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Treatment and outcome of childhood cerebral sinovenous thrombosis
Conclusions Within the IPSS registry, children with risk factors of trauma or intracranial surgery were less likely to receive anticoagulation for CSVT. Anticoagulation was associated with a lower odds of severe neurologic impairment or death at hospital discharge, but this finding is limited and needs further confirmation in randomized, controlled, prospective studies.
Source: Neurology Clinical Practice - June 8, 2020 Category: Neurology Authors: Felling, R. J., Hassanein, S. M. A., Armstrong, J., Aversa, L., Billinghurst, L., Goldenberg, N. A., Lee, J. E., Maxwell, E. C., Noetzel, M. J., Lo, W., on behalf of the International Pediatric Stroke Study Group Tags: Childhood stroke, Hematologic, Pediatric stroke; see Cerebrovascular Disease/ Childhood stroke, Intracerebral hemorrhage, Cerebral venous thrombosis Research Source Type: research
Low Serum Eicosapentaenoic Acid Levels in Cryptogenic Stroke with Active Cancer
Since Armand Trousseau first described migratory superficial thrombophlebitis in 1865, patients with malignant cancer have been known to be in a hypercoagulable state and at risk for the development of cancer-associated thrombosis.1 Approximately 7% of cancer patients have symptomatic cerebrovascular diseases during the clinical course of cancer, and 15% have cerebrovascular lesions at autopsy.2 Previous studies have demonstrated that cancer patients with cryptogenic ischemic stroke often have high serum D-dimer levels and multiple vascular lesions and show cryptogenic stroke etiology, which seems to be due to a hypercoagulable state.
Source: Journal of Stroke and Cerebrovascular Diseases - May 15, 2020 Category: Neurology Authors: Tesseki Izumi, Hitoki Nanaura, Naohiko Iguchi, Maki Ozaki, Kazuma Sugie Source Type: research
Risk factors and pathogenic microorganism characteristics for pneumonia in convalescent patients with stroke: A retrospective study of 380 patients from a rehabilitation hospital
Stroke significantly impacts public health and ranks among the leading causes of death and disabilities, resulting in enormous costs measured in both health care resources and lost productivity. It results primarily from embolus or thrombosis for ischemic stroke and hypertension for hemorrhagic stroke, respectively . In 2016, there were 5.5 million deaths and 116.4 million disability-adjusted life-years (DALYs) owed to stroke . As reported, the impact of stroke on the Chinese population is more severe compared to average global levels, and the prevalence of stroke continues to surpass that of ischemic heart disease [3 –4].
Source: Journal of Stroke and Cerebrovascular Diseases - May 14, 2020 Category: Neurology Authors: Jia Xu, Zhiling Yang Source Type: research
Anatomical distribution of lower-extremity deep venous thrombosis in patients with acute stroke
Post-stroke paralysis is a common contributor to deep vein thrombosis (DVT) of the lower extremities. DVT of the lower extremities can spread to the proximal circulation, and the detachment of the thrombus may result in fatal pulmonary embolism. Therefore, the early diagnosis and timely treatment of DVT should be highlighted.1 DVT can occur in various sites in deep veins of the lower extremities, and the clinical risks and therapeutic guidelines for thrombus in different anatomical locations considerably varies.
Source: Journal of Stroke and Cerebrovascular Diseases - May 11, 2020 Category: Neurology Authors: Xun-can Liu, Xiao-wei Chen, Zhen-lan Li, Shou-chun Wang, Chen Chen Source Type: research
AbstractThe COVID-19 pandemic is associated with neurological symptoms and complications including stroke. There is hypercoagulability associated with COVID-19 that is likely a “sepsis-induced coagulopathy” and may predispose to stroke. The SARS-CoV-2 virus binds to angiotensin-converting enzyme 2 (ACE2) present on brain endothelial and smooth muscle cells. ACE2 is a key part of the renin angiotensin system (RAS) and a counterbalance to angiotensin-converting enzyme 1 (ACE1) and angiotensin II. Angiotensin II is proinflammatory, is vasoconstrictive, and promotes organ damage. Depletion of ACE2 by SARS-CoV-2 may tip the...
Source: Translational Stroke Research - May 7, 2020 Category: Neurology Source Type: research
Efficacy and Safety of Thrombolytic Therapy for Stroke with Unknown Time of Onset: A Meta-Analysis of Observational Studies
Recombinant tissue plasminogen activator (rt-PA) is one of the most effective therapies available for patients with known-onset stroke (KOS). Whether rt-PA treatment would improve functional outcomes in patients with stroke with unknown time of onset (UTOS) is undetermined, we aimed to systematically assess the efficacy and safety of thrombolysis for UTOS patients in this meta-analysis.
