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Total 177 results found since Jan 2013.
Cerebral Venous Sinus Thrombosis Associated with Dutasteride Use.
Abstract Cerebral venous thrombosis (CVT) is an uncommon cause of stroke that mainly affects young adults with known risk factors of prothrombotic conditions, pregnancy, infection, malignancy, and drugs. Dutasteride is a 5α-reductase inhibitor that is used for benign prostate hypertrophy and androgenetic alopecia. To date, CVT caused by dutasteride use has not been reported. A 25-year-old male presented with headache and diplopia. He had taken 0.5 mg of dutasteride every other day for 9 months to treat alopecia. A headache developed 7 months after he started taking medication, and horizontal diplopia occurred 1 m...
Source: Yonsei Medical Journal - May 30, 2020 Category: Universities & Medical Training Authors: Choi BK, Cheon K, Cho BH, Jung JW, Lee KY Tags: Yonsei Med J Source Type: research
Racial Disparities in Magnetic Resonance Imaging and Perfusion-Diffusion Mismatch
The central concept of mismatch between perfusion and diffusion targets identified by magnetic resonance imaging offers an approximation of the tissue at risk of infarction if reperfusion is not achieved. This measure is becoming increasingly relevant in determining eligibility for and prognosis following thrombolytic and endovascular treatments, particularly at extended time windows. A few studies have shown that Black stroke patients are more likely to suffer small-vessel ischemic strokes and fewer cardioembolic strokes occluding large vessels.
Source: Journal of Stroke and Cerebrovascular Diseases - April 16, 2020 Category: Neurology Authors: Benjamin Taylor King Tags: Poster 03 Source Type: research
Sinus of Valsalva Thrombosis Detected on Computed Tomography after Transcatheter Aortic Valve Replacement.
CONCLUSIONS: Cardiac CT after TAVR can detect sinus of Valsalva thrombosis, and attention should be paid to this potential source of subsequent systemic embolization. PMID: 32281322 [PubMed - as supplied by publisher]
Source: Korean Circulation Journal - April 14, 2020 Category: Cardiology Tags: Korean Circ J Source Type: research
Acute Ischemic Stroke.
Authors: Rossi UG, Ierardi AM, Cariati M Abstract A 77-year-old woman with a history of hypertension developed acute onset of aphasia and right hemiplegia and hemisensory loss. She was urgently referred to emergency department. Cerebral multidetector computed tomographic angiography (MD-CTA) revealed an acute ischemic stroke due to the occlusion of the left middle cerebral artery (Figure 1). Since the symptoms started three hours previously, the patient was candidate for mechanical thrombectomy. The patient then performed a selective digital subtraction angiography (DSA) of the left internal carotid artery that con...
Source: Acta Neurologica Taiwanica - February 1, 2020 Category: Neurology Tags: Acta Neurol Taiwan Source Type: research
Successful thrombolytic therapy with recombinant tissue plasminogen activator in ischemic stroke after idarucizumab administration for reversal of dabigatran: a case report
ConclusionsIntravenous thrombolytic therapy with recombinant tissue plasminogen activator after reversal of dabigatran with idarucizumab may be safe and feasible in patients with acute ischemic stroke with lacunar infarct. Furthermore, intravenous thrombolytic therapy with recombinant tissue plasminogen activator could be used in patients in emergency settings until just before the end of the recommended time limit within which it needs to be administered because of the immediate effect of idarucizumab.
Source: Journal of Medical Case Reports - December 26, 2019 Category: General Medicine Source Type: research
Modified diffusion-weighted imaging-Alberta Stroke Program Early Computed Tomography Score including deep white matter lesions predicts symptomatic intracerebral hemorrhage following intravenous thrombolysis
AbstractThe Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is widely used for the assessment of early ischemic changes (EICs) before thrombolysis. However, for symptomatic intracerebral hemorrhage (sICH) following intravenous recombinant tissue plasminogen activator (rt-PA), the prediction abilities of CT-ASPECTS, diffusion-weighted imaging (DWI)-ASPECTS, and DWI-ASPECTS including EICs in deep white matter (DWI-ASPECTS + W) are unclear. We investigated associations between each score and sICH following intravenous rt-PA. Data from consecutive patients who received intravenous rt-PA for acute ischemic...
