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Stroke , ischemic stroke , intracerebral

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https://www.readbyqxmd.com/read/27914497/acute-management-of-stroke-patients-taking-non-vitamin-k-antagonist-oral-anticoagulants-addressing-real-world-anticoagulant-management-issues-in-stroke-aramis-registry-design-and-rationale
#1
Ying Xian, Adrian F Hernandez, Tina Harding, Gregg C Fonarow, Deepak L Bhatt, Robert E Suter, Yosef Khan, Lee H Schwamm, Eric D Peterson
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs, dabigatran, rivaroxaban, apixaban, and edoxaban) have been increasingly used as alternatives to warfarin for stroke prophylaxis in patients with atrial fibrillation. Yet there is substantial lack of information on how patients on NOACs are currently treated when they have an acute ischemic stroke and the best strategies for treating intracerebral hemorrhage for those on chronic anticoagulation with warfarin or a NOAC. These are critical unmet needs for real world clinical decision making in these emergent patients...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27913203/incidence-of-recurrent-intracerebral-hemorrhages-in-a-multiethnic-south-asian-population
#2
Liming Qiu, Trisha Upadhyaya, Angela An Qi See, Yew Poh Ng, Nicolas Kon Kam King
INTRODUCTION: Spontaneous primary intracerebral hemorrhage (ICH) accounts for approximately 25% of all strokes in Singapore. Incidence of recurrent ICH is not well studied, and previous studies have reported inconsistent findings in the rate and risk factors associated with ICH recurrences. We aimed to study the incidence of recurrent ICHs in Singapore and to identify the associated risk factors as well as pattern of ICH recurrence. METHODS: A retrospective review of all consecutive admissions for intracerebral hemorrhage at the National Neuroscience Institute between January 2006 and November 2013 was performed...
November 29, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27909202/prediction-of-blood-brain-barrier-disruption-and-intracerebral-hemorrhagic-infarction-using-arterial-spin-labeling-magnetic-resonance-imaging
#3
Takeya Niibo, Hajime Ohta, Shirou Miyata, Ichiro Ikushima, Kazuchika Yonenaga, Hideo Takeshima
BACKGROUND AND PURPOSE: Arterial spin-labeling magnetic resonance imaging is sensitive for detecting hyperemic lesions (HLs) in patients with acute ischemic stroke. We evaluated whether HLs could predict blood-brain barrier (BBB) disruption and hemorrhagic transformation (HT) in acute ischemic stroke patients. METHODS: In a retrospective study, arterial spin-labeling was performed within 6 hours of symptom onset before revascularization treatment in 25 patients with anterior circulation large vessel occlusion on baseline magnetic resonance angiography...
December 1, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27907969/neuroprotection-in-critical-care-neurology
#4
Menno R Germans, Hieronymus D Boogaarts, R Loch Macdonald
Ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and traumatic brain injury-all have in common early brain injury due to brain tissue destruction, reduced cerebral blood flow and oxygen delivery, and overall substantial morbidity and mortality. The pathophysiology of brain tissue damage likely includes common cellular mechanisms. Neuroprotection has seldom, if ever, been shown to reduce early brain injury. Secondary brain injury develops after these conditions due to macroscopic events such as increased intracranial pressure and reduced cerebral blood flow, as well as cellular processes including vascular damage, inflammation, and apoptotic/necrotic cell death...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27906754/management-of-acute-stroke-in-patients-on-oral-anticoagulants
#5
Jan C Purrucker, Thorsten Steiner
PURPOSE OF REVIEW: An increasing number of patients are receiving oral anticoagulants. Since non-vitamin K antagonist oral anticoagulants (NOACs) were approved, primary prevention of ischemic stroke has become simpler. However, managing ischemic stroke and intracerebral hemorrhage while on oral anticoagulation (OAC) has become more complex. This review covers the latest developments in managing ischemic and hemorrhagic stroke in patients receiving vitamin K antagonists (VKA) and NOACs...
