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Intracranial hemorrhage in large vessel occlusion patients receiving endovascular thrombectomy with or without intravenous alteplase: a secondary analysis of the DIRECT-MT trial
Conclusions Our data showed that in the DIRECT-MT trial, alteplase did not increase overall ICH for large vessel occlusion patients treated with thrombectomy, but it increased the parenchymal hematoma rate.
Source: Journal of NeuroInterventional Surgery - September 15, 2023 Category: Neurosurgery Authors: Hu, X., Zhou, Y., Ospel, J., Yao, F., Liu, Y., Wang, H., Li, B., Hui, P., Yang, P., Zhang, Y., Zhang, L., Li, Z., Xing, P., Shi, H., Han, H., Wang, S., Fang, Q., Liu, J., for the Direct-MT investigators Tags: Open access, Ischemic stroke Source Type: research

Grace Under Pressure: Resiliency of Quality Monitoring of Stroke Care During the Covid-19 Pandemic in Mexico City
Stroke is one of the leading causes of death and disability among adults worldwide. The World Health Organization (WHO) officially declared a COVID-19 pandemic on March 11, 2020. The first case in Mexico was confirmed in February 2020, subsequently becoming one of the countries most affected by the pandemic. In 2020, The National Institute of Neurology of Mexico started a Quality assurance program for stroke care, consisting of registering, monitoring and feedback of stroke quality measures through the RES-Q platform. We aim to describe changes in the demand for stroke healthcare assistance at the National Institute of Neu...
Source: Frontiers in Neurology - April 6, 2022 Category: Neurology Source Type: research

Emerging agents for the treatment and prevention of stroke: progress in clinical trials
Expert Opin Investig Drugs. 2021 Sep 24. doi: 10.1080/13543784.2021.1985463. Online ahead of print.ABSTRACTINTRODUCTION: Recent years have witnessed unprecedented progress in stroke care, but unmet needs persist regarding the efficacy of acute treatment and secondary prevention. Novel approaches are being tested to enhance the efficacy of thrombolysis or provide neuroprotection in non-thrombolized patients.AREAS COVERED: The current review highlights pharmaceutical agents under evaluation in clinical trials concerning the acute, subacute, and chronic phase post-stroke. We examine the evidence in favor of tenecteplase as an...
Source: Expert Opinion on Investigational Drugs - September 24, 2021 Category: Drugs & Pharmacology Authors: Apostolos Safouris Georgios Magoufis Georgios Tsivgoulis Source Type: research

Disparities between Asian and Non-Asian Thrombolyzed Acute Ischemic Stroke Patients in the Enhanced Control of Hypertension and Thrombolysis Stroke Trial
Conclusions: Within the context of an international clinical trial of thrombolyzed AIS patients, demography, risk factors, management, and odds of early neurological deterioration and ICH, all differ between Asian and non-Asian participants. However, patterns of functional recovery are similar between these major regional groups.Cerebrovasc Dis
Source: Cerebrovascular Diseases - June 21, 2021 Category: Neurology Source Type: research

Influence of Sex on Stroke Prognosis: A Demographic, Clinical, and Molecular Analysis
Conclusion Our data suggest that women who suffer from IS present with a poorer functional outcome than men at 3-months, regardless of other preclinical and clinical factors during the acute phase. These relationships seem to be mediated by atrial dysfunction and inflammation. The inflammatory response is slightly higher in women; however, there are no sex differences in their functional behavior. There is a probable relationship between the molecular marker of atrial dysfunction NT-proBNP and worse functional outcome in women, and the connection seems to be more important in cardioembolic stroke patients. In patients wi...
Source: Frontiers in Neurology - April 16, 2019 Category: Neurology Source Type: research

Lipid-Lowering Pretreatment and Outcome Following Intravenous Thrombolysis for Acute Ischaemic Stroke: A Post Hoc Analysis of the Enhanced Control of Hypertension and Thrombolysis Stroke Study Trial
Conclusions: Lipid-lowering pretreatment is not associated with adverse outcome in AIS patients treated with intravenous alteplase, whether assessed by 90-day death and disability or death alone.Cerebrovasc Dis 2018;45:213 –220
Source: Cerebrovascular Diseases - April 27, 2018 Category: Neurology Source Type: research

