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Total 5768 results found since Jan 2013.

Clopidogrel increases risk of pneumonia compared with aspirin in acute ischemic minor stroke patients
AbstractAntiplatelet agents may increase the risk of infections via suppressing platelet-mediated immune response. Here we assessed the contribution of clopidogrel versus aspirin to the development of pneumonia during an acute ischemic stroke admission. A retrospective cohort study was conducted of acute ischemic stroke patients who were admitted to our hospital from 2015 to 2018. Included patients received uninterrupted clopidogrel or aspirin therapy and did not take other antiplatelet agents throughout their stay. The interest outcome was development of pneumonia after stroke. Conditional logistic regression model after ...
Source: Journal of Thrombosis and Thrombolysis - October 9, 2020 Category: Hematology Source Type: research

SARS ‐CoV2 disease seen through the prism of acutely decompensated chronic kidney disease and ischemic stroke: What lesson we have learned from using prophylaxis therapy of vascular thromboembolism?
Our case underlines the tight management of antithrombotic therapy in the context of acutely decompensated chronic kidney disease, ischemic stroke, and SARS ‐CoV2 infection, the development of stroke as a SARS‐CoV2 complication increase the chances of adverse outcomes that may be mitigated by a rapid recognition and institution of available treatments. AbstractOur case underlines the tight management of antithrombotic therapy in the context of acutely decompensated chronic kidney disease, ischemic stroke, and SARS ‐CoV2 infection, the development of stroke as a SARS‐CoV2 complication increase the chances of adverse...
Source: Clinical Case Reports - October 7, 2020 Category: General Medicine Authors: Asmaa Hazim, Jehanne Aasfara, Ilham Slassi, Bernard Canaud, Amal Haoudar, Abdelhamid Naitlhou, Chafik El Kettani Tags: CASE REPORT Source Type: research

Stroke and Novel Coronavirus Infection in Humans: A Systematic Review and Meta-Analysis
Conclusions: The occurrence of stroke in patients with COVID-19 infection is uncommon, but it may pose as an important prognostic marker and indicator of severity of infection, by causing large vessels occlusion and exhibiting a thrombo-inflammatory vascular picture. Physicians should be made aware and remain vigilant on the possible two-way relationship between stroke and COVID-19 infection. The rate of stroke among patients with COVID-19 infection may increase in the future as they share the common risk factors.
Source: Frontiers in Neurology - October 5, 2020 Category: Neurology Source Type: research

Unraveling the Effects of Trimethylamine N-Oxide on Stroke: "The lower, the better?"
Authors: Yamashita T, Yoshida N, Emoto T, Hirata KI PMID: 32999209 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - October 2, 2020 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research

A Rare Case of Myocarditis, Intracardiac Thrombus And Embolic Stroke Caused By Mycoplasma Pneumoniae
We describe a rare case of mycoplasma pneumoniae myocarditis complicated by acute systolic heart failure, left ventricular thrombus and embolic stroke.
Source: Journal of Cardiac Failure - September 30, 2020 Category: Cardiology Authors: Raksha Kulkarni, Mansi Oberoi, Tony Oliver Tags: 176 Source Type: research

Cardio-Ankle Vascular Index Predicts Post-Discharge Stroke in Patients with Heart Failure.
CONCLUSION: CAVI independently predicts stroke in patients with HF.The trial registration number: UMIN000029132. PMID: 32981919 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - September 29, 2020 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research

Potential Therapeutic Effects of Sodium Glucose-linked Cotransporter 2 Inhibitors in Stroke.
CONCLUSIONS: It is unlikely that SGLT inhibitors have a positive or negative effect on stroke risk, but the question that remains unanswered is whether SGLT inhibitors can yield a protective effect after acute ischemic stroke. Future observational studies and registries may be the first step to help answer this question. (Clin Ther. 2020; XX:XXX-XXX) © 2020 Elsevier HS Journals, Inc. PMID: 33008610 [PubMed - as supplied by publisher]
Source: Clinical Therapeutics - September 28, 2020 Category: Drugs & Pharmacology Authors: Al Hamed FA, Elewa H Tags: Clin Ther Source Type: research

