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https://www.readbyqxmd.com/read/28330015/contact-aspiration-versus-stent-retriever-front-line-for-recanalisation-in-acute-cerebral-infarction-the-aster-trial
#1
Bertrand Lapergue, Julien Labreuche, Michel Piotin
RATIONALE: Mechanical thrombectomy (MT) with a stent retriever (SR), in association with intravenous (IV) rtPA, is now the standard of care in anterior circulation ischemic stroke caused by large vessel occlusion (LVO). Favorable outcome is strongly associated with the successful reperfusion status. New techniques for MT such as contact aspiration (CA) seem promising to increase reperfusion status and clinical outcome in retrospective studies. We aim at ascertaining whether CA is more efficient than stent retriever as a front-line endovascular procedure...
March 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28330012/mechanical-thrombectomy-for-minor-and-mild-stroke-patients-harboring-large-vessel-occlusion-in-the-anterior-circulation-a-multicenter-case-control-study
#2
Cyril Dargazanli, Caroline Arquizan, Arturo Consoli, Benjamin Gory, Omer Eker, Xavier Ayrignac, Jean-Pierre Decroix, Astrid Corlobé, Isabelle Mourand, Grégory Gascou, Mahmoud Charif, Julien Labreuche, Alain Duhamel, Paul-Emile Labeyrie, Hocine Redjem, Gabriele Ciccio, Stanislas Smajda, Carlos Riquelme, Oguzhan Coskun, Jean-Philippe Desilles, Frédéric Bourdain, Roberto Riva, Mikael Obadia, Francis Turjman, Georges Rodesch, Pierre Labauge, Alain Bonafé, Mikael Mazighi, Vincent Costalat, Michel Piotin, Raphaël Blanc, Bertrand Lapergue
BACKGROUND AND PURPOSE: Proximal large vessel occlusion (LVO) is present in up to 30% of minor strokes. There is no proven effectiveness of MT in the subgroup of minor stroke with LVO in the anterior circulation and data about mechanical thrombectomy (MT) in this subgroup of patients are sparse, with optimal management of these patients being yet not definitely addressed. The purpose of this case-control study was to evaluate MT in patients suffering from acute ischemic stroke (AIS) and LVO in the anterior circulation, presenting with minor to mild stroke symptoms (NIHSS<8)...
March 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28328821/is-carotid-sonography-a-useful-tool-for-predicting-functional-capabilities-in-ischemic-stroke-patients-following-carotid-artery-stenting
#3
Chih-Ming Lin, Jian-Chi Su, Yu-Jun Chang, Chi-Kuang Liu, Henry Horng-Shing Lu, Yuh-Jyh Jong
Carotid stenosis is a major cause of stroke and timely intervention with stenting manipulation can significantly reduce the risk of secondary stroke. The impact of stenting procedures on patient functional capabilities has not yet been explored. The primary aim of this study was to examine associations between periprocedural carotid sonography parameters and post-treatment functional capabilities in stroke patients.Sixty-seven patients who received carotid stenting at 1 angiography laboratory were included...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328164/anti-n-methyl-d-aspartate-receptor-encephalitis-in-m%C3%A4-ori-and-pacific-island-children-in-new-zealand
#4
Hannah F Jones, Shekeeb S Mohammad, Peter W Reed, Paul P J Dunn, Richard H Steele, Russell C Dale, Cynthia Sharpe
AIM: To investigate the incidence and severity of anti-N-methyl-d-aspartate (anti-NMDA) receptor encephalitis in children from New Zealand. METHOD: A retrospective case series was undertaken of all children (≤18y) diagnosed with anti-NMDA receptor encephalitis from January 2008 to October 2015. RESULTS: Sixteen patients were identified with anti-NMDA receptor antibodies in the cerebrospinal fluid, three of whom had an associated teratoma...
March 22, 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28328006/clinical-experience-and-results-of-microsurgical-resection-of-arterioveonous-malformation-in-the-presence-of-space-occupying-intracerebral-hematoma
#5
Damiano G Barone, Hani J Marcus, Mathew R Guilfoyle, J Nicholas P Higgins, Nagui Antoun, Thomas Santarius, Rikin A Trivedi, Ramez W Kirollos
BACKGROUND: Management of ruptured arteriovenous malformations (AVMs) with a mass-producing intracerebral hematoma (ICH) represents a surgical dilemma. OBJECTIVE: To evaluate the clinical outcome and obliteration rates of microsurgical resection of AVM when performed concomitantly with evacuation of an associated space-occupying ICH. METHODS: Data of patients with AVM were collected prospectively. Cases were identified in which an AVM was resected and an associated space-occupying ICH was evacuated at the same time, and divided into "group 1," in which the surgery was performed acutely within 48 h of presentation (secondary to elevated intracranial pressure); and "group 2," in which selected patients were operated upon in the presence of a liquefying ICH in the "subacute" stage...
