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Stroke complication

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https://www.readbyqxmd.com/read/29775153/feasibility-safety-and-changes-in-systolic-blood-pressure-associated-with-endovascular-revascularization-of-symptomatic-and-chronically-occluded-cervical-internal-carotid-artery-using-a-newly-suggested-radiographic-classification-of-chronically-occluded-cervical
#1
David Hasan, Mario Zanaty, Robert M Starke, Elias Atallah, Nohra Chalouhi, Pascal Jabbour, Amit Singla, Waldo R Guerrero, Daichi Nakagawa, Edgar A Samaniego, Nnenna Mbabuike, Rabih G Tawk, Adnan H Siddiqui, Elad I Levy, Roberta L Novakovic, Jonathan White, Clemens M Schirmer, Thomas G Brott, Hussain Shallwani, L Nelson Hopkins
OBJECTIVE The overall risk of ischemic stroke from a chronically occluded internal carotid artery (COICA) is around 5%-7% per year despite receiving the best available medical therapy. Here, authors propose a radiographic classification of COICA that can be used as a guide to determine the technical success and safety of endovascular recanalization for symptomatic COICA and to assess the changes in systemic blood pressure following successful revascularization. METHODS The radiographic images of 100 consecutive subjects with COICA were analyzed...
May 18, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29775142/aspirin-for-primary-prevention-of-stroke-in-traumatic-cerebrovascular-injury-association-with-increased-risk-of-transfusion
#2
Russell L Griffin, Stephanie R Falatko, Stella Aslibekyan, Virginia Strickland, Mark R Harrigan
OBJECTIVE Blunt traumatic extracranial carotid or vertebral artery injury (i.e., traumatic cerebrovascular injury [TCVI]) occurs in 1%-2% of all blunt trauma admissions, carries a 10% risk of thromboembolic ischemic stroke, and accounts for up to 9600 strokes annually in the US. Screening CT angiograms (CTAs) of patients with trauma has become ubiquitous in recent years, and patients with initially asymptomatic TCVI are commonly treated with antiplatelet agents to prevent stroke. Prophylaxis with antiplatelets is thought to be safer than anticoagulation, which carries a significant risk of hemorrhage in patients with trauma...
May 18, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29774601/the-impact-of-mitral-stenosis-on-outcomes-of-aortic-valve-stenosis-patient-undergoing-surgical-aortic-valve-replacement-or-transcatheter-aortic-valve-replacement
#3
Yasser Al-Khadra, Fahed Darmoch, Motaz Baibars, Amir Kaki, Zaher Fanari, M Chadi Alraies
BACKGROUND: The concomitant presence of mitral stenosis (MS) in the setting of symptomatic aortic stenosis represent a clinical challenge. Little is known regarding the outcome of mitral stenosis (MS) patients undergoing transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR). Therefore, we sought to study the outcome of MS patients undergoing aortic valve replacement (AVR). METHOD: Using weighted data from the National Inpatient Sample (NIS) database between 2011 and 2014, we identified patients who were diagnosed with MS...
May 17, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29774429/the-utility-of-superb-microvascular-imaging-for-the-detection-of-deep-vein-thrombosis
#4
Yuta Hagiwara, Rie Sasaki, Takahiro Shimizu, Kaima Soga, Chihiro Hatada, Motoki Miyauchi, Takanori Okamura, Masaru Sakurai, Hisanao Akiyama, Yasuhiro Hasegawa
Superb microvascular imaging (SMI) reduces motion artifacts significantly and allows visualization of low-velocity blood flow in vessels; thus, thrombi are clearly demonstrated compared to conventional B-mode and color Doppler imaging. Ultrasonographic images of the lower extremities of a 69-year-old woman with acute ischemic stroke complicated with deep vein thrombosis (DVT) are presented. Because SMI allows visualization of low-velocity blood flow, echo contrast between the thrombus and the surrounding flow makes it possible to clearly visualize the thrombus...
