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Prothrombotic States and Ischemic Stroke in the Young (P3.231)
Conclusions: There is no association between prothrombotic risk factors (analyzed individually or as a group) and idiopathic ischemic stroke in the young, even in those with a PFO or with migraine.Disclosure: Dr. Boudjani has nothing to disclose. Dr. Lanthier has received compensation for activities with Bristol-Myers-Squibb, Sanofi-Aventis, Boehringer-Ingelheim, and Astra-Zeneca as a speaker.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Boudjani, H., Lanthier, S. Tags: Stroke in the Young Source Type: research
Clinical Predictors of Hemorrhagic Transformation in Non Lacunar Ischemic Stroke (P6.041)
Conclusions: predictors for HT in our cohort were also related with severe vascular disease. Identification of these high risk patients is crucial in clinical decision making regarding thrombolytic treatment and optimal timing for antithrombotic therapy initiation.Disclosure: Dr. Zurru has nothing to disclose. Dr. Colla Machado has nothing to disclose. Dr. Alonzo has nothing to disclose. Dr. Brescacin has nothing to disclose. Dr. Pigretti has nothing to disclose. Dr. Luzzi has nothing to disclose. Dr. Balian has nothing to disclose. Dr. Waisman has nothing to disclose. Dr. Cristiano has received personal compensation for a...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Zurru, M., Colla Machado, P., Alonzo, C., Brescacin, L., Pigretti, S., Luzzi, A., Balian, N., Waisman, G., Cristiano, E. Tags: In-Hospital Stroke and Stroke Complications Source Type: research
90 Day Outcome after Reperfusion Therapy of Stroke Patients with Baseline Disability: Unique Observations from Patients Treated on the Mobile Stroke Unit (P6.052)
Conclusion: In comparison to previously published data our analysis shows unfavorable outcome in the majority of patients with baseline disability who received thrombolytic therapy. The small sample size is a limitation to this analysis, and further studies are needed to assess if this subpopulation should be included in clinical trials assessing new therapies or modalities to deliver them.Disclosure: Dr. almaghrabi has nothing to disclose. Dr. Sarraj has nothing to disclose. Dr. Bowry has nothing to disclose. Dr. Parker has nothing to disclose. Dr. Yamal has nothing to disclose. Dr. Grotta has received personal compensati...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Almaghrabi, T., Sarraj, A., Bowry, R., Parker, S., Yamal, J.-M., Grotta, J. Tags: Prehospital Stroke Care and Uses of NIHSS Source Type: research
Neurogenesis in Stroke Recovery
Abstract Stroke, resulting from limited blood flow to the brain, is one of the most important causes of morbidity and mortality worldwide. Stroke is classified as ischemic, due to lack of blood flow, or hemorrhagic, due to bleeding. Because 87 % of strokes are classified as ischemic, this type will be the predominant focus of this review. Except for thrombolytic therapy, there is no established treatment to reduce the neurological deficits caused by ischemic stroke. Therefore, it is necessary to develop new therapeutic strategies designed to improve neurological functions after ischemic stroke. Recently, therapie...
Source: Translational Stroke Research - March 17, 2016 Category: Neurology Source Type: research
Thrombolytic Recanalization of Carotid Arteries Is Highly Dependent on Degree of Stenosis, Despite Sonothrombolysis Stroke
Conclusions In this model, the degree of carotid stenosis had a large effect on thrombolytic recanalization. Sonothrombolysis using standard parameters for intracranial sonothrombolysis did not increase recanalization. Further testing is warranted. The degree of underlying stenosis may be an important predictor of thrombolytic recanalization, and clinical correlation of these findings may provide new approaches to treatment selection for patients with carotid occlusion.
Source: JAHA:Journal of the American Heart Association - February 23, 2016 Category: Cardiology Authors: Tomkins, A. J., Hood, R. J., Pepperall, D., Null, C. L., Levi, C. R., Spratt, N. J. Tags: Ultrasound, Cerebrovascular Disease/Stroke, Stenosis, Thrombosis Source Type: research
Thrombus Length Estimation on Delayed Gadolinium-Enhanced T1 Clinical Sciences
Conclusions— The dGE-T1, obtained by simply adjusting scanning order in multimodal magnetic resonance imaging protocol, is a useful tool for thrombus length estimation and middle cerebral artery recanalization prediction after IVT.
