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Brain natriuretic peptide level on admission predicts recurrent stroke after discharge in stroke survivors with atrial fibrillation
Previous reports indicate that approximately 5–10% of patients with ischemic stroke in Japan experience a stroke recurrence within the first year [1,2]. Recurrent stroke results in further disabilities. Therefore, it is important to identify risk factors associated with recurrent stroke. Several factors have been shown to be associated with recurrent stroke including large artery atherosclerosis [3], diabetes mellitus [3], previous transient ischemic attack (TIA) [3], atrial fibrillation (AF) [3], hypertension [3], increasing age [3], fibrinogen levels [4,5], D-dimer levels [5], and C-reactive protein levels [6].
Source: Clinical Neurology and Neurosurgery - October 3, 2014 Category: Neurosurgery Authors: Kensaku Shibazaki, Kazumi Kimura, Junya Aoki, Kenichiro Sakai, Naoki Saji, Junichi Uemura Source Type: research

E-008 Clinical and Radiographic Outcome of Acute Ischemic Stroke Patient who Presented with Middle Cerebral Artery Occlusion-A Single Center Experience
Conclusions Solitaire retrieval device achieves a very high rate of recanalazitation in acute ischemic stroke with MCA occlusion and results in a good clinical outcome. However, a considerable valuable time is still lost from ER arrival to IR arrival. Patients who required endotracheal intubation at presentation and or had NIHSS 20 or higher are associated with poor outcome despite TICI3 recanalization. Further studied are required. Disclosures Y. Lodi: None. V. Reddy: None. A. Devasenapathy: None. J. Chou: None. K. Shehades: None. K. Sethi: None. D. Galyon: None. S. Bajwa: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2014 Category: Neurosurgery Authors: Lodi, Y., Reddy, V., Devasenapathy, A., Chou, J., Shehades, K., Sethi, K., Galyon, D., Bajwa, S. Tags: Electronic poster abstracts Source Type: research

Conjugate upward gaze paralysis with unilateral ptosis caused by a unilateral midbrain infarction
A 73-year-old woman with atrial fibrillation presented with a sudden right hemiparesis, with diplopia and left ptosis, and was admitted at an Emergency Unit. The neurological examination found fluctuations on consciousness level, predominant crural right hemiparesis and right central facial paralysis without sensitive abnormalities. The first ophthalmological evaluation showed normal pupillary reflexes, total left ptosis and paresis of adduction of the left eye, with conjugated horizontal palsy for right gaze and conjugated vertical palsy for upward and downward gaze on saccadic and smooth pursuit eye movements. The conver...
Source: Journal of Neurology, Neurosurgery and Psychiatry - December 10, 2013 Category: Neurosurgery Authors: dos Santos, B. L., Simao, G. N., Pontes-Neto, O. M. Tags: Brain stem / cerebellum, Cranial nerves, Drugs: CNS (not psychiatric), Stroke, Ophthalmology Neurological pictures Source Type: research

Newly detected paroxysmal atrial fibrillation after tia and ischaemic stroke on cardiac monitoring: systematic review and meta-analysis in relation to duration of recording
Conclusion Cardiac monitoring after TIA or ischaemic stroke detects clinically important rates of pAF in studies of unselected populations, with high rates of subsequent anticoagulation. A monitoring period of 5–7 days appears to be adequate.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Yiin, G. S., Lovett, N. G., Rothwell, P. M. Tags: Stroke Association of British Neurologists (ABN) joint meeting with the Royal College of Physicians (RCP), London, 23-24 October 2013 Source Type: research

Incidence, outcome and future projections of atrial fibrillation-related stroke and systemic embolism at age >=80 years: 10-year results of a population-based study
Conclusion Numbers of AF–related ischaemic strokes at age ≥80 years are projected to treble by 2050, along with numbers of systemic emboli, unless rates of anticoagulation in older patients increase.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Yiin, G. S., Howard, D. P., Paul, N. L., Mehta, Z., Rothwell, P. M. Tags: Stroke Association of British Neurologists (ABN) joint meeting with the Royal College of Physicians (RCP), London, 23-24 October 2013 Source Type: research

