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Low Levels of Caveolin-1 Predict Symptomatic Bleeding After Thrombolytic Therapy in Patients With Acute Ischemic Stroke Brief Report
Background and Purpose—Experimental models of cerebral ischemia demonstrate that the decrease in the caveolin-1 membrane protein results in an increase in endothelial permeability. Because this phenomenon is responsible for hemorrhagic transformation (HT) after cerebral ischemia, we aimed to determine whether caveolin-1 levels may predict bleeding after recombinant tissue-type plasminogen activator (r-tPA) administration in patients with acute stroke.Methods—We studied 133 patients with a first hemispheric stroke treated with r-tPA within 4.5 hours of symptom onset. HT was evaluated and classified on cranial computed t...
Source: Stroke - May 25, 2018 Category: Neurology Authors: Mar Castellanos, Cecile van Eendenburg, Carme Gubern, Elisabet Kadar, Gemma Huguet, Josep Puig, Tomas Sobrino, Gerard Blasco, Joaquin Serena, Juan Manuel Sanchez Tags: Biomarkers, Endothelium/Vascular Type/Nitric Oxide, Blood-Brain Barrier, Ischemic Stroke Brief Reports Source Type: research

Predictors of Thrombolysis Administration in Mild Stroke Clinical Sciences
Conclusions—Mild acutely presenting stroke patients are more likely to receive thrombolysis if they are young, white, or Hispanic and arrive early to the hospital with more severe neurological presentation. Identification of predictors of thrombolysis is important in design of future studies to assess the use of thrombolysis for mild stroke.
Source: Stroke - February 26, 2018 Category: Neurology Authors: Negar Asdaghi, Kefeng Wang, Maria A. Ciliberti-Vargas, Carolina Marinovic Gutierrez, Sebastian Koch, Hannah Gardener, Chuanhui Dong, David Z. Rose, Enid J. Garcia, W. Scott Burgin, Juan Carlos Zevallos, Tatjana Rundek, Ralph L. Sacco, Jose G. Romano Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke, Transient Ischemic Attack (TIA) Original Contributions Source Type: research

Associations Between Collateral Status and Thrombus Characteristics and Their Impact in Anterior Circulation Stroke Clinical Sciences
Conclusions—Patients with lower thrombus burden and higher thrombus perviousness scores had higher collateral score. The positive effect of thrombus perviousness on clinical outcome was only present in patients with moderate and high collateral scores.Clinical Trial Registration—URL: http://www.trialregister.nl. Unique identifier: NTR1804 and URL: http://www.controlled-trials.com Unique identifier: ISRCTN10888758.
Source: Stroke - January 22, 2018 Category: Neurology Authors: Heitor C. Alves, Kilian M. Treurniet, Bruna G. Dutra, Ivo G. H. Jansen, Anna M.M. Boers, Emilie M.M. Santos, Olvert A. Berkhemer, Diederik W.J. Dippel, Aad van der Lugt, Wim H. van Zwam, Robert J. van Oostenbrugge, Hester F. Lingsma, Yvo B.W.E.M. Roos, Al Tags: Computerized Tomography (CT), Ischemic Stroke Original Contributions Source Type: research

Permeable Thrombi Are Associated With Higher Intravenous Recombinant Tissue-Type Plasminogen Activator Treatment Success in Patients With Acute Ischemic Stroke Clinical Sciences
Conclusions— Thrombus perviousness, as measured on computed tomography in the acute stage of ischemic stroke, is strongly associated with recanalization after intravenous r-tPA treatment and with favorable functional outcome.
Source: Stroke - July 24, 2016 Category: Neurology Authors: Santos, E. M. M., Dankbaar, J. W., Treurniet, K. M., Horsch, A. D., Roos, Y. B., Kappelle, L. J., Niessen, W. J., Majoie, C. B., Velthuis, B., Marquering, H. A., on behalf of the DUST Investigators, Duijm, Keizer, van der Lugt, Dippel, Droogh - de Greeve, Tags: Computerized Tomography (CT), Prognosis, Revascularization, Treatment, Ischemic Stroke Clinical Sciences Source Type: research

