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Impact of Alcohol Consumption on the Outcome of Ischemic Stroke and Thrombolysis: Role of the Hepatic Clearance of Tissue-Type Plasminogen Activator Basic Sciences
Conclusions— An efficient liver-driven clearance of tPA might influence the safety of thrombolysis after stroke.
Source: Stroke - May 22, 2015 Category: Neurology Authors: Lemarchand, E., Gauberti, M., Martinez de Lizarrondo, S., Villain, H., Repesse, Y., Montagne, A., Vivien, D., Ali, C., Rubio, M. Tags: Acute Cerebral Infarction, Thrombolysis Basic Sciences Source Type: research

Time-Dependent Thrombus Resolution After Tissue-Type Plasminogen Activator in Patients With Stroke and Mice Clinical Sciences
Conclusions— Early administration of tPA after stroke onset is associated with better thrombus resolution.
Source: Stroke - June 22, 2015 Category: Neurology Authors: Kim, Y. D., Nam, H. S., Kim, S. H., Kim, E. Y., Song, D., Kwon, I., Yang, S.-H., Lee, K., Yoo, J., Lee, H. S., Heo, J. H. Tags: Arterial thrombosis, Acute Cerebral Infarction, Thrombolysis Clinical Sciences Source Type: research

Dynamic Evolution of Diffusion-Weighted Imaging Lesions in Patients With Minor Ischemic Stroke Brief Reports
Conclusions— The most common pattern of infarct evolution in patients with minor stroke is a reduction in volume, but complete resolution is uncommon.
Source: Stroke - July 27, 2015 Category: Neurology Authors: Kate, M. P., Riaz, P., Gioia, L., Sivakumar, L., Jeerakathil, T., Buck, B., Beaulieu, C., Butcher, K. Tags: Acute Cerebral Infarction, Computerized tomography and Magnetic Resonance Imaging Brief Reports Source Type: research

Effects of Low-Frequency Repetitive Transcranial Magnetic Stimulation Combined with Intensive Speech Therapy on Cerebral Blood Flow in Post-Stroke Aphasia
Abstract We provided an intervention to chronic post-stroke aphasic patients using low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) guided by a functional magnetic resonance imaging (fMRI) evaluation of language laterality, combined with intensive speech therapy (ST). We performed a single photon emission-computed tomography (SPECT) scan pre- and post-intervention and investigated the relationship between cerebral blood flow (CBF) and language function. Fifty right-handed chronic post-stroke aphasic patients were enrolled in the study. During their 11-day hospital admission, the patients receiv...
Source: Translational Stroke Research - August 7, 2015 Category: Neurology Source Type: research

Network dysfunction predicts speech production after left hemisphere stroke
Conclusions: Speech production is dependent on complex interactions among widely distributed brain networks, indicating that residual speech production after stroke depends on more than the restoration of local domain-specific functions. Our understanding of the recovery of function following focal lesions is not adequately captured by consideration of ipsilesional or contralesional brain regions taking over lost domain-specific functions, but is perhaps best considered as the interaction between what remains of domain-specific networks and domain-general systems that regulate behavior.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Geranmayeh, F., Leech, R., Wise, R. J. S. Tags: All Cerebrovascular disease/Stroke, Aphasia ARTICLE Source Type: research

RehAtt - scanning training for neglect enhanced by multi-sensory stimulation in Virtual Reality.
CONCLUSION: RehAtt™ is a new concept for rehabilitation of neglect. Training with the VR-method improved spatial attention and showed transfer to improved spatial attention in activities of daily living in chronic neglect. Our results are promising and merit further studies. PMID: 27077985 [PubMed - as supplied by publisher]
Source: Topics in Stroke Rehabilitation - March 7, 2016 Category: Neurology Authors: Fordell H, Bodin K, Eklund A, Malm J Tags: Top Stroke Rehabil Source Type: research

