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Ischemic Stroke and Risk of Venous Thromboembolism in the General Population: The Tromso Study Epidemiology
ConclusionsThe risk of VTE increased during the first 3 months after an ischemic stroke. The particularly high risk of provoked VTE suggests that additional predisposing factors, such as immobilization, potentiate the VTE risk in patients with ischemic stroke.
Source: JAHA:Journal of the American Heart Association - November 7, 2016 Category: Cardiology Authors: Rinde, L. B., Smabrekke, B., Mathiesen, E. B., Lochen, M.–L., Nȷolstad, I., Hald, E. M., Wilsgaard, T., Brakkan, S. K., Hansen, J.–B. Tags: Epidemiology, Risk Factors, Ischemic Stroke, Thrombosis Original Research Source Type: research
Emerging Subspecialties in Neurology: Pediatric stroke and cerebrovascular disorders
In 1895, a neuropathologist at the University of Vienna observed that "a large number of cases of infantile cerebral palsy is caused by the same factors that bring about the majority of cases of cerebral paralysis of adults: by tearing, embolism, and thrombosis of cerebral vessels."1 While Sigmund Freud would go on to become better known for other endeavors, his observation that children can have strokes paved the way for the development of the emerging subspecialty of pediatric stroke and cerebrovascular disorders.
Source: Neurology - October 31, 2016 Category: Neurology Authors: Bernson-Leung, M. E., deVeber, G. A. Tags: Childhood stroke, All Cerebrovascular disease/Stroke, Pediatric stroke; see Cerebrovascular Disease/ Childhood stroke, All Education RESIDENT AND FELLOW SECTION Source Type: research
Renal Function and the Risk of Stroke and Bleeding in Patients With Atrial Fibrillation Clinical Sciences
Background and Purpose—We sought to determine the risk of stroke/thromboembolism and bleeding associated with reduced renal function in patients with atrial fibrillation and the risk of stroke and bleeding associated with warfarin treatment in specific estimated glomerular filtration rate (eGFR) groups.Methods—We conducted a register-based cohort study and included patients discharged with nonvalvular atrial fibrillation from 1997 to 2011 with available eGFR.Results—A total of 17 349 patients were identified with eGFR available at baseline. All levels of lower eGFR were associated with higher risk of stroke/thrombo...
Source: Stroke - October 24, 2016 Category: Neurology Authors: Bonde, A. N., Lip, G. Y. H., Kamper, A.–L., Fosbol, E. L., Staerk, L., Carlson, N., Torp–Pedersen, C., Gislason, G., Olesen, J. B. Tags: Atrial Fibrillation Original Contributions Source Type: research
Resolving Thrombus in the Left Atrial Appendage by Edoxaban Treatment after Acute Ischemic Stroke: Report of 2 Cases
Here we report first 2 cases of patients with nonvalvular atrial fibrillation with acute cardioembolic stroke in whom thrombi in the left atrial appendage (LAA) were resolved by edoxaban administration. Case 1 reports an 86-year-old woman who suddenly showed right hemiparesis and aphasia due to occlusion of the left middle cerebral artery. She received mechanical thrombectomy and recovered neurologically. Transesophageal echocardiography (TEE) performed on day 1 demonstrated thrombus in the LAA.
Source: Journal of Stroke and Cerebrovascular Diseases - August 30, 2016 Category: Neurology Authors: Shin Saito, Seigo Shindo, Shun Tsudaka, Kazutaka Uchida, Manabu Shirakawa, Shinichi Yoshimura Tags: Case Studies Source Type: research
Cognitive Outcomes following Thrombolysis in Acute Ischemic Stroke: A Systematic Review
Patients treated with thrombolytic therapy within 4.5 hours after stroke onset appear to have improved survival and functional outcomes. Poststroke cognitive impairment is associated with reduced quality of life and survival and needs to be reviewed in consideration of the administration of thrombolysis. This review aims to systematically evaluate literature exploring the effect of thrombolysis for ischemic stroke on cognition.
