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Secondary Stroke Prevention: Improving Diagnosis and Management with Newer Technologies
AbstractTreatment of hypertension, diabetes, high cholesterol, smoking cessation, and healthy lifestyle have all contributed to the decline in the incidence of vascular disease over the last several decades. Patients who suffer an acute stroke are at a high risk for recurrence. Introduction of newer technologies and their wider use allows for better identification of patients in whom the risk of recurrence following an acute stroke may be very high. Traditionally, the major focus for diagnosis and management has focused on patient history, examination, imaging for carotid stenosis/occlusion, and detection of AF and paroxys...
Source: Translational Stroke Research - September 1, 2016 Category: Neurology Source Type: research

Cerebral Small Vessel Disease Burden Is Increased in Systemic Lupus Erythematosus Clinical Sciences
This study aimed to determine the association between SLE and features on neuroimaging of cerebral small vessel disease (SVD), a risk factor for stroke.Methods—Consecutive patients attending a clinic for SLE were recruited. All patients underwent brain magnetic resonance imaging; had blood samples taken for markers of inflammation, endothelial dysfunction, cholesterol, and autoantibodies; and underwent cognitive and psychiatric testing. The data were compared with sex- and age-matched healthy controls and patients with minor stroke. Features of SVD were measured, a total SVD score calculated, and associations sought with...
Source: Stroke - October 23, 2016 Category: Neurology Authors: Wiseman, S. J., Bastin, M. E., Jardine, C. L., Barclay, G., Hamilton, I. F., Sandeman, E., Hunt, D., Amft, E. N., Thomson, S., Belch, J. F. F., Ralston, S. H., Wardlaw, J. M. Tags: Risk Factors, Imaging, Ischemic Stroke Original Contributions Source Type: research

Letter by Scheitz et al Regarding Article, “Randomized Controlled Trial of Early Versus Delayed Statin Therapy in Patients With Acute Ischemic Stroke: ASSORT Trial (Administration of Statin on Acute Ischemic Stroke Patient)” Letter to the Editor
Source: Stroke - February 26, 2018 Category: Neurology Authors: Jan F. Scheitz, Kennedy R. Lees, Matthias Endres Tags: Cerebrovascular Disease/Stroke, Intracranial Hemorrhage, Ischemic Stroke, Neuroprotectants Letters to the Editor Source Type: research

Response by Yoshimura et al to Letter Regarding Article, “Randomized Controlled Trial of Early Versus Delayed Statin Therapy in Patients With Acute Ischemic Stroke: ASSORT Trial (Administration of Statin on Acute Ischemic Stroke Patient)” Letter to the Editor
Source: Stroke - February 26, 2018 Category: Neurology Authors: Shinichi Yoshimura, Kazutaka Uchida, Takeshi Morimoto Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke, Neuroprotectants Letters to the Editor Source Type: research

HDAC9 Polymorphism Alters Blood Gene Expression in Patients with Large Vessel Atherosclerotic Stroke
AbstractThe histone deacetylase 9 (HDAC9) polymorphism rs2107595 is associated with an increased risk for large vessel atherosclerotic stroke (LVAS). In humans, there remains a need to better understand this HDAC9 polymorphism ’s contribution to large vessel stroke. In this pilot study, we evaluated whether the HDAC9 polymorphism rs2107595 is associated with differences in leukocyte gene expression in patients with LVAS. HDAC9 SNP rs2107595 was genotyped in 155 patients (43 LVAS and 112 vascular risk factor controls). R NA isolated from blood was processed on whole genome microarrays. Gene expression was compared between...
Source: Translational Stroke Research - April 13, 2018 Category: Neurology Source Type: research

Statin Use and the Risk of Dementia in Patients with Stroke: A Nationwide Population-Based Cohort Study
Background: Patients with stroke have an increased risk of  dementia. Some studies have found that statin use might lower the risk of incident dementia; however, there is still a lack of data from patients with stroke. Therefore, the aim of our study was to investigate the impact of statin use on the risk of dementia in patients with stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - August 6, 2018 Category: Neurology Authors: Mei-Lien Pan, Chien-Chi Hsu, Yi-Min Chen, Hui-Kung Yu, Gwo-Chi Hu Source Type: research

Apolipoproteins B and A1 in Ischemic Stroke Subtypes
Introduction: Elevated serum apolipoprotein B and the apolipoprotein B/A1 ratio have been associated with ischemic stroke and intracranial atherosclerotic disease. We sought to assess the relationship between serum levels of apolipoprotein B, apolipoprotein A1, and the apolipoprotein B/A1 ratio with ischemic stroke subtypes and large artery atherosclerosis location. Materials and Methods: We evaluated serum apolipoprotein B and apolipoprotein A1 levels in consecutive, statin-na ïve, adult ischemic stroke patients admitted to an academic medical center in southern India.
Source: Journal of Stroke and Cerebrovascular Diseases - February 9, 2020 Category: Neurology Authors: Rizwan Kalani, Soumya Krishnamoorthy, D. Deepa, Srinivas Gopala, Dorairaj Prabhakaran, David Tirschwell, P.N. Sylaja Source Type: research

