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Preliminary data on utility of subcutaneous unfractionated heparin in patients with deep cerebral venous thrombosis
We describe the outcomes of 37 (isolated:combined: 11:26) patients of DCVT diagnosed by MRI, treated with SCUFH in a tertiary care stroke unit. It was a prospective observational cohort study using 5000 U of SCUFH every 6 hourly for 10 days with oral Acenocoumarol started on day 7, with monitoring. The outcome was assessed by modified Rankin scale (mRS), National Institute of Health Stroke Scale (NIHSS) and Barthel ’s activities of daily life (BADL) at 3 months. The mean age of the cohort was 27.9 ± 9.7 years, females (n = 24) outnumbering the males (n = 13). Mean duration of symptoms being 10.2 ± 15.9 da...
Source: Journal of Thrombosis and Thrombolysis - June 15, 2017 Category: Hematology Source Type: research

Use of Noncontrast Computed Tomography and Computed Tomographic Perfusion in Predicting Intracerebral Hemorrhage After Intravenous Alteplase Therapy Clinical Sciences
Background and Purpose—Intracerebral hemorrhage is a feared complication of intravenous alteplase therapy in patients with acute ischemic stroke. We explore the use of multimodal computed tomography in predicting this complication.Methods—All patients were administered intravenous alteplase with/without intra-arterial therapy. An age- and sex-matched case–control design with classic and conditional logistic regression techniques was chosen for analyses. Outcome was parenchymal hemorrhage on 24- to 48-hour imaging. Exposure variables were imaging (noncontrast computed tomography hypoattenuation degree, relative volume...
Source: Stroke - May 22, 2017 Category: Neurology Authors: Connor Batchelor, Pooneh Pordeli, Christopher D. d’Esterre, Mohamed Naȷm, Fahad S. Al–Aȷlan, Mari E. Boesen, Connor McDougall, Lisa Hur, Enrico Fainardi, Jai Jai Shiva Shankar, Marta Rubiera, Alexander V. Khaw, Michael D. Hill, Tags: Blood-Brain Barrier, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

Neutrophil-to-Lymphocyte Ratio Is an Independent Predictor for In-Hospital Mortality in Spontaneous Intracerebral Hemorrhage
Background and Purpose: Stroke-associated immunosuppression and inflammation are increasingly recognized as factors that trigger infections and thus, potentially influence the outcome after stroke. Several studies demonstrated that elevated neutrophil-to-lymphocyte ratio (NLR) is a significant predictor of adverse outcomes in patients with ischemic stroke. However, little is known about the impact of NLR on short-term mortality in intracerebral hemorrhage (ICH).Methods: This observational study included 855 consecutive ICH-patients. Patient demographics, clinical, laboratory, and in-hospital measures as well as neuroradiol...
Source: Cerebrovascular Diseases - April 18, 2017 Category: Neurology Source Type: research

Treatment Outcome of Carotid Artery Stenting Underwent within 14 Days of Stroke Onset - Consideration of Safety and Efficacy of Urgent Carotid Artery Stenting for Neurologically Progressing Patients.
Authors: Kanematsu Y, Satomi J, Kuwayama K, Yamaguchi I, Yoshioka S, Kinouchi T, Tada Y, Yamamoto N, Matsubara S, Satoh K, Nagahiro S Abstract As the safety and effectiveness of urgent carotid artery stenting (CAS) for neurologically progressing patients remain controversial, we retrospectively analyzed the outcome of urgent CAS based on the patients' pathophysiological condition and neuroimaging findings. We divided 71 patients who underwent CAS within 14 days of stroke onset into two groups. Group 1 (n = 35) was comprised of patients with progressing neurologic signs and a reversible ischemic penumbra on magnetic...
Source: Neurologia Medico-Chirurgica - April 7, 2017 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Prognostic parameters for symptomatic intracranial hemorrhage after intravenous thrombolysis in acute ischemic stroke in an Asian population.
Abstract Symptomatic intracranial hemorrhage (sICH) is a major complication after intravenous thrombolysis leading to severe disability and death. The incidence was higher in Asian than in westernized countries. Prognostic factors across ethnicities are presumably different. Studies in Asian populations are limited. Clinical data from January 2008 to September 2016 in one provincial and four regional hospitals in the northern part of Thailand were retrospectively reviewed. Patients were those with acute ischemic stroke, to whom recombinant tissue plasminogen activator (rt-PA) had been prescribed. They were classif...
Source: Current Neurovascular Research - March 27, 2017 Category: Neurology Authors: Lokeskrawee T, Muengtaweepongsa S, Patumanond J, Tiamkao S, Thamangraksat T, Phankhian P, Pleumpanupatand P, Sribussara P, Kitjavijit T, Supap A, Rattanaphibool W, Prisiri J Tags: Curr Neurovasc Res Source Type: research

