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Cerebrovascular Diseases

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https://www.readbyqxmd.com/read/28427054/preceding-intravenous-thrombolysis-in-patients-receiving-endovascular-therapy
#1
Hong-Kyun Park, Jong-Won Chung, Jeong-Ho Hong, Min Uk Jang, Hyun-Du Noh, Jong-Moo Park, Kyusik Kang, Soo Joo Lee, Youngchai Ko, Jae Guk Kim, Jae-Kwan Cha, Dae-Hyun Kim, Hyun-Wook Nah, Moon-Ku Han, Beom Joon Kim, Tai Hwan Park, Sang-Soon Park, Kyung Bok Lee, Jun Lee, Keun-Sik Hong, Yong-Jin Cho, Byung-Chul Lee, Kyung-Ho Yu, Mi-Sun Oh, Ki-Hyun Cho, Joon-Tae Kim, Dong-Eog Kim, Wi-Sun Ryu, Jay Chol Choi, Wook-Joo Kim, Dong-Ick Shin, Min-Ju Yeo, Sung Il Sohn, Ji Sung Lee, Juneyoung Lee, Byung-Woo Yoon, Hee-Joon Bae
BACKGROUND: The beneficial effects of endovascular therapy (EVT) in acute ischemic stroke have been demonstrated in recent clinical trials using new-generation thrombectomy devices. However, the comparative effectiveness and safety of preceding intravenous thrombolysis (IVT) in this population has rarely been evaluated. METHODS: From a prospective multicenter stroke registry database in Korea, we identified patients with acute ischemic stroke who were treated with EVT within 8 h of onset and admitted to 14 participating centers during 2008-2013...
April 21, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28419989/admission-low-magnesium-level-is-associated-with-in-hospital-mortality-in-acute-ischemic-stroke-patients
#2
Shoujiang You, Chongke Zhong, Huaping Du, Yu Zhang, Danni Zheng, Xia Wang, Chenhong Qiu, Hongru Zhao, Yongjun Cao, Chun-Feng Liu
BACKGROUND: Low magnesium levels are associated with an elevated risk of stroke. In this study, we investigated the association between magnesium levels on hospital admission and in-hospital mortality in acute ischemic stroke (AIS) patients. METHODS: A total of 2,485 AIS patients, enrolled from December 2013 to May 2014 across 22 hospitals in Suzhou city, were included in this study. The patients were divided into 4 groups according to their level of admission magnesium: Q1 (<0...
April 19, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28419988/neutrophil-to-lymphocyte-ratio-is-an-independent-predictor-for-in-hospital-mortality-in-spontaneous-intracerebral-hemorrhage
#3
Antje Giede-Jeppe, Tobias Bobinger, Stefan T Gerner, Jochen A Sembill, Maximilian I Sprügel, Vanessa D Beuscher, Hannes Lücking, Philip Hoelter, Joji B Kuramatsu, Hagen B Huttner
BACKGROUND AND PURPOSE: Stroke-associated immunosuppression and inflammation are increasingly recognized as factors that trigger infections and thus, potentially influence the outcome after stroke. Several studies demonstrated that elevated neutrophil-to-lymphocyte ratio (NLR) is a significant predictor of adverse outcomes in patients with ischemic stroke. However, little is known about the impact of NLR on short-term mortality in intracerebral hemorrhage (ICH). METHODS: This observational study included 855 consecutive ICH-patients...
April 19, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28419982/resting-heart-rate-and-ischemic-stroke-in-patients-with-heart-failure
#4
Koki Nakanishi, Marco R Di Tullio, Min Qian, John L P Thompson, Arthur J Labovitz, Douglas L Mann, Ralph L Sacco, Patrick M Pullicino, Ronald S Freudenberger, John R Teerlink, Susan Graham, Gregory Y H Lip, Bruce Levin, Jay P Mohr, Richard Buchsbaum, Conrado J Estol, Dirk J Lok, Piotr Ponikowski, Stefan D Anker, Shunichi Homma
BACKGROUND: Although high resting heart rate (RHR) is known to be associated with an increased risk of mortality and hospital admission in patients with heart failure, the relationship between RHR and ischemic stroke remains unclear. This study is aimed at investigating the relationship between RHR and ischemic stroke in patients with heart failure in sinus rhythm. METHODS: We examined 2,060 patients with systolic heart failure in sinus rhythm from the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction trial...
