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Stroke , ischemic stroke , intracerebral

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https://www.readbyqxmd.com/read/28424044/emergent-carotid-thromboendarterectomy-for-acute-symptomatic-occlusion-of-the-extracranial-internal-carotid-artery
#1
Igor Gunka, Dagmar Krajickova, Michal Lesko, Stanislav Jiska, Jan Raupach, Miroslav Lojik, Radovan Maly
BACKGROUND: Strokes secondary to acute internal carotid artery (ICA) occlusion are associated with an extremely poor prognosis. The best treatment approach in this setting is still unknown. The aim of our study was to evaluate the efficacy, safety, and outcomes of emergent surgical revascularization of acute extracranial ICA occlusion in patients with minor to severe ischemic stroke. METHODS: A retrospective analysis was performed using prospectively collected data of consecutive patients who underwent carotid thromboendarterectomy for symptomatic acute ICA occlusion during the period from January 2013 to December 2015...
May 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28419988/neutrophil-to-lymphocyte-ratio-is-an-independent-predictor-for-in-hospital-mortality-in-spontaneous-intracerebral-hemorrhage
#2
Antje Giede-Jeppe, Tobias Bobinger, Stefan T Gerner, Jochen A Sembill, Maximilian I Sprügel, Vanessa D Beuscher, Hannes Lücking, Philip Hoelter, Joji B Kuramatsu, Hagen B Huttner
BACKGROUND AND PURPOSE: Stroke-associated immunosuppression and inflammation are increasingly recognized as factors that trigger infections and thus, potentially influence the outcome after stroke. Several studies demonstrated that elevated neutrophil-to-lymphocyte ratio (NLR) is a significant predictor of adverse outcomes in patients with ischemic stroke. However, little is known about the impact of NLR on short-term mortality in intracerebral hemorrhage (ICH). METHODS: This observational study included 855 consecutive ICH-patients...
April 19, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28412317/medical-treatment-for-spontaneous-anticoagulation-related-intracerebral-hemorrhage-in-the-netherlands
#3
Laura J de Schipper, M Irem Baharoglu, Yvo B W E M Roos, Frank de Beer
BACKGROUND: Spontaneous anticoagulation-related intracerebral hemorrhage accounts for up to a quarter of spontaneous intracerebral hemorrhage cases and is associated with higher hematoma volume and a worse outcome. Guidelines recommend rapid anticoagulant reversal but mode and timing are not specified and optimal strategy is uncertain. Variability in everyday practice is unknown. METHODS: An invitation to a web-based survey was sent to 85 Dutch stroke neurologists in different hospitals, with questions about importance, timing, and medical management of spontaneous anticoagulation-related intracerebral hemorrhage...
April 12, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28408066/derivation-and-validation-of-a-scoring-system-for-intravenous-tissue-plasminogen-activator-use-in-asian-patients
#4
Leonard L L Yeo, Shih-Chao Chien, Jr-Rung Lin, Chia-Wei Liow, Jiann-Der Lee, Tsung-I Peng, Teoh Hock Luen, Vijay Sharma, Bernard Chan, Tsong-Hai Lee
BACKGROUND AND PURPOSE: As Chinese Asian populations have an increased risk of intracerebral hemorrhage (ICH) after intravenous tissue plasminogen activator (IV tPA), we aimed to design a rapid, clinically applicable risk scoring system to predict ICH and functional outcomes after IV tPA treatment in Asian ischemic stroke patients. METHODS: From January 2009 to December 2012, consecutive acute ischemic stroke patients treated with IV tPA recruited from the Stroke Registry in Chang Gung Healthcare System (SRICHS) in Taiwan and the National University Hospital of Singapore (NUHS) acute stroke database were used to create and validate a scoring system...
April 10, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28395017/prevalence-of-cardiovascular-risk-factors-and-strokes-in-younger-adults
#5
Mary G George, Xin Tong, Barbara A Bowman
Importance: While stroke mortality rates have decreased substantially in the past 2 decades, this trend has been primarily limited to older adults. Increasing trends in stroke incidence and hospitalizations have been noted among younger adults, but there has been concern that this reflected improved diagnosis through an increased use of imaging rather than representing a real increase. Objectives: To determine whether stroke hospitalization rates have continued to increase and to identify the prevalence of associated stroke risk factors among younger adults...