November 30, 2016: Current Opinion in Neurology
https://www.readbyqxmd.com/read/27906602/meta-analysis-of-pre-clinical-trials-of-therapeutic-hypothermia-for-intracerebral-hemorrhage
#6
Kara R Melmed, Patrick D Lyden
Therapeutic hypothermia (TH) is a potent neuroprotectant for experimental ischemic stroke, but studies of TH for intracerebral hemorrhage (ICH) are emerging. We systematically reviewed the experimental literature to assess TH efficacy for ICH. We found 18 suitable papers; quality scores were moderately good. Compared with normothermia, TH reduced measures of edema (mean effect size (95% CI) -1.6873 (-2.3640, -1.0106), p < 0.0001) or blood-brain barrier leakage (p < 0.0001) and improved behavioral outcomes (p < 0...
December 1, 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27905989/the-histone-deacetylase-inhibitor-sodium-butyrate-exhibits-neuroprotective-effects-for-ischemic-stroke-in-middle-aged-female-rats
#7
Min Jung Park, Farida Sohrabji
BACKGROUND: Sodium butyrate (NaB) is a histone deacetylase (HDAC) inhibitor exhibiting anti-inflammatory and neuroprotective effects in a rat ischemic model of stroke as well as a myocardial ischemia model. Although clinical evidence shows that older women are at higher risk for stroke occurrence and greater stroke severity, no studies have evaluated the effectiveness of NaB either in females or in older animals. METHODS: To determine the effects of NaB on stroke in older females, acyclic middle-aged Sprague-Dawley female rats (9-11 months old, constant diestrus) were subject to middle cerebral artery occlusion (MCAo) by intracerebral injection of recombinant endothelin-1...
December 1, 2016: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/27902730/spectrum-of-cerebrovascular-disease-in-patients-with-multiple-myeloma-undergoing-chemotherapy-results-of-a-case-control-study
#8
Archana Hinduja, Kaustubh Limaye, Rahul Ravilla, Appalnaidu Sasapu, Xenofon Papanikolaou, Lai Wei, Michel Torbey, Sarah Waheed
OBJECTIVES: Patients with multiple myeloma (MM) are at increased risk of arterial thrombosis. Our aim was to determine the risk factors, mechanisms and outcome of strokes in these patients. METHODS: We conducted a retrospective matched case-control study from our database of MM patients enrolled in Total Therapy (TT) 2, TT3a and TT3b protocols who developed a vascular event (transient ischemic attack, ischemic stroke, or intracerebral hemorrhage) from October 1998 to January 2014...
2016: PloS One
https://www.readbyqxmd.com/read/27899749/long-term-risk-of-dementia-among-survivors-of-ischemic-or-hemorrhagic-stroke
#9
Priscila Corraini, Victor W Henderson, Anne G Ording, Lars Pedersen, Erzsébet Horváth-Puhó, Henrik T Sørensen
BACKGROUND AND PURPOSE: Stroke is a risk factor for dementia, but the risk of dementia after different stroke types is poorly understood. We examined the long-term risk of dementia among survivors of any first-time stroke and of first-time ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage. METHODS: We conducted a 30-year nationwide population-based cohort study using data from Danish medical databases (1982-2013) covering all Danish hospitals...
November 29, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27894886/utility-of-urgent-computed-tomography-angiography-in-the-setting-of-intraparenchymal-brain-hemorrhage
#10
Omran Kaskar, Larry B Goldstein
BACKGROUND AND PURPOSE: Patients presenting with an intracerebral hemorrhage (ICH) generally have an initial noncontrast computed tomography (NCCT) of the brain. Computed tomography angiography (CTA) can help identify secondary causes of ICH and detect a "spot sign." We hypothesized that performing an urgent CTA in the setting of a presumed primary ICH has only limited utility and did not alter urgent management. METHODS: This was a retrospective study of consecutive patients presenting with a primary ICH identified from the Duke University Stroke Registry from 2010 to 2013 who had an ICH detected on an initial NCCT...