Source: Journal of Thrombosis and Thrombolysis - November 19, 2019 Category: Hematology Source Type: research
Young male with syphilitic cerebral arteritis presents with signs of acute progressive stroke: A case report
Conclusion Progressive stroke was the initial symptom of the neurosyphilis. Disease progression is rapid and difficult to control with a single course of penicillin.
Source: Medicine - November 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Role of Biological Markers for Cerebral Bleeding Risk STRATification in Patients with Atrial Fibrillation on Oral Anticoagulants for Primary or Secondary Prevention of Ischemic Stroke (Strat-AF Study): Study Design and Methodology.
Conclusions: The Strat-AF study may be an essential step towards the exploration of the role of a combined clinical biomarker or multiple biomarker models in predicting stroke risk in AF, and might sustain the incorporation of such new markers in the existing stroke prediction schemes by the demonstration of a greater incremental value in predicting stroke risk and improvement in clinical outcomes in a cost-effective fashion. PMID: 31548494 [PubMed - in process]
Source: Medicina (Kaunas) - September 23, 2019 Category: Universities & Medical Training Authors: Poggesi A, Barbato C, Galmozzi F, Camilleri E, Cesari F, Chiti S, Diciotti S, Galora S, Giusti B, Gori AM, Marzi C, Melone A, Mistri D, Pescini F, Pracucci G, Rinnoci V, Sarti C, Fainardi E, Marcucci R, Salvadori E Tags: Medicina (Kaunas) Source Type: research
Pathophysiologic mechanisms, neuroimaging and treatment in wake-up stroke.
Abstract Wake-up stroke (WUS) or ischemic stroke occurring during sleep accounts for 14%-29.6% of all ischemic strokes. Management of WUS is complicated by its narrow therapeutic time window and attributable risk factors, which can affect the safety and efficacy of administering intravenous (IV) tissue plasminogen activator (t-PA). This manuscript will review risk factors of WUS, with a focus on obstructive sleep apnea, potential mechanisms of WUS, and evaluate studies assessing safety and efficacy of IV t-PA treatment in WUS patients guided by neuroimaging to estimate time of symptom onset. The authors used PubMe...
Source: CNS Spectrums - September 12, 2019 Category: Neurology Authors: Elfil M, Eldokmak M, Baratloo A, Ahmed N, Amin HP, Koo BB Tags: CNS Spectr Source Type: research
MRI-Based Predictors of Hemorrhagic Transformation in Patients With Stroke Treated by Intravenous Thrombolysis
Clinical and biological risk factors for hemorrhagic transformation (HT) after intravenous thrombolysis (IT) have been well established in several registries. The added value of magnetic resonance imaging (MRI) variables has been studied in small samples, and is controversial. We aimed to assess the added value of MRI variables in HT, beyond that of clinical and biological factors. We enrolled 474 consecutive patients with brain infarction treated by IT alone at our primary stroke center between January 2011 and August 2017. Baseline demographic, clinical, biological, and imaging characteristics were collected. MRI variab...
Source: Frontiers in Neurology - August 27, 2019 Category: Neurology Source Type: research
Patent Foramen Ovale and Ischemic Stroke in Patients With Pulmonary Embolism: A Prospective Cohort Study.
Conclusion: Frequency of recent ischemic stroke in patients with symptomatic PE was higher in patients with PFO than in those without PFO. This finding supports the hypothesis that paradoxical embolism is an important mechanism of ischemic stroke in patients with PFO. Primary Funding Source: French Ministry of Health. PMID: 31060047 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - May 7, 2019 Category: Internal Medicine Authors: Le Moigne E, Timsit S, Ben Salem D, Didier R, Jobic Y, Paleiron N, Le Mao R, Joseph T, Hoffmann C, Dion A, Rousset J, Le Gal G, Lacut K, Leroyer C, Mottier D, Couturaud F Tags: Ann Intern Med Source Type: research
Intravenous Thrombolysis in Posterior Circulation Stroke
Conclusions: Up to date, no data about PCIS and IVT are available from RTCs. Based on limited results from retrospective clinical studies and case series, IVT is safer for use in PCIS than in ACIS. Patients with brainstem ischemia, vertebral artery occlusion, and absence of basilar or posterior cerebral artery occlusion could be considered for treatment with IVT even in borderline cases. Time to IVT in PCIS seems to be a less crucial factor than in ACIS. IVT for PCIS may be beneficial even after 4.5 h from symptom onset. Introduction History of Intravenous Thrombolysis—The Most Relevant Studies Intravenous...
