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https://www.readbyqxmd.com/read/29660221/brainstem-leukoaraiosis-independently-predicts-poor-outcome-after-ischemic-stroke
#1
Eva Giralt-Steinhauer, Santiago Medrano, Carolina Soriano-Tárraga, Marina Mola-Caminal, Raquel Rasal, Elisa Cuadrado-Godia, Ana Rodríguez-Campello, Angel Ois, J Capellades, Jordi Jimenez-Conde, Jaume Roquer
BACKGROUND: Increased supratentorial white matter hyperintensities volume (S-WMHV) has been reported as a predictor of worse outcome in acute ischemic stroke (AIS) patients. However, few studies focus on less common locations such as brainstem-white matter hyperintensities (B-WMH), and their relationship with S-WMHV. This study aimed to examine whether B-WMH affects clinical outcome after AIS or transient ischemic attack (TIA). METHODS: Based on MRI evidence, B-WMH was evaluated in 313 prospectively identified patients with AIS/TIA and registered as absent or present...
April 16, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29621285/serious-hemorrhages-after-ischemic-stroke-or-tia-incidence-mortality-and-predictors
#2
Joachim Ögren, Anna-Lotta Irewall, Lars Söderström, Thomas Mooe
BACKGROUND: Data are lacking on the risk and impact of a serious hemorrhage on the prognosis after ischemic stroke (IS) or transient ischemic attack (TIA). We aimed to estimate the incidence of serious hemorrhage, analyze the impact on mortality, and identify predictors of hemorrhage after discharge from IS or TIA. METHODS AND FINDINGS: All patients admitted to Östersund Hospital for an IS or TIA in 2010-2013 were included (n = 1528, mean age: 75.1 years). Serious hemorrhages were identified until 31st December 2015...
2018: PloS One
https://www.readbyqxmd.com/read/29614501/the-serotonin-transporter-gene-polymorphisms-and-risk-of-ischemic-stroke
#3
Janne Kaergaard Mortensen, Kristian Lundsgaard Kraglund, Søren Paaske Johnsen, Ole Mors, Grethe Andersen, Henriette N Buttenschøn
INTRODUCTION: Serotonin is known as a neurotransmitter; however, it also plays an important role in platelet aggregation as it is released upon platelet activation. The serotonin transporter (SERT) is responsible for the uptake of serotonin into platelets. Functional polymorphisms in the SERT gene may influence platelet activity, as they result in different levels of transporters and thereby different levels of serotonin in platelets. SERT gene polymorphisms have thus been associated with the risk of myocardial infarction...
April 3, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29600887/prognosis-of-dolichoectasia-in-non-cardioembolic-transient-ischemic-attack-and-minor-stroke
#4
Xinmiao Zhang, Jing Jing, Xingquan Zhao, Liping Liu, Xia Meng, Anxin Wang, Yuesong Pan, David Wang, Yilong Wang, Yongjun Wang
Objectives This study aimed to estimate the prognosis of dolichoectasia in non-cardioembolic transient ischemic attack (TIA) and minor stroke patients. Methods Data were derived from the imaging subgroup of patients in the Clopidogrel in High-risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial. Dolichoectasia was defined as ectasia (basilar artery diameter >4.5 mm) and dolichosis (either basilar artery bifurcation above the suprasellar cistern or lateral to the margin of the clivus or dorsum sellae)...
