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Thrombolysis in Ischemic Stroke Without Arterial Occlusion at Presentation Clinical Sciences
Conclusions— This study provides crucial data that patients with ischemic stroke who do not have visible arterial occlusion at presentation may benefit from thrombolysis.
Source: Stroke - August 25, 2014 Category: Neurology Authors: Lahoti, S., Gokhale, S., Caplan, L., Michel, P., Samson, Y., Rosso, C., Limaye, K., Hinduja, A., Singhal, A., Ali, S., Pettigrew, L. C., Kryscio, R., Dedhia, N., Hastak, S., Liebeskind, D. S. Tags: Cerebral Lacunes, Embolic stroke, Computerized tomography and Magnetic Resonance Imaging, Pathology of Stroke, Thrombolysis Clinical Sciences Source Type: research

Smoking-Thrombolysis Paradox: Recanalization and Reperfusion Rates After Intravenous Tissue Plasminogen Activator in Smokers With Ischemic Stroke Original Contributions
Conclusions— Smoking is independently associated with recanalization and reperfusion, indicating that thrombolytic therapy acts more effectively in smokers; because of small numbers, these results should be considered preliminary. Clinical Trial Registration— URL: http://clinicaltrials.gov. Unique Identifier: NCT00715533.
Source: Stroke - January 18, 2013 Category: Neurology Authors: Kufner, A., Nolte, C. H., Galinovic, I., Brunecker, P., Kufner, G. M., Endres, M., Fiebach, J. B., Ebinger, M. Tags: Fibrinolysis, Angiography, Computerized tomography and Magnetic Resonance Imaging, Risk Factors for Stroke, Thrombolysis Original Contributions Source Type: research

Identification of Reversible Disruption of the Human Blood-Brain Barrier Following Acute Ischemia Brief Reports
Conclusions— This study demonstrates that diffuse, mild BBB disruption in the acutely ischemic human brain is reversible with reperfusion. This study also confirms prior findings that focal severe BBB disruption confers an increased risk of hemorrhagic transformation in patients treated with intravenous tissue-type plasminogen activator.
Source: Stroke - August 21, 2016 Category: Neurology Authors: Simpkins, A. N., Dias, C., Leigh, R., on behalf of the National Institutes of Health Natural History of Stroke Investigators, Benson, Hsia, Latour, Luby, Lynch, Merino, Nadareishvili, Warach Tags: Magnetic Resonance Imaging (MRI), Blood-Brain Barrier, Intracranial Hemorrhage, Ischemic Stroke Brief Reports Source Type: research

Thrombolytic Therapy Is an Only Determinant Factor for Stroke Evolution in Large Anterior Choroidal Artery Infarcts
Conclusions: Thrombolytic therapy is an only determinant factor for stroke evolution in large AChA infarcts, which reduced the risk of stroke evolution and improved functional outcome.
Source: Journal of Stroke and Cerebrovascular Diseases - October 16, 2013 Category: Neurology Authors: Meng-Chen Wu, Li-Kai Tsai, Chung-Chu Wu, Shin-Joe Yeh, Sung-Chun Tang, Yun-Ju Chen, Chien-Lin Chen, Jiann-Shing Jeng Tags: Original Articles Source Type: research

Ischemic Stroke in Evolution: Predictive Value of Perfusion Computed Tomography
Background: Various perfusion computed tomography (PCT) parameters have been used to identify tissue at risk of infarction in the setting of acute stroke. The purpose of this study was to examine predictive value of the PCT parameters commonly used in clinical practice to define ischemic penumbra. The patient selection criterion aimed to exclude the effect of thrombolysis from the imaging data.Methods: Consecutive acute stroke patients were screened and a total of 18 patients who initially underwent PCT and CT angiogram (CTA) on presentation but did not qualify to receive thrombolytic therapy were selected. The PCT images ...
Source: Journal of Stroke and Cerebrovascular Diseases - August 19, 2013 Category: Neurology Authors: Amir Kheradmand, Marc Fisher, David Paydarfar Tags: Original Articles Source Type: research

Translational perspectives on perfusion–diffusion mismatch in ischemic stroke
Magnetic resonance imaging has tremendous potential to illuminate ischemic stroke pathophysiology and guide rational treatment decisions. Clinical applications to date have been largely limited to trials. However, recent analyses of the major clinical studies have led to refinements in selection criteria and improved understanding of the potential implications for the risk vs. benefit of thrombolytic therapy. In parallel, preclinical studies have provided complementary information on the evolution of stroke that is difficult to obtain in humans due to the requirement for continuous or repeated imaging and pathological veri...
Source: International Journal of Stroke - October 1, 2013 Category: Neurology Authors: Bruce C. V. Campbell, I. Mhairi Macrae Tags: Review Source Type: research