Source: Frontiers in Neurology - April 26, 2019 Category: Neurology Source Type: research
Frequency of Hemorrhage on Follow Up Imaging in Stroke Patients Treated With rt-PA Depending on Clinical Course
Conclusions: Frequency of hemorrhagic transformation in Routine follow-up brain imaging and consecutive changes in therapeutic management were different depending on clinical course measured by NHISS score. Introduction Brain imaging 24–36 h after systemic thrombolysis for acute ischemic stroke is recommended in American Stroke Association and European Stroke Organization guidelines (1, 2). Brain imaging is performed to detect secondary bleeding or hemorrhagic transformation in order to adapt medical stroke prevention if necessary. Guideline recommendations are based on the results of the first study on rt-PA...
Source: Frontiers in Neurology - April 16, 2019 Category: Neurology Source Type: research
Post-Stroke Blood-Brain Barrier Disruption and Poor Functional Outcome in Patients Receiving Thrombolytic Therapy
Conclusions: Post-stroke BBB disruption appears to be predictive of functional outcome irrespective of stroke size.Cerebrovasc Dis
Source: Cerebrovascular Diseases - April 15, 2019 Category: Neurology Source Type: research
Cardiac papillary fibroelastoma and stroke during pregnancy: Case report.
We report the case of a woman with severe headache associated with visual disturbances, without hypertension or proteinuria at 32 weeks of pregnancy. MRI revealed multiple recent cerebral vascular accidents. An echocardiogram detected a papillary fibroelastoma of 5mm. Maternal fetal experts determined it safe to continue the pregnancy. Childbirth at 39 weeks was normal uneventful for the newborn and mother. In the postpartum, despite the theoretical operative indication to resect the small residual papillary fibroelastoma, the patient was followed expectantly because of the stable neuro-cardiologic state. A fibroelastoma c...
Source: Annales de Cardiologie et d'Angeiologie - January 24, 2019 Category: Cardiology Authors: Binhas M, Zakine C, Khelil N, Mekacher L, Wafo E, Lebonhomme JJ, Iung B Tags: Ann Cardiol Angeiol (Paris) 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
A case report of left atrial myxoma-induced acute myocardial infarction and successive stroke
Rationale: Left atrial myxoma is a common primary cardiac tumor, however, due to poor image quality or atypical myxoma images, it is often misdiagnosed by echocardiograph. A case of left atrial myxoma being misdiagnosed as a thrombus, which successively caused acute myocardial infarction (AMI) and stroke, is very rare. Contrast-enhanced echocardiography can play an important role in definitive diagnosis. Patient concerns: A 44-year-old woman was diagnosed AMI because of chest pain with no significant stenosis in the coronary arteries. One month later, the patient was suddenly found unconscious, magnetic resonance imag...
Source: Medicine - December 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report 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
Ischemic stroke following a wasp sting – a rare complication: a case report
ConclusionTreating physicians should be aware of the rare but possible complication of ischemic stroke following a case of wasp sting.
Source: Journal of Medical Case Reports - October 14, 2018 Category: General Medicine Source Type: research
Biohybrids of scaffolding hyaluronic acid biomaterials plus adipose stem cells home local neural stem and endothelial cells: Implications for reconstruction of brain lesions after stroke
AbstractEndogenous neurogenesis in stroke is insufficient to replace the lost brain tissue, largely due to the lack of a proper biological structure to let new cells dwell in the damaged area. We hypothesized that scaffolds made of hyaluronic acid (HA) biomaterials (BM) could provide a suitable environment to home not only new neurons, but also vessels, glia and neurofilaments. Further, the addition of exogenous cells, such as adipose stem cells (ASC) could increase this effect. Athymic mice were randomly assigned to a one of four group: stroke alone, stroke and implantation of BM, stroke and implantation of BM with ASC, a...