Source: Stroke - February 22, 2016 Category: Neurology Authors: Yan, S., Chen, Q., Xu, M., Sun, J., Liebeskind, D. S., Lou, M. Tags: Angiography, Ischemic Stroke Clinical Sciences Source Type: research
Stroke: Highlights of Selected Articles Stroke: Highlights of Selected Articles
Source: Stroke - February 22, 2016 Category: Neurology Tags: Computerized Tomography (CT), Revascularization, Meta Analysis, Ischemic Stroke, Thrombosis Stroke: Highlights of Selected Articles Source Type: research
Post-IV thrombolytic headache and hemorrhagic transformation risk in acute ischemic stroke
Conclusion: tPA-associated headache does not predict increased risk of HT and has no other prognostic importance in patients with AIS. Prospective studies with a larger cohort may be needed to further explore this relationship.
Source: Neurology Clinical Practice - February 15, 2016 Category: Neurology Authors: Chaudhry, S. A., Kwon, S. Y., Kneale, H., Al Jajeh, A., Hussain, S., Razak, A. Tags: All Cerebrovascular disease/Stroke, Embolism, Intracerebral hemorrhage Research Source Type: research
Mechanisms and outcomes of stroke during pregnancy and the postpartum period: A cross-sectional study
Conclusion: Compared with nonpregnant women of the same age group, women with PAS had fewer vascular risk factors. Cerebral venous thrombosis and RCVS were more common in PAS, most of which occurred postpartum. These results provide further evidence for the unique pathophysiology of pregnancy-related stroke, raising important questions for future investigation.
Source: Neurology Clinical Practice - February 15, 2016 Category: Neurology Authors: Miller, E. C., Yaghi, S., Boehme, A. K., Willey, J. Z., Elkind, M. S. V., Marshall, R. S. Tags: Migraine, Stroke in young adults, All Cerebrovascular disease/Stroke, Subarachnoid hemorrhage Research Source Type: research
Multiple Myeloma Stage I, II and Renal Insufficiency Are Associated with Increased Stroke Risk (S31.003)
Conclusion: In multiple myeloma,patient’s renal insufficiency and MM Stage I and II were independent predictors of increased stroke risk. Besides these hypercoagulability, atrial fibrillation, watershed strokes and small vessel disease played important role.Disclosure: Dr. Limaye has nothing to disclose. Dr. Ravilla has nothing to disclose. Dr. Appalnaidu has nothing to disclose. Dr. Papanikolaou has nothing to disclose. Dr. Waheed has nothing to disclose. Dr. Hinduja has nothing to disclose.
Source: Neurology - February 7, 2016 Category: Neurology Authors: Limaye, K., Ravilla, R., Sasapu, A., Papanikolaou, X., Waheed, S., Hinduja, A. Tags: Stroke Risk, Outcomes, and Complications Source Type: research
Elevated FVIII Predicts Subsequent Acute Ischemic Stroke in Patients with Transient Ischemic Attack (S42.004)
CONCLUSIONS: In our sample, eFVIII was associated with increased risk of a subsequent AIS admission. These findings may indicate a greater risk for other future thrombotic events in post-TIA patients with eFVIII and begs the question as to optimal antithrombotic therapy in this population.Disclosure: Dr. Semmes has nothing to disclose. Dr. Monlezun, Jr has nothing to disclose. Dr. Samai has nothing to disclose. Dr. Martin-Schild has received personal compensation for activities with Genentech.
Source: Neurology - February 7, 2016 Category: Neurology Authors: Semmes, E., Monlezun, Jr, D., Samai, A., Martin-Schild, S. Tags: Stroke Mechanism and Modifiers Source Type: research
Withdrawal of Antithrombotic Agents and the Risk of Stroke
Antithrombotic medications are effective for ischemic stroke prevention, but stoppage of these medications is associated with an increased risk of thromboembolism. The frequency of antithrombotic withdrawal in the general population is unknown.
Source: Journal of Stroke and Cerebrovascular Diseases - January 28, 2016 Category: Neurology Authors: Monica L. Wagner, Jane C. Khoury, Kathleen Alwell, Eric Rademacher, Daniel Woo, Matthew L. Flaherty, Aaron M. Anderson, Opeolu Adeoye, Simona Ferioli, Brett M. Kissela, Dawn Kleindorfer, Joseph P. Broderick Source Type: research
Coexistence of Deep Vein Thrombosis, Heterotopic Ossification, and Complex Regional Pain Syndrome due to Hemorrhagic Stroke
A patient who developed hemiplegia related to a hemorrhagic stroke and who had not been started on venous thromboembolism prophylaxis or a physical medicine and rehabilitation program was admitted to our clinic on the 4th month after the event. Our patient had pain, swelling, redness, increased temperature at the right lower extremity, range of motion limitation at the hip and knee, deep vein thrombosis (DVT) and complex regional pain syndrome (CRPS) at the same side lower extremity, and heterotopic ossification (HO) at the hip.
