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Stroke , ischemic stroke , intracerebral

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https://www.readbyqxmd.com/read/29141072/association-of-cetp-gene-variants-with-risk-for-vascular-and-nonvascular-diseases-among-chinese-adults
#1
Iona Y Millwood, Derrick A Bennett, Michael V Holmes, Ruth Boxall, Yu Guo, Zheng Bian, Ling Yang, Sam Sansome, Yiping Chen, Huaidong Du, Canqing Yu, Alex Hacker, Dermot F Reilly, Yunlong Tan, Michael R Hill, Junshi Chen, Richard Peto, Hongbing Shen, Rory Collins, Robert Clarke, Liming Li, Robin G Walters, Zhengming Chen
Importance: Increasing levels of high-density lipoprotein (HDL) cholesterol through pharmacologic inhibition of cholesteryl ester transfer protein (CETP) is a potentially important strategy for prevention and treatment of cardiovascular disease (CVD). Objective: To use genetic variants in the CETP gene to assess potential risks and benefits of lifelong lower CETP activity on CVD and other outcomes. Design, Setting, and Participants: This prospective biobank study included 151 217 individuals aged 30 to 79 years who were enrolled from 5 urban and 5 rural areas of China from June 25, 2004, through July 15, 2008...
November 15, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29137615/advance-directives-proxy-opinions-and-treatment-restrictions-in-patients-with-severe-stroke
#2
Floor A S de Kort, Marjolein Geurts, Paul L M de Kort, Julia H van Tuijl, Ghislaine J M W van Thiel, L Jaap Kappelle, H Bart van der Worp
BACKGROUND: Patients with severe stroke often do not have the capacity to participate in discussions on treatment restrictions because of a reduced level of consciousness, aphasia, or another cognitive disorder. We assessed the role of advance directives and proxy opinions in the decision-making process of incapacitated patients. METHODS: Sixty patients with severe functional dependence (Barthel Index ≤6) at day four after ischemic stroke or intracerebral hemorrhage were included in a prospective two-center cohort study...
November 14, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29136204/thrombolysis-is-an-independent-risk-factor-for-poor-outcome-after-carotid-revascularization
#3
Ananth K Vellimana, Chad W Washington, Chester K Yarbrough, Thomas K Pilgram, Brian L Hoh, Colin P Derdeyn, Gregory J Zipfel
BACKGROUND: Thrombolysis is the standard of care for acute ischemic stroke patients presenting in the appropriate time window. Studies suggest that the risk of recurrent ischemia is lower if carotid revascularization is performed early after the index event. The safety of early carotid revascularization in this patient population is unclear. OBJECTIVE: To evaluate the safety of carotid revascularization in patients who received thrombolysis for acute ischemic stroke...
November 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29134723/the-ct-defined-hyperdense-arterial-sign-as-a-marker-for-acute-intracerebral-large-vessel-occlusion
#4
Jaims Lim, Jordan A Magarik, Michael T Froehler
BACKGROUND AND PURPOSE: To determine the sensitivity and specificity of the hyperdense artery sign (HAS) on thin-slice non-contrast computed tomography (NCCT), combined with brief clinical history, as an indicator for large vessel occlusion (LVO) in the setting of acute ischemic stroke. METHODS: Ninety-nine LVO and 102 non-LVO acute ischemic stroke patients were retrospectively identified from a prospective database at a single institution. After reviewing each patient's neurologic presentation based on his or her initial National Institute of Health Stroke Scale (NIHSS) and neurologic evaluation, all thin (1 mm) and thick (5 mm) NCCT scans were reviewed for the HAS...
November 14, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/29131095/intracranial-internal-carotid-artery-wall-calcification-in-ischemic-strokes-treated-with-thrombolysis
#5
Miguel Tábuas-Pereira, João Sargento-Freitas, Fernando Silva, Joana Parra, Patrícia Mendes, Vera Seara, Miguel Mesquita, Mariana Baptista, Gustavo Cordeiro, Luis Cunha
BACKGROUND: Calcifications are an important element of atherosclerotic plaques and have been used as a marker of atherosclerosis and clinical outcome predictor in different vascular territories. CT-scan, performed in the acute ischemic stroke setting, can reliably detect intracranial arterial calcifications. OBJECTIVES: To investigate the association between intracranial internal carotid artery calcification and functional outcome, symptomatic intracerebral hemorrhage (sICH), recanalization, and death...