Source: Journal of Biomedical Materials Research Part B: Applied Biomaterials - October 11, 2018 Category: Materials Science Authors: Leyre Sanchez ‐Rojas, Ulises Gómez‐Pinedo, María Soledad Benito‐Martin, Gonzalo León‐Espinosa, Fernando Rascón‐Ramirez, Cristina Lendinez, Cristina Martínez‐Ramos, Jorge Matías‐Guiu, Manuel Monleón Pradas, Juan A. Barcia Tags: Original Research Report Source Type: research
Presentation of Acute Childhood Stroke in a Tertiary Pediatric Emergency Department
Conclusions The spectrum of stroke in a developing country was similar to published series from developed countries in terms of final diagnosis, risk factors, and delay to ED presentation, neuroimaging, and long-term neurodeficits. No tropical diseases were identified as risk factors.
Source: Pediatric Emergency Care - August 1, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research
T Cells Prevent Hemorrhagic Transformation in Ischemic Stroke by P-Selectin Binding.
CONCLUSIONS: The study identifies lymphopenia as a previously unrecognized risk factor for secondary hemorrhagic transformation in mice after severe ischemic stroke. T cells prevent hemorrhagic transformation by their capacity to bind platelets through P-selectin. The results highlight the role of T cells in bridging immunity and hemostasis in ischemic stroke. PMID: 29903733 [PubMed - as supplied by publisher]
Source: Arteriosclerosis, Thrombosis and Vascular Biology - June 14, 2018 Category: Cardiology Authors: Salas-Perdomo A, Miró-Mur F, Urra X, Justicia C, Gallizioli M, Zhao Y, Brait VH, Laredo C, Tudela R, Hidalgo A, Chamorro Á, Planas AM Tags: Arterioscler Thromb Vasc Biol Source Type: research
A previously healthy, unimmunized 11-month-old boy presented with acute right-sided weakness. On the day of presentation, his mother noted that his right arm and leg seemed to be weak when she woke him from his usual afternoon nap. Evaluation at an urgent care center confirmed right-sided facial weakness, decreased strength and movement of his right upper and lower extremities, and a lack of right-sided support in a sitting position. Computed tomography of the head without contrast was normal. He was transferred to a regional care center where head magnetic resonance imaging and magnetic resonance angiography demonstrated ...
Source: The Journal of Pediatrics - April 19, 2018 Category: Pediatrics Authors: Surabhi B. Vora, Catherine Amlie-Lefond, Francisco A. Perez, Ann J. Melvin Tags: Insights and Images Source Type: research
Thrombosed Aneurysm of the Posterior Inferior Cerebellar Artery and Lateral Medullary Ischemia as the Initial Presentation of Polyarteritis Nodosa: Case Report and Literature Review
A 27-year-old woman with a previously undiagnosed polyarteritis nodosa (PAN) developed lateral medullary stroke related to a thrombosed posterior inferior cerebellar artery (PICA)-origin aneurysm. A concurrent thrombosis of the PICA was identified on high-resolution 3-dimensional CUBE T1 magnetic resonance imaging sequence at 3 T. Body computed tomography angiography, magnetic resonance imaging–magnetic resonance angiography, and digital angiography revealed multiple tiny aneurysms of the visceral arteries and bilateral kidney infarcts.
Source: Journal of Stroke and Cerebrovascular Diseases - March 27, 2018 Category: Neurology Authors: Monique Boukobza, Antoine Dossier, Jean-Pierre Laissy Tags: Case Studies Source Type: research
Erythrocyte Fraction Within Retrieved Thrombi Contributes to Thrombolytic Response in Acute Ischemic Stroke Clinical Sciences
Conclusions—In EVT-attempted patients with acute ischemic stroke, IVT responsiveness would be closely associated with RBC fraction.