Source: Journal of Stroke and Cerebrovascular Diseases - August 26, 2016 Category: Neurology Authors: Laura Jayne Broome, Ceri Elisabeth Battle, Matthew Lawrence, Phillip Adrian Evans, Michael Stuart Dennis Source Type: research
Aspiration Thrombectomy After Intravenous Alteplase Versus Intravenous Alteplase Alone Clinical Sciences
Conclusions— THERAPY did not achieve its primary end point in this underpowered sample. Directions of effect for all prespecified outcomes were both internally and externally consistent toward benefit. It is possible that an alternate method of thrombectomy, primary aspiration, will benefit selected patients harboring large vessel occlusions. Further study on this topic is indicated. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01429350.
Source: Stroke - August 22, 2016 Category: Neurology Authors: Mocco, J., Zaidat, O. O., von Kummer, R., Yoo, A. J., Gupta, R., Lopes, D., Frei, D., Shownkeen, H., Budzik, R., Ajani, Z. A., Grossman, A., Altschul, D., McDougall, C., Blake, L., Fitzsimmons, B.-F., Yavagal, D., Terry, J., Farkas, J., Lee, S. K., Baxter Tags: Ischemic Stroke Clinical Sciences Source Type: research
Incidence and Predictors of Early Recanalization After Intravenous Thrombolysis: A Systematic Review and Meta-Analysis Brief Reports
Conclusion— The overall incidence of ER after intravenous thrombolysis is substantial, highlighting the importance of reliably predicting ER to limit futile, interhospital transfers. Incidence of no-ER is particularly high for proximal occlusion and severe strokes. Given the scarcity of published data, further studies are needed to improve no-ER prediction accuracy.
Source: Stroke - August 22, 2016 Category: Neurology Authors: Seners, P., Turc, G., Maier, B., Mas, J.-L., Oppenheim, C., Baron, J.-C. Tags: Imaging, Meta Analysis, Ischemic Stroke Brief Reports Source Type: research
Rare Variants in the ADAMTS13 Von Willebrand Factor-Binding Domain Contribute to Pediatric Stroke Original Articles
Conclusions— Our data provide a link between the genetic architecture of ADAMTS13, ADAMTS13 levels, and stroke susceptibility. Altogether, these studies render ADAMTS13 an attractive candidate for functional studies and may contribute to personalized diagnosis and treatment options in future.
Source: Circulation: Cardiovascular Genetics - August 16, 2016 Category: Cardiology Authors: Stoll, M., Ruhle, F., Witten, A., Barysenka, A., Arning, A., Strauss, C., Nowak-Gottl, U. Tags: Cardiovascular Disease, Genetic, Association Studies, Ischemic Stroke, Thrombosis Original Articles Source Type: research
Effective ADAPT Thrombectomy in a Patient with Acute Stroke due to Cardiac Papillary Elastofibroma: Histological Thrombus Confirmation
A 75-year-old man with hypertension and atrial fibrillation was admitted to our emergency room with right-sided hemiplegia and complete aphasia (National Institutes of Health Stroke Scale [NIHSS] score = 18). A noncontrast computed tomography scan showed a slight hypodensity in the left insular region and a bright hyperdense sign in the M1 tract of the left middle cerebral artery (MCA). Angio-CT confirmed an occlusion of the M1 tract of the MCA. Magnetic resonance diffusion-weighted imaging/p erfusion-weighted imaging was obtained and revealed a mismatch in the left parietal cortical region.
Source: Journal of Stroke and Cerebrovascular Diseases - August 15, 2016 Category: Neurology Authors: Francesco Biraschi, Francesco Diana, Francesco Alesini, Giulio Guidetti, Simone Peschillo Tags: Case Studies Source Type: research
Mechanical thrombectomy versus systemic thrombolysis in MCA stroke: a distance to thrombus-based outcome analysis
Conclusions In patients with an acute MCA occlusion and a DT <16 mm, IVT–MT leads to a significantly better outcome than in patients treated with IVT alone.
Source: Journal of NeuroInterventional Surgery - August 12, 2016 Category: Neurosurgery Authors: Lobsien, D., Gawlitza, M., Schaudinn, A., Schob, S., Hobohm, C., Fritzsch, D., Quäschling, U., Hoffmann, K.-T., Friedrich, B. Tags: Ischemic stroke Source Type: research
Thrombolysis for Ischemic Stroke during Pregnancy: A Case Report and Review of the Literature
We report the successful use of intravenous alteplase (tissue plasminogen activator; tPA) thrombolysis in a pregnant woman with acute cardioembolic stroke presumed to be paradoxical embolism through a patent foramen ovale.