March 15, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28328002/endovascular-treatment-of-middle-cerebral-artery-m2-occlusion-strokes-clinical-and-procedural-predictors-of-outcomes
#6
Maxim Mokin, Christopher T Primiani, Zeguang Ren, Peter Kan, Edward Duckworth, Raymond D Turner, Aquilla S Turk, Kyle M Fargen, Guilherme Dabus, Italo Linfante, Travis M Dumont, Leonardo B C Brasiliense, Hussain Shallwani, Kenneth V Snyder, Adnan H Siddiqui, Elad I Levy
BACKGROUND: Patients with strokes from M2 segment middle cerebral artery (MCA) occlusion have been underrepresented in recent randomized trials of endovascular therapy. OBJECTIVE: To better understand the clinical, imaging, and procedural predictors of successful recanalization and clinical outcomes in this population of patients. METHODS: We performed a multicenter retrospective analysis of consecutive patients with acute MCA M2 segment occlusion who underwent thrombectomy with stent retrievers or primary aspiration thrombectomy (including A Direct Aspiration First Pass Technique approach)...
March 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327955/differences-in-functional-outcome-across-subtypes-with-spetzler-martin-grade-ii-arteriovenous-malformations
#7
Alice L Hung, Wuyang Yang, Erick M Westbroek, Tomas Garzon-Muvdi, Justin M Caplan, Maria Braileanu, Joanna Y Wang, Geoffrey P Colby, Alexander L Coon, Rafael J Tamargo, Judy Huang
BACKGROUND: The Spetzler-Martin grading system for brain arteriovenous malformations (AVMs) is based on size (S), eloquence (E), and deep venous drainage (V). However, variation exists due to subgroup heterogeneity. While previous studies have demonstrated variations in outcomes within grade III AVMs, no studies have focused on grade II AVM subtypes. OBJECTIVE: We aim to delineate how functional outcomes differ among patients with subtypes of grade II AVMs. METHODS: We retrospectively reviewed patients with AVMs evaluated at our institution from 1990 to 2013...
February 4, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327941/degree-of-vascular-encasement-in-sphenoid-wing-meningiomas-predicts-postoperative-ischemic-complications
#8
D Jay McCracken, Raymond A Higginbotham, Jason H Boulter, Yuan Liu, John A Wells, Sameer H Halani, Amit M Saindane, Nelson M Oyesiku, Daniel L Barrow, Jeffrey J Olson
BACKGROUND: Sphenoid wing meningiomas (SWMs) can encase arteries of the circle of Willis, increasing their susceptibility to intraoperative vascular injury and severe ischemic complications. OBJECTIVE: To demonstrate the effect of circumferential vascular encasement in SWM on postoperative ischemia. METHODS: A retrospective review of 75 patients surgically treated for SWM from 2009 to 2015 was undertaken to determine the degree of circumferential vascular encasement (0°-360°) as assessed by preoperative magnetic resonance imaging (MRI)...
January 28, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327921/the-superior-cerebellar-artery-aneurysm-a-posterior-circulation-aneurysm-with-favorable-microsurgical-outcomes
#9
Ana Rodríguez-Hernández, Brian P Walcott, Harjus Birk, Michael T Lawton
BACKGROUND: Superior cerebellar artery (SCA) aneurysms are usually grouped with aneurysms that arise from the upper basilar artery or more broadly, the posterior circulation. However, the SCA aneurysm has distinctive anatomy that facilitates safe surgical management, notably few associated perforating arteries, and excellent exposure in the carotid-oculomotor triangle. OBJECTIVE: To demonstrate the outcomes of patients treated with microsurgery in a continuous surgical series...
January 24, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327912/long-term-neurological-outcome-and-quality-of-life-after-world-federation-of-neurosurgical-societies-grades-iv-and-v-aneurysmal-subarachnoid-hemorrhage-in-an-interdisciplinary-treatment-concept
#10
Christoph Schwartz, Thomas Pfefferkorn, Caroline Ebrahimi, Caroline Ottomeyer, Gunther Fesl, Andreas Bender, Andreas Straube, Hans-Walter Pfister, Suzette Heck, Jörg-Christian Tonn, Christian Schichor
BACKGROUND: Detailed data on long-term functional outcome of patients with World Federation of Neurosurgical Societies (WFNS) grades IV and V aneurysmal subarachnoid hemorrhages (aSAH) are still scarce. OBJECTIVE: Assessment of long-term outcome of WFNS IV and V aSAH patients. METHODS: Functional outcome and quality of life were assessed by the modified Rankin scale (mRS) and the 36-item short-form health survey in consecutively treated aSAH WFNS IV and V patients between 2005 and 2010...
