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Stroke , ischemic stroke , intracerebral

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https://www.readbyqxmd.com/read/28527588/mechanical-thrombectomy-for-acute-ischemic-stroke-in-a-patient-with-concomitant-spontaneous-intracerebral-hemorrhage
#1
Stefano Forlivesi, Paolo Bovi, Manuel Cappellari
Data from randomized clinical trials and current guidelines suggest that patients with anterior circulation occlusion with contraindications to intravenous thrombolysis may benefit from direct mechanical thrombectomy. Nevertheless, no data are available on the efficacy and safety of direct mechanical thrombectomy in patients with concomitant spontaneous intracerebral hemorrhage. We report the case of a 51-year-old woman with a spontaneous intracerebral hemorrhage in the right parietal and occipital lobes, who experienced, 7 days later, an occlusion of the proximal left middle cerebral artery...
May 17, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28522231/large-amount-of-cannabis-ingestion-resulting-in-spontaneous-intracerebral-hemorrhage-a-case-report
#2
Kunakorn Atchaneeyasakul, Luis F Torres, Amer M Malik
Although multiple cases of cannabis-associated ischemic stroke have been reported, there are only 2 reported cases of hemorrhagic stroke with an associated cerebral vasoconstriction. To our knowledge, we present the first case of basal ganglia hemorrhage after a large-volume oral ingestion of cannabis without other identified risk factors. In our case, cerebral digital subtraction angiography within 24 hours of presentation did not reveal vasoconstriction leading to a possible alternative explanation for hemorrhagic stroke, including cannabis-induced transient arterial hypertension and autoregulation disruption...
May 15, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28515266/total-small-vessel-disease-score-and-risk-of-recurrent-stroke-validation-in-2-large-cohorts
#3
Kui Kai Lau, Linxin Li, Ursula Schulz, Michela Simoni, Koon Ho Chan, Shu Leong Ho, Raymond Tak Fai Cheung, Wilhelm Küker, Henry Ka Fung Mak, Peter M Rothwell
OBJECTIVE: In patients with TIA and ischemic stroke, we validated the total small vessel disease (SVD) score by determining its prognostic value for recurrent stroke. METHODS: Two independent prospective studies were conducted, one comprising predominantly Caucasian patients with TIA/ischemic stroke (Oxford Vascular Study [OXVASC]) and one predominantly Chinese patients with ischemic stroke (University of Hong Kong [HKU]). Cerebral MRI was performed and assessed for lacunes, microbleeds, white matter hyperintensities (WMH), and perivascular spaces (PVS)...
May 17, 2017: Neurology
https://www.readbyqxmd.com/read/28507269/randomized-multicenter-trial-of-artss-2-argatroban-with-recombinant-tissue-plasminogen-activator-for-acute-stroke
#4
Andrew D Barreto, Gary A Ford, Loren Shen, Claudia Pedroza, Jon Tyson, Chunyan Cai, Mohammad H Rahbar, James C Grotta
BACKGROUND AND PURPOSE: We conducted a randomized exploratory study to assess safety and the probability of a favorable outcome with adjunctive argatroban, a direct thrombin-inhibitor, administered to recombinant tissue-type plasminogen activator (r-tPA)-treated ischemic stroke patients. METHODS: Patients treated with standