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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
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)...
September 6, 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...
September 5, 2018: Cerebrovascular Diseases
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No abstract text is available yet for this article.
September 4, 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...
August 23, 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...
August 22, 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...
August 9, 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...
August 9, 2018: Cerebrovascular Diseases
Jun Fujinami, Tomoyuki Ohara, Fukiko Kitani-Morii, Yasuhiro Tomii, Naoki Makita, Takehiro Yamada, Takashi Kasai, Yoshinari Nagakane, Masanori Nakagawa, Toshiki Mizuno
BACKGROUND: This study assessed the incidence and predictors of short-term stroke recurrence in ischemic stroke patients with active cancer, and elucidated whether cancer-associated hypercoagulation is related to early recurrent stroke. METHODS: We retrospectively enrolled acute ischemic stroke patients with active cancer admitted to our hospital between 2006 and 2017. Active cancer was defined as diagnosis or treatment for any cancer within 12 months before stroke onset, known recurrent cancer or metastatic disease...
July 31, 2018: Cerebrovascular Diseases
Andreia Carvalho, Mariana Rocha, Marta Rodrigues, Tiago Gregório, Henrique Costa, André Cunha, Sérgio Castro, Miguel Veloso, Manuel Ribeiro, Pedro Jorge Gonçalves Barros
BACKGROUND: A 2013 consensus statement recommended the use of the modified Treatment In Cerebral Ischemia (mTICI) scale to evaluate angiographic revascularization after endovascular treatment (EVT) of acute ischemic stroke due to its higher inter-rater agreement and capacity of clinical outcome prediction. The current definition of successful revascularization includes the achievement of grades mTICI 2b or 3. However, mTICI 2b grade encompasses a large heterogeneity of revascularization states, and prior studies suggested that the magnitude of benefit derived from mTICI 2b and mTICI 3 does not seem to be equivalent...
July 31, 2018: Cerebrovascular Diseases
Daniella Kadian-Dodov, Judith Z Goldfinger, Susan Gustavson, Jeffrey W Olin
BACKGROUND AND PURPOSE: Fibromuscular dysplasia (FMD) is a non-atherosclerotic arteriopathy most often affecting the carotid and renal arteries. In the United States Registry for FMD, 41.7% of patients experienced an aneurysm and/or dissection by the time of entry into the Registry. We sought to determine the occurrence of neurovascular events after FMD diagnosis and any changes on cervical artery imaging that may be attributable to FMD. METHODS: Patients followed at the Mount Sinai Medical Center (US Registry for FMD enrollment center) with confirmed FMD and > 1 cervical artery imaging study (at least ± 6 months from the baseline carotid duplex ultrasound [CDU]) between the years 2003 and 2015 were included...
July 31, 2018: Cerebrovascular Diseases
Alexandre Gauthier, Patrick Gérardin, Pauline Renou, Sharmila Sagnier, Sabrina Debruxelles, Mathilde Poli, François Rouanet, Stéphane Olindo, Igor Sibon
BACKGROUND: Along with pharmacological and mechanical recanalization, improving cerebral perfusion through the recruitment of collateral vessels during the acute phase of ischaemic stroke (IS) is a clinical challenge. Our objective was to assess the effectiveness and safety of Trendelenburg positioning (TP), a procedure intended to increase cerebral blood flow, on the outcome of IS. METHODS: Two cohorts of patients with an acute supratentorial IS related to a large artery occlusion were compared...
July 27, 2018: Cerebrovascular Diseases
Johanna Reimer, Cornelia Montag, Alexander Schuster, Walter Moeller-Hartmann, Jan Sobesky, Wolf-Dieter Heiss, Olivier Zaro-Weber
BACKGROUND: In acute stroke, the magnetic resonance (MR) imaging-based mismatch concept is used to select patients with tissue at risk of infarction for reperfusion therapies. There is however a controversy if non-deconvolved or deconvolved perfusion weighted (PW) parameter maps perform better in tissue at risk prediction and which parameters and thresholds should be used to guide treatment decisions. METHODS: In a group of 22 acute stroke patients with consecutive MR and quantitative positron emission tomography (PET) imaging, non-deconvolved parameters were validated with the gold standard for penumbral-flow (PF) detection 15O-water PET...
July 13, 2018: Cerebrovascular Diseases
Eliza C Miller, Kathryn M Sundheim, Joshua Z Willey, Amelia K Boehme, Dritan Agalliu, Randolph S Marshall
BACKGROUND: Pregnancy is a sex-specific risk factor for causing hemorrhagic stroke (HS) in young adults. Unique physiological characteristics during pregnancy may alter the relative risk for HS in pregnant/postpartum (PP) women compared to HS in other young women. We compared patient characteristics and HS subtypes between young non-pregnant and PP women. METHODS: We reviewed the medical records of all women 18-45 years old admitted to our center with HS from October 15, 2008 through March 31, 2015, and compared patient characteristics and stroke mechanisms using logistic regression...
July 6, 2018: Cerebrovascular Diseases
Tzu-Chao Lin, Bing-Yan Zeng, Yen-Wen Chen, Meng-Ni Wu, Tien-Yu Chen, Pao-Yen Lin, Ching-Kuan Wu, Ping-Tao Tseng, Chung-Yao Hsu
BACKGROUND AND PURPOSE: Periodic limb movements of sleep (PLMS) are usually comorbid with hypertension, tachycardia, and coronary arterial diseases, which are also risk factors for cerebrovascular accidents (CVA). However, evidence about the relationship between CVA and PLMS is still weak. The aim of this study was to investigate (1) the prevalence of CVA in patients with PLMS, and (2) the severity of PLMS in patients with or without CVA through a meta-analysis. METHODS: The electronic databases of PubMed, Embase, ScienceDirect, ClinicalKey, Cochrane Library, ProQuest, Web of Science, and ClinicalTrials...
July 6, 2018: Cerebrovascular Diseases
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