Source: Journal of Stroke and Cerebrovascular Diseases - February 29, 2020 Category: Neurology Authors: Ruo-lin Zhu, Jing Xu, Cheng-juan Xie, Ying Hu, Kai Wang Source Type: research
Biomarker Application for Precision Medicine in Stroke
AbstractStroke remains one of the leading causes of long-term disability and mortality despite recent advances in acute thrombolytic therapies. In fact, the global lifetime risk of stroke in adults over the age of 25 is approximately 25%, with 24.9 million cases of ischemic stroke and 18.7 million cases of hemorrhagic stroke reported in 2015. One of the main challenges in developing effective new acute therapeutics and enhanced long-term interventions for stroke recovery is the heterogeneity of stroke, including etiology, comorbidities, and lifestyle factors that uniquely affect each individual stroke survivor. In this com...
Source: Translational Stroke Research - December 18, 2019 Category: Neurology Source Type: research
Mechanical Thrombectomy in Pediatric Stroke: Report of Three New Cases
Mechanical thrombectomy for treatment of arterial ischemic stroke (AIS) and cerebral venous thrombosis (CVT) is well-studied in adult populations, but not in children.
Source: Journal of Stroke and Cerebrovascular Diseases - December 13, 2019 Category: Neurology Authors: Whitney L. Gervelis, Meredith R. Golomb Source Type: research
Delay to Tissue Plasminogen Activator in Hypertensive Stroke Patients: An Analysis of Delay Duration Across Agents
A subset of ischemic stroke patients present with blood pressures above that considered safe for thrombolytic administration, requiring antihypertensive therapy. Guideline statements are ambivalent regarding which antihypertensive agent should be used to obtain a satisfactory blood pressure
Source: Journal of Stroke and Cerebrovascular Diseases - December 4, 2019 Category: Neurology Authors: Joseph F. Carrera, Brian J. Sorace, Bradford B. Worrall, Andrew M. Southerland, Nicole A. Chiota-McCollum Source Type: research
Safety and Efficacy of Intravenous Thrombolytic Therapy in Patients With Acute Posterior Circulation Stroke: A Single-Center Study
This study was designed to evaluate the prestroke and baseline characteristics, stroke sub-types, complications, and outcomes of PCS patients and compare them with anterior circulation stroke (ACS) after intravenous thrombolysis. Methods: Data of consecutive patients with PCS and ACS treated with alteplase in a standard dose of 0.9 mg/kg in our stroke center were collected and analyzed retrospectively.
Source: Journal of Stroke and Cerebrovascular Diseases - December 2, 2019 Category: Neurology Authors: Xuan Zhu, Nuo Wang, Huangbin Lin, Ping Zhang, Lei Chen, Minmin Zhang, Benqiang Deng, Tao Wu Source Type: research
Is Door-to-Needle Time Reduced for Emergency Medical Services Transported Stroke Patients Routed Directly to the Computed Tomography Scanner on Emergency Department Arrival?
A nationally recommended practice to accelerate thrombolytic therapy for acute ischemic stroke is to route emergency medical services (EMS)-transported stroke patients directly to the computed tomography (CT) scanner on arrival. We evaluated door-to-needle time with direct-to-CT routing versus emergency department (ED)-bed first routing.
Source: Journal of Stroke and Cerebrovascular Diseases - November 4, 2019 Category: Neurology Authors: Bryan Sloane, Nichole Bosson, Nerses Sanossian, Jeffrey L. Saver, Lorrie Perez, Marianne Gausche-Hill Source Type: research
Multicenter prospective analysis of stroke patients taking oral anticoagulants: The PASTA registry - Study design and characteristics
The management of atrial fibrillation and deep venous thrombosis has evolved with the development of direct oral anticoagulants (DOAC), and oral anticoagulant (OAC) might influence the development or clinical course in both ischemic and hemorrhagic stroke. However, detailed data on the differences between the effects of the prior prescription of warfarin and DOAC on the clinical characteristics, neuroradiologic findings, and outcome of stroke are limited.
