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Effect of glibenclamide on the prevention of secondary brain injury following ischemic stroke in humans.
Abstract Cerebral edema and hemorrhagic conversion are common, potentially devastating complications of ischemic stroke and are associated with high rates of mortality and poor functional outcomes. Recent work exploring the molecular pathophysiology of the neurogliovascular unit in ischemic stroke suggests that deranged cellular ion homeostasis due to altered function and regulation of ion pumps, channels, and secondary active transporters plays an integral role in the development of cytotoxic and vasogenic edema and hemorrhagic conversion. Among these proteins involved in ion homeostasis, the ischemia-induced, no...
Source: Neurosurgical Focus - January 1, 2014 Category: Neurosurgery Authors: Khanna A, Walcott BP, Kahle KT, Simard JM Tags: Neurosurg Focus Source Type: research

Magnetic resonance-guided, high-intensity focused ultrasound sonolysis: potential applications for stroke.
Abstract Stroke is one of the leading causes of death worldwide and a significant source of long-term morbidity. Unfortunately, a substantial number of stroke patients either are ineligible or do not significantly benefit from contemporary medical and interventional therapies. To address this void, investigators recently made technological advances to render transcranial MR-guided, high-intensity focused ultrasound (MRg-HIFU) sonolysis a potential therapeutic option for both acute ischemic stroke (AIS)-as an alternative for patients with emergent large-vessel occlusion (ELVO) who are ineligible for endovascular me...
Source: Neurosurgical Focus - February 1, 2018 Category: Neurosurgery Authors: Ilyas A, Chen CJ, Ding D, Romeo A, Buell TJ, Wang TR, Kalani MYS, Park MS Tags: Neurosurg Focus Source Type: research

Management of acute ischemic stroke due to tandem occlusion: should endovascular recanalization of the extracranial or intracranial occlusive lesion be done first?
CONCLUSIONS Tandem occlusions present treatment challenges, but high recanalization rates were possible in the present series using acute carotid artery stenting and mechanical thrombectomy concurrently. Proximal-to-distal and aspiration approaches were most commonly used because they were safe, efficacious, and feasible. Further study in the setting of a randomized controlled trial is needed to determine the best sequence for the treatment approach and the best technology for tandem occlusion. PMID: 28366065 [PubMed - in process]
Source: Neurosurgical Focus - April 1, 2017 Category: Neurosurgery Authors: Rangel-Castilla L, Rajah GB, Shakir HJ, Shallwani H, Gandhi S, Davies JM, Snyder KV, Levy EI, Siddiqui AH Tags: Neurosurg Focus Source Type: research

Direct thrombectomy versus bridging thrombolysis with mechanical thrombectomy in middle cerebral artery stroke: a real-world analysis through National Inpatient Sample data
CONCLUSIONS: In the analysis of the NIS database, the MT+IVT group had significantly higher rates of minimal disability at the time of hospital discharge versus the MT-alone group, despite a higher rate of ICH. The question of whether to treat patients with MT+IVT rather than MT alone is currently being addressed in ongoing prospective clinical trials (SWIFT-DIRECT [NCT03494920], MR CLEAN-NO IV [ISRCTN80619088], and DIRECT-SAFE [NCT03494920]). The results of these studies will contribute to greater understanding and progressive improvement in outcomes for AIS patients.PMID:34198246 | DOI:10.3171/2021.4.FOCUS21132
Source: Neurosurgical Focus - July 1, 2021 Category: Neurosurgery Authors: Sandeep Kandregula Amey R Savardekar Pankaj Sharma Jerry McLarty Jennifer Kosty Krystle Trosclair Hugo Cuellar Bharat Guthikonda Source Type: research

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