Thrombus Permeability Is Associated With Improved Functional Outcome and Recanalization in Patients With Ischemic Stroke Clinical Sciences
Conclusions— This study shows that simultaneous measurement of thrombus attenuation in noncontrast computed tomography and computed tomographic angiography allows for quantification of thrombus perviousness. Thrombus perviousness is strongly associated with improved functional outcome, smaller final infarct volume, and higher recanalization rate.
Source: Stroke - February 22, 2016 Category: Neurology Authors: Santos, E. M. M., Marquering, H. A., den Blanken, M. D., Berkhemer, O. A., Boers, A. M. M., Yoo, A. J., Beenen, L. F., Treurniet, K. M., Wismans, C., van Noort, K., Lingsma, H. F., Dippel, D. W. J., van der Lugt, A., van Zwam, W. H., Roos, Y. B. W. E. M., Tags: Angiography, Computerized Tomography (CT), Quality and Outcomes, Ischemic Stroke, Thrombosis Clinical Sciences Source Type: research

White Matter Lesions Double the Risk of Post-Thrombolytic Intracerebral Hemorrhage Clinical Sciences
Conclusions— WMLs visible on computed tomography are associated with a more than doubled risk of sICH in patients treated with intravenous thrombolysis for acute ischemic stroke.
Source: Stroke - July 27, 2015 Category: Neurology Authors: Curtze, S., Haapaniemi, E., Melkas, S., Mustanoja, S., Putaala, J., Sairanen, T., Sibolt, G., Tiainen, M., Tatlisumak, T., Strbian, D. Tags: Computerized tomography and Magnetic Resonance Imaging, Thrombolysis Clinical Sciences Source Type: research

Time-Dependent Thrombus Resolution After Tissue-Type Plasminogen Activator in Patients With Stroke and Mice Clinical Sciences
Conclusions— Early administration of tPA after stroke onset is associated with better thrombus resolution.
Source: Stroke - June 22, 2015 Category: Neurology Authors: Kim, Y. D., Nam, H. S., Kim, S. H., Kim, E. Y., Song, D., Kwon, I., Yang, S.-H., Lee, K., Yoo, J., Lee, H. S., Heo, J. H. Tags: Arterial thrombosis, Acute Cerebral Infarction, Thrombolysis Clinical Sciences Source Type: research

Role of Imaging in Current Acute Ischemic Stroke Workflow for Endovascular Therapy Understanding and Applying the Endovascular Trials
Ischemic stroke is caused by a thrombus that blocks an intracranial artery. Brain tissue beyond the blocked artery survives for a variable period of time because of blood and nutrients received through tiny vessels called collaterals. Imaging the brain and the vasculature that supplies it is therefore a vital first step in treating patients with acute ischemic stroke. In this review, we focus on current evidence for imaging selection of patients for endovascular therapy in the context of the recently positive clinical trials, such as Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke ...
Source: Stroke - May 22, 2015 Category: Neurology Authors: Menon, B. K., Campbell, B. C. V., Levi, C., Goyal, M. Tags: CT and MRI, Emergency treatment of Stroke Understanding and Applying the Endovascular Trials Source Type: research

Occult Anterograde Flow Is an Under-Recognized but Crucial Predictor of Early Recanalization With Intravenous Tissue-Type Plasminogen Activator Clinical Sciences
Conclusions— Occult anterograde flow through thrombus can be assessed by perfusion computed tomography T0 maps and predicts early recanalization with intravenous tissue-type plasminogen activator robustly.
Source: Stroke - March 23, 2015 Category: Neurology Authors: Ahn, S. H., d'Esterre, C. D., Qazi, E. M., Najm, M., Rubiera, M., Fainardi, E., Hill, M. D., Goyal, M., Demchuk, A. M., Lee, T. Y., Menon, B. K. Tags: Fibrinolysis, Computerized tomography and Magnetic Resonance Imaging, Thrombolysis Clinical Sciences Source Type: research

Sensitivity and Specificity of the Hyperdense Artery Sign for Arterial Obstruction in Acute Ischemic Stroke Clinical Sciences
Conclusions— When present in acute ischemic stroke, HAS indicates a high likelihood of arterial obstruction, but its absence indicates only a 50/50 chance of normal arterial patency. Thin-slice CT improves sensitivity of HAS detection. Clinical Trial Registration— URL: http://www.controlled-trials.com/ISRCTN25765518. Unique identifier: ISRCTN25765518.
Source: Stroke - December 22, 2014 Category: Neurology Authors: Mair, G., Boyd, E. V., Chappell, F. M., von Kummer, R., Lindley, R. I., Sandercock, P., Wardlaw, J. M., IST-3 Collaborative Group Tags: Arterial thrombosis, Acute Cerebral Infarction, Angiography Clinical Sciences Source Type: research