Source: Journal of Stroke and Cerebrovascular Diseases - October 29, 2019 Category: Neurology Authors: Satoshi Suda, Yasuyuki Iguchi, Shigeru Fujimoto, Yoshiki Yagita, Yu Kono, Masayuki Ueda, Kenichi Todo, Tomoyuki Kono, Takayuki Mizunari, Mineo Yamazaki, Takao Kanzawa, Seiji Okubo, Kimito Kondo, Nobuhito Nakajima, Takeshi Inoue, Takeshi Iwanaga, Makoto Na Source Type: research
Novel Definition of Stroke “Good Responders” Predicts 90-Day Outcome after Thrombolysis
Identifying predictors of good response in thrombolytic-treated stroke is important to clinical care, resource allocation, and research design. We developed a simple, novel measure of “Good Responders” to assess if 2 short-term variables could predict 90-day outcomes after thrombolysis in stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - October 14, 2019 Category: Neurology Authors: Alyssa E. Bautista, Dawn M. Meyer, Brett C. Meyer Source Type: research
Even Faster Door-to-Alteplase Times and Associated Outcomes in Acute Ischemic Stroke
We report a single-center, retrospective assessment of the safety and efficacy of alteplase treatment within 45 minutes. Methods: Five hundred and eighty-six patients were treated with alteplase in our emergency departments (EDs) between January 2014 and October 2016; 368 patients were included for analysis.
Source: Journal of Stroke and Cerebrovascular Diseases - October 10, 2019 Category: Neurology Authors: Sarah Jung, Jamie M. Rosini, Jason T. Nomura, Richard J. Caplan, Jonathan Raser-Schramm Source Type: research
The First 10 Thrombolysis for Acute Ischemic Stroke in Lao People's Democratic Republic under Teleconsultation from Thailand
This study aimed to evaluate the feasibility and safety of thrombolytic therapy administration at Mittaphab Hospital, Lao PDR under the international telestroke consultation system from King Chulalongkorn Memorial Hospital, Thailand. Methods: Acute ischemic stroke patients who presented at Mittaphab Hospital within 4.5 hours after the onset and received thrombolytic therapy between December 2016 and June 2017 were studied.
Source: Journal of Stroke and Cerebrovascular Diseases - September 14, 2019 Category: Neurology Authors: Aurauma Chutinet, Saysavath Keosodsay, Pongpat Vorasayan, Jitlada Samajarn, Wasan Akarathanawat, Naruchorn Kijpaisalratana, Naly Norsakpeseuth, Ketmany Phetsiriseng, Snong Thongsna, Pakkawan Vongvasinkul, Nijasri C. Suwanwela Source Type: research
Stroke Center Care and Outcome: Results from the CSPPC Stroke Program
AbstractThe aim of this study was to assess the association between admission to stroke centers for acute ischemic stroke and complications and mortality during hospitalization in a Chinese population by means of an observational study using data from the China Stroke Center Data-Sharing Platform. We compared in-hospital complications and mortality for patients admitted with acute ischemic stroke (N = 13,236) between November 1, 2018 and December 31, 2018 at stroke center (SH) and non-stroke center (CH) hospitals using distance to hospitals as an instrumental variable to adjust for potential prehospital selection bias....
Source: Translational Stroke Research - September 8, 2019 Category: Neurology Source Type: research
The Value of the CHADS2 and CHA2DS2-VASc Score for Predicting the Prognosis in Lacunar Stroke with or without Atrial Fibrillation Patients
Background: The CHADS2 and CHA2DS2-VASc scoring systems have been proved efficacy to stratify stroke and thromboembolism risk in patients with atrial fibrillation (AF). Whether CHADS2 and CHA2DS2-VASc score has predictive value for the prognosis in lacunar stroke (LS) patients remains unclear. Methods: A total of 763 consecutive patients with LS (mean age: 66 ± 12 years; 464 male) were enrolled in this study between January 2013 and December 2014. Patients were divided into LS without AF (LS; n = 679) and LS with AF (LS-AF; n = 84) groups.
Source: Journal of Stroke and Cerebrovascular Diseases - August 30, 2019 Category: Neurology Authors: Hong-Jie Yang, Guang-Ji Wang, Wei Shuai, Cai-Jie Shen, Bin Kong, He Huang Source Type: research
Floating Aortic Thrombus: A Rare Cause of Acute Ischemic Stroke Necessitating Modification of Access Route for Thrombectomy
We report 2 patients with acute occlusion of middle cerebral artery successfully treated by mechanical thrombectomy performed via transbrachial access. Both patients had floating aortic arch thrombi precluding safe transfemoral access due to risk of further iatrogenic embolization. Moreover both patients were diagnosed with hypercoagulopathy secondary to lung malignancy (paraneoplastic etiology, Trousseau's syndrome) as the cause of both aortic thrombi and acute ischemic stroke. Mechanical thrombectomy in the setting of a floating aortic thrombus has been mentioned only once as part of general management of floating aortic...
