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Cerebrovascular Diseases

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https://www.readbyqxmd.com/read/28088807/posterior-versus-anterior-circulation-stroke-in-young-adults-a-comparative-study-of-stroke-aetiologies-and-risk-factors-in-stroke-among-young-fabry-patients-sifap1
#1
Bettina von Sarnowski, Ulf Schminke, Ulrike Grittner, Christian Tanislav, Tobias Böttcher, Michael G Hennerici, Turgut Tatlisumak, Jukka Putaala, Manfred Kaps, Franz Fazekas, Christian Enzinger, Arndt Rolfs, Christof Kessler
BACKGROUND: Although 20-30% of all strokes occur in the posterior circulation, few studies have explored the characteristics of patients with strokes in the posterior compared to the anterior circulation so far. Especially data on young patients is missing. METHODS: In this secondary analysis of data of the prospective multi-centre European sifap1 study that investigated stroke and transient ischemic attack (TIA) patients aged 18-55 years, we compared vascular risk factors, stroke aetiology, presence of white matter hyperintensities (WMH) and cerebral microbleeds (CMB) between patients with ischaemic posterior circulation stroke (PCS) and those having suffered from anterior circulation stroke (ACS) based on cerebral MRI...
January 14, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28088803/small-versus-large-ruptured-intracranial-aneurysm-concerns-with-the-site-of-aneurysm
#2
Bum Joon Kim, Hyun Goo Kang, Byeong-Duk Kwun, Jae-Sung Ahn, Jisung Lee, Sung Ho Lee, Dong-Wha Kang, Jong S Kim, Sun U Kwon
BACKGROUND: Although size is one of the strongest predictors, small aneurysms often rupture. We compared the characteristics of small and large ruptured intracranial aneurysms (RIAs) according to their location to find the factors associated with small RIAs in each location. METHODS: Patients with subarachnoid hemorrhage due to saccular RIAs were consecutively enrolled. The sizes were dichotomized as small (<5 mm) or large, and the location was classified as paraclinoid-distal internal carotid artery, sidewalls of anterior or middle cerebral artery (MCA; sidewall), MCA-bifurcation, anterior or posterior communicating artery (Acom or Pcom, respectively), and posterior circulation RIAs...
January 14, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28088798/the-intracranial-b2leed3s-score-and-the-risk-of-intracranial-hemorrhage-in-ischemic-stroke-patients-under-antiplatelet-treatment
#3
Pierre Amarenco, Leila Sissani, Julien Labreuche, Eric Vicaut, Marie Germaine Bousser, Angel Chamorro, Marc Fisher, Ian Ford, Kim M Fox, Michael G Hennerici, Heinrich Mattle, Peter M Rothwell, Philippe Gabriel Steg, Hans-Christoph Diener, Ralph L Sacco, Jacoba P Greving, Ale Algra
BACKGROUND: Chronic antiplatelet therapy in the post-acute phase of non-cardioembolic ischemic stroke is limited by the risk of intracranial hemorrhage (ICH) complications. METHODS: We developed an ICH risk score based on the PERFORM trial cohort (n = 19,100), which included patients with a non-cardioembolic ischemic stroke or transient ischemic attack, and externally validated this score in one contemporary trial of very similar size and inclusion criteria, the PRoFESS trial (n = 20,332 patients)...
January 14, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28049202/aortic-atherosclerosis-determines-increased-retrograde-blood-flow-as-a-potential-mechanism-of-retrograde-embolic-stroke
#4
Thomas Wehrum, Felix Guenther, Werner Vach, Beryl Primrose Gladstone, Sarah Wendel, Alexander Fuchs, Kehzong Wu, Christoph Johannes Maurer, Andreas Harloff
BACKGROUND: Retrograde brain embolization from complex plaques of the proximal descending aorta (DAo) has been identified as a new potential mechanism of stroke. Our purpose was to identify predictors of increased retrograde aortic blood flow indicating an elevated risk of brain embolization from the DAo. METHODS: A total of 485 patients with acute ischemic stroke were prospectively included and underwent transesophageal echocardiography. Blood flow velocities in the proximal DAo were studied using 2D pulse-wave Doppler ultrasound...
January 4, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28049200/a-mouse-model-of-post-stroke-pneumonia-induced-by-intra-tracheal-inoculation-with-streptococcus-pneumoniae
#5
Eva Mracsko, Sabine Stegemann-Koniszewski, Shin-Young Na, Alexander Dalpke, Dunja Bruder, Felix Lasitschka, Roland Veltkamp
BACKGROUND: Stroke-induced immunodeficiency increases the risk of infectious complications, which adversely affects neurological outcome. Among those, pneumonia affects as many as one third of stroke patients and is the main contributor to mortality in the post-acute phase of stroke. Experimental findings on post-stroke susceptibility to spontaneous pneumonia in mice are contradictory. Here, we established a mouse model inducing standardized bacterial pneumonia and characterized the impaired pulmonary cellular and humoral immune responses after experimental stroke...