SARS-CoV-2 infection and its association with thrombosis and ischemic stroke: A review COVID-19, thrombosis, and ischemic stroke
This review of current literature provides background to the COVID-19 pandemic, as well as an examination of potential pathophysiologic mechanisms behind development of thrombosis and ischemic stroke related to COVID-19. SARS-CoV-2 infection is well-documented to cause severe pneumonia, however, thrombosis and thrombotic complications, such as ischemic stroke, have also been documented in a variety of patient demographics. SARS-CoV-2 infection is known to cause a significant inflammatory response, as well as invasion of vascular endothelial cells, resulting in endothelial dysfunction.
Source: The American Journal of Emergency Medicine - September 28, 2020 Category: Emergency Medicine Authors: Jonathan Snell Source Type: research

SARS-CoV-2 infection and its association with thrombosis and ischemic stroke: a review
This review of current literature provides background to the COVID-19 pandemic, as well as an examination of potential pathophysiologic mechanisms behind development of thrombosis and ischemic stroke related to COVID-19. SARS-CoV-2 infection is well-documented to cause severe pneumonia, however, thrombosis and thrombotic complications, such as ischemic stroke, have also been documented in a variety of patient demographics. SARS-CoV-2 infection is known to cause a significant inflammatory response, as well as invasion of vascular endothelial cells, resulting in endothelial dysfunction.
Source: The American Journal of Emergency Medicine - September 28, 2020 Category: Emergency Medicine Authors: Jonathan Snell Source Type: research

Unfractionated Heparin in SARS-CoV-2 Pneumonia: Ischemic Stroke Case Report
We present a patient with COVID-19 pneumonia who was managed with unfractionated heparin (UFH) infusion and developed a large ischemic infarct shortly after cessation of the infusion. In retrospect, the patient's coagulation parameters were consistent with overt DIC, although some of these parameters are easily masked by the effects of UFH. These findings emphasize the importance of anticoagulation as well as its careful discontinuation, as failure to do so may result in a significant thromboembolic event.
Source: Frontiers in Neurology - September 24, 2020 Category: Neurology Source Type: research

Developmental venous anomaly associated ischemic stroke caused by minor head trauma: a case report - Lee CH, Shin BS, Kang HG.
We report a case of ischemic stroke in the area of a DVA after minor...
Source: SafetyLit - September 23, 2020 Category: International Medicine & Public Health Tags: Economics of Injury and Safety, PTSD, Injury Outcomes Source Type: news

Interactive Effects of a Combination of the HDAC3 and HDAC9 Genes with Diabetes Mellitus on the Risk of Ischemic Stroke.
CONCLUSION:  Our results suggested that the combination of the HDAC3 and HDAC9 genes with a history of diabetes mellitus could exacerbate the deterioration of atherosclerosis, thereby increasing the risk of IS. Further studies are warranted to explore our results in other populations. PMID: 32961570 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - September 21, 2020 Category: Hematology Authors: Chiou HY, Bai CH, Lien LM, Hu CJ, Jeng JS, Tang SC, Lin HJ, Hsieh YC Tags: Thromb Haemost Source Type: research

Plasma D ‐dimer concentrations predicting stroke risk and rivaroxaban benefit in patients with heart failure and sinus rhythm: an analysis from the COMMANDER‐HF trial
ConclusionIn COMMANDER ‐HF, rivaroxaban reduced the risk of stroke but the benefit may be confined to patients with D‐dimer concentrations above 515ng/mL. Prospective trials are warranted to confirm these findings.
Source: European Journal of Heart Failure - September 20, 2020 Category: Cardiology Authors: Jo ão Pedro Ferreira, Carolyn S. P. Lam, Stefan D. Anker, Mandeep R. Mehra, Dirk J. Veldhuisen, William M. Byra, David A. La Police, John G. F. Cleland, Barry Greenberg, Faiez Zannad Tags: Research Article Source Type: research

Japanese and Non-Japanese Patients with Transient Ischemic Attack or Minor Stroke: A Five-Year Risk Analysis of Stroke and Vascular Events.
CONCLUSIONS: Recurrent stroke and intracranial hemorrhage were determined to be more prevalent at 5 years after TIA or minor stroke in Japanese patients than in non-Japanese patients. Strategies to mitigate the long-term risks of stroke, aside from adherence to current guidelines, should take Japanese-patient-specific residual risks into account. PMID: 32938836 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - September 19, 2020 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research

