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https://www.readbyqxmd.com/read/29352059/increased-blood-pressure-variability-after-endovascular-thrombectomy-for-acute-stroke-is-associated-with-worse-clinical-outcome
#1
Alicia E Bennett, Michael J Wilder, J Scott McNally, Jana J Wold, Gregory J Stoddard, Jennifer J Majersik, Safdar Ansari, Adam de Havenon
BACKGROUND AND PURPOSE: Blood pressure variability has been found to contribute to worse outcomes after intravenous tissue plasminogen activator, but the association has not been established after intra-arterial therapies. METHODS: We retrospectively reviewed patients with an ischemic stroke treated with intra-arterial therapies from 2005 to 2015. Blood pressure variability was measured as standard deviation (SD), coefficient of variation (CV), and successive variation (SV)...
January 19, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29352054/increased-blood-brain-barrier-permeability-in-contralateral-hemisphere-predicts-worse-outcome-in-acute-ischemic-stroke-after-reperfusion-therapy
#2
Chang Liu, Shenqiang Yan, Ruiting Zhang, Zhicai Chen, Feina Shi, Ying Zhou, Meixia Zhang, Min Lou
AIMS: We sought to investigate the risk factors of blood-brain barrier (BBB) disruption, and its potential impact on 90-day clinical outcome in acute ischemic stroke (AIS) patients after reperfusion therapy. METHODS: Consecutive acute anterior circulation AIS patients imaged with computed tomographic perfusion (CTP) before reperfusion therapy were included. Tmax >6 s was used for the volumetric measurement of the hypoperfusion area. BBB permeability (BBBP) was calculated as the average relative permeability-surface area product (rPS) within the hypoperfusion region (rPShypo-i) and its contralateral mirror region (rPShypo-c) on CTP-derived PS color maps...
January 19, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29351673/the-barrow-neurological-institute-grading-scale-as-a-predictor-for-delayed-cerebral-ischemia-and-outcome-after-aneurysmal-subarachnoid-hemorrhage-data-from-a-nationwide-patient-registry-swiss-sos
#3
Marian Christoph Neidert, Nicolai Maldaner, Martin Nikolaus Stienen, Michel Roethlisberger, Daniel W Zumofen, Donato D'Alonzo, Serge Marbacher, Rodolfo Maduri, Isabel Charlotte Hostettler, Bawarjan Schatlo, Michel M Schneider, Martin A Seule, Daniel Schöni, Johannes Goldberg, Christian Fung, Marta Arrighi, Daniele Valsecchi, Philippe Bijlenga, Karl Schaller, Oliver Bozinov, Luca Regli, Jan-Karl Burkhardt
BACKGROUND: The Barrow Neurological Institute (BNI) scale is a novel quantitative scale measuring maximal subarachnoid hemorrhage (SAH) thickness to predict delayed cerebral ischemia (DCI). This scale could replace the Fisher score, which was traditionally used for DCI prediction. OBJECTIVE: To validate the BNI scale. METHODS: All patient data were obtained from the prospective aneurysmal SAH multicenter registry. In 1321 patients, demographic data, BNI scale, DCI, and modified Rankin Scale (mRS) score up to the 1-yr follow-up (1FU) were available for descriptive and univariate statistics...
January 17, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29350878/perfusion-ct-in-posterior-circulation-stroke-predictors-and-prognostic-implications-of-focal-hypoperfusion
#4
Lars-Peder Pallesen, Dimitris Lambrou, Ashraf Eskandari, Jessica Barlinn, Kristian Barlinn, Heinz Reichmann, Vincent Dunet, Philippe Maeder, Volker Puetz, Patrik Michel
BACKGROUND: We aimed to determine predictors of focal hypoperfusion on CT Perfusion (CTP) in patients with acute posterior circulation stroke and its association with long-term outcome. METHODS: We selected patients with posterior circulation stroke from the Acute STroke Registry and Analysis of Lausanne (ASTRAL) who underwent CTP within 24 hours of stroke onset as part of the stroke imaging protocol. Hypoperfusion was defined as an area of visually well demarcated mean-transit-time (MTT) prolongation corresponding to an arterial territory on standard reconstruction CTP imaging maps...