March 30, 2018: Neurological Research
https://www.readbyqxmd.com/read/29597211/associations-between-pre-admission-risk-scores-and-two-year-clinical-outcomes-in-ischemic-stroke-or-transient-ischemic-attack-patients-with-non-valvular-atrial-fibrillation
#5
Keisuke Tokunaga, Hiroshi Yamagami, Masatoshi Koga, Kenichi Todo, Kazumi Kimura, Ryo Itabashi, Tadashi Terasaki, Yoshiaki Shiokawa, Kenji Kamiyama, Shunya Takizawa, Satoshi Okuda, Yasushi Okada, Tomoaki Kameda, Yoshinari Nagakane, Yasuhiro Hasegawa, Satoshi Shibuya, Yasuhiro Ito, Hideki Matsuoka, Kazuhiro Takamatsu, Kazutoshi Nishiyama, Kazuomi Kario, Yoshiki Yagita, Takanari Kitazono, Naoto Kinoshita, Junji Takasugi, Takuya Okata, Sohei Yoshimura, Shoichiro Sato, Shoji Arihiro, Kazunori Toyoda
BACKGROUND: We aimed to clarify associations between pre-admission risk scores (CHADS2, CHA2DS2-VASc, and HAS-BLED) and 2-year clinical outcomes in ischemic stroke or transient ischemic attack (TIA) patients with non-valvular atrial fibrillation (NVAF) using a prospective, multicenter, observational registry. METHODS: From 18 Japanese stroke centers, ischemic stroke or TIA patients with NVAF hospitalized within 7 days after onset were enrolled. Outcome measures were defined as death/disability (modified Rankin Scale score ≥3) at 2 years, 2-year mortality, and ischemic or hemorrhagic events within 2 years...
March 29, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29540612/association-of-white-matter-hyperintensities-with-short-term-outcomes-in-patients-with-minor-cerebrovascular-events
#6
Charlotte Zerna, Amy Y X Yu, Jayesh Modi, Shiel K Patel, Jonathan I Coulter, Eric E Smith, Shelagh B Coutts
BACKGROUND AND PURPOSE: White matter lesions (WML) are associated with cognitive decline, increased stroke risk, and disability in old age. We hypothesized that superimposed acute cerebrovascular occlusion on chronic preexisting injury (leukoaraiosis) leads to worse outcome after minor cerebrovascular event, both using quantitative (volumetric) and qualitative (Fazekas scale) assessment, as well as relative total brain volume. METHODS: WML volume assessment was performed in 425 patients with high-risk transient ischemic attack (TIA; motor/speech deficits >5 minutes) or minor strokes from the CATCH study (CT and MRI in the Triage of TIA and Minor Cerebrovascular Events to Identify High Risk Patients)...
April 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29523641/cpap-as-treatment-of-sleep-apnea-after-stroke-a-meta-analysis-of-randomized-trials
#7
Anne-Kathrin Brill, Thomas Horvath, Andrea Seiler, Millene Camilo, Alan G Haynes, Sebastian R Ott, Matthias Egger, Claudio L Bassetti
OBJECTIVE: To perform a systematic review and meta-analysis of randomized controlled trials (RCTs) examining the effectiveness of continuous positive airway pressure (CPAP) in stroke patients with sleep disordered breathing (SDB). METHODS: In a systematic literature search of electronic databases (MEDLINE, Embase, and the Cochrane Library) from 1980 to November 2016, we identified RCTs that assessed CPAP compared to standard care or sham CPAP in adult patients with stroke or TIA with SDB...
March 9, 2018: Neurology
https://www.readbyqxmd.com/read/29507777/risk-factors-associated-with-90-day-recurrent-stroke-in-patients-on-dual-antiplatelet-therapy-for-minor-stroke-or-high-risk-tia-a-subgroup-analysis-of-the-chance-trial
#8
Runqi Wangqin, Xianwei Wang, Yilong Wang, Ying Xian, Xingquan Zhao, Liping Liu, Hao Li, Xia Meng, Yongjun Wang
Objective: Many patients receiving dual antiplatelet therapy still had recurrent strokes. We aimed to identify factors associated with recurrent stroke at 90 days in patients receiving dual antiplatelet therapy in Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events trial. Methods: Patients with transient ischaemic attack or minor stroke receiving clopidogrel and aspirin in the trial were analysed in the study. The primary outcome was recurrent stroke within 90 days after the index event...