January 4, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28049199/systemic-atherosclerosis-relate-to-brain-arterial-diameters-the-northern-manhattan-study
#6
Jose Gutierrez, Tatjana Rundek, Ken Cheung, Ahmet Bagci, Noam Alperin, Ralph L Sacco, Clinton B Wright, Mitchell S V Elkind, Marco R Di Tullio
BACKGROUND: Phenotypic expressions of arterial disease vary throughout the body and it is not clear to what extent systemic atherosclerosis influences brain arterial remodeling. We aim to test the hypothesis that systemic atherosclerosis is associated with brain arterial diameters. METHODS: Stroke-free participants in the Northern Manhattan Study MRI subcohort in whom carotid ultrasound, transthoracic echocardiogram, and brain MRA (n = 482) were performed were included in this analysis...
January 4, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28049196/refining-prognosis-for-intracerebral-hemorrhage-by-early-reassessment
#7
Matthew B Maas, Brandon A Francis, Rajbeer S Sangha, Bryan D Lizza, Eric M Liotta, Andrew M Naidech
BACKGROUND: Prognostic assessments, which are crucial for decision-making in critical illnesses, have shown unsatisfactory reliability. We compared the accuracy of a widely used prognostic score against a model derived from clinical data obtained 5 days after admission for patients with intracerebral hemorrhage (ICH), a condition for which prognostication has proven notoriously challenging and prone to bias. METHODS: Patients enrolled in a prospective observational cohort study of spontaneous ICH underwent hourly Glasgow Coma Scale (GCS) assessment...
January 4, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28049189/functional-long-term-outcome-after-left-versus-right-sided-intracerebral-hemorrhage
#8
Vanessa D Beuscher, Joji B Kuramatsu, Stefan T Gerner, Julia Köhn, Hannes Lücking, Stephan P Kloska, Hagen B Huttner
BACKGROUND AND PURPOSE: Hemispheric location might influence outcome after intracerebral hemorrhage (ICH). INTERACT suggested higher short-term mortality in right hemispheric ICH, yet statistical imbalances were not addressed. This study aimed at determining the differences in long-term functional outcome in patients with right- vs. left-sided ICH with a priori-defined sub-analysis of lobar vs. deep bleedings. METHODS: Data from a prospective hospital registry were analyzed including patients with ICH admitted between January 2006 and August 2014...
January 4, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27992865/a-current-estimation-of-the-early-risk-of-stroke-after-transient-ischemic-attack-a-systematic-review-and-meta-analysis-of-recent-intervention-studies
#9
Joan Valls, Maranta Peiro-Chamarro, Serafí Cambray, Jessica Molina-Seguin, Ikram Benabdelhak, Francisco Purroy
OBJECTIVE: Recent studies have demonstrated that there is a decrease in the risk of subsequent stroke after transient ischemic attack (TIA) when urgent care (UC) is administered. However, no meta-analysis has been developed with contemporaneous TIA studies. We perform a systematic review and a meta-analysis to establish the risk of early stroke recurrence (SR) considering data from studies that offered UC to TIA patients. METHODS: We searched for studies, without language restriction, from January 2007 to January 2015 according to PRISMA guidelines...
December 20, 2016: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27951536/glial-fibrillary-acidic-protein-for-prehospital-diagnosis-of-intracerebral-hemorrhage
#10
Michal Rozanski, Carolin Waldschmidt, Alexander Kunz, Ulrike Grittner, Martin Ebinger, Matthias Wendt, Benjamin Winter, Kerstin Bollweg, Kersten Villringer, Jochen B Fiebach, Heinrich J Audebert
BACKGROUND: Both, acute ischemic stroke (AIS) and hemorrhage stroke (intracerebral hemorrhage, ICH) require early attention but different treatment strategies. Plasma glial fibrillary acidic protein (GFAP) levels were found to be elevated in ICH patients after they arrived in the hospital. Because treatment options differed, we sought to determine whether GFAP can be used to accurately differentiate between of AIS and ICH in the prehospital setting. METHODS: We assessed acute stroke patients in the Stroke Emergency Mobile (STEMO)...