Source: Stroke - February 26, 2018 Category: Neurology Authors: Mun Hee Choi, Geun Hwa Park, Jin Soo Lee, Sung Eun Lee, Seong-Joon Lee, Jang-Hee Kim, Ji Man Hong Tags: Ischemic Stroke Original Contributions Source Type: research
Patients With Undetermined Stroke Have Increased Atrial Fibrosis Brief Report
Conclusions—The LA phenotype that was found in patients with undetermined cause supports the hypothesis that an atrial disease may be associated with stroke.
Source: Stroke - February 26, 2018 Category: Neurology Authors: Ana Catarina Fonseca, Pedro Alves, Nuno Inacio, Joao Pedro Marto, Miguel Viana–Baptista, Teresa Pinho–e–Melo, Jose M. Ferro, Ana G. Almeida Tags: Magnetic Resonance Imaging (MRI), Ischemic Stroke, Embolism Brief Reports Source Type: research
Detection of Left Ventricular Thrombus by Cardiac Magnetic Resonance in Embolic Stroke of Undetermined Source Clinical Sciences
Background and Purpose—We aimed to use contrast-enhanced cardiac magnetic resonance (CE-CMR) imaging to elucidate the prevalence of left ventricular (LV) thrombus in patients suspected of embolic stroke of undetermined source (ESUS) with previous myocardial infarction or LV dysfunction (LV ejection fraction [LVEF]
Source: Stroke - August 28, 2017 Category: Neurology Authors: Junji Takasugi, Hiroshi Yamagami, Teruo Noguchi, Yoshiaki Morita, Tomotaka Tanaka, Yoshinori Okuno, Satoshi Yasuda, Kazunori Toyoda, Yasufumi Gon, Kenichi Todo, Manabu Sakaguchi, Kazuyuki Nagatsuka Tags: Diagnostic Testing, Magnetic Resonance Imaging (MRI), Ischemic Stroke, Embolism, Thrombosis Original Contributions Source Type: research
Recurrent Stroke Due to Metastatic Pulmonary Tumor Emboli as an Important Clinical Entity
We present an autopsy case of repetitive stroke due to tumor emboli, indistinguishable from thromboembolism with a hypercoagulable state in its clinical course. A 72-year-old man diagnosed with stage IVA oropharyngeal squamous cell carcinoma received chemoradiotherapy. Follow-up imaging revealed mediastinal lymph nodes and pulmonary metastasis. One year later, the patient experienced right arm weakness, and brain magnetic resonance imaging showed acute ischemic lesions in multiple vascular territories.
Source: Journal of Stroke and Cerebrovascular Diseases - March 30, 2017 Category: Neurology Authors: Junji Takasugi, Manabu Sakaguchi, Naoki Oyama, Yasufumi Gon, Yasukazu Terasaki, Tsutomu Sasaki, Susumu Nakahara, Kenji Ohshima, Yumiko Hori, Eiichi Morii, Hideki Mochizuki Tags: Case Studies Source Type: research
Voxel-Based Lesion Mapping of Cryptogenic Stroke in Patients with Advanced Cancer: A Detailed Magnetic Resonance Imaging Analysis of Distribution Pattern
Ischemic stroke is one form of cancer-associated thrombosis that can greatly worsen a patient's performance status. The present investigation aimed to elucidate the characteristic distribution pattern(s) of cryptogenic stroke lesions using a voxel-based lesion-mapping technique and examine the differences in clinical manifestations between cryptogenic and conventional strokes in patients with advanced cancer.