Natural History of Perihematomal Edema and Impact on Outcome After Intracerebral Hemorrhage Clinical Sciences
Background and Purpose—Edema may worsen outcome after intracerebral hemorrhage (ICH). We assessed its natural history, factors influencing growth, and association with outcome.Methods—We estimated edema volumes in ICH patients from the Helsinki ICH study using semiautomated planimetry. We assessed the correlation between edema extension distance (EED) and time from ICH onset, creating an edema growth trajectory model up to 3 weeks. We interpolated expected EED at 72 hours and identified clinical and imaging characteristics associated with faster edema growth. Association of EED and mortality was assessed using logistic...
Source: Stroke - March 27, 2017 Category: Neurology Authors: Teddy Y. Wu, Gagan Sharma, Daniel Strbian, Jukka Putaala, Patricia M. Desmond, Turgut Tatlisumak, Stephen M. Davis, Atte Meretoja Tags: Intracranial Hemorrhage Original Contributions Source Type: research

The efficacy and safety of high-dose statins in acute phase of ischemic stroke and transient ischemic attack: a systematic review
AbstractInconsistent findings in the studies have been observed concerning the higher dose of statins use in the acute phase of ischemic stroke and transient ischemic attack (TIA). Therefore, we performed a systematic review to assess this issue. A computerized literature search in PubMed, Cochrane Library databases, and EMBASE for randomized controlled trials (RCTs) was conducted. The efficacy outcome indicators were National Institutes of Health Stroke Scale (NIHSS) score, infarct volume, and recurrence of stroke; the safety outcome indicators were intracranial hemorrhage events, cardiovascular and cerebrovascular events...
Source: Internal and Emergency Medicine - March 15, 2017 Category: Emergency Medicine Source Type: research

Evaluation of the role of susceptibility-weighted imaging in thrombolytic therapy for acute ischemic stroke
Publication date: Available online 20 February 2017 Source:Journal of Clinical Neuroscience Author(s): Guangjian Zhao, Ling Sun, Ziran Wang, Liquan Wang, Zhongrong Cheng, Hongyan Lei, Daiqun Yang, Yansen Cui, Shirui Zhang We inspected low-intensity venous signals and microbleeds in patients with acute ischemic stroke (AIS) using susceptibility-weighted imaging (SWI) before and after administration of within-thrombolytic-time-window thrombolytic therapies, and observed their prognosis and safety, in order to guide individualized thrombolytic therapies. Patients with AIS were divided into groups A or B according to the pres...
Source: Journal of Clinical Neuroscience - February 20, 2017 Category: Neuroscience Source Type: research

Endovascular stroke treatment in a small ‐volume stroke center
DiscussionThe use of general interventional radiologists in EVT of LVO may be a possible approach for improving EVT coverage where availability of specialized neurointerventionalists is challenging. EVT for LVO stroke performed by general interventional radiologists in close cooperation with diagnostic neuroradiologists and stroke neurologists can be safe and efficacious despite the low number of annual procedures. The use of general interventional radiologists in EVT of LVO may be a possible approach for improving EVT coverage where availability of specialized neurointerventionalists is challenging. Our results show that...
Source: Brain and Behavior - January 31, 2017 Category: Neurology Authors: Gry N. Behzadi, Lars Fjetland, Rajiv Advani, Martin W. Kurz, Kathinka D. Kurz Tags: ORIGINAL RESEARCH Source Type: research

