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Stroke , ischemic stroke , intracerebral

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https://www.readbyqxmd.com/read/28794254/sex-specific-stroke-incidence-over-time-in-the-greater-cincinnati-northern-kentucky-stroke-study
#1
Tracy E Madsen, Jane Khoury, Kathleen Alwell, Charles J Moomaw, Eric Rademacher, Matthew L Flaherty, Daniel Woo, Jason Mackey, Felipe De Los Rios La Rosa, Sharyl Martini, Simona Ferioli, Opeolu Adeoye, Pooja Khatri, Joseph P Broderick, Brett M Kissela, Dawn Kleindorfer
OBJECTIVE: Recent data suggest stroke incidence is decreasing over time, but it is unknown whether incidence is decreasing in women and men to the same extent. METHODS: Within our population of 1.3 million, all incident strokes among residents ≥20 years old were ascertained at all hospitals during July 1993-June 1994 and calendar years 1999, 2005, and 2010. A sampling scheme was used to ascertain out-of-hospital cases. Sex-specific incidence rates per 100,000 among black and white participants, age- and race-adjusted, were standardized to the 2000 US Census population...
August 9, 2017: Neurology
https://www.readbyqxmd.com/read/28762187/the-choroid-plexus-is-a-key-cerebral-invasion-route-for-t-cells-after-stroke
#2
Gemma Llovera, Corinne Benakis, Gaby Enzmann, Ruiyao Cai, Thomas Arzberger, Alireza Ghasemigharagoz, Xiang Mao, Rainer Malik, Ivana Lazarevic, Sabine Liebscher, Ali Ertürk, Lilja Meissner, Denis Vivien, Christof Haffner, Nikolaus Plesnila, Joan Montaner, Britta Engelhardt, Arthur Liesz
Neuroinflammation contributes substantially to stroke pathophysiology. Cerebral invasion of peripheral leukocytes-particularly T cells-has been shown to be a key event promoting inflammatory tissue damage after stroke. While previous research has focused on the vascular invasion of T cells into the ischemic brain, the choroid plexus (ChP) as an alternative cerebral T-cell invasion route after stroke has not been investigated. We here report specific accumulation of T cells in the peri-infarct cortex and detection of T cells as the predominant population in the ipsilateral ChP in mice as well as in human post-stroke autopsy samples...
July 31, 2017: Acta Neuropathologica
https://www.readbyqxmd.com/read/28756141/evaluation-of-the-patient-health-questionnaire-2-as-a-screening-tool-for-depression-during-the-acute-stroke-admission
#3
Lakshmi Shankar, Nicole Smith, Ken Uchino, Nicolas R Thompson, Leopoldo Pozuelo, Irene L Katzan
BACKGROUND: The ideal time to screen for poststroke depression remains uncertain. We evaluated the 2-item Patient Health Questionnaire (PHQ-2) as a screening tool for depression during the acute stroke admission by determining the prevalence of positive depression screen during admission and by calculating the level of agreement between positive screens during admission and follow-up. METHODS: This was a retrospective cohort of adult stroke survivors discharged January to December 2013 with principal discharge diagnosis of acute ischemic stroke or intracerebral hemorrhage...
July 26, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28752508/safety-and-effectiveness-of-intravenous-thrombolysis-for-acute-ischemic-stroke-outside-the-coverage-of-national-health-insurance-in-taiwan
#4
Yu-Hsiang Su, Chih-Hung Chen, Huey-Juan Lin, Yu-Wei Chen, Mei-Chiun Tseng, Han-Chieh Hsieh, Chih-Hung Chen, Sheng-Feng Sung
PURPOSE: Only a small percentage of ischemic stroke patients were treated with intravenous thrombolysis in Taiwan, partly because of the narrow reimbursement criteria of the National Health Insurance (NHI). We aimed to assess the safety and effectiveness of intravenous thrombolysis not covered by the NHI. METHODS: This is a retrospective analysis of register data from four hospitals. All patients who received intravenous tissue plasminogen activator and fulfilled the American Heart Association/American Stroke Association (AHA/ASA) thrombolysis guidelines between January 2007 and June 2012 were distinguished into two groups: those in accordance (reimbursement group) and those not in accordance (non-reimbursement group) with the NHI reimbursement criteria...
