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Cerebrovascular Diseases

Eun-Jae Lee, Cheol-Hyun Chung, Kyoung-Hyo Choi, Jae-Won Lee, Suk-Jung Choo, Sung-Ho Jung, Dong-Wha Kang, Jong S Kim, Sun U Kwon
BACKGROUND: In the previous prospective observational study, we found that cerebral atherosclerosis is an independent predictor of acute stroke after coronary artery bypass grafting (CABG). However, it is unknown whether intracranial cerebral atherosclerosis (ICAS) is important as much as extracranial cerebral atherosclerosis (ECAS) in estimating the risk of post-CABG adverse events. Extending the previous study, we aimed to investigate the immediate and long-term prognostic value of the location of cerebral atherosclerosis in CABG patients...
November 8, 2018: Cerebrovascular Diseases
Junichiro Suzuki, Noriyoshi Nakai, Naohide Kondo, Hirotake Tsuji, Ryosuke Inagaki, Soma Furukawa, Mai Iwata, Suguru Nishida, Yasuhiro Ito
BACKGROUND: Emergency medical services are an important part of acute stroke management. We devised a prehospital stroke scale, the TOYOTA prehospital stroke scale for tissue plasminogen activator (t-PA) intravenous therapy (TOPSPIN) for triaging patients with ischemic stroke and especial indications for intravenous t-PA therapy in December 2006; this scale comprises 5 items including consciousness, atrial fibrillation, language disorder, disturbance of the upper extremities, and disturbance of the lower extremities...
November 1, 2018: Cerebrovascular Diseases
John W P Wong, Leonid Churilov, Richard Dowling, Peter Mitchell, Steven Bush, Lasheta Kanesan, Bernard Yan
BACKGROUND/AIM: Endovascular thrombectomy may be performed in anticoagulated patients taking vitamin-K antagonists (VKA) or direct-acting oral anticoagulants (DOAC) in whom the use of intravenous tissue plasminogen activator (tPA) is contraindicated. We aimed to investigate the efficacy and safety of mechanical thrombectomy specifically in anticoagulated patients ineligible for thrombolysis. METHODS: We performed a retrospective analysis of a prospectively collected database of consecutive ischaemic stroke patients undergoing mechanical thrombectomy from January 2008 to June 2017...
November 1, 2018: Cerebrovascular Diseases
Ana Dionísio, Isabel Catarina Duarte, Miguel Patrício, Miguel Castelo-Branco
BACKGROUND: Following a stroke event, patients often are severely affected by disabilities that hinder their quality-of-life. There are currently several rehabilitative options and strategies, and it is crucial to find the most effective interventions. The applicability of transcranial magnetic stimulation (TMS) to the recovery of nonmotor functions such as communication skills, swallowing ability and spatial attention after stroke remains important clinical questions. SUMMARY: We searched PubMed and ISI Web of Science for articles that used repetitive TMS protocols to rehabilitate post-stroke deficits...
October 19, 2018: Cerebrovascular Diseases
Penelope van Veenendaal, Bernard Yan, Leonid Churilov, Richard Dowling, Steven Bush, Peter Mitchell
BACKGROUND: Endovascular clot retrieval (ECR) improves outcomes for acute ischaemic stroke with large artery occlusion. However, the provision of ECR requires resource-intensive comprehensive stroke centres (CSC), which are impractical to establish in regional hospitals. An alternative is a "hub-and-spoke" model, whereby ischaemic strokes are triaged at the regional primary centres and where eligible, transferred to a CSC. We aimed to compare the outcomes of patients directly admitted to a CSC with patients treated in the "hub-and-spoke" model...
October 9, 2018: Cerebrovascular Diseases
Joshua A Cuoco, Christopher M Busch, Brendan J Klein, Michael J Benko, Rachel Stein, Andrew D Nicholson, Eric A Marvin
BACKGROUND: Missense mutations in the gene that codes for smooth muscle actin, ACTA2, cause diffuse smooth muscle dysfunction and a distinct cerebral arteriopathy collectively known as multisystemic smooth muscle dysfunction syndrome (MSMDS). Until recently, ACTA2 cerebral arteriopathy was considered to be a variant of moyamoya disease. However, recent basic science and clinical data have demonstrated that the cerebral arteriopathy caused by mutant ACTA2 exhibits genetic loci, histopathology, neurological sequelae, and radiographic findings unique from moyamoya disease...
October 9, 2018: Cerebrovascular Diseases
Bendix Labeit, Hannah Mueller, Paul Muhle, Inga Claus, Tobias Warnecke, Rainer Dziewas, Sonja Suntrup-Krueger
BACKGROUND: For the early detection of post-stroke dysphagia (PSD), valid screening parameters are crucial as part of a step-wise diagnostic procedure. This study examines the role of the National Institute of Health Stroke Scale (NIH-SS) as a potential low-threshold screening parameter. METHODS: During a ten-year period, 687 newly admitted patients at University Hospital Muenster were included in a retrospective analysis, if they had ischemic or haemorrhagic stroke confirmed by neuroimaging and had received NIH-SS scoring and endoscopic swallowing evaluation upon admission...