Developmental venous anomaly associated ischemic stroke caused by minor head trauma: A case report
We report a case of ischemic stroke in the area of a DVA after minor head trauma in a patient with DVA and without a predisposition thrombosis. Patient concerns: A healthy 17-year-old male was admitted to the emergency room due to left hemiparesis, which was caused by a ball hitting the right side of his head during a soccer game. Diagnosis: Brain magnetic resonance (MR) susceptibility-weighted image showed several small veins draining to the central vein in the area from the right posterior putamen to the periventricular white matter. Interventions: We diagnosed the patient with an ischemic stroke associated with...
Source: Medicine - September 18, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Management of Acute Ischemic Stroke-Specific Focus on Anesthetic Management for Mechanical Thrombectomy.
Abstract Acute ischemic stroke is a neurological emergency with a high likelihood of morbidity, mortality, and long-term disability. Modern stroke care involves multidisciplinary management by neurologists, radiologists, neurosurgeons, and anesthesiologists. Current American Heart Association/American Stroke Association (AHA/ASA) guidelines recommend thrombolytic therapy with intravenous (IV) alteplase within the first 3-4.5 hours of initial stroke symptoms and endovascular mechanical thrombectomy within the first 16-24 hours depending on specific inclusion criteria. The anesthesia and critical care provider may b...
Source: Anesthesia and Analgesia - September 16, 2020 Category: Anesthesiology Authors: Businger J, Fort AC, Vlisides PE, Cobas M, Akca O Tags: Anesth Analg Source Type: research

Prestroke statin use enhances collateralization in acute ischemic stroke patients.
CONCLUSIONS: Our findings suggest that prestroke statin use was associated with good leptomeningeal collaterals and clinical outcomes in acute ischemic stroke (AIS) patients presenting with occlusion of the middle cerebral artery. However, clinical studies should be conducted to verify this claim. PMID: 32925118 [PubMed - as supplied by publisher]
Source: Restorative Neurology and Neuroscience - September 16, 2020 Category: Neurology Tags: Restor Neurol Neurosci Source Type: research

Left atrial appendage exclusion is effective in reducing postoperative stroke after mitral valve replacement
ConclusionsConcurrent LAA exclusion during MVR is a safe and effective way to reduce postoperative ischemic stroke, particularly in patients with AF.
Source: Journal of Cardiac Surgery - September 15, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Shengli Jiang, Huajun Zhang, Shixiong Wei, Lin Zhang, Zhiyun Gong, Bojun Li, Yao Wang Tags: ORIGINAL ARTICLE Source Type: research

Coagulation factor XII, XI, and VIII activity levels and secondary events after first ischemic stroke.
CONCLUSIONS: In our study of mild to moderate ischemic stroke patients, high activity levels of FXI and FVIII but not FXII were associated with worse vascular outcomes in the three-year period after first ischemic stroke. PMID: 32935900 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - September 15, 2020 Category: Hematology Authors: Rohmann JL, Huo S, Sperber PS, Piper SK, Rosendaal FR, Heuschmann PU, Endres M, Liman TG, Siegerink B Tags: J Thromb Haemost Source Type: research

The administration of rtPA before mechanical thrombectomy in acute ischemic stroke patients is associated with a significant reduction of the retrieved clot area but it does not influence revascularization outcome
AbstractBoth intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) are evidence-based treatments for acute ischemic stroke (AIS) in selected cases. Recanalization may occur following IVT without the necessity of further interventions or requiring a subsequent MT procedure. IVT prior to MT (bridging-therapy) may be associated with benefits or hazards. We studied the retrieved clot area and degree of recanalization in patients undergoing MT or bridging-therapy for whom it was possible to collect thrombus material. We collected mechanically extracted thrombi from 550 AIS patients from four International stroke cente...
Source: Journal of Thrombosis and Thrombolysis - September 15, 2020 Category: Hematology Source Type: research

Complex Aortic Arch Atherosclerosis in Acute Ischemic Stroke Patients with Non-Valvular Atrial Fibrillation.
CONCLUSIONS: Even in patients with ischemic stroke with non-valvular AF, concomitant CAPs should be considered in older individuals and those who have diabetes or low HDL-C. PMID: 32908035 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - September 12, 2020 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research

Vascular PDGFR-alpha protects against BBB dysfunction after stroke in mice
AbstractBlood –brain barrier (BBB) dysfunction underlies the pathogenesis of many neurological diseases. Platelet-derived growth factor receptor-alpha (PDGFRα) induces hemorrhagic transformation (HT) downstream of tissue plasminogen activator in thrombolytic therapy of acute stroke. Thus, PDGFs are attractive therapeutic targets for BBB dysfunction. In the present study, we examined the role of PDGF signaling in the process of tissue remodeling after middle cerebral arterial occlusion (MCAO) in mice. Firstly, we found that imatinib increased lesion size after permanent MCAO in wild-type mice. Moreover, i matinib-induced...
Source: Angiogenesis - September 11, 2020 Category: Molecular Biology Source Type: research

