: The real life evidence
Patients who receive antithrombotic therapy as secondary prevention in the early phase of non valvular atrial fibrillation (NVAF)-related acute ischemic stroke (AIS) have a better prognosis compared with patients who do not receive antithrombotic treatment [1]. In the VISTA registry the incidence of stroke recurrence, symptomatic intracranial bleeding, all-cause mortality and 90-day modified Rankin Scale (mRS) ≥4 in patients with NVAF-related AIS not receiving antithrombotic treatment was 19.8%, 9.3%, 40.7% and 65.3%, respectively compared with patients receiving vitamin K antagonists (VKAs) (10.6%, 2.9%, 25.5% and 46.6%...
Source: Thrombosis Research - November 3, 2018 Category: Hematology Authors: Luca Masotti, Elisa Grifoni, Alessandro Dei, Vieri Vannucchi, Federico Moroni, Stefano Spolveri, Grazia Panigada, Giancarlo Landini Tags: Letter to the Editors-in-Chief Source Type: research

Iron nanoparticle contrast enhanced microwave imaging for emergent stroke: A pilot study
Publication date: Available online 1 November 2018Source: Journal of Clinical NeuroscienceAuthor(s): Joseph S. Hudson, Timothy K. Chung, Benjamin S. Prout, Yasunori Nagahama, Madhavan L. Raghavan, David M. HasanAbstractEmergent stroke is mostly evaluated using hospital based imaging. Quick imaging allows for rapid administration of IV thrombolysis and outcome improvement. Microwave imaging (MI) is an emerging portable imaging modality. Iron oxide nanoparticles are known to interact with microwave frequency electromagnetic radiation. In this manuscript, we provide proof of concept for a novel iron oxide nanoparticle enhance...
Source: Journal of Clinical Neuroscience - November 2, 2018 Category: Neuroscience Source Type: research

Percutaneous vascular interventions versus intravenous thrombolytic treatment for acute ischaemic stroke.
CONCLUSIONS: The present review directly compared intravenous thrombolytic treatment with percutaneous vascular interventions for ischaemic stroke. We found no evidence from RCTs that percutaneous vascular interventions are superior to intravenous thrombolytic treatment with respect to functional outcome. Quality of evidence was low (outcome assessment was blinded, but not the treating physician or participants). New trials with adequate sample sizes are warranted because of the rapid development of new techniques and devices for such interventions. PMID: 30365156 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - October 26, 2018 Category: General Medicine Authors: Lindekleiv H, Berge E, Bruins Slot KM, Wardlaw JM Tags: Cochrane Database Syst Rev Source Type: research

Management of acute ischemic stroke after pulmonary resection: incidence and efficacy of endovascular thrombus aspiration
ConclusionSince cerebral infarction impairs the patient ’s quality of life, thrombus removal should be considered if possible.
Source: General Thoracic and Cardiovascular Surgery - October 26, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Cumulative Effects of LDL Cholesterol and CRP Levels on Recurrent Stroke and TIA.
CONCLUSIONS: The control of both LDL cholesterol and CRP levels appears to be effective for preventing recurrent stroke and TIA in patients with non-cardiogenic ischemic stroke. PMID: 30318492 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - October 16, 2018 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research

Prognostic Value of International Normalized Ratio in Ischemic Stroke Patients without Atrial Fibrillation or Anticoagulation Therapy.
CONCLUSIONS: Increased admission INR was associated with adverse stroke outcomes among acute ischemic stroke patients without atrial fibrillation or anticoagulation therapy. PMID: 30318486 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - October 16, 2018 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research

Very early versus delayed mobilisation after stroke.
CONCLUSIONS: VEM, which usually involved first mobilisation within 24 hours of stroke onset, did not increase the number of people who survived or made a good recovery after their stroke. VEM may have reduced the length of stay in hospital by about one day, but this was based on low-quality evidence. Based on the potential hazards reported in the single largest RCT, the sensitivity analysis of trials commencing mobilisation within 24 hours, and the NMA, there was concern that VEM commencing within 24 hours may carry an increased risk, at least in some people with stroke. Given the uncertainty around these effect estimates,...
Source: Cochrane Database of Systematic Reviews - October 16, 2018 Category: General Medicine Authors: Langhorne P, Collier JM, Bate PJ, Thuy MN, Bernhardt J Tags: Cochrane Database Syst Rev Source Type: research