Cell therapy for cerebral hemorrhage: Five year follow-up report.
Authors: Chang Z, Mao G, Sun L, Ao Q, Gu Y, Liu Y Abstract The aim of the study was to examine treatment of cerebral hemorrhages with bone-marrow or human umbilical cord-derived mesenchymal stem cells (BMSCs or Hu-MSCs) and conventional surgical approaches, and determine and compare the effectiveness, feasibility, safety and reproducibility of each method. A retrospective analysis was performed on a cohort of cell-treated cerebral hemorrhage patients from October 1, 2007 to October 1, 2009. A total of 24 patients, all of whom received conventional surgical treatment, were classified as follows: i) The control group...
Source: Experimental and Therapeutic Medicine - January 20, 2017 Category: Journals (General) Tags: Exp Ther Med Source Type: research

Mechanical Thrombectomy Using the Trevo ProVue in 50 Consecutive Patients with Anterior Circulation Stroke: A Single-Center Experience after Approval of the Stent Retriever in Japan.
Authors: Imahori T, Tanaka K, Koyama J, Arai A, Shiomi R, Iwahashi H, Yokote A, Matsushima K, Matsui D, Kobayashi M, Fujita A, Hosoda K, Kohmura E Abstract Mechanical thrombectomy using the stent retriever has been proven to be effective for select patients with acute ischemic stroke. We evaluated our early experience using the device after its approval in 2014 in Japan, with a special emphasis on the occlusion site. Fifty consecutive endovascular revascularization procedures for treating anterior acute large vessel occlusion were performed using the Trevo ProVue as the first-line device at our institute between Ap...
Source: Neurologia Medico-Chirurgica - December 29, 2016 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Predictors of in-hospital mortality and dependence at discharge in patients with MCA stroke with intravenous thrombolysis
AbstractEarly risk stratification of mortality and dependence is important for guiding medical decision-making in stroke care. The study aim is to evaluate whether there are any differences between risk factors for in-hospital mortality and dependence at discharge in patients with first-episode ischemic stroke in the middle cerebral artery (MCA) receiving intravenous thrombolysis (IVT) treatment. The study comprised a single-center cohort of patients admitted consecutively for first-episode MCA ischemic stroke. A logistic regression analysis was performed to determine the variables associated with in-hospital mortality and...
Source: Internal and Emergency Medicine - December 26, 2016 Category: Emergency Medicine Source Type: research

Leukoaraiosis is a predictor of futile recanalization in acute ischemic stroke
AbstractFutile recanalization occurs when successful recanalization fails to improve clinical outcome in acute ischemic stroke patients. Predictors of futile recanalization are still debated and may help in selecting patients for reperfusion strategies. We aim to determine whether leukoaraiosis may be useful in predicting futile recanalization in acute ischemic stroke patients treated by endovascular mechanical thrombectomy. We included in the analysis patients with acute ischemic stroke due to anterior circulation large vessel occlusion undergoing endovascular mechanical thrombectomy obtaining complete vessel recanalizati...
Source: Journal of Neurology - December 20, 2016 Category: Neurology Source Type: research

Is There Benefit from Stenting on Cognitive Function in Intracranial Atherosclerosis
Background: Revascularization of stenotic cerebral arteries is hypothesized to improve cognition by increasing cerebral perfusion.Aims: We compared cognition impairment among patients treated with percutaneous angioplasty and stenting (PTAS) and aggressive medical management (AMM) versus AMM alone in the Stenting versus Aggressive Medical Therapy for Intracranial Arterial Stenosis (SAMMPRIS) Trial.Methods: In SAMMPRIS, 451 patients with recent transient ischemic attack or stroke attributed to 70-99% intracranial stenosis were randomized to PTAS plus AMM or AMM alone. Patients who had stroke as the qualifying event with Nat...
Source: Cerebrovascular Diseases - November 8, 2016 Category: Neurology Source Type: research

High Plasma Levels of d -Dimer Are Independently Associated with a Heightened Risk of Deep Vein Thrombosis in Patients with Intracerebral Hemorrhage
AbstractDeep venous thrombosis (DVT) is a complication of stroke. Our aim was to determine whetherd-dimer plasma levels at admission could be a risk factor for DVT in Chinese patients with acute intracerebral hemorrhage (ICH). From December 2012 to November 2014, all patients with first-ever acute ICH were included. At baseline, the demographical and clinical data were taken. These patients were assessed for DVT using color Doppler ultrasonography (CDUS) on 15  days after ICH and whenever clinically requested. Multivariate analyses were performed using logistic regression models. Receiver operating characteristic (ROC) cu...
Source: Molecular Neurobiology - September 6, 2016 Category: Neurology Source Type: research

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