Increased intracranial hemorrhage of mechanical thrombectomy in acute ischemic stroke patients with atrial fibrillation
This study aimed to investigate the potential association between AF and outcomes after MT in AIS patients. A post-hoc analysis of a multi-center prospective clinical trial was conducted. Before and after propensity score matching (PSM), the clinical features were compared between patients with and without AF. Multivariable logistic regression and mediation analyses were performed to assess the relationship between AF and ICH. Of the total 245 patients, 123 patients were included in the AF group. After PSM, the AF group showed more retrieval attempts (P = 0.004), comparable favorable outcome (P = 0.493), and mortal...
Source: Journal of Thrombosis and Thrombolysis - September 11, 2020 Category: Hematology Source Type: research

Cottonseed oil alleviates ischemic stroke injury by inhibiting the inflammatory activation of microglia and astrocyte
Ischemic stroke is the second leading cause of death globally. The narrow time window for administering effective thrombolytic therapy motivates the search for alternative prevention strategies. Microglia and ...
Source: Journal of Neuroinflammation - September 11, 2020 Category: Neurology Authors: Min Liu, Zhipeng Xu, Long Wang, Lixia Zhang, Yi Liu, Jiangbei Cao, Qiang Fu, Yanhong Liu, Hao Li, Jingsheng Lou, Wugang Hou, Weidong Mi and Yulong Ma Tags: Research Source Type: research

Stroke epidemiology based on experience from Krasnik county in eastern Poland.
CONCLUSIONS: Women aged around 78-years-old were the most likely to suffer a stroke. In men, it occurred eight years earlier. Despite residents of urban areas being hospitalised due to stroke more often, deaths caused by this disease were recorded the most frequently among rural residents. It can be concluded that primary stroke prevention is the only effective measure for reducing morbidity and premature mortality in the population. PMID: 32955229 [PubMed - in process]
Source: Annals of Agricultural and Environmental Medicine : AAEM - September 10, 2020 Category: Environmental Health Authors: Drop B, Marek K, Marzena FN Tags: Ann Agric Environ Med Source Type: research

Elevated International Normalized Ratio as a Manifestation of Post-thrombolytic Coagulopathy in Acute Ischemic Stroke
Conclusions: We report an under-recognized early transient coagulopathy associated with elevated INR in stroke patients after treatment with tPA.
Source: Journal of Stroke and Cerebrovascular Diseases - July 30, 2014 Category: Neurology Authors: Vivien H. Lee, James J. Conners, Shawna Cutting, Sarah Y. Song, Richard A. Bernstein, Shyam Prabhakaran Tags: Original Articles Source Type: research

Teaching NeuroImages: Extracranial internal carotid artery aneurysm causing embolic stroke
A 42-year-old man with no history of trauma experienced acute numbness in his right arm and leg. A pulsating left cervical tumor was noted on clinical examination. Carotid ultrasound demonstrated significant widening of the left proximal internal carotid artery (ICA) and a large nonocclusive hypoechoic structure compatible with an aneurysm and intraluminal thrombus (figure, B, D, and E). MRI confirmed a fusiform extracranial ICA aneurysm and showed a left-sided small embolic stroke (figure, A and C). The patient underwent anticoagulation with low-molecular-weight heparin and eventually surgical treatment (i.e., resection a...
Source: Neurology - July 14, 2014 Category: Neurology Authors: Barlinn, K., Kepplinger, J., Puetz, V., Bodechtel, U. Tags: Stroke in young adults, MRI, Ultrasound, Embolism RESIDENT AND FELLOW SECTION Source Type: research

Recurrent thromboembolic events after ischemic stroke in patients with cancer
Conclusions: Patients with acute ischemic stroke in the setting of active cancer (especially adenocarcinoma) face a substantial short-term risk of recurrent ischemic stroke and other types of thromboembolism.
Source: Neurology - June 30, 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: All Cerebrovascular disease/Stroke, All Oncology, Cohort studies, Infarction ARTICLE Source Type: research