Delayed Endovascular Thrombectomy in a Patient Suffering from Stroke in Progression after Intravenous Thrombolytic Therapy.
CONCLUSION: In LAO patients, directly proceeding EVT following IVT may not be hesitated. In addition, while LAO patients with incomplete IV-tPA treatment responses result in transient improvement of neurological symptoms but later reversed, EVT may be a potential rescue therapy in carefully selected patients. PMID: 30315557 [PubMed - in process]
Source: Acta Neurologica Taiwanica - October 15, 2018 Category: Neurology Tags: Acta Neurol Taiwan Source Type: research

Ischemic stroke following a wasp sting – a rare complication: a case report
ConclusionTreating physicians should be aware of the rare but possible complication of ischemic stroke following a case of wasp sting.
Source: Journal of Medical Case Reports - October 14, 2018 Category: General Medicine Source Type: research

Reperfusion Changes After  Stroke and Practical Approaches for Neuroprotection
Reperfusion is the first line of care in a growing number of eligible acute ischemic stroke patients. Early reperfusion with thrombolytic drugs and endovascular mechanical devices is associated with improved outcome and lower mortality rates compared with natural history. Reperfusion is not without risk, however, and may result in reperfusion injury, which manifests in hemorrhagic transformation, brain edema, infarct progression, and neurologic worsening. In this article, the functional and structural changes and underlying molecular mechanisms of ischemia and reperfusion are reviewed. The pathways that lead to reperfusion...
Source: Neuroimaging Clinics - October 13, 2018 Category: Radiology Authors: Jae H. Choi, John Pile-Spellman Source Type: research

Role of Echocardiography in Assessment of Cardioembolic Sources: a Strong Diagnostic Resource in Patients with Ischemic Stroke
AbstractPurpose of ReviewThis review will discuss the most frequent sources of cardiac embolism and the role of echocardiography in these different clinical settings, and, in addition, provide suggestions about the choice between transthoracic (TTE) and transesophageal echocardiography (TEE).Recent FindingsStroke is the third leading cause of death in industrial countries, and 15 –40% of all ischemic strokes are due to cardioembolism. TTE and TEE are cornerstones in the detection of cardioembolic sources and provide fundamental information about the embolic risk and most suitable treatment of these patients, improving lo...
Source: Current Cardiology Reports - October 11, 2018 Category: Cardiology Source Type: research

Biohybrids of scaffolding hyaluronic acid biomaterials plus adipose stem cells home local neural stem and endothelial cells: Implications for reconstruction of brain lesions after stroke
AbstractEndogenous neurogenesis in stroke is insufficient to replace the lost brain tissue, largely due to the lack of a proper biological structure to let new cells dwell in the damaged area. We hypothesized that scaffolds made of hyaluronic acid (HA) biomaterials (BM) could provide a suitable environment to home not only new neurons, but also vessels, glia and neurofilaments. Further, the addition of exogenous cells, such as adipose stem cells (ASC) could increase this effect. Athymic mice were randomly assigned to a one of four group: stroke alone, stroke and implantation of BM, stroke and implantation of BM with ASC, a...
Source: Journal of Biomedical Materials Research Part B: Applied Biomaterials - October 11, 2018 Category: Materials Science Authors: Leyre Sanchez ‐Rojas, Ulises Gómez‐Pinedo, María Soledad Benito‐Martin, Gonzalo León‐Espinosa, Fernando Rascón‐Ramirez, Cristina Lendinez, Cristina Martínez‐Ramos, Jorge Matías‐Guiu, Manuel Monleón Pradas, Juan A. Barcia Tags: Original Research Report Source Type: research

Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial
Publication date: Available online 28 September 2018Source: The Lancet NeurologyAuthor(s): Scott E Kasner, Balakumar Swaminathan, Pablo Lavados, Mukul Sharma, Keith Muir, Roland Veltkamp, Sebastian F Ameriso, Matthias Endres, Helmi Lutsep, Steven R Messé, J David Spence, Krassen Nedeltechev, Kanjana Perera, Gustavo Santo, Veronica Olavarria, Arne Lindgren, Shrikant Bangdiwala, Ashkan Shoamanesh, Scott D Berkowitz, Hardi MundlSummaryBackgroundPatent foramen ovale (PFO) is a contributor to embolic stroke of undetermined source (ESUS). Subgroup analyses from previous studies suggest that anticoagulation could reduce recurren...
Source: The Lancet Neurology - October 5, 2018 Category: Neurology Source Type: research

Influence of cytochrome P450 polymorphisms on the antiplatelet effects of prasugrel in patients with non-cardioembolic stroke previously treated with clopidogrel
AbstractThis randomized double-blind crossover study aimed to investigate the influence of cytochrome P450 (CYP) 2C19 polymorphisms on the antiplatelet effects of prasugrel in patients with non-cardioembolic stroke treated with clopidogrel. Patients received clopidogrel 75  mg/day for>  4 weeks. Subsequently, patients received prasugrel 3.75 mg/day (group A;n = 64) or 2.5 mg/day (group B;n = 65) for 4 weeks followed by a 4 week switched-dose regimen. To assess the influence of CYP2C19 polymorphisms, patients were classified as extensive metabolizers (EMs), intermediate metabolizers (IMs), and poor metabo...
Source: Journal of Thrombosis and Thrombolysis - October 5, 2018 Category: Hematology Source Type: research

Tenecteplase versus alteplase for management of acute ischemic stroke: a pairwise and network meta-analysis of randomized clinical trials
AbstractTenecteplase is a genetically mutated variant of alteplase with superior pharmacodynamic and pharmacokinetic properties. However, its efficacy and safety in acute ischemic strokes are limited. Hence, we conducted a study to evaluate the efficacy and safety of tenecteplase compared with alteplase in acute ischemic stroke. Electronic databases were searched for randomized clinical trials (RCTs) comparing tenecteplase with alteplase in acute ischemic stroke patients eligible for thrombolysis. We evaluated various efficacy and safety outcomes using random-effects models for both pairwise and Bayesian network meta-analy...
Source: Journal of Thrombosis and Thrombolysis - October 5, 2018 Category: Hematology Source Type: research

Diagnostic accuracy of biomarker D-dimer in patients after stroke suspected from venous thromboembolism: A diagnostic meta-analysis.
Abstract D-dimer is a promising biomarker for identification of venous thromboembolism (VTE) in patients with stroke. The purpose of our study is to evaluate the diagnostic value of D-dimer as a promising biomarker for VTE in patients after stroke. We performed an exhaustive search of leading databases including Pubmed, Embase, the Cochrane library, China National Knowledge Infrastructure (CNKI), and China Biology Medicine disc (CBM) from inception to Oct 13, 2017. We included studies written in English and Chinese. We included studies that appraised the diagnostic value of D-dimer with reference standard for VTE ...
Source: Clinical Biochemistry - September 24, 2018 Category: Biochemistry Authors: Zhang D, Li F, Du X, Zhang X, Zhang Z, Zhao W, Du G Tags: Clin Biochem Source Type: research

Anticoagulation for Stroke Prevention in Older Adults with Atrial Fibrillation and Comorbidity: Current Evidence and Treatment Challenges.
Authors: Sabbag A, Yao X, Siontis KC, Noseworthy PA Abstract The burden of atrial fibrillation (AF) is projected to increase substantially over the next decade in parallel with the aging of the population. The increasing age, level of comorbidity, and polypharmacy will complicate the treatment of older adults with AF. For instance, advanced age and chronic kidney disease have been shown to increase the risk of both thromboembolism and bleeding in patients with AF. Frailty, recurrent falls and polypharmacy, while very common among elderly patients with AF, are often overlooked in the clinical decision making despite...
Source: Korean Circulation Journal - September 22, 2018 Category: Cardiology Tags: Korean Circ J Source Type: research