November 25, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27885484/the-impact-of-cerebral-microbleeds-on-intracerebral-hemorrhage-and-poor-functional-outcome-of-acute-ischemic-stroke-patients-treated-with-intravenous-thrombolysis-a-systematic-review-and-meta-analysis
#11
REVIEW
Shuang Wang, Yan Lv, Xin Zheng, Jing Qiu, Hui-Sheng Chen
It is still controversial whether pre-existing cerebral microbleeds (CMBs) increase the risks of intracranial hemorrhage (ICH) and poor functional outcome (PFO) in acute ischemic stroke (AIS) patients treated with intravenous thrombolysis (IVT). Therefore, we performed a systematic review and meta-analysis to determine the impact of CMBs on ICH and PFO of AIS patients with IVT. We searched PubMed, EMBASE and Web of Science from inception to August 3, 2016, with language restriction in English. We included studies that reported the relationship between CMBs and ICH or PFO after thrombolysis...
November 24, 2016: Journal of Neurology
https://www.readbyqxmd.com/read/27881450/glial-fibrillary-acidic-protein-serum-levels-distinguish-between-intracerebral-hemorrhage-and-cerebral-ischemia-in-the-early-phase-of-stroke
#12
Sebastian Luger, Jens Witsch, Andreas Dietz, Gerhard F Hamann, Jens Minnerup, Hauke Schneider, Matthias Sitzer, Katja E Wartenberg, Marion Niessner, Christian Foerch
BACKGROUND: Recent studies have suggested that glial fibrillary acidic protein (GFAP) serum concentrations distinguish between intracerebral hemorrhage (ICH) and ischemic stroke (IS) shortly after symptom onset. In this prospective multicenter trial we validated GFAP in an independent patient cohort and assessed the quantitative relationship between GFAP release, bleeding size, and localization. METHODS: We included patients with a persistent neurological deficit (NIH Stroke Scale ≥4) suggestive of stroke within 6 h of symptom onset...
November 23, 2016: Clinical Chemistry
https://www.readbyqxmd.com/read/27881167/differing-association-of-alcohol-consumption-with-different-stroke-types-a-systematic-review-and-meta-analysis
#13
Susanna C Larsson, Alice Wallin, Alicja Wolk, Hugh S Markus
BACKGROUND: Whether light-to-moderate alcohol consumption is protective against stroke, and whether any association differs by stroke type, is controversial. We conducted a meta-analysis to summarize the evidence from prospective studies on alcohol drinking and stroke types. METHODS: Studies were identified by searching PubMed to September 1, 2016, and reference lists of retrieved articles. Additional data from 73,587 Swedish adults in two prospective studies were included...
November 24, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27881133/alcohol-and-stroke-the-splitters-win-again
#14
EDITORIAL
Arthur L Klatsky, H Nicole Tran
Study of the relationships of alcohol drinking and risk of stroke can readily become mired in the labyrinthine interactions of drinking categorizations, non-linear associations, disparate cardiovascular conditions, and the heterogeneous types of stroke. This Commentary discusses the recent article by Larsson et al. (BMC Medicine 14:178, 2016). The authors split their material into separate meta-analyses of subarachnoid hemorrhage, intracerebral hemorrhage, and ischemic stroke, finding disparate alcohol-stroke relationships...
November 24, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27869707/ex-vivo-characterization-of-bioimpedance-spectroscopy-of-normal-ischemic-and-hemorrhagic-rabbit-brain-tissue-at-frequencies-from-10-hz-to-1-mhz
#15
Lin Yang, Ge Zhang, Jiali Song, Meng Dai, Canhua Xu, Xiuzhen Dong, Feng Fu
Stroke is a severe cerebrovascular disease and is the second greatest cause of death worldwide. Because diagnostic tools (CT and MRI) to detect acute stroke cannot be used until the patient reaches the hospital setting, a portable diagnostic tool is urgently needed. Because biological tissues have different impedance spectra under normal physiological conditions and different pathological states, multi-frequency electrical impedance tomography (MFEIT) can potentially detect stroke. Accurate impedance spectra of normal brain tissue (gray and white matter) and stroke lesions (ischemic and hemorrhagic tissue) are important elements when studying stroke detection with MFEIT...
