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Condition: Hemorrhagic Stroke
Management: National Institutes of Health (NIH)

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Total 163 results found since Jan 2013.

Correlation between ambulatory function and clinical factors in hemiplegic patients with intact single lateral corticospinal tract: A pilot study
Abstract: To define the relationship between the complete destruction of 1 lateral corticospinal tract (CST), as demonstrated by diffusion tensor imaging (DTI) tractography, and ambulatory function 6 months following stroke. Twenty-six adults (17 male, 9 female) with poststroke hemiplegia who were transferred to the physical medicine and rehabilitation department. Participants underwent DTI tractography, which showed that 1 lateral CST had been clearly destroyed. Functional ambulation classification (FAC) scores at admission, discharge, and 6 months after discharge were used to evaluate the patients’ ability to walk. T...
Source: Medicine - August 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

E-057 Process Improvement in Door-to-Groin Puncture Times at a Comprehensive Stroke Center Shows a Trend Towards Reduced Mortality at 90 Days
ConclusionOur systematic process improvement initiative significantly reduced door-to-groin puncture times and showed a trend towards reduced mortality at 90 days. A multidisciplinary approach and ensuring hospital system investment are key to an effective process.DisclosuresY. Kayan: 2; C; Medtronic, Penumbra. J. Delgado Almandoz: 2; C; Medtronic, Penumbra. M. Young: None. J. Fease: None. J. Scholz: None. A. Milner: None. T. Hehr: None. M. Mulder: None. P. Roohani: None. R. Tarrel: None.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Kayan, Y., Delgado Almandoz, J., Young, M., Fease, J., Scholz, J., Milner, A., Hehr, T., Mulder, M., Roohani, P., Tarrel, R. Tags: Electronic poster abstracts Source Type: research

O-011 Symptomatic Intracranial Hemorrhage After Reperfusion Therapy - Impact of Definition on its Frequency
ConclusionUnder the trial definition, any apparent extravascular blood in the brain or cranium with an increase of 4 or more on the NIHSS, associated or not, is considered a sICH; as a result, the inclusion of hemorrhagic infarctions (HI1 and HI2) in this definition resulted in an apparent relative increase in sICH rates. Subjecting the THERAPY cohort to other definitions yielded notable variance in complication rates. As there is no current standardization for the quantification of sICH, further analysis and data are needed to identify and standardize a succinct and relevant definition.DisclosuresR. von Kummer: 2; C; Penu...
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: von Kummer, R., Frei, D., Yoo, A., Zaidat, O., Khatri, P., Gupta, R., Lopes, D., Shownkeen, H., Meyer, D., Buell, H., Bach, V., Kuo, S., Bose, A., Sit, S., Mocco, J. Tags: Oral abstracts Source Type: research

O-025 The Superiority of Thrombectomy over IV rtPA Monotherapy May be Associated with Thrombus Length - Results of the THERAPY Trial
ConclusionExtensive thrombus burden presents a challenge for stroke intervention, posing greater risk of complications and poor clinical outcome. However, this effect is dampened when IAT is the interventional modality, leading to a more favorable prognosis over IV-rtPA alone. This study finding supports the use of aspiration thrombectomy in treatment of extended thrombi, demonstrating relative advantages over thrombolytic monotherapy, and enables better clinical outcomes.DisclosuresR. von Kummer: 2; C; Penumbra, Inc. J. Mocco: 1; C; Penumbra, Inc. O. Zaidat: 6; C; Penumbra, Inc. P. Khatri: 1; C; Penumbra, Inc. R. Gupta: 6...
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: von Kummer, R., Mocco, J., Zaidat, O., Khatri, P., Gupta, R., Frei, D., Lopes, D., Shownkeen, H., Berkhemer, O., Meyer, D., Chauke, M., Hak, S., Kuo, S., Buell, H., Bose, A., Sit, S., Yoo, A. Tags: Oral abstracts Source Type: research

Chapter 66 Endovascular treatment of acute ischemic stroke
Publication date: 2016 Source:Handbook of Clinical Neurology, Volume 136 Author(s): Thabele Leslie-Mazwi, James Rabinov, Joshua A. Hirsch Endovascular thrombectomy is an effective treatment for major acute ischemic stroke syndromes caused by major anterior circulation artery occlusions (commonly referred to as large vessel occlusion) and is superior to intravenous thrombolysis and medical management. Treatment should occur as quickly as is reasonably possible. All patients with moderate to severe symptoms (National Institutes of Health stroke scale >8) and a treatable occlusion should be considered. The use of ...
Source: Handbook of Clinical Neurology - July 16, 2016 Category: Neurology Source Type: research