November 13, 2017: European Neurology
https://www.readbyqxmd.com/read/29127270/low-dose-tirofiban-improves-functional-outcome-in-acute-ischemic-stroke-patients-treated-with-endovascular-thrombectomy
#6
Wenbo Zhao, Ruiwen Che, Shuyi Shang, Chuanjie Wu, Chuanhui Li, Longfei Wu, Jian Chen, Jiangang Duan, Haiqing Song, Hongqi Zhang, Feng Ling, Yuping Wang, David Liebeskind, Wuwei Feng, Xunming Ji
BACKGROUND AND PURPOSE: Chinese patients largely experience acute ischemic stroke (AIS) because of large artery atherosclerosis rather than cardioembolism, and whether tirofiban is safe and effective in these patients treated with endovascular thrombectomy (ET) is unknown. This study evaluated the safety and efficacy of tirofiban in Chinese patients with AIS treated with ET. METHODS: This observational study is based on a single-center prospective registry study...
November 10, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29127269/intracerebral-hemorrhage-and-outcome-after-thrombolysis-in-stroke-patients-using-selective-serotonin-reuptake-inhibitors
#7
Jan F Scheitz, Guillaume Turc, Linda Kujala, Alexandros A Polymeris, Mirjam R Heldner, Thomas P Zonneveld, Hebun Erdur, Sami Curtze, Christopher Traenka, Céline Brenière, Roland Wiest, Andrea Rocco, Gerli Sibolt, Henrik Gensicke, Matthias Endres, Nicolas Martinez-Majander, Yannick Béjot, Paul J Nederkoorn, Catherine Oppenheim, Marcel Arnold, Stefan T Engelter, Daniel Strbian, Christian H Nolte
BACKGROUND AND PURPOSE: Selective serotonin-reuptake inhibitors (SSRIs) impair platelet function and have been linked to a higher risk of spontaneous intracerebral hemorrhage-an association that may be augmented by oral anticoagulants (OAC). We aimed to assess whether preadmission treatment with SSRIs in patients with acute ischemic stroke is associated with post-thrombolysis symptomatic intracerebral hemorrhage (sICH) and functional outcome. METHODS: A multicenter retrospective analysis was conducted in prospective registries of patients treated by thrombolysis within 4...
November 10, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29117953/brain-microbleeds-anticoagulation-and-hemorrhage-risk-meta-analysis-in-stroke-patients-with-af
#8
Andreas Charidimou, Christopher Karayiannis, Tae-Jin Song, Dilek Necioglu Orken, Vincent Thijs, Robin Lemmens, Jinkwon Kim, Su Mei Goh, Thanh G Phan, Cathy Soufan, Ronil V Chandra, Lee-Anne Slater, Shamir Haji, Vincent Mok, Solveig Horstmann, Kam Tat Leung, Yuichiro Kawamura, Nobuyuki Sato, Naoyuki Hasebe, Tsukasa Saito, Lawrence K S Wong, Yannie Soo, Roland Veltkamp, Kelly D Flemming, Toshio Imaizumi, Velandai Srikanth, Ji Hoe Heo
OBJECTIVES: To assess the association between cerebral microbleeds (CMBs) and future spontaneous intracerebral hemorrhage (ICH) risk in ischemic stroke patients with nonvalvular atrial fibrillation (AF) taking oral anticoagulants. METHODS: This was a meta-analysis of cohort studies with >50 patients with recent ischemic stroke and documented AF, brain MRI at baseline, long-term oral anticoagulation treatment, and ≥6 months of follow-up. Authors provided summary-level data on stroke outcomes stratified by CMB status...
November 8, 2017: Neurology
https://www.readbyqxmd.com/read/29117341/association-of-physical-activity-with-risk-of-major-cardiovascular-diseases-in-chinese-men-and-women
#9
Derrick A Bennett, Huaidong Du, Robert Clarke, Yu Guo, Ling Yang, Zheng Bian, Yiping Chen, Iona Millwood, Canqing Yu, Pan He, Xiangyang Zheng, Rory Collins, Junshi Chen, Richard Peto, Liming Li, Zhengming Chen
Importance: In China, the patterns and levels of physical activity differed from those in high-income countries. Substantial uncertainty remains about the relevance, both qualitatively and quantitatively, of domain-specific physical activity for cardiovascular disease (CVD) subtypes in Chinese adults. Objective: To assess the shape and strength of the associations of total, occupational, and nonoccupational physical activity with CVD subtypes in Chinese men and women...
