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Neuroprotection in Acute Ischemic Stroke: A Battle Against the Biology of Nature
Stroke is the second most common cause of global death following coronary artery disease. Time is crucial in managing stroke to reduce the rapidly progressing insult of the ischemic penumbra and the serious neurologic deficits that might follow it. Strokes are mainly either hemorrhagic or ischemic, with ischemic being the most common of all types of strokes. Thrombolytic therapy with recombinant tissue plasminogen activator and endovascular thrombectomy are the main types of management of acute ischemic stroke (AIS). In addition, there is a vital need for neuroprotection in the setting of AIS. Neuroprotective agents are im...
Source: Frontiers in Neurology - May 31, 2022 Category: Neurology Source Type: research

Unusual Histopathological Findings in Mechanically Removed Stroke Thrombi – A Multicenter Experience
ConclusionIn our retrospective multicenter study, we characterized stroke thrombi histopathologically and found subgroups of thrombi defined by presence of rarely seen components. These defined subgroups showed relation to underlying cardiovascular disease, patient characteristics, and mechanical thrombectomy technique. Knowledge about these components may increase our understanding of stroke pathophysiology and influence interventional procedures.
Source: Frontiers in Neurology - May 17, 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

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

Current Challenges and Future Directions in Handling Stroke Patients With Patent Foramen Ovale —A Brief Review
The role of patent foramen ovale (PFO) in stroke was debated for decades. Randomized clinical trials (RCTs) have shown fewer recurrent events after PFO closure in patients with cryptogenic stroke (CS). However, in clinical practice, treating stroke patients with coexisting PFO raises some questions. This brief review summarizes current knowledge and challenges in handling stroke patients with PFO and identifies issues for future research. The rationale for PFO closure was initially based on the concept of paradoxical embolism from deep vein thrombosis (DVT). However, RCTs did not consider such details, limiting their impac...
Source: Frontiers in Neurology - April 28, 2022 Category: Neurology Source Type: research

The Value of Contrast-Enhanced Ultrasound in the Evaluation of Carotid Web
ConclusionsCEUS may have a higher diagnostic accuracy for CaW with thrombosis, and it has a higher clinical application prospect.
Source: Frontiers in Neurology - April 27, 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

Potential Biomarkers of Acute Ischemic Stroke Etiology Revealed by Mass Spectrometry-Based Proteomic Characterization of Formalin-Fixed Paraffin-Embedded Blood Clots
ConclusionOur results outlined a set of 14 proteins for a proof-of-principle characterization of cardioembolic and LAA FFPE clots, advancing the proteome profile of AIS human thrombi and understanding the pathophysiology of ischemic stroke.
Source: Frontiers in Neurology - April 19, 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

Predictive Factors for Early-Onset Seizures in Patients With Cerebral Venous Sinus Thrombosis
Seizures are reported to be important factors contributing to poor prognosis in patients with cerebral venous sinus thrombosis (CVST). However, the predictive factors for concurrent early onset seizures in patients with CVST remain unclear. To identify the predictive factors of early seizures in patients with CVST, this study retrospectively evaluated the clinical data of patients diagnosed with CVST at two centers from January 2011 to December 2020 and analyzed the relationship between admission characteristics and early onset seizures. A total of 112 CVST patients (63 men and 49 women; mean age 39.82 ± 15.70 years) were...
Source: Frontiers in Neurology - March 29, 2022 Category: Neurology Source Type: research

Predictive Value of the Systemic Immune Inflammation Index for Adverse Outcomes in Patients With Acute Ischemic Stroke
ConclusionThe systemic immune-inflammation index is associated with short-term adverse outcomes in patients with acute ischemic stroke, and the nomograms can predict the risk of adverse outcomes in patients with acute ischemic stroke.
Source: Frontiers in Neurology - March 18, 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

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

J147 Reduces tPA-Induced Brain Hemorrhage in Acute Experimental Stroke in Rats
ConclusionOur results demonstrate that J147 treatment alone exerts cerebral cytoprotective effects in a suture model of acute ischemic stroke, while in an embolic stroke model co-administration of J147 with tPA reduces delayed tPA-induced intracerebral hemorrhage and confers cerebroprotection. These findings suggest that J147-tPA combination therapy could be a promising approach to improving the treatment of ischemic stroke.
Source: Frontiers in Neurology - March 2, 2022 Category: Neurology Source Type: research

Clot Meniscus Sign Is Associated With Thrombus Permeability and Choice of Mechanical Thrombectomy Technique in Acute Middle Cerebral Artery Occlusion
ConclusionPatients with MCAO with positive meniscus sign have higher thrombus permeability and are more suitable for CA to acquire better clinical outcomes.
Source: Frontiers in Neurology - February 24, 2022 Category: Neurology Source Type: research

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