The effect and associated factors of dispatcher recognition of stroke: A retrospective observational study
ConclusionThe dispatchers should spend more time identifying stroke patients by following the dispatch protocol. Recognition of stroke by dispatchers was associated with improved stroke care.
Source: Journal of the Formosan Medical Association - September 20, 2018 Category: General Medicine Source Type: research

Imaging features and safety and efficacy of endovascular stroke treatment: a meta-analysis of individual patient-level data
Publication date: October 2018Source: The Lancet Neurology, Volume 17, Issue 10Author(s): Luis San Román, Bijoy K Menon, Jordi Blasco, María Hernández-Pérez, Antoni Dávalos, Charles B L M Majoie, Bruce C V Campbell, Francis Guillemin, Hester Lingsma, René Anxionnat, Jonathan Epstein, Jeffrey L Saver, Henk Marquering, John H Wong, Demetrius Lopes, Gernot Reimann, Hubert Desal, Diederik W J Dippel, Shelagh Coutts, Richard du Mesnil de RochemontSummaryBackgroundEvidence regarding whether imaging can be used effectively to select patients for endovascular thrombectomy (EVT) is scarce. We aimed to investigate the associat...
Source: The Lancet Neurology - September 19, 2018 Category: Neurology Source Type: research

Endovascular Thrombectomy in Acute-Onset Ischemic Stroke – beyond the Standard Time Windows: A Case Report and a Review of the Literature
We present a case of delayed thrombectomy in a 43-year-old man with acute dysarthria, left-sided weakness, and visual neglect. Initial MRI/A demonstrated a small completed stroke and a thrombus in the right middle cerebral artery. Thirty-seven hours after symptom onset, his weakness acutely worsened. A repeat MRI revealed an unchanged core infarct volume and a cerebral angiogram suggested an abrupt occlusion of the right distal M1. Thrombectomy was performed with complete reperfusion and the patient ’s strength recovered following the procedure. We compared our clinical reasoning with the DEFUSE-3 and DAWN study criteria...
Source: Case Reports in Neurology - September 18, 2018 Category: Neurology Source Type: research

HDAC4 in ischemic stroke: mechanisms and therapeutic potential
Stroke is one of the leading causes of death and disability worldwide, and the majority of the cases are ischemic stroke. However, it still lacks effective treatment except for thrombolytic therapy in an extre...
Source: Clinical Epigenetics - September 12, 2018 Category: Research Authors: Qingsheng Kong, Yongnan Hao, Xin Li, Xin Wang, Bingyuan Ji and Yili Wu Tags: Review Source Type: research

Clinical and Imaging Characteristics Associated With Thrombus Recanalization in Ischemic Stroke
This cohort study examines baseline clinical and biochemical variables, intracranial thrombus characteristics, and stroke workflow interval times associated with clot recanalization among patients with ischemic stroke treated with intravenous alteplase.
Source: JAMA - September 11, 2018 Category: General Medicine Source Type: research

Introduction of direct oral anticoagulant within 7  days of stroke onset: a nomogram to predict the probability of 3-month modified Rankin Scale score  & gt;  2
AbstractIn clinical practice, direct oral anticoagulants (DOACs) are often started earlier ( ≤ 7 days) than in randomized clinical trials after stroke. We aimed to develop a nomogram model incorporating time of DOAC introduction ≤ 7 days of stroke onset in combination with different degrees of stroke radiological/neurological severity at the time of treatment to predict the prob ability of unfavorable outcome. We conducted a multicenter prospective study including 344 patients who started DOAC 1–7 days after atrial fibrillation-related stroke onset. Computed tomography scan 24–36 h after stroke onset was ...
Source: Journal of Thrombosis and Thrombolysis - September 10, 2018 Category: Hematology Source Type: research

Effectiveness of Initiating Deep Vein Thrombosis Prophylaxis in Patients With Stroke: An Integrative Review
Venous thromboembolism (VTE) is a frequent and potentially fatal complication of immobility caused by cerebrovascular disease. This review examines the efficiency of deep vein thrombosis (DVT) prophylaxis methods. Patients with stroke initiated on DVT prophylaxis were compared with those who did not have any prophylaxis. Integrative review research design was used and included articles from 2010 to 2016. Search terms such as “DVT prophylaxis” and “stroke” were used to identify scientific publications. Of 173 studies identified, 12 articles were included and rated using the Canadian Medical Association and Center fo...
Source: Journal of Neuroscience Nursing - September 8, 2018 Category: Neuroscience Tags: Article Source Type: research