April 10, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28387710/in-vivo-bioimpedance-spectroscopy-characterization-of-healthy-hemorrhagic-and-ischemic-rabbit-brain-within-10-hz-1-mhz
#6
Lin Yang, Wenbo Liu, Rongqing Chen, Ge Zhang, Weichen Li, Feng Fu, Xiuzhen Dong
Acute stroke is a serious cerebrovascular disease and has been the second leading cause of death worldwide. Conventional diagnostic modalities for stroke, such as CT and MRI, may not be available in emergency settings. Hence, it is imperative to develop a portable tool to diagnose stroke in a timely manner. Since there are differences in impedance spectra between normal, hemorrhagic and ischemic brain tissues, multi-frequency electrical impedance tomography (MFEIT) shows great promise in detecting stroke. Measuring the impedance spectra of healthy, hemorrhagic and ischemic brain in vivo is crucial to the success of MFEIT...
April 7, 2017: Sensors
https://www.readbyqxmd.com/read/28386082/nicotinamide-mononucleotide-attenuates-brain-injury-after-intracerebral-hemorrhage-by-activating-nrf2-ho-1-signaling-pathway
#7
Chun-Chun Wei, Yuan-Yuan Kong, Guo-Qiang Li, Yun-Feng Guan, Pei Wang, Chao-Yu Miao
Replenishment of NAD(+) has been shown to protect against brain disorders such as amyotrophic lateral sclerosis and ischemic stroke. However, whether this intervention has therapeutic effects in intracerebral hemorrhage (ICH) is unknown. In this study, we sought to determine the potential therapeutic value of replenishment of NAD(+) in ICH. In a collagenase-induced ICH (cICH) mouse model, nicotinamide mononucleotide (NMN), a key intermediate of nicotinamide adenine dinucleotide (NAD(+)) biosynthesis, was administrated at 30 minutes post cICH from tail vein to replenish NAD(+)...
April 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28382161/edaravone-encapsulated-agonistic-micelles-rescue-ischemic-brain-tissue-by-tuning-blood-brain-barrier-permeability
#8
Qu Jin, Yu Cai, Sihan Li, Haoran Liu, Xingyu Zhou, Chunqiang Lu, Xihui Gao, Jun Qian, Jun Zhang, Shenghong Ju, Cong Li
Thrombolysis has been a standard treatment for ischemic stroke. However, only 2-7% patients benefit from it because the thrombolytic agent has to be injected within 4.5 h after the onset of symptoms to avoid the increasing risk of intracerebral hemorrhage. As the only clinically approved neuroprotective drug, edaravone (EDV) rescues ischemic brain tissues by eradicating over-produced reactive oxygen species (ROS) without the limitation of therapeutic time-window. However, EDV's short circulation half-life and inadequate cerebral uptake attenuate its therapeutic efficacy...
2017: Theranostics
https://www.readbyqxmd.com/read/28381652/treatment-outcome-of-carotid-artery-stenting-underwent-within-14-days-of-stroke-onset-consideration-of-safety-and-efficacy-of-urgent-carotid-artery-stenting-for-neurologically-progressing-patients
#9
Yasuhisa Kanematsu, Junichiro Satomi, Kazuyuki Kuwayama, Izumi Yamaguchi, Shotaro Yoshioka, Tomoya Kinouchi, Yoshiteru Tada, Nobuaki Yamamoto, Shunji Matsubara, Koichi Satoh, Shinji Nagahiro
As the safety and effectiveness of urgent carotid artery stenting (CAS) for neurologically progressing patients remain controversial, we retrospectively analyzed the outcome of urgent CAS based on the patients' pathophysiological condition and neuroimaging findings. We divided 71 patients who underwent CAS within 14 days of stroke onset into two groups. Group 1 (n = 35) was comprised of patients with progressing neurologic signs and a reversible ischemic penumbra on magnetic resonance images (MRI). They were treated by urgent CAS...