January 19, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29348677/the-proliferation-capacity-of-cultured-neural-stem-cells-promoted-by-csf-collected-from-sah-patients-correlates-to-clinical-outcome
#5
Yun-An Chen, Kuo-Chuan Wang, Der-Zen Liu, Tai-Horng Young, Li-Kai Tsai
Neurogenesis from endogenous neural stem cells (NSCs) might contribute to functional recovery after stroke based on animal studies; however, the relationship between neurogenesis and post-stroke outcome has rarely been demonstrated in humans. We prospectively collected cerebrospinal fluid (CSF) from 36 patients with subarachnoid hemorrhage (SAH). The CSF was added to the culture medium of the rat NSCs to test the effects on proliferation (proliferation index [PI], percentage of Ki-67 immunoreactive cells). We correlated the PI with functional outcome based on the modified Rankin Scale at 3 months post-SAH...
January 18, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29345016/evaluation-of-the-implementation-of-a-24-hour-stroke-thrombolysis-emergency-treatment-for-patients-with-acute-ischemic-stroke
#6
Jun Zhao, Xingqiang Li, Yingchun Liang, Liang Zhao, Xinping Zhang, Yunlin Liu
AIMS AND OBJECTIVES: To assess the trends of intravenous (IV) thrombolysis with recombinant tissue plasminogen activator (rt-PA) among patients with acute ischemic stroke (AIS) admitted to our hospital between 2012 and 2014 and investigate the effects of a 24-hours (h) stroke thrombolysis emergency treatment on the intra-hospital clinical data and outcomes of these patients treated with IV rt-PA thrombolysis. BACKGROUND: Although pre-notification of stroke by emergency medical services have been endorsed by the national recommendations and implemented in some developed countries, the development in China is limited...
January 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29343588/modeling-the-impact-of-interhospital-transfer-network-design-on-stroke-outcomes-in-a-large-city
#7
Neal S Parikh, Abhinaba Chatterjee, Iván Díaz, Ankur Pandya, Alexander E Merkler, Gino Gialdini, Benjamin R Kummer, Saad A Mir, Michael P Lerario, Matthew E Fink, Babak B Navi, Hooman Kamel
BACKGROUND AND PURPOSE: We sought to model the effects of interhospital transfer network design on endovascular therapy eligibility and clinical outcomes of stroke because of large-vessel occlusion for the residents of a large city. METHODS: We modeled 3 transfer network designs for New York City. In model A, patients were transferred from spoke hospitals to the closest hub hospitals with endovascular capabilities irrespective of hospital affiliation. In model B, which was considered the base case, patients were transferred to the closest affiliated hub hospitals...
January 17, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29342319/validation-of-the-individualized-neuromuscular-quality-of-life-in-japanese-patients-with-myotonic-dystrophy
#8
Haruo Fujino, Toshio Saito, Masanori P Takahashi, Hiroto Takada, Takahiro Nakayama, Katsuhisa Ogata, Michael R Rose, Osamu Imura, Tsuyoshi Matsumura
INTRODUCTION: The Individualized Neuromuscular Quality of Life (INQoL) is used to measure the quality of life (QoL) of patients with neuromuscular disease. We conducted this study to translate and validate the Japanese version of the INQoL in patients with myotonic dystrophy. METHODS: Forward and backward translation, patient testing, and psychometric validation were performed. We used the SF-36 Health Survey and the modified Rankin scale for concurrent validation...
January 17, 2018: Muscle & Nerve
https://www.readbyqxmd.com/read/29341411/the-effect-of-recanalization-on-long-term-neurological-outcome-after-cerebral-venous-thrombosis
#9
E Rezoagli, I Martinelli, D Poli, U Scoditti, S M Passamonti, P Bucciarelli, W Ageno, F Dentali
BACKGROUND: Studies with limited sample size and with discordant results described the recanalization time course of cerebral venous thrombosis (CVT). The neurological outcome after a first episode of CVT is good, but the role of recanalization on the neurological dependency is still debated. OBJECTIVES: The aim of the study is to assess the recanalization rate after cerebral venous thrombosis (CVT) and its prognostic role on long-term neurological outcome. PATIENTS/METHODS: In a retrospective observational multicentre cohort study, patients with an acute first episode of CVT with at least one available imaging test during follow-up were enrolled...
January 16, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29341345/increase-in-neutrophil-after-r-tpa-thrombolysis-predicts-poor-functional-outcome-of-ischemic-stroke-a-longitudinal-study
#10
Jijun Shi, Hao Peng, Shoujiang You, Yuanyuan Liu, Jiaping Xu, Yingying Xu, Huihui Liu, Rongfang Shi, Yongjun Cao, Chun-Feng Liu
BACKGROUND: Neutrophil, a pivotal immune responder to ischemic brain insult, has been involved in neuroplasticity and increases after stroke. r-tPA, a promising treatment improving neuroplasticity, promotes neutrophil degranulation. However, the dynamic profile of neutrophil after r-tPA treatment and its effect on neurological recovery after stroke is not well studied. METHODS: We measured cell counts of neutrophil, lymphocyte, and their ratio (NLR) on admission and 24 hours after r-tPA infusion in 372 consecutively recruited acute ischemic stroke patients (mean age 64 years)...