Source: Journal of Stroke and Cerebrovascular Diseases - August 21, 2019 Category: Neurology Authors: Sinan Balci, Ethem Murat Arsava, Mehmet Akif Topcuoglu, Anil Arat Source Type: research
Prognostic Value of Clot Burden Score in Acute Ischemic Stroke after Reperfusion Therapies: A Systematic Review and Meta-Analysis
Background and Aim: Clot burden score (CBS) was designed to weight the thrombus status in cerebral anterior circulation. We performed a systematic review and meta-analysis to investigate the prognostic value of CBS in acute ischemic stroke (AIS) patients undergoing reperfusion therapies. Methods: We searched relevant databases for eligible articles reporting CBS in AIS patients. The effect sizes of good functional outcome, recanalization, or hemorrhagic transformation (HT) were pooled with random-/fixed-effect models.
Source: Journal of Stroke and Cerebrovascular Diseases - August 3, 2019 Category: Neurology Authors: Guoming Li, Guangliang Wu, Zhengjie Qin, Huiping Li, Xiao Cheng, Yefeng Cai Source Type: research
Stroke in Association with Thyroid Goitre: A Case Report
Ischaemic stroke secondary to isolated internal carotid artery thrombus without risk factors is uncommon. A 55-year-old woman presented to the acute stroke unit with acute right middle cerebral artery territory infarction secondary to right internal carotid artery occlusion. There were no risk factors for cerebrovascular disease, but mediastinal imaging showed the presence of a large retrosternal goitre which was displacing the mediastinal structures including the brachiocephalic and common carotid artery.
Source: Journal of Stroke and Cerebrovascular Diseases - March 29, 2019 Category: Neurology Authors: Linford Fernandes, Ahamad Hassan Tags: Case Report Source Type: research
Predictors of Left Atrial Thrombi and Spontaneous Echocardiographic Contrast in the Acute Phase After Cardioembolic Stroke in Patients With Atrial Fibrillation
This study aims to investigate the utility of CHADS2 and CHA2DS2-VASc scores for predicting LAT/SEC, and to investigate the risk factors of residual LAT/SEC after CES onset. Methods: This retrospective study included 124 patients who were admitted with the acute phase of CES at our center. The clinical, echocardiographic variables, the CHADS2/CHA2DS2-VASc scores, and National Institutes of Health Stroke Scale score were retrospectively assessed on admission.
Source: Journal of Stroke and Cerebrovascular Diseases - March 29, 2019 Category: Neurology Authors: Hideyuki Kishima, Takanao Mine, Eiji Fukuhara, Kenki Ashida, Kazutaka Uchida, Shinichi Yoshimura, Masaharu Ishihara Source Type: research
Dynamic Detection of Thrombolysis in Embolic Stroke Rats by Synchrotron Radiation Angiography
AbstractA rodent model of embolic middle cerebral artery occlusion is used to mimic cerebral embolism in clinical patients. Thrombolytic therapy is the effective treatment for this ischemic injury. However, it is difficult to detect thrombolysis dynamically in living animals. Synchrotron radiation angiography may provide a novel approach to directly monitor the thrombolytic process and assess collateral circulation after embolic stroke. Thirty-six adult Sprague-Dawley rats underwent the embolic stroke model procedure and were then treated with tissue plasminogen activator. The angiographic images were obtained in vivo by s...
Source: Translational Stroke Research - January 24, 2019 Category: Neurology Source Type: research
Efficacy of Tirofiban Administered at Different Time Points after Intravenous Thrombolytic Therapy with Alteplase in Patients with Acute Ischemic Stroke
To evaluate the efficacy of tirofiban administered at different time points within 24 hours of intravenous thrombolysis with alteplase in acute ischemic stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - January 14, 2019 Category: Neurology Authors: Jin Liu, Qiuyan Shi, Yuan Sun, Jingyuan He, Bin Yang, Chunyang Zhang, Rui Guo Source Type: research
Short-Term Risk of Ischemic Stroke After Detection of Left Ventricular Thrombus on Cardiac Magnetic Resonance Imaging
Background: The short-term risk of ischemic stroke in patients with left ventricular (LV) thrombus identified via delayed-enhancement cardiac magnetic resonance (DE-CMR) imaging is uncertain. Methods: We performed a retrospective cohort study of patients who underwent DE-CMR for evaluation of LV systolic dysfunction at NewYork-Presbyterian Hospital/Weill Cornell between 2007 and 2016. We identified all hospitalized patients who had DE-CMR evidence of LV thrombus, and as controls, all hospitalized patients who had no DE-CMR evidence of LV thrombus; 2 control patients were randomly selected for each patient with LV thrombus.