Source: Journal of Stroke and Cerebrovascular Diseases - January 8, 2016 Category: Neurology Authors: Engin Koyuncu, Güldal Funda Nakipoğlu Yüzer, Didem Yenigün, Neşe Özgirgin Tags: Case Studies Source Type: research
Secondary Prevention of Stroke with Warfarin in Patients with Nonvalvular Atrial Fibrillation: Subanalysis of the J-RHYTHM Registry
Prior ischemic stroke or transient ischemic attack (TIA) is a high risk for thromboembolism in patients with nonvalvular atrial fibrillation (NVAF). To clarify rates of thromboembolic and hemorrhagic events, and target intensities of warfarin for secondary prevention, a subanalysis was performed using data from the J-RHYTHM Registry.
Source: Journal of Stroke and Cerebrovascular Diseases - December 22, 2015 Category: Neurology Authors: Eitaro Kodani, Hirotsugu Atarashi, Hiroshi Inoue, Ken Okumura, Takeshi Yamashita, Hideki Origasa, J-RHYTHM Registry Investigators Source Type: research
Multicenter clinical experience in over 125 patients with the Penumbra Separator 3D for mechanical thrombectomy in acute ischemic stroke
Conclusions The results suggest that the Separator 3D enables safe and effective revascularization of occluded large arteries in acute stroke intervention, leading to a high rate of functional independence at 90 days.
Source: Journal of NeuroInterventional Surgery - December 13, 2015 Category: Neurosurgery Authors: Behme, D., Kowoll, A., Mpotsaris, A., Hader, C., Hechelhammer, L., Weber, J., Weber, W. Tags: Ischemic stroke Source Type: research
Partial MHC Constructs Treat Thromboembolic Ischemic Stroke Characterized by Early Immune Expansion
Abstract Inflammation and thrombosis are tightly linked, with inflammation contributing to thromboembolism and to stroke outcome. Thromboembolism is a frequent cause of ischemic stroke; yet, the most used occlusion mouse models of experimental stroke do not effectively replicate thromboembolism. Our group recently described a novel thromboembolic mouse model of stroke that successfully occludes the middle cerebral artery with high reproducibility. In the current study, we characterize the peripheral and local immune outcomes as well as the ischemic response to immune therapy in a clinically relevant mouse model of...
Source: Translational Stroke Research - December 1, 2015 Category: Neurology Source Type: research
Migraine makes the stroke grow faster?
Long associated with increased incidence of stroke,1,2 migraine has been linked with mechanisms involving the vasculature (vasospasm, arterial dissection, endothelial dysfunction, venous thrombosis), heart (patent foramen ovale), and blood (hypercoagulability).3 Since cerebral ischemia can induce cortical spreading depression, the physiologic process underlying aura, migraine with aura may theoretically represent a TIA equivalent in a subset of people. In addition to the heightened occurrence of stroke in migraineurs, a growing body of evidence suggests more dire consequences when stroke occurs, with experiments in mice wi...
Source: Neurology - November 30, 2015 Category: Neurology Authors: Tietjen, G. E., Sacco, S. Tags: Migraine, All Cerebrovascular disease/Stroke EDITORIALS Source Type: research
Thrombus Features in Hyperacute Ischemic Stroke: A Perspective on Using Length and Density Evaluation
More insights in the etiopathogenesis of thrombi could be helpful in the treatment of patients with acute ischemic stroke (AIS). One of the most confident and early imaging findings of stroke includes arterial hyperdensity. The purpose of this study was to determine whether thrombi's density and length would be useful for predicting their origin.
Source: Journal of Stroke and Cerebrovascular Diseases - November 17, 2015 Category: Neurology Authors: Felipe Torres Pacheco, César Augusto Pinheiro Ferreira Alves, Rubens Jose Gagliardi, Antônio Jose da Rocha Source Type: research
Ultra-acute CT perfusion imaging: A stroke in the scanner
A stroke patient with a mild right hemiparesis (NIH Stroke Scale score 4) underwent dual-slab CT perfusion (CTP). In the midst of acquiring the lower CTP slab, she became aphasic and developed a dense right hemiparesis (NIH Stroke Scale score 17). Reconstruction of the CTP into a dynamic CT angiogram demonstrates fragmentation of an internal carotid artery thrombus at the time of clinical worsening (figure 1; video on the Neurology® Web site at Neurology.org). The upper CTP slab, acquired 2 minutes later, provides the earliest known view of the hemodynamics of ischemic stroke in humans. It demonstrates total absence of...
