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W Z Pan, D X Zhou, X C Zhang, L Zhang, L Wei, J B Ge
Objective: To investigate the safety and efficacy of transcatheter aortic valve replacement(TAVR) through transcarotid approach for patients with severe aortic valve stenosis. Methods: The clinical data of 9 symptomatic severe aortic valve stenosis patients who had high or prohibitive risk for surgery and not suitable for TAVR through femoral artery access,and thus received TAVR through transcarotid approach in our hospital from November 2015 to February 2017 were retrospectively analyzed.The patients were followed up to observe the safety and efficacy of the procedure...
March 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
Woo-Jin Lee, Keun-Hwa Jung, Young Jin Ryu, Jeong-Min Kim, Soon-Tae Lee, Kon Chu, Manho Kim, Sang Kun Lee, Chul-Ho Sohn, Jae-Kyu Roh
Objective: We aimed to evaluate the impact of underlying mechanism of basilar artery (BA) occlusion on the outcomes after endovascular therapy (EVT) for reperfusion and the outcome factors associated with each mechanism, and to identify radiologic parameters enabling to distinguish the underlying mechanism. Methods: From a registry database, 194 consecutive patients with acute BA occlusion who underwent EVT were analyzed. Stroke mechanism, classified into in situ atherosclerotic thrombosis (ISAT) and embolism, clot sign location profiles in pre-angiography magnetic resonance image (MRI), parameters of angiography and EVT, and reperfusion were assessed...
March 2018: Annals of Clinical and Translational Neurology
Masaki Naganuma, Yuichiro Inatomi, Makoto Nakajima, Toshiro Yonehara, Yukio Ando
BACKGROUND: Uric acid (UA), an antioxidant with neuroprotective effects, favorably affects stroke outcome. However, the effect has not been examined in patients treated with edaravone, a frequently used free radical scavenger. We investigated whether the use of edaravone affected the relationship between UA levels and outcome in acute ischemic stroke. METHODS: We retrospectively evaluated 1,114 consecutive ischemic stroke patients with premorbid modified Rankin Scale (mRS) scores <2 admitted within 24 h of onset (mean, 74 years; median UA levels, 333 μmol/L)...
March 20, 2018: Cerebrovascular Diseases
Hyun Goo Kang, Bum Joon Kim, Sang Hun Lee, Dong-Wha Kang, Sun U Kwon, Jong S Kim
BACKGROUND: Lateral medullary infarction (LMI) is not an uncommon disease. Although lesions are usually restricted to the lateral medullary area, some patients have additional infarcts in other parts of the brain. The clinical features and prognosis of isolated LMI (pure LMI, LMIpr) have been investigated. However, it remains unclear whether clinical characteristics, prognosis and factors associated with prognosis differ between patients with LMIpr and those with additional lesions (LMI plus, LMIpl)...
March 20, 2018: Cerebrovascular Diseases
Zusen Ye, Hao Zhang, Lingli Sun, Huan Cai, Yonggang Hao, Zongliang Xu, Zhizhong Zhang, Xinfeng Liu
Elevated C-reactive protein (CRP) levels increase the risk of poor functional disability in patients with ischemic stroke (IS). This study aimed to investigate the association between CRP gene polymorphisms and 3-month functional disability of large artery atherosclerotic (LAA) stroke in Han Chinese. Patients with first-ever LAA IS were prospectively enrolled in Nanjing Stroke Registry Program between August 2013 and October 2015. Five single-nucleotide polymorphisms (SNPs) (rs876537, rs2794520, rs3093059, rs7553007 and rs11265260) in CRP gene related to CRP levels in Asian by genome-wide association study were genotyped...
March 19, 2018: Neuromolecular Medicine
Tsuyoshi Ohta, Kenji Okada, Maki Fukuda, Noritaka Masahira, Toshiki Matsuoka, Takaya Tsuno, Mitsuhiro Takemura
OBJECT: The purpose of this study was to investigate the safety and efficacy of intravenous low-dose alteplase for acute ischemic stroke patients with relative contraindications. METHODS: The consecutive series of patients admitted within 4.5 hours of ischemic stroke onset between September 2012 and April 2017 were retrospectively evaluated. A good outcome at 90 days and symptomatic intracerebral hemorrhage were evaluated to determine the association with intravenous low-dose alteplase, especially in the presence of relative contraindications...
March 16, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Fang Yuan, Fang Yang, Wen Li, Xiai Yang, Qiong Gao, Lijie Bi, Yongli Jiang, Wen Jiang
OBJECTIVES: To investigate clinical characteristics and outcomes of nonconvulsive status epilepticus (NCSE) after convulsive status epilepticus (CSE) and determine risk factors for unfavorable outcomes. METHODS: We reviewed consecutive patients with NCSE after CSE over eight years in the neurological intensive care unit. Clinical presentations and the Salzburg EEG criteria for NCSE were used to identify patients with NCSE after CSE. Demographics, clinical features, and anti-epileptic treatment responses were collected and analyzed...
