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Specialty: Neurology
Management: National Institutes of Health (NIH)

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Total 425 results found since Jan 2013.

Use of Diterpene Ginkgolides Meglumine Injection to Regulate Plasma Levels of PAI-1 and t-PA in Patients With Acute Atherosclerotic Cerebral Infarction
Background: To: (i) explore the effect of diterpene ginkgolides meglumine injection (DGMI) on neurological deficit symptoms in acute atherosclerotic cerebral infarction (AACI) patients; (ii) measure the level of plasma plasminogen activator inhibitor (PAI)-1 and tissue plasminogen activator (t-PA). Methods: Eighty AACI patients were divided equally and randomly into the DGMI group and control group. In addition to basic treatment, the DGMI group was treated with DGMI (25 mg/d) for 14 days. The control group had basic treatment without DGMI. Before and after treatment, the degree of neurological deficit was ass...
Source: The Neurologist - November 1, 2022 Category: Neurology Tags: Original Articles Source Type: research

Impact of patency of the carotid terminus and middle cerebral artery on early clinical outcomes in patients with acute internal carotid artery occlusion and mild symptoms
This study aimed to address the association between early clinical outcomes and patency of the ICT and middle cerebral artery (MCA) in patients with acute ICAO with mild symptoms. Methods: Of 1214 consecutive patients with acute ischemic stroke or transient ischemic attack due to large vessel occlusion, patients with ipsilateral ICAO and initial National Institutes of Health Stroke Scale score (NIHSS) ≤ 5 were retrospectively enrolled. We examined the associations between clinical factors including patency of the ICT and MCA and recurrence of stroke or early neurological deterioration (REND). Significant early neurologi...
Source: Cerebrovascular Diseases Extra - October 24, 2022 Category: Neurology Source Type: research

A lesion extending three or more slices as a predictor of progressive infarction in anterior circulation small subcortical infarction
Progressive infarction (PI) is common in small subcortical infarction and may lead to a poor outcome. The purpose of our study is to identify neuroimaging predictors for PI. From April 2017 to December 2020, we enrolled 86 patients with an anterior circulation subcortical infarction within 48 h after onset. Progressive infarction was defined by an increase of ≥ one point in motor power or ≥ two points in the total National Institute of Health Stroke Scale score within 7 days after admission and further confirmed by diffusion-weighted imaging (DWI). To identify predictors, demographic characteristics, clinical informati...
Source: Frontiers in Neurology - October 5, 2022 Category: Neurology Source Type: research

Clinical effect of successful reperfusion in patients presenting with NIHSS < 6 and large vessel occlusion
Endovascular thrombectomy is now recommended as the standard treatment for acute ischemic stroke (AIS) with proximal large  vessel occlusion (LVO) of the anterior circulation with National Institutes of Health Stroke Scale (NIHSS) ≥6.1 The Safe Implementation of Thrombolysis in Stroke (SITS) International Stroke Thrombolysis registry reviewed vessel imaging and reported that 25% of patients with mild stroke had extr acranial or intracranial occlusion.2 The efficacy of endovascular thrombectomy (EVT) in patients with a low NIHSS with the presence of AIS-LVO continues to be hotly debated, including retrospective and pros...
Source: Journal of Stroke and Cerebrovascular Diseases - September 1, 2022 Category: Neurology Authors: Yang Hu, Shuhan Huang, Gongbo Li, Min Song, Yuqing Zhang, Dongmei Wu, Yangmei Chen, Meng Zhang, Haiyan Luo Source Type: research

Remote ischemic conditioning for acute ischemic stroke part 2: Study protocol for a randomized controlled trial
This study is an investigator-initiated, multicenter, prospective, randomized, open-label, parallel-group clinical trial. The sample size is 400, comprising 200 patients who will receive RIC and 200 controls. The patients will be divided into three groups according to their National Institutes of Health Stroke Scale score at enrollment: 5–9, mild; 10–14, moderate; 15–20, severe. The RIC protocol will be comprised of four cycles, each consisting of 5 min of blood pressure cuff inflation (at 200 mmHg or 50 mmHg above the systolic blood pressure) followed by 5 min of reperfusion, with the cuff placed on the thigh on the...
Source: Frontiers in Neurology - August 8, 2022 Category: Neurology Source Type: research