Impact of code stroke on thrombolytic therapy in patients with acute ischemic stroke at a secondary referral hospital in Taiwan
ConclusionCode stroke is effective in reducing in-hospital delays. The accuracy of code stroke activation has acceptable sensitivity but low specificity. Rapid patient assessment by neurologists increases the number of patients eligible for thrombolytic therapy.
Source: Journal of the Chinese Medical Association - September 7, 2018 Category: General Medicine Source Type: research

Worldwide Analysis of Radiology Access and Education for Stroke Care: View From Abroad From 14 Countries
The World Health Organization reports that stroke is among the leading causes of death in noncommunicable diseases worldwide despite advances in acute stroke care [1]. Early interventions in cerebrovascular accidents can prevent mortality and minimize debilitating effects of stroke. There have been major recent advancements in stroke care to intervene more quickly and effectively. We are entering a new era of stroke imaging-based treatment for late acute ischemic stroke. Recent neurointerventional trials, such as DAWN and DEFUSE 3, have transformed the way clinicians provide acute stroke care in the United States and provi...
Source: Journal of the American College of Radiology : JACR - September 6, 2018 Category: Radiology Authors: Jesus Uribe, Simon Ammanuel, Bhavya Rehani Tags: A View From Abroad Source Type: research

Preadmission use of Glucocorticoids and Risk of Cardiovascular Events in Patients with Ischemic Stroke.
CONCLUSIONS: During the first year after ischemic stroke, current glucocorticoid use was associated with moderately increased risk of myocardial infarction and venous thromboembolism and lower risk of hemorrhagic stroke, while the risk of recurrent ischemic stroke was not affected. This article is protected by copyright. All rights reserved. PMID: 30179297 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - September 4, 2018 Category: Hematology Authors: Sundbøll J, Darvalics B, Horváth-Puhó E, Adelborg K, Laugesen K, Schmidt M, Henderson VW, Sørensen HT Tags: J Thromb Haemost Source Type: research

A hospital-based study of stroke in young from North East India
Conclusion: Although traditional risk factors are associated with stroke in young, unfavorable behavioral pattern such as alcohol abuse may cause and promote development stroke in young.
Source: Annals of Indian Academy of Neurology - September 4, 2018 Category: Neurology Authors: Masaraf Hussain Shri Ram Sharma MD Jamil Source Type: research

Hemorrhagic stroke and cerebral venous thrombosis: rare neurological sequelae of chickenpox infection
Anuradha Mehta, Aanchal Arora, Manoj Sharma, Rupali Malik, Yogesh Chandra PorwalAnnals of Indian Academy of Neurology 2018 21(3):228-232 Chickenpox (varicella) is primarily a disease of childhood which occurs due to infection with varicella-zoster virus (VZV). Primary VZV infection is rare in adults due to exposure in early childhood in our country. In adults, it is associated with some serious systemic and neurological complications which can follow both primary infection and reactivation of VZV. Neurological sequelae caused by primary VZV infection are rare and include encephalitis, aseptic meningitis, myelitis, acute c...
Source: Annals of Indian Academy of Neurology - September 4, 2018 Category: Neurology Authors: Anuradha Mehta Aanchal Arora Manoj Sharma Rupali Malik Yogesh Chandra Porwal Source Type: research

Model development and comparison of low hemorrhage-risk endoluminal patch thrombolytic treatment for ischemic stroke
A thrombus blocking flow in a blood vessel deprives the brain cells of oxygen resulting in ischemic stroke and paralysis [1]. Thrombolysis treatment can be used to unblock the vessel [2]. A high dose of thrombolytic agents (urokinase plasminogen activator (uPA) or tissue plasminogen activator (tPA)) is administered to dissolve the blocking thrombus in eligible patients who are within 4.5  h from stroke onset [3,4]. Typically, 10,000–60,000 IU/kg (
Source: Medical Engineering and Physics - August 31, 2018 Category: Biomedical Engineering Authors: Zhen Qin, Francesco Ciucci, Chi Hang Chon, John C.K. Kwok, David C.C. Lam Source Type: research

