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Cerebrovascular Diseases Extra

Kenneth Bruun Pedersen, Alexander Chemnitz, Charlotte Madsen, Niels C F Sandgaard, Søren Bak, Axel Brandes
BACKGROUND: Atrial fibrillation (AF) is a major cause of stroke. Therefore, all patients with ischemic stroke or transient ischemic attack (TIA) should be examined with 12-lead electrocardiogram (ECG) and continuous monitoring to detect AF. Current guidelines recommend at least 24 h continuous ECG monitoring, which is primarily based on studies investigating patients with ischemic stroke. The aim of our study was to investigate the diagnostic yield of 12-lead ECG and Holter monitoring in patients with TIA...
November 30, 2016: Cerebrovascular Diseases Extra
Parveen K Garg, Willam J H Koh, Joseph A Delaney, Ethan A Halm, Calvin H Hirsch, William T Longstreth, Kenneth J Mukamal, Anna Kucharska-Newton, Joseph F Polak, Lesley Curtis
BACKGROUND: Population-based risk factors for carotid artery revascularization are not known. We investigated the association between demographic and clinical characteristics and incident carotid artery revascularization in a cohort of older adults. METHODS: Among Cardiovascular Health Study participants, a population-based cohort of 5,888 adults aged 65 years or older enrolled in two waves (1989-1990 and 1992-1993), 5,107 participants without a prior history of carotid endarterectomy (CEA) or cerebrovascular disease had a carotid ultrasound at baseline and were included in these analyses...
November 16, 2016: Cerebrovascular Diseases Extra
Ashu Bhasin, M V Padma Srivastava, Sujata Mohanty, Sivasubramaniam Vivekanandhan, Sakshi Sharma, Senthil Kumaran, Rohit Bhatia
BACKGROUND: The emerging role of stem cell technology and transplantation has helped scientists to study their potential role in neural repair and regeneration. The fate of stem cells is determined by their niche, consisting of surrounding cells and the secreted trophic growth factors. This interim report evaluates the safety, feasibility and efficacy (if any) of bone marrow-derived mononuclear stem cells (BM-MNC) in chronic ischemic stroke by studying the release of serum vascular endothelial growth factor (VEGF) and brain-derived neurotrophic growth factor (BDNF)...
October 19, 2016: Cerebrovascular Diseases Extra
Joan Porter, Luke Mondor, Moira K Kapral, Jiming Fang, Ruth E Hall
BACKGROUND/AIMS: The reliability of diagnostic coding of acute stroke and transient ischemic attack (TIA) in administrative data is uncertain. The purpose of this study is to determine the agreement between administrative data sources and chart audit for the identification of stroke type, stroke risk factors, and the use of hospital-based diagnostic procedures in patients with stroke or TIA. METHODS: Medical charts for a population-based sample of patients (n = 14,508) with ischemic stroke, intracerebral hemorrhage (ICH), or TIA discharged from inpatient and emergency departments (ED) in Ontario, Canada, between April 1, 2012 and March 31, 2013, were audited by trained abstractors...
October 18, 2016: Cerebrovascular Diseases Extra
Shawna Cutting, Elizabeth Regan, Vivien H Lee, Shyam Prabhakaran
BACKGROUND AND PURPOSE: Following transient ischemic attack (TIA), there is increased risk for ischemic stroke. The American Heart Association recommends admission of patients with ABCD2 scores ≥3 for observation, rapid performance of diagnostic tests, and potential acute intervention. We aimed to determine if there is a relationship between ABCD2 scores, in-hospital ischemic events, and in-hospital treatments after TIA admission. METHODS: We reviewed consecutive patients admitted between 2006 and 2011 following a TIA, defined as transient focal neurological symptoms attributed to a specific vascular distribution and lasting <24 h...
October 8, 2016: Cerebrovascular Diseases Extra
Edward Chan, Craig S Anderson, Xia Wang, Hisatomi Arima, Anubhav Saxena, Tom J Moullaali, Candice Delcourt, Guojun Wu, Jinchao Wang, Guofang Chen, Pablo M Lavados, Christian Stapf, Thompson Robinson, John Chalmers
BACKGROUND: Intraventricular hemorrhage (IVH) extension is common following acute intracerebral hemorrhage (ICH) and is associated with poor prognosis. AIM: To determine whether intensive blood pressure (BP)-lowering therapy reduces IVH growth. METHODS: Pooled analyses of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trials (INTERACT1 and INTERACT2) computed tomography (CT) substudies; multicenter, open, controlled, randomized trials of patients with acute spontaneous ICH and elevated systolic BP, randomly assigned to intensive (<140 mm Hg) or guideline-based (<180 mm Hg) BP management...
September 8, 2016: Cerebrovascular Diseases Extra
Marine M Tanashyan, Polina I Kuznetsova, Alla A Shabalina, Anton A Raskurazhev, Olga V Lagoda, Irina N Subortseva, Anait L Melikyan
BACKGROUND: Disturbances of microcirculation play a significant role in the development and progression of both acute and chronic cerebrovascular diseases (CVD) and may be associated with different hemogram abnormalities. One of the reasons of the prothrombogenic state of the endothelium is the increase in the number of blood corpuscles leading to (non-Ph) myeloproliferative disorders (MPD) including essential thrombocythemia (ET), polycythemia vera (PV), and primary myelofibrosis (PM)...
September 7, 2016: Cerebrovascular Diseases Extra
Heather Pagram, Andrew Bivard, Lisa F Lincz, Christopher Levi
INTRODUCTION: Circulating neutrophil and lymphocyte levels may be modifiable outcome predictors of ischemic stroke. We sought to compare these immune cell parameters with advanced imaging assessment and the 90-day clinical outcome. METHODS: We used a retrospectively collected cohort of consecutive ischemic stroke patients presenting within 4.5 h of symptom onset who had acute CT perfusion and routine blood collection before treatment with intravenous thrombolysis and 24-hour MRI scanning at the John Hunter Hospital...
January 22, 2016: Cerebrovascular Diseases Extra
Teruo Kimura, Adam Tucker, Toshihide Sugimura, Toshitaka Seki, Shin Fukuda, Satoru Takeuchi, Shiro Miyata, Tsutomu Fujita, Akira Hashizume, Naoto Izumi, Kazutsune Kawasaki, Makoto Katsuno, Masaaki Hashimoto, Kazuhiro Sako
BACKGROUND AND PURPOSE: The optimal use of antiplatelet therapy for intracranial branch atheromatous disease (BAD) is not known. METHODS: We conducted a prospective multicenter, single-group trial of 144 consecutive patients diagnosed with probable BAD. All patients were treated within 12 h of symptom onset to prevent clinical progression using dual antiplatelet therapy with cilostazol plus one oral antiplatelet drug (aspirin or clopidogrel). Endpoints of progressive BAD in the dual therapy group at 2 weeks were compared with a matched historical control group of 142 patients treated with single oral antiplatelet therapy using either cilostazol, aspirin, or clopidogrel...
12, 2016: Cerebrovascular Diseases Extra
Misaki Kohama, Shinichiro Sugiyama, Kenichi Sato, Hidenori Endo, Kuniyasu Niizuma, Toshiki Endo, Makoto Ohta, Yasushi Matsumoto, Miki Fujimura, Teiji Tominaga
BACKGROUND: Transcranial Doppler (TCD) is used to monitor cerebral vasospasm after subarachnoid hemorrhage (SAH), but its diagnostic ability is reported to be limited. Therefore, the purpose of this study was to investigate the relationship between the diagnosability of TCD and the localization of the vasospasm. METHODS: This retrospective study included 20 patients who presented with symptomatic vasospasm after SAH. All 20 patients underwent daily TCD examinations and cerebral angiography after the onset of delayed cerebral ischemia...
2016: Cerebrovascular Diseases Extra
Sajjad Muhammad, Oliver Planz, Markus Schwaninger
BACKGROUND: Thrombolysis is the only approved therapy for acute stroke. However, life-threatening complications such as intracerebral hemorrhage (ICH) can develop after intravenous administration of tissue plasminogen activator (tPA). Both infection and thrombolysis during cerebral ischemia disrupt the blood-brain barrier (BBB). tPA can induce matrix metalloproteinase-9 (MMP-9), which is known to be involved in BBB disruption. However, it has still not been investigated whether preexisting influenza virus infection during thrombolysis after acute stroke affects systemic levels of MMP-9 and its inhibitor TIMP-1 and whether increased systemic MMP-9 levels affect ICH...
2016: Cerebrovascular Diseases Extra
Maria Carlsson, Tom Wilsgaard, Stein Harald Johnsen, Anne Merete Vangen-Lønne, Maja-Lisa Løchen, Inger Njølstad, Ellisiv Bøgeberg Mathiesen
BACKGROUND: The aim of this study was to explore temporal trends in incidence and case fatality rates of intracerebral hemorrhage (ICH) over the last two decades in a Norwegian municipality. METHODS: Incident cases of primary ICH were registered in the period from 1995 through 2012 in 32,530 participants of the longitudinal population-based Tromsø Study. Poisson regression models were used to obtain incidence rates over time in age- and sex-adjusted and age- and sex-specific models...
2016: Cerebrovascular Diseases Extra
M Koenig-Bruhin, T Vanbellingen, R Schumacher, T Pflugshaupt, J M Annoni, R M Müri, S Bohlhalter, T Nyffeler
BACKGROUND: Screening of aphasia in acute stroke is crucial for directing patients to early language therapy. The Language Screening Test (LAST), originally developed in French, is a validated language screening test that allows detection of a language deficit within a few minutes. The aim of the present study was to develop and validate two parallel German versions of the LAST. METHODS: The LAST includes subtests for naming, repetition, automatic speech, and comprehension...
