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Topographic Assessment of Acute Ischemic Changes for Prognostication of Anterior Circulation Stroke
CONCLUSIONSTopographic assessment of acute ischemic changes using the sASPECTS (including caudate, lentiform nucleus, insula, and M5) can predict disability/death in anterior circulation stroke as accurately as the ASPECTS; and may help predict response to treatment and risk of developing symptomatic ICH.
Source: Journal of Neuroimaging - August 31, 2016 Category: Radiology Authors: Seyedmehdi Payabvash, Siamak Noorbaloochi, Adnan I. Qureshi Tags: Clinical Investigative Study Source Type: research

Determining Stroke Onset Time Using Quantitative MRI: High Accuracy, Sensitivity and Specificity Obtained from Magnetic Resonance Relaxation Times
Many ischaemic stroke patients are ineligible for thrombolytic therapy due to unknown onset time. Quantitative MRI (qMRI) is a potential surrogate for stroke timing. Rats were subjected to permanent middle cerebral artery occlusion and qMRI parameters including hemispheric differences in apparent diffusion coefficient, T2-weighted signal intensities, T1 and T2 relaxation times (qT1, qT2) andf1,f2 andVoverlap were measured at hourly intervals at 4.7 or 9.4 T. Accuracy and sensitivity for identifying strokes scanned within and beyond 3 h of onset was determined. Accuracy forVoverlap,f2 and qT2 (>90%) was significantly higher...
Source: Cerebrovascular Diseases Extra - August 25, 2016 Category: Neurology 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

Simple In-Hospital Interventions to Reduce Door-to-CT Time in Acute Stroke.
Conclusion. Our interventions significantly reduced DTC time and resulted in an acceptable DTN time. These interventions are feasible in most hospitals and should be considered. PMID: 27478641 [PubMed]
Source: International Journal of Vascular Medicine - August 2, 2016 Category: Cardiology Tags: Int J Vasc Med Source Type: research

Drip-and-Ship Thrombolytic Therapy Supported by the Telestroke System for Acute Ischemic Stroke Patients Living in Medically Under-served Areas.
Authors: Kageji T, Obata F, Oka H, Kanematsu Y, Tabata R, Tani K, Bando H, Nagahiro S Abstract There are a few stroke specialists in medically under-served areas in Japan. Consequently, in remote area patients may not receive thrombolysis with intravenous recombinant tissue plasminogen activator (iv rt-PA), the standard treatment for acute ischemic stroke. Using a mobile telestroke support system (TSS) that accesses the internet via a smart phone, we implemented iv rt-PA infusion therapy under a drip-and-ship protocol to treat the stroke patients in medically under-served areas. The physicians at the Tokushima Pref...
Source: Neurologia Medico-Chirurgica - June 25, 2016 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Nano-zymography Using Laser-Scanning Confocal Microscopy Unmasks Proteolytic Activity of Cell-Derived Microparticles
Cell-derived microparticles (MPs) are nano-sized vesicles released by activated cells in the extracellular milieu. They act as vectors of biological activity by carrying membrane-anchored and cytoplasmic constituents of the parental cells. Although detection and characterization of cell-derived MPs may be of high diagnostic and prognostic values in a number of human diseases, reliable measurement of their size, number and biological activity still remains challenging using currently available methods. In the present study, we developed a protocol to directly image and functionally characterize MPs using high-resolution las...
Source: Theranostics - June 5, 2016 Category: Molecular Biology Authors: Aurélien Briens, Maxime Gauberti, Jérôme Parcq, Joan Montaner, Denis Vivien, Sara Martinez de Lizarrondo Tags: Research Paper Source Type: research

Effect of prehospital notification on acute stroke care: a multicenter study
The sooner thrombolytic therapy is given to acute ischemic stroke patients, the better the outcome. Prehospital notification may shorten the time between hospital arrival and brain computed tomography (door-to...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - April 27, 2016 Category: Emergency Medicine Authors: Ming-Ju Hsieh, Sung-Chun Tang, Wen-Chu Chiang, Li-Kai Tsai, Jiann-Shing Jeng and Matthew Huei-Ming Ma Source Type: research

Stroke Code Simulation Lab; Save Time Save Brain! (P2.375)
CONCLUSIONS: The stroke code simulation lab met its objectives of improving the neurology residents’ knowledge and experience managing stroke codes. It was perceived as a valuable exercise. Further data will determine if the stroke code simulation lab improves patient care.Disclosure: Dr. Mao has nothing to disclose. Dr. Zidan has nothing to disclose. Dr. Afzal has nothing to disclose. Dr. Cherukuri has nothing to disclose. Dr. Qadeer has nothing to disclose. Dr. Bradshaw has received research support from Cytokinetcs.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Mao, Y., Zidan, A., Afzal, U., Cherukuri, R., Qadeer, U., Bradshaw, D. Tags: Research Methodology and Education: Patient Safety and Quality Source Type: research