Opportunities for intervention: stroke treatments, disability and mortality in urban Tanzania
ConclusionsThe 90-day mortality of stroke presenting at MNH is 50%, much higher than in higher income settings. Although severe stroke presentations are a major factor, efforts to improve the quality of care and prevent complications of stroke are urgently needed. Acute stroke interventions with low number needed to treat represent challenging long-term goals.
Source: International Journal for Quality in Health Care - August 28, 2018 Category: International Medicine & Public Health Source Type: research

Enhanced activity of ADAMTS13 variant (R568K/F592Y/R660K/Y661F/Y665F) against platelet agglutination in vitro and in a murine model of acute ischaemic stroke.
CONCLUSION: The limited proteolytic activity of WT ADAMTS13 in in vitro models of arterial thrombosis suggests an in vivo requirement for conformational activation. The enhanced activity of the GoF ADAMTS13 variant translates to a more pronounced protective effect in experimental stroke. This article is protected by copyright. All rights reserved. PMID: 30152919 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - August 28, 2018 Category: Hematology Authors: South K, Denorme F, Salles-Crawley II, De Meyer SF, Lane DA Tags: J Thromb Haemost Source Type: research

Does renal function have incremental predictive value of stroke in atrial fibrillation?
It is well known that both atrial fibrillation (AF) and chronic kidney disease (CKD) are respectively independent predictors of stroke and systemic thromboembolism. A number of epidemiological and observational studies have shown that there are close relationships between AF and CKD [1 –3]. Indeed, the prevalence of AF increases from non-CKD to CKD stages of 1 to 2, 3 and 4 to 5 by 1.0%, 2.8%, 2.7%, and 4.2%, respectively [1], and the prevalence is 7% to 27% in patients with end-stage renal disease who are undergoing hemodialysis therapy [2].
Source: International Journal of Cardiology - August 28, 2018 Category: Cardiology Authors: Yukihito Higashi Tags: Editorial Source Type: research

Ability of the Khorana score to predict recurrent thromboembolism in cancer patients with ischemic stroke
In this study, the Khorana score had poor discriminatory ability for predicting RTE in cancer patients with AIS. Future research is needed to identify better methods for predicting RTE in this high-risk population.
Source: Journal of Clinical Neuroscience - August 23, 2018 Category: Neuroscience Source Type: research

Revascularization and Endothelial Progenitor Cells in Stroke.
Abstract Stroke is one of the leading causes of death and disability worldwide. Tremendous improvements have been achieved in the acute care of stroke patients with the implementation of stroke units, thrombolytic drugs and endovascular trombectomies. However, stroke survivors with neurological deficits require long periods of neurorehabilitation, which is the only approved therapy for post- stroke recovery. With this scenario more treatments are urgently needed, and only the understanding of the mechanisms of brain recovery might contribute to identify new therapeutic agents. Fortunately brain injury after stroke...
Source: Am J Physiol Cell Ph... - August 22, 2018 Category: Cytology Authors: Esquiva G, Grayston A, Rosell A Tags: Am J Physiol Cell Physiol Source Type: research

Recanalisation therapies for wake-up stroke.
CONCLUSIONS: There is insufficient evidence from randomised controlled trials for recommendations concerning recanalisation therapies for wake-up stroke. Results from ongoing trials will hopefully establish the efficacy and safety of such therapies. PMID: 30129656 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - August 21, 2018 Category: General Medicine Authors: Roaldsen MB, Lindekleiv H, Mathiesen EB, Berge E Tags: Cochrane Database Syst Rev Source Type: research

Risk factors for stroke and choice of oral anticoagulant in atrial fibrillation
ConclusionsThe uptake of DOACs was rapid and spurred an increase in new users of oral anticoagulants for atrial fibrillation from 2010 to 2015 in Norway. The mean CHA2DS2-VASc score did not change substantially during this period. Vascular disease, heart failure, and diabetes were associated with initiation of warfarin, and previous stroke, age 65 –74 and female sex with initiation of DOACs.
Source: European Journal of Clinical Pharmacology - August 16, 2018 Category: Drugs & Pharmacology Source Type: research