January 2016: Cerebrovascular Diseases Extra
Luís Henrique de Castro-Afonso, Guilherme Seizem Nakiri, Octávio Marques Pontes-Neto, Antônio Carlos dos Santos, Daniel Giansante Abud
BACKGROUND: Patients who wake up having experienced a stroke while asleep represent around 20% of acute stroke admissions. According to international guidelines for the management of acute stroke, patients presenting with wake-up stroke are not currently eligible to receive revascularization treatments. In this study, we aimed to assess the opinions of stroke experts about the management of patients with wake-up stroke by using an international multicenter electronic survey. METHOD: This study consisted of 8 questions on wake-up stroke treatment...
January 2016: Cerebrovascular Diseases Extra
Lauren E Dunn, Adam B Schweber, Daniel K Manson, Andrea Lendaris, Charlotte Herber, Randolph S Marshall, Ronald M Lazar
BACKGROUND: Most stroke recovery occurs by 90 days after onset, with proportional recovery models showing an achievement of about 70% of the maximal remaining recovery. Little is known about recovery during the acute stroke period. Moreover, data are described for groups, not for individuals. In this observational cohort study, we describe for the first time the daily changes of acute stroke patients with motor and/or language deficits over the first week after stroke onset. METHODS: Patients were enrolled within 24-72 h after stroke onset with upper extremity hemiparesis, aphasia, or both, and were tested daily until day 7 or discharge with the upper-extremity Fugl-Meyer Assessment of Motor Recovery after Stroke, the Boston Naming Test, and the comprehension domain from the Western Aphasia Battery...
January 2016: Cerebrovascular Diseases Extra
Toshitaka Umemura, Takahiko Kawamura, Shinichi Mashita, Takashi Kameyama, Gen Sobue
BACKGROUND: Large artery atherosclerosis is a major cause of ischemic stroke worldwide. Differential biomarker profiles associated with extra- and intracranial atherosclerosis are a topic of considerable interest. Cystatin C (CysC), a marker of renal function, is a risk factor for cardiovascular disease. AIM: We sought to determine whether CysC levels were associated with extra- and intracranial large artery stenosis (LAS) in patients with acute ischemic stroke...
January 2016: Cerebrovascular Diseases Extra
Liliana Sousa Nanji, Teresa P Melo, Patrícia Canhão, Ana Catarina Fonseca, José Manuel Ferro
BACKGROUND: Some cases of subarachnoid haemorrhage (SAH) have been associated with vigorous physical activity, including sports. Our research aimed to describe the association between SAH and sports and to identify the types of sports that were more frequently found as precipitating factors in a tertiary single-centre SAH register. METHODS: We retrieved information from a prospectively collected SAH registry and reviewed discharge notes of acute SAH patients admitted to the Stroke Unit of Hospital de Santa Maria, Lisbon, between 1995 and 2014...
September 2015: Cerebrovascular Diseases Extra
Christopher Jan Schwarzbach, Marc Fatar, Philipp Eisele, Anne D Ebert, Michael G Hennerici, Kristina Szabo
BACKGROUND: Due to the lack of specific diagnostic markers, the diagnosis of cancer-related stroke strongly depends on its phenotype. Distinct DWI lesion patterns with involvement of multiple vascular territories have been reported repeatedly in cancer-related stroke but have not been addressed in detail in a selected cohort of prospectively recruited cancer patients with emphasis on hypercoagulable conditions. PATIENTS AND METHODS: Ischemic stroke patients with known malignant cancer activity, laboratory evidence of strong plasmatic hypercoagulation (D-dimer levels > 3 µg/ml) and without competing stroke etiologies according to the recently introduced ASCOD (A - atherosclerosis, S - small vessel disease, C - cardiac pathology, O - other cause, and D - dissection) classification of evidence-rated etiology of stroke subtypes were included in the analysis...
September 2015: Cerebrovascular Diseases Extra
Csilla Égi, Júlia Horváth, Katalin Hahn, Bernadette Kalman, József Betlehem, Lajos Nagy
BACKGROUND: Stroke is a devastating disease with increasing incidence and prevalence due to population aging. Even with the best care, a proportion of patients dies or is left with significant neurological and cognitive disability. Organization of stroke centers markedly improved outcomes worldwide. We initiated a 'lysis alarm' program in September 2013 at our medical center. METHODS: This is a retrospective review of electronic data from patients with acute ischemic stroke before (October 2012-June 2013) and after (October 2013-June 2014) the 'lysis alarm' program was introduced at our medical center...
September 2015: Cerebrovascular Diseases Extra
Yanina R Timasheva, Timur R Nasibullin, Olga E Mustafina
Hypertension is the major risk factor for stroke, and genetic factors contribute to its development. Inflammation has been hypothesized to be the key link between blood pressure elevation and stroke. We performed an analysis of the association between inflammatory mediator gene polymorphisms and the incidence of stroke in patients with essential hypertension (EH). The study group consisted of 625 individuals (296 patients with noncomplicated EH, 71 hypertensive patients with ischemic stroke, and 258 control subjects)...
September 2015: Cerebrovascular Diseases Extra
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