Initial Body Temperature in Ischemic Stroke: Nonpotentiation of Tissue-Type Plasminogen Activator Benefit and Inverse Association With Severity Clinical Sciences
Conclusions— In patients with hyperacute stroke, higher presenting temperatures are associated with less severe neurological deficits and reduced final infarct volumes. Presenting temperature does not modify the benefit of tPA on 3-month favorable outcome.
Source: Stroke - December 22, 2014 Category: Neurology Authors: Kim, S. H., Saver, J. L. Tags: Thrombolysis Clinical Sciences Source Type: research

Isolated Cortical Vein Thrombosis: Systematic Review of Case Reports and Case Series Brief Reports
Conclusions— Signs of increased intracranial pressure seem to be less common in isolated cortical vein thrombosis compared with cerebral venous and sinus thrombosis. MRI and in some cases conventional angiography are the most frequently used diagnostic modalities and anticoagulation is the most widely used therapy.
Source: Stroke - May 27, 2014 Category: Neurology Authors: Coutinho, J. M., Gerritsma, J. J., Zuurbier, S. M., Stam, J. Tags: Cerebral Venous Thrombosis Brief Reports Source Type: research

Association Between Arterial Calcifications and Nonlacunar and Lacunar Ischemic Strokes Clinical Sciences
Conclusions— The only difference we found between nonlacunar and lacunar strokes was a higher calcification volume in the aortic arch in nonlacunar strokes. Our findings only partially confirm the notion of distinct etiologies and suggest that the potential role of other plaque components, plaque morphology, and aortic arch calcifications in ischemic stroke subtypes awaits further evaluation.
Source: Stroke - February 24, 2014 Category: Neurology Authors: van Dijk, A. C., Fonville, S., Zadi, T., van Hattem, A. M. G., Saiedie, G., Koudstaal, P. J., van der Lugt, A. Tags: Pathophysiology, Acute Stroke Syndromes Clinical Sciences Source Type: research

Clot Length Distribution and Predictors in Anterior Circulation Stroke: Implications for Intra-Arterial Therapy Brief Reports
Conclusions— The majority of anterior circulation proximal occlusions are ≥8 mm long, helping to explain the low published rates of intravenous tissue-type plasminogen activator recanalization. Internal carotid artery-terminus occlusion is an excellent marker for clot length ≥8 mm; vessel-imaging status alone may be sufficient. Thin-section noncontrast computed tomography seems useful for patients with middle cerebral artery occlusion because of the wide variability of clot lengths.
Source: Stroke - November 25, 2013 Category: Neurology Authors: Kamalian, S., Morais, L. T., Pomerantz, S. R., Aceves, M., Sit, S. P., Bose, A., Hirsch, J. A., Lev, M. H., Yoo, A. J. Tags: Acute Cerebral Infarction, Computerized tomography and Magnetic Resonance Imaging, Thrombolysis, Other Stroke Treatment - Surgical Brief Reports Source Type: research

Good Outcome Rate of 35% in IV-tPA-Treated Patients With Computed Tomography Angiography Confirmed Severe Anterior Circulation Occlusive Stroke Clinical Sciences
Conclusions— IV-tPA treatment resulted in significantly better outcomes in patients with severely symptomatic stroke with major anterior circulation occlusions. The 35% good outcome rate was similar to rates found in endovascular therapy trials. Vascular imaging may help in patient selection and stratification for trials of IV-thrombolytic and endovascular therapies.
Source: Stroke - October 21, 2013 Category: Neurology Authors: Gonzalez, R. G., Furie, K. L., Goldmacher, G. V., Smith, W. S., Kamalian, S., Payabvash, S., Harris, G. J., Halpern, E. F., Koroshetz, W. J., Camargo, E. C. S., Dillon, W. P., Lev, M. H. Tags: CT and MRI, Acute Cerebral Infarction, Computerized tomography and Magnetic Resonance Imaging, Thrombolysis, Other Stroke Treatment - Surgical Clinical Sciences Source Type: research

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