Brain activity underlying tool-related and imitative skills after major left hemisphere stroke
Apraxia is a debilitating cognitive motor disorder that frequently occurs after left hemisphere stroke and affects tool-associated and imitative skills. However, the severity of the apraxic deficits varies even across patients with similar lesions. This variability raises the question whether regions outside the left hemisphere network typically associated with cognitive motor tasks in healthy subjects are of additional functional relevance. To investigate this hypothesis, we explored regions where functional magnetic resonance imaging activity is associated with better cognitive motor performance in patients with left hem...
Source: Brain - April 25, 2016 Category: Neurology Authors: Martin, M., Nitschke, K., Beume, L., Dressing, A., Bühler, L. E., Ludwig, V. M., Mader, I., Rijntjes, M., Kaller, C. P., Weiller, C. Tags: CNS Injury and Stroke Original Articles Source Type: research

IV thrombolysis for acute ischemic stroke: Is there a paradigm shift on the horizon?
Good outcomes following thrombolysis for acute ischemic stroke are strongly associated with onset to treatment time—faster administration of IV recombinant tissue plasminogen activator (rtPA) increases the probability of neurologic recovery.1 Door-to-needle quality-improvement initiatives have proven successful in reducing treatment times after a patient arrives in the emergency department with suspected stroke.2 Additional efforts to reduce onset to treatment times have focused on systems of care in the prehospital setting before emergency department arrival.3,4 Some of the most promising successes have come through...
Source: Neurology - July 10, 2016 Category: Neurology Authors: Barrett, K. M., Gottesman, R. F. Tags: CT, All Clinical trials, All Cerebrovascular disease/Stroke, Intracerebral hemorrhage EDITORIALS Source Type: research

How Patient Demographics, Imaging, and Beliefs Influence Tissue-Type Plasminogen Activator Use: A Survey of North American Neurologists Clinical Sciences
Conclusions— Diagnostic certainty and likelihood of treatment with tissue-type plasminogen activator increase with additional clinical data, with the history being the most important factor for diagnostic and treatment decisions. Respondents had difficulty in interpreting the results of CT perfusion scans although they had little impact on treatment decisions. We did not identify treatment bias based on patient age, race, or sex.
Source: Stroke - July 24, 2016 Category: Neurology Authors: Shamy, M. C. F., Pugliese, M., Meisel, K., Rodriguez, R., Kim, A. S., Stahnisch, F. W., Smith, E. E. Tags: Computerized Tomography (CT), Ethics and Policy, Quality and Outcomes, Ischemic Stroke Clinical Sciences Source Type: research

Visual Determination of Conjugate Eye Deviation on Computed Tomography Scan Predicts Diagnosis of Stroke Code Patients
Head computed tomography (CT) is critical for stroke code evaluations and often happens prior to completion of the neurological exam. Eye deviation on neuroimaging (DeyeCOM sign) has utility for predicting stroke diagnosis and correlates with National Institutes of Health Stroke Scale (NIHSS) gaze score. We further assessed the utility of the DeyeCOM sign, without complex caliper-based eye deviation calculations, but simply with a visual determination method.
Source: Journal of Stroke and Cerebrovascular Diseases - August 26, 2016 Category: Neurology Authors: Ilana Spokoyny, James Y. Chen, Rema Raman, Karin Ernstrom, Kunal Agrawal, Royya F. Modir, Dawn M. Meyer, Brett C. Meyer Source Type: research