March 15, 2017: Acta Neurologica Taiwanica
https://www.readbyqxmd.com/read/28751552/plasma-glial-fibrillary-acidic-protein-in-the-differential-diagnosis-of-intracerebral-hemorrhage
#5
Aristeidis H Katsanos, Konstantinos Makris, Dimitra Stefani, Katerina Koniari, Eleni Gialouri, Moses Lelekis, Maria Chondrogianni, Christina Zompola, Efthymios Dardiotis, Ioannis Rizos, John Parissis, Eleni Boutati, Konstantinos Voumvourakis, Georgios Tsivgoulis
BACKGROUND AND PURPOSE: Plasma GFAP (glial fibrillary acidic protein) has recently emerged as a potential biomarker for the differentiation of acute intracerebral hemorrhage (ICH) from acute ischemic stroke (AIS). We prospectively assessed the diagnostic accuracy of GFAP in the differential diagnosis of ICH. METHODS: Consecutive patients presenting to the emergency department within 6 hours from symptom onset were evaluated. All patients underwent extensive diagnostic work-up and were classified according to discharge diagnosis in AIS, ICH, subarachnoid hemorrhage, and stroke mimics...
July 27, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28748994/-intravenous-thrombolysis-for-acute-ischemic-stroke-a-four-years%C3%A2-experience-in-a-chilean-public-hospital
#6
Álvaro Soto V, Gladys Morales I, Marcela Grandjean B, Débora Pollak W, Carolina Del Castillo C, Pía García F, Alexis Von Johnn A, Alfonso Riquelme G
BACKGROUND: Intravenous thrombolysis (IVT) with alteplase (tissue plasminogen activator) is the standard pharmacological treatment in acute ischemic stroke (AIS), reducing disability in patients. AIM: To report the results a thrombolysis protocol during four years in a regional public hospital. MATERIAL AND METHODS: Data from 106 consecutive patients aged 68 ± 13 years (57% men) who were treated with IVT, from May 2012 until April 2016, was analyzed...
April 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28747462/mechanical-thrombectomy-outcomes-with-and-without-intravenous-thrombolysis-in-stroke-patients-a-meta-analysis
#7
Eva A Mistry, Akshitkumar M Mistry, Mohammad Obadah Nakawah, Rohan V Chitale, Robert F James, John J Volpi, Matthew R Fusco
BACKGROUND AND PURPOSE: Whether prior intravenous thrombolysis provides any additional benefits to the patients undergoing mechanical thrombectomy for large vessel, acute ischemic stroke remains unclear. METHODS: We conducted a meta-analysis of 13 studies obtained through PubMed and EMBASE database searches to determine whether functional outcome (modified Rankin Scale) at 90 days, successful recanalization rate, and symptomatic intracerebral hemorrhage rate differed between patients who underwent mechanical thrombectomy with (MT+IVT) and without (MT-IVT) pre-treatment with intravenous thrombolysis...
July 26, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28739832/influence-of-renal-impairment-on-outcome-for-thrombolysis-treated-acute-ischemic-stroke-enchanted-enhanced-control-of-hypertension-and-thrombolysis-stroke-study-post-hoc-analysis
#8
Susan J Carr, Xia Wang, Veronica V Olavarria, Pablo M Lavados, Jorge A Rodriguez, Jong S Kim, Tsong-Hai Lee, Richard I Lindley, Octavio M Pontes-Neto, Stefano Ricci, Shoichiro Sato, Vijay K Sharma, Mark Woodward, John Chalmers, Craig S Anderson, Thompson G Robinson
BACKGROUND AND PURPOSE: Renal dysfunction (RD) is associated with poor prognosis after stroke. We assessed the effects of RD on outcomes and interaction with low- versus standard-dose alteplase in a post hoc subgroup analysis of the ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study). METHODS: A total of 3220 thrombolysis-eligible patients with acute ischemic stroke (mean age, 66.5 years; 37.8% women) were randomly assigned to low-dose (0...
