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Cerebrovascular Diseases Extra

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https://www.readbyqxmd.com/read/28803231/in-potential-stroke-patients-on-warfarin-the-international-normalized-ratio-predicts-ischemia
#1
Cathy Cao, Ashley Martinelli, Brian Spoelhof, Rafael H Llinas, Elisabeth B Marsh
BACKGROUND: Stroke can occur in patients on warfarin despite anticoagulation. Patients with a low international normalized ratio (INR) should theoretically be at greater risk for ischemia than those who are therapeutic. Therefore, INR may be able to indicate whether new neurological deficits are more likely strokes or stroke mimics in patients on warfarin. This study evaluates the association and predictive value of INR in determining the likelihood of ischemia. METHODS: Patients were identified using the acute stroke registry at a Primary Stroke Center from January 2013 through December 2014...
August 11, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28558372/dosage-calculation-for-intravenous-thrombolysis-of-ischemic-stroke-to-weigh-or-to-estimate
#2
Andreas Ragoschke-Schumm, Asem Razouk, Martin Lesmeister, Stefan Helwig, Iris Q Grunwald, Klaus Fassbender
BACKGROUND: Estimation is a widely used method of assessing the weight of patients with acute stroke. Because the dosage of tissue plasminogen activator (tPA) is weight-dependent, errors in estimation lead to incorrect dosing. METHODS: We installed a ground-level scale in the computed tomography (CT) suite of our hospital and also integrated a scale into the CT table of our Mobile Stroke Unit in order to prospectively assess the differences between reported, estimated, and measured weights of acute stroke patients...
May 30, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28463832/outcomes-of-endovascular-thrombectomy-with-and-without-thrombolysis-for-acute-large-artery-ischaemic-stroke-at-a-tertiary-stroke-centre
#3
Chee-Keong Wee, William McAuliffe, Constantine C Phatouros, Timothy J Phillips, David Blacker, Tejinder P Singh, Ellen Baker, Graeme J Hankey
BACKGROUND AND PURPOSE: Endovascular thrombectomy (EVT) improves the functional outcome when added to best medical therapy, including alteplase, in patients with acute ischaemic stroke secondary to large vessel occlusion (LVO) in the anterior circulation. However, the evidence for EVT in alteplase-ineligible patients is less compelling. It is also uncertain whether alteplase is necessary in patients with successful recanalization by EVT, as the treatment effect of EVT may be so powerful that bridging alteplase may not add to efficacy and may compromise safety by increasing bleeding risks...
May 2, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28259883/measurement-of-oxygen-desaturation-is-not-useful-for-the-detection-of-aspiration-in-dysphagic-stroke-patients
#4
Thomas Marian, Jens Schröder, Paul Muhle, Inga Claus, Stephan Oelenberg, Christina Hamacher, Tobias Warnecke, Sonja Suntrup-Krüger, Rainer Dziewas
BACKGROUND: Dysphagia is one of the most dangerous symptoms of acute stroke. Various screening tools have been suggested for the early detection of this condition. In spite of conflicting results, measurement of oxygen saturation (SpO2) during clinical swallowing assessment is still recommended by different national guidelines as a screening tool with a decline in SpO2 ≥2% usually being regarded as a marker of aspiration. This paper assesses the sensitivity of SpO2 measurements for the evaluation of aspiration risk in acute stroke patients...
March 4, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28253498/brain-natriuretic-peptide-is-a-powerful-predictor-of-outcome-in-stroke-patients-with-atrial-fibrillation%C3%A2
#5
Kenji Maruyama, Shinichiro Uchiyama, Tsuyoshi Shiga, Mutsumi Iijima, Kentaro Ishizuka, Takao Hoshino, Kazuo Kitagawa
BACKGROUND: Since stroke patients with nonvalvular atrial fibrillation (NVAF) have poor outcomes in general, the prediction of outcomes following discharge is of utmost concern for these patients. We previously reported that brain natriuretic peptide (BNP) levels were significantly higher in NVAF patients with larger infarcts, higher modified Rankin Scale (mRS) score, and higher CHADS2 score. In the present study, we evaluated an array of variables, including BNP, in order to determine significant predictors for functional outcome in patients with NVAF after acute ischemic stroke (AIS)...
March 2, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28208139/mri-based-neuroanatomical-predictors-of-dysphagia-dysarthria-and-aphasia-in-patients-with-first-acute-ischemic-stroke%C3%A2
#6
Heather L Flowers, Mohammed A AlHarbi, David Mikulis, Frank L Silver, Elizabeth Rochon, David Streiner, Rosemary Martino
BACKGROUND: Due to the high post-stroke frequency of dysphagia, dysarthria, and aphasia, we developed comprehensive neuroanatomical, clinical, and demographic models to predict their presence after acute ischemic stroke. METHODS: The sample included 160 randomly selected first-ever stroke patients with confirmed infarction on magnetic resonance imaging from 1 tertiary stroke center. We documented acute lesions within 12 neuroanatomical regions and their associated volumes...
February 16, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28161702/the-course-and-impact-of-poststroke-insomnia-in-stroke-survivors-aged-18-to-65-years-results-from-the-psychosocial-outcomes-in-stroke-poise-study%C3%A2
#7
Nick Glozier, Tom J Moullaali, Børge Sivertsen, Dukyeon Kim, Gillian Mead, Stephen Jan, Qiang Li, Maree L Hackett
BACKGROUND: Insomnia symptoms are common in the population and have negative psychosocial and functional sequelae. There are no prospective studies of the course of such symptoms and their impact, if any, in stroke survivors. This prospective cohort study investigated insomnia after stroke in working-age adults and evaluated its impact on psychological and functional outcomes over the subsequent year. METHODS: We prospectively recruited 441 young (<65 years) consecutive stroke survivors from 20 public hospitals in the New South Wales Stroke Service network...