Frequency and Predictors of Dysphagia in Patients With Recent Small Subcortical Infarcts Brief Report
Background and Purpose—Detailed data on the occurrence of swallowing dysfunction in patients with recent small subcortical infarcts (RSSI) in the context of cerebral small vessel disease are lacking. This prompted us to assess the frequency of and risk factors for dysphagia in RSSI patients.Methods—We identified all inpatients with magnetic resonance imaging–confirmed RSSI between January 2008 and February 2013. Demographic and clinical data were extracted from our stroke database, and magnetic resonance imaging scans were reviewed for morphological changes. Dysphagia was determined according to the Gugging Swallowin...
Source: Stroke - December 22, 2016 Category: Neurology Authors: Simon Fandler, Thomas Gattringer, Sebastian Eppinger, Kathrin Doppelhofer, Daniela Pinter, Kurt Niederkorn, Christian Enzinger, Joanna M. Wardlaw, Franz Fazekas Tags: Magnetic Resonance Imaging (MRI), Complications, Cerebrovascular Disease/Stroke, Ischemic Stroke Brief Reports Source Type: research

Continuous theta-burst stimulation may improve visuospatial neglect via modulating the attention network: a randomized controlled study.
CONCLUSION: cTBS of the left posterior parietal cortex in patients with VSN may induce changes in inter-regional RSFC in the right ventral attention network. These changes may be associated with improved recovery of behavioral deficits after behavioral training. The TPJ and superior temporal sulcus may play crucial roles in recovery from VSN. PMID: 28107807 [PubMed - as supplied by publisher]
Source: Topics in Stroke Rehabilitation - January 19, 2017 Category: Neurology Authors: Fu W, Cao L, Zhang Y, Huo S, Du J, Zhu L, Song W Tags: Top Stroke Rehabil Source Type: research

Distinction between contrast staining and hemorrhage after endovascular stroke treatment: one CT is not enough
Conclusions There are no density thresholds for PCHDs that allow predicting the absence or presence of hemorrhage with 100% specificity and acceptable sensitivity. A CT scan performed at least 19–24 h after endovascular therapy is the only reliable method to differentiate contrast staining from hemorrhage.
Source: Journal of NeuroInterventional Surgery - March 15, 2017 Category: Neurosurgery Authors: Dekeyzer, S., Nikoubashman, O., Lutin, B., De Groote, J., Vancaester, E., De Blauwe, S., Hemelsoet, D., Wiesmann, M., Defreyne, L. Tags: Ischemic stroke Source Type: research

Exacerbation of Thromboinflammation by Hyperglycemia Precipitates Cerebral Infarct Growth and Hemorrhagic Transformation Basic Sciences
Conclusions—We show that hyperglycemia primes the thromboinflammatory cascade, thus, amplifying middle cerebral artery occlusion–induced DMT. DMT exacerbation in hyperglycemic rats impaired reperfusion and precipitated neurovascular damage, blood–brain barrier disruption, and hemorrhagic transformation. Our results designate DMT as a possible target for reduction of the deleterious impact of hyperglycemia in acute ischemic stroke.
Source: Stroke - June 26, 2017 Category: Neurology Authors: Jean–Philippe Desilles, Varouna Syvannarath, Veronique Ollivier, Clement Journe, Sandrine Delbosc, Celina Ducroux, William Boisseau, Liliane Louedec, Lucas Di Meglio, Stephane Loyau, Martine Jandrot–Perrus, Louis Potier, Jean–Baptiste Mi Tags: Biomarkers, Inflammation, Pathophysiology, Blood-Brain Barrier, Ischemic Stroke Original Contributions Source Type: research

Impact of ASPECT scores and infarct distribution on outcomes among patients undergoing thrombectomy for acute ischemic stroke with the ADAPT technique
Conclusions Patients with moderate-sized core infarcts involving various distributions in either hemisphere can potentially achieve similar good outcomes compared with those with no core infarction at presentation. A treatment algorithm for acute ischemic stroke, which employs hardline ASPECTS thresholds or excludes patients with basal ganglia infarcts, might preclude patients who would potentially benefit from mechanical thrombectomy with ADAPT.
Source: Journal of NeuroInterventional Surgery - August 17, 2017 Category: Neurosurgery Authors: Hungerford, J. P., Hyer, M., Turk, A. S., Turner, R. D., Chaudry, M. I., Fargen, K. M., Spiotta, A. M. Tags: Ischemic stroke Source Type: research