Source: Neurology - November 9, 2015 Category: Neurology Authors: Christensen, S., Obi, C., Albers, G., Lansberg, M. Tags: CT, All Cerebrovascular disease/Stroke, Embolism, Infarction VIDEO NEUROIMAGES Source Type: research
Academic-Community Hospital Comparison of Vulnerabilities in Door-to-Needle Process for Acute Ischemic Stroke Original Articles
Conclusions— Although the identification of common critical failures suggests opportunities for a generalizable process redesign, differences in the criticality and nature of failures must be addressed at the individual hospital level, to develop robust and sustainable solutions to reduce DTN time.
Source: Circulation: Cardiovascular Quality and Outcomes - October 29, 2015 Category: Cardiology Authors: Prabhakaran, S., Khorzad, R., Brown, A., Nannicelli, A. P., Khare, R., Holl, J. L. Tags: Treatment, Ethics and Policy, Ischemic Stroke Original Articles Source Type: research
Alteplase Reduces Downstream Microvascular Thrombosis and Improves the Benefit of Large Artery Recanalization in Stroke Basic Sciences
Conclusions— Our data demonstrate that DMT is an early phenomenon initiated before recanalization. We further show that alteplase-dependent maintenance of downstream perfusion during MCAO improves acute ischemic stroke outcome through a fibrinogen-dependent platelet aggregation reduction. Our results indicate that early targeting of DMT represents a therapeutic strategy to improve the benefit of large artery recanalization in acute ischemic stroke.
Source: Stroke - October 26, 2015 Category: Neurology Authors: Desilles, J.-P., Loyau, S., Syvannarath, V., Gonzalez-Valcarcel, J., Cantier, M., Louedec, L., Lapergue, B., Amarenco, P., Ajzenberg, N., Jandrot-Perrus, M., Michel, J.-B., Ho-Tin-Noe, B., Mazighi, M. Tags: Fibrinolysis, Fibrinogen/fibrin, Acute Cerebral Infarction, Brain Circulation and Metabolism, Thrombolysis Basic Sciences Source Type: research
Early Loss of Immediate Reperfusion While Stent Retriever in Place Predicts Successful Final Reperfusion in Acute Ischemic Stroke Patients Brief Reports
Conclusions— ELOIR during the embedding period after deployment of stent retrievers is associated with successful final reperfusion, likely because of greater thrombus engagement with the stent retriever. ELOIR may be a useful finding to guide duration of embedding time in clinical practice and design of novel stent retrievers.
Source: Stroke - October 26, 2015 Category: Neurology Authors: Okawa, M., Tateshima, S., Liebeskind, D., Rao, N., Jahan, R., Gonzalez, N., Szeder, V., Ali, L., Kim, D., Saver, J., Duckwiler, G. Tags: Acute Cerebral Infarction, Acute Stroke Syndromes, Embolic stroke Brief Reports Source Type: research
Letter by Avasarala Regarding Article, "2015 AHA/ASA Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association" Letters to the Editor
Source: Stroke - October 26, 2015 Category: Neurology Authors: Avasarala, J. Tags: Fibrinolysis, Arterial thrombosis, Acute Stroke Syndromes, Other Stroke Treatment - Surgical, Other Vascular biology Letters to the Editor Source Type: research
Cerebral hemorrhage following thrombolytic therapy for stroke: Are neutrophils really neutral?
An ideal biomarker can accurately predict disease risk stratification. The longstanding link between inflammatory responses and atherosclerotic disease and vascular events suggests great promise for inflammatory measures as biomarkers in stroke and other vascular disease. Recent studies across multiple areas and disciplines have suggested that leukocytes, as an inflammatory marker, and specifically neutrophils, may hold promise in predicting poor outcomes in various cardiovascular diseases (e.g., heart failure, acute coronary syndromes, stable coronary artery disease), including stroke, as well as in neoplasms, infections,...
Source: Neurology - October 19, 2015 Category: Neurology Authors: Roever, L., Levine, S. R. Tags: All Cerebrovascular disease/Stroke, All epidemiology, Prevalence studies, Risk factors in epidemiology, Intracerebral hemorrhage EDITORIALS Source Type: research
Racial Disparities in Intravenous Recombinant Tissue Plasminogen Activator Use Persist at Primary Stroke Centers Stroke
Conclusions Racial disparities in intravenous rt-PA use were not reduced by presentation to PSCs. Black patients were less likely to receive thrombolytic treatment than white patients at both non-PSCs and PSCs. Hispanic patients were less likely to be seen at PSCs relative to white patients and were less likely to receive intravenous rt-PA in the fully adjusted model.