April 6, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28379461/current-practice-trends-for-use-of-early-venous-thromboembolism-prophylaxis-after-intracerebral-hemorrhage
#10
Laurel J Cherian, Eric E Smith, Lee H Schwamm, Gregg C Fonarow, Phillip J Schulte, Ying Xian, Jingjing Wu, Shyam K Prabhakaran
BACKGROUND: Venous thromboembolism (VTE) is common after intracerebral hemorrhage (ICH). Guidelines recommend early VTE prophylaxis. OBJECTIVE: To determine characteristics associated with early chemoprophylaxis (CP) after ICH in the Get With The Guidelines-Stroke registry. METHODS: In this observational cohort study, we identified patients with ICH between January 1, 2009 and September 30, 2013, who (1) were non-ambulatory and/or not comfort care measures by hospital day 2; (2) were not transferred to another acute care facility; and (3) had known VTE prophylaxis status at end of hospital day 2...
April 4, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28377383/risk-of-stroke-in-patients-with-heart-failure-a-population-based-30-year-cohort-study
#11
Kasper Adelborg, Szimonetta Szépligeti, Jens Sundbøll, Erzsébet Horváth-Puhó, Victor W Henderson, Anne Ording, Lars Pedersen, Henrik Toft Sørensen
BACKGROUND AND PURPOSE: The long-term risk of specific stroke subtypes among heart failure patients is largely unknown. We examined short-term and long-term risk of ischemic stroke, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) in heart failure patients and in a general population comparison cohort. METHODS: In this nationwide cohort study (1980-2012), we used Danish population-based medical registries to identify and follow (1) all patients hospitalized for the first time with heart failure and (2) a birth year-, sex-, and calendar year-matched general population comparison cohort...
April 4, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28361615/unclear-onset-intracerebral-hemorrhage-clinical-characteristics-hematoma-features-and-outcomes
#12
Yasuteru Inoue, Fumio Miyashita, Masatoshi Koga, Kazuo Minematsu, Kazunori Toyoda
Background and purpose Although unclear-onset ischemic stroke, including wake-up ischemic stroke, is drawing attention as a potential target for reperfusion therapy, acute unclear-onset intracerebral hemorrhage has been understudied. Clinical characteristics, hematoma features, and outcomes of patients who developed intracerebral hemorrhage during sleep or those with intracerebral hemorrhage who were unconscious when witnessed were determined. Methods Consecutive intracerebral hemorrhage patients admitted within 24 hours after onset or last-known normal time were classified into clear-onset intracerebral hemorrhage and unclear-onset intracerebral hemorrhage groups...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28358291/feasibility-and-utility-of-an-integrated-medical-imaging-and-informatics-smartphone-system-for-management-of-acute-stroke
#13
Kristina Shkirkova, Eftitan Y Akam, Josephine Huang, Sunil A Sheth, May Nour, Conrad W Liang, Michael McManus, Van Trinh, Gary Duckwiler, Jason Tarpley, Fernando Vinuela, Jeffrey L Saver
Background Rapid dissemination and coordination of clinical and imaging data among multidisciplinary team members are essential for optimal acute stroke care. Aim To characterize the feasibility and utility of the Synapse Emergency Room mobile (Synapse ERm) informatics system. Methods We implemented the Synapse ERm system for integration of clinical data, computerized tomography, magnetic resonance, and catheter angiographic imaging, and real-time stroke team communications, in consecutive acute neurovascular patients at a Comprehensive Stroke Center...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28356003/young-stroke-patients-treated-with-intravenous-thrombolysis-have-a-more-favorable-outcome-and-mortality-compared-with-older-patients
#14
Jijun Shi, Yongjun Cao, Shoujiang You, Zhichao Huang, Xia Zhang, Huihui Liu, Chun-Feng Liu
BACKGROUND: Previous clinical studies suggest that intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator benefits stroke patients, but the efficacy of IVT in young stroke patients is not well-studied in China. OBJECTIVE: We compared the safety and efficacy of IVT with recombinant tissue plasminogen activator between Chinese young stroke patients (18-50 years old) and older patients (51-80 years old). METHODS: We analyzed data from the Soochow Stroke Registry for 373 stroke patients (18-50 years, n=74 vs...