April 19, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28402976/apelin-13-protects-against-ischemic-blood-brain-barrier-damage-through-the-effects-of-aquaporin-4
#5
Heling Chu, Xiaobo Yang, Chuyi Huang, Zidan Gao, Yuping Tang, Qiang Dong
BACKGROUND: Apelin-13 has been found to have protective effects on many neurological diseases, including cerebral ischemia. However, whether Apelin-13 acts on blood-brain barrier (BBB) disruption following cerebral ischemia is largely unknown. Aquaporin-4 (AQP4) has a close link with BBB due to the high concentration in astrocyte foot processes and regulation of astrocytes function. Here, we aimed to test Apelin-13's effects on ischemic BBB injury and examine whether the effects were dependent on AQP4...
April 13, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28395275/tracheostomy-extubation-reintubation-airway-management-decisions-in-intubated-stroke-patients
#6
Corinna Steidl, Julian Boesel, Sonja Suntrup-Krueger, Silvia Schoenenberger, Faisal Al-Suwaidan, Tobias Warnecke, Jens Minnerup, Rainer Dziewas
BACKGROUND: Both delayed and premature extubation increase complication rate, the need for tracheostomy (TT), the duration of intensive care unit stay, and mortality. In this study, we therefore investigated factors associated with primary TT and predictors for extubation failure (EF) in a sample of severely affected ventilated stroke patients. METHODS: One hundred eighty five intubated stroke patients were prospectively analyzed in this observational study. Patients not meeting predefined clinical and respiratory extubation criteria received a TT...
April 11, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28384632/is-reperfusion-useful-in-ischaemic-stroke-patients-presenting-with-a-low-national-institutes-of-health-stroke-scale-and-a-proximal-large-vessel-occlusion-of-the-anterior-circulation
#7
Cyril Dargazanli, Arturo Consoli, Benjamin Gory, Raphaël Blanc, Julien Labreuche, Cristian Preda, Frédéric Bourdain, Jean-Pierre Decroix, Hocine Redjem, Gabriele Ciccio, Mikael Mazighi, Stanislas Smajda, Jean-Philippe Desilles, Roberto Riva, Paul-Emile Labeyrie, Oguzhan Coskun, Georges Rodesch, Francis Turjman, Michel Piotin, Bertrand Lapergue
BACKGROUND: In population-based studies, patients presenting with minor or mild stroke symptoms represent about two-thirds of stroke patients, and almost one-third of these patients are unable to ambulate independently at the time of discharge. Although mechanical thrombectomy (MT) has become the standard of care for acute ischaemic stroke with proximal large vessel occlusion (LVO) in the anterior circulation, the management of patients harbouring proximal occlusion and minor-to-mild stroke symptoms has not yet been determined by recent trials...
April 7, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28343220/hemorrhagic-transformations-after-thrombectomy-risk-factors-and-clinical-relevance
#8
Johannes Kaesmacher, Mirjam Kaesmacher, Christian Maegerlein, Claus Zimmer, Alexandra S Gersing, Silke Wunderlich, Benjamin Friedrich, Tobias Boeckh-Behrens, Justus F Kleine
BACKGROUND: Hemorrhagic transformation (HT) is a major complication of acute ischemic stroke, potentially associated with clinical deterioration. We attempted to identify risk factors and evaluated clinical relevance of minor and major HTs following endovascular thrombectomy (ET) in isolated middle cerebral artery (MCA) occlusions. METHODS: This is a retrospective single-center analysis of 409 patients with isolated MCA occlusion treated with ET. Patients' and procedural characteristics, severity of HT according to the European Cooperative Acute Stroke Study criteria, and clinical outcomes were analyzed...
March 25, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28319954/comparison-of-initial-vasopressors-used-for-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage
#9
Bhaskar Roy, Louise D McCullough, Rajat Dhar, James Grady, Yu-Bo Wang, Robert J Brown
BACKGROUND: The main reason for morbidity after aneurysmal subarachnoid hemorrhage (aSAH) is delayed cerebral ischemia (DCI). The mainstay of medical therapy for treating DCI is induced hypertension with vasopressors to restore cerebral perfusion. Both phenylephrine (PE) and norepinephrine (NE) are commonly used for induced hypertension, but the impact of the initial choice of vasopressor on the efficacy, adverse effects, or outcome after hemodynamic therapy for DCI is unknown. METHODS: Sixty-three patients with aSAH between January 2012 and October 2014, who developed DCI (defined as new focal deficit or decline in Glasgow Coma Score) and in which PE (n = 45) or NE (n = 18) treatment was initiated were evaluated in this retrospective study...