Source: Journal of Stroke and Cerebrovascular Diseases - March 28, 2017 Category: Neurology Authors: Takamune Achiha, Masatoshi Takagaki, Hiroshi Oe, Mio Sakai, Hitoshi Matsui, Katsuhiko Nakanishi, Tomohiko Ozaki, Yasunori Fujimoto, Toshiki Yoshimine, Katsuyuki Nakanishi, Manabu Kinoshita Source Type: research
Acute Cerebral Venous Thrombosis Clinical Sciences
Background and Purpose—Cerebral venous thrombosis (CVT) affects venous hemodynamics and can provoke severe stroke and chronic intracranial hypertension. We sought to comprehensively analyze 3-dimensional blood flow and hemodynamic alterations during acute CVT including collateral recruitment and at follow-up.Methods—Twenty-two consecutive patients with acute CVT were prospectively included and underwent routine brain magnetic resonance imaging (MRI) and 4-dimensional flow MRI at 3 T for the in vivo assessment of cerebral blood flow. Neurological and MRI follow-up at 6 months was performed in 18 patients.Results—Three...
Source: Stroke - February 27, 2017 Category: Neurology Authors: Florian Schuchardt, Anja Hennemuth, Laure Schroeder, Stephan Meckel, Michael Markl, Thomas Wehrum, Andreas Harloff Tags: Magnetic Resonance Imaging (MRI), Complications, Cerebrovascular Disease/Stroke, Intracranial Hemorrhage, Thrombosis Original Contributions Source Type: research
Is Unexplained Early Neurological Deterioration After Intravenous Thrombolysis Associated With Thrombus Extension? Clinical Sciences
Conclusions—In this study, unexplained END occurring after thrombolysis was independently associated with susceptibility vessel sign extension, suggesting in situ thrombus extension or re-embolization. These findings strengthen the need to further investigate early post-thrombolysis administration of antithrombotics to reduce the risk of this ominous clinical event.
Source: Stroke - January 23, 2017 Category: Neurology Authors: Pierre Seners, Robert Hurford, Marie Tisserand, Guillaume Turc, Laurence Legrand, Olivier Naggara, Jean-Louis Mas, Catherine Oppenheim, Jean-Claude Baron Tags: Magnetic Resonance Imaging (MRI), Ischemic Stroke Original Contributions Source Type: research
Infarct Pattern and Collateral Status in Adult Moyamoya Disease Clinical Sciences
Conclusions—In the studied population of adult MMD patients, embolic phenomenon played an important role in ischemic stroke. Therapeutic strategies against thromboembolism, as well as collateral enhancing strategies targeting improvement of hemodynamic status or increased washout of emboli, are warranted.
Source: Stroke - December 23, 2016 Category: Neurology Authors: Dong Yeop Kim, Jeong Pyo Son, Je Young Yeon, Gyeong-Moon Kim, Jong-Soo Kim, Seung-Chyul Hong, Oh Young Bang Tags: Mechanisms, Magnetic Resonance Imaging (MRI), Ischemic Stroke, Moyamoya Original Contributions Source Type: research
Identification of Reversible Disruption of the Human Blood-Brain Barrier Following Acute Ischemia Brief Reports
Conclusions— This study demonstrates that diffuse, mild BBB disruption in the acutely ischemic human brain is reversible with reperfusion. This study also confirms prior findings that focal severe BBB disruption confers an increased risk of hemorrhagic transformation in patients treated with intravenous tissue-type plasminogen activator.
Source: Stroke - August 22, 2016 Category: Neurology Authors: Simpkins, A. N., Dias, C., Leigh, R., on behalf of the National Institutes of Health Natural History of Stroke Investigators, Benson, Hsia, Latour, Luby, Lynch, Merino, Nadareishvili, Warach Tags: Magnetic Resonance Imaging (MRI), Blood-Brain Barrier, Intracranial Hemorrhage, Ischemic Stroke Brief Reports 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
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
Does b1000-b0 Mismatch Challenge Diffusion-Weighted Imaging-Fluid Attenuated Inversion Recovery Mismatch in Stroke? Brief Reports
Conclusions— b1000–b0 mismatch may identify patients with ischemic stroke of the within 4.5 hours of onset with high positive predictive value, perhaps constituting an alternative imaging tissue clock.