Poststroke dementia is associated with recurrent ischaemic stroke
Conclusions Poststroke dementia predicts recurrence of ischaemic stroke in long-term follow-up and should be considered when estimating prognosis.
Source: Journal of Neurology, Neurosurgery and Psychiatry - June 9, 2013 Category: Neurosurgery Authors: Sibolt, G., Curtze, S., Melkas, S., Putaala, J., Pohjasvaara, T., Kaste, M., Karhunen, P. J., Oksala, N. K. J., Erkinjuntti, T. Tags: Dementia, Stroke, Hypertension, Memory disorders (psychiatry) Cerebrovascular disease Source Type: research

Dabigatran, intracranial hemorrhage, and the neurosurgeon.
Abstract Dabigatran etexilate (Pradaxa) is a novel oral anticoagulant that has gained FDA approval for the prevention of ischemic stroke and systemic embolism in patients with nonvalvular atrial fibrillation. In randomized trials, the incidence of hemorrhagic events has been demonstrated to be lower in patients treated with dabigatran compared with the traditional anticoagulant warfarin. However, dabigatran does not have reliable laboratory tests to measure levels of anticoagulation and there is no pharmacological antidote. These drawbacks are challenging in the setting of intracerebral hemorrhage. In this article...
Source: Neurosurgical Focus - May 1, 2013 Category: Neurosurgery Authors: Awad AJ, Walcott BP, Stapleton CJ, Yanamadala V, Nahed BV, Coumans JV Tags: Neurosurg Focus Source Type: research

High-sensitivity troponin assay improves prediction of cardiovascular risk in patients with cerebral ischaemia
Conclusions hsTropT predicts vascular events and all-cause mortality in patients with acute cerebral ischaemia and improves prediction beyond established clinical scores.
Source: Journal of Neurology, Neurosurgery and Psychiatry - April 8, 2013 Category: Neurosurgery Authors: Stahrenberg, R., Niehaus, C.-F., Edelmann, F., Mende, M., Wohlfahrt, J., Wasser, K., Seegers, J., Hasenfuss, G., Groschel, K., Wachter, R. Tags: Open access, Stroke, Ischaemic heart disease Cerebrovascular disease Source Type: research

The value of the use of plasma B-type natriuretic peptide among acute ischemic stroke patients in a Chinese emergency department
In this study, 142 of 238 acute ischemic stroke patients met the study criteria [mean age 70.84±11.48 years, 74 (52.11%) female]. Of the 142 patients, 35.92% were diagnosed with LAA at discharge, 25.35% with CE, 27.46% with SAO, 11.27% with SOE or SUE. Age, previous cardiac disease, atrial fibrillation, the length of hospital stays, SSS score on admission≤25 and mRS≥3 or death at discharge were all significantly higher in the CE patients compared to other subtypes (p
Source: Clinical Neurology and Neurosurgery - March 21, 2013 Category: Neurosurgery Authors: Wu Zhixin, Yang Lianhong, Huang Wei, Li Lianda, Jiang Longyuan, Zhang Yingjian, Wang Jinliang, He Mingfeng Tags: Original articles Source Type: research

Atrial fibrillation predicts good functional outcome following intravenous tissue plasminogen activator in patients with severe stroke
Conclusion: Presence of AF was associated with favorable 90-day outcome following intravenous thrombolysis in patients with severe stroke at baseline, while the association did not exist in patients with mild stroke.
Source: Clinical Neurology and Neurosurgery - September 17, 2012 Category: Neurosurgery Authors: Sheng-Feng Sung, Yu-Wei Chen, Mei-Chiun Tseng, Cheung-Ter Ong, Huey-Juan Lin Tags: Original articles Source Type: research

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