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Cerebrovascular Diseases

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https://www.readbyqxmd.com/read/29316564/primary-prevention-of-stroke-in-chronic-kidney-disease-patients-a-scientific-update
#1
Stefana Catalina Bilha, Alexandru Burlacu, Dimitrie Siriopol, Luminita Voroneanu, Adrian Covic
BACKGROUND: Although chronic kidney disease (CKD) is an independent risk factor for stroke, official recommendations for the primary prevention of stroke in CKD are generally lacking. SUMMARY: We searched PubMed and ISI Web of Science for randomised controlled trials, observational studies, reviews, meta-analyses and guidelines referring to measures of stroke prevention or to the treatment of stroke-associated risk factors (cardiovascular disease in general and atrial fibrillation (AF), arterial hypertension or carotid artery disease in particular) among the CKD population...
January 9, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29208850/carotid-artery-stenosis-contralateral-to-acute-tandem-occlusion-an-independent-predictor-of-poor-clinical-outcome-after-mechanical-thrombectomy-with-concomitant-carotid-artery-stenting
#2
Volker Maus, Daniel Behme, Jan Borggrefe, Christoph Kabbasch, Fatih Seker, Cicek Hüseyin, Utako Birgit Barnikol, Leonard Leong Litt Yeo, Patrick Brouwer, Michael Söderman, Markus Möhlenbruch, Marios Nikos Psychogios, Thomas Liebig, Christian Dohmen, Gereon Rudolf Fink, Anastasios Mpotsaris
BACKGROUND AND PURPOSE: Cerebral ischemic strokes due to extra-/intracranial tandem occlusions (TO) of the anterior circulation are responsible for causing mechanical thrombectomy (MT). The impact of concomitant contralateral carotid stenosis (CCS) upon outcome remains unclear in this stroke subtype. METHODS: Retrospective analysis of prospectively collected data of 4 international stroke centers between 2011 and 2017. One hundred ninety-seven consecutive patients with anterior TO were treated with MT and acute carotid artery stenting (CAS)...
November 24, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29176326/high-systolic-blood-pressure-after-successful-endovascular-treatment-affects-early-functional-outcome-in-acute-ischemic-stroke
#3
Ilko L Maier, Ioannis Tsogkas, Daniel Behme, Mathias Bähr, Michael Knauth, Marios-Nikos Psychogios, Jan Liman
BACKGROUND: Endovascular treatment (EVT) has been shown to significantly improve functional outcome in patients with acute large cerebral vessel occlusions. To date, no evidence-based recommendations on blood pressure management after successful EVT exist. Previous studies showed an association between high pre-EVT systolic blood pressure (SBP) and functional outcome, but do not answer the question on how to manage blood pressure after successful recanalization. The purpose of this study was to determine the role of blood pressure measurements as a predictor for early functional outcome in patients with successful EVT...
November 24, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29176313/acute-kidney-injury-following-acute-ischemic-stroke-and-intracerebral-hemorrhage-a-meta-analysis-of-prevalence-rate-and-mortality-risk
#4
Andrés Zorrilla-Vaca, Wendy Ziai, E Sander Connolly, Romer Geocadin, Richard Thompson, Lucia Rivera-Lara
BACKGROUND: The epidemiology of acute renal dysfunction after stroke is routinely overlooked following stroke events. Our aim in this meta-analysis is to report the prevalence of acute kidney injury (AKI) following acute stroke and its impact on mortality. METHODS: A systematic literature search was performed on PubMed, EMBASE and Google Scholar for observational studies examining the prevalence and mortality risk of stroke patients with AKI as a complication. The pooled prevalence rates and odds ratios for mortality risk were calculated using subgroup analyses between the stroke subtypes: acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH)...
November 24, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29130956/ischemic-stroke-histological-thrombus-composition-and-pre-interventional-ct-attenuation-are-associated-with-intervention-time-and-rate-of-secondary-embolism
#5
Peter B Sporns, Uta Hanning, Wolfram Schwindt, Aglae Velasco, Boris Buerke, Christian Cnyrim, Jens Minnerup, Walter Heindel, Astrid Jeibmann, Thomas Niederstadt
BACKGROUND AND PURPOSE: The introduction of stent retrievers has made the complete extraction and histological analysis of human thrombi possible. A number of large randomized trials have proven the efficacy of thrombectomy for ischemic stroke; however, thrombus composition could have an impact on the efficacy and risk of the intervention. We therefore investigated the impact of histologic thrombus features on interventional outcome and procedure-related embolisms. For a pre-interventional estimation of histologic features and outcome parameters, we assessed the pre-interventional CT attenuation of the thrombi...