November 8, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29115734/more-extensive-white-matter-hyperintensity-is-linked-with-higher-risk-of-remote-intracerebral-hemorrhage-after-intravenous-thrombolysis
#10
Yi Chen, Shenqiang Yan, Mengjun Xu, Genlong Zhong, David S Liebeskind, Min Lou
BACKGROUND AND PURPOSES: Remote intracerebral hemorrhage (rICH) is infrequent after intravenous thrombolysis (IVT) and its mechanism remains poorly understood. We aim to assess its frequency and possible relationship with the severity of white matter hyperintensity (WMH) in acute ischemic stroke (AIS) patients. METHODS: We prospectively analyzed data from consecutive AIS patients with MRI and IVT. WMH volume was quantitatively measured. rICH was defined as intracranial hemorrhage that appears in brain regions without visible ischemic changes on 24h follow-up imaging...
November 8, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29114975/real-world-evidence-for-off-label-intravenous-thrombolysis-in-acute-ischemic-stroke
#11
Georgios Tsivgoulis, Vasileios-Arsenios Lioutas
The most feared complication of intravenous tissue-plasminogen-activator (tPA) delivery in patients with acute ischemic stroke (AIS) is symptomatic intracerebral hemorrhage (sICH) which has been the driver behind most of the exclusion criteria in all randomized-controlled clinical trials (RCTs) evaluating the safety and efficacy of intravenous thrombolysis (IVT) for AIS(1) . This article is protected by copyright. All rights reserved.
November 8, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29110771/vascular-diseases-and-bleedings
#12
Harald Hegen, Michael Auer, Florian Deisenhammer
Diseases of the central nervous system that are caused by an underlying vascular pathology typically result in either hemorrhage or ischemia. Most prominent entities include spontaneous subarachnoid hemorrhage, spontaneous intracerebral hemorrhage, and ischemic stroke. For anatomic reasons, cerebrospinal fluid (CSF) qualifies as body fluid for the exploration of biomarkers in these disorders. Even though in subarachnoid hemorrhage a few CSF parameters have been established for routine diagnostic purposes, there is still an unmet need and broad interest in the identification of molecules that would allow further insight into disease mechanisms and supplement patients' medical care...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29092768/continuous-infusion-labetalol-vs-nicardipine-for-hypertension-management-in-stroke-patients
#13
Jason P Hecht, Patrick G Richards
BACKGROUND: Labetalol and nicardipine are antihypertensives commonly used in the management of elevated blood pressure (BP) following an acute stroke, but there is limited evidence to suggest which agent as a continuous infusion should be used preferentially in this setting. OBJECTIVE: This study aimed to compare the safety, efficacy, and ease of administration of continuous-infusion labetalol with continuous-infusion nicardipine following an acute stroke. METHODS: This retrospective cohort study of patients with acute ischemic stroke or intracerebral hemorrhage included patients if they received either study agent within 24 hours of admission...
October 30, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29084408/influence-of-renal-function-on-treatment-results-after-stroke-thrombectomy
#14
Mona Laible, Markus Alfred Möhlenbruch, Johannes Pfaff, Ekkehart Jenetzky, Peter Arthur Ringleb, Martin Bendszus, Timolaos Rizos
BACKGROUND: Renal dysfunction (RD) may be associated with poor outcome in ischemic stroke patients treated with mechanical thrombectomy (MT), but data concerning this important and emerging comorbidity do not exist so far. Here, we investigated the influence of RD on postprocedural intracerebral hemorrhage (ICH), clinical outcome, and mortality in a large prospectively collected cohort of acute ischemic stroke patients treated with MT. METHODS: Consecutive patients with anterior-circulation stroke treated with MT between October 2010 and January 2016 were included...
October 31, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29081474/cardiovascular-and-bleeding-risks-in-acute-myocardial-infarction-newly-treated-with-ticagrelor-vs-clopidogrel-in-taiwan
#15
Cheng-Han Lee, Ching-Lan Cheng, Yea-Huei Kao Yang, Ting-Hsing Chao, Ju-Yi Chen, Yi-Heng Li
BACKGROUND: There are few data on ticagrelor in Asian patients. This study evaluated clinical outcomes with ticagrelor and clopidogrel in Taiwanese patients with acute myocardial infarction (AMI).Methods and Results:We used the Taiwan National Health Insurance Research Database to identify 27,339 AMI patients aged ≥18 years between January 2012 and December 2014, and only patients who survived greater than or equal to 30 days after AMI and took dual antiplatelet therapy were included...