Source: JAHA:Journal of the American Heart Association - October 14, 2015 Category: Cardiology Authors: Aparicio, H. J., Carr, B. G., Kasner, S. E., Kallan, M. J., Albright, K. C., Kleindorfer, D. O., Mullen, M. T. Tags: Stroke Source Type: research
A Case of Recurrent Ischemic Stroke Involving Subacute, Progressive Intracranial Cerebral Arterial Sclerosis Prior to Diagnosis with -mutated Polycythemia Vera
A 58-year-old man presenting with no vascular risk factors visited our hospital with right hemiparesis and total aphasia. Diffusion-weighted magnetic resonance imaging of the brain showed multiple hyperintensities in watershed distributions in the left hemisphere. Magnetic resonance angiography (MRA) revealed stenosis of the middle cerebral artery, despite normal MRA findings 2 months prior. One year after the first stroke, the patient experienced a recurrent ischemic stroke involving the left anterior choroidal artery, pulmonary embolism, and deep venous thrombosis.
Source: Journal of Stroke and Cerebrovascular Diseases - September 29, 2015 Category: Neurology Authors: Tomohisa Nezu, Shiro Aoki, Kazuhide Ochi, Sayaka Sugihara, Tetsuya Takahashi, Naohisa Hosomi, Hirofumi Maruyama, Masayasu Matsumoto Tags: Case Studies Source Type: research
Cross-National Key Performance Measures of the Quality of Acute Stroke Care in Western Europe Clinical Sciences
Conclusions— On the basis of experience of quality registers in Europe, we have proposed a common set of performance measures that will facilitate the international comparison of acute stroke care quality.
Source: Stroke - September 28, 2015 Category: Neurology Authors: Norrving, B., Bray, B. D., Asplund, K., Heuschmann, P., Langhorne, P., Rudd, A. G., Wagner, M., Wiedmann, S., Wolfe, C. D. A., for the European Implementation Score Collaboration Tags: Health policy and outcome research Clinical Sciences Source Type: research
Potential new uses of non-vitamin K antagonist oral anticoagulants to treat and prevent stroke
Conclusion: There may be a role for NOACs in stroke prevention and treatment beyond atrial fibrillation. Randomized controlled trials are needed to compare NOACs to current stroke prevention and treatment strategies in certain subgroups of patients with cerebrovascular disease.
Source: Neurology - September 21, 2015 Category: Neurology Authors: Yaghi, S., Kamel, H., Elkind, M. S. V. Tags: Stroke prevention, All Cerebrovascular disease/Stroke, Infarction, Cerebral venous thrombosis VIEWS & amp;amp; REVIEWS Source Type: research
Development and validation of a simplified Stroke-Thrombolytic Predictive Instrument
Conclusion: A simpler model using a 3-item stroke severity score, instead of the 15-item NIH Stroke Scale, has similar prognostic value and may be easier to use in routine care. Future studies are needed to test whether it can improve process and clinical outcomes.
Source: Neurology - September 14, 2015 Category: Neurology Authors: Kent, D. M., Ruthazer, R., Decker, C., Jones, P. G., Saver, J. L., Bluhmki, E., Spertus, J. A. Tags: All Cerebrovascular disease/Stroke ARTICLE Source Type: research
Accuracy of First Recorded “Last Known Normal” Times of Stroke Code Patients
This study investigates whether a difference exists between preliminary LKN times (first responders and emergency department practitioners) and revised LKN times (neurology/stroke practitioners), and what potential impact on emergent management of acute stroke this discrepancy may pose.
Source: Journal of Stroke and Cerebrovascular Diseases - September 1, 2015 Category: Neurology Authors: Ilana Spokoyny, Rema Raman, Karin Ernstrom, Alex J. Kim, Brett C. Meyer, Navaz P. Karanjia Source Type: research
Critical Early Thrombolytic and Endovascular Reperfusion Therapy for Acute Ischemic Stroke Victims: a Call for Adjunct Neuroprotection
This article has 3 main goals: (1) first to emphasize the utility and cost-effectiveness of rt-PA to treat stroke; (2) second to review the recent endovascular trials with respect to efficacy, safety, and cost-effectiveness as a stroke treatment; and (3) to further consider and evaluate strategies to develop novel neuroprotective drugs. A thesis will be put forth so that future stroke trials and therapy development can optimally promote recovery so that stroke victims can return to “normal” life.
Source: Translational Stroke Research - August 29, 2015 Category: Neurology Source Type: research
Recurrent Stroke: The Value of the CHA2DS2VASc Score and the Essen Stroke Risk Score in a Nationwide Stroke Cohort Clinical Sciences
Conclusions— In this cohort of non–atrial fibrillation patients with incident ischemic stroke, increasing CHA2DS2VASc score and Essen Stroke Risk Score was associated with increasing risk of recurrent stroke, death, and cardiovascular events. Their discriminatory performance was modest and further refinements are required for clinical application.
