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Perioperative Stroke
AbstractPurpose of ReviewThis review overviews perioperative stroke as it pertains to specific surgical procedures.Recent FindingsAs awareness of perioperative stroke increases, so does the opportunity to potentially improve outcomes for these patients by early stroke recognition and intervention.SummaryPerioperative stroke is defined to be any stroke that occurs within 30  days of the initial surgical procedure. The incidence of perioperative stroke varies and is dependent on the specific type of surgery performed. This chapter overviews the risks, mechanisms, and acute evaluation and management of perioperative stroke i...
Source: Current Neurology and Neuroscience Reports - April 26, 2020 Category: Neuroscience Source Type: research

Diagnostic Value of Somatosensory Evoked Potential Changes During Carotid Endarterectomy for 30-Day Perioperative Stroke
Carotid Endarterectomy (CEA) is a standard surgical treatment in the secondary prevention of stroke performed in patients with both symptomatic and asymptomatic carotid stenosis (CS)(Malcharek et al. 2013), (Pennekamp et al. 2011), (Pulli et al. 2002), (Reinert et al. 2012). CEA is shown to benefit symptomatic and asymptomatic patients, when compared to medical management alone in the short term and long term due to decreased stroke. (Akhmedov et al. 2013), (Baton et al. 2007), (Floriani et al. 1989), (Hartmann et al.
Source: Clinical Neurophysiology - June 13, 2018 Category: Neuroscience Authors: Rajiv P. Reddy, Indraneel S. Brahme, Tejas Karnati, Jeffrey Balzer, Donald J. Crammond, Katherine Anetakis, Parthasarathy D. Thirumala Source Type: research

The impact of pre-operative symptoms on carotid endarterectomy Outcomes: Analysis of the ACS-NSQIP carotid endarterectomy database
Publication date: Available online 1 February 2020Source: Journal of Clinical NeuroscienceAuthor(s): Varun S. Shah, Daniel Kreatsoulas, David Dornbos, Santino Cua, Ciarán J. PowersAbstractCarotid artery stenosis accounts for up to 20% of ischemic strokes. Since the 1950 s, one of the primary surgical treatment for this condition is carotid endarterectomy (CEA). Because of improvement of medical therapy for carotid artery atherosclerosis and the increased use of carotid artery stents, CEA is indicated if the risk of stroke and death are low. The goal of this study is to characterize the impact of pre-operative stroke and ...
Source: Journal of Clinical Neuroscience - February 2, 2020 Category: Neuroscience Source Type: research

Ischemic complications after tailored carotid artery stenting in different subpopulations with high-grade stenosis: Feared but rare
Publication date: Available online 28 November 2014 Source:Journal of Clinical Neuroscience Author(s): José E. Cohen , J. Moshe Gomori , Eyal Itshayek , Stylianos Pikis , Galina Keigler , Roni Eichel , Ronen R. Leker Although the procedural and postoperative safety profile of carotid artery stenting (CAS) has been steadily improving, many centers still recommend carotid endarectomy (CEA) over CAS. We assessed outcomes (procedural and postoperative stroke) following tailored CAS in a cohort of patients managed at a single academic medical center. Outcomes for patients with carotid artery stenosis treated from 2005–2013...
Source: Journal of Clinical Neuroscience - November 29, 2014 Category: Neuroscience Source Type: research

Transient ischemic attack as a medical emergency.
Authors: Okada Y Abstract Since transient ischemic attack (TIA) is regarded as a medical emergency with high risk for early stroke recurrence, the underlying mechanisms should be immediately clarified to conclude a definitive diagnosis and provide early treatment. Early risk stratification using ABCD(2) scores can predict the risk of ischemic stroke occurring after TIA. Carotid ultrasonography (US) can evaluate the degree of stenosis, plaque properties and flow velocity of ICA lesions. High-risk mobile plaques can be classified by carotid US, and aortogenic sources of emboli can be detected by transesophageal echoc...
Source: Frontiers of Neurology and Neuroscience - December 2, 2015 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

Diagnostic accuracy of EEG changes during carotid endarterectomy in predicting perioperative strokes
Publication date: Available online 21 October 2015 Source:Journal of Clinical Neuroscience Author(s): Parthasarathy D. Thirumala, Karthy Thiagarajan, Satyanarayana Gedela, Donald J. Crammond, Jeffrey R. Balzer The 30 day stroke rate following carotid endarterectomy (CEA) ranges between 2–6%. Such periprocedural strokes are associated with a three-fold increased risk of mortality. Our primary aim was to determine the diagnostic accuracy of electroencephalogram (EEG) in predicting perioperative strokes through meta-analysis of existing literature. An extensive search for relevant literature was undertaken using PubM...
Source: Journal of Clinical Neuroscience - October 22, 2015 Category: Neuroscience Source Type: research

Carotid Artery Stenosis: Medical Therapy, Surgery, and Stenting
AbstractPurpose of ReviewThe purpose of the study was to update the recent information pertaining to carotid artery stenosis risk stratification and treatment.Recent FindingsCurrent decision-making related to carotid artery stenosis is based on clinical trials that are outdated. Medical therapy has improved considerably in the past two decades, and this has reduced the stroke rate for both symptomatic and asymptomatic carotid stenoses. In recent community-based studies, the stroke risk with asymptomatic stenosis has been<  1% per year. For asymptomatic carotid stenosis, new trials such as CREST 2 and ECST 2 will determ...
Source: Current Neurology and Neuroscience Reports - August 19, 2017 Category: Neuroscience Source Type: research

Neuropsychological performance after carotid endarterectomy
Conclusions: CEA not only decreases the long-term risk of ischemic stroke, but may also improve cognitive performance. In a small percentage of cases, there is higher risk of embolic stroke and silent microembolization due to surgery, which may have a negative impact on cognitive function. However, we did not detect any cognitive impairment after CEA in our patients.PMID:35164472 | DOI:10.31083/j.jin2101036
Source: Journal of Integrative Neuroscience - February 15, 2022 Category: Neuroscience Authors: Lenka Kr ámská Martin Kov ář Lucia Hre šková Martin Jerie Source Type: research

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