December 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/29459397/predictors-of-thrombolysis-administration-in-mild-stroke-florida-puerto-rico-collaboration-to-reduce-stroke-disparities
#9
Negar Asdaghi, Kefeng Wang, Maria A Ciliberti-Vargas, Carolina Marinovic Gutierrez, Sebastian Koch, Hannah Gardener, Chuanhui Dong, David Z Rose, Enid J Garcia, W Scott Burgin, Juan Carlos Zevallos, Tatjana Rundek, Ralph L Sacco, Jose G Romano
BACKGROUND AND PURPOSE: Mild stroke is the most common cause for thrombolysis exclusion in patients acutely presenting to the hospital. Thrombolysis administration in this subgroup is highly variable among different clinicians and institutions. We aim to study the predictors of thrombolysis in patients with mild ischemic stroke in the FL-PR CReSD registry (Florida-Puerto Rico Collaboration to Reduce Stroke Disparities). METHODS: Among 73 712 prospectively enrolled patients with a final diagnosis of ischemic stroke or TIA from January 2010 to April 2015, we identified 7746 cases with persistent neurological symptoms and National Institutes of Health Stroke Scale ≤5 who arrived within 4 hours of symptom onset...
March 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29438515/diabetes-and-long-term-outcomes-of-ischaemic-stroke-findings-from-get-with-the-guidelines-stroke
#10
Justin B Echouffo-Tcheugui, Haolin Xu, Roland A Matsouaka, Ying Xian, Lee H Schwamm, Eric E Smith, Deepak L Bhatt, Adrian F Hernandez, Paul A Heidenreich, Gregg C Fonarow
Aims: There is a paucity of data on the influence of diabetes on long-term outcomes after ischaemic stroke (IS). We assessed whether outcomes after IS differ between patients with and without diabetes. Methods and results: Patients aged ≥65 years (n = 409 060) in Get With The Guidelines-Stroke (nationwide registry of stroke patients from 1690 sites in the USA) were followed for 3 years post-discharge. The outcomes of interest were mortality, cardiovascular and non-cardiovascular hospitalizations, heart failure (HF), and recurrence of IS/transient ischaemic attack (TIA)...
February 9, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29428326/a-modified-definition-for-obstructive-sleep-apnea-in-home-sleep-apnea-testing-after-stroke-or-transient-ischemic-attack
#11
Namita Patel, Afsaneh Raissi, Sara Elias, Maneesha Kamra, Tetyana Kendzerska, Brian J Murray, Mark I Boulos
BACKGROUND: Home sleep apnea testing (HSAT) underestimates obstructive sleep apnea (OSA) severity. Overnight oxygen desaturation has been shown to be a strong predictor of incident stroke, and may be helpful in determining which patients with lower apnea-hypopnea indices (AHIs) should be offered treatment. OBJECTIVES: To examine whether a modified definition for OSA that uses oxygen desaturation (i.e., AHI 5-14.9 per hour and lowest O2 desaturation ≤88%), as compared to an AHI ≥ 15 per hour, would impact: (1) changes in Epworth Sleepiness Scale scores post-continuous positive airway pressure (CPAP) initiation; (2) CPAP compliance rates; and (3) the accuracy of automated versus manual scoring of HSAT...
February 7, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29385837/verification-of-a-proteomic-biomarker-panel-to-diagnose-minor-stroke-and-transient-ischaemic-attack-phase-1-of-spectra-a-large-scale-translational-study
#12
Andrew M Penn, Maximilian B Bibok, Viera K Saly, Shelagh B Coutts, Mary L Lesperance, Robert F Balshaw, Kristine Votova, Nicole S Croteau, Anurag Trivedi, Angela M Jackson, Janka Hegedus, Evgenia Klourfeld, Amy Y X Yu, Charlotte Zerna, Christoph H Borchers
OBJECTIVE: To derive a plasma biomarker protein panel from a list of 141 candidate proteins which can differentiate transient ischaemic attack (TIA)/minor stroke from non-cerebrovascular ('mimic') conditions in emergency department (ED) settings. DESIGN: Prospective clinical study (#NCT03050099) with up to three timed blood draws no more than 36 hours following symptom onset. Plasma samples analysed by multiple reaction monitoring-mass spectrometry (MRM-MS). PARTICIPANTS: 545 participants suspected of TIA enrolled in the EDs of two urban medical centres...