Strategic Planning to Reduce the Burden of Stroke Among Veterans: Using Simulation Modeling to Inform Decision Making Clinical Sciences
Conclusions— Prevention strategies tend to have larger population impacts, though interventions targeting specific high-risk groups tend to be more efficient in terms of number-needed-to-treat per QALY gained.
Source: Stroke - June 23, 2014 Category: Neurology Authors: Lich, K. H., Tian, Y., Beadles, C. A., Williams, L. S., Bravata, D. M., Cheng, E. M., Bosworth, H. B., Homer, J. B., Matchar, D. B. Tags: Health policy and outcome research Clinical Sciences Source Type: research

Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association AHA/ASA Guideline
The aim of this updated guideline is to provide comprehensive and timely evidence-based recommendations on the prevention of future stroke among survivors of ischemic stroke or transient ischemic attack. The guideline is addressed to all clinicians who manage secondary prevention for these patients. Evidence-based recommendations are provided for control of risk factors, intervention for vascular obstruction, antithrombotic therapy for cardioembolism, and antiplatelet therapy for noncardioembolic stroke. Recommendations are also provided for the prevention of recurrent stroke in a variety of specific circumstances, includi...
Source: Stroke - June 23, 2014 Category: Neurology Authors: Kernan, W. N., Ovbiagele, B., Black, H. R., Bravata, D. M., Chimowitz, M. I., Ezekowitz, M. D., Fang, M. C., Fisher, M., Furie, K. L., Heck, D. V., Johnston, S. C., Kasner, S. E., Kittner, S. J., Mitchell, P. H., Rich, M. W., Richardson, D., Schwamm, L. H Tags: AHA Statements and Guidelines AHA/ASA Guideline Source Type: research

Stroke in Patients With Aortic Stenosis: The Simvastatin and Ezetimibe in Aortic Stenosis Study Clinical Sciences
Conclusions— In patients with aortic stenosis not prescribed oral anticoagulation, atrial fibrillation, AVR with concomitant coronary artery bypass grafting, and CHA2DS2-VASc score were the major predictors of stroke. Incident stroke was strongly associated with mortality. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00092677.
Source: Stroke - June 23, 2014 Category: Neurology Authors: Greve, A. M., Dalsgaard, M., Bang, C. N., Egstrup, K., Ray, S., Boman, K., Rossebo, A. B., Gohlke-Baerwolf, C., Devereux, R. B., Kober, L., Wachtell, K. Tags: Thrombosis risk factors, CV surgery: valvular disease, Acute Cerebral Infarction Clinical Sciences Source Type: research

Acute Cerebrovascular Disease Occurring After Hospital Discharge for Labor and Delivery Clinical Sciences
Conclusions— The incidence of postpartum acute CVD after hospital discharge for labor and delivery is similar to rates reported for all postpartum events in previous publications, suggesting that a substantial proportion of postpartum CVD occurs after discharge.
Source: Stroke - June 23, 2014 Category: Neurology Authors: Hovsepian, D. A., Sriram, N., Kamel, H., Fink, M. E., Navi, B. B. Tags: Acute Cerebral Hemorrhage, Acute Cerebral Infarction, Intracerebral Hemorrhage, Risk Factors for Stroke, Stroke in Children and the Young Clinical Sciences Source Type: research

Emergence of the Primary Pediatric Stroke Center: Impact of the Thrombolysis in Pediatric Stroke Trial Clinical Sciences
Conclusions— Before preparing for TIPS, centers interested in pediatric stroke had not developed systematic strategies to diagnose and treat acute pediatric stroke. TIPS trial preparation has resulted in establishment of pediatric acute stroke centers with clinical and system preparedness for evaluation and care of children with acute stroke, including use of a standardized protocol for evaluation and treatment of acute arterial stroke in children that includes use of intravenous tissue-type plasminogen activator. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01591096.
Source: Stroke - June 23, 2014 Category: Neurology Authors: Bernard, T. J., Rivkin, M. J., Scholz, K., deVeber, G., Kirton, A., Gill, J. C., Chan, A. K., Hovinga, C. A., Ichord, R. N., Grotta, J. C., Jordan, L. C., Benedict, S., Friedman, N. R., Dowling, M. M., Elbers, J., Torres, M., Sultan, S., Cummings, D. D., Tags: Fibrinolysis, Acute Cerebral Infarction, Thrombolysis Clinical Sciences Source Type: research