October 31, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29130951/prehospital-computed-tomography-angiography-in-acute-stroke-management
#6
Michael Kettner, Stefan Alexander Helwig, Andreas Ragoschke-Schumm, Lenka Schwindling, Safwan Roumia, Isabel Keller, Daniel Martens, Johann Kulikovski, Matthias Manitz, Martin Lesmeister, Silke Walter, Iris Quasar Grunwald, Thomas Schlechtriemen, Wolfgang Reith, Klaus Fassbender
BACKGROUND: An ambulance equipped with a computed tomography (CT) scanner, a point-of-care laboratory, and telemedicine capabilities (mobile stroke unit [MSU]) has been shown to enable the delivery of thrombolysis to stroke patients directly at the emergency site, thereby significantly decreasing time to treatment. However, work-up in an MSU that includes CT angiography (CTA) may also potentially facilitate triage of patients directly to the appropriate target hospital and specialized treatment, according to their individual vascular pathology...
October 31, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29084408/influence-of-renal-function-on-treatment-results-after-stroke-thrombectomy
#7
Mona Laible, Markus Alfred Möhlenbruch, Johannes Pfaff, Ekkehart Jenetzky, Peter Arthur Ringleb, Martin Bendszus, Timolaos Rizos
BACKGROUND: Renal dysfunction (RD) may be associated with poor outcome in ischemic stroke patients treated with mechanical thrombectomy (MT), but data concerning this important and emerging comorbidity do not exist so far. Here, we investigated the influence of RD on postprocedural intracerebral hemorrhage (ICH), clinical outcome, and mortality in a large prospectively collected cohort of acute ischemic stroke patients treated with MT. METHODS: Consecutive patients with anterior-circulation stroke treated with MT between October 2010 and January 2016 were included...
October 31, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29073629/early-cognitive-impairment-after-intracerebral-hemorrhage-in-the-interact1-study
#8
Shoujiang You, Xia Wang, Richard I Lindley, Thompson Robinson, Craig S Anderson, Yongjun Cao, John Chalmers
BACKGROUND: Data on cognitive impairment after acute intracerebral hemorrhage (ICH) are limited. This study is aimed at determining the frequency and predictors of cognitive impairment among participants of the pilot phase, Intensive Blood Pressure (BP) Reduction in Acute Cerebral Hemorrhage Trial (INTERACT1). METHODS: INTERACT1 was an open randomized trial of early intensive (target systolic BP <140 mm Hg) compared with contemporaneous guideline-recommended BP lowering in 404 patients with elevated systolic BP (150-220 mm Hg) within 6 h of ICH onset...
October 26, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29073616/serum-1-5-anhydroglucitol-risk-factor-of-acute-ischemic-stroke-and-transient-ischemic-attack-in-well-controlled-diabetes
#9
Yuji Shiga, Masaru Kuriyama, Yuhei Kanaya, Shinichi Takeshima, Makoto Takemaru, Kazuhiro Takamatsu, Yutaka Shimoe, Yasunori Fujikawa, Masakazu Nishigaki
BACKGROUND: Serum 1,5-anhydroglucitol (1,5-AG) levels are a measure that provides information on daily glycemic variations. We evaluated whether 1,5-AG could be a possible marker of acute ischemic stroke (AIS) or transient ischemic attacks (TIA) in patients with diabetes mellitus (DM). METHODS: We retrospectively reviewed electronic medical records of 5,294 AIS/TIA patients. Of the 5,294, 1,898 had diabetes and in 1,246, serum 1,5-AG levels were measured (group S)...
October 26, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29073590/temporal-associations-between-fatigue-depression-and-apathy-after-stroke-results-of-the-cognition-and-affect-after-stroke-a-prospective-evaluation-of-risks-study
#10
Elles Douven, Sebastian Köhler, Syenna H J Schievink, Robert J van Oostenbrugge, Julie Staals, Frans R J Verhey, Pauline Aalten
BACKGROUND: Poststroke fatigue (PSF) is a form of pathological fatigue that can develop after stroke and has a negative impact on functional outcome. PSF is associated with poststroke depression (PSD), which in turn shows similarities with poststroke apathy (PSA). This study aimed at disentangling the temporal associations between PSF and PSD and between PSF and PSA. METHODS: A total of 250 stroke patients were included, of which 243 completed the Fatigue Severity Scale, Montgomery-Åsberg Depression Rating Scale, and Apathy Evaluation Scale at 3 months poststroke, with follow-up measurements at 6 and 12 months after initial testing...