Tenecteplase versus alteplase for management of acute ischemic stroke: a pairwise and network meta-analysis of randomized clinical trials
AbstractTenecteplase is a genetically mutated variant of alteplase with superior pharmacodynamic and pharmacokinetic properties. However, its efficacy and safety in acute ischemic strokes are limited. Hence, we conducted a study to evaluate the efficacy and safety of tenecteplase compared with alteplase in acute ischemic stroke. Electronic databases were searched for randomized clinical trials (RCTs) comparing tenecteplase with alteplase in acute ischemic stroke patients eligible for thrombolysis. We evaluated various efficacy and safety outcomes using random-effects models for both pairwise and Bayesian network meta-analy...
Source: Journal of Thrombosis and Thrombolysis - August 16, 2018 Category: Hematology Source Type: research

Apolipoprotein E and PAI-1 gene polymorphisms and no association with arterial ischemic stroke and peripheral arterial disease manifestations
Conclusion: No significant difference was observed by comparing patients and controls. In this study, no association was found between the presence of the evaluated polymorphisms and the occurrence of thrombotic events.RESUMO Introdu ção: A trombose arterial é considerada uma doença multifatorial, resultante da interação de fatores de risco genéticos e adquiridos. Objetivos: O objetivo deste estudo foi investigar a presença dos polimorfismos nos genes do inibidor da ativação do plasminogênio tipo 1 (PAI-1) e da apoli poproteína E (ApoE), bem como suas interações com níveis de PAI-1 e lipídios e perfis de ap...
Source: Jornal Brasileiro de Patologia e Medicina Laboratorial - August 14, 2018 Category: Pathology Source Type: research

Saving the brain initiative – Developing an effective hub-and-spoke model to improve the acute stroke management pathways in urban India
We aimed to develop and evaluate a hub-and-spoke model in the East Delhi by assessing knowledge and creating awareness through sensitization programs in target communities and among general physicians (GPs) along with implementation of a standard stroke management protocol (SMP) at our institute in order to extend the benefit of thrombolytic therapy.
Source: Journal of the Neurological Sciences - August 9, 2018 Category: Neurology Authors: Suman Kushwaha, Puneet Talwar, Niketa Chandel, Aldrin Anthony, Siddharth Maheshwari, Sarbjeet Khurana Source Type: research

Influence of cytochrome P450 polymorphisms on the antiplatelet effects of prasugrel in patients with non-cardioembolic stroke previously treated with clopidogrel
AbstractThis randomized double-blind crossover study aimed to investigate the influence of cytochrome P450 (CYP) 2C19 polymorphisms on the antiplatelet effects of prasugrel in patients with non-cardioembolic stroke treated with clopidogrel. Patients received clopidogrel 75  mg/day for>  4 weeks. Subsequently, patients received prasugrel 3.75 mg/day (group A;n = 64) or 2.5 mg/day (group B;n = 65) for 4 weeks followed by a 4 week switched-dose regimen. To assess the influence of CYP2C19 polymorphisms, patients were classified as extensive metabolizers (EMs), intermediate metabolizers (IMs), and poor metabo...
Source: Journal of Thrombosis and Thrombolysis - August 3, 2018 Category: Hematology Source Type: research

Antineuroinflammatory Effect of SMTP-7 in Ischemic Mice
Stachybotrys microspora triprenyl phenol-7 (SMTP-7) has both potentials of thrombolytic and neuroprotective effects, but its detailed neuroprotective mechanisms in ischemic stroke are still unclear. Here, we assessed the neuroprotective effects of SMTP-7 for anti-inflammatory and antiapoptosis mechanisms after 60 minutes of transient middle cerebral artery occlusion (tMCAO) in mice.
Source: Journal of Stroke and Cerebrovascular Diseases - August 2, 2018 Category: Neurology Authors: Yong Huang, Yasuyuki Ohta, Jingwei Shang, Ryuta Morihara, Yumiko Nakano, Yusuke Fukui, Xia Liu, Xiaowen Shi, Tian Feng, Toru Yamashita, Kota Sato, Mami Takemoto, Nozomi Hishikawa, Eriko Suzuki, Keiji Hasumi, Koji Abe Source Type: research