November 18, 2016: Sensors
https://www.readbyqxmd.com/read/27864523/carotid-artery-web-and-ischemic-stroke-a-case-control-study
#16
Jonathan M Coutinho, Sheldon Derkatch, Alphonse R J Potvin, George Tomlinson, Leanne K Casaubon, Frank L Silver, Daniel M Mandell
OBJECTIVE: To determine whether there is an association between carotid artery web and ischemic stroke. METHODS: This was a single-center, age- and sex-matched, case-control study. Cases were consecutive patients with anterior circulation ischemic stroke of undetermined etiology (Trial of Org 10172 in Acute Stroke Treatment [TOAST] classification). Controls were consecutive patients with cerebral aneurysms, arteriovenous malformations, or primary intracerebral hemorrhages...
November 18, 2016: Neurology
https://www.readbyqxmd.com/read/27852229/access-timing-and-frequency-of-very-early-stroke-rehabilitation-insights-from-the-baden-wuerttemberg-stroke-registry
#17
Björn Reuter, Christoph Gumbinger, Tamara Sauer, Horst Wiethölter, Ingo Bruder, Curt Diehm, Peter A Ringleb, Werner Hacke, Michael G Hennerici, Rolf Kern
BACKGROUND: While the precise timing and intensity of very early rehabilitation (VER) after stroke onset is still under discussion, its beneficial effect on functional disability is generally accepted. The recently published randomized controlled AVERT trial indicated that patients with severe stroke might be more susceptible to harmful side effects of VER, which we hypothesized is contrary to current clinical practice. We analyzed the Baden-Wuerttemberg stroke registry to gain insight into the application of VER in acute ischemic stroke (IS) and intracerebral hemorrhage (ICH) in clinical practice...
November 16, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27824310/-diagnosis-and-treatment-of-stroke-during-pregnancy
#18
Melinda Vanya, Ivan Devosa, Delia Szok, Gyorgy Bartfai
Stroke, the sudden onset of brain dysfunction from a vascular cause, is one of the most common causes of long-term disability. Although rare during childbearing years, stroke is even more devastating when it occurs in a young woman trying to start a family. Pregnancy and the postpartum period are associated with an increased risk of ischemic stroke and intracerebral hemorrhage, although the incidence estimates have varied. There are several causes of stroke that are in fact unique to pregnancy and the postpartum period, such as preeklampszia and eklampszia, amniotic fluid embolus, postpartum angiopathy and postpartum cardiomyopathy...
September 2016: Neuropsychopharmacologia Hungarica
https://www.readbyqxmd.com/read/27823836/acdd-4-score-a-simple-tool-for-assessing-risk-of-pneumonia-after-stroke
#19
Sandeep Kumar, Sarah Marchina, Joseph Massaro, Wayne Feng, Sourabh Lahoti, Magdy Selim, Shoshana J Herzig
BACKGROUND: Pneumonia is a serious but a preventable stroke complication. Prediction scales for post-stroke pneumonia have been proposed with an intent to improve surveillance and prevention but they remain under-utilized in clinical practice. Most existing scales were developed using both ventilated and non-ventilated patients which may affect their accuracy. We derived and validated a novel, pragmatic scale to predict hospital-acquired pneumonia (HAP) after stroke employing only a non-ventilated stroke cohort...
November 1, 2016: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/27819418/numbers-of-stroke-patients-and-stroke-subtypes-according-to-highest-and-lowest-daily-temperatures-in-seoul
#20
Dong Won Shin, Jee Eun Yoon, Hye Won Hwang, Ji Sun Kim, Sukh Que Park, Hakjae Roh, Moo Young Ahn, Kyung Bok Lee
BACKGROUND AND PURPOSE: There is conflicting evidence for whether or not the incidence of stroke is influenced by the daily temperature. The association between daily temperature and incidence of stroke is largely unknown in Korea. This study attempted to evaluate whether the maximum or minimum daily temperature is associated with increased numbers of strokes and stroke subtypes among Seoul residents. METHODS: We obtained the maximum and minimum daily temperatures in Seoul from the Korean Meteorological Administration between January 2005 and December 2014...
October 2016: Journal of Clinical Neurology
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