February 1, 2018: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/29363651/rationale-and-study-design-for-a-single-arm-phase-iia-study-investigating-feasibility-of-preventing-ischemic-cerebrovascular-events-in-high-risk-patients-with-acute-non-disabling-ischemic-cerebrovascular-events-using-remote-ischemic-conditioning
#13
Shi-Meng Liu, Wen-Le Zhao, Hai-Qing Song, Ran Meng, Si-Jie Li, Chang-Hong Ren, Bruce Ovbiagele, Xun-Ming Ji, Wu-Wei Feng
BACKGROUND: Acute minor ischemic stroke (AMIS) or transient ischemic attack (TIA) is a common cerebrovascular event with a considerable high recurrence. Prior research demonstrated the effectiveness of regular long-term remote ischemic conditioning (RIC) in secondary stroke prevention in patients with intracranial stenosis. We hypothesized that RIC can serve as an effective adjunctive therapy to pharmacotherapy in preventing ischemic events in patients with AMIS/TIA. This study aimed to investigate the feasibility, safety, and preliminary efficacy of daily RIC in inhibiting cerebrovascular/cardiovascular events after AMIS/TIA...
February 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29336708/emergency-dispatcher-stroke-recognition-associations-with-downstream-care
#14
J Adam Oostema, Todd Chassee, Mathew Reeves
OBJECTIVE: As the first point of contact for patients activating emergency medical services (EMS), emergency dispatchers have the earliest opportunity to recognize stroke. We sought to quantify dispatcher stroke recognition and its relationships with EMS stroke recognition and response speed. METHODS: We assembled a cohort of consecutive EMS-transported patients with a dispatcher suspected stroke or a hospital discharge diagnosis of stroke or transient ischemic attack (TIA)...
January 16, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29330312/high-sensitive-c-reactive-protein-and-dual-antiplatelet-in-intracranial-arterial-stenosis
#15
Jiejie Li, Anxin Wang, Xingquan Zhao, Liping Liu, Xia Meng, Jinxi Lin, Jing Jing, Xinying Zou, Yilong Wang, Yongjun Wang
OBJECTIVE: To determine the relationship of high-sensitive C-reactive protein (hsCRP) and the efficacy and safety of dual antiplatelet therapy in patients with and without intracranial arterial stenosis (ICAS) in the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial. METHODS: A subgroup of 807 patients with both magnetic resonance angiography images and hsCRP measurement was analyzed. Cox proportional hazards models were used to assess the interaction of hsCRP levels with the effects of dual and single antiplatelet therapy...
February 6, 2018: Neurology
https://www.readbyqxmd.com/read/29306602/alpha-2-antiplasmin-arg407lys-polymorphism-and-cryptogenic-ischemic-cerebrovascular-events-association-with-neurological-deficit
#16
Joanna Wzorek, Marek Karpiński, Ewa Wypasek, Michał Michalski, Andrzej Szczudlik, Krzysztof Piotr Malinowski, Anetta Undas
OBJECTIVE: Genetic background of cryptogenic ischemic stroke (IS) and transient ischemic attack (TIA) remains uncertain. Alpha-2-antiplasmin (α2AP) Arg407Lys polymorphism has been shown to be less common in patients with abdominal aortic aneurysm (AAA) compared with healthy controls. We investigated associations of α2AP Arg407Lys polymorphism with cryptogenic IS and TIA. METHODS: We studied 165 consecutive Caucasian patients who experienced cryptogenic IS (n=123) or TIA (n=42)...