October 26, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28968602/early-rebleeding-after-brain-arteriovenous-malformation-rupture-clinical-impact-and-predictive-factors-a-monocentric-retrospective-cohort-study
#11
Eimad Shotar, Silvia Pistocchi, Idriss Haffaf, Bruno Bartolini, Alice Jacquens, Aurélien Nouet, Jacques Chiras, Vincent Degos, Nader-Antoine Sourour, Frédéric Clarençon
BACKGROUND: Brain arteriovenous malformations (BAVMs) are a leading cause of intracranial hemorrhage in young adults. This study aimed to identify individual predictive factors of early rebleeding after BAVM rupture and determine its impact on prognosis. METHODS: Early rebleeding was defined as a spontaneous intracranial hemorrhage within 30 days of BAVM rupture in patients with nonobliterated BAVMs. One hundred fifty one patients with 158 BAVM hemorrhagic events admitted to a tertiary care center during 14 years were included...
October 3, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28968597/cerebral-cavernous-malformations-patient-reported-outcome-validates-conservative-management
#12
Vitor Chehuen Bicalho, Anke Bergmann, Flávio Domingues, João Thiago Frossard, Jorge Paes Barreto Marcondes de Souza
BACKGROUND: Cerebral cavernous malformations (CCM) are clusters of dilated sinusoidal channels lined by a single layer of endothelium. In contradistinction to arteriovenous malformations, these lesions do not have smooth muscle or elastin in their lining and they are angiographically occult, and the MRI is the most sensitive test for CCM detection. CCM are one of the most prevalent vascular malformations of the central nervous system, affecting about 0.4-0.6% of the general population...
October 3, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28946147/ischemic-stroke-patients-demonstrate-increased-carotid-plaque-microvasculature-compared-to-ocular-transient-ischemic-attack-patients
#13
Raf H M van Hoof, Floris H B M Schreuder, Patty Nelemans, Martine T B Truijman, Narender P van Orshoven, Tobien H Schreuder, Werner H Mess, Sylvia Heeneman, Robert J van Oostenbrugge, Joachim E Wildberger, M Eline Kooi
BACKGROUND: Patients with a recent ischemic stroke have a higher risk of recurrent stroke compared to (ocular) transient ischemic attack (TIA) patients. Plaque microvasculature is considered as a feature of plaque vulnerability and can be quantified with carotid dynamic contrast-enhanced MRI (DCE-MRI). The purpose of this cross-sectional study was to explore the association between plaque microvasculature and the type of recent cerebrovascular events in symptomatic patients with mild-to-moderate carotid stenosis...
September 26, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28910807/cerebral-infarct-topography-and-early-outcome-after-surgery-for-symptomatic-carotid-stenosis-a-multicentre-study
#14
Caroline Kazandjian, Nicla Settembre, Fabien Lareyre, Benjamin Kretz, Agnès Soudry-Faure, Yannick Béjot, Sergueï Malikov, Reda Hassen-Khodja, Elixene Jean-Baptiste, Eric Steinmetz
INTRODUCTION: Although carotid stenosis can cause both territorial and border-zone (BZ) cerebral infarcts (CI), the influence of CI topography on postoperative complications after surgery remains unclear. We compared early outcomes after endarterectomy on the basis of CI location: territorial (T group) or BZ group. MATERIAL AND METHODS: During the period between 2009 and 2013, ischaemic stroke patients who had undergone surgery for symptomatic carotid stenosis were identified from prospective databases from 3 French centres...
September 15, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28903096/early-screening-parameters-for-dysphagia-in-acute-ischemic-stroke
#15
Christian Henke, Christian Foerch, Sriramya Lapa
BACKGROUND: Dysphagia is a frequent symptom in patients with acute stroke. It is associated with malnutrition, aspiration and mortality. The identification of early screening parameters for dysphagia promptly leading to a professional swallowing examination is therefore of utmost importance. This study aimed to detect early and easily assessable predictors of dysphagia in a large cohort of patients with acute ischemic stroke. METHODS: Our analysis was based on data from a prospective in-hospital registry...
