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Secondary neurodegeneration of ipsilateral substantia nigra in acute ischemic stroke
ConclusionsA better understanding of the secondary degeneration of the substantia nigra has the potentiality to offer a chance for neuroprotection in acute stroke, but further studies are needed.
Source: Neurological Sciences - August 1, 2023 Category: Neurology Source Type: research

Application of the “1-2-3-4-day” rule to stroke severity at baseline versus at 24 h to start direct oral anticoagulant for atrial fibrillation within 7 days from symptom onset
ConclusionsThe application of “1-2-3-4-day” rule to start DOAC for AF within 7 days from symptom onset differed when applied to baseline neurological stroke severity versus 24-h neurological and radiological severity, but safety and effecacy are similar.
Source: Neurological Sciences - March 7, 2023 Category: Neurology Source Type: research

Elevated troponin I levels on admission predict long-term mortality in patients with acute cerebral infarction following thrombolysis
ConclusionsEven after adjusting for several possible confounders, cTnI elevation in patients with ACI treated with rt-PA was associated with a 1.80-fold increased risk of 5-year mortality.
Source: Neurological Sciences - May 17, 2022 Category: Neurology Source Type: research

Coexisting of aortic arch atheroma and atrial fibrillation for short-term recurrence and poor functional outcome in acute stroke
ConclusionsAortic arch atheroma concomitant with AF is not rare and appears associated with increased risks of stroke recurrence and poor functional outcome.
Source: Neurological Sciences - November 8, 2021 Category: Neurology Source Type: research

Insertable cardiac monitors for detection of atrial fibrillation after cryptogenic stroke: a meta-analysis
ConclusionsThe longer the time of ICM monitoring after cryptogenic stroke, the higher the detection rate of AF. Further research is still needed to determine the optimal duration of long-term cardiac monitoring.
Source: Neurological Sciences - February 2, 2021 Category: Neurology Source Type: research

Prevalence and predictors of atrial fibrillation in patients with embolic stroke of undetermined source: a real-life single-center retrospective study
ConclusionsAtrial fibrillation may be detected in a relevant proportion (up to 50%) of patients with embolic stroke of undetermined source if a careful and extensive diagnostic work-up is employed. Excessive supraventricular electric activity and left atrial enlargement are significant predictors of the occurrence of atrial fibrillation in these patients.
Source: Neurological Sciences - January 14, 2021 Category: Neurology Source Type: research

The impact of cigarette smoking in predicting stroke using CHADS 2 and CHA 2 DS 2 -VASc schemas
ConclusionCigarette smoking status has impact on stroke stratification using CHADS2 and CHA2DS2-VASc scheme. The discrimination of the CHADS2 and CHA2DS2-VASc scheme for stroke can be significantly improved if smoking status is additionally considered.
Source: Neurological Sciences - June 21, 2020 Category: Neurology Source Type: research

Antithrombotic regimen for ischemic stroke patients with concomitant atrial fibrillation and extracranial/intracranial artery stenosis: what is the best way?
Source: Neurological Sciences - March 25, 2020 Category: Neurology Source Type: research

Why we fail: mechanisms and co-factors of unsuccessful thrombectomy in acute ischemic stroke
ConclusionIn 20% of failing MT, thrombus cannot be reached/passed. Direct carotid puncture or surgical arterial access could be considered in these cases.In 80% of failing interventions, thrombus can be passed with the device, but the occluded vessel cannot be recanalized. Rescue techniques can be an option. Development of new devices and techniques is necessary to improve recanalization rates. Assessment of pre-existing illness could sensitize for occurring complications.
Source: Neurological Sciences - January 22, 2020 Category: Neurology Source Type: research

Rivaroxaban in cervical and “cervico-cerebral” artery dissections: a new therapeutic option?
We describe four cases of CADs and, firstly in literature, cervico-cerebral (CCADs) in young patients (average age of 42  years) treated with rivaroxaban 20 mg daily. Three of these four dissections had affected the vertebral artery (condition with an unfavorable prognosis and more often complicated by subarachnoid hemorrhages), and the other one was a carotid dissection at the extra-intracranial passage. All patien ts were followed clinically and with serial neurosonological examinations at 1, 3, and 6 months and with magnetic resonance angiography (MRA) at 6 months. All patients presented a good outcome with vascular...
Source: Neurological Sciences - April 11, 2019 Category: Neurology Source Type: research

Dementia: new vistas and opportunities
AbstractOver the past four decades, Alzheimer disease has become near synonymous with dementia and the amyloid/tau hypothesis as its dominant explanation. However, this monorail approach to etiology has failed to yield a single disease-modifying drug. Part of the explanation stems from the fact that most dementias in the elderly result from interactive Alzheimer and cerebrovascular pathologies. Stroke and dementia share the same risk factors and their control is associated with a decrease in stroke and some dementias. Additionally, intensive control of risk factors and enhancement of protective factors improve cognition. M...
Source: Neurological Sciences - January 21, 2019 Category: Neurology Source Type: research

Clinical skills or high-tech MR in TIA patients: what makes the difference?
ConclusionsThe long-term outcomes of TIA patients did not differ according to the definitions applied. Therein suggesting that, even without acute MRI results, a clinical diagnosis seemed to be enough to assure prompt medical treatment and similar long-term outcomes.
Source: Neurological Sciences - December 1, 2018 Category: Neurology Source Type: research

Use of rivaroxaban in patients with stroke
AbstractRivaroxaban, an inhibitor of Factor Xa, is a direct oral anti-coagulant that has been found to be non-inferior to warfarin in preventing cerebral ischemia in patients with non-valvular atrial fibrillation and in the subgroup of patients with a history of the previous stroke or transient ischemic attack. Vascular neurologists in daily clinical practice may encounter patients taking rivaroxaban or patients who may benefit from its use. In this paper, we review the current clinical indications, contraindications, and clinical management guidelines for rivaroxaban while providing a special focus on neurological aspects...
Source: Neurological Sciences - February 24, 2017 Category: Neurology Source Type: research

Factors associated with early hospital arrival in acute ischemic stroke patients
Abstract Early diagnosis and treatment in acute ischemic stroke are crucial in terms of survival and disability. Many stroke patients remain disabled because of the treatment delay. The purpose of this study was to investigate the factors associated with the early hospital arrival in acute ischemic stroke patients. 113 patients diagnosed with acute ischemic stroke were included in this prospective study performed at the Karadeniz Technical University Medical Faculty Hospital. Patients’ characteristics and patients’ and relatives’ emotional and behavioral reactions were compared between early (within 3 ...
Source: Neurological Sciences - September 26, 2014 Category: Neurology Source Type: research