February 3, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28125807/the-role-of-white-matter-damage-in-the-risk-of-periprocedural-diffusion-weighted-lesions-after-carotid-artery-stenting
#8
Paola Maggio, Claudia Altamura, Domenico Lupoi, Matteo Paolucci, Riccardo Altavilla, Francesco Tibuzzi, Francesco Passarelli, Roberto Arpesani, Guido Di Giambattista, Rosario Francesco Grasso, Giacomo Luppi, Fabrizio Fiacco, Mauro Silvestrini, Patrizio Pasqualetti, Fabrizio Vernieri
BACKGROUND: White matter hyperintensities (WMH) are a common finding in aged individuals affected by carotid artery disease and are a risk factor for first-ever and recurrent stroke. We investigated if white matter damage increases the risk of brain microembolism during carotid artery stenting (CAS), as evaluated by the appearance of new areas of restricted diffusion on diffusion-weighted images (DWI). METHODS: We evaluated 47 patients with severe internal carotid artery (ICA) stenosis undergoing CAS, comparing preprocedural clinical, ultrasound and radiological characteristics...
January 27, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28433996/factor-xii-as-a-risk-marker-for-hemorrhagic-stroke-a-prospective-cohort-study
#9
Kristina Johansson, Jan-Håkan Jansson, Lars Johansson, Ingemar Bylesjö, Torbjörn K Nilsson, Mats Eliasson, Stefan Söderberg, Marcus Lind
BACKGROUND: Coagulation factor XII (FXII) is involved in pathological thrombus formation and is a suggested target of anticoagulants. It is unclear whether FXII levels are correlated with cardiovascular risk factors and whether they are associated with myocardial infarction or ischemic or hemorrhagic stroke. The aim of this study was to investigate the correlation between FXII and cardiovascular risk factors in the general population. We also aimed to study the associations between FXII levels and future myocardial infarction and ischemic and hemorrhagic stroke...
2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28399527/blunt-traumatic-extracranial-cerebrovascular-injury-and-ischemic-stroke
#10
Paul M Foreman, Mark R Harrigan
BACKGROUND: Ischemic stroke occurs in a significant subset of patients with blunt traumatic cerebrovascular injury (TCVI). The patients are victims of motor vehicle crashes, assaults or other high-energy collisions, and suffer ischemic stroke due to injury to the extracranial carotid or vertebral arteries. SUMMARY: An increasing number of patients with TCVI are being identified, largely because of the expanding use of computed tomography angiography for screening patients with blunt trauma...
2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28376486/volume-and-characteristics-of-intracerebral-hemorrhage-with-direct-oral-anticoagulants-in-comparison-with-warfarin%C3%A2
#11
Tomohide Adachi, Haruhiko Hoshino, Makoto Takagi, Shodo Fujioka
BACKGROUND: Patients undergoing anticoagulation therapy often experience intracerebral hemorrhages (ICHs), and warfarin in particular is known to increase hematoma expansion in ICHs, which results in a poor outcome. Recent studies reported that, in comparison with warfarin, direct oral anticoagulants (DOACs) cause fewer ICHs with better functional outcome. However, since it is still unknown whether DOACs are associated with a smaller hematoma volume of ICHs, we aimed to compare the volume, hematoma expansion, and outcomes associated with ICHs treated with DOACs and warfarin...
2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28359069/high-risk-of-seizures-and-epilepsy-after-decompressive-hemicraniectomy-for-malignant-middle-cerebral-artery-stroke%C3%A2
#12
Rosane Brondani, Andrea Garcia de Almeida, Pedro Abrahim Cherubini, Suelen Mandelli Mota, Luiz Carlos de Alencastro, Apio Cláudio Martins Antunes, Marino Bianchin Muxfeldt
BACKGROUND: Decompressive hemicraniectomy (DHC) is a life-saving procedure for treatment of large malignant middle cerebral artery (MCA) strokes. Post-stroke epilepsy is an additional burden for these patients, but its incidence and the risk factors for its development have been poorly investigated. OBJECTIVE: To report the prevalence and risk factors for post-stroke seizures and post-stroke epilepsy after DHC for treatment of large malignant MCA strokes in a cohort of 36 patients...
2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/27898406/low-incidence-of-atrial-fibrillation-in-patients-with-transient-ischemic-attack
#13
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...
2016: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/27846623/paracrine-mechanisms-of-intravenous-bone-marrow-derived-mononuclear-stem-cells-in-chronic-ischemic-stroke
#14
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)...
2016: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/27846618/risk-factors-for-incident-carotid-artery-revascularization-among-older-adults-the-cardiovascular-health-study
#15
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...
2016: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/27771707/peripheral-immune-cell-counts-and-advanced-imaging-as-biomarkers-of-stroke-outcome
#16
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...
2016: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/27750249/how-reliable-are-administrative-data-for-capturing-stroke-patients-and-their-care
#17
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...
2016: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/27728903/ultra-early-combination-antiplatelet-therapy-with-cilostazol-for-the-prevention-of-branch-atheromatous-disease-a-multicenter-prospective-study
#18
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...
2016: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/27721312/high-abcd2-scores-and-in-hospital-interventions-following-transient-ischemic-attack
#19
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...
2016: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/27665361/difference-in-transcranial-doppler-velocity-and-patient-age-between-proximal-and-distal-middle-cerebral-artery-vasospasms-after-aneurysmal-subarachnoid-hemorrhage
#20
COMPARATIVE STUDY
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
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