March 12, 2018: Epilepsy Research
Aderaldo Costa Alves Junior, Pedro Tadao Hamamoto Filho, Marcelo Pacheco Gonçalves, Aristides Augusto Palhares Neto, Marco Antonio Zanini
Cranioplasty is a common procedure in neurosurgical practice, but associated with high complication rates. In the current study, the authors describe surgical characteristics and results of cranioplasty performed in a tertiary teaching hospital in Brazil. Data were obtained from electronic medical records of cranioplasties performed between January 2013 and November 2016. The sample comprised of 33 patients, and the mean follow-up time was 16 months. Patients presented most of the times a good preoperative status, with 84...
March 16, 2018: Journal of Craniofacial Surgery
Sixtine Gilliot, Igor Sibon, Jean-Louis Mas, Thierry Moulin, Yannick Béjot, Charlotte Cordonnier, Maurice Giroud, Pascal Odou, Régis Bordet, Denis Vivien, Didier Leys
BACKGROUND: Many patients who receive intravenous (i.v.) recombinant tissue-plasminogen activator (rt-PA) for acute cerebral ischemia were under angiotensin-converting enzyme inhibitors (ACE-Is) or angiotensin receptor blockers (ARBs) at stroke onset. ACE-Is and ARBs have neuroprotective properties in animal models. OBJECTIVE: To evaluate whether the 3-month outcome of patients treated with i.v. rt-PA for cerebral ischemia was influenced by on-going therapy with ACE-Is or ARBs...
March 16, 2018: Journal of Neurology
Nitin Goyal, Georgios Tsivgoulis, Donald Frei, Aquilla Turk, Blaise Baxter, Michael T Froehler, J Mocco, Abhi Pandhi, Ramin Zand, Konark Malhotra, Daniel Hoit, Lucas Elijovich, David Loy, Raymond D Turner, Justin Mascitelli, Kiersten Espaillat, Aristeidis H Katsanos, Anne W Alexandrov, Andrei V Alexandrov, Adam S Arthur
OBJECTIVE: In this multicenter study, we sought to evaluate comparative safety and efficacy of combined IV thrombolysis (IVT) and mechanical thrombectomy (MT) vs direct MT in emergent large vessel occlusion (ELVO) patients. METHODS: Consecutive ELVO patients treated with MT at 6 high-volume endovascular centers were evaluated. Standard safety and efficacy outcomes (successful reperfusion [modified Thrombolysis in Cerebral Infarction IIb/III], functional independence [FI] [modified Rankin Scale (mRS) score of 0-2 at 3 months], favorable functional outcome [mRS of 0-1 at 3 months], functional improvement [mRS shift by 1-point decrease in mRS score]) were compared between patients who underwent combined IVT and MT vs MT alone...
March 16, 2018: Neurology
Andreas Kastrup, Freimuth Brunner, Helmut Hildebrandt, Christian Roth, Michael Winterhalter, Panagiotis Papanagiotou
BACKGROUND AND PURPOSE: In patients with large vessel occlusions, endovascular treatment (ET) has been shown to be superior to intravenous thrombolysis (IVT) in recent trials. However, the effectiveness of ET in elderly patients is uncertain. METHODS: Using our stroke database, we compared the rates of good outcome (modified Rankin scale (mRS) ≤2), excellent outcome (mRS 0-1), poor outcome (mRS 5-6) at discharge, in-hospital death, infarct size, and symptomatic intracranial hemorrhage (SICH) in patients aged ≥80 years with distal intracranial carotid artery, M1 and M2 occlusions during two time periods...
March 16, 2018: Journal of Neurointerventional Surgery
Xiaowei Li, Jingze Li, Xuehui Yang, Zhaosheng Sun, Jinrong Zhang, Wangmiao Zhao, Shuzhi Dong, Cong Li, Yanqiao Ye, Jianchao Chen, Yongqian Li, Yi Xiang, Jianhui Mao, Guangjie Li, Hong Guo, Wenchao Zhang, Hao Guo, Yazhao Zhang, Mingzhe Zhang, Wanzeng Zhang, Zhanyi Xu, Baoshuai Zhao, Jianhui Wei, Gengshui Zhao, Ronghua Ma, Xiuzhi Shen, Chunyan Ge, Cunling Zheng, Shang Li, Yan Wang
BACKGROUND: Prognosis of spontaneous intracerebral hemorrhage (ICH) remains poor worldwide. AIMS OF THE STUDY: To investigate the effect and optimal protocol for hyperbaric-oxygen therapy (HBOT), and reduce incidence of upper gastrointestinal bleeding (UGIB) in ICH. METHODS: This prospective, randomized, controlled trial included 565 patients with acute severe ICH. Participants were randomly assigned to a sham-control group (Group A) and four intervention groups: Groups B and C with 2...