Source: Journal of Stroke and Cerebrovascular Diseases - January 10, 2019 Category: Neurology Authors: Alexander E. Merkler, Javid Alakbarli, Gino Gialdini, Babak B. Navi, Santosh B. Murthy, Parag Goyal, Jiwon Kim, Richard B. Devereux, Monika M. Safford, Costantino Iadecola, Hooman Kamel, Jonathan W. Weinsaft Source Type: research
Talk About Thrombolysis. Regular Case-Based Discussions of Stroke Thrombolysis Improve Door-to-Needle Time by 20%.
Background: The outcome of stroke patients can be improved by a rapid initiation of thrombolytic therapy. Here, we sought to determine whether an additional simple but thorough case-based discussion of recent thrombolysed cases with the entire neurologic staff can improve the door-to-needle time without changes to the implemented stroke protocol. Methods: For every performed thrombolysis, a route card, consisting of a timeline with 3 time points and target times, had to be completed by the attending neurologist.
Source: Journal of Stroke and Cerebrovascular Diseases - December 28, 2018 Category: Neurology Authors: Caroline Klingner, Albrecht G ünther, Stefan Brodoehl, Otto W. Witte, Carsten M. Klingner Source Type: research
Intravenous Thrombolysis in Acute Ischemic Stroke After Idarucizumab Reversal of Dabigatran Effect: Analysis of the Cases From Taiwan
Background: Asians with atrial fibrillation carry a higher risk of ischemic stroke than non-Asians even under treatment of nonvitamin K antagonist oral anticoagulants. The purpose of the study was to observe the feasibility of intravenous thrombolytic therapy after administering a reversal agent, idarucizumab, in dabigatran-treated patients with acute ischemic stroke in Taiwan. Methods: Dabigatran-treated patients with acute ischemic stroke who received intravenous recombinant tissue plasminogen activator (rt-PA) after idarucizumab reversal were enrolled in the retrospective nationwide study.
Source: Journal of Stroke and Cerebrovascular Diseases - December 17, 2018 Category: Neurology Authors: Chen-Wen Fang, Yi-Te Tsai, Ping-Chen Chou, Hsi-Ming Chen, Chien-Ming Lu, Chen-Rong Tsao, Chih-Lin Chen, Mu-Chien Sun, Yu-Song Shih, Cheng-Yang Hsieh, Lu-An Chen, Po-Lin Chen, Jung-Tze Yeh, Yi-Heng Li Source Type: research
Preclinical Validation of the Therapeutic Potential of Glasgow Oxygen Level Dependent (GOLD) Technology: a Theranostic for Acute Stroke
AbstractIn acute stroke patients, penumbral tissue is non-functioning but potentially salvageable within a time window of variable duration and represents target tissue for rescue. Reperfusion by thrombolysis and/or thrombectomy can rescue penumbra and improve stroke outcomes, but these treatments are currently available to a minority of patients. In addition to the utility of Glasgow Oxygen Level Dependent (GOLD) as an MRI contrast capable of detecting penumbra, its constituent perfluorocarbon (PFC) oxygen carrier, combined with normobaric hyperoxia, also represents a potential acute stroke treatment through improved oxyg...
Source: Translational Stroke Research - November 30, 2018 Category: Neurology Source Type: research
Subcutaneous Heparin Therapy for Patients with Cancer-Associated Stroke
Anticoagulation therapy, particularly subcutaneous heparin therapy, is recommended for cancer-associated thrombosis. However, not starting or discontinuing anticoagulation was not rare. The aim of the present study was to examine the practical issues related to anticoagulation therapy and effects of subcutaneous heparin therapy for cancer-associated stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - November 5, 2018 Category: Neurology Authors: Hiroyuki Kawano, Yuko Honda, Tatsuo Amano, Haruko Okano, Rieko Suzuki, Masataka Torii, Yoshiko Unno, Yoshiaki Shiokawa, Teruyuki Hirano Source Type: research
Early Magnetic Resonance Imaging Decreases Hospital Length of Stay in Patients with Ischemic Stroke
Imaging modalities are important part of stroke evaluation. Noncontrast head computed tomography (CT) is the initial imaging modality in acute stroke and although important to rule out acute hemorrhage and making a decision on thrombolytic treatment, ischemic changes may not be visible on CT for up to 24 hours. Magnetic resonance imaging (MRI) brain is an invaluable tool to confirm an ischemic stroke and facilitates stroke evaluation. Objective of this study was to investigate the correlation between time to MRI and length of hospital stay.