July 24, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28738489/-trend-analysis-on-the-death-rate-of-ischemic-heart-disease-and-cerebrovascular-disease-among-xuzhou-residents-from-2011-to-2015
#9
P P Chen, P A Lou, P Zhang, C Qiao, T Li, Z M Dong
Objective: To analyze the epidemiological characteristics and trend of ischemic heart disease and cerebrovascular disease mortality among Xuzhou residents from 2011 to 2015. Methods: The mortality data of the ischemic heart disease and cerebrovascular disease were obtained from the registration disease surveillance system covering the residents of the city from 2011 to 2015. Ischemic heart disease and cerebrovascular disease were identified according to the international classification of diseases (ICD-10), Ischemic heart diseases include I20 to I25 (angina pectoris, acute myocardial infarction, certain current complications following acute myocardial infarction, other acute ischemic heart diseases chronic ischemic heart disease); cerebrovascular diseases include I60 to I69 (subarachnoid hemorrhage, intracerebral hemorrhage, other non-traumatic hemorrhage, cerebral infarction, stroke not specified as hemorrhage or infarction, other cerebrovascular diseases, sequelae of cerebrovascular disease)...
July 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28730950/statistical-analysis-plan-for-the-head-position-in-stroke-trial-headpost-an-international-cluster-cross-over-randomized-trial
#10
Laurent Billot, Mark Woodward, Hisatomi Arima, Maree L Hackett, Paula Muñoz Venturelli, Pablo M Lavados, Alejandro Brunser, Bin Peng, Liying Cui, Lily Song, Stephane Heritier, Stephen Jan, Sandy Middleton, Verónica V Olavarría, Joyce Lim, Thompson Robinson, Octavio Pontes-Neto, Caroline Watkins, Craig S Anderson
Background There is evidence to indicate that the lying flat head position increases cerebral blood flow and oxygenation in patients with acute ischemic stroke, but how these physiological effects translate into clinical outcomes is uncertain. The Head Position in Stroke Trial aims to determine the comparative effectiveness of lying flat (0°) compared to sitting up (≥30°) head positioning, initiated within 24 h of hospital admission for patients with acute stroke. Design An international, pragmatic, cluster-randomized, crossover, open, blinded outcome assessed clinical trial...
August 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28729134/macrophage-migration-inhibitory-factor-levels-in-serum-from-patients-with-acute-intracerebral-hemorrhage-potential-contribution-to-prognosis
#11
Qun Lin, Jian-Yong Cai, Chuan Lu, Jun Sun, Hua-Jun Ba, Mao-Hua Chen, Xian-Dong Chen, Jun-Xia Dai, Jian-Hu Lin
BACKGROUND: Intracerebral hemorrhage (ICH) pathophysiology involves inflammation. Macrophage migration inhibition factor (MIF), a pro-inflammatory cytokine, is related to prognosis of ischemic stroke. The aim of this study was to investigate whether serum MIF levels are associated with severity and outcomes in patients with acute ICH. METHODS: We enrolled a total of 120 consecutive ICH patients and 120 healthy controls and sampled blood on admission and at study entry respectively...
