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Characteristics and Outcomes of Children with Cerebral Sinus Venous Thrombosis
ConclusionsCSVT, which has a U-shaped age distribution, is an uncommon condition in children. Stroke is common in children with CSVT, and it is associated with an increased need for mechanical ventilation and increased mortality. The need for mechanical ventilation is more common in infants, and it is associated with increased mortality across all age groups.
Source: Neurocritical Care - July 12, 2023 Category: Neurology Source Type: research

Trends in post-discharge prophylactic anticoagulant use among stroke patients in the United States between 2006 and 2019
Stroke is an independent risk factor for venous thromboembolism (VTE). Although the risk of VTE persists after hospital discharge, information on the utilization of anticoagulants among stroke patients after discharge remains limited.
Source: Journal of Stroke and Cerebrovascular Diseases - August 12, 2022 Category: Neurology Authors: Ghadeer K. Dawwas, Adam Cuker, Aaron Rothstein, Sean Hennessy Source Type: research

Stroke Treatment With PAR-1 Agents to Decrease Hemorrhagic Transformation
Ischemic stroke is the most widespread cause of disability and a leading cause of death in developed countries. To date, the most potent approved treatment for acute stroke is recanalization therapy with thrombolytic drugs such as tissue plasminogen activator (rt-PA or tPA) or endovascular mechanical thrombectomy. Although tPA and thrombectomy are widely available in the United States, it is currently estimated that only 10–20% of stroke patients get tPA treatment, in part due to restrictive selection criteria. Recently, however, tPA and thrombectomy selection criteria have loosened, potentially allowing more patients to...
Source: Frontiers in Neurology - March 15, 2021 Category: Neurology Source Type: research

Tenecteplase for Acute Ischemic Stroke Treatment
Semin Neurol DOI: 10.1055/s-0040-1722722The introduction of thrombolytic therapy in the 1990s has transformed acute ischemic stroke treatment. Thus far, intravenous recombinant tissue plasminogen activator (rt-PA) also known as alteplase is the only thrombolytic proven to be efficacious and approved by the United States Food and Drug Administration. But the thrombolytic agent tenecteplase (TNK) is emerging as a potential replacement for rt-PA. TNK has greater fibrin specificity, slower clearance, and higher resistance to plasminogen activator inhibitor-1 than rt-PA. Hence, TNK has the potential to provide superior lysis wi...
Source: Seminars in Neurology - January 20, 2021 Category: Neurology Authors: Baird, Alison E. Jackson, Richard Jin, Weijun Tags: Review Article Source Type: research

Malignant Cerebral Ischemia in A COVID-19 Infected Patient: Case Review and Histopathological Findings
Severe acute respiratory syndrome coronavirus (SARS-CoV-2) is responsible for an unprecedented worldwide pandemic that has severely impacted the United States. As the pandemic continues, a growing body of evidence suggests that infected patients may develop significant coagulopathy with resultant thromboembolic complications including deep vein thrombosis, pulmonary embolism, myocardial infarction, and ischemic stroke. However, this data is limited and comes from recent small case series and observational studies on stroke types, mechanisms, and outcomes.
Source: Journal of Stroke and Cerebrovascular Diseases - August 4, 2020 Category: Neurology Authors: Smit D. Patel, Ryan Kollar, Patrick Troy, Xianyuan Song, Mohammad Khaled, Augusto Parra, Mubashir Pervez Source Type: research

Expansion of the dimensions in the current management of acute ischemic stroke
AbstractStroke is the fifth leading cause of death in the United States with a huge burden on health care. Acute ischemic stroke (AIS) accounts for 87% of all stroke. The use of thrombolytic agents in AIS treatment is well known since 1950 but no FDA approval until 1996, due to lack of strong evidence showing benefits outweigh the risk of intracranial hemorrhage. The NINDS trial led to the approval of intravenous tissue plasminogen activator treatment (IV recombinant tPA) within 3  h of stroke. Due to this limitation of 3–4.5 h. window, evolution began in the development of effective endovascular therapy (EVT). Multipl...
Source: Journal of Neurology - May 19, 2020 Category: Neurology Source Type: research

Asian Study of Cerebral Venous Thrombosis
The objective of the present study is to identify risk factors, presentation, and outcome of CVT in Asian patients. Methods: Asian CVT registry is a prospective multinational observational study that included patients (aged> 16 years) with symptomatic CVT. Results: Eight hundred and twelve patients (59% women) from 20 centers in 9 Asian countries were included.
Source: Journal of Stroke and Cerebrovascular Diseases - July 23, 2019 Category: Neurology Authors: Mohammad Wasay, Subash Kaul, Bindu Menon, Alper I. Dai, Mohammad Saadatnia, Abdul Malik, Ahmed Khalifa, Afshin Borhani-Haghigi, Manmohan Mehndiratta, Maria Khan, Nimalendu Bikash Bhowmik, Safia Awan Source Type: research

Hemodynamic Characteristics Associated With Paraclinoid Aneurysm Recurrence in Patients After Embolization
Conclusions: High peak systolic WSS, OSI and velocity around aneurysm neck areas after embolization of paraclinoidal aneurysms may be important factors leading to recurrence. Introduction Paraclinoid aneurysms are defined as aneurysms arising from the segment of the internal carotid artery (ICA) between the distal dural ring and the origin of the posterior communicating artery. They account for approximately 1.3–5% of all intracranial aneurysms and they comprise the majority of such aneurysms in females (1–3). Hemodynamic characteristics are thought to be the most important risk factors for occurrence...
Source: Frontiers in Neurology - April 24, 2019 Category: Neurology Source Type: research