September 25, 2018: Cerebrovascular Diseases
Yilun Zhou, Yin Zhang, Yuesong Pan, Jing Jing, Xingquan Zhao, Liping Liu, Chunxue Wang, Hao Li, Hongyi Yan, Xia Meng, Yilong Wang, Yongjun Wang
BACKGROUND: Insulin resistance is associated with cardiovascular morbidity and mortality in the general population. However, the relationship between insulin resistance and health outcomes is controversial in patients with impaired renal function. Our study aimed to investigate the association between insulin resistance and prognosis in a cohort of non-diabetic stroke patients with different estimated glomerular filtration rate (eGFR) strata. METHODS: Data were derived from Abnormal Glucose Regulation in Patients with Acute Stroke across China (ACROSS-China) registry...
September 20, 2018: Cerebrovascular Diseases
Jose Díaz-Pérez, Guillermo Parrilla, Mariano Espinosa de Rueda, Jose María Cabrera-Maqueda, Blanca García-Villalba, Maria Teresa Alba-Isasi, Ana Morales, Joaquín Zamarro
BACKGROUND: Strokes due to carotid artery occlusion (CAO) are associated with bad clinical prognosis and poor response to intravenous thrombolysis. Several studies in the past have shown the benefits of mechanical thrombectomy (MT) and compared bridging therapy (BT) and primary MT (PMT) in large vessel occlusions, but only a few studies have focused on the specific population of CAO and their response to endovascular treatment. METHODS: Retrospective review of patients treated at our center between January 2010 and June 2017 that (1) presented with acute ischemic stroke caused by CAO in the first 4...
September 13, 2018: Cerebrovascular Diseases
Sung-Ho Ahn, Bum-Joon Kim, Yeon-Jung Kim, Dong-Wha Kang, Sun U Kwon, Jong S Kim
BACKGROUND: Clinical syndromes secondary to infarcts in the distal basilar artery (BA) area have been described as "top of the basilar" (TOB) syndrome. However, in the era of advanced imaging technology, it has been realized that the clinical and imaging features are quite diverse in patients with distal BA occlusion. The aim of the present study was to investigate the patterns and clinical outcomes of TOB assessed with modern images and categorize TOBs accordingly. Additionally, we examined the possible influence of the posterior communicating artery (PcoA) on the patterns of TOB...
September 10, 2018: Cerebrovascular Diseases
Zhu Shi, Wei C Zheng, Xiao L Fu, Xue W Fang, Pei S Xia, Wei J Yuan
BACKGROUND: Thromboelastography (TEG) provides an integrated measurement of blood coagulation function and has been reported to be a useful tool for predicting clinical outcomes in patients with cardiovascular diseases. We aimed to investigate the application of TEG on admission for predicting early neurological deterioration (END) in patients with acute ischemic stroke and its potential correlation with the evolution of ischemic lesions. METHODS: Among patients consecutively admitted between January 1, 2016, and September 31, 2017, those presenting with mild and moderate acute ischemic stroke (National Institutes of Health Stroke Scale [NIHSS] score ≤14) within 24 h of stroke onset were identified and included in this study...
September 10, 2018: Cerebrovascular Diseases
Sabrina A Eltringham, Karen Kilner, Melanie Gee, Karen Sage, Benjamin D Bray, Sue Pownall, Craig J Smith
BACKGROUND: Patients with dysphagia are at an increased risk of stroke-associated pneumonia. There is wide variation in the way patients are screened and assessed during the acute phase. The aim of this review was to identify the methods of assessment and management in acute stroke that influence the risk of stroke-associated pneumonia. Studies of stroke patients that reported dysphagia screening, assessment or management and occurrence of pneumonia during acute phase stroke were screened for inclusion after electronic searches of multiple databases from inception to November 2016...
September 10, 2018: Cerebrovascular Diseases
Yoshitaka Yamaguchi, Masatoshi Koga, Shoichiro Sato, Hiroshi Yamagami, Kenichi Todo, Satoshi Okuda, Yasushi Okada, Kazumi Kimura, Yoshiaki Shiokawa, Kenji Kamiyama, Ryo Itabashi, Yasuhiro Hasegawa, Kazuomi Kario, Kyohei Fujita, Masaya Kumamoto, Teppei Kamimura, Daisuke Ando, Toshihiro Ide, Takeshi Yoshimoto, Masayuki Shiozawa, Soichiro Matsubara, Sohei Yoshimura, Kazuyuki Nagatsuka, Kazunori Toyoda
BACKGROUND: Previous studies have revealed that hematoma growth mainly occurs during the first 6 h after the onset of spontaneous intracerebral hemorrhage (ICH). Early lowering of blood pressure (BP) may be beneficial for preventing hematoma growth. However, relationships between timing of BP lowering and hematoma growth in ICH remain unclear. We investigated associations between timing of BP lowering and hematoma growth for ICH. METHODS: The Stroke Acute Management with Urgent Risk-factor Assessment and Improvement (SAMURAI)-ICH Study was a multicenter, prospective, observational study investigating the safety and feasibility of early (within 3 h from onset) reduction of systolic BP (SBP) to < 160 mm Hg with intravenous nicardipine for acute hypertension in cases of spontaneous ICH...