Source: Journal of Stroke and Cerebrovascular Diseases - November 3, 2018 Category: Neurology Authors: Bharti Manwani, Subhendu Rath, Nora S. Lee, Ilene Staff, Christoph Stretz, Janhavi Modak, Pasquale F. Finelli Source Type: research
MMP10 Promotes Efficient Thrombolysis After Ischemic Stroke in Mice with Induced Diabetes
AbstractDiabetes is an important risk factor for ischemic stroke (IS). Tissue-type plasminogen activator (tPA) has been associated with less successful revascularization and poor functional outcome in diabetes. We assessed whether a new thrombolytic strategy based on MMP10 was more effective than tPA in a murine IS model of streptozotocin (STZ)-induced diabetes. Wild-type mice were administered a single dose of streptozotocin (STZ) (180 mg/kg) to develop STZ-induced diabetes mellitus. Two weeks later, IS was induced by thrombin injection into the middle cerebral artery and the effect of recombinant MMP10 (6.5 μg/kg), t...
Source: Translational Stroke Research - July 27, 2018 Category: Neurology Source Type: research
Acute Stroke Patients With Mild-to-Moderate Pre-existing Disability Should Be Considered for Thrombolysis Treatment
Thrombolytic therapy in patients with pre-existing disability presenting with acute ischemic stroke (AIS) is controversial because of concerns regarding poor outcomes and futility of treatment. We hypothesized that a similar proportion of patients with and without pre-existing disability would return to their premorbid functional status following thrombolysis.
Source: Journal of Stroke and Cerebrovascular Diseases - July 20, 2018 Category: Neurology Authors: Wenwen Zhang, Skye Coote, Tanya Frost, Helen M. Dewey, Philip M.C. Choi Source Type: research
Letter by van de Graaf et al Regarding Article, “Thrombus Neutrophil Extracellular Traps Content Impair tPA-Induced Thrombolysis in Acute Ischemic Stroke” Letter to the Editor
Source: Stroke - June 25, 2018 Category: Neurology Authors: Rob A. van de Graaf, Heleen M.M. van Beusekom, Bob Roozenbeek Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke, Thrombosis Letters to the Editor Source Type: research
Response by Ducroux et al to Letter Regarding Article, “Thrombus Neutrophil Extracellular Traps Content Impair tPA-Induced Thrombolysis in Acute Ischemic Stroke” Letter to the Editor
Source: Stroke - June 25, 2018 Category: Neurology Authors: Celina Ducroux, Jean-Philippe Desilles, Benoit Ho-Tin-Noe Tags: Inflammation, Pathophysiology, Cerebrovascular Procedures, Ischemic Stroke Letters to the Editor Source Type: research
Similar Outcomes for Contact Aspiration and Stent Retriever Use According to the Admission Clot Burden Score in ASTER Clinical Sciences
Conclusions—First-line mechanical thrombectomy with contact aspiration compared with stent retriever did not result in an increased successful reperfusion rate in acute ischemic stroke patients with large vessel occlusion of the anterior circulation according to the admission CBS. The latter, however, seems to be a reliable prognostic indicator of angiographic and clinical outcome.
Source: Stroke - June 25, 2018 Category: Neurology Authors: Francois Zhu, Bertrand Lapergue, Maeva Kyheng, Raphael Blanc, Julien Labreuche, Malek Ben Machaa, Alain Duhamel, Gautier Marnat, Suzana Saleme, Vincent Costalat, Serge Bracard, Sebastien Richard, Hubert Desal, Mikael Mazighi, Arturo Consoli, Michel Piotin Tags: Cerebrovascular Disease/Stroke Original Contributions Source Type: research
Antithrombotic Therapy Strategy for Cancer-Associated Ischemic Stroke: A Case Series of 26 Patients
The risk of complications from thromboembolism is increased for patients with malignancy. Cancer-associated stroke is also a serious issue with regard to the management of patients with cancer because stroke incidence often causes disabilities that affect daily life and cancer treatment strategy.
Source: Journal of Stroke and Cerebrovascular Diseases - May 17, 2018 Category: Neurology Authors: Hiroyuki Naito, Tomohisa Nezu, Naohisa Hosomi, Shiro Aoki, Hiroki Ueno, Kazuhide Ochi, Hirofumi Maruyama Tags: Case Studies Source Type: research
Impact of angiotensin-converting enzyme inhibition on platelet tissue factor expression in stroke-prone rats
Conclusion: The current study shows for the first time that in hypertension the number of TF-positive megakaryocytes increases thus releasing in the circulation more platelets carrying a functionally active TF. AngII stimulates platelets to express TF.