Prospective, open ‐label safety study of intravenous recombinant tissue plasminogen activator in wake‐up stroke
ObjectiveIt is estimated that one of four ischemic strokes are noticed upon awakening and are not candidates for intravenous recombinant tissue plasminogen activator (rtPA) because their symptoms are >3 hours from last seen normal (LSN). We tested the safety of rtPA in a multicenter, single‐arm, prospective, open‐label study (NCT01183533) in patients with wake‐up stroke (WUS). MethodsWe aimed to enroll 40 WUS patients with disabling deficits. Patients were 18 to 80 years of age, National Institutes of Health Stroke Scale (NIHSS) ≤25, and selected only on the appearance of noncontrast computed tomography (ie, ove...
Source: Annals of Neurology - July 11, 2016 Category: Neurology Authors: Andrew D. Barreto, Christopher V. Fanale, Andrei V. Alexandrov, Kevin C. Gaffney, Farhaan S. Vahidy, Claude B. Nguyen, Amrou Sarraj, Mohammad Rahbar, James C. Grotta, Sean I. Savitz, Tags: Research Article Source Type: research

Prospective, open‐label safety study of intravenous recombinant tissue plasminogen activator in wake‐up stroke
ObjectiveIt is estimated that one of four ischemic strokes are noticed upon awakening and are not candidates for intravenous recombinant tissue plasminogen activator (rtPA) because their symptoms are >3 hours from last seen normal (LSN). We tested the safety of rtPA in a multicenter, single‐arm, prospective, open‐label study (NCT01183533) in patients with wake‐up stroke (WUS). MethodsWe aimed to enroll 40 WUS patients with disabling deficits. Patients were 18 to 80 years of age, National Institutes of Health Stroke Scale (NIHSS) ≤25, and selected only on the appearance of noncontrast computed tomography (ie, ove...
Source: Annals of Neurology - July 11, 2016 Category: Neurology Authors: Andrew D. Barreto, Christopher V. Fanale, Andrei V. Alexandrov, Kevin C. Gaffney, Farhaan S. Vahidy, Claude B. Nguyen, Amrou Sarraj, Mohammad Rahbar, James C. Grotta, Sean I. Savitz, Tags: Research Article Source Type: research

Efficacy of intra-arterial therapy in the elderly requires further study
We salute Dr Ghobrial and colleagues for their important contribution regarding the endovascular management of elderly ischemic stroke patients.1 Although this topic is relatively new to the literature, it is of critical importance to the field of intra-arterial therapy (IAT), given the increasing use of catheter based stroke therapies2 and the expanding population of elderly Americans who are at the highest risk for ischemic stroke. The authors conducted an extensive, retrospective, single center study using chart review that identified elderly patients (aged >75 years) that underwent IAT between 2006 and 2012. Th...
Source: Journal of NeuroInterventional Surgery - June 11, 2016 Category: Neurosurgery Authors: Hirsch, J. A., Mehta, B. P., Chandra, R. V., Leslie-Mazwi, T. M., Rost, N. S., Yoo, A. J. Tags: PostScript Source Type: research

Risk of intracerebral haemorrhage with alteplase after acute ischaemic stroke: a secondary analysis of an individual patient data meta-analysis
Publication date: Available online 8 June 2016 Source:The Lancet Neurology Author(s): William N Whiteley, Jonathan Emberson, Kennedy R Lees, Lisa Blackwell, Gregory Albers, Erich Bluhmki, Thomas Brott, Geoff Cohen, Stephen Davis, Geoffrey Donnan, James Grotta, George Howard, Markku Kaste, Masatoshi Koga, Rüdiger von Kummer, Maarten G Lansberg, Richard I Lindley, Patrick Lyden, Jean Marc Olivot, Mark Parsons, Danilo Toni, Kazunori Toyoda, Nils Wahlgren, Joanna Wardlaw, Gregory J del Zoppo, Peter Sandercock, Werner Hacke, Colin Baigent Background Randomised trials have shown that alteplase impr...
Source: The Lancet Neurology - June 8, 2016 Category: Neurology Source Type: research