February 2, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28324263/decannulation-and-functional-outcome-after-tracheostomy-in-patients-with-severe-stroke-decast-a-prospective-observational-study
#11
Hauke Schneider, Franziska Hertel, Matthias Kuhn, Maximilian Ragaller, Birgit Gottschlich, Anne Trabitzsch, Markus Dengl, Marcus Neudert, Heinz Reichmann, Sigrid Wöpking
BACKGROUND: Tracheostomy is performed in ventilated stroke patients affected by persisting severe dysphagia, reduced level of consciousness, or prolonged mechanical ventilation. The study aim was to determine the frequency and predictors of successful decannulation and long-term functional outcome in tracheotomized stroke patients. METHODS: A prospective single-center observational study recruited ventilated patients with ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage...
March 21, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28324261/prophylactic-anticonvulsants-in-intracerebral-hemorrhage
#12
Jason Mackey, Ashley D Blatsioris, Elizabeth A S Moser, Ravan J L Carter, Chandan Saha, Alec Stevenson, Abigail L Hulin, Darren P O'Neill, Aaron A Cohen-Gadol, Thomas J Leipzig, Linda S Williams
BACKGROUND AND PURPOSE: Prophylactic anticonvulsants are routinely prescribed in the acute setting for intracerebral hemorrhage (ICH) patients, but some studies have reported an association with worse outcomes. We sought to characterize the prevalence and predictors of prophylactic anticonvulsant administration after ICH as well as guideline adherence. We also sought to determine whether prophylactic anticonvulsants were independently associated with poor outcome. METHODS: We performed a retrospective study of primary ICH in our two academic centers...
March 21, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28324183/multimodality-management-and-outcomes-of-brain-arterio-venous-malformations-avms-in-children-personal-experience-and-review-of-the-literature-with-specific-emphasis-on-age-at-first-avm-bleed
#13
REVIEW
Anan Shtaya, John Millar, Owen Sparrow
PURPOSE: The purpose of this paper is to study the presentation and analyse the results of multimodality treatment of brain arterio-venous malformations (AVMs) in children at our centre and review age at first AVM rupture in the literature. METHODS: Of 52 patients aged <18 years, 47 with brain AVMs (27 males and 20 females) aged 4-17 years (mean 12.2) were retrospectively reviewed. PubMed search revealed five additional studies including 267 patients where the prevalence of age-related AVMs rupture was analysed...
March 21, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28323878/microsurgery-for-intracranial-arteriovenous-malformation-long-term-outcomes-in-445-patients
#14
Qingqing Ren, Min He, Yunhui Zeng, Zhiyong Liu, Hao Liu, Jianguo Xu
BACKGROUND: The management of intracranial arteriovenous malformations(AVMs) poses challenges to the cerebrovascular specialists. OBJECTIVE: To review the long-term outcomes of intracranial AVMs treated with microsurgical resections. METHODS: We performed a retrospective review of 445 patients with intracranial AVMs treated in our hospital from January 1st, 2008 to December 31st, 2014. The extracted data included demographic characteristics, clinical presentations, Spetzler-Martin (SM) grades, Supplemented Spetzler-Martin (SM-Supp) Grades, treatment modalities, long-term outcomes, and obliteration rates...
2017: PloS One
https://www.readbyqxmd.com/read/28323192/multimodality-management-of-spetzler-martin-grade-3-brain-arteriovenous-malformations-with-subgroup-analysis
#15
Isaac Josh Abecassis, John D Nerva, Abdullah Feroze, Jason Barber, Basavaraj V Ghodke, Louis J Kim, Laligam N Sekhar
INTRODUCTION: Spetzler-Martin grade 3 (SM3) lesions entail 4 distinct subtypes described based on size, eloquence, and deep venous drainage (DVD) (3A-3D). The ideal management of each is contentious, and the results of A Randomized Trial of Unruptured Brain AVMs (ARUBA) introduced additional controversy and attention towards management strategies of unruptured bAVMs. METHODS: We retrospectively reviewed 114 patients with treated SM3 bAVMs, including both ruptured and unruptured lesions...