December 26, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/29306185/pre-stroke-employment-results-in-better-patient-reported-outcomes-after-minor-stroke-short-title-functional-outcomes-after-minor-stroke
#17
Elisabeth B Marsh, Erin Lawrence, Argye E Hillis, Karen Chen, Rebecca F Gottesman, Rafael H Llinas
OBJECTIVE: Individuals with "minor stroke" lack a dense hemiparesis or aphasia; however, commonly endorse persistent cognitive and motor problems despite low NIHSS scores. They also report problems with mood, energy, and the ability to think clearly that are less well characterized. Socioeconomic factors and stroke severity can influence patient-reported outcomes. In this study we explore patient-reported outcomes and the influence of these factors after minor stroke. PATIENTS AND METHODS: Patients returning to clinic post-stroke with an NIHSS of ≤ 4 were administered a scale to quantify problems with daily activities and resulting functional burden, along with measures of fatigue and depression...
February 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29279801/technical-factors-affecting-outcomes-following-endovascular-treatment-of-posterior-circulation-atherosclerotic-lesions
#18
Matthew D Alexander, Jeffrey M Rebhun, Steven W Hetts, Matthew R Amans, Fabio Settecase, Robert J Darflinger, Christopher F Dowd, Van V Halbach, Randall T Higashida, Daniel L Cooke
Background: Atherosclerotic disease of the vertebrobasilar system causes significant morbidity and mortality. All lesions require aggressive medical management, but the role of endovascular interventions remains unsettled. This study examines such endovascular interventions for vertebrobasilar atherosclerosis. Methods: Retrospective review was performed of prospectively maintained procedure logs at three hospitals with comprehensive neurointerventional services...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29274727/antiplatelet-therapy-with-aspirin-clopidogrel-and-dipyridamole-versus-clopidogrel-alone-or-aspirin-and-dipyridamole-in-patients-with-acute-cerebral-ischaemia-tardis-a-randomised-open-label-phase-3-superiority-trial
#19
Philip M Bath, Lisa J Woodhouse, Jason P Appleton, Maia Beridze, Hanne Christensen, Robert A Dineen, Lelia Duley, Timothy J England, Katie Flaherty, Diane Havard, Stan Heptinstall, Marilyn James, Kailash Krishnan, Hugh S Markus, Alan A Montgomery, Stuart J Pocock, Marc Randall, Annemarei Ranta, Thompson G Robinson, Polly Scutt, Graham S Venables, Nikola Sprigg
BACKGROUND: Intensive antiplatelet therapy with three agents might be more effective than guideline treatment for preventing recurrent events in patients with acute cerebral ischaemia. We aimed to compare the safety and efficacy of intensive antiplatelet therapy (combined aspirin, clopidogrel, and dipyridamole) with that of guideline-based antiplatelet therapy. METHODS: We did an international, prospective, randomised, open-label, blinded-endpoint trial in adult participants with ischaemic stroke or transient ischaemic attack (TIA) within 48 h of onset...
March 3, 2018: Lancet
https://www.readbyqxmd.com/read/29244081/atrial-fibrillation-type-matters-greater-infarct-volume-and-worse-neurological-defects-seen-in-acute-cardiogenic-cerebral-embolism-due-to-persistent-or-permanent-rather-than-paroxysmal-atrial-fibrillation
#20
Osamu Inaba, Yasuteru Yamauchi, Masahiro Sekigawa, Naoyuki Miwa, Junji Yamaguchi, Yasutoshi Nagata, Toru Obayashi, Takamichi Miyamoto, Tomoyuki Kamata, Mitsuaki Isobe, Masahiko Goya, Kenzo Hirao
Aims: Some studies have shown that the type of atrial fibrillation (AF), whether paroxysmal AF (PAF) or persistent or permanent AF (PeAF), affects the incidence of ischaemic stroke. This study sought to determine the relationship between the AF pattern and the severity and brain volume of infarction in an AF population including transient ischaemic attack (TIA) patients. Methods and results: This was a retrospective observational study. We studied 161 consecutive patients who were admitted to our stroke care unit with cardiogenic embolism or TIA related to non-valvular AF (age 79 ± 9...
December 12, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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