March 21, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28319953/dual-versus-single-energy-ct-angiography-imaging-for-patients-undergoing-intracranial-aneurysm-repair
#10
Amr Abdulazim, Christian Rubbert, Dorothea Reichelt, Christian Mathys, Bernd Turowski, Hans-Jakob Steiger, Daniel Hänggi, Nima Etminan
BACKGROUND: The invasiveness and risk of thromboembolic complications of catheter angiography underline the need for alternative imaging modalities in patients following intracranial aneurysm (IA) repair. However, the overall image quality of existing noninvasive imaging modalities, such as single-energy CT angiography (SE-CTA), compromises its value in this respect. OBJECTIVE: We prospectively investigated the value of a novel dual-energy CTA (DE-CTA) scanner and algorithm for assessing the degree of occlusion and parent vessel patency in patients following IA repair...
March 21, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28319946/rebleeding-and-outcome-in-patients-with-symptomatic-brain-stem-cavernomas
#11
Antonio Arauz, Hernán M Patiño-Rodriguez, Mónica Chavarria-Medina, Mayra Becerril, Gabriel Mauricio Longo, Edgar Nathal
PURPOSE: We sought to evaluate the long-term functional outcomes and identify the potential risk factors for rebleeding in patients with brain stem cavernous malformations (BCMs) who presented with hemorrhages and were surgically or conservatively treated and prospectively monitored. METHODS: From January 1990 to July 2015, we included patients with first hemorrhagic episodes secondary to single BCMs. Modified Rankin score (mRS) was used for neurological status assessment...
March 21, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28319944/time-of-day-could-affect-cognitive-screening-performance-in-older-patients-with-tia-and-stroke
#12
Sara Mazzucco, Linxin Li, Maria A Tuna, Sarah T Pendlebury, Rhoda Frost, Rose Wharton, Peter M Rothwell
BACKGROUND AND PURPOSE: The impact of time-of-day on the cognitive performance of older patients with limited cognitive reserve after a transient ischemic attack (TIA) or stroke, and on short cognitive tests, such as the Montreal Cognitive Assessment (MoCA), is unknown. We retrospectively studied whether morning versus afternoon assessment might affect the classification of patients aged 70 or older as severe (SCI), mild (MCI), and no (NCI) cognitive impairment by the MoCA. METHODS: Morning (12 p...
March 21, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28259890/carotid-intraplaque-hemorrhage-a-biomarker-for-subsequent-ischemic-cerebrovascular-event
#13
Zhongzhao Teng, Adam J Brown, Jonathan H Gillard
No abstract text is available yet for this article.
March 4, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28259886/post-stroke-seizures-is-associated-with-low-alberta-stroke-program-early-ct-score
#14
Ziyuan Chen, Leonid Churilov, Miriam Koome, Ziyi Chen, Jillian Naylor, Patrick Kwan, Bernard Yan
BACKGROUND: Ischemic stroke is a leading cause of new-onset seizures. Cortical ischemia and large ischemic lesion size are among the most consistently reported risk factors for post-stroke seizures. Alberta Stroke Program Early CT Score (ASPECTS) is a simple and reliable tool for quantifying the extent of cerebral ischemia and may function as a screening tool for patients with high risk of seizure development. We investigated the association of post-stroke seizures with the extent of ischemia assessed by ASPECTS and with cortical involvement identified on non-contrast CT (NCCT)...
March 4, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28259876/asymptomatic-carotid-t1-high-intense-plaque-as-a-risk-factor-for-a-subsequent-cerebrovascular-ischemic-event
#15
Yoshitaka Kurosaki, Kazumichi Yoshida, Hitoshi Fukuda, Akira Handa, Masaki Chin, Sen Yamagata
BACKGROUND: Intraplaque hemorrhage, detected as a high-signal intensity on carotid MRI, is also strongly associated with ischemic events in symptomatic patients. However, in asymptomatic patients, the relationship of the T1-high intense plaque and the subsequent stroke is not clear. The aim of this study is to test the hypothesis that asymptomatic carotid T1-high intense plaque is a risk factor for a subsequent cerebrovascular ischemic event. METHODS: Of the 1,353 consecutive patients, who underwent head and carotid MRI as part of their annual medical check-up, the imaging quality of 13 was poor and 150 did not present for follow-up examination, thus leaving 1,190 subjects for evaluation...