International benchmarking for acute thrombolytic therapy implementation in Australia and Japan
Publication date: July 2016 Source:Journal of Clinical Neuroscience, Volume 29 Author(s): Hiroyuki Kawano, Christopher Levi, Yuichiro Inatomi, Heather Pagram, Erin Kerr, Andrew Bivard, Neil Spratt, Ferdinand Miteff, Toshiro Yonehara, Yukio Ando, Mark Parsons Although a wide range of strategies have been established to improve intravenous tissue plasminogen activator (IV-tPA) treatment rates, international benchmarking has not been regularly used as a systems improvement tool. We compared acute stroke codes (ASC) between two hospitals in Australia and Japan to study the activation process and potentially improv...
Source: Journal of Clinical Neuroscience - May 29, 2016 Category: Neuroscience Source Type: research

Emergency endovascular revascularization of tandem occlusions: Internal carotid artery dissection and intracranial large artery embolism
We present our recent experience in the endovascular management of occlusive ICAD and major intracranial occlusion. Consecutive anterior circulation acute stroke patients meeting Medical Center criteria for endovascular management of ICAD from June 2011 to June 2015 were included. Clinical, imaging, and procedure data were collected retrospectively under Institutional Review Board approval. The endovascular procedure for carotid artery revascularization and intracranial stent thrombectomy is described. Six patients met inclusion criteria (National Institutes of Health Stroke Scale score 12–24, time from symptom onset 2...
Source: Journal of Clinical Neuroscience - April 29, 2016 Category: Neuroscience Source Type: research

Treatment of patients with mild acute ischemic stroke and associated large vessel occlusion
Publication date: Available online 3 April 2016 Source:Journal of Clinical Neuroscience Author(s): Russell Cerejo, Esteban Cheng-Ching, Ferdinand Hui, M. Shazam Hussain, Ken Uchino, Jennifer Bullen, Gabor Toth Several recent studies have shown that patients presenting with mild acute ischemic stroke (mAIS) symptoms may have an unfavorable natural history. The presence of associated large vessel occlusion (LVO) may lead to even worse outcomes, but most mAIS patients are still excluded from acute stroke treatment (AST). A retrospective review of patients with acute ischemic stroke presenting to our institution betwe...
Source: Journal of Clinical Neuroscience - April 3, 2016 Category: Neuroscience Source Type: research

The Penumbra System for the Treatment of Acute Ischemic Stroke: Report of Two Cases.
We report two patients with acute ischemic stroke in whom the mechanical device Penumbra System was used for thrombolysis and embolectomy. The Penumbra System provided the revascularization of the primary occlusion site in the two patients and complete revascularization was obtained. Improvement was observed in both cases on the National Institutes of Health Stroke Scale and on modified Rankin scale scores at 1 and 30 days post-procedure. Neither of the patients had intracranial hemorrhage. The Penumbra System is a valuable device as a treatment for acute ischemic stroke secondary to large vessel occlusion. PMID: 2695...
Source: Turkish Neurosurgery - March 10, 2016 Category: Neurosurgery Authors: Zhang X, Gao JW, Jabbour P Tags: Turk Neurosurg Source Type: research

Factors Associated with Thrombolysis Outcome in Ischemic Stroke Patients with Atrial Fibrillation
In this study, we investigated factors that influence the effect of intravenous thrombolysis in these patients. Our results showed that thrombolysis was independently associated with a favorable outcome (P < 0.001) and did not influence the mortality of AF-related ischemic stroke, although it increased the risk of hemorrhage within 24 h after treatment. Risk factors for a poor outcome at admission were: heart failure (P = 0.045); high systolic pressure (P = 0.039); high blood glucose (P = 0.030); and a high National Institutes of Health Stroke Scale (NIHSS) score (P < 0.001). Moreover, high systolic pressur...
Source: Neuroscience Bulletin - March 7, 2016 Category: Neuroscience Source Type: research

Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials
Publication date: Available online 18 February 2016 Source:The Lancet Author(s): Mayank Goyal, Bijoy K Menon, Wim H van Zwam, Diederik W J Dippel, Peter J Mitchell, Andrew M Demchuk, Antoni Dávalos, Charles B L M Majoie, Aad van der Lugt, Maria A de Miquel, Geoffrey A Donnan, Yvo B W E M Roos, Alain Bonafe, Reza Jahan, Hans-Christoph Diener, Lucie A van den Berg, Elad I Levy, Olvert A Berkhemer, Vitor M Pereira, Jeremy Rempel, Mònica Millán, Stephen M Davis, Daniel Roy, John Thornton, Luis San Román, Marc Ribó, Debbie Beumer, Bruce Stouch, Scott Brown, Bruce C V Campbell, Robert J van ...
Source: The Lancet - February 19, 2016 Category: Journals (General) Source Type: research