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Efficacy and safety of naotaifang capsules for hypertensive cerebral small vessel disease: Study protocol for a multicenter, randomized, double-blind, placebo-controlled clinical trial
Conclusion: The protocol will comfirm whether naotaifang capsules reduce Fazekas scores, dilated Virchow-robin spaces grades, and the number of lacunar infarctions and cerebral microbleeds, clinical blood pressure, increase mini-mental state examination scores, traditional Chinese medicine syndrome scores of Qi deficiency and blood stasis (QDBS), and improve the quality of life of subjects. The consolidated evidence from this study will shed light on the benefits of Chinese herbs for hypertensive cerebral small vessel disease, such as nourishing qi, promoting blood circulation and removing blood stasis, and dredging collat...
Source: Frontiers in Pharmacology - January 6, 2023 Category: Drugs & Pharmacology Source Type: research

An MRI based ischemic stroke classification & #8211; A mechanism oriented approach
James Jose, Joe JamesAnnals of Indian Academy of Neurology 2022 25(6):1019-1028 Oxfordshire Community Stroke Project and Trial of Org 10172 in acute stroke treatment are the commonly used ischemic stroke classification systems at present. However, they underutilize the newer imaging technologies. Diffusion-weighted magnetic resonance imaging (DW-MRI) of the brain can detect the site and extent of infarcts accurately. From the MRI patterns, the mechanisms of ischemic stroke can be inferred. We propose to classify ischemic infarcts into the following types based on their DW-MRI appearance: cortical territorial infarcts, str...
Source: Annals of Indian Academy of Neurology - December 3, 2022 Category: Neurology Authors: James Jose Joe James Source Type: research

Propensity of stroke in standard versus various aortic arch variants: A 200 patients study
Conclusions: Standard aortic arch Type 2, bovine aortic arch Type A, and Type B are associated with an early age at stroke presentation. During routine carotid evaluation by CT or MR angiography in stroke patients, it would be better to evaluate the aortic arch as well, especially in young patients.
Source: Annals of Indian Academy of Neurology - September 9, 2022 Category: Neurology Authors: Swapnil Samadhiya Vijay Sardana Bharat Bhushan Dilip Maheshwari Seeta Ram Yadav Ravi Goyal Source Type: research

Post-varicella neurological complications: A preliminary observation from a tertiary care centre of Eastern India
Conclusion: Chickenpox is a common viral disease and most patients recover without any complication. Although rare, neurological complications following acute varicella infection may have myriad presentations ranging from lower motor neuron facial palsy to life-threatening encephalitis. Compared to other studies, varicella encephalitis and ataxia were not so common in our study group. Response to therapy was uniformly good except in the patients presenting with ataxia. Response was particularly good to central and peripheral demyelinating disorders.
Source: Annals of Indian Academy of Neurology - May 25, 2022 Category: Neurology Authors: Subhadeep Gupta Atanu Biswas Atanu Chandra Biman Kanti Ray Arpan Dutta Alak Pandit Source Type: research

Do imaging markers of cerebral small vessel disease predict hematoma volume and outcome in acute intracerebral hemorrhage ?
Conclusions: WMHL in MRI serves as a predictor of hematoma expansion, a large volume bleed, and poor outcome in hypertensive ICH and may be incorporated into existing prediction models.
Source: Annals of Indian Academy of Neurology - April 28, 2021 Category: Neurology Authors: Anand R Warrier Rohit Bhatia Ajay Garg MV Padma Srivastava Deepa Dash Manjari Tripathi Mamta Bhushan Singh Vishwajeet Singh Sreenivas Vishnubhatla Kameshwar Prasad Source Type: research

Metabolic Stroke: A Novel Presentation in a Child with Succinic Semialdehyde Dehydrogenase Deficiency
Sangeetha Yoganathan, Gautham Arunachal, Lisa Kratz, Mugil Varman, Maya Thomas, Sniya Valsa Sudhakar, Samuel Philip Oommen, Sumita DandaAnnals of Indian Academy of Neurology 2020 23(1):113-117 Succinic semialdehyde dehydrogenase (SSADH) deficiency is an autosomal recessive disorder of gamma-aminobutyric acid metabolism. Children with SSADH deficiency usually manifest with developmental delay, behavioral symptoms, language dysfunction, seizures, hypotonia, extrapyramidal symptoms, and ataxia. Diagnosis of SSADH deficiency is established by an abnormal urine organic acid pattern, including increased excretion of 4-hydroxybu...
Source: Annals of Indian Academy of Neurology - January 20, 2020 Category: Neurology Authors: Sangeetha Yoganathan Gautham Arunachal Lisa Kratz Mugil Varman Maya Thomas Sniya Valsa Sudhakar Samuel Philip Oommen Sumita Danda Source Type: research

The risk of symptomatic intracranial hemorrhage after thrombolysis for acute stroke: Current concepts and perspectives
Conclusions: In addition to the already known risk factors considered in the standard protocols, an individualized evaluation of risks is needed to minimize the risk of brain hemorrhage after thrombolysis for ischemic stroke.
Source: Annals of Indian Academy of Neurology - June 30, 2019 Category: Neurology Authors: Pedro J Modrego Source Type: research