Source: Journal of Stroke and Cerebrovascular Diseases - August 11, 2016 Category: Neurology Authors: Steven Tversky, Richard B. Libman, Marina L. Reppucci, Andrea M. Tufano, Jeffrey M. Katz Tags: Case Studies Source Type: research
Outcomes With Edoxaban Versus Warfarin in Patients With Previous Cerebrovascular Events: Findings From ENGAGE AF-TIMI 48 (Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction 48) Clinical Sciences
Conclusions— Patients with atrial fibrillation with previous IS/TIA are at high risk of recurrent thromboembolism and bleeding. HDER is at least as effective and is safer than warfarin, regardless of the presence or the absence of previous IS or TIA. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00781391.
Source: Stroke - July 25, 2016 Category: Neurology Authors: Rost, N. S., Giugliano, R. P., Ruff, C. T., Murphy, S. A., Crompton, A. E., Norden, A. D., Silverman, S., Singhal, A. B., Nicolau, J. C., SomaRaju, B., Mercuri, M. F., Antman, E. M., Braunwald, E., on behalf of the ENGAGE AF-TIMI 48 Investigators Tags: Atrial Fibrillation, Anticoagulants, Ischemic Stroke Clinical Sciences Source Type: research
Diabetes Mellitus Impairs Cognitive Function in Middle-Aged Rats and Neurological Recovery in Middle-Aged Rats After Stroke Basic Sciences
Conclusions— Our data suggest that DM exacerbates neurovascular damage and hinders brain repair processes, which likely contribute to the impairment of stroke recovery.
Source: Stroke - July 25, 2016 Category: Neurology Authors: Zhang, L., Chopp, M., Zhang, Y., Xiong, Y., Li, C., Sadry, N., Rhaleb, I., Lu, M., Zhang, Z. G. Tags: Basic Science Research, Cognitive Impairment, Neurogenesis Basic Sciences Source Type: research
Recurrent Stroke due to Patent Foramen Ovale Closure Device Thrombus Eight Years after Implantation
We present a case of cardioembolic stroke secondary to a mobile thrombus on a PFO closure device 8 years after implantation.
Source: Journal of Stroke and Cerebrovascular Diseases - July 18, 2016 Category: Neurology Authors: Thomas V. Kodankandath, Sanskriti Mishra, Richard B. Libman, Paul Wright Tags: Case Studies Source Type: research
Ambulatory Status Protects against Venous Thromboembolism in Acute Mild Ischemic Stroke Patients
Ischemic stroke patients are at high risk (up to 18%) for venous thromboembolism. We conducted a retrospective cross-sectional study to understand the predictors of acute postmild ischemic stroke patient's ambulatory status and its relationship with venous thromboembolism, hospital length of stay, and in-hospital mortality.
Source: Journal of Stroke and Cerebrovascular Diseases - July 13, 2016 Category: Neurology Authors: Jason-Flor V. Sisante, Michael G. Abraham, Milind A. Phadnis, Sandra A. Billinger, Manoj K. Mittal Source Type: research
Stroke: Highlights of Selected Articles Stroke: Highlights of Selected Articles
Source: Stroke - June 27, 2016 Category: Neurology Tags: Stem Cells, Magnetic Resonance Imaging (MRI), Quality and Outcomes, Ischemic Stroke, Thrombosis Stroke: Highlights of Selected Articles Source Type: research
Prothrombotic State in Patients With a Left Atrial Appendage Thrombus of Unknown Origin and Cerebrovascular Events Clinical Sciences
Conclusions— Prothrombotic blood alterations could be involved in the LAA thrombus formation in patients without documented atrial fibrillation and are associated with increased risk of stroke or transient ischemic attack during follow-up.
Source: Stroke - June 27, 2016 Category: Neurology Authors: Meus, R., Son, M., Sobczyk, D., Undas, A. Tags: Ischemic Stroke Clinical Sciences Source Type: research
Warfarin-Resistant Deep Vein Thrombosis during the Treatment of Acute Ischemic Stroke in Lung Adenocarcinoma
A 66-year-old man with acute ischemic stroke in the setting of lung adenocarcinoma developed acute-onset deep vein thrombosis (DVT) of the lower limbs after changing to warfarin from a heparin combination. The diagnosis of warfarin-resistant DVT was established based on the laboratory data and clinical evaluation. Heparin administration resulted in good control of thrombin regulation. Cancer patients are at high risk of venous thromboembolism, and the combination of these 2 conditions is known as Trousseau's syndrome.