Source: Stroke - August 24, 2015 Category: Neurology Authors: Andersen, S. D., Gorst-Rasmussen, A., Lip, G. Y. H., Bach, F. W., Larsen, T. B. Tags: Risk Factors, Acute Cerebral Infarction Clinical Sciences Source Type: research
Residual Risk of Stroke and Death in Anticoagulated Patients According to the Type of Atrial Fibrillation: AMADEUS Trial Clinical Sciences
Conclusions— The risk of cardiovascular death, stroke, or systemic embolism is higher in anticoagulated patients with permanent AF than in those with nonpermanent AF, regardless of preexisting heart failure.
Source: Stroke - August 24, 2015 Category: Neurology Authors: Senoo, K., Lip, G. Y. H., Lane, D. A., Buller, H. R., Kotecha, D. Tags: Thrombosis risk factors Clinical Sciences Source Type: research
Duration of Diabetes Mellitus and Risk of Thromboembolism and Bleeding in Atrial Fibrillation: Nationwide Cohort Study Clinical Sciences
Conclusions— In patients with atrial fibrillation, longer duration of diabetes mellitus was associated with a higher risk of thromboembolism, but not with a higher risk of anticoagulant-related bleeding. Considering the critical balance between preventing thromboembolism and avoiding bleeding, longer duration of diabetes mellitus may favor initiation of anticoagulant therapy.
Source: Stroke - July 27, 2015 Category: Neurology Authors: Overvad, T. F., Skjoth, F., Lip, G. Y. H., Lane, D. A., Albertsen, I. E., Rasmussen, L. H., Larsen, T. B. Tags: Thrombosis risk factors, Type 1 diabetes, Type 2 diabetes, Embolic stroke, Anticoagulants Clinical Sciences Source Type: research
Heart rate variability and baroreceptor sensitivity in acute stroke: a systematic review
BackgroundAutonomic nervous system dysfunction is common after acute stroke and is associated with elevated risk of cardiac arrhythmia and mortality. Heart rate variability and baroreceptor sensitivity have been investigated as parameters of autonomic nervous system dysfunction for the prediction of stroke outcome. SummaryWe performed a systematic literature review on heart rate variability and baroreceptor sensitivity as parameters for autonomic nervous function in acute stroke. Twenty‐two studies were included. Associations between heart rate variability or baroreceptor sensitivity and stroke severity, early and late c...
Source: International Journal of Stroke - July 23, 2015 Category: Neurology Authors: Laetitia Yperzeele, Robbert‐Jan van Hooff, Guy Nagels, Ann De Smedt, Jacques De Keyser, Raf Brouns Tags: Systematic review Source Type: research
Perception Versus Actual Performance in Timely Tissue Plasminogen Activation Administration in the Management of Acute Ischemic Stroke Stroke
Conclusions Hospitals often overestimate their ability to deliver timely tPA to treated patients. Our findings indicate the need to routinely provide comparative provider performance rates as a key step to improving the quality of acute stroke care.
Source: JAHA:Journal of the American Heart Association - July 22, 2015 Category: Cardiology Authors: Lin, C. B., Cox, M., Olson, D. M., Britz, G. W., Constable, M., Fonarow, G. C., Schwamm, L., Peterson, E. D., Shah, B. R. Tags: Stroke Source Type: research
Canadian Stroke Best Practice Recommendations: Hyperacute Stroke Care Guidelines, Update 2015
The 2015 update of the Canadian Stroke Best Practice Recommendations Hyperacute Stroke Care guideline highlights key elements involved in the initial assessment, stabilization, and treatment of patients with transient ischemic attack (TIA), ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and acute venous sinus thrombosis. The most notable change in this 5th edition is the addition of new recommendations for the use of endovascular therapy for patients with acute ischemic stroke and proximal intracranial arterial occlusion. This includes an overview of the infrastructure and resources required ...
Source: International Journal of Stroke - July 6, 2015 Category: Neurology Authors: Leanne K. Casaubon, Jean‐Martin Boulanger, Dylan Blacquiere, Scott Boucher, Kyla Brown, Tom Goddard, Jacqueline Gordon, Myles Horton, Jeffrey Lalonde, Christian LaRivière, Pascale Lavoie, Paul Leslie, Jeanne McNeill, Bijoy K. Menon, Brian Moses, Melani Tags: Guidelines Source Type: research
High levels of von Willebrand factor and low levels of its cleaving protease, ADAMTS13, are associated with stroke in young HIV‐infected patients
ConclusionsStroke in human immunodeficiency virus infection is associated with a prothrombotic state, characterized by elevated von Willebrand factor and low ADAMTS13 levels.
