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Blood-Based Biomarkers: A Forgotten Friend of Hyperacute Ischemic Stroke
Ischemic stroke (IS) is the second leading cause of death worldwide. Multimodal neuroimaging techniques that have significantly facilitated the diagnosis of hyperacute IS are not widely used in underdeveloped areas and community hospitals owing to drawbacks such as high cost and lack of trained operators. Moreover, these methods do not have sufficient resolution to detect changes in the brain at the cellular and molecular levels after IS onset. In contrast, blood-based biomarkers can reflect molecular and biochemical alterations in both normal and pathophysiologic processes including angiogenesis, metabolism, inflammation,...
Source: Frontiers in Neurology - June 8, 2021 Category: Neurology Source Type: research

Regulation of Blood Flow in the Cerebral Posterior Circulation by Parasympathetic Nerve Fibers: Physiological Background and Possible Clinical Implications in Patients With Vertebrobasilar Stroke
Posterior circulation involves the vertebrobasilar arteries, which supply oxygen and glucose to vital human brainstem structures and other areas. This complex circulatory- perfusion system is not homogenous throughout the day; rather, its hemodynamic changes rely on physiological demands, ensuring brainstem perfusion. This dynamic autoregulatory pattern maintains cerebral perfusion during blood pressure changes. Accumulative evidence suggests that activity within the autonomic nervous system is involved in the regulation of cerebral blood flow. Neither the sympathetic nor parasympathetic nervous systems work independently....
Source: Frontiers in Neurology - October 29, 2021 Category: Neurology Source Type: research

Association of Serum Biomarkers With Post-Thrombolytic Symptomatic Intracranial Hemorrhage in Stroke: A Comprehensive Protein Microarray Analysis From INTRECIS Study
ConclusionsOur finding indicated that baseline serum CRP, GDNF, IFN-γ, IGFBP-6, IL-4, LYVE-1, MMP-2, PAI-1, and PDGF-AA levels were associated with post-thrombolytic sICH in stroke.
Source: Frontiers in Neurology - January 31, 2022 Category: Neurology Source Type: research

MicroCT Can Characterize Clots Retrieved With Mechanical Thrombectomy From Acute Ischemic Stroke Patients –A Preliminary Report
ConclusionOur study shows that volumetric and density analysis of the clot opens new perspectives for clot characterization and for a better understanding of thrombus structure and composition.
Source: Frontiers in Neurology - March 7, 2022 Category: Neurology Source Type: research

Ischemic Stroke of Suspected Cardioembolic Origin Despite Anticoagulation: Does Thrombus Analysis Help to Clarify Etiology?
ConclusionThrombi of the suspected cardioembolic origin of patients with prior OAC do not differ in their histologic composition from those without prior OAC, but both differ from non-cardioembolic thrombi. These histologic results make a non-cardioembolic etiology for strokes despite prior OAC rather unlikely but favor other reasons for these ischemic events. Perviousness assessment reinforces the histologic findings, with additional information about the OAC thrombi, which present with higher perviousness. This suggests that OAC would not affect the relative histologic thrombus composition but may alter the microstructur...
Source: Frontiers in Neurology - March 11, 2022 Category: Neurology Source Type: research

Hyperdense Artery Sign in Patients With Acute Ischemic Stroke –Automated Detection With Artificial Intelligence-Driven Software
ConclusionAutomated detection of HAS and estimation of thrombus length on NCCT by the tested software is feasible with a sensitivity and specificity comparable to that of trained neuroradiologists.
Source: Frontiers in Neurology - April 5, 2022 Category: Neurology Source Type: research

An Optimal Animal Model of Ischemic Stroke Established by Digital Subtraction Angiography-Guided Autologous Thrombi in Cynomolgus Monkeys
ConclusionOur study may provide an optimal non-human primate model for an in-depth study of the pathogenesis and treatment of focal cerebral ischemia.
Source: Frontiers in Neurology - April 25, 2022 Category: Neurology Source Type: research

