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Stroke , ischemic stroke , intracerebral

Marius Georg Kaschner, Julian Caspers, Christian Rubbert, Raul Lande, Bastian Kraus, John-Ih Lee, Michael Gliem, Sebastian Jander, Bernd Turowski
Introduction While effectiveness of mechanical thrombectomy (MTE) in M1 segment occlusion is approved for patients with severe impairment, there is a lack of evidence for a potential benefit of MTE in patients with minor to moderate symptoms. The purpose of this study was to evaluate neurological outcome and occurrence of periprocedural complications after MTE in patients with low National Institutes of Health Stroke Scale (NIHSS) scores. Materials and methods A retrospective analysis of 1081 consecutive patients with anterior circulation ischemic stroke due to M1 occlusion detected by computed tomography angiography and treated with MTE at our hospital between February 2012 and November 2017 was performed...
January 1, 2018: Interventional Neuroradiology
Jin Soo Lee, Seong-Joon Lee, Ji Man Hong, Jin Wook Choi, Jeong-Ho Hong, Hyuk-Won Chang, Chang-Hyun Kim, Yong-Won Kim, Dong-Hun Kang, Yong-Sun Kim, Bruce Ovbiagele, Andrew M Demchuk, Yang-Ha Hwang, Sung-Il Sohn
Background and Purpose: The purpose of the current study is to evaluate the influence of temporal patterns related to the availability of new endovascular treatment (EVT) devices on care processes and outcomes among patients with AIS. Materials and Methods: We enrolled 720 consecutive patients (January 2011 to May 2016) in a retrospective registry, ASIAN KR, from three Korean hospitals, who received EVT for acute ischemic stroke (AIS) caused by cervicocephalic arterial occlusions...
March 2018: Neurointervention
Morten Würtz, Morten Schmidt, Erik Lerkevang Grove, Erzsébet Horváth-Puhó, Victor W Henderson, Christian Fynbo Christiansen, Henrik Toft Sørensen
Aims: The impact of preadmission antiplatelet treatment on prognosis after stroke is poorly understood. We therefore investigated whether preadmission use of aspirin and clopidogrel was associated with mortality in patients hospitalized with ischemic stroke, intracerebral hemorrhage (ICH), or subarachnoid hemorrhage (SAH). Methods and Results: We used nationwide population-based registries to identify all first-time hospitalizations for stroke and subsequent mortality in patients treated with aspirin and clopidogrel in Denmark during 2004-2012...
March 8, 2018: European Heart Journal. Cardiovascular Pharmacotherapy
Yoav Eizenberg, Ehud Grossman, David Tanne, Silvia Koton
The impact of beta-blockers (BB) treatment on stroke outcome is unclear. We used data from a prospective national stroke registry to assess the associations between use of BB and poor outcome 3 months after stroke. Using the National Acute Stroke Israeli (NASIS) registry, we identified 1126 patients with ischemic stroke and intracerebral hemorrhage with pre-stroke hypertension treatment, who were followed for 3-months. Functional outcome and mortality at 3-month were compared by use of BB, adjusting for demographics and clinical factors...
March 9, 2018: Journal of Clinical Hypertension
Maximiliano A Hawkes, Alejandro A Rabinstein
Background: We summarize the existing evidence on the potential benefit of oral anticoagulation (OAC) in intracerebral hemorrhage (ICH) survivors with nonvalvular atrial fibrillation (NVAF). Methods: Systematic review of the literature to address the following issues: (1) prevalence of NVAF in ICH survivors, (2) current prescription of OAC, (3) factors associated with resumption of OAC, (4) risk of ischemic stroke (IS) and recurrent ICH, and (5) ideal timing for restarting OAC in ICH survivors with NVAF...
February 2018: Neurology. Clinical Practice
Carl Willers, Ingrid Lekander, Elisabeth Ekstrand, Mikael Lilja, Hélène Pessah-Rasmussen, Katharina S Sunnerhagen, Mia von Euler
BACKGROUND: Differences in stroke care and health outcomes between men and women are debated. The objective of this study was to explore the relationship between patients' sex and post-stroke health outcomes and received care in a Swedish setting. METHODS: Patients with a registered diagnosis of acute intracerebral hemorrhage (ICH) or ischemic stroke (IS) within regional administrative systems (ICD-10 codes I61* or I63*) and the Swedish Stroke Register during 2010-2011 were included and followed for 1 year...