Association of Changed Serum Brain Biomarkers With Perihematomal Edema and Early Clinical Outcome in Primary ICH Patients
Background: Perihematomal edema (PHE) following primary intracranial hemorrhages (ICHs) affects the patient outcome. Also, serum biomarkers such as S100 calcium-binding protein B (S100B) and glial fibrillary acidic protein (GFAP) have been associated with ICHs outcome. We aimed to investigate the association between these biomarkers and PHE in ICH patients. Methods: In this cross-sectional study, patients with primary ICH between January 2020 and August 2020 were evaluated. All participants underwent spiral brain computed tomography scans upon admission, and 48 to 72 hours later and quantification of initial hem...
Source: The Neurologist - July 1, 2022 Category: Neurology Tags: Original Articles Source Type: research

Large Middle Cerebral Artery Ischemic Stroke in a Therapeutically Anticoagulated Patient With Severe SARS-CoV-2 Infection
Introduction: Coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with hypercoagulability which can predispose infected patients to both arterial and venous thromboembolic complications. Despite therapeutic anticoagulation, there remains a risk of ischemic strokes, which may lead to adverse patient outcomes. Only a few cases are described in the literature regarding SARS-CoV-2 positive patients developing thrombotic ischemic strokes despite therapeutic anticoagulation. Case Report: The following is a case discussion regarding a 71-year-old female with pas...
Source: The Neurologist - July 1, 2022 Category: Neurology Tags: Case Report/Case Series Source Type: research

Implications of the National Institutes of Health Stroke Scale Cookie Theft Picture —A Closer Look
This Viewpoint discusses the implications of use of the National Institutes of Health Stroke Scale Cookie Theft picture.
Source: JAMA Neurology - June 13, 2022 Category: Neurology Source Type: research

Circular RNA FUNDC1 for Prediction of Acute Phase Outcome and Long-Term Survival of Acute Ischemic Stroke
This study aimed to explore the potential value of circRNAs for identifying acute neurological deterioration and estimating long-term survival for acute ischemic stroke (AIS). One hundred healthy controls and 200 patients with AIS within 72 h were recruited, 140 of whom were admitted within 24 h after onset. CircRNA levels in peripheral blood were measured by quantitative polymerase chain reaction (qPCR). Compared to the controls, the levels of three circRNAs were significantly increased in three subgroups of patients, including large artery atherosclerosis (LAA) stroke, small artery occlusion (SAO) stroke, and cardioembol...
Source: Frontiers in Neurology - June 3, 2022 Category: Neurology Source Type: research

Efficacy and Safety of Recombinant Human Prourokinase in Acute Ischemic Stroke: A Phase IIa Randomized Clinical Trial
AbstractRecombinant human prourokinase (rhPro-UK) is a novel thrombolytic that has been approved to treat patients with acute myocardial infarction. However, the safety and efficacy of intravenous rhPro-UK in patients with acute ischemic stroke (AIS) has not been well established. We aimed to investigate the safety and preliminary efficacy of rhPro-UK in patients with AIS in a multi-center phase IIa trial setting. One hundred nineteen patients within 4.5  h of AIS onset were enrolled in this randomized, open-label, 23-center phase IIa clinical trial. Patients were randomly assigned to 35 mg (n = 40) or 50 mg (n =â...
Source: Translational Stroke Research - May 3, 2022 Category: Neurology Source Type: research