Predictors of functional outcome and hemorrhagic complications in acute ischemic stroke patients treated with intravenous thrombolysis - A retrospective analysis 
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Predictors of functional outcome and hemorrhagic complications in acute ischemic stroke patients treated with intravenous thrombolysis - A retrospective analysis
. Int J Clin Pharmacol Ther. 2017 Oct 26;: Authors: Zhao Q, Shan W, Liu L, Fu X, Liu P, Hu Y Abstract Intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (rt-PA) within 4.5 hours is an effective and routine therapy for acute ischemic stroke (AIS). The purpose of the study was to identify predictors of functional outcome at 3 months and hemorrhagic complications after IVT. A total of 123 AIS patients treated with in...
Source: International Journal of Clinical Pharmacology and Therapeutics - November 4, 2017 Category: Drugs & Pharmacology Tags: Int J Clin Pharmacol Ther Source Type: research

A Diagnostic Approach to Stroke in Young Adults
Opinion statementOptimal diagnosis and management of stroke in young adults benefit from a multidisciplinary team, including a vascular neurology specialist. In addition to the “standard” vascular risk factors including smoking, hypertension, diabetes, and hyperlipidemia, one needs to consider alternative etiologies including substance abuse, carotid/vertebral artery dissections, and rare genetic conditions among others. Once a young patient is determined to have had a stroke, the next question a clinician should ask iswhy did this patient have a stroke? A “heart to head” diagnostic approach is recommended. A thoro...
Source: Current Treatment Options in Cardiovascular Medicine - September 25, 2017 Category: Cardiology Source Type: research

Recurrent stroke in a patient with vitamin B12 deficiency and MTHFR mutation
We report an unusual case of recurrent stroke in a patient with vitamin B12 deficiency who was also homozygous for the methylene tetrahydrofolate reductase (MTHFR) gene mutation. The patient was a 35-year-old male vegetarian with no known medical history who initially presented with global aphasia, slurred speech, right facial weakness, and right-sided hemiplegia and was found to have a stroke (NIH Stroke Scale score of 25). At that time a CT scan of the head ruled out intracranial hemorrhage and a CT angiogram of the head and neck was done. The patient was found to have occlusion of the M1 segment of the left middle cereb...
Source: Neurology Clinical Practice - February 12, 2017 Category: Neurology Authors: Zacharia, G., Shani, D., Ortiz, R. A. Tags: Stroke in young adults, Stroke prevention, Hematologic, All Cerebrovascular disease/Stroke Case Source Type: research

Lack of trial data may lead to wrong clinical choices
Data access should be mandatory, argue authorsRelated items from OnMedicaDoctors’ leaders consult on ethical use of dataDrug giant agrees to release all Tamiflu trial dataNICE rejects arguments against wider statin useUS doctor says FDA should have withdrawn rosuvastatinTime to rethink 4.5h window for alteplase after stroke
Source: OnMedica Latest News - October 23, 2015 Category: UK Health Source Type: news

Cholesterol drugs lower risk of stroke in healthy older adults by 30%
Study suggests drugs might be considered for preventing stroke in older peopleRelated items from OnMedicaPoor response to statins may indicate blocked arteriesStatins and dietary changes have saved 20,000 lives Stroke rates rocket in younger men and womenHigh cholesterol in 30s raises heart disease riskTime to rethink 4.5h window for alteplase after stroke
Source: OnMedica Latest News - May 20, 2015 Category: UK Health Source Type: news

Modern Medical Management of Acute Ischemic Stroke.
Abstract The modern management of patients with ischemic stroke begins by having a system in place that organizes the provision of preventive, acute treatment, and rehabilitative services. In the acute setting, initial evaluation is aimed at rapidly establishing a diagnosis by excluding stroke mimics, distinguishing between ischemic and hemorrhagic strokes, and determining if the patient is a candidate for treatment with intravenous tissue plasminogen activator (IV-tPA, alteplase). In some centers, select patients who do not qualify for administration of IV-tPA may be considered for endovascular intervention. Gene...
Source: Methodist DeBakey Cardiovascular Journal - August 14, 2014 Category: Cardiology Authors: Goldstein LB Tags: Methodist Debakey Cardiovasc J Source Type: research