March 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28323182/treatment-of-large-and-giant-middle-cerebral-artery-aneurysms-risk-factors-for-unfavorable-outcomes
#16
Wonhyoung Park, Jaewoo Chung, Jae Sung Ahn, Jung Cheol Park, Byung Duk Kwun
OBJECTIVE: This study aimed to assess the clinical and radiological outcomes after neurosurgical treatment of large and giant aneurysms of the middle cerebral artery (MCA). In addition, we aimed to identify risk factors for unfavorable outcomes. METHODS: This retrospective study included 105 patients with 106 large or giant MCA aneurysms treated with neurosurgical methods, including microsurgery and endovascular treatment, over a 15-year period. RESULTS: The mean aneurysm size was 15...
March 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28322105/clinical-features-and-biological-markers-of-lung-cancer-associated-stroke
#17
Xingrui Xie, Li Chen, Jinsheng Zeng, Chao Qin, Daobin Cheng, Xinxian Wei, Zhijian Liang
Objective To identify the unique clinical features and biological markers of lung cancer-associated stroke. Methods We recruited 102 patients with lung cancer plus stroke, 102 with lung cancer, and 102 with stroke. Detailed information was analysed and compared among groups. Results The groups were age-matched. Patients with lung cancer plus stroke showed multiple lesions involving multiple cerebral artery territories on magnetic resonance imaging, compared with stroke-alone patients. These patients also had a poorer modified Rankin Scale score at 30 days, and high mortality (18...
December 2016: Journal of International Medical Research
https://www.readbyqxmd.com/read/28321713/low-titre-gad-antibody-associated-late-onset-cerebellar-ataxia-with-a-significant-clinical-response-to-intravenous-immunoglobulin-treatment
#18
Timotej Petrijan, Marija Menih
Antiglutamic acid decarboxylase antibody-associated cerebellar ataxia (GAD-Abs CA) is a rare, but increasingly detected, autoimmune neurological disorder characterized by the clinical presence of a cerebellar syndrome concomitant with positive GAD-Abs levels in serum and cerebrospinal fluid (CSF). It represents 3% of all immune-mediated sporadic CAs. Low-titre GAD-Abs CA is an even rarer subtype of GAD-Abs CA. We report on a 68-year-old woman with a 3-year history of progressive gait ataxia. In addition to the modified Rankin Scale (mRS), we used two other objective scales to evaluate CA severity, i...
March 20, 2017: Cerebellum
https://www.readbyqxmd.com/read/28320635/safety-and-efficacy-of-multipotent-adult-progenitor-cells-in-acute-ischaemic-stroke-masters-a-randomised-double-blind-placebo-controlled-phase-2-trial
#19
David C Hess, Lawrence R Wechsler, Wayne M Clark, Sean I Savitz, Gary A Ford, David Chiu, Dileep R Yavagal, Ken Uchino, David S Liebeskind, Alexander P Auchus, Souvik Sen, Cathy A Sila, Jeffrey D Vest, Robert W Mays
BACKGROUND: Multipotent adult progenitor cells are a bone marrow-derived, allogeneic, cell therapy product that modulates the immune system, and represents a promising therapy for acute stroke. We aimed to identify the highest, well-tolerated, and safest single dose of multipotent adult progenitor cells, and if they were efficacious as a treatment for stroke recovery. METHODS: We did a phase 2, randomised, double-blind, placebo-controlled, dose-escalation trial of intravenous multipotent adult progenitor cells in 33 centres in the UK and the USA...
March 17, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28320438/regulatory-t-cell-frequency-but-not-plasma-il-33-levels-represents-potential-immunological-biomarker-to-predict-clinical-response-to-intravenous-immunoglobulin-therapy
#20
Mohan S Maddur, Emmanuel Stephen-Victor, Mrinmoy Das, Praveen Prakhar, Varun K Sharma, Vikas Singh, Magalie Rabin, Jamma Trinath, Kithiganahalli N Balaji, Francis Bolgert, Jean-Michel Vallat, Laurent Magy, Srini V Kaveri, Jagadeesh Bayry
BACKGROUND: Intravenous immunoglobulin (IVIG) is a polyspecific pooled immunoglobulin G preparation and one of the commonly used therapeutics for autoimmune diseases including those of neurological origin. A recent report in murine model proposed that IVIG expands regulatory T (Treg) cells via induction of interleukin 33 (IL-33). However, translational insight on these observations is lacking. METHODS: Ten newly diagnosed Guillain-Barré syndrome (GBS) patients were treated with IVIG at the rate of 0...
March 20, 2017: Journal of Neuroinflammation
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