Source: Stroke - February 22, 2016 Category: Neurology Authors: Geraldo, A. F., Berner, L.-P., Haesebaert, J., Chabrol, A., Cho, T.-H., Derex, L., Hermier, M., Louis-Tisserand, G., Chamard, L., Klaerke Mikkelsen, I., Ribe, L., Ostergaard, L., Hjort, N., Pedraza, S., Thomalla, G., Baron, J.-C., Nighoghossian, N., Berth Tags: Cardiopulmonary Resuscitation and Emergency Cardiac Care, Magnetic Resonance Imaging (MRI), Cerebrovascular Disease/Stroke, Ischemic Stroke, Thrombosis Brief Reports Source Type: research
A Case of Recurrent Ischemic Stroke Involving Subacute, Progressive Intracranial Cerebral Arterial Sclerosis Prior to Diagnosis with -mutated Polycythemia Vera
A 58-year-old man presenting with no vascular risk factors visited our hospital with right hemiparesis and total aphasia. Diffusion-weighted magnetic resonance imaging of the brain showed multiple hyperintensities in watershed distributions in the left hemisphere. Magnetic resonance angiography (MRA) revealed stenosis of the middle cerebral artery, despite normal MRA findings 2 months prior. One year after the first stroke, the patient experienced a recurrent ischemic stroke involving the left anterior choroidal artery, pulmonary embolism, and deep venous thrombosis.
Source: Journal of Stroke and Cerebrovascular Diseases - September 29, 2015 Category: Neurology Authors: Tomohisa Nezu, Shiro Aoki, Kazuhide Ochi, Sayaka Sugihara, Tetsuya Takahashi, Naohisa Hosomi, Hirofumi Maruyama, Masayasu Matsumoto Tags: Case Studies Source Type: research
Younger Stroke Patients With Large Pretreatment Diffusion-Weighted Imaging Lesions May Benefit From Endovascular Treatment Clinical Sciences
Conclusions— There was a growing risk for poor outcome and symptomatic intracerebral hemorrhage with increasing pretreatment DWI lesion volumes. Nevertheless, favorable outcome was achieved in every third patient with DWI lesions >70 mL after successful endovascular reperfusion, whereas after poor or failed reperfusion, outcome was favorable in only every 12th patient. Therefore, endovascular treatment might be considered in patients with large DWI lesions, especially in younger patients.
Source: Stroke - August 24, 2015 Category: Neurology Authors: Gilgen, M. D., Klimek, D., Liesirova, K. T., Meisterernst, J., Klinger-Gratz, P. P., Schroth, G., Mordasini, P., Hsieh, K., Slotboom, J., Heldner, M. R., Broeg-Morvay, A., Mono, M.-L., Fischer, U., Mattle, H. P., Arnold, M., Gralla, J., El-Koussy, M., Jun Tags: Acute Cerebral Infarction, Thrombolysis, Other Stroke Treatment - Medical Clinical Sciences Source Type: research
Tenecteplase-Tissue-Type Plasminogen Activator Evaluation for Minor Ischemic Stroke With Proven Occlusion Clinical Sciences
Conclusions— Administration of TNK–tissue-type plasminogen activator in minor stroke with intracranial occlusion is both feasible and safe. A larger randomized controlled trial is needed to prove that this treatment is efficacious. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01654445.
Source: Stroke - February 23, 2015 Category: Neurology Authors: Coutts, S. B., Dubuc, V., Mandzia, J., Kenney, C., Demchuk, A. M., Smith, E. E., Subramaniam, S., Goyal, M., Patil, S., Menon, B. K., Barber, P. A., Dowlatshahi, D., Field, T., Asdaghi, N., Camden, M.-C., Hill, M. D., for the TEMPO-1 Investigators Tags: Computerized tomography and Magnetic Resonance Imaging, Thrombolysis Clinical Sciences Source Type: research
Imaging of occlusive thrombi in acute ischemic stroke
Thrombi, or clots, often occlude proximal segments of the cerebral arterial circulation in acute ischemic stroke. Thromboembolic occlusion or thrombi superimposed on atherosclerotic plaque are the principal focus of acute stroke therapies such as thrombolysis or thrombectomy. We review the imaging characteristics of thrombi on multimodal computed tomography and magnetic resonance imaging, angiography, and ultrasonography, summarizing recent studies that facilitate therapeutic decision‐making from these noninvasive studies. Information about the location, size, and imaging characteristics can be ascertained using these te...