January 17, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29340574/effect-of-general-anesthesia-and-conscious-sedation-during-endovascular-therapy-on-infarct-growth-and-clinical-outcomes-in-acute-ischemic-stroke-a-randomized-clinical-trial
#11
Claus Z Simonsen, Albert J Yoo, Leif H Sørensen, Niels Juul, Søren P Johnsen, Grethe Andersen, Mads Rasmussen
Importance: Endovascular therapy (EVT) is the standard of care for select patients who had a stroke caused by a large vessel occlusion in the anterior circulation, but there is uncertainty regarding the optimal anesthetic approach during EVT. Observational studies suggest that general anesthesia (GA) is associated with worse outcomes compared with conscious sedation (CS). Objective: To examine the effect of type of anesthesia during EVT on infarct growth and clinical outcome...
January 16, 2018: JAMA Neurology
https://www.readbyqxmd.com/read/29336363/utility-and-safety-of-intrathecal-methotrexate-treatment-in-severe-anti-n-methyl-d-aspartate-receptor-encephalitis-a-pilot-study
#12
Xun-Zhe Yang, Hua-Dong Zhu, Hai-Tao Ren, Yi-Cheng Zhu, Bin Peng, Li-Ying Cui, Hong-Zhi Guan
BACKGROUND: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a treatable autoimmune neurologic syndrome that occurs with or without tumor association. However, some severe cases are refractory to systemic immunotherapy. This pilot study aimed to evaluate the utility and safety of intrathecal methotrexate injection for severe patients with anti-NMDAR encephalitis who did not respond to first-line immunotherapy. METHODS: Intrathecal injections with methotrexate and dexamethasone were performed weekly in four legible patients within consecutive 4 weeks...
January 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29335886/effect-of-actual-age-on-outcome-at-discharge-in-patients-by-surgical-clipping-and-endovascular-coiling-for-ruptured-cerebral-aneurysm-in-japan
#13
Fusao Ikawa, Masaru Abiko, Daizo Ishii, Jyumpei Ohshita, Takahito Okazaki, Shigeyuki Sakamoto, Shotai Kobayashi, Kaoru Kurisu
The Japanese population features the highest rate of elderly individuals worldwide. However, the difference of actual age indication for surgical clipping (SC) and endovascular coiling (EC) has never reported. We clarified the effect of actual age on poor outcome at discharge in patients by each treatment for ruptured cerebral aneurysm according to the Japanese Stroke Data Bank. A total of 3593 patients with ruptured saccular cerebral aneurysm were treated by SC and/or EC between 2000 and 2013. The effect of actual age on poor outcome (modified Rankin scale [mRS] score > 2) at discharge was evaluated by the cutoff age using receiver operating characteristic analysis for each treatment...
January 15, 2018: Neurosurgical Review
https://www.readbyqxmd.com/read/29334680/blood-pressure-variability-in-acute-ischemic-stroke-influence-of-infarct-location-in-the-insular-cortex
#14
Juri Kitamura, Hiroki Ueno, Michiaki Nagai, Naohisa Hosomi, Kie Honjo, Masahiro Nakamori, Tomoya Mukai, Eiji Imamura, Tomohisa Nezu, Shiro Aoki, Tomohiko Ohshita, Eiichi Nomura, Shinichi Wakabayashi, Hirofumi Maruyama, Masayasu Matsumoto
BACKGROUND: The aim of this study was to elucidate the influence of insular infarction on blood pressure (BP) variability and outcomes according to the region of the insular cortex affected. METHODS: A total of 90 patients diagnosed with acute unilateral ischemic stroke were registered. The BP variability was calculated over 24 h after admission (hyperacute) and for 2-3 days after admission (acute). Patients were classified into groups of right and left, and then right anterior, right posterior, left anterior, and left posterior insular infarction...
January 15, 2018: European Neurology
https://www.readbyqxmd.com/read/29334037/improvement-in-the-prognosis-of-cerebral-venous-sinus-thrombosis-over-a-22-year-period
#15
Dustin Anderson, Julie Kromm, Thomas Jeerakathil
BACKGROUND: Cerebral venous thrombosis is a rare cause of stroke, with a number of well-defined risk factors. However, there exist few studies that describe trends in the prognosis of this disease over time. METHODS: A retrospective study was performed on patients diagnosed with cerebral venous thrombosis at the University of Alberta Hospital during two time periods: 1988-1998 (21 patients) and 1999-2009 (40 patients). Signs and symptoms, risk factors, imaging findings, etiologies, treatment modalities, and status at discharge were examined...