Source: International Journal of Stroke - June 29, 2015 Category: Neurology Authors: Sameera Allie, Alan Stanley, Alan Bryer, Muriel Meiring, Marc I. Combrinck Tags: Research Source Type: research
Combined lysis of thrombus with ultrasound and systemic tissue plasminogen activator for emergent revascularization in acute ischemic stroke (CLOTBUST‐ER): design and methodology of a multinational phase 3 trial
ConclusionsSince intravenous recombinant tissue‐plasminogen‐activator remains the only medical therapy to reverse ischemic stroke applicable in the emergency department, our trial will determine if the additional use of transcranial ultrasound improves functional outcomes in patients with severe acute ischemic stroke (NCT#01098981).
Source: International Journal of Stroke - June 29, 2015 Category: Neurology Authors: Peter D. Schellinger, Andrei V. Alexandrov, Andrew D. Barreto, Andrew M. Demchuk, Georgios Tsivgoulis, Martin Kohrmann, John Alleman, Virginia Howard, George Howard, Anne W. Alexandrov, Gordon Brandt, Carlos A. Molina, Tags: Protocol Source Type: research
Time-Dependent Thrombus Resolution After Tissue-Type Plasminogen Activator in Patients With Stroke and Mice Clinical Sciences
Conclusions— Early administration of tPA after stroke onset is associated with better thrombus resolution.
Source: Stroke - June 22, 2015 Category: Neurology Authors: Kim, Y. D., Nam, H. S., Kim, S. H., Kim, E. Y., Song, D., Kwon, I., Yang, S.-H., Lee, K., Yoo, J., Lee, H. S., Heo, J. H. Tags: Arterial thrombosis, Acute Cerebral Infarction, Thrombolysis Clinical Sciences Source Type: research
Prophylactic Edaravone Prevents Transient Hypoxic-Ischemic Brain Injury: Implications for Perioperative Neuroprotection Basic Sciences
Conclusions— Acute application of Edaravone may be a useful strategy to prevent postsurgery stroke and cognitive impairment, especially in patients with severe carotid stenosis.
Source: Stroke - June 22, 2015 Category: Neurology Authors: Sun, Y.-Y., Li, Y., Wali, B., Li, Y., Lee, J., Heinmiller, A., Abe, K., Stein, D. G., Mao, H., Sayeed, I., Kuan, C.-Y. Tags: Animal models of human disease, Other Stroke Treatment - Medical, Coagulation and fibronolysis Basic Sciences Source Type: research
Homocysteine, Ischemic Stroke, and Coronary Heart Disease in Hypertensive Patients: A Population-Based, Prospective Cohort Study Clinical Sciences
Conclusions— Hyperhomocysteinemia in Chinese hypertensive patients is significantly associated with IS risk but not coronary heart disease susceptibility, and folic acid supplementation can efficiently reduce tHcy levels.
Source: Stroke - June 22, 2015 Category: Neurology Authors: Han, L., Wu, Q., Wang, C., Hao, Y., Zhao, J., Zhang, L., Fan, R., Liu, Y., Li, R., Chen, Z., Zhang, T., Chen, S., Ma, J., Liu, S., Peng, X., Duan, S. Tags: Myocardial cardiomyopathy disease, Valvular heart disease, Clinical Studies, Acute Cerebral Hemorrhage, Cerebral Venous Thrombosis Clinical Sciences Source Type: research
Effect Size Estimates for the ESCAPE Trial: Proportional Odds Regression Versus Other Statistical Methods Clinical Sciences
Conclusions— The mRS distribution for both treatment and control groups influences the power of the investigated statistical models to assess treatment efficacy. A careful evaluation of the expected outcome distribution across the mRS scale is required to determine the best choice of primary analysis.
Source: Stroke - June 22, 2015 Category: Neurology Authors: Sajobi, T. T., Zhang, Y., Menon, B. K., Goyal, M., Demchuk, A. M., Broderick, J. P., Hill, M. D. Tags: Thrombolysis, Other Stroke Treatment - Surgical Clinical Sciences Source Type: research
Unfavorable Outcome of Thrombolysis in Chinese Patients with Cardioembolic Stroke: a Prospective Cohort Study.