Source: International Journal of Stroke - December 26, 2014 Category: Neurology Authors: Gregory G. Gasparian, Nerses Sanossian, Mark S. Shiroishi, David S. Liebeskind Tags: Review Source Type: research
Advantages of susceptibility‐weighted magnetic resonance sequences in the visualization of intravascular thrombi in acute ischemic stroke
ConclusionsSWAN was more sensitive than T2* in the visualization of SVS in the intracranial arteries during the acute phase of ischemic stroke. Our study shows that the low number of SVS visualized using T2* in previous studies is probably related to a lack of sensitivity of the sequence, rather than to the nature or age of the thrombus. The greater sensitivity of SWAN seems to be linked to the visualization of SVS in cases of small thrombi.
Source: International Journal of Stroke - October 1, 2014 Category: Neurology Authors: R. Allibert, C. Billon Grand, F. Vuillier, F. Cattin, E. Muzard, A. Biondi, T. Moulin, E. Medeiros Tags: Short Report Source Type: research
Cervical Arterial Dissections and Association With Cervical Manipulative Therapy: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association AHA/ASA Scientific Statement
Conclusions— CD is an important cause of ischemic stroke in young and middle-aged patients. CD is most prevalent in the upper cervical spine and can involve the internal carotid artery or vertebral artery. Although current biomechanical evidence is insufficient to establish the claim that CMT causes CD, clinical reports suggest that mechanical forces play a role in a considerable number of CDs and most population controlled studies have found an association between CMT and VAD stroke in young patients. Although the incidence of CMT-associated CD in patients who have previously received CMT is not well established, an...
Source: Stroke - September 22, 2014 Category: Neurology Authors: Biller, J., Sacco, R. L., Albuquerque, F. C., Demaerschalk, B. M., Fayad, P., Long, P. H., Noorollah, L. D., Panagos, P. D., Schievink, W. I., Schwartz, N. E., Shuaib, A., Thaler, D. E., Tirschwell, D. L., on behalf of the American Heart Association Strok Tags: AHA Statements and Guidelines AHA/ASA Scientific Statement Source Type: research
Thrombolysis in Ischemic Stroke Without Arterial Occlusion at Presentation Clinical Sciences
Conclusions— This study provides crucial data that patients with ischemic stroke who do not have visible arterial occlusion at presentation may benefit from thrombolysis.
Source: Stroke - August 25, 2014 Category: Neurology Authors: Lahoti, S., Gokhale, S., Caplan, L., Michel, P., Samson, Y., Rosso, C., Limaye, K., Hinduja, A., Singhal, A., Ali, S., Pettigrew, L. C., Kryscio, R., Dedhia, N., Hastak, S., Liebeskind, D. S. Tags: Cerebral Lacunes, Embolic stroke, Computerized tomography and Magnetic Resonance Imaging, Pathology of Stroke, Thrombolysis Clinical Sciences Source Type: research
Fatal Intracranial Hemorrhage after Intravenous Thrombolytic Therapy for Acute Ischemic Stroke Associated with Cancer-related Nonbacterial Thrombotic Endocarditis
Nonbacterial thrombotic endocarditis (NBTE) is associated with hypercoagulability in patients with inflammatory states such as cancer and autoimmune diseases. Cardiac vegetations caused by NBTE often lead to life-threatening systemic thromboembolism that most frequently affects the brain, spleen, and kidneys. A 54-year-old woman diagnosed with ovarian cancer suddenly developed back pain and left hemiparesis. Although intravenous alteplase (rt-PA) therapy was administered to treat hyperacute ischemic infarction detected by magnetic resonance imaging, intracranial hemorrhage occurred in the left hemisphere several hours late...
Source: Journal of Stroke and Cerebrovascular Diseases - August 11, 2014 Category: Neurology Authors: Takuya Yagi, Kie Takahashi, Mariko Tanikawa, Morinobu Seki, Takato Abe, Norihiro Suzuki Tags: Case Reports 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
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
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
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