September 10, 2018: Cerebrovascular Diseases
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No abstract text is available yet for this article.
September 4, 2018: Cerebrovascular Diseases
Satoshi Koizumi, Takahiro Ota, Keigo Shigeta, Tatsuo Amano, Masayuki Ueda, Yuji Matsumaru, Yoshiaki Shiokawa, Teruyuki Hirano
BACKGROUND: Mechanical thrombectomy (MT) has become the standard of care for acute ischemic stroke with large vessel occlusion; however, evidence remains insufficient for MT for elderly patients, especially with respect to factors affecting their outcomes. METHODS: This study was a retrospective analysis of a multicenter registry of MT, called Tama Registry of Acute Endovascular Thrombectomy. Patients were divided by their age into 2 groups: Nonelderly (NE; < 80) and elderly (E; ≥80)...
2018: Cerebrovascular Diseases
Nijasri C Suwanwela, Christopher L H Chen, 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, Ka Sing Lawrence Wong, Niphon Poungvarin, Gaik Bee Eow, Narayanaswamy Venketasubramanian
BACKGROUND AND PURPOSE: MLC601 has been shown in preclinical studies to enhance neurorestorative mechanisms after stroke. The aim of this post hoc analysis was to assess whether combining MLC601 and rehabilitation has an effect on improving functional outcomes after stroke. METHODS: Data from the CHInese Medicine NeuroAiD Efficacy on Stroke (CHIMES) and CHIMES-Extension (CHIMES-E) studies were analyzed. CHIMES-E was a 24-month follow-up study of subjects included in CHIMES, a multi-centre, double-blind placebo-controlled trial which randomized subjects with acute ischemic stroke, to either MLC601 or placebo for 3 months in addition to standard stroke treatment and rehabilitation...
2018: Cerebrovascular Diseases
Stefan T Gerner, Katrin Auerbeck, Maximilian I Sprügel, Jochen A Sembill, Dominik Madžar, Philipp Gölitz, Philip Hoelter, Joji B Kuramatsu, Stefan Schwab, Hagen B Huttner
BACKGROUND: Troponin I is a widely used and reliable marker of myocardial damage and its levels are routinely measured in acute stroke care. So far, the influence of troponin I elevations during hospital stay on functional outcome in patients with atraumatic intracerebral hemorrhage (ICH) is unknown. METHODS: Observational single-center study including conservatively treated ICH patients over a 9-year period. Patients were categorized according to peak troponin I level during hospital stay (≤0...
2018: Cerebrovascular Diseases
Elena López-Cancio, Marc Ribó, Pere Cardona, Joaquín Serena, Francisco Purroy, Ernest Palomeras, Josep Maria Aragonès, Dolores Cocho, Moisés Garcés, Elsa Puiggròs, Iñigo Soteras, Ana Cabanelas, David Villagrasa, Ester Catena, Eduard Sanjurjo, Nuria López Claverol, Dolors Carrión, Mercè López, Sònia Abilleira, Antoni Dávalos, Natalia Pérez de la Ossa
OBJECTIVES: The study aimed to evaluate the impact of a telestroke network on acute stroke care in Catalonia, by measuring thrombolysis rates, access to endovascular treatment, and clinical outcome of telestroke patients in a population-based study. METHODS: Telestroke network was implemented on March 2013 and consists of 12 community hospitals and 1 expert stroke neurologist 24 h/7 day, covering a population of 1.3 million inhabitants. Rest of the population (6...
2018: Cerebrovascular Diseases
Joonsang Yoo, Sung-Il Sohn, Jinkwon Kim, Seong Hwan Ahn, Kijeong Lee, Jang-Hyun Baek, Kyoungsub Kim, Jeong-Ho Hong, Jaseong Koo, Young Dae Kim, Jaehyuk Kwak, Hyo Suk Nam, Ji Hoe Heo
BACKGROUND: The actions and responses of the hospital personnel during acute stroke care in the emergency department (ED) may differ according to the severity of a patient's stroke symptoms. We investigated whether the time from arrival at ED to various care steps differed between patients with minor and non-minor stroke who were treated with intravenous tissue plasminogen activator (IV tPA). METHODS: We included consecutive patients who received IV tPA during a 1...
2018: Cerebrovascular Diseases
Volker Maus, Jan Borggrefe, Daniel Behme, Christoph Kabbasch, Nuran Abdullayev, Utako Birgit Barnikol, Leonard Leong Litt Yeo, Patrick A Brouwer, Michael Söderman, Markus Möhlenbruch, Thomas Liebig, Gereon Rudolf Fink, Anastasios Mpotsaris
BACKGROUND: One endovascular treatment option of acute ischemic stroke due to tandem occlusion (TO) comprises intracranial thrombectomy and acute extracranial carotid artery stenting (CAS). In this setting, the order of treatment may impact the clinical outcome in this stroke subtype. METHODS: Retrospective analysis was performed on data prospectively collected in 4 international stroke centers between 2013 and 2017. One hundred sixty-five patients with anterior TO were treated by endovascular therapy...
2018: Cerebrovascular Diseases
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