Safety and Efficacy of Tirofiban During Intravenous Thrombolysis Bridging to Mechanical Thrombectomy for Acute Ischemic Stroke Patients: A Meta-Analysis
ConclusionThe use of tirofiban during IVT bridging mechanical thrombectomy for AIS does not increase the risk of sICH and ICH in patients and reduces the risk of postoperative re-occlusion and mortality in patients within 3 months. However, this result needs to be further confirmed by additional large-sample, multicenter, prospective randomized controlled trials.Systematic Review Registrationhttp://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022297441.
Source: Frontiers in Neurology - April 29, 2022 Category: Neurology Source Type: research

Factors That Influence Susceptibility Vessel Sign in Patients With Acute Stroke Referred for Mechanical Thrombectomy
ConclusionIn the acute phase of proximal occlusion ischemic stroke, absence of SVS was associated with a shorter symptom onset–imaging time for patients with a known symptom onset time.
Source: Frontiers in Neurology - May 11, 2022 Category: Neurology Source Type: research

Factors affecting physician decision-making regarding antiplatelet therapy in minor ischemic stroke
ConclusionsMany factors affect doctors' decisions regarding antiplatelet therapy, especially guidelines, age, admission SBP level, and hypertensive disease.
Source: Frontiers in Neurology - September 1, 2022 Category: Neurology Source Type: research

Predictors of deep-vein thrombosis for acute stroke at admission to a rehabilitation unit: A retrospective study
ConclusionOlder age, lower BBS, and higher D-dimer levels at rehabilitation admission were independent risk factors for DVT. Therefore, ultrasonography should be performed for those patients with these three significant factors before implementing rehabilitation therapy.
Source: Frontiers in Neurology - March 31, 2023 Category: Neurology Source Type: research

Functional and technical outcomes in acute ischemic stroke patients with hyperdense middle cerebral artery sign treated with endovascular thrombectomy
ConclusionPatients with HMCAS treated with EVT do not have a worse outcome at 3  months compared with no-HMCAS patients. Patients with HMCAS required a greater number of thrombus passes and longer procedure times.
Source: Frontiers in Neurology - May 25, 2023 Category: Neurology Source Type: research

MRI-Based Predictors of Hemorrhagic Transformation in Patients With Stroke Treated by Intravenous Thrombolysis
Clinical and biological risk factors for hemorrhagic transformation (HT) after intravenous thrombolysis (IT) have been well established in several registries. The added value of magnetic resonance imaging (MRI) variables has been studied in small samples, and is controversial. We aimed to assess the added value of MRI variables in HT, beyond that of clinical and biological factors. We enrolled 474 consecutive patients with brain infarction treated by IT alone at our primary stroke center between January 2011 and August 2017. Baseline demographic, clinical, biological, and imaging characteristics were collected. MRI variab...
Source: Frontiers in Neurology - August 26, 2019 Category: Neurology Source Type: research

Utility of Transthoracic Echocardiography in Diagnostic Evaluation of Ischemic Stroke
Conclusion: Our findings suggest that despite widespread use, the overall yield of TTE in AIS is low. Stratifying patients according to their likelihood of benefitting from it will be important toward better resource utilization.
Source: Frontiers in Neurology - February 17, 2020 Category: Neurology Source Type: research

Transcirculation Approach for Mechanical Thrombectomy in Acute Ischemic Stroke: A Multicenter Study and Review of the Literature
Conclusions: Transcirculation approaches may be used to access the target lesion when the parent artery cannot be crossed through conventional antegrade routes. These techniques are feasible but should be reserved as a bailout maneuver when anterograde MT is not possible. Newer endovascular devices have improved neurological and angiographic outcomes in transcirculation cases.
Source: Frontiers in Neurology - May 6, 2020 Category: Neurology Source Type: research

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