May 17, 2018: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/29774194/improper-use-of-thrombolytic-agents-in-acute-hemiparesis-following-misdiagnosis-of-acute-ischemic-stroke
#5
Min Chan Kim, Seok Won Kim
Objective: Acute hemiparesis is often an early presentation of acute ischemic stroke, though it can occur in various disorders. This study aimed to investigate the improper use of thrombolytic agents for patients with acute hemiparesis, following the misdiagnosis of acute ischemic stroke. Methods: We analyzed the clinical and radiological data of nine patients initially misdiagnosed with cerebral stroke in the emergency room from May 2013 to January 2017. All the patients were treated with tissue plasminogen activator (TPA) owing to the presence of acute hemiparesis...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29774186/ring-enhancing-lesions-in-neonatal-meningitis-an-analysis-of-neuroradiology-pitfalls-through-exemplificative-cases-and-a-review-of-the-literature
#6
Mario Ganau, Kshitij Mankad, Uma Rami Srirambhatla, Zubair Tahir, Felice D'Arco
Very often the clinical course of neonatal meningitis (NM) is characterized by sudden worsening, at times associated with cerebrovascular complications and strokes or the formation of cerebral abscesses. The immediate recognition of these pathological patterns is pivotal in providing clinicians with useful information to differentiate between those different pathological entities, which may both present as ring-enhancing lesions on neuroradiology investigations. Understanding their natural history and diagnostic features is of paramount importance to timely adopt the most appropriate medical and surgical management...
April 2018: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/29773712/acute-kidney-injury-and-risk-of-heart-failure-and-atherosclerotic-events
#7
Alan S Go, Chi-Yuan Hsu, Jingrong Yang, Thida C Tan, Sijie Zheng, Juan D Ordonez, Kathleen D Liu
BACKGROUND AND OBJECTIVES: AKI in the hospital is common and is associated with excess mortality. We examined whether AKI is also independently associated with a higher risk of different cardiovascular events in the first year after discharge. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a retrospective analysis of a cohort between 2006 and 2013 with follow-up through 2014, within Kaiser Permanente Northern California. We identified all adults admitted to 21 hospitals who had one or more in-hospital serum creatinine test result and survived to discharge...
May 17, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29773578/relationship-between-glycated-hemoglobin-and-stroke-risk-a-systematic-review-and-meta-analysis
#8
REVIEW
John Peter Mitsios, Elif Ilhan Ekinci, Gregory Peter Mitsios, Leonid Churilov, Vincent Thijs
BACKGROUND: Diabetes mellitus is a major risk factor for ischemic stroke. Rising hemoglobin A1c (HbA1c ) levels are associated with microvascular diabetes mellitus complication development; however, this relationship has not been established for stroke risk, a macrovascular complication. METHODS AND RESULTS: We conducted a systematic review and meta-analysis of observational cohort and nested case-control cohort studies assessing the association between rising HbA1c levels and stroke risk in adults (≥18 years old) with and without type 1 or type 2 diabetes mellitus...
May 17, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29773497/indications-for-red-cell-transfusions-in-pediatric-patients
#9
REVIEW
Jill M Cholette, Suzie A Noronha, Jerard Seghatchian, Neil Blumberg
Red cell transfusions are amongst the most common therapeutic procedures in seriously ill children, particularly in the inpatient setting. This is despite the fact that there is no evidence base for most clinical settings, with the exception of patients with hemoglobinopathies, particularly thalassemia and sickle cell anemia. Obviously exsanguinating hemorrhage and life threatening anemia are urgent indications for which no other therapeutic approach is currently available. Most transfusions are, however, given prophylactically to prevent the complications of hypoxia or hemodynamic stability, based upon expert opinion and a faith in the oxygen carrying capacity and beneficial hemodynamic properties of transfused red cells...
May 10, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29773445/transcatheter-aortic-valve-insertion-in-patients-with-hostile-ascending-aorta-calcification
#10
Akio Nakasu, Kevin L Greason, Vuyisile T Nkomo, Mackram F Eleid, Alberto Pochettino, Katherine S King, Gurpreet S Sandhu, Eric E Williamson, David R Holmes
OBJECTIVE: Calcification of the ascending aorta complicates aortic valve replacement. Transcatheter aortic valve replacement is an alternative procedure in this situation, but it requires manipulation through the hostile area in the ascending aorta. We reviewed our transcatheter aortic valve insertion experience to better understand the surgical mortality risk of valve insertion in patients with extensive calcification of the ascending aorta. METHODS: We retrospectively reviewed the records of 665 consecutive patients who received transcatheter aortic valve insertion from November 2008 through December 2015...