March 7, 2018: Biology of Sex Differences
Norberto L Cabral, Vivian Nagel, Adriana B Conforto, Claudio H Amaral, Vanessa G Venancio, Juliana Safanelli, Felipe Ibiapina, Alexandre L Longo, Viviane de Hiroki F Zetola
Background Information about long-term outcomes after stroke in developing countries provided by population-based methodologies is scarce. Aim This study aimed to know outcomes five years after a first-ever stroke in Joinville, Brazil. Methods Data were extracted from the Joinville Stroke Registry about all patients who had strokes in Joinville in 2010 and were followed up to 2015. Stroke recurrence, Kaplan-Meier survival probabilities, functional outcomes, and causes of death were ascertained at 30 days, six months, one and five years...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Muhammad T Khan, Asad Ikram, Omar Saeed, Taha Afridi, Cathy A Sila, Matthew S Smith, Khadija Irshad, Ashfaq Shuaib
We present a systemic review of available literature on the complications of deep venous thrombosis that develops in patients presenting with acute stroke. There are several pharmacological and physical treatment options available and used. We aim to summarize the management plans currently used at different centers. In conclusion, low-dose anticoagulant therapy for ischemic stroke is recommended. In the case of intracerebral hemorrhage, pneumatic sequential compression devices should be placed initially, followed by the administration of ultra-fractioned heparin on the next day, and then oral anticoagulant therapy to replace the heparin after a week in high-risk patients...
December 23, 2017: Curēus
Katharina Maria Busl
Infectious complications in the neurointensive care unit (neuro-ICU) are common, including pneumonia, urinary tract infection, bloodstream infection, and intracranial infection. The neuro-ICU population poses a specific challenge in the diagnosis of infections, because of the high incidence of fever in acutely brain-injured patients. Furthermore, susceptibility to infections is likely enhanced by brain-injury (induced immune modulation). This article reviews the concept of brain injury-induced immune modulation, and summarizes available data and knowledge on nosocomial meningitis and ventriculitis, and systemic infectious complications in patients with traumatic brain injury, ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and status epilepticus...
April 2018: Neurosurgery Clinics of North America
Xiaoning Han, Xiaochun Zhao, Xi Lan, Qian Li, Yufeng Gao, Xi Liu, Jieru Wan, Zengjin Yang, Xuemei Chen, Weidong Zang, Austin M Guo, John R Falck, Raymond C Koehler, Jian Wang
20-HETE, an arachidonic acid metabolite synthesized by cytochrome P450 4A, plays an important role in acute brain damage from ischemic stroke or subarachnoid hemorrhage. We tested the hypothesis that 20-HETE inhibition has a protective effect after intracerebral hemorrhage (ICH) and then investigated its effect on angiogenesis. We exposed hippocampal slice cultures to hemoglobin and induced ICH in mouse brains by intrastriatal collagenase injection to investigate the protective effect of 20-HETE synthesis inhibitor N-hydroxy-N'-(4- n-butyl-2-methylphenyl)-formamidine (HET0016)...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
Carolin Hoyer, Alexandra Filipov, Eva Neumaier-Probst, Kristina Szabo, Anne Ebert, Angelika Alonso
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs) have gained increasing importance for stroke prevention in patients with non-valvular atrial fibrillation (AF). With changing prescription practice, among other factors, clinicians can expect to see rising numbers of patients with ischemic stroke and pre-existing NOAC therapy. Few data exist regarding a potential impact of NOAC on stroke severity and outcome. AIMS: To evaluate the impact of pre-admission NOAC therapy on ischemic stroke severity...
February 23, 2018: Journal of Thrombosis and Thrombolysis
Christoph Hanefeld, Alexander Haschemi, Thomas Lampert, Hans J Trampisch, Andreas Mügge, Janine Miebach, Cordula Kloppe, Renate Klaaßen-Mielke
BACKGROUND: Persons of lower socio-economic status are at higher risk of disease, especially with respect to severe and chronic illnesses. To date, there have not been any studies with large case numbers regarding acute medical emergencies in this population. METHODS: In a retrospective study, data were obtained on all cases treated by emergency physicians in Bochum, Germany, in 2014/2015, including the diagnoses that were made by the emergency physicians. There were a total of 16 767 cases...
January 26, 2018: Deutsches Ärzteblatt International
Ilya Bragin, Justine M Chen
Thrombocytopenia (platelet count: < 100,000/mm3 ) is considered a contraindication in the use of intravenous thrombolysis for acute ischemic stroke. Little literature exists regarding tissue plasminogen activator (tPA) usage in thrombocytopenic patients, especially in older patients. Age and stroke severity are major prognostic indicators of the risk of hemorrhagic transformation. The Stroke Prognostication using Age and NIH Stroke Scale (SPAN) index estimates a patient's risk of intracerebral hemorrhage (ICH) and clinical response to thrombolysis by combining age in years with the National Institutes of Health Stroke Scale (NIHSS) scores...
December 11, 2017: Curēus
Chunggab Choi, Hye Min Kim, Jeeheun Shon, Jiae Park, Hyeong-Taek Kim, Seung-Hun Oh, Nam Keun Kim, Ok-Joon Kim
The blood-brain barrier (BBB) is major obstacle in drug or stem cell treatment in chronic stroke. We hypothesized that adding mannitol to temozolomide (TMZ) is a practically applicable method for resolving the low efficacy of intravenous mannitol therapy. In this study, we investigated whether BBB permeability could be increased by this combined treatment. First, we established a chronic ischemic stroke rat model and examined changes in leakage of Evans blue dye within a lesion site, and in expression of tight junction proteins (TJPs), by this combined treatment...