December 13, 2016: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27951543/adverse-influence-of-pre-stroke-dementia-on-short-term-functional-outcomes-in-patients-with-acute-ischemic-stroke-the-fukuoka-stroke-registry
#11
Yoshinobu Wakisaka, Ryu Matsuo, Jun Hata, Junya Kuroda, Takanari Kitazono, Masahiro Kamouchi, Tetsuro Ago
BACKGROUND: Dementia and stroke are major causes of disability in the elderly. However, the association between pre-stroke dementia and functional outcome after stoke remains unresolved. We aimed to determine this association in patients with acute ischemic stroke. METHODS: Among patients registered in the Fukuoka Stroke Registry from June 2007 to May 2015, 4,237 patients with ischemic stroke within 24 h of onset, who were functionally independent before the onset, were enrolled in this study...
December 10, 2016: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27898402/recent-update-on-carotid-endarterectomy-versus-carotid-artery-stenting
#12
Raywat Noiphithak, Anusak Liengudom
Carotid artery stenosis (CS) is a major cause of ischemic stroke. Treatment of CS consists of best medical treatment and carotid revascularization (CR), including carotid endarterectomy (CEA) and carotid artery stenting (CAS). Both CR techniques have their own procedural risks. Therefore, selection of the appropriate treatment for patients with CS is relatively complicated. Many studies and guidelines have reported the efficacy of each treatment for both symptomatic and asymptomatic patients. However, the results are still controversial, especially concerning the efficacy and safety of CEA and CAS...
November 30, 2016: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27871078/cerebral-microhemorrhages-and-meningeal-siderosis-in-infective-endocarditis
#13
Ajay Malhotra, Joseph Schindler, Brian Mac Grory, Stacy Y Chu, Teddy S Youn, Charles Matouk, David M Greer, Matthew Schrag
OBJECTIVE: Patients with infective endocarditis (IE) frequently experience cerebral insults, and neurological involvement in IE has been reported to herald a worse prognosis. In this manuscript, we describe a distinctive pattern of findings on susceptibility-weighted imaging (SWI) sequences in subjects with IE. METHODS: Patients with IE who underwent SWI MRI at an academic hospital from 2009 to 2014 were retrospectively analyzed. The pattern of findings was compared to SWI findings in groups of subjects with cerebral amyloid angiopathy (CAA) or severe hypertension...
November 22, 2016: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27866207/post-stroke-fatigue-may-be-associated-with-the-promoter-region-of-a-monoamine-oxidase-a-gene-polymorphism
#14
Smi Choi-Kwon, Mihye Ko, Sang-Eun Jun, Juhan Kim, Kyung-Hee Cho, Hyun-Wook Nah, Hasup Song, Jong S Kim
BACKGROUND: Post-stroke fatigue (PSF) is a common sequela of stroke. Despite reports of serotonergic involvement in the etiology of PSF, the potential contribution of serotonergic genes in the development of PSF needs to be investigated. METHODS: A total of 373 patients, who experienced ischemic stroke for PSF, were evaluated 3 months after the stroke. PSF was assessed using the Fatigue Severity Scale. The genomic DNA collected and stored in a -70°C freezer was genotyped for 6 polymorphisms in genes associated with serotonin synthesis (tryptophan hydroxylase 1 (TPH1) A218C, TPH2 rs10879355, and TPH2 rs4641528), transport (the promoter region of the serotonin transporter protein), and catabolism (the 30-bp functional variable number tandem repeat) polymorphism in the promoter region of monoamine oxidase A (MAO-A)...
November 19, 2016: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27846631/prognostic-factors-and-pattern-of-long-term-recovery-with-mlc601-neuroaid%C3%A2-in-the-chinese-medicine-neuroaid-efficacy-on-stroke-recovery-extension-study
#15
Narayanaswamy Venketasubramanian, Chun Fan Lee, Sherry H Young, San San Tay, Thirugnanam Umapathi, Annabelle Y Lao, Herminigildo H Gan, Alejandro C Baroque Ii, Jose C Navarro, Hui Meng Chang, Joel M Advincula, Sombat Muengtaweepongsa, Bernard P L Chan, Carlos L Chua, Nirmala Wijekoon, H Asita de Silva, John Harold B Hiyadan, Nijasri C Suwanwela, K S Lawrence Wong, Niphon Poungvarin, Gaik Bee Eow, Christopher L H Chen
BACKGROUND: The Chinese Medicine NeuroAiD Efficacy on Stroke recovery - Extension (CHIMES-E) study is among the few acute stroke trials with long-term outcome data. We aimed to evaluate the recovery pattern and the influence of prognostic factors on treatment effect of MLC601 over 2 years. METHODS: The CHIMES-E study evaluated the 2 years outcome of subjects aged ≥18 years with acute ischemic stroke, National Institutes of Health Stroke Scale (NIHSS) score 6-14, pre-stroke modified Rankin Scale (mRS) score ≤1 included in a multicenter, randomized, double-blind, placebo-controlled trial of MLC601 for 3 months...