A Novel Homozygous Non-sense Mutation in the Catalytic Domain of MTHFR Causes Severe 5,10-Methylenetetrahydrofolate Reductase Deficiency
Conclusion: We identified a novel non-sense mutation in MTHFR gene in a single Egyptian family with severe MTHFR deficiency. The present investigation is clinically important, as it adds to the growing list of MTHFR mutations, which might help in genetic counseling of families of affected children and proper genotype-phenotype correlation. Background Severe 5,10-Methylenetetrahydrofolate reductase (MTHFR; OMIM 236250) deficiency is a rare inborn error of metabolism and inherited in an autosomal recessive fashion. It is a very common disorder of folate metabolism and is clinically characterized with low plasma methion...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

Cryptotanshinone Attenuates Oxygen-Glucose Deprivation/ Recovery-Induced Injury in an in vitro Model of Neurovascular Unit
Conclusions Despite the above limitations, we indicate that the protective mechanism of CTs against OGD/R damage might exert via inhibiting neuron apoptosis and attenuating BBB disruption. Furthermore, we also clarified that CTs inhibited neuronal apoptosis possibly by blocking the activation of MAPK signaling pathways, and CTs alleviating BBB disruption may associated with the regulation of TJPs and MMP-9 in our experiment. Accordingly, CTs will represent a novel and potent candidate for the treatment of CIRI in the future. Ethics Statement This study was carried out in accordance with the recommendations of China�...
Source: Frontiers in Neurology - April 17, 2019 Category: Neurology Source Type: research

Asymptomatic Carotid Stenosis Is Associated With Circadian and Other Variability in Embolus Detection
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this t...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Cardiac Imaging Within Emergency CT Angiography for Acute Stroke Can Detect Atrial Clots
This study was approved by the ethics committee of the medical faculty of the Ruhr University Bochum. FIGURE 1 Figure 1. Flow chart showing the selection of the study population. Results A total of 59 patients underwent emergency CCTA (Figure 2A) for suspected stroke, of which 44 received the final diagnosis ischemic stroke. There were 17 patients who had ischemic stroke or TIA and known or newly diagnosed atrial fibrillation (Table 1; mean age: 77.5 years, standard deviation: 8.4 years; 53% female). As hypothesized, intracardiac thrombi could be visualized: once in an artificially occluded left atrial appe...
Source: Frontiers in Neurology - April 9, 2019 Category: Neurology Source Type: research

Endovascular Thrombolysis or Thrombectomy for Cerebral Venous Thrombosis: Study of Nationwide Inpatient Sample 2004-2014
In this study, we analyze Nationwide Inpatient Sample (NIS) data to evaluate the safety and efficacy of endovascular therapy (ET) versus medical management in CVT. We also examined the yearly trends of ET utilization in the United States. Methods: International Classification of Diseases, Ninth Revision, Clinical Modification codes were utilized to identify CVT patients who received ET.
Source: Journal of Stroke and Cerebrovascular Diseases - April 1, 2019 Category: Neurology Authors: Fazeel M. Siddiqui, Matthew W. Weber, Sudeepta Dandapat, Steve Scaife, Michael Buhnerkempe, Santiago Ortega-Gutierrez, Nazan Aksan, Augusto Elias, Jonathan M. Coutinho Source Type: research

Stroke in Pregnancy
Pregnancy confers a substantially increased risk of stroke in women. The period of highest risk of stroke is the peripartum/postpartum phase, coinciding with the highest risk for hypertensive disorders of pregnancy and peak gestational hypercoagulability. Hemorrhagic stroke is the most common type of obstetric stroke. Hypertensive disorders of pregnancy are important contributors to obstetric stroke and predispose women to premature cardiovascular disease. The rate of stroke associated with hypertensive disorders of pregnancy has increased in the United States. Other conditions associated with obstetric stroke include post...
Source: Neurologic Clinics - November 21, 2018 Category: Neurology Authors: Erica C. Camargo, Steven K. Feske, Aneesh B. Singhal Source Type: research

Disparities and Trends in Door-to-Needle Time Clinical Sciences
Conclusions—In the FL-PR CReSD, achievement of DTNT ≤60 and DTNT ≤45 remains low. Compared with Whites, Blacks less likely receive tPA treatment within 45 minutes during off hours. Treatment within 60 and 45 minutes is lower in women compared with men and lowest in West Central Florida compared with other Florida regions and Puerto Rico. Further research is needed to identify reasons for delayed thrombolytic treatment in women and Blacks and factors contributing to regional disparities in DTNT.
Source: Stroke - July 24, 2017 Category: Neurology Authors: Sofia A. Oluwole, Kefeng Wang, Chuanhui Dong, Maria A. Ciliberti-Vargas, Carolina M. Gutierrez, Li Yi, Jose G. Romano, Enmanuel Perez, Brittany Ann Tyson, Maranatha Ayodele, Negar Asdaghi, Hannah Gardener, David Z. Rose, Enid J. Garcia, Juan Carlos Zevall Tags: Health Services, Quality and Outcomes, Ischemic Stroke Original Contributions Source Type: research