Source: Journal of Hypertension - May 1, 2018 Category: Cardiology Tags: ORIGINAL PAPERS: Stroke Source Type: research
Failed Thrombectomy in Acute Ischemic Stroke Editorials
Source: Stroke - March 26, 2018 Category: Neurology Authors: Jens Fiehler Tags: Revascularization, Cerebrovascular Disease/Stroke, Ischemic Stroke, Thrombosis Editorial Source Type: research
Thrombolytic Therapy in Severe Cardioembolic Stroke After Reversal of Dabigatran with Idarucizumab: Case Report and Literature Review
Whether idarucizumab, an antidote of dabigatran, can be used effectively and safely before thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) in patients with stroke undergoing treatment with dabigatran remains unknown. We herein describe a 57-year-old man who developed severe cardioembolic stroke with a National Institutes of Health Stroke Scale score of 22 in the left middle cerebral artery territory while undergoing treatment with dabigatran for nonvalvular atrial fibrillation and who was treated with rt-PA after the reversal of dabigatran with idarucizumab.
Source: Journal of Stroke and Cerebrovascular Diseases - March 16, 2018 Category: Neurology Authors: Yuichiro Ohya, Noriko Makihara, Kayo Wakisaka, Takao Morita, Tetsuro Ago, Takanari Kitazono, Hitonori Takaba Tags: Case Studies Source Type: research
The predictive role of CHA2DS2–VASc score between venous thromboembolism and ischemic stroke: a large-scale cohort study
Conclusion: Our study is the first to concern the performance of CHA2DS2–VASc score in predicting the risk of ischemic stroke in VTE patients and the risk of VTE in ischemic stroke patients. Nevertheless, the performance of the score was modest, and the transportability of the score in these populations still needs to be defined.
Source: Journal of Hypertension - February 2, 2018 Category: Cardiology Tags: ORIGINAL PAPERS: Stroke Source Type: research
Left Atrial Appendage Morphology and Embolic Stroke of Undetermined Source: A Cross-Sectional Multicenter Pilot Study
The left atrial appendage (LAA) is the main source of thrombus in atrial fibrillation, and there is an association between non-chicken wing (NCW) LAA morphology and stroke. We hypothesized that the prevalence of NCW LAA morphology would be higher among patients with cardioembolic (CE) stroke and embolic stroke of undetermined source (ESUS) than among those with noncardioembolic stroke (NCS).
Source: Journal of Stroke and Cerebrovascular Diseases - February 2, 2018 Category: Neurology Authors: Shadi Yaghi, Andrew D. Chang, Peter Hung, Brian Mac Grory, Scott Collins, Ajay Gupta, Jacques Reynolds, Caitlin B. Finn, Morgan Hemendinger, Shawna M. Cutting, Ryan A. McTaggart, Mahesh Jayaraman, Audrey Leasure, Lauren Sansing, Nikhil Panda, Christopher Source Type: research
Campaign —Once Again Streptokinase Trials (COAST) in Acute Ischemic Stroke
Every year, 1.5 million people suffer from stroke worldwide, the leading cause of disability and the second most common cause of death.1 Stroke incidence in developing countries is much higher and is further rising,2 whereas access to effective acute stroke treatment is very limited. Only 1% stroke sufferers in developing countries have access to the highly expensive tissue plasminogen activator (tPA), the only proven and recommended thrombolytic agent for acute ischemic stroke treatment.3
Source: Journal of Stroke and Cerebrovascular Diseases - December 18, 2017 Category: Neurology Authors: Muhammad Shabbir, Arsalan Ahmad Tags: Letter to the Editor Source Type: research
Race/Ethnic Differences in the Risk of Hemorrhagic Complications Among Patients With Ischemic Stroke Receiving Thrombolytic Therapy Clinical Sciences
Conclusions— In patients with stroke receiving tPA, hemorrhagic complications were slightly higher in blacks and Asians, but not in Hispanics compared with whites. Asians also faced significantly higher risk for sICH relative to other race/ethnic groups. Future studies are needed to evaluate whether reduction in tPA dose similar to that used in many Asian countries could improve the safety of tPA therapy in Asians in the United States with acute ischemic strokes while maintaining efficacy.
Source: Stroke - July 28, 2014 Category: Neurology Authors: Mehta, R. H., Cox, M., Smith, E. E., Xian, Y., Bhatt, D. L., Fonarow, G. C., Peterson, E. D., for the Get With The Guidelines-Stroke Program Tags: Thrombolysis Clinical Sciences Source Type: research
Cryptogenic Subtype Predicts Reduced Survival Among Cancer Patients With Ischemic Stroke Clinical Sciences
Conclusions— Cryptogenic stroke is independently associated with reduced survival in patients with active cancer and ischemic stroke.