March 13, 2018: Archives of Medical Research
Brin Freund, James J Gugger, Alexandra Reynolds, William O Tatum, Jan Claassen, Peter W Kaplan
PURPOSE: Periodic discharges (PDs) are EEG patterns denoting brain dysfunction and ictal tendency. Their exact meaning regarding etiology and outcomes is not well known. In particular, bilateral independent PDs (BIPDs) are poorly described. METHODS: We performed a retrospective, multicenter study evaluating neuroimaging, epileptic, clinical, and EEG correlates of BIPDs. RESULTS: Twenty-five patients studied with a mean Glasgow Coma Scale 6...
March 15, 2018: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Da Li, Yu-Ming Jiao, Liang Wang, Fu-Xin Lin, Jun Wu, Xian-Zeng Tong, Shuo Wang, Yong Cao
OBJECTIVE Surgical management of brainstem lesions is challenging due to the highly compact, eloquent anatomy of the brainstem. This study aimed to evaluate the safety and efficacy of preoperative diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) in brainstem cavernous malformations (CMs). METHODS A prospective randomized controlled clinical trial was performed by using stratified blocked randomization. The primary eligibility criterion of the study was being a surgical candidate for brainstem CMs (with informed consent)...
March 16, 2018: Journal of Neurosurgery
Jinbing Zhao, Hongyi Liu, Yuanjie Zou, Wenbin Zhang, Shengxue He
The present retrospective study was performed to evaluate the clinical outcome, as well as post-operative collateral formation and revascularization patterns in combined bypass. Surgical revascularization has been the mainstay of treatment for moyamoya patients. A total of 76 hemispheres from 64 moyamoya patients undergoing combined superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis and encephalo-duro-myo-synangiosis (EDMS) were retrospectively reviewed. Computed tomography perfusion and DSA were routinely performed...
April 2018: Experimental and Therapeutic Medicine
V Bhatia, V Gupta, D Khurana, R R Sharma, N Khandelwal
BACKGROUND AND PURPOSE: Stroke is a debilitating illness for which treatment window is limited. Most patients present to the healthcare facility beyond that window. Autologous stem cells have shown some promise for this group of patients. This study was performed to evaluate the safety and the efficacy of intra-arterial infusion of bone marrow-derived mononuclear cells in patients with middle cerebral artery ischemic stroke. MATERIALS AND METHODS: A prospective, randomized, open-label, blinded-end point study was performed from July 2015 to June 2016...
March 15, 2018: AJNR. American Journal of Neuroradiology
Dae-Hyun Kim, Deok-Soo Lee, Hyun-Wook Nah, Jae-Kwan Cha
BACKGROUND: A significant proportion of patients with mild ischemic stroke become disabled despite receiving intravenous thrombolytic therapy. The purpose of this study was to assess the clinical and radiological factors associated with unfavorable outcomes in patients with minor ischemic stroke that received intravenous recombinant tissue plasminogen activator (rt-PA) therapy. METHODS: We identified anterior circulation stroke patients with initial National Institutes of Health Stroke Scale (NIHSS) scores ≤5 who received intravenous thrombolysis within 4...
March 15, 2018: BMC Neurology
Yuji Shono, Hiroshi Sugimori, Ryu Matsuo, Yoshihisa Fukushima, Yoshinobu Wakisaka, Junya Kuroda, Tetsuro Ago, Masahiro Kamouchi, Takanari Kitazono
Background The safety of antithrombotic therapy for patients with acute ischemic stroke harboring unruptured intracranial aneurysms remains unclear. Aims This study was performed to determine whether treatment with antiplatelets, anticoagulants, or intravenous thrombolytic agents is safe for patients with acute ischemic stroke and unruptured intracranial aneurysms. Methods Among 9149 patients with acute ischemic stroke enrolled in the Fukuoka Stroke Registry from June 2007 to December 2014, 8857 patients with data on cerebrovascular imaging and three-month outcomes were included in this study...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Arshad Nawaz Malik, Imran Amjad
Objective of the study was to determine the effect of circuit gait training versus traditional gait training on mobility performance and quality of life in sub-acute and chronic stroke patients. A randomized control trial was conducted and stroke patients of either gender having 2-4 score on Rankin Modified Scale and able to stand 10 seconds were included in study. A total of 32 individuals were randomly assigned into two groups. They were assigned a 40-50 min/session for 3-4 days/week over length of 06 weeks...
March 2018: JPMA. the Journal of the Pakistan Medical Association
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)...
March 14, 2018: Stroke; a Journal of Cerebral Circulation
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