March 4, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28245439/demographic-risk-factors-for-vascular-lesions-as-etiology-of-intraventricular-hemorrhage-in-prospectively-screened-cases
#16
Maged D Fam, Alice Pang, Hussein A Zeineddine, Steven Mayo, Agnieszka Stadnik, Michael Jesselson, Lingjiao Zhang, Rachel Dlugash, Wendy Ziai, Daniel Hanley, Issam A Awad
BACKGROUND: Spontaneous intraventricular hemorrhage (IVH) is associated with high rates of morbidity and mortality despite critical care and other advances. An important step in clinical management is to confirm/rule out an underlying vascular lesion, which influences further treatment, potential for further bleeding, and prognosis. Our aim is to compare demographic and clinical characteristics between IVH patients with and without an underlying vascular lesion, and among cohorts with different vascular lesions...
February 28, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28241134/risk-of-ischemic-stroke-and-transient-ischemic-attack-is-increased-up-to-90-days-after-non-carotid-and-non-cardiac-surgery
#17
Armin J Grau, Martin Eicke, Christoph Burmeister, Roland Hardt, Eberhard Schmitt, Sieghard Dienlin
BACKGROUND: The risk of stroke after cardiac and carotid surgery is well established. In contrast, stroke risk in association with non-cardiac and non-carotid surgery and its time course are insufficiently known. We investigated the prevalence of recent and planned surgery among patients with stroke and transient ischemic attack (TIA), time dependency of stroke risk, stroke etiology, and interruption of antithrombotic medication in association with surgery. METHODS: Data on type and date of surgery and similar interventions within the last year or planned for the next 2 weeks were anonymously collected together with demographic data, vascular risk factors, stroke severity, handicap before stroke and stroke etiology within a state-wide, mandatory, hospital-based acute stroke care quality monitoring project (Rhineland-Palatinate, Germany) for 1 year (2010)...
February 28, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28241129/how-should-we-lower-blood-pressure-after-cerebral-hemorrhage-a-systematic-review-and-meta-analysis
#18
Simona Lattanzi, Claudia Cagnetti, Leandro Provinciali, Mauro Silvestrini
BACKGROUND: The optimal treatment of high blood pressure (BP) after acute intra-cerebral hemorrhage (ICH) is controversial. SUMMARY: The aim of the study was to evaluate the safety and efficacy of early intensive vs. conservative BP lowering treatment in patients with ICH. Randomized controlled trials with active and control groups receiving intensive and conservative BP lowering treatments were identified. The following outcomes were assessed: 3-month mortality and combined death or major disability, 24-h hematoma growth, early neurological deterioration, occurrence of hypotension, severe hypotension, and serious treatment-emergent adverse events...
February 28, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28241126/morbidity-after-hemorrhage-in-children-with-untreated-brain-arteriovenous-malformation
#19
Li Ma, Helen Kim, Xiao-Lin Chen, Chun-Xue Wu, Jun Ma, Hua Su, Yuanli Zhao
BACKGROUND: Children with untreated brain arteriovenous malformations (bAVM) are at risk of encountering life-threatening hemorrhage very early in their lives. The primary aim of invasive treatment is to reduce unfavorable outcome associated with a bAVM rupture. A better understanding of the morbidity of bAVM hemorrhage might be helpful for weighing the risks of untreated bAVM and invasive treatment. Our aim was to assess the clinical outcome after bAVM rupture and identify features to predict severe hemorrhage in children...
February 28, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28241122/numerical-investigation-of-vasospasm-detection-by-extracranial-blood-velocity-ratios
#20
Jaiyoung Ryu, Nerissa Ko, Xiao Hu, Shawn C Shadden
BACKGROUND: Early diagnosis of vasospasm following subarachnoid hemorrhage can prevent cerebral ischemia and improve neurological outcomes. This study numerically evaluates the relevance of extracranial blood velocity indices to detect vasospasm. METHODS: A numerical model of cerebral blood flow was used to evaluate the hemodynamics associated with anterior and posterior vasospasm under normal and impaired cerebral autoregulation conditions. Extracranial blood velocities at the carotid and vertebral arteries and their ratios between ipsilateral and contralateral, anterior and posterior, and downstream and upstream arteries were monitored during vasospasm progression...
February 28, 2017: Cerebrovascular Diseases
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