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Moyamoya and childhood stroke: Catching up with Tyler and Ryan
Ryan (above left) and Tyler Earle of Winnipeg, Canada had a ticking time bomb inside their heads. Both boys have a rare brain disorder called moyamoya that had caused the arteries feeding their brains to become dangerously narrowed. At first, they experienced only headaches. But then Ryan suddenly lost his ability to write, began having trouble with word-finding and became weak on one side of his body — signs he had suffered a stroke. He was diagnosed with moyamoya and had partial surgery, but a second stroke took away part of his vision and partially paralyzed him. Ryan needed a second operation as soon as possible. By ...
Source: Thrive, Children's Hospital Boston - May 12, 2016 Category: Pediatrics Authors: Nancy Fliesler Tags: Diseases & Conditions Cerebrovascular Disorders and Stroke Program Dr. Edward Smith moyamoya Source Type: news

Predictors of Restenosis Following Carotid Angioplasty and Stenting Brief Reports
Conclusions— Carotid restenosis after carotid angioplasty is associated with ipsilateral stroke occurrence. In our sample, hypertension, angioplasty without stent, and impaired vasoreactivity identify patients at high risk of restenosis and could help to select patients for follow-up ultrasonography imaging.
Source: Stroke - July 24, 2016 Category: Neurology Authors: Zapata-Arriaza, E., Moniche, F., Gonzalez, A., Bustamante, A., Escudero-Martinez, I., De la Torre Laviana, F. J., Prieto, M., Mancha, F., Montaner, J. Tags: Angiography, Ultrasound, Stent, Ischemic Stroke, Atherosclerosis Brief Reports Source Type: research

Anesthesia and neurologic outcome of endovascular therapy in acute ischemic stroke: MR (not so) CLEAN
Recent trials have confirmed the effectiveness of endovascular mechanical thrombectomy for selected acute ischemic stroke patients with large artery occlusion, whose outcomes remained poor despite optimal medical management. Among many challenges for thrombectomy implementation is determining whether general anesthesia (GA) reduces the benefits of thrombectomy, as several recent studies suggest.1,2 Berkhemer et al.3 approach this question with a post hoc analysis of Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN), the first prospective, randomized stud...
Source: Neurology - August 14, 2016 Category: Neurology Authors: Crosby, G., Muir, K. W. Tags: Stroke prevention, Infarction EDITORIALS Source Type: research

Revisiting the NIH Stroke Scale as a screening tool for proximal vessel occlusion: can advanced imaging be targeted in acute stroke?
Conclusions In this cohort, specific NIHSS criteria were highly sensitive for emergent large vessel occlusion and, if validated, may allow for clinical screening prior to advanced imaging with CT angiography.
Source: Journal of NeuroInterventional Surgery - November 14, 2016 Category: Neurosurgery Authors: Moore, R. D., Jackson, J. C., Venkatesh, S. L., Quarfordt, S. D., Baxter, B. W. Tags: Ischemic stroke Source Type: research

Risk of acute kidney injury associated with neuroimaging obtained during triage and treatment of patients with acute ischemic stroke symptoms
Conclusions This study provides preliminary evidence of the safety and feasibility of obtaining CTSS with additional DSA imaging, whether for diagnosis or intervention, to identify possible acute ischemic stroke.
Source: Journal of NeuroInterventional Surgery - November 14, 2016 Category: Neurosurgery Authors: Hall, S. L., Munich, S. A., Cress, M. C., Rangel-Castilla, L., Levy, E. I., Snyder, K. V., Siddiqui, A. H. Tags: Ischemic stroke Source Type: research

Prediction of Blood-Brain Barrier Disruption and Intracerebral Hemorrhagic Infarction Using Arterial Spin-Labeling Magnetic Resonance Imaging Clinical Sciences
Background and Purpose—Arterial spin-labeling magnetic resonance imaging is sensitive for detecting hyperemic lesions (HLs) in patients with acute ischemic stroke. We evaluated whether HLs could predict blood–brain barrier (BBB) disruption and hemorrhagic transformation (HT) in acute ischemic stroke patients.Methods—In a retrospective study, arterial spin-labeling was performed within 6 hours of symptom onset before revascularization treatment in 25 patients with anterior circulation large vessel occlusion on baseline magnetic resonance angiography. All patients underwent angiographic procedures intended for endovasc...
Source: Stroke - December 22, 2016 Category: Neurology Authors: Takeya Niibo, Hajime Ohta, Shirou Miyata, Ichiro Ikushima, Kazuchika Yonenaga, Hideo Takeshima Tags: Imaging, Magnetic Resonance Imaging (MRI), Blood-Brain Barrier, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

Intracranial Carotid Artery Calcification Relates to Recanalization and Clinical Outcome After Mechanical Thrombectomy Clinical Sciences
Conclusions—A larger amount of ICAC before mechanical thrombectomy in acute stroke patients is an indicator of worse postprocedural arterial revascularization and poorer functional outcome.
Source: Stroke - January 22, 2017 Category: Neurology Authors: Maria Hernandez–Perez, Daniel Bos, Laura Dorado, Karliȷn Pellikaan, Meike W. Vernooiȷ, Elena Lopez–Cancio, Natalia Perez de la Ossa, Meritxell Gomis, Carlos Castano, Josep Munuera, Josep Puig, Monica Millan, Antoni Davalos Tags: Computerized Tomography (CT), Imaging, Cerebrovascular Disease/Stroke, Cerebrovascular Procedures, Ischemic Stroke Original Contributions Source Type: research