Thrombolytic therapy for stroke in patients with preexisting cognitive impairment
Conclusions: Ischemic stroke patients with PSCI should receive rtPA if they are eligible. This conclusion cannot be extended to severe cognitive impairment or severe strokes. Classification of evidence: This study provides Class IV evidence that in patients with PSCI presenting with acute ischemic stroke, IV rtPA improves outcomes.
Source: Neurology - June 9, 2014 Category: Neurology Authors: Murao, K., Leys, D., Jacquin, A., Kitazono, T., Bordet, R., Bejot, Y., Kimura, K., Godefroy, O., Wakisaka, Y., Moulin, S., Ago, T., Sibon, I., Bombois, S., Mas, J.-L., Henon, H., Pasquier, F., Giroud, M., Cordonnier, C., Okada, Y., On behalf of the OPHELI Tags: All Cerebrovascular disease/Stroke, All Cognitive Disorders/Dementia, MCI (mild cognitive impairment), Infarction ARTICLE Source Type: research

Abstract 8: Association Between Hospital "Get With The Guidelines-Stroke" Performance Measures And Outcomes Among Patients With Acute Ischemic Stroke In China Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics
Conclusions: A significant association between hospital care process and outcomes was found, supporting the use of GWTG-Stroke performance metrics as a means of assessing and helping improve stroke care quality in China.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Li, Z., Wang, Y., Wang, Y., Zhao, X., Wang, C., Liu, L., Wang, C., Zhang, C., Pan, Y., Yang, X. Tags: Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics Source Type: research

Management of acute stroke in patients taking novel oral anticoagulants
Each year, 1·0–2·0% of individuals with atrial fibrillation and 0·1–0·2% of those with venous thromboembolism who are receiving one of the novel oral anticoagulants (dabigatran, rivaroxaban, or apixaban) can be expected to experience an acute ischemic stroke. Additionally, 0·2–0·5% of individuals with atrial fibrillation who are receiving one of the novel oral anticoagulants can be expected to experience an intracranial hemorrhage. This opinion piece addresses the current literature and offers practical approaches to the management of patients receiving novel oral anticoagulants who present with an ischemic or ...
Source: International Journal of Stroke - June 1, 2014 Category: Neurology Authors: Graeme J. Hankey, Bo Norrving, Werner Hacke, Thorsten Steiner Tags: Review Source Type: research

Totaled Health Risks in Vascular Events Score Predicts Clinical Outcomes in Patients With Cardioembolic and Other Subtypes of Ischemic Stroke Clinical Sciences
Conclusions— The THRIVE score is a simple tool that helps clinicians estimate good outcome and death after ischemic stroke.
Source: Stroke - May 27, 2014 Category: Neurology Authors: Lei, C., Wu, B., Liu, M., Chen, Y., Yang, H., Wang, D., Lin, S., Hao, Z. Tags: Acute Cerebral Infarction Clinical Sciences Source Type: research

Mechanical Discordance of the Left Atrium and Appendage: A Novel Mechanism of Stroke in Paroxysmal Atrial Fibrillation Brief Reports
Conclusions— A quarter of patients with paroxysmal AF demonstrate a prothrombotic AF LAA pulse wave Doppler phenotype, despite concurrent sinus rhythm ECG. These findings provide a novel explanation for ongoing thromboembolism in the paroxysmal AF population, despite apparent ECG maintenance of sinus rhythm.
Source: Stroke - April 28, 2014 Category: Neurology Authors: Warraich, H. J., Gandhavadi, M., Manning, W. J. Tags: Echocardiography, Embolic stroke Brief Reports Source Type: research

Stroke Literature Synopses: Clinical Science Stroke Literature Synopses: Clinical Science
Source: Stroke - April 28, 2014 Category: Neurology Authors: Lin, M. P., Towfighi, A. Tags: Arterial thrombosis, Deep vein thrombosis, Other Treatment, Epidemiology Stroke Literature Synopses: Clinical Science Source Type: research

Reduced Smoke-like Echo and Resolved Thrombus in the Left Atrium with Rivaroxaban Therapy in an Acute Cardioembolic Stroke Patient
We report a case of a nonvalvular atrial fibrillation (NVAF) patient with acute cardioembolic stroke in whom rivaroxaban, an oral direct factor Xa inhibitor, reduced a smoke-like echo in the left atrium and resolved a thrombus in the left atrial appendage. A 71-year-old man was admitted because of the sudden onset of right hemiplegia and aphasia and was diagnosed with acute cardioembolic stroke associated with NVAF. The patient had not been treated with warfarin before admission, and rivaroxaban therapy (15 mg once daily) was initiated. Transesophageal echocardiography was performed on day 8 and a mobile thrombus was foun...
Source: Journal of Stroke and Cerebrovascular Diseases - April 11, 2014 Category: Neurology Authors: Shin Saito, Hirofumi Tomita, Yoshihiro Kimura, Hiroshi Shiroto, Joji Hagii, Norifumi Metoki, Hiroyasu Hitomi, Takaatsu Kamada, Tomohiro Osanai, Ken Okumura, Minoru Yasujima Tags: Case Reports Source Type: research