DWI Lesion Patterns Predict Outcome in Stroke Patients with Thrombolysis
Background: Lesion patterns may predict prognosis after acute ischemic stroke within the middle cerebral artery (MCA) territory; yet it remains unclear whether such imaging prognostic factors are related to patient outcome after intravenous thrombolysis. Aims: The aim of this study is to investigate the clinical outcome after intravenous thrombolysis in acute MCA ischemic strokes with respect to diffusion-weighted imaging (DWI) lesion patterns. Methods: Consecutive acute ischemic stroke cases of the MCA territory treated over a 7-year period were retrospectively analyzed. All acute MCA stroke patients underwent a MRI scan ...
Source: Cerebrovascular Diseases - October 30, 2015 Category: Neurology Source Type: research

Thrombolytic therapy for pulmonary embolism.
CONCLUSIONS: There is low quality evidence that thrombolytics reduce death following acute pulmonary embolism compared with heparin. Furthermore, thrombolytic therapies included in the review were heterogeneous. Thrombolytic therapy may be helpful in reducing the recurrence of pulmonary emboli but may cause more major and minor haemorrhagic events and stroke. More high quality double blind RCTs assessing safety and cost-effectiveness are required. PMID: 26419832 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - September 30, 2015 Category: Journals (General) Authors: Hao Q, Dong BR, Yue J, Wu T, Liu GJ Tags: Cochrane Database Syst Rev Source Type: research

Stroke of a cardiac myxoma origin
Conclusion: Cardiac myxoma stroke is rare. Often does it affect young females. For an improved diagnostic accuracy, magnetic resonance imaging of the brain and echocardiography are imperative for young stroke patients in identifying the cerebral infarct and determining the stroke of a cardiac origin. Immediate thrombolytic therapy may completely resolve the cerebral stroke and improve the neurologic function of the patients. An early surgical resection of cardiac myxoma is recommended in patients with not large territory cerebral infarct. Resumo Objetivo: As características clínicas do acidente vascular cerebral causado ...
Source: Revista Brasileira de Cirurgia Cardiovascular - June 19, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Assessment of acute stroke cerebral CT examinations by anaesthesiologists
ConclusionsThis study suggests that anaesthesiologists who are experienced in pre‐hospital care may be quickly trained to assess cerebral CT examinations in acute stroke patients with regard to radiological contraindications for thrombolytic therapy.
Source: Acta Anaesthesiologica Scandinavica - May 1, 2015 Category: Anesthesiology Authors: M. R. Hov, T. Nome, E. Zakariassen, D. Russell, J. Røislien, H. M. Lossius, C. G. Lund Tags: Original Article Source Type: research

Beating the Clock: Time Delays to Thrombolytic Therapy with Advanced Imaging and Impact of Optimized Workflow
This study is to assess the time delay while using this scanner compared with our 64-slice scanner.
Source: Journal of Stroke and Cerebrovascular Diseases - April 20, 2015 Category: Neurology Authors: Santanu Chakraborty, James Ross, Mathew J. Hogan, Dar Dowlatshahi, Grant Stotts Source Type: research

Improvement in Rates of Thrombolytic Therapy in Acute Stroke by a Telestroke Program in Rural Northern Wisconsin (P1.011)
Conclusion: Following development of a Telestroke program in northern Wisconsin, rural stroke patients benefited from dramatic increases in access to neurological expertise and acute thrombolytic treatment. Patients and providers have embraced the program with plans to expand Telestroke to other remote access hospitals.Disclosure: Dr. Kartje has nothing to disclose. Dr. Klemm has nothing to disclose. Dr. Heil has nothing to disclose. Dr. Antoniotti has nothing to disclose. Dr. Martin has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Kartje, R., Klemm, S., Heil, L., Antoniotti, N., Martin, T. Tags: Cerebrovascular Disease and Interventional Neurology I ePosters Source Type: research

Systems and Care Process Parameters as Determinants of Onset-to-Treatment Times in Acute Ischemic Stroke: A Simulation Study (P1.018)
CONCLUSIONS: We employed a realistic simulation of AIS care to explore performance characteristics of proposed AIS care process configurations during the narrow window of opportunity to deliver thrombolytic therapy. This simulation methodology provides a model for prototyping process reengineering, in which essential details and assumptions in AIS care are identified for critical review by stakeholders. Study Supported by: Genentech, Inc.Disclosure: Dr. Levy has received personal compensation for activities with Genentech. Dr. Norris has received personal compensation for activities with Genentech. Dr. Tayama has received ...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Levy, D., Norris, D., Tayama, D. Tags: Cerebrovascular Disease and Interventional Neurology I ePosters Source Type: research

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