April 7, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29770166/free-radical-damage-in-ischemia-reperfusion-injury-an-obstacle-in-acute-ischemic-stroke-after-revascularization-therapy
#11
REVIEW
Ming-Shuo Sun, Hang Jin, Xin Sun, Shuo Huang, Fu-Liang Zhang, Zhen-Ni Guo, Yi Yang
Acute ischemic stroke is a common cause of morbidity and mortality worldwide. Thrombolysis with recombinant tissue plasminogen activator and endovascular thrombectomy are the main revascularization therapies for acute ischemic stroke. However, ischemia-reperfusion injury after revascularization therapy can result in worsening outcomes. Among all possible pathological mechanisms of ischemia-reperfusion injury, free radical damage (mainly oxidative/nitrosative stress injury) has been found to play a key role in the process...
2018: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29770118/neuroinflammation-as-a-target-for-intervention-in-subarachnoid-hemorrhage
#12
REVIEW
Airton Leonardo de Oliveira Manoel, R Loch Macdonald
Aneurysmal subarachnoid hemorrhage (SAH) is a sub-type of hemorrhagic stroke associated with the highest rates of mortality and long-term neurological disabilities. Despite the improvement in the management of SAH patients and the reduction in case fatality in the last decades, disability and mortality remain high in this population. Brain injury can occur immediately and in the first days after SAH. This early brain injury can be due to physical effects on the brain such as increased intracranial pressure, herniations, intracerebral, intraventricular hemorrhage, and hydrocephalus...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29768962/successful-thrombectomy-in-endocarditis-related-stroke-case-report-and-review-of-the-literature
#13
Manuel Bolognese, Alexander von Hessling, Martin Müller
Neurological complications of infective endocarditis are frequent, especially ischaemic strokes. As intravenous thrombolysis in infective endocarditis-related ischaemic stroke has a controversial benefit/risk ratio, alternative treatment regimens have to be considered. We present the case of a young patient with septic embolism of the middle cerebral artery who was successfully treated with mechanical thrombectomy, and give a short review of the existing literature.
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29768672/catheter-ablation-for-atrial-fibrillation-on-uninterrupted-direct-oral-anticoagulants-a-safe-approach
#14
V Sawhney, M Shaukat, E Volkova, N Jones, R Providencia, S Honarbakhsh, G Dhillon, A Chow, M Lowe, P Lambiase, M Dhinoja, S Sporton, M J Earley, R J Schilling, R J Hunter
BACKGROUND: Current consensus guidelines suggest DOACs are interrupted peri-procedurally for catheter ablation (CA) of AF. However, this may predispose patients to thromboembolic complications. This study investigates the safety of CA for AF on uninterrupted DOACs compared to uninterrupted warfarin. METHODS: Single centre, retrospective study of consecutive patients undergoing CA for AF. All patients were heparinised prior to trans-septal puncture with a target activated clotting time (ACT) of 300-350 seconds...
May 16, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29768250/metabolic-regulation-of-synaptic-activity
#15
Sergei V Fedorovich, Tatyana V Waseem
Brain tissue is bioenergetically expensive. In humans, it composes approximately 2% of body weight and accounts for approximately 20% of calorie consumption. The brain consumes energy mostly for ion and neurotransmitter transport, a process that occurs primarily in synapses. Therefore, synapses are expensive for any living creature who has brain. In many brain diseases, synapses are damaged earlier than neurons start dying. Synapses may be considered as vulnerable sites on a neuron. Ischemic stroke, an acute disturbance of blood flow in the brain, is an example of a metabolic disease that affects synapses...
May 16, 2018: Reviews in the Neurosciences
https://www.readbyqxmd.com/read/29768161/-practical-aspects-of-anticoagulant-therapy-in-patients-with-atrial-fibrillation-and-arterial-hypertension
#16
Z D Kobalava, A A Shavarov
Atrial fibrillation (AF) represents the most frequent sustained cardiac arrhythmia, the prevalence of AF is 1-2 % in the general population and up to 6 % for population over 80 years. Arterial hypertension (AH) is the commonest background comorbidity in patients with AF. Patients with AF have 3-6‑fold increased risk of ischemic stroke in comparison to that in general population, additionally the presence of AH leads an 2-3‑fold increase in risk of subsequent stroke. Current clinical guidelines recommend long-time anticoagulant treatment for prevention of stroke and thromboembolic complications in majority of patients with confirmed AF...