October 27, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29076879/managing-high-blood-pressure-during-acute-ischemic-stroke-and-intracerebral-hemorrhage
#16
Karen O Appiah, Jatinder S Minhas, Thompson G Robinson
PURPOSE OF REVIEW: Blood pressure (BP) elevations above premorbid levels are observed in at least 60% of acute ischemic and hemorrhagic stroke patients, within the first 24 h of symptom onset. A number of potential causes have been hypothesized, and high BP may be associated with poor stroke outcome. This review discusses management strategies of high BP in acute stroke, in the context of current guidelines. RECENT FINDINGS: Excessive BP elevation can impact acute stroke therapeutic strategies, particularly in modifying intervention safety and efficacy...
October 25, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29070714/statins-and-the-risk-of-intracerebral-hemorrhage-in-patients-with-previous-ischemic-stroke-or-transient-ischemic-attack
#17
David Gaist, Larry B Goldstein, Lucía Cea Soriano, Luis Alberto García Rodríguez
BACKGROUND AND PURPOSE: Although there is no overall association between statin use and intracerebral hemorrhage (ICH), whether there is an increased risk among those with a history of ischemic stroke (IS) or transient ischemic attack (TIA) remains controversial. We evaluated the relationship of preadmission statin use with the risk of ICH in patients with a history of IS or TIA in a population-based cohort. METHODS: The Health Improvement Network primary care database in the United Kingdom was used to identify new users of low-dose aspirin and a matched comparison...
October 25, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29063241/prevalence-and-clinical-characteristics-of-cortical-superficial-siderosis-in-patients-with-acute-stroke
#18
Satoshi Suda, Takashi Shimoyama, Shizuka Suzuki, Takahiro Ouchi, Masafumi Arakawa, Junya Aoki, Kentaro Suzuki, Yuki Sakamoto, Seiji Okubo, Yasuhiro Nishiyama, Chikako Nito, Masahiro Mishina, Kazumi Kimura
Cortical superficial siderosis (cSS) is a pathologic and radiologic diagnosis of hemosiderin deposition in subpial brain layers. However, cSS has not been fully studied in patients with acute stroke. Here, we investigated the prevalence of cSS in patients with acute stroke and analyzed the relationship between cSS and different clinical and neuroimaging characteristics. From September 2014 through June 2016, consecutive patients with acute stroke who were admitted to our department were retrospectively investigated...
October 23, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/29040110/racial-differences-in-palliative-care-use-after-stroke-in-majority-white-minority-serving-and-racially-integrated-u-s-hospitals
#19
Roland Faigle, Wendy C Ziai, Victor C Urrutia, Lisa A Cooper, Rebecca F Gottesman
OBJECTIVES: Racial/ethnic differences in palliative care resource use after stroke have been recognized, but it is unclear whether patient or hospital characteristics drive this disparity. We sought to determine whether palliative care use after intracerebral hemorrhage and ischemic stroke differs between hospitals serving varying proportions of minority patients. DESIGN: Population-based cross-sectional study. SETTING: Inpatient hospital admissions from the Nationwide Inpatient Sample between 2007 and 2011...
December 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29023523/the-role-of-glutamate-in-neuronal-ion-homeostasis-a-case-study-of-spreading-depolarization
#20
Niklas Hübel, Mahshid S Hosseini-Zare, Jokūbas Žiburkus, Ghanim Ullah
Simultaneous changes in ion concentrations, glutamate, and cell volume together with exchange of matter between cell network and vasculature are ubiquitous in numerous brain pathologies. A complete understanding of pathological conditions as well as normal brain function, therefore, hinges on elucidating the molecular and cellular pathways involved in these mostly interdependent variations. In this paper, we develop the first computational framework that combines the Hodgkin-Huxley type spiking dynamics, dynamic ion concentrations and glutamate homeostasis, neuronal and astroglial volume changes, and ion exchange with vasculature into a comprehensive model to elucidate the role of glutamate uptake in the dynamics of spreading depolarization (SD)-the electrophysiological event underlying numerous pathologies including migraine, ischemic stroke, aneurysmal subarachnoid hemorrhage, intracerebral hematoma, and trauma...
October 2017: PLoS Computational Biology
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