January 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/29330079/impact-of-platelet-transfusion-on-intracerebral-hemorrhage-ich-in-patients-on-antiplatelet-therapy-an-analysis-based-on-ich-score
#16
Gregory D Arnone, Prateek Kumar, Matt C Wonais, Darian R Esfahani, Sally A Campbell-Lee, Fady T Charbel, Sepideh Amin-Hanjani, Ali Alaraj, Andreea Seicean, Ankit I Mehta
OBJECTIVE: Platelet transfusions for intracerebral hemorrhage (ICH) patients on antiplatelet therapy (APT) remain controversial. Diverging past research and differences in platelet preparation warrant further investigation of this topic. In this study, the association between platelet transfusion and clinical outcomes of ICH is investigated in patients matched by ICH score, a validated predictor of mortality. METHODS: A consecutive review of all patients from 2012 to 2015 with non-traumatic ICH was performed...
January 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29327997/mechanical-thrombectomy-in-basilar-artery-occlusion-influence-of-reperfusion-on-clinical-outcome-and-impact-of-the-first-line-strategy-adapt-vs-stent-retriever
#17
Benjamin Gory, Mikael Mazighi, Raphael Blanc, Julien Labreuche, Michel Piotin, Francis Turjman, Bertrand Lapergue
OBJECTIVE Several randomized trials have been focused on patients with anterior circulation stroke, whereas few data on posterior circulation stroke are available. Thus, new mechanical thrombectomy (MT) strategies, including a direct-aspiration first-pass technique (ADAPT), remain to be evaluated in basilar artery occlusion (BAO) patients. The authors here assessed the influence of reperfusion on outcome in BAO patients and examined whether ADAPT improves the reperfusion rate compared with stent retriever devices...
January 12, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29327142/quality-of-life-and-disability-12-months-after-surgery-vs-conservative-management-for-unruptured-brain-arteriovenous-malformations-scottish-population-based-and-australian-hospital-based-studies
#18
Joan Margaret O'Donnell, Rustam Al-Shahi Salman, Maurizio Manuguerra, Nazih Assaad, Michael Kerin Morgan
BACKGROUND: Few data are available on disability and quality of life (QOL) after surgery versus conservative management for unruptured brain arteriovenous malformations (uAVMs). OBJECTIVE: The aim of this study was to test the hypothesis that QOL and disability are worse after surgery ± preoperative embolisation for uAVM compared with conservative management. METHODS: We included consecutive patients diagnosed with uAVM from a prospective population-based study in Scotland (1999-2003; 2006-2010) and a prospective hospital-based series in Australia (2011-2015)...
January 11, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29326379/blood-pressure-levels-post-mechanical-thrombectomy-and-outcomes-in-non-recanalized-large-vessel-occlusion-patients
#19
Nitin Goyal, Georgios Tsivgoulis, Abhi Pandhi, Kira Dillard, Diana Alsbrook, Jason J Chang, Balaji Krishnaiah, Christopher Nickele, Daniel Hoit, Khalid Alsherbini, Andrei V Alexandrov, Adam S Arthur, Lucas Elijovich
OBJECTIVE: Permissive hypertension may benefit patients with non-recanalized large vessel occlusion (nrLVO) post mechanical thrombectomy (MT) by maintaining brain perfusion. Data evaluating the impact of post-MT blood pressure (BP) levels on outcomes in nrLVO patients are scarce. We investigated the association of the post-MT BP course with safety and efficacy outcomes in nrLVO. METHODS: Hourly systolic BP (SBP) and diastolic BP (DBP) values were prospectively recorded for 24 hours following MT in consecutive nrLVO patients...
January 11, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29325955/endovascular-patch-embolization-for-blood-blister-like-aneurysms-in-the-dorsal-segment-of-the-internal-carotid-artery
#20
Xudong Hao, Guilin Li, Jian Ren, Jingwei Li, Chuan He, Hong-Qi Zhang
OBJECTIVE: Blood blister-like aneurysms (BBAs) in the dorsal segment of the internal carotid artery (ICA) are fragile and difficult to treat, and the optimal treatment for BBAs is still controversial. We report clinical and angiographic results with procedural details for the treatment of BBA by using the endovascular patch embolization method. METHODS: We retrospectively reviewed patients who presented with subarachnoid hemorrhage(SAH) caused by ICA-BBAs and were treated with the endovascular patch embolization method in our center from October 2011 to March 2015...
January 8, 2018: World Neurosurgery
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