July 17, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28728534/comparisons-of-aspects-5-and-6-for-endovascular-treatment-in-anterior-circulation-occlusive-stroke
#12
Wenchen Li, Shijun Li, Meifen Dai, Shang Wang, Yunyun Xiong
Background Whether ASPECTS 5 and ASPECTS 6 were significantly different on clinical outcomes in acute anterior circulation ischemic stroke undergoing endovascular treatment remains unclear. We aimed to retrospectively compare the effectiveness and safety of ASPECTS 5 and ASPECTS 6 in acute anterior circulation large-artery occlusive stroke patients. Methods A total of 41 patients, 14 in the ASPECTS 5 group and 27 in the ASPECTS 6 group, were enrolled between January 2014 and June 2016. Modified Rankin Scale 0-2 was considered as good functional outcome...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28720659/microbleeds-cerebral-hemorrhage-and-functional-outcome-after-stroke-thrombolysis-individual-patient-data-meta-analysis
#13
Andreas Charidimou, Guillaume Turc, Catherine Oppenheim, Shenqiang Yan, Jan F Scheitz, Hebun Erdur, Pascal P Klinger-Gratz, Marwan El-Koussy, Wakoh Takahashi, Yusuke Moriya, Duncan Wilson, Chelsea S Kidwell, Jeffrey L Saver, Asma Sallem, Solene Moulin, Myriam Edjlali-Goujon, Vincent Thijs, Zoe Fox, Ashkan Shoamanesh, Gregory W Albers, Heinrich P Mattle, Oscar R Benavente, H Rolf Jäger, Gareth Ambler, Junya Aoki, Jean-Claude Baron, Kazumi Kimura, Wataru Kakuda, Shunya Takizawa, Simon Jung, Christian H Nolte, Min Lou, Charlotte Cordonnier, David J Werring
BACKGROUND AND PURPOSE: We assessed whether the presence, number, and distribution of cerebral microbleeds (CMBs) on pre-intravenous thrombolysis MRI scans of acute ischemic stroke patients are associated with an increased risk of intracerebral hemorrhage (ICH) or poor functional outcome. METHODS: We performed an individual patient data meta-analysis, including prospective and retrospective studies of acute ischemic stroke treated with intravenous tissue-type plasminogen activator...
July 18, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28717091/thrombolysis-related-multiple-lobar-hemorrhaging-in-cerebral-amyloid-angiopathy-with-extensive-strictly-lobar-cerebral-microbleeding
#14
Makoto Eriguchi, Yusuke Yakushiji, Jun Tanaka, Masashi Nishihara, Hideo Hara
A hemi-paralyzed 86-year-old man was diagnosed with ischemic stroke and underwent thrombolysis. Pre-thrombolysis brain magnetic resonance imaging revealed extensive strictly lobar cerebral microbleeding (CMB). Post-thrombolytic computed tomography revealed asymptomatic multiple intracerebral hemorrhaging (ICH). His age, CMB topography, and decreased cerebral spinal fluid amyloid-β 40 and 42 levels were compatible with a diagnosis of cerebral amyloid angiopathy (CAA). There is no consensus on the safety of thrombolysis for acute stroke patients with CAA...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28716274/head-ct-findings-at-a-public-hospital-in-rural-haiti
#15
Yannis K Valtis, Maggie F Cochran, Louine Martineau, Bregenet Lamour, Jeffrey B Mendel, Aaron L Berkowitz
BACKGROUND: Neuroimaging is often unavailable in low-income countries, creating challenges for precise diagnosis of neurologic disease in individual patients, and impeding acquisition of precise neuroepidemiologic data for program and policy development. METHODS: We analyzed reports from 3614 head CTs performed between July 2013 and January 2016 at Hôpital Universitaire de Mirebalais, a public academic hospital in rural Haiti, extracting patients' age, study indication, and radiologic findings...
August 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28710330/assessment-of-the-interaction-of-age-and-sex-on-90-day-outcome-after-intracerebral-hemorrhage
#16
Michael L James, Carl D Langefeld, Padmini Sekar, Charles J Moomaw, Mitchell S V Elkind, Bradford B Worrall, Kevin N Sheth, Sharyl R Martini, Jennifer Osborne, Daniel Woo
OBJECTIVE: Because age affects hormonal production differently in women compared with men, we sought to define sex and age interactions across a multiracial/ethnic population after intracerebral hemorrhage (ICH) to uncover evidence that loss of gonadal hormone production would result in loss of the known neuroprotective effects of gonadal hormones. METHODS: Clinical and radiographic data from participants in the Ethnic/Racial Variations of Intracerebral Hemorrhage study and the Genetic and Environmental Risk Factors for Hemorrhagic Stroke study prior to December 2013 were used...