Acupuncture for Post-stroke Shoulder-Hand Syndrome: A Systematic Review and Meta-Analysis
Conclusions: Acupuncture therapy seems effective for motor function, pain relief and activities of daily living in stroke patients with mild SHS, when it is used in combination with rehabilitation. The low certainty of evidence downgrades our confidence in making recommendations to clinical practice. Introduction Shoulder-hand syndrome (SHS) is a common condition among people who have had a stroke, with its reported prevalence ranging from 12% to 49% (1, 2). The main symptoms of SHS include pain, hyperalgesia, joint swelling and limitations in range of motion (ROM) (3). Post-stroke SHS is also named type I complex ...
Source: Frontiers in Neurology - April 25, 2019 Category: Neurology Source Type: research

Shengui Sansheng San Ameliorates Cerebral Energy Deficiency via Citrate Cycle After Ischemic Stroke
Conclusion In summary, SSS extraction significantly ameliorates cerebral energy metabolism via boosting citrate cycle, which mainly embodies the enhancements of blood glucose concentration, glucose and lactate transportation and glucose utilization, as well as the regulations of relative enzymes activities in citrate cycle. These ameliorations ultimately resulted in numerous ATP yield after stroke, which improved neurological function and infarcted volume. Collectively, it suggests that SSS extraction has exerted advantageous effect in the treatment of cerebral ischemia. Ethics Statement All animal operations were accor...
Source: Frontiers in Pharmacology - April 22, 2019 Category: Drugs & Pharmacology Source Type: research

Consecutive Slides on Axial View Is More Effective Than Transversal Diameter to Differentiate Mechanisms of Single Subcortical Infarctions in the Lenticulostriate Artery Territory
Conclusion: Consecutive slides on axial view (≥4 consecutive slices) might be more effective than transversal diameter to identify the atherosclerotic mechanisms of SSIs in the lenticulostriate artery territory. Clinical Trial Registration: http://www.clinicaltrials.gov. Unique identifier: NCT00664846 Introduction Single subcortical infarctions (SSIs) have been considered to be caused by lipohyalinosis degeneration in small artery disease, traditionally called lacunar infarct (1). However, atherosclerosis occurring in the parental artery blocking the orifice of the branch artery or atherosclerosis in the p...
Source: Frontiers in Neurology - April 8, 2019 Category: Neurology Source Type: research

Stenosis Length and Degree Interact With the Risk of Cerebrovascular Events Related to Internal Carotid Artery Stenosis
Conclusion: We found a statistically insignificant tendency for the ultrasound-measured length of sICAS<70% to be longer than that of sICAS≥70%. Moreover, the ultrasound-measured length of sICAS<90% was significantly longer than that of sICAS 90%. Among patients with sICAS≥70%, the degree and length of stenosis were inversely correlated. Larger studies are needed before a clinical implication can be drawn from these results. Introduction Internal carotid artery stenosis (ICAS) causes around one-fifth of ischemic cerebrovascular stroke and has the highest risk of early stroke recurrence...
Source: Frontiers in Neurology - April 8, 2019 Category: Neurology Source Type: research

Rapid processing of perfusion and diffusion for ischemic strokes in the extended time window: An Indian experience
Conclusion: In extended time windows, RAPID provides a fast and reliable estimate of salvageable brain tissue to help select patients for endovascular treatment.
Source: Annals of Indian Academy of Neurology - December 26, 2018 Category: Neurology Authors: Devashish Vyas Vikram Bohra Vivek Karan Vikram Huded Source Type: research

Long ‐term progression of white matter hyperintensities in ischemic stroke
ConclusionsAge and marked WMH at index stroke, but not stroke subtype, predicted long ‐term WMH progression after ischemic stroke before 70 years of age, whereas age and hypertension predicted acquisition of marked WMH in those with no or only mild WMH at baseline.
Source: Acta Neurologica Scandinavica - November 4, 2018 Category: Neurology Authors: Lukas Holmegaard, Christer Jensen, Petra Redfors, Christian Blomstrand, Christina Jern, Katarina Jood Tags: ORIGINAL ARTICLE Source Type: research

Sneddon ’s syndrome—A diagnostic and therapeutic challenge
A 49-year-old female presented with a four-hour history of ataxia and left-sided hemidysesthesia. A generalized, irregular, violaceous, net-like skin pattern was noted. The young patient had suffered five strokes over the last six years. In the past, despite extensive workup, no diagnosis had been made. Antinuclear and anti-phospholipid antibodies were negative, and no evidence of thrombophilia was found. Magnetic resonance imaging showed acute dot-like diffusion anomalies in the medial and posterior cerebral artery-supplied areas as well as old stroke residues.
Source: Journal of the American Academy of Dermatology - May 31, 2017 Category: Dermatology Source Type: research

Systematic Review and Meta-Analysis of Cohort Studies Examining Effect of Anticoagulation and Risk of Cerebral Hemorrhage in patients with Cerebral Microbleeds (P2.276)
Conclusions:Results of this meta-analysis suggest that patients with CMBs started on anticoagulation after ischemic stroke are more likely to have ICH outcomes than patients without CMBs. However, the study was limited by small sample sizes based on extracted data and lack of quality prospective cohort studies meeting inclusion criteria. Further investigation is necessary to conclude increased risk of ICH in this patient population.Disclosure: Dr. Faheem has nothing to disclose. Dr. Wang has received research support from TEVA Pharmaceuticals Ltd. Dr. Gronseth has received personal compensation in an editorial capacity for...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Faheem, N., Wang, Y., Gronseth, G. Tags: Intracerebral Hemorrhage Source Type: research

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