November 15, 2016: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27842319/designated-stroke-center-status-and-hospital-characteristics-as-predictors-of-in-hospital-mortality-among-hemorrhagic-stroke-patients-in-new-york-2008-2012
#16
Hajere J Gatollari, Anna Colello, Bonnie Eisenberg, Ian Brissette, Jorge Luna, Mitchell S V Elkind, Joshua Z Willey
BACKGROUND: Although designated stroke centers (DSCs) improve the quality of care and clinical outcomes for ischemic stroke patients, less is known about the benefits of DSCs for patients with intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH). HYPOTHESIS: Compared to non-DSCs, hospitals with the DSC status have lower in-hospital mortality rates for hemorrhagic stroke patients. We believed these effects would sustain over a period of time after adjusting for hospital-level characteristics, including hospital size, urban location, and teaching status...
November 15, 2016: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27820930/is-there-benefit-from-stenting-on-cognitive-function-in-intracranial-atherosclerosis
#17
Tanya N Turan, Alison Smock, George Cotsonis, David Bachman, Sami Al Kasab, Michael J Lynn, Azhar Nizham, Collin P Derdeyn, David Fiorella, Scott Janis, Bethany Lane, Jean Montgomery, Marc I Chimowitz
BACKGROUND: Revascularization of stenotic cerebral arteries is hypothesized to improve cognition by increasing cerebral perfusion. AIMS: We compared cognition impairment among patients treated with percutaneous angioplasty and stenting (PTAS) and aggressive medical management (AMM) versus AMM alone in the Stenting versus Aggressive Medical Therapy for Intracranial Arterial Stenosis (SAMMPRIS) Trial. METHODS: In SAMMPRIS, 451 patients with recent transient ischemic attack or stroke attributed to 70-99% intracranial stenosis were randomized to PTAS plus AMM or AMM alone...
November 5, 2016: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27750252/optimized-flat-detector-ct-in-stroke-imaging-ready-for-first-line-use
#18
Matthias Eckert, Philipp Gölitz, Hannes Lücking, Tobias Struffert, Frauke Knossalla, Arnd Doerfler
BACKGROUND: Using flat-detector CT (FD-CT) for stroke imaging has the advantage that both diagnostic imaging and endovascular therapy can be performed directly within the Angio Suite without any patient transfer and time delay. Thus, stroke management could be speeded up significantly, and patient outcome might be improved. But as precondition for using FD-CT as primary imaging modality, a reliable exclusion of intracranial hemorrhage (ICH) has to be possible. This study aimed to investigate whether optimized native FD-CT, using a newly implemented reconstruction algorithm, may reliably detect ICH in stroke patients...
October 18, 2016: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27750251/white-matter-hyperintensities-improve-ischemic-stroke-recurrence-prediction
#19
Søren Due Andersen, Torben Bjerregaard Larsen, Anders Gorst-Rasmussen, Yousef Yavarian, Gregory Y H Lip, Flemming W Bach
BACKGROUND: Nearly one in 5 patients with ischemic stroke will invariably experience a second stroke within 5 years. Stroke risk stratification schemes based solely on clinical variables perform only modestly in non-atrial fibrillation (AF) patients and improvement of these schemes will enhance their clinical utility. Cerebral white matter hyperintensities are associated with an increased risk of incident ischemic stroke in the general population, whereas their association with the risk of ischemic stroke recurrence is more ambiguous...
October 18, 2016: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27750246/the-course-of-activities-in-daily-living-who-is-at-risk-for-decline-after-first-ever-stroke
#20
Roderick Wondergem, Martijn F Pisters, Eveline J Wouters, Nick Olthof, Rob A de Bie, Johanna M A Visser-Meily, Cindy Veenhof
BACKGROUND: Stroke is not only an acute disease, but for the majority of patients, it also becomes a chronic condition. There is a major concern about the long-term follow-up with respect to activities of daily living (ADL) in stroke survivors. Some patients seem to be at risk for decline after a first-ever stroke. The purpose of this study was to determine the course of ADL from 3 months after the first-ever stroke and onward and identify factors associated with decline in ADL. METHODS: A systematic literature search of 3 electronic databases through June 2015 was conducted...
October 18, 2016: Cerebrovascular Diseases
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