February 17, 2018: Biochemical and Biophysical Research Communications
Azra Zafar, Majed Alabdali, Rizwana Shahid, Danah Aljaafari, Fahd A Al-Khamis, Aishah I Albakr, Saima Nazish, Abdulla A Al-Sulaiman, Alon Abraham
OBJECTIVE: To assess the burden and describe the pattern of neurological disorders requiring admissions in a teaching hospital of Al Khobar. METHODS: This is a retrospective, cross sectional study, carried out in the Neurology Department of King Fahd Hospital of the University from January 2009 to December 2016. Neurological disorders were grouped as ischemic stroke, intracerebral hemorrhage, transient ischemic attack, cerebral venous sinus thrombosis, seizure disorders, central nervous system infection, multiple sclerosis, neuropathies, myopathies, headache, dementia and miscellaneous group...
January 2018: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
David Černík, Daniel Šaňák, Petra Divišová, Martin Köcher, Filip Cihlář, Jana Zapletalová, Tomáš Veverka, Andrea Prcúchová, Dušan Ospalík, Marie Černá, Petra Janoušová, Michal Král, Tomáš Dorňák, Vojtěch Prášil, David Franc, Petr Kaňovský
INTRODUCTION/PURPOSE: Mechanical thrombectomy (MT) for acute ischemic stroke (IS) can be performed also in patients on anticoagulation therapy (AT); however, sufficient and reliable data about safety and efficacy of MT are still missing. Thus, we aimed to compare these parameters between patients treated on AT and without AT. MATERIALS AND METHODS: All consecutive IS patients treated with MT using stent retrievers were included in the retrospective analysis. Neurological deficit was scored using National Institutes of Health Stroke Scale (NIHSS) and 90-day clinical outcome using modified Rankin scale with a score 0-2 for good outcome...
February 15, 2018: Cardiovascular and Interventional Radiology
Line Klingen Gjærde, Thomas Clement Truelsen, Jennifer Lyn Baker
BACKGROUND AND PURPOSE: Attained height, an indicator of genetic potential and childhood growth environment, is inversely associated with stroke, but the mechanisms are poorly understood. We investigated whether childhood height and growth are associated with ischemic stroke (IS) and intracerebral hemorrhage (ICH). METHODS: In a cohort of Danish schoolchildren born 1930 to 1989, with measured height from 7 to 13 years, we investigated associations of childhood stature and growth with risks of adult IS and ICH...
February 15, 2018: Stroke; a Journal of Cerebral Circulation
Deena M Nasr, Kelly D Flemming, Giuseppe Lanzino, Harry J Cloft, David F Kallmes, Mohammad Hassan Murad, Waleed Brinjikji
BACKGROUND AND PURPOSE: Vertebrobasilar non-saccular and dolichoectatic aneurysms (VBDA) are a rare type of aneurysm and are generally associated with poor prognosis. In order to better characterize the natural history of VBDAs, we performed a systematic review and meta-analysis of the literature to determine rates of mortality, growth, rupture, ischemia, and intraparenchymal hemorrhage. MATERIALS AND METHODS: We searched the literature for longitudinal natural history studies of VBDA patients reporting clinical and imaging outcomes...
February 13, 2018: Cerebrovascular Diseases
Loris Poli, Mario Grassi, Marialuisa Zedde, Simona Marcheselli, Giorgio Silvestrelli, Maria Sessa, Andrea Zini, Maurizio Paciaroni, Cristiano Azzini, Massimo Gamba, Antonella Toriello, Rossana Tassi, Elisa Giorli, Rocco Salvatore Calabrò, Marco Ritelli, Alessandro De Vito, Nicola Pugliese, Giuseppe Martini, Alessia Lanari, Corrado Lodigiani, Marina Padroni, Valeria De Giuli, Filomena Caria, Andrea Morotti, Paolo Costa, Davide Strambo, Manuel Corato, Rosario Pascarella, Massimo Del Sette, Giovanni Malferrari, Marina Colombi, Alessandro Padovani, Alessandro Pezzini
Whether to resume antithrombotic treatment after oral anticoagulant-related intracerebral haemorrhage (OAC-ICH) is debatable. In this study, we aimed at investigating long-term outcome associated with OAC resumption after warfarin-related ICH, in comparison with secondary prevention strategies with platelet inhibitors or antithrombotic discontinuation. Participants were patients who sustained an incident ICH during warfarin treatment (2002-2014) included in the Multicenter Study on Cerebral Hemorrhage in Italy...
February 12, 2018: Thrombosis and Haemostasis
Aline Meirhaeghe, Dominique Cottel, Béatrice Cousin, Marie-Pierre Dumont, Nadine Marécaux, Philippe Amouyel, Jean Dallongeville
BACKGROUND: Age and sex have a major impact on stroke onset. AIMS: We aimed to compare the attack, incidence, and 28-day mortality rate for stroke as well as risk factors in men and women aged 35 and over. METHODS: Data were obtained between 2008 and 2015 from the stroke population-based registry covering the city of Lille (northern France). RESULTS: A total of 2426 strokes (1917 incident strokes) were recorded. The number of strokes was lower in women than in men when considering individuals under the age of 75 but was twice as high when considering individuals aged 75 or over...
February 8, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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