July 14, 2017: Neurology
https://www.readbyqxmd.com/read/28688756/mechanical-behavior-of-rf-treated-thrombus-in-mechanical-thrombectomy
#17
Chi Hang Chon, Zhen Qin, John Ck Kwok, David Cc Lam
Intra-arterial mechanical thrombectomy (IAMT) treatments for ischemic stroke have higher recanalization rate, longer treatment time window and lower risk of symptomatic intracerebral hemorrhage (sICH). However, distal embolization may occur because of loose fragments produced during maceration and engagement. The naturally coagulated thrombus is fragile and has poor binding with thrombectomy device. Improvement of thrombus-device binding can reduce fragments breaking loose during wire pull and enhance protein crosslinking in the thrombus that can increase fragmentation resistance...
July 5, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28680764/early-transition-to-comfort-measures-only-in-acute-stroke-patients-analysis-from-the-get-with-the-guidelines-stroke-registry
#18
Shyam Prabhakaran, Margueritte Cox, Barbara Lytle, Phillip J Schulte, Ying Xian, Darin Zahuranec, Eric E Smith, Mathew Reeves, Gregg C Fonarow, Lee H Schwamm
BACKGROUND: Death after acute stroke often occurs after forgoing life-sustaining interventions. We sought to determine the patient and hospital characteristics associated with an early decision to transition to comfort measures only (CMO) after ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) in the Get With The Guidelines-Stroke registry. METHODS: We identified patients with IS, ICH, or SAH between November 2009 and September 2013 who met study criteria...
June 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28679854/acute-occlusions-of-dual-layer-carotid-stents-after-endovascular-emergency-treatment-of-tandem-lesions
#19
Umut Yilmaz, Heiko Körner, Ruben Mühl-Benninghaus, Andreas Simgen, Catherine Kraus, Silke Walter, Stefanie Behnke, Klaus Faßbender, Wolfgang Reith, Marcus M Unger
BACKGROUND AND PURPOSE: A new generation of carotid artery stents that uses a second micromesh layer to reduce embolic events during carotid artery stenting has recently been introduced. The purpose of this study was to compare acute occlusion rates of these new dual-layer stents with those of single-layer stents in the setting of emergency carotid artery stenting with intracranial mechanical thrombectomy in acute ischemic stroke. METHODS: Consecutive patients with acute tandem (intra- and extracranial) lesions of the anterior circulation who were endovascularly treated at our institution were identified from our registry of neuroendovascular interventions...
July 5, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28679849/mendelian-genes-and-risk-of-intracerebral-hemorrhage-and-small-vessel-ischemic-stroke-in-sporadic-cases
#20
Michael Chong, Martin O'Donnell, Vincent Thijs, Antonio Dans, Patricio López-Jaramillo, Diego Gómez-Arbeláez, Charles Mondo, Anna Czlonkowska, Marta Skowronska, Shahram Oveisgharan, Salim Yusuf, Guillaume Paré
BACKGROUND AND PURPOSE: Mendelian strokes are rare genetic disorders characterized by early-onset small-vessel stroke. Although extensively studied among families with syndromic features, whether these genes affect risk among sporadic cases is unknown. METHODS: We sequenced 8 genes responsible for Mendelian stroke in a case-control study of sporadic stroke cases (≤70 years). Participants included 1251 primary stroke cases of small-vessel pathology (637 intracerebral hemorrhage and 614 small-vessel ischemic stroke cases) and 1716 controls from the INTERSTROKE study (Study of the Importance of Conventional and Emerging Risk Factors of Stroke in Different Regions and Ethnic Groups of the World)...
July 5, 2017: Stroke; a Journal of Cerebral Circulation
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