Presentation of Acute Childhood Stroke in a Tertiary Pediatric Emergency Department
Conclusions The spectrum of stroke in a developing country was similar to published series from developed countries in terms of final diagnosis, risk factors, and delay to ED presentation, neuroimaging, and long-term neurodeficits. No tropical diseases were identified as risk factors.
Source: Pediatric Emergency Care - August 1, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Usual Dietary Intake and Risk of Stroke.
Authors: Adachi H PMID: 30047512 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - July 28, 2018 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research

Implications of Janus Kinase 2 Mutation in Embolic Stroke of Unknown Source
The role of genetic mutations in cerebral ischemia is not completely understood. Among these genetic variations, Philadelphia-negative gain-of-function mutation in the janus kinase 2 (JAK2) protein leads to overexpression of the genes involved in cell growth and proliferation, and has been linked to development of hematological malignancies, specifically, myeloproliferative neoplasms (MPNs; essential thrombocythemia [ET], polycythemia vera [PV], and primary myelofibrosis). Overt ET and PV are known to induce a prothrombotic state that leads to development of vascular complications, including cerebral arterial or venous thrombosis.
Source: Journal of Stroke and Cerebrovascular Diseases - July 26, 2018 Category: Neurology Authors: Gabriela Trifan, Neelofer Shafi, Fernando D. Testai Source Type: research

Medium-Chain Acylcarnitines Are Associated With Cardioembolic Stroke and Stroke Recurrence: A Metabolomics Study.
CONCLUSIONS: Metabolomics provided an improved understanding of CE pathogenesis and stroke recurrence. We have identified decanoylcarnitine and octanoylcarnitine as novel biomarkers for CE and stroke recurrence. PMID: 30026276 [PubMed - as supplied by publisher]
Source: Arteriosclerosis, Thrombosis and Vascular Biology - July 19, 2018 Category: Cardiology Authors: Seo WK, Jo G, Shin MJ, Oh K Tags: Arterioscler Thromb Vasc Biol Source Type: research

Glomerular Filtration Rate is Associated with Hemorrhagic Transformation in Acute Ischemic Stroke Patients without Thrombolytic Therapy.
Conclusions: The present study strongly showed that lower GFR is an independently predictor of HT; in addition, large infarct volume, AF, and HA are also important risks of HT for AIS patients without TT, which offered a practical information that risk factors should be paid attention or eliminated to prevent HT for stroke patients though the level of evidence seems to be unstable. PMID: 29998881 [PubMed - in process]
Source: Chinese Medical Journal - July 14, 2018 Category: General Medicine Authors: Liu MS, Liao Y, Li GQ Tags: Chin Med J (Engl) Source Type: research

Number of ischemic strokes potentially eligible for revascularization treatments in an Italian Comprehensive Stroke Center: a modeling study
AbstractTo rationally plan acute services, the proportion of ischemic strokes that may be eligible for revascularization treatments should be estimated. We aimed to estimate the proportion of patients directly admitted to an Italian Comprehensive Stroke Center who may be eligible for intravenous thrombolysis (IVT), combined IVT and endovascular thrombectomy (ET), or direct ET according to the current guidelines. We conducted a retrospective analysis based on data prospectively collected from 876 consecutive adult ischemic stroke patients who were directly admitted to the Stroke Unit of the University Hospital of Verona wit...
Source: Journal of Thrombosis and Thrombolysis - July 14, 2018 Category: Hematology Source Type: research

How fast can acute stroke treatment become to still be reliable?
(University of Helsinki) Neurologists around the world are aware that the delivery of thrombolytic treatment for stroke in Helsinki University Hospital, Finland, is freaking fast -- but is it too fast? A new study published on July 11 in the journal Neurology clarified whether the team of neurologists in Helsinki actually have enough time to diagnose stroke correctly before it is treated.
Source: EurekAlert! - Medicine and Health - July 13, 2018 Category: International Medicine & Public Health Source Type: news