Alpha 1-Antitrypsin Therapy Mitigated Ischemic Stroke Damage in Rats
Our objective is to develop a new therapy for the treatment of stroke. Currently, the only effective therapy for acute ischemic stroke is the thrombolytic agent recombinant tissue plasminogen activator. α1-Antitrypsin (AAT), a serine proteinase inhibitor with potent anti-inflammatory, anti-apoptotic, antimicrobial, and cytoprotective activities, could be beneficial in stroke. The goal of this study is to test whether AAT can improve ischemic stroke outcome in an established rat model. Middle cerebral artery occlusion was induced in male rats via intracranial (i.c.) microinjection of endothelin-1. Five to 10 minutes after...
Source: Journal of Stroke and Cerebrovascular Diseases - March 3, 2014 Category: Neurology Authors: Huong L. Moldthan, Aaron C. Hirko, Jeffrey S. Thinschmidt, Maria B. Grant, Zhimin Li, Joanna Peris, Yuanqing Lu, Ahmed S. Elshikha, Michael A. King, Jeffrey A. Hughes, Sihong Song Tags: Original Articles Source Type: research

Recurrent Ischemic Stroke in a Patient with the Trousseau Syndrome Treated with Dabigatran
A 70-year-old man with multiple ischemic strokes was diagnosed with cardiac embolism and treated with dabigatran. Three months later, he suddenly developed vertigo and vomiting. Magnetic resonance imaging, showed recurrent lesions and blood tests revealed hypercoagulability, hypoproteinemia, and elevated cytokeratin 19 fragments that serve as a tumor marker of lung cancer. Chest computed tomography showed there were small nodules in bilateral lungs and swollen mediastinal lymph nodes. A conclusive diagnosis was impossible because the patient declined invasive procedures. We suspected primary lung cancer and diagnosed conco...
Source: Journal of Stroke and Cerebrovascular Diseases - February 21, 2014 Category: Neurology Authors: Kosuke Yoshida, Takashi Kimura, Yoko Aburakawa, Yasuhiro Suzuki, Kenji Kuroda, Osamu Yahara Tags: Case Reports Source Type: research

Stroke in a young patient? Ask about synthetic cannabinoids
3 out of 5 stars Ischemic stroke after use of synthetic marijuana “spice”. Freeman MJ et al. Neurology 2013;81:1-4. Abstract This interesting paper, from the University of South Florida in Tampa, describes a brother and sister who at different times both developed ischemic strokes shortly after smoking a synthetic marijuana product. The 26-year-old brother presented with dysarthria, expressive aphasia, and right-sided weakness after smoking “Spice” a few hours previously. Head CT showed a clot in the proximal middle cerebral artery. His symptoms resolved after treatment with thrombolytics. The 19-y...
Source: The Poison Review - December 11, 2013 Category: Toxicology Authors: Leon Tags: Medical cerebral ischemia jwh-018 spice stroke synthetic cannabinoid Source Type: news

Stroke and Cardiac Papillary Fibroelastoma: Mechanical Thrombectomy after Thrombolytic Therapy
We describe a case of a 34-year-old man with a sudden development of right hemiparesis and aphasia because of infarction of the left middle cerebral artery that was submitted to intravenous (IV) recombinant tissue plasminogen activator and mechanical thrombectomy. Transesophageal echocardiogram showed a small mass on the anterior leaflet of the mitral valve. Cardiac surgery was performed, and histological examination of the removed material was consistent with cardiac papillary fibroelastoma (CPF). Experience in using IV thrombolysis for the treatment of embolic stroke because of CPF is limited. To the best of our knowledg...
Source: Journal of Stroke and Cerebrovascular Diseases - October 21, 2013 Category: Neurology Authors: Ana F. Santos, João Pinho, Vítor Ramos, Joana Pardal, Jaime Rocha, Carla Ferreira Tags: Case Reports Source Type: research