Statin Pretreatment Might Be Associated with Decreased Myocardial Injury After Ischemic Stroke
In this study, we aimed at investigating the association between statin pretreatment and poststroke myocardial injury. Methods: Six hundred seventy-one patients diagnosed as acute ischemic stroke were enrolled. According to the histories of statin pretreatment before stroke, patients were categorized into nonstatin (n  = 474) and statin groups (n = 197), with the latter further divided into low-dosage, standard-dosage, and high-dosage subgroups according the dosages of statins.
Source: Journal of Stroke and Cerebrovascular Diseases - February 20, 2020 Category: Neurology Authors: Ke-Wu Wang, Chao Feng, Yin-Fei Wu, Jing Huang, Wen-Bo Xiao, Shu-Dong Xia Source Type: research

Cholesterol Crystal in Thrombus Removed by Mechanical Thrombectomy Should be a Strong Marker for Aortogenic Embolic Stroke
Aortogenic embolic stroke (AES) is an important stroke mechanism. However, as many stroke patients have aortic atheromatous lesions, it is unclear whether these lesions are the cause of these strokes. Cholesterol crystals are the solid, crystalline form of cholesterol that is found in atherosclerosis, but not in cardiac diseases such as atrial fibrillation, valvular diseases, and cardiomyopathy. Therefore, if a cholesterol crystal is found in a thrombus removed by mechanical thrombectomy (MT), this makes it possible to diagnose a patient as having an atheromatous lesion.
Source: Journal of Stroke and Cerebrovascular Diseases - August 11, 2020 Category: Neurology Authors: Noriko Matsumoto, Mizuho Takahashi, Takehiro Katano, Akihito Kutsuna, Takuya Kanamaru, Yuki Sakamoto, Kentaro Suzuki, Junya Aoki, Yasuhiro Nishiyama, Shinobu Kunugi, Akira Shimizu, Kazumi Kimura Tags: Case Report Source Type: research

Controversies: Stroke Prevention in Chronic Kidney Disease
Risk of both ischemic and hemorrhagic stroke is increased in the chronic kidney disease (CKD) population, particularly in end-stage kidney disease patients. Uremic factors that contribute to stroke risk include blood pressure variability, vascular calcification, build-up of vascular toxins, chronic inflammation, platelet dysfunction and increased brain microbleeds. This paper discusses the controversial evidence for stroke prevention strategies including blood pressure control, statins, antiplatelet agents, and anticoagulation in the CKD population.
Source: Journal of Stroke and Cerebrovascular Diseases - February 25, 2021 Category: Neurology Authors: Wei Ling Lau Source Type: research

Treatment of Ischemic Stroke by Atorvastatin-Loaded PEGylated Liposome
AbstractThere is insufficient evidence on the effect of nanoparticles, particularly liposomes loaded with a statin, on acute ischemic stroke. We investigated the impact of atorvastatin-loaded PEG (polyethylene glycol) conjugated liposomes (LipoStatin) on the outcomes in rats with cerebral ischemia –reperfusion. PEGylated liposome loaded with atorvastatin was developed as a nanoparticle to specifically accumulate in an ischemic region and release the drug to ameliorate the harmful effects of the stroke. LipoStatin was administered to rats with transient middle cerebral artery occlusion throu gh the tail vein immediately a...
Source: Translational Stroke Research - January 14, 2023 Category: Neurology Source Type: research

Statin Therapy Should Not be Discontinued in Patients With Intracerebral Hemorrhage Controversies in Stroke
Source: Stroke - June 24, 2013 Category: Neurology Authors: Bustamante, A., Montaner, J. Tags: Acute Cerebral Hemorrhage, Cerebral Lacunes, Neuroprotectors, Other Stroke Treatment - Medical Controversies in Stroke Source Type: research

Continued Statin Treatment After Acute Intracranial Hemorrhage: Fighting Fire With Fire Controversies in Stroke
Source: Stroke - June 24, 2013 Category: Neurology Authors: Molina, C. A., Selim, M. H. Tags: Acute Cerebral Hemorrhage, Other Stroke Treatment - Medical Controversies in Stroke Source Type: research

Apolipoprotein E, Statins, and Risk of Intracerebral Hemorrhage Clinical Sciences
Conclusions— Statin use does not seem to attenuate the association of HC with decreased risk for nonlobar ICH. Our data support a gene-by-drug effect for lobar ICH, but larger sample sizes are needed to confirm the association before any clinical change is warranted. Clinical Trial Registration— URL: http://clinicaltrials.gov. Unique identifier: NCT00930280.
Source: Stroke - October 21, 2013 Category: Neurology Authors: Woo, D., Deka, R., Falcone, G. J., Flaherty, M. L., Haverbusch, M., Martini, S. R., Greenberg, S. M., Ayres, A. M., Sauerbeck, L., Kissela, B. M., Kleindorfer, D. O., Moomaw, C. J., Anderson, C. D., Broderick, J. P., Rosand, J., Langefeld, C. D., Woo, J. Tags: Embolic stroke Clinical Sciences Source Type: research

Strong Improvement of Apolipoprotein E/Low-Density Lipoprotein Receptor Signals by Telmisartan in Poststroke Spontaneously Hypertensive Stroke Resistant
Conclusions: These findings suggest that both low and high doses of telmisartan prevented the activation of ApoE/LDL-R in SHR-SR after tMCAO, and that the antimetabolic effect was regarded as the most important mechanism with few additional benefits by lowering BP in this transient stroke model.
Source: Journal of Stroke and Cerebrovascular Diseases - September 1, 2014 Category: Neurology Authors: Toru Yamashita, Yun Zhai, Tomoko Kurata, Nozomi Hishikawa, Nobutoshi Morimoto, Yasuyuki Ohta, Kentaro Deguchi, Koji Abe Tags: Original Articles Source Type: research