Fatal Intracranial Hemorrhage after Intravenous Thrombolytic Therapy for Acute Ischemic Stroke Associated with Cancer-related Nonbacterial Thrombotic Endocarditis
Nonbacterial thrombotic endocarditis (NBTE) is associated with hypercoagulability in patients with inflammatory states such as cancer and autoimmune diseases. Cardiac vegetations caused by NBTE often lead to life-threatening systemic thromboembolism that most frequently affects the brain, spleen, and kidneys. A 54-year-old woman diagnosed with ovarian cancer suddenly developed back pain and left hemiparesis. Although intravenous alteplase (rt-PA) therapy was administered to treat hyperacute ischemic infarction detected by magnetic resonance imaging, intracranial hemorrhage occurred in the left hemisphere several hours late...
Source: Journal of Stroke and Cerebrovascular Diseases - August 11, 2014 Category: Neurology Authors: Takuya Yagi, Kie Takahashi, Mariko Tanikawa, Morinobu Seki, Takato Abe, Norihiro Suzuki Tags: Case Reports Source Type: research

Intravenous Thrombolysis in Posterior Circulation Stroke
Conclusions: Up to date, no data about PCIS and IVT are available from RTCs. Based on limited results from retrospective clinical studies and case series, IVT is safer for use in PCIS than in ACIS. Patients with brainstem ischemia, vertebral artery occlusion, and absence of basilar or posterior cerebral artery occlusion could be considered for treatment with IVT even in borderline cases. Time to IVT in PCIS seems to be a less crucial factor than in ACIS. IVT for PCIS may be beneficial even after 4.5 h from symptom onset. Introduction History of Intravenous Thrombolysis—The Most Relevant Studies Intravenous...
Source: Frontiers in Neurology - April 25, 2019 Category: Neurology Source Type: research

Frequency of Hemorrhage on Follow Up Imaging in Stroke Patients Treated With rt-PA Depending on Clinical Course
Conclusions: Frequency of hemorrhagic transformation in Routine follow-up brain imaging and consecutive changes in therapeutic management were different depending on clinical course measured by NHISS score. Introduction Brain imaging 24–36 h after systemic thrombolysis for acute ischemic stroke is recommended in American Stroke Association and European Stroke Organization guidelines (1, 2). Brain imaging is performed to detect secondary bleeding or hemorrhagic transformation in order to adapt medical stroke prevention if necessary. Guideline recommendations are based on the results of the first study on rt-PA...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Post-Stroke Blood-Brain Barrier Disruption and Poor Functional Outcome in Patients Receiving Thrombolytic Therapy
Conclusions: Post-stroke BBB disruption appears to be predictive of functional outcome irrespective of stroke size.Cerebrovasc Dis
Source: Cerebrovascular Diseases - April 15, 2019 Category: Neurology Source Type: research

Management of Acute Ischemic Stroke-Specific Focus on Anesthetic Management for Mechanical Thrombectomy.
Abstract Acute ischemic stroke is a neurological emergency with a high likelihood of morbidity, mortality, and long-term disability. Modern stroke care involves multidisciplinary management by neurologists, radiologists, neurosurgeons, and anesthesiologists. Current American Heart Association/American Stroke Association (AHA/ASA) guidelines recommend thrombolytic therapy with intravenous (IV) alteplase within the first 3-4.5 hours of initial stroke symptoms and endovascular mechanical thrombectomy within the first 16-24 hours depending on specific inclusion criteria. The anesthesia and critical care provider may b...
Source: Anesthesia and Analgesia - July 6, 2020 Category: Anesthesiology Authors: Businger J, Fort AC, Vlisides PE, Cobas M, Akca O Tags: Anesth Analg Source Type: research

Pre- and in-hospital delays in the use of thrombolytic therapy for patients with acute ischemic stroke in rural and urban Egypt
ConclusionThe limited availability of stroke-ready hospitals in rural Egypt leads to delays in stroke management, with subsequent treatment inequality of rural patients with acute stroke.
Source: Frontiers in Neurology - January 20, 2023 Category: Neurology Source Type: research

Thrombolytic Therapy in Wake-Up Stroke Patients
Conclusions: Available data suggest promising strategies to identify WUS patients who may benefit from thrombolysis. Once on-going trials are complete, there may be sufficient information to redefine tPA eligibility for previously excluded patients.
Source: Clinical Neuropharmacology - May 1, 2017 Category: Neurology Tags: Review Articles Source Type: research

Acute Ischemic Stroke.
Authors: Rossi UG, Ierardi AM, Cariati M Abstract A 77-year-old woman with a history of hypertension developed acute onset of aphasia and right hemiplegia and hemisensory loss. She was urgently referred to emergency department. Cerebral multidetector computed tomographic angiography (MD-CTA) revealed an acute ischemic stroke due to the occlusion of the left middle cerebral artery (Figure 1). Since the symptoms started three hours previously, the patient was candidate for mechanical thrombectomy. The patient then performed a selective digital subtraction angiography (DSA) of the left internal carotid artery that con...
Source: Acta Neurologica Taiwanica - February 1, 2020 Category: Neurology Tags: Acta Neurol Taiwan Source Type: research

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