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Canadian Stroke Best Practice Recommendations: Hyperacute Stroke Care Guidelines, Update 2015
The 2015 update of the Canadian Stroke Best Practice Recommendations Hyperacute Stroke Care guideline highlights key elements involved in the initial assessment, stabilization, and treatment of patients with transient ischemic attack (TIA), ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and acute venous sinus thrombosis. The most notable change in this 5th edition is the addition of new recommendations for the use of endovascular therapy for patients with acute ischemic stroke and proximal intracranial arterial occlusion. This includes an overview of the infrastructure and resources required ...
Source: International Journal of Stroke - July 6, 2015 Category: Neurology Authors: Leanne K. Casaubon, Jean‐Martin Boulanger, Dylan Blacquiere, Scott Boucher, Kyla Brown, Tom Goddard, Jacqueline Gordon, Myles Horton, Jeffrey Lalonde, Christian LaRivière, Pascale Lavoie, Paul Leslie, Jeanne McNeill, Bijoy K. Menon, Brian Moses, Melani Tags: Guidelines Source Type: research

Oral direct thrombin inhibitor as an alternative in the management of cerebral venous thrombosis: a series of 15 patients
ConclusionsWe report the largest series of cerebral vein thrombosis patients treated with dabigatran. Clinical outcome was excellent in most patients and not different from other studies. Dabigatran could possibly be considered an alternative to warfarin; nevertheless, further prospective assessment with randomized controlled studies is warranted.
Source: International Journal of Stroke - February 1, 2015 Category: Neurology Authors: Marcelo D. Mendonça, Raquel Barbosa, Vera Cruz‐e‐Silva, Sofia Calado, Miguel Viana‐Baptista Tags: Research 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

Should minor stroke patients be thrombolyzed? A focused review and future directions
Stroke is a leading cause of morbidity and mortality worldwide. Up to 80% of ischemic stroke patients may initially present with minor symptoms. Minor stroke and transient ischemic attack patients are typically treated conservatively with antiplatelet agents and general vascular prevention strategies. Yet a high proportion develop recurrent stroke or progression of stroke and up to one in four of these patients are disabled or dead at follow‐up. Minor or rapidly improving symptoms are the top reasons for withholding thrombolytic therapy to time‐eligible stroke patients as they are believed to be ‘too good to treat’...
Source: International Journal of Stroke - December 25, 2014 Category: Neurology Authors: Amy Y. X. Yu, Michael D. Hill, Shelagh B. Coutts Tags: Review (invited) 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

Evaluation of plasma d‐dimer plus fibrinogen in predicting acute CVST
Conclusionsd‐dimer may serve as an important screening tool to determine the urgency of obtaining magnetic resonance imaging/magnetic resonance venography or digital subtraction angiography in patients presenting with clinical symptoms that are suspected of cerebral venous sinus thrombosis. Furthermore, d‐dimer in combination with fibrinogen may increase the predictive value of acute cerebral venous sinus thrombosis.
Source: International Journal of Stroke - March 19, 2013 Category: Neurology Authors: Ran Meng, Xiaoying Wang, Mohammed Hussain, David Dornbos, Lu Meng, Yu Liu, Yan Wu, Mingming Ning, Buonanno Ferdinando S, Eng H. Lo, Yuchuan Ding, Xunming Ji Tags: Research Source Type: research