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Chapter 66 Endovascular treatment of acute ischemic stroke
Publication date: 2016 Source:Handbook of Clinical Neurology, Volume 136 Author(s): Thabele Leslie-Mazwi, James Rabinov, Joshua A. Hirsch Endovascular thrombectomy is an effective treatment for major acute ischemic stroke syndromes caused by major anterior circulation artery occlusions (commonly referred to as large vessel occlusion) and is superior to intravenous thrombolysis and medical management. Treatment should occur as quickly as is reasonably possible. All patients with moderate to severe symptoms (National Institutes of Health stroke scale >8) and a treatable occlusion should be considered. The use of ...
Source: Handbook of Clinical Neurology - July 16, 2016 Category: Neurology Source Type: research

Clinical diagnostic tools for screening of perioperative stroke in general surgery: a systematic review
Perioperative stroke is a devastating complication that carries high mortality and functional disability. Unfortunately, residual anaesthesia and analgesia may obscure important warning signs and may lead to a delay in the assessment and treatment of major stroke after surgery. The purpose of this review is to examine the utility of existing stroke scales, for the recognition of perioperative stroke in the general surgical population. A total of 21 stroke scales have been described in the literature. Diagnostic performance was reported in 17 scales. The majority of the stroke scales were designed to evaluate current neurol...
Source: British Journal of Anaesthesia - February 10, 2016 Category: Anesthesiology Authors: Sun, Z., Yue, Y., Leung, C. C. H., Chan, M. T. V., Gelb, A. W., on behalf of the Study Group for Perioperative Stroke In China (POSIC), on behalf of the Study Group for Perioperative Stroke In China (POSIC), Wu, Yue, Sun, Guo, Ding, Wang, Tian, Mei, Yao, Tags: Review Articles Source Type: research

Impact of Mechanical Thrombectomy on the Organization of the Management of Acute Ischemic Stroke
Background: Several trials and meta-analyses have recently demonstrated the superiority of endovascular therapy over standard medical treatment in patients presenting with acute ischemic stroke. In order to offer the best possible treatment to a maximum number of patients, many stroke care networks probably have to be reorganized. After analyzing the reliability of data in the literature, an algorithm is suggested for a pre-hospital and in-hospital alert system to improve the timeliness of subsequent treatment: a drip-and-ship approach. Summary: Five recent well-designed randomized studies have demonstrated the benefit of ...
Source: European Neurology - January 16, 2016 Category: Neurology Source Type: research

UCLA researchers provide first evidence of how obstructive sleep apnea damages the brain
Courtesy of Rajesh Kumar Brains with obstructive sleep apnea (left) and without UCLA researchers have reported the first evidence that obstructive sleep apnea contributes to a breakdown of the blood–brain barrier, which plays an important role in protecting brain tissue. The discovery, reported in the Sept. 1 issue of the Journal of Neuroimaging, could lead to new approaches for treating obstructive sleep apnea, which affects an estimated 22 million American adults. The disorder causes frequent interruptions in breathing during sleep because the airways narrow or become blocked. The blood–brain barrier limits harmful...
Source: UCLA Newsroom: Health Sciences - September 1, 2015 Category: Universities & Medical Training Source Type: news

P-008 on intent to treat adapt technique for 201 cases of anterior circulation acute ischemic stroke
We report our single center experience results of endovascular treatment of anterior circulation of ischemic stroke by the technique of direct aspiration.MethodsBetween September 2013 to March 2015 we reviewed the data of 201 patients presenting with large vessels anterior circulation occlusion for which the ADAPT technique was utilized in first intention and was associated with stentriever technique when necessary. Procedural and clinical data were collected for analysis. An univariate analysis of the following factors: Age, prior antiplatelet or anticoagulative therapy, localisation of the occlusion, an intravenous throm...
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Blanc, R., Redjem, H., Bartolini, B., Ciccio, G., Smajda, S., Taylor, G., Lamrabet, S., Paraschakis, P., Piotin, M. Tags: SNIS 12th Annual Meeting Oral Poster Abstracts Source Type: research

Guy Who Wanted To Be A Real-Life Hulk Almost Had To Have Arms Amputated
A bodybuilder who wanted to resemble The Incredible Hulk is instead feeling green, after the synthetic muscle injections he used caused myriad health problems and nearly led to the amputation of his arms. Romario dos Santos Alves, a 25-year-old from Caldas Novas, Brazil, told Barcroft Media he started injecting his muscles with the mixture of oil and alcohol three years ago in an attempt to beef up his physique. But once he started, he found it difficult to stop. After repeated injections left him sporting 25-inch biceps -- and in the hospital -- Alves says he realized he had to kick the habit for good. Doctors informed ...
Source: Healthy Living - The Huffington Post - May 5, 2015 Category: Consumer Health News Source Type: news

Precision medicine is coming, but not anytime soon
President Obama’s announcement of a Precision Medicine Initiative was one of the few items in this year’s State of the Union address to garner bipartisan support. And for good reason. Precision medicine, also known as personalized medicine, offers the promise of health care — from prevention to diagnosis to treatment — based on your unique DNA profile. Who wouldn’t want that? We’ve already had a taste of precision medicine. Relatively low-tech therapies like eyeglasses, orthotic devices, allergy treatments, and blood transfusions have long been personalized for the individual. Genetic analysis o...
Source: New Harvard Health Information - March 26, 2015 Category: Consumer Health News Authors: Beverly Merz Tags: Health care personalized health care precision medicine Source Type: news

Vessel perforation during withdrawal of Trevo ProVue stent retriever during mechanical thrombectomy for acute ischemic stroke.
Abstract The authors report a case of an intracranial extravasation during the withdrawal of a Trevo ProVue stent retriever device in a patient being treated for acute ischemic stroke. An 82-year-old woman developed sudden left hemiparesis and aphasia during an urgent cardiac catheterization procedure for a non-ST elevation myocardial infarction. She had a baseline National Institutes of Health Stroke Scale (NIHSS) score of at least 10 and no improvement with intravenous administration of tissue plasminogen activator (tPA). Cerebral angiography was performed with conscious sedation, confirming an occlusion of the ...
Source: Journal of Neurosurgery - June 13, 2014 Category: Neurosurgery Authors: Leishangthem L, Satti SR Tags: J Neurosurg Source Type: research

Carotid Artery Free-Floating Thrombus Caused by Paradoxical Embolization From Greater Saphenous Vein Ascending Thrombophlebitis
We report a case of a young woman without cardiovascular risk factors who was admitted to our emergency department with listlessness and altered mental status. The clinical examination revealed right lower limb swelling. Magnetic resonance imaging and contrast-enhanced computed tomographic scans revealed a free floating thrombus of the left internal carotid artery (ICA) with a large bilateral frontal ischemic lesion. The diagnosis of a medium-sized PFO with moderate right-to-left contrast shunting was made after transesophageal echocardiography. No other cardiac sources for embolization were detected, while an ascending th...
Source: Annals of Vascular Surgery - April 28, 2013 Category: Surgery Authors: Luigi Irace, Roberto Gabrielli, Maria Sofia Rosati, Maria Fabrizia Giannoni, Anna Castiglione, Antonella Laurito, Bruno Gossetti Tags: Case Report Abstracts Source Type: research

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