Streamlining door to recanalization processes in endovascular stroke therapy
Conclusions This pilot study demonstrates that D2P times can be significantly reduced with a standardized multidisciplinary approach. There was no significant difference in the rate of 3-month good outcome, which is most likely due to the small sample size and confounding baseline patient characteristics.
Source: Journal of NeuroInterventional Surgery - March 15, 2017 Category: Neurosurgery Authors: Aghaebrahim, A., Streib, C., Rangaraju, S., Kenmuir, C. L., Giurgiutiu, D.-V., Horev, A., Saeed, Y., Callaway, C. W., Guyette, F. X., Martin-Gill, C., Pacella, C., Ducruet, A. F., Jankowitz, B. T., Jovin, T. G., Jadhav, A. P. Tags: Ischemic stroke Source Type: research

Long term experience using the ADAPT technique for the treatment of acute ischemic stroke
Conclusions ADAPT is an effective method to achieve good clinical and angiographic outcomes, and serves as a useful firstline method for revascularization.
Source: Journal of NeuroInterventional Surgery - April 13, 2017 Category: Neurosurgery Authors: Vargas, J., Spiotta, A., Fargen, K., Turner, R., Chaudry, I., Turk, A. Tags: Editor''s choice, Ischemic stroke Source Type: research

Retinal and Ophthalmic Artery Studies in Ischemic Stroke Patients Using Fundus Photography and Transcranial Doppler Methods (P4.252)
Conclusions:Our study in a robust sample of non-severe stroke patients showed that abnormal retinal AVR is strongly associated with IS patients even after accounting for traditional risk factors. OA-TCD studies, on the other hand, did not have significant associations with stroke group.Disclosure: Dr. Patil has nothing to disclose. Dr. Narayan has nothing to disclose. Dr. Babu K has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Patil, K., Narayan, S., Babu, K. R. Tags: Acute and Diagnostic Imaging in Ischemic Stroke and TIA Source Type: research

Recent Nationwide Trends in Transcranial Doppler Utilization During Acute Ischemic Stroke Hospitalizations (P4.296)
Conclusions:Over the last decade there has been a slight but steady decrease in the use of TCD during AIS hospitalizations in the US. Future studies should examine the cost-utility of TCD, especially with the advent of endovascular stroke treatment systems.Disclosure: Dr. Liu has nothing to disclose. Dr. Lunagariya has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Feng has nothing to disclose. Dr. Ovbiagele has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Liu, Y., Lunagariya, A., Patel, U., Patel, A., Feng, W., Ovbiagele, B. Tags: In-Hospital Stroke Care Source Type: research

Neurons Over Nephrons Clinical Sciences
Background and Purpose—Because of the perceived risk of contrast-induced acute kidney injury (AKI), many centers require pre-imaging serum creatinine levels, potentially delaying care. We performed a systematic review and meta-analysis evaluating AKI rates in patients with acute ischemic stroke receiving computed tomographic angiography (CTA) and computed tomographic perfusion (CTP).Methods—We searched MEDLINE, EMBASE, and the Web of Science through December 2016 for studies reporting on AKI in patients with acute ischemic stroke receiving CTA/CTP. Using a random-effects model, estimates were pooled across studies. Out...
Source: Stroke - June 26, 2017 Category: Neurology Authors: Waleed Brinjikji, Andrew M. Demchuk, Mohammad H. Murad, Alejandro A. Rabinstein, Robert J. McDonald, Jennifer S. McDonald, David F. Kallmes Tags: Imaging, Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research

Acute Occlusions of Dual-Layer Carotid Stents After Endovascular Emergency Treatment of Tandem Lesions Clinical Sciences
Conclusions—The recently introduced dual-layer stents have a higher risk of acute occlusion compared with single-layer stents in the treatment of acute stroke.
Source: Stroke - July 24, 2017 Category: Neurology Authors: Umut Yilmaz, Heiko Korner, Ruben Muhl–Benninghaus, Andreas Simgen, Catherine Kraus, Silke Walter, Stefanie Behnke, Klaus Fassbender, Wolfgang Reith, Marcus M. Unger Tags: Revascularization, Stent, Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research

Features of Patients Aged 80 Years or Older with Embolic Stroke of Undetermined Source
In this study, we investigated the features of this condition in patients greater than or equal to 80 years of age. Methods: All patients with acute ischemic stroke in our hospital underwent diffusion-weighted imaging, magnetic resonance angiography, T2-weighted imaging, and fluid-attenuated inversion recovery sequence imaging. Embolic stroke of undetermined source was defined as a radiologically confirmed nonlacunar brain infarct on diffusion-weighted imaging without (1) extracranial or intracranial atherosclerosis causing greater than or equal to 50% luminal stenosis in arteries supplying the ischemic area, (2) major-ris...
Source: Journal of Stroke and Cerebrovascular Diseases - October 24, 2018 Category: Neurology Authors: Tomonori Iwata, Kazunari Honma, Hideyuki Hanano, Ayana Kadokura, Eiichiro Nagata, Shunya Takizawa Source Type: research

Certification criteria for stroke units in Germany : Update 2018.
This article describes the revised criteria for certified stroke units (SU) in Germany that will apply from 1 October 2018. Due to the high level of quality only minor adjustments and specifications were necessary in many places and the majority of criteria remained unchanged. For the first time a uniform personnel quota of ≥1.75 full-time staff per monitor bed is defined, which is a better reflection of the treatment reality. The evidence-based process of acute vascular imaging using computed tomography angiography (CTA) and alternatively magnetic resonance angiography (MRA) is now defined as a minimum rate of≥20 % ...
Source: Der Nervenarzt - October 29, 2018 Category: Neurology Authors: Nabavi DG, Koennecke HC, Ossenbrink M, Grau A, Busse O, die Stroke Unit Kommission, den Zertifizierungsausschuss der DSG, den Vorstand der DSG, den Zertifizierungsausschuss der DSG Tags: Nervenarzt Source Type: research