Source: Stroke - July 28, 2014 Category: Neurology Authors: Navi, B. B., Singer, S., Merkler, A. E., Cheng, N. T., Stone, J. B., Kamel, H., Iadecola, C., Elkind, M. S. V., DeAngelis, L. M. Tags: Arterial thrombosis, Thrombophilia, Acute Cerebral Infarction, Embolic stroke, Pathology of Stroke Clinical Sciences Source Type: research
Diagnostic Yield of Pelvic Magnetic Resonance Venography in Patients With Cryptogenic Stroke and Patent Foramen Ovale Clinical Sciences
Conclusions— Among patients with ischemic stroke/transient ischemic attack and patent foramen ovale, the majority of detected DVTs were in LE veins rather than the pelvic veins and did not differ by stroke subtype. The routine inclusion of pelvic magnetic resonance venography in the diagnostic evaluation of CS warrants further prospective investigation.
Source: Stroke - July 28, 2014 Category: Neurology Authors: Liberman, A. L., Daruwalla, V. J., Collins, J. D., Maas, M. B., Botelho, M. P. F., Ayache, J. B., Carr, J., Ruff, I., Bernstein, R. A., Alberts, M. J., Prabhakaran, S. Tags: Deep vein thrombosis, Other diagnostic testing, Acute Cerebral Infarction, Embolic stroke Clinical Sciences Source Type: research
Vessel Wall Magnetic Resonance Imaging in Acute Ischemic Stroke: Effects of Embolism and Mechanical Thrombectomy on the Arterial Wall Clinical Sciences
Conclusions— Mechanical thrombectomy results in intracranial arterial wall thickening and enhancement, potentially mimicking the VW-MRI appearance of primary arteritis. This arterial wall abnormality is less common in patients with arterial occlusion who have been treated with medical therapy alone.
Source: Stroke - July 28, 2014 Category: Neurology Authors: Power, S., Matouk, C., Casaubon, L. K., Silver, F. L., Krings, T., Mikulis, D. J., Mandell, D. M. Tags: Embolic stroke, Computerized tomography and Magnetic Resonance Imaging, Pathology of Stroke, Primary and Secondary Stroke Prevention Clinical Sciences Source Type: research
Different Doses of Recombinant Tissue-Type Plasminogen Activator for Acute Stroke in Chinese Patients Clinical Sciences
Conclusions— These results did not support the dose of 0.9 mg/kg of r-tPA being optimal for all patients in the East Asian population. In elderly patients (71–80 years), a lower dose of 0.6 mg/kg is associated with a better outcome. Confirmation of the results through randomized trial is required.
Source: Stroke - July 28, 2014 Category: Neurology Authors: Chao, A.-C., Liu, C.-K., Chen, C.-H., Lin, H.-J., Liu, C.-H., Jeng, J.-S., Hu, C.-J., Chung, C.-P., Hsu, H.-Y., Sheng, W.-Y., Hu, H.-H., on behalf of the Taiwan Thrombolytic Therapy for Acute Ischemic Stroke (TTT-AIS) Study Group Tags: Thrombolysis Clinical Sciences Source Type: research
Community-Based Stroke System of Care for Chinese Rural Areas Clinical Sciences
Conclusions— A stroke system of care would be reliable and practical in Chinese rural areas. Clinical Trial Registration— URL: http://www.chictr.org. Unique identifier: ChiCTR-RCH-13003408.
Source: Stroke - July 28, 2014 Category: Neurology Authors: He, M., Wang, J., Gong, L., Dong, Q., Ji, N., Xing, H., Zhou, Y., Qin, S., Wang, H., Zhang, H., Hui, R., Wang, Y. Tags: Other Stroke Treatment - Medical Clinical Sciences Source Type: research
Establishment of Government-Initiated Comprehensive Stroke Centers for Acute Ischemic Stroke Management in South Korea Clinical Sciences
Conclusions— The Regional CSC program has improved the performance of acute stroke management in South Korea and can be used as a model for rapidly improving stroke management.
Source: Stroke - July 28, 2014 Category: Neurology Authors: Kim, J., Hwang, Y.-H., Kim, J.-T., Choi, N.-C., Kang, S.-Y., Cha, J.-K., Ha, Y. S., Shin, D.-I., Kim, S., Lim, B.-H. Tags: Emergency treatment of Stroke Clinical Sciences Source Type: research