September 14, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28877524/selection-paradigms-for-large-vessel-occlusion-acute-ischemic-stroke-endovascular-therapy
#16
Mehdi Bouslama, Meredith T Bowen, Diogo C Haussen, Seena Dehkharghani, Jonathan A Grossberg, Letícia C Rebello, Srikant Rangaraju, Michael R Frankel, Raul G Nogueira
BACKGROUND: Optimal patient selection methods for thrombectomy in large vessel occlusion stroke (LVOS) are yet to be established. We sought to evaluate the ability of different selection paradigms to predict favorable outcomes. METHODS: Review of a prospectively collected database of endovascular patients with anterior circulation LVOS, adequate CT perfusion (CTP), National Institutes of Health Stroke Scale (NIHSS) ≥10 from September 2010 to March 2016. Patients were retrospectively assessed for thrombectomy eligibility by 4 mismatch criteria: Perfusion-Imaging Mismatch (PIM): between CTP-derived perfusion defect and ischemic core volumes; Clinical-Core Mismatch (CCM): between age-adjusted NIHSS and CTP core; Clinical-ASPECTS Mismatch (CAM-1): between age-adjusted NIHSS and ASPECTS; Clinical-ASPECTS Mismatch (CAM-2): between NIHSS and ASPECTS...
September 7, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28869961/contribution-of-neuro-imaging-for-prediction-of-functional-recovery-after-ischemic-stroke
#17
Wolf-Dieter Heiss
Prediction measures of recovery and outcome after stroke perform with only modest levels of accuracy if based only on clinical data. Prediction scores can be improved by including morphologic imaging data, where size, location, and development of the ischemic lesion is best documented by magnetic resonance imaging. In addition to the primary lesion, the involvement of fiber tracts contributes to prognosis, and consequently the use of diffusion tensor imaging (DTI) to assess primary and secondary pathways improves the prediction of outcome and of therapeutic effects...
September 5, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28854435/n-terminal-prosomatostatin-and-risk-of-vascular-dementia
#18
Hannes Holm, Katarina Nägga, Erik D Nilsson, Fabrizio Ricci, Eduardo Cinosi, Olle Melander, Oskar Hansson, Erasmus Bachus, Martin Magnusson, Artur Fedorowski
BACKGROUND: Increased somatostatin plasma concentration has been found in patients with vascular dementia. However, it is unknown whether or not somatostatin levels may predict dementia development in the general population. To this end, we sought to assess the association of circulating N-terminal prosomatostatin (NT-proSST) with incident dementia among community-dwelling older adults. METHODS: In the prospective population-based Malmö Preventive Project, 5,347 study participants (mean age: 69 ± 6years; 70% men) provided plasma for the determination of NT-proSST concentration...
August 31, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28848210/clinical-effectiveness-and-safety-outcomes-of-endovascular-treatment-for-acute-anterior-circulation-ischemic-stroke-in-china
#19
Wenjie Zi, Huaiming Wang, Dong Yang, Yonggang Hao, Meng Zhang, Yu Geng, Min Lin, Yue Wan, Zhonghua Shi, Zhiming Zhou, Wei Wang, Haowen Xu, Xiguang Tian, Penghua Lv, Shuiping Wang, Wenhua Liu, Zhen Wang, Xintong Liu, Fuqiang Guo, Dequan Zheng, Hua Li, Mingyi Tu, Ping Jin, Guodong Xiao, Yuxiu Liu, Gelin Xu, Yunyun Xiong, Xinfeng Liu
BACKGROUNDS AND PURPOSE: This study was aimed at investigating the outcomes and predictors for the poor functional outcome after endovascular treatment (EVT) in a large, mostly Asian population. METHODS: Between January 2014 and June 2016, acute stroke patients with anterior circulation occlusion and EVT were retrospectively enrolled from 21 stroke centers in China. The main outcomes were modified Rankin Scale (0-2 as functional independence, 3-6 as poor) at 90 days, symptomatic intracranial hemorrhage (sICH) at 72 h, and death at 90 days...
August 26, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28848080/the-impact-of-discrepancy-between-measured-versus-stated-weight-on-hemorrhagic-transformation-and-clinical-outcomes-after-intravenous-alteplase-thrombolysis
#20
Dong Hoon Shin, Min-Ju Kang, Jin Wook Kim, Dong-Jin Shin, Hyeon-Mi Park, Young Hee Sung, Eung Yeop Kim
BACKGROUND: An accurate measurement of patient weight is important in determining the dosage for intravenous alteplase thrombolysis. In most emergency rooms, however, weight is not measured. We investigated the difference between stated and measured weight and its effect on hemorrhagic transformation and clinical outcomes. METHODS: We enrolled 128 consecutive patients who had hyperacute stroke and were treated by alteplase. Alteplase dose was calculated using the weight provided by patient or guardian/caregiver, and the actual weight was measured after administration...
August 26, 2017: Cerebrovascular Diseases
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