Source: Journal of Stroke and Cerebrovascular Diseases - June 22, 2016 Category: Neurology Authors: Hiroyuki Naito, Shiro Aoki, Naoko Sumi, Kazuhide Ochi, Naohisa Hosomi, Hirofumi Maruyama, Masayasu Matsumoto Tags: Case Studies Source Type: research
Performance of bedside stroke recognition tools in discriminating childhood stroke from mimics
Conclusions: Adult stroke recognition tools perform poorly in children and require modification to be useful for pediatric stroke identification. Classification of evidence: This study provides Class II evidence that, for children presenting to the ED with brain attack symptoms, the CPSS and ROSIER tools do not accurately distinguish strokes from mimics.
Source: Neurology - June 6, 2016 Category: Neurology Authors: Mackay, M. T., Churilov, L., Donnan, G. A., Babl, F. E., Monagle, P. Tags: All Clinical Neurology, All Cerebrovascular disease/Stroke, Pediatric stroke; see Cerebrovascular Disease/ Childhood stroke ARTICLE Source Type: research
Comparative Effectiveness of Interventions for Stroke Prevention in Atrial Fibrillation: A Network Meta-Analysis Arrhythmia and Electrophysiology
Conclusions The entire spectrum of therapy to prevent thromboembolism in nonvalvular AF significantly reduced stroke/systemic embolism events and mortality.
Source: JAHA:Journal of the American Heart Association - May 20, 2016 Category: Cardiology Authors: Tereshchenko, L. G., Henrikson, C. A., Cigarroa, J., Steinberg, J. S. Tags: Atrial Fibrillation, Anticoagulants, Treatment, Meta Analysis, Cerebrovascular Disease/Stroke Arrhythmia and Electrophysiology Source Type: research
Mechanical thrombectomy for acute ischemic stroke with cerebral microbleeds
Conclusions Patients with CMBs are not at increased risk for HT and mortality following mechanical thrombectomy for acute stroke. Excluding such patients from mechanical thrombectomy is unwarranted. The risk of HT in patients with ≥5 CMBs requires further study.
Source: Journal of NeuroInterventional Surgery - May 13, 2016 Category: Neurosurgery Authors: Shi, Z.-S., Duckwiler, G. R., Jahan, R., Tateshima, S., Gonzalez, N. R., Szeder, V., Saver, J. L., Kim, D., Ali, L. K., Starkman, S., Vespa, P. M., Salamon, N., Villablanca, J. P., Vinuela, F., Feng, L., Loh, Y., Liebeskind, D. S. Tags: Ischemic stroke Source Type: research
Impact of Prehospital Intervention on Delay Time to Thrombolytic Therapy in a Stroke Center with a Systemized Stroke Code Program
The use of emergency medical services (EMS) and notification to hospitals by paramedics for patients with suspected stroke are crucial determinants in reducing delay time to acute stroke treatment. The aim of this study is to investigate whether EMS use and prehospital notification (PN) can shorten the time to thrombolytic therapy in a stroke center with a systemized stroke code program.
Source: Journal of Stroke and Cerebrovascular Diseases - April 7, 2016 Category: Neurology Authors: Dae-Hyun Kim, Hyun-Wook Nah, Hyun-Seok Park, Jae-Hyung Choi, Myong-Jin Kang, Jae-Taeck Huh, Jae-Kwan Cha Source Type: research
Vascular Territories of Ischemic Stroke in Associated Takotsubo Cardiomyopathy (P1.221)
Conclusions: TC is a reversible cardiomyopathy that has an association with ischemic stroke. This condition can notably be both the cause and effect of stroke. Ischemic stroke of the left middle cerebral artery appears to be the most prevalent. In female patients suffering from middle cerebral artery distribution ischemic stroke and cardiac dysfunction, TC should be considered.Disclosure: Dr. Zia has nothing to disclose. Dr. Silliman has received research support from Genzyme Corporation, Biogen Idec, and Novartis.
Source: Neurology - April 4, 2016 Category: Neurology Authors: Zia, A., Silliman, S. Tags: Cardiac Mechanisms and Complications of Stroke Source Type: research
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 4, 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 4, 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 4, 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 18, 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 8, 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 8, 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