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Advances in stroke medicine.
Authors: Campbell BC Abstract In recent years, reperfusion therapies such as intravenous thrombolysis and endovascular thrombectomy for ischaemic stroke have dramatically reduced disability and revolutionised stroke management. Thrombolysis with alteplase is effective when administered to patients with potentially disabling stroke, who are not at high risk of bleeding, within 4.5 hours of the time the patient was last known to be well. Emerging evidence suggests that other thrombolytics such as tenecteplase may be even more effective. Treatment may be possible beyond 4.5 hours in patients selected using brain imagi...
Source: Medical Journal of Australia - May 6, 2019 Category: General Medicine Tags: Med J Aust Source Type: research

Development of a machine learning-based real-time location system to streamline acute endovascular intervention in acute stroke: a proof-of-concept study
Conclusions ML-based RTLS technology using WiFi fingerprinting has the potential to streamline delivery of acute stroke endovascular intervention by efficiently tracking patient and staff movement during stroke calls.
Source: Journal of NeuroInterventional Surgery - July 14, 2022 Category: Neurosurgery Authors: Lim, D. Z., Yeo, M., Dahan, A., Tahayori, B., Kok, H. K., Abbasi-Rad, M., Maingard, J., Kutaiba, N., Russell, J., Thijs, V., Jhamb, A., Chandra, R. V., Brooks, M., Barras, C., Asadi, H. Tags: Vascular neurology Source Type: research

Carotid endarterectomy: the change in practice over 11  years in a stroke centre
ConclusionThe trends in CEA practice at our centre align with international trends and guidelines. This study provides a representative indicator of Australian hospital practice, and illustrates how evidence from research is translated into clinical care.
Source: ANZ Journal of Surgery - November 13, 2017 Category: Surgery Authors: Gabrielle T. W. Tse, Monique F. Kilkenny, Chris Bladin, Michael Grigg, Helen M. Dewey Tags: Original Article Source Type: research

Stenosis Length and Degree Interact With the Risk of Cerebrovascular Events Related to Internal Carotid Artery Stenosis
Conclusion: We found a statistically insignificant tendency for the ultrasound-measured length of sICAS<70% to be longer than that of sICAS≥70%. Moreover, the ultrasound-measured length of sICAS<90% was significantly longer than that of sICAS 90%. Among patients with sICAS≥70%, the degree and length of stenosis were inversely correlated. Larger studies are needed before a clinical implication can be drawn from these results. Introduction Internal carotid artery stenosis (ICAS) causes around one-fifth of ischemic cerebrovascular stroke and has the highest risk of early stroke recurrence...
Source: Frontiers in Neurology - April 8, 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

Angiographical Identification of Intracranial, Atherosclerosis-Related, Large Vessel Occlusion in Endovascular Treatment
Conclusions Among only a few identification methods, the ICAS-LVO can be feasibly identified by angiographical findings. The identification of ICAS-LVO based on based on occlusion type, is a reliable and practical identification method for ICAS-LVO. Procedural details by occlusion type and its predictability to endovascular results were reported. Furthermore, occlusion type can be determined before or in the early stages of the procedure, which may be most helpful in setting up an optimal endovascular treatment strategy. Author Contributions J-HB established the study idea, designed the manuscript structure, acquired an...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Correlation Between Intracranial Arterial Calcification and Imaging of Cerebral Small Vessel Disease
Conclusion: Intracranial artery calcification is common in patients with ischemic cerebrovascular disease and the intracranial carotid artery is most frequently affected. Intracranial arterial calcifications might be associated with imaging markers of SVD and are highly correlated with WMHs, lacunes, and CMBs. Quantification of calcification on CT provides additional information on the pathophysiology of SVD. Intracranial arterial calcification could act as a potential marker of SVD. Introduction Atherosclerosis is a systemic vascular process that is considered a major cause of cerebrovascular and cardiovascular di...
Source: Frontiers in Neurology - April 30, 2019 Category: Neurology Source Type: research

Neurological Involvement in Primary Systemic Vasculitis
Conclusion Neurological involvement is a common complication of PSV (Table 1), and neurologists play an important role in the identification and diagnosis of PSV patients with otherwise unexplained neurological symptoms as their chief complaint. This article summarizes the neurological manifestations of PSV and hopes to improve neuroscientists' understanding of this broad range of diseases. TABLE 1 Table 1. Common CNS and PNS involvements of primary systemic vasculitis. Author Contributions SZ conceived the article and wrote the manuscript. DY and GT reviewed and edited the manuscript. All authors ...
Source: Frontiers in Neurology - April 25, 2019 Category: Neurology Source Type: research

Does the Addition of Non-Approved Inclusion and Exclusion Criteria for rtPA Impact Treatment Rates? Findings in Australia, the UK, and the USA
Conclusions: Non-standard criteria for rtPA eligibility were evident in all three countries and could, in part, explain comparably low use of rtPA. Differences in the use of standard criteria may signify practitioner intolerance for those derived from original efficacy studies that are no longer relevant.Intervent Neurol 2019;8:1 –12
Source: Interventional Neurology - October 5, 2018 Category: Neurology Source Type: research

Clinical features, sex differences and outcomes of myocardial infarction with nonobstructive coronary arteries: a registry analysis
Conclusion The incidence of MINOCA was 9.5%. Compared to OACD-MI, patients with MINOCA have less cardiac risk factors. In-hospital outcomes of patients diagnosed with MINOCA were better than OACD-MI.
Source: Coronary Artery Disease - December 23, 2020 Category: Cardiology Tags: Acute Coronary Syndromes Source Type: research

Differences in management and outcomes for men and women with ST-elevation myocardial infarction.
CONCLUSION: Women with STEMI are less likely to receive invasive management, revascularisation, or preventive medication at discharge. The reasons for these persistent differences in care require investigation. PMID: 30025513 [PubMed - as supplied by publisher]
Source: Medical Journal of Australia - July 22, 2018 Category: General Medicine Tags: Med J Aust Source Type: research

Factors that influence whether patients with acute coronary syndromes undergo cardiac catheterisation
CONCLUSIONS: Although a larger proportion of patients who presented to catheterisation-capable hospitals underwent catheterisation, patients with similar characteristics were selected for the procedure, independent of the hospital of presentation. Major outcomes for patients were also similar, suggesting equitable management of patients with ACS across Australia.PMID:33792058 | DOI:10.5694/mja2.50997
Source: Medical Journal of Australia - April 1, 2021 Category: General Medicine Authors: Michael Ayad Karice Hyun Mario D'Souza Julie Redfern Janice Gullick Mark Ryan David B Brieger Source Type: research

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