CONCLUSIONS: Patients with cardioembolic stroke had more SICH after thrombolysis, and worse clinical outcome at 3-month follow-up compared with those with LAA. This emphasizes the importance of preventing cardioembolism. PMID: 26096605 [PubMed - as supplied by publisher]
Source: CNS Neuroscience and Therapeutics - June 20, 2015 Category: Neuroscience Authors: Wang XG, Zhang LQ, Liao XL, Pan YS, Shi YZ, Wang CJ, Wang YL, Liu LP, Zhao XQ, Wang YJ, Li D, Wang CX, Thrombolysis Implementation and Monitoring of acute ischemic Stroke in China (TIMS-China) Investigators Tags: CNS Neurosci Ther Source Type: research
Predictors of Reperfusion in Patients with Acute Ischemic Stroke BRAIN
CONCLUSIONS: Recanalization and reperfusion are strongly associated but not always equivalent in ischemic stroke. A smaller total ischemic area is the only independent predictor of complete reperfusion.
Source: American Journal of Neuroradiology - June 11, 2015 Category: Radiology Authors: Horsch, A. D., Dankbaar, J. W., Niesten, J. M., van Seeters, T., van der Schaaf, I. C., van der Graaf, Y., Mali, W. P. T. M., Velthuis, B. K., on behalf of the Dutch Acute Stroke Study Investigators Tags: BRAIN Source Type: research
Targeting neutrophils in ischemic stroke: translational insights from experimental studies
Frank R Sharp
Source: Journal of Cerebral Blood Flow and Metabolism - May 29, 2015 Category: Neuroscience Authors: Glen C JicklingDaZhi LiuBradley P AnderBoryana StamovaXinhua ZhanFrank R Sharp Tags: atherosclerosis cerebral ischemia immune system neutrophil stroke thrombus Source Type: research
Improving the Prediction of Spontaneous and Post-thrombolytic Recanalization in Ischemic Stroke Patients
Endovascular treatment for acute ischemic stroke patients was recently shown to improve recanalization rates and clinical outcome in a well-defined study population. Intravenous thrombolysis (IVT) alone is insufficiently effective to recanalize in certain patients or of little value in others. Accordingly, we aimed at identifying predictors of recanalization in patients treated with or without IVT.
Source: Journal of Stroke and Cerebrovascular Diseases - May 23, 2015 Category: Neurology Authors: Peter Vanacker, Dimitris Lambrou, Ashraf Eskandari, George Ntaios, Patrick Cras, Philippe Maeder, Reto Meuli, Patrik Michel Source Type: research
Carotid I's, L's and T's: collaterals shape the outcome of intracranial carotid occlusion in acute ischemic stroke
Conclusions Collateral flow patterns distinguish the nature and impact of ICA occlusions on expected revascularization and subsequent clinical outcomes in acute ischemic stroke. The nomenclature of terminal ICA occlusions introduced here (carotid I's, L's, and T's) may enhance future endovascular trials targeting such proximal occlusions. Trial registration number NCT00318071 (http://clinicaltrials.gov). MERCI was not registered because enrollment began before July 1, 2005.
Source: Journal of NeuroInterventional Surgery - May 14, 2015 Category: Neurosurgery Authors: Liebeskind, D. S., Flint, A. C., Budzik, R. F., Xiang, B., Smith, W. S., Duckwiler, G. R., Nogueira, R. G., for the MERCI and Multi-MERCI Investigators Tags: Ischemic stroke Source Type: research
Abstract 21: Stroke Physician Report Cards Improve Physician Response Times for Thrombolytic Treatment Session Title: Concurrent Session IIC: Oral Abstracts - Stroke
Conclusion: The results show that direct, personal and comparative feedback to stroke physicians influences their page-to-response, page-to-needle times and may affect DTN times. There was a clear trend overall, and the page-to-response and page-to-needle times showed significant improvement. Though our numbers were too small to detect statistical significance for individuals, the benefit of improved treatment times is likely clinically significant.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Yanase, L., Corless, L., Stuchiner, T., Baraban, E. Tags: Session Title: Concurrent Session IIC: Oral Abstracts - Stroke Source Type: research
Risk communication in the hyperacute setting of stroke thrombolysis: an interview study of clinicians
Conclusions Risk communication about thrombolysis involves complex uncertainties. We elucidate the challenges of effective risk communication in a hyperacute setting and identify the issues regarding variation in risk communication and the use of less effective formats for the communication of numerical risks and benefits. The paper identifies good practice, such as the phased transfer of information over the care pathway, and ways in which clinicians might be supported to overcome challenges. This includes standardised risk and benefit information alongside appropriate personalisation of risk communication. Effective risk...
Source: Emergency Medicine Journal - April 18, 2015 Category: Emergency Medicine Authors: Lie, M. L. S., Murtagh, M. J., Watson, D. B., Jenkings, K. N., Mackintosh, J., Ford, G. A., Thomson, R. G. Tags: Stroke, Radiology, Clinical diagnostic tests Original article Source Type: research