March 27, 2017: Current Neurovascular Research
https://www.readbyqxmd.com/read/28351417/the-choroid-plexus-as-a-site-of-damage-in-hemorrhagic-and-ischemic-stroke-and-its-role-in-responding-to-injury
#15
REVIEW
Jianming Xiang, Lisa J Routhe, D Andrew Wilkinson, Ya Hua, Torben Moos, Guohua Xi, Richard F Keep
While the impact of hemorrhagic and ischemic strokes on the blood-brain barrier has been extensively studied, the impact of these types of stroke on the choroid plexus, site of the blood-CSF barrier, has received much less attention. The purpose of this review is to examine evidence of choroid plexus injury in clinical and preclinical studies of intraventricular hemorrhage, subarachnoid hemorrhage, intracerebral hemorrhage and ischemic stroke. It then discusses evidence that the choroid plexuses are important in the response to brain injury, with potential roles in limiting damage...
March 28, 2017: Fluids and Barriers of the CNS
https://www.readbyqxmd.com/read/28350278/stroke-doctors-who-are-we-a-world-stroke-organization-survey
#16
Atte Meretoja, Monica Acciarresi, Rufus O Akinyemi, Bruce Campbell, Dar Dowlatshahi, Coralie English, Nils Henninger, Alexandre Poppe, Jukka Putaala, Monica Saini, Shoichiro Sato, Bo Wu, Michael Brainin, Bo Norrving, Stephen Davis
Background Specialist training provides skilled workforce for service delivery. Stroke medicine has evolved rapidly in the past years. No prior information exists on background or training of stroke doctors globally. Aims To describe the specialties that represent stroke doctors, their training requirements, and the scientific organizations ensuring continuous medical education. Methods The World Stroke Organization conducted an expert survey between June and November 2014 using e-mailed questionnaires. All Organization for Economic Co-operation and Development countries with >1 million population and other countries with >50 million population were included ( n = 49, total 5...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28344073/role-of-thrombin-par1-pkc%C3%AE-%C3%AE-axis-in-brain-pericytes-in-thrombin-induced-mmp-9-production-and-blood-brain-barrier-dysfunction-in-vitro
#17
Takashi Machida, Shinya Dohgu, Fuyuko Takata, Junichi Matsumoto, Ikuya Kimura, Mariko Koga, Keiko Nakamoto, Atsushi Yamauchi, Yasufumi Kataoka
Thrombin, an essential component in the coagulation cascade, participates in the pathogenesis of brain diseases, such as ischemic stroke, intracerebral hemorrhage, Alzheimer's disease and Parkinson's disease through blood-brain barrier (BBB) dysfunction. It is thought that the thrombin-matrix metalloproteinase (MMP)-9 axis is an important process in the pathogenesis of neurovascular disease, such as BBB dysfunction. We recently reported that brain pericytes are the most MMP-9-releasing cells in response to thrombin stimulation among the BBB-constituting cells...
March 24, 2017: Neuroscience
https://www.readbyqxmd.com/read/28333925/video-based-educational-intervention-associated-with-improved-stroke-literacy-self-efficacy-and-patient-satisfaction
#18
Mary Carter Denny, Farhaan Vahidy, Kim Y T Vu, Anjail Z Sharrief, Sean I Savitz
BACKGROUND AND PURPOSE: Interventions are needed to improve stroke literacy among recent stroke survivors. We developed an educational video for patients hospitalized with acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH). METHODS: A 5-minute stroke education video was shown to our AIS and ICH patients admitted from March to June 2015. Demographics and a 5-minute protocol Montreal Cognitive Assessment were also collected. Questions related to stroke knowledge, self-efficacy, and patient satisfaction were answered before, immediately after, and 30 days after the video...
2017: PloS One
https://www.readbyqxmd.com/read/28325378/-epidemiology-of-strokes-in-pediatry
#19
Yannick Béjot, Benoit Delpont, Christelle Blanc, Véronique Darmency, Frédéric Huet, Maurice Giroud
Incidence of perinatal arterial stroke (ischemic stroke, intracerebral hemorrhage and subarachnoid hemorrhage) occurring between 20 weeks of gestation and postnatal day 28 ranges between 20 and 65 cases per 100,000 living births. In children aged 29 days to 18 years old, the total incidence is 1.3 to 4.3 for 100,000 per year. In France, almost 450 children are hospitalized for a stroke each year, among them approximately half have an intracerebral hemorrhage.
March 2017: Soins. Pédiatrie, Puériculture
https://www.readbyqxmd.com/read/28324263/decannulation-and-functional-outcome-after-tracheostomy-in-patients-with-severe-stroke-decast-a-prospective-observational-study
#20
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
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