2018: Kardiologiia
https://www.readbyqxmd.com/read/29766335/ticagrelor-versus-clopidogrel-as-part-of-dual-or-triple-antithrombotic-therapy-a-systematic-review-and-meta-analysis
#17
Ioannis Andreou, Alexandros Briasoulis, Christos Pappas, Ignatios Ikonomidis, Dimitrios Alexopoulos
PURPOSE: Clopidogrel is the standard P2Y12 receptor inhibitor used in patients requiring both antiplatelet therapy and oral anticoagulation (OAC). We investigated the safety and efficacy of ticagrelor as an alternative to clopidogrel in patients on OAC. METHODS: A systematic electronic literature search was performed in MEDLINE, EMBASE, and the Cochrane Library for randomised controlled studies that examined the relative safety and efficacy of clopidogrel versus ticagrelor among patients requiring therapy with antiplatelet agents plus OAC...
May 15, 2018: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/29765398/epidemiology-of-intracranial-hemorrhage-associated-with-oral-anticoagulants-in-spain-trends-in-anticoagulation-complications-registry-the-tac-2-study
#18
Gustavo Zapata-Wainberg, Sonia Quintas, Álvaro Ximénez-Carrillo Rico, Jaime Masjuán Vallejo, Pere Cardona, Mar Castellanos Rodrigo, Lorena Benavente Fernández, Andrés García Pastor, José Egido, José Maciñeiras, Joaquín Serena, María Del Mar Freijo Guerrero, Francisco Moniche, José Vivancos
Objective: Patients receiving treatment with oral anticoagulants (OACs) are at risk of intracranial hemorrhage (ICH). In this study, we describe the epidemiological and clinical characteristics of patients receiving OACs who experience ICH and compare those receiving vitamin K antagonists (ICH-VKAs) with those receiving direct OACs (ICH-DOACs). Methods: We performed a national, multicenter, descriptive, observational, retrospective study of all adult patients receiving OACs who were admitted to the neurology department with ICH over a 1-year period...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29765397/lvis-jr-device-for-y-stent-assisted-coil-embolization-of-wide-neck-intracranial-aneurysms-a-multicenter-experience
#19
Edgar A Samaniego, Aldo A Mendez, Thanh N Nguyen, Vladimir Kalousek, Waldo R Guerrero, Sudeepta Dandapat, Guilherme Dabus, Italo Linfante, Ameer E Hassan, Alexander Drofa, Evgueni Kouznetsov, David Leedahl, David Hasan, Alberto Maud, Santiago Ortega-Gutierrez
Background and Purpose: Complex wide-neck intracranial aneurysms are challenging to treat. We report a multicenter experience using the LVIS Jr stent for "Y-stent"-assisted coiling embolization of wide-neck bifurcation aneurysms. Methods: Seven centers provided retrospective data on patients who underwent Y-stenting. Technical complications, immediate posttreatment angiographic results, clinical outcomes, and imaging follow-up were assessed. Results: Thirty patients/aneurysms were treated: 15 basilar tip, 8 middle cerebral artery, 4 anterior communicating artery, 1 pericallosal, and 2 posterior inferior cerebellar artery aneurysms...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29765394/mechanical-thrombectomy-in-elderly-stroke-patients-with-mild-to-moderate-baseline-disability
#20
Diana E Slawski, Hisham Salahuddin, Julie Shawver, Cynthia L Kenmuir, Gretchen E Tietjen, Andrea Korsnack, Syed F Zaidi, Mouhammad A Jumaa
Background: The number of elderly patients suffering from ischemic stroke is rising. Randomized trials of mechanical thrombectomy (MT) generally exclude patients over the age of 80 years with baseline disability. The aim of this study was to understand the efficacy and safety of MT in elderly patients, many of whom may have baseline impairment. Methods: Between January 2015 and April 2017, 96 patients ≥80 years old who underwent MT for stroke were selected for a chart review...
April 2018: Interventional Neurology
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