Thrombolytic Therapy Is an Only Determinant Factor for Stroke Evolution in Large Anterior Choroidal Artery Infarcts
Conclusions: Thrombolytic therapy is an only determinant factor for stroke evolution in large AChA infarcts, which reduced the risk of stroke evolution and improved functional outcome.
Source: Journal of Stroke and Cerebrovascular Diseases - October 16, 2013 Category: Neurology Authors: Meng-Chen Wu, Li-Kai Tsai, Chung-Chu Wu, Shin-Joe Yeh, Sung-Chun Tang, Yun-Ju Chen, Chien-Lin Chen, Jiann-Shing Jeng Tags: Original Articles Source Type: research

A Rare Cause of Embolic Stroke in Hereditary Hemorrhagic Telangiectasia
A 57-year-old male patient with hereditary hemorrhagic telangiectasia presented with an acute right middle cerebral artery ischemic stroke. Investigations revealed a right middle cerebral artery M2 occlusion, hypoxemia, and a large pulmonary arteriovenous malformation and right lower limb deep venous thrombosis. Closure of the pulmonary arteriovenous malformation was successfully performed with an Amplatzer device. Catheter closure of pulmonary arteriovenous malformations in patients with hereditary hemorrhagic telangiectasia is a recognized treatment modality to prevent recurrent ischemic stroke and other embolic and he...
Source: Journal of Stroke and Cerebrovascular Diseases - September 16, 2013 Category: Neurology Authors: Nawaf Yassi, Bernard Yan, Richard Dowling, Peter J. Mitchell Tags: Case Reports Source Type: research

Ischemic Stroke in Evolution: Predictive Value of Perfusion Computed Tomography
Background: Various perfusion computed tomography (PCT) parameters have been used to identify tissue at risk of infarction in the setting of acute stroke. The purpose of this study was to examine predictive value of the PCT parameters commonly used in clinical practice to define ischemic penumbra. The patient selection criterion aimed to exclude the effect of thrombolysis from the imaging data.Methods: Consecutive acute stroke patients were screened and a total of 18 patients who initially underwent PCT and CT angiogram (CTA) on presentation but did not qualify to receive thrombolytic therapy were selected. The PCT images ...
Source: Journal of Stroke and Cerebrovascular Diseases - August 19, 2013 Category: Neurology Authors: Amir Kheradmand, Marc Fisher, David Paydarfar Tags: Original Articles Source Type: research

Waking up to new treatments for stroke - WAKE-UP trial starts in the UK
WAKE-UP - a large European clinical trial to test whether current 'clot dissolving' treatments can be used in people who wake up with the symptoms of stroke enrolled the first UK patients at the Southern General Hospital this week. Every year about two million patients have a stroke in the EU. Up to 20 per cent of stroke patients wake up with stroke symptoms so the time the stroke started is unknown. This makes patients ineligible for the only approved treatment for acute stroke- the delivery the thrombolytic or 'clot dissolving' drug rtPA...
Source: Health News from Medical News Today - July 29, 2013 Category: Consumer Health News Tags: Stroke Source Type: news

Earlier Treatment Following Stroke Onset Associated With Reduced Risk Of In-Hospital Death, Higher Rate Of Discharge To Home
In a study that included nearly 60,000 patients with acute ischemic stroke, thrombolytic treatment (to help dissolve a blood clot) that was started more rapidly after symptom onset was associated with reduced in-hospital mortality and intracranial hemorrhage and higher rates of independent walking ability at discharge and discharge to home, according to a study in the June 19 issue of JAMA. "Intravenous (IV) tissue-type plasminogen activator (tPA) is a treatment of proven benefit for select patients with acute ischemic stroke as long as 4.5 hours after onset...
Source: Health News from Medical News Today - June 20, 2013 Category: Consumer Health News Tags: Stroke Source Type: news

Speed Vital For Stroke Patients' Survival
The sooner stroke patients receive thrombolytic treatment, the lower their risk of in-hospital mortality and intracranial hemorrhage, says a new study published in JAMA (Journal of the American Medical Association). In addition, the prompter the treatment, the higher the rate of walking ability at discharge. Intravenous (IV) tissue-type plasminogen activator (tPA) is a form of treatment proven to help stroke patients within 4.5 hours of onset of symptoms...
Source: Health News from Medical News Today - June 19, 2013 Category: Consumer Health News Tags: Stroke Source Type: news