Predictive Factors for Early-Onset Seizures in Patients With Cerebral Venous Sinus Thrombosis
Seizures are reported to be important factors contributing to poor prognosis in patients with cerebral venous sinus thrombosis (CVST). However, the predictive factors for concurrent early onset seizures in patients with CVST remain unclear. To identify the predictive factors of early seizures in patients with CVST, this study retrospectively evaluated the clinical data of patients diagnosed with CVST at two centers from January 2011 to December 2020 and analyzed the relationship between admission characteristics and early onset seizures. A total of 112 CVST patients (63 men and 49 women; mean age 39.82 ± 15.70 years) were...
Source: Frontiers in Neurology - March 29, 2022 Category: Neurology Source Type: research

Is Selenium Supplementation Beneficial in Acute Ischemic Stroke?
This study proposed to investigate the effect of intravenous Se (Selenase) administration in patients with acute ischemic stroke (AIS) on neurological outcomes, antioxidant enzyme activity, and inflammatory marker levels. Methods: AIS patients (n=50) were recruited from a neurology unit of a university-affiliated hospital. Patients were randomly assigned to receive either Selenase or placebo (saline) for 5 days. The modified ranking scale, the national institute of health stroke scale, and the mini-mental state examination, as primary outcomes, and the serum GPx concentration, total antioxidant activity, and tumor n...
Source: The Neurologist - March 1, 2022 Category: Neurology Tags: Original Articles Source Type: research

Multi-ancestry GWAS reveals excitotoxicity associated with outcome after ischaemic stroke
AbstractDuring the first hours after stroke onset, neurological deficits can be highly unstable: some patients rapidly improve, while others deteriorate. This early neurological instability has a major impact on long-term outcome. Here, we aimed to determine the genetic architecture of early neurological instability measured by the difference between the National Institutes of Health Stroke Scale (NIHSS) within 6  h of stroke onset and NIHSS at 24 h.A total of 5876 individuals from seven countries (Spain, Finland, Poland, USA, Costa Rica, Mexico and Korea) were studied using a multi-ancestry meta-analyses. We found tha...
Source: Brain - February 25, 2022 Category: Neurology Source Type: research

Evaluation of stroke prognostication using age and NIH Stroke Scale index (SPAN-100 index) in delayed intravenous thrombolysis patients (beyond 4.5 hours)
the efficacy of delayed intravenous tissue plasminogen activator (tPA), beyond the 4.5 h window, is evolving. Advanced age and high admission National Institutes of Health Stroke Scale (NIHSS) score are proposed to adversely affect the outcome of delayed thrombolysis and limit the inclusion criteria. The summation of patient age and admission NIHSS score was introduced as the SPAN-100 index as a tool of prediction of the clinical outcome after acute ischemic stroke (AIS). We aimed to assess the SPAN-100 index in AIS thrombolysed patients after 4.5 h.
Source: Journal of Stroke and Cerebrovascular Diseases - February 16, 2022 Category: Neurology Authors: Nada Elsaid, Guido Bigliardi, Maria Luisa Dell'Acqua, Laura Vandelli, Ludovico Ciolli, Livio Picchetto, Giuseppe Borz ì, Riccardo Ricceri, Roberta Pentore, Stefano Vallone, Stefano Meletti, Ahmed Saied Source Type: research

Data Do Not Support Selection of Patients for Stroke Treatment Within the 16- to 24-Hour Interval —Reply
In Reply We thank Powers for his comments regarding our article. He raises the question if the positive result for patients with target perfusion-imaging mismatch in the 12.8- to 24-hour tercile in the Analysis of Pooled Data From Randomized Studies of Thrombectomy More Than 6 Hours After Last Well Known (AURORA) study could solely be due to a benefit from 12.8 to 16 hours since last known well subgroup, with neutral or negative effects in the 16- to 24-hour time period. This was not the case. Data for patients in the 16- to 24-hour group with the target mismatch profile demonstrated an odds ratio of 3.82 (95% CI, 1.07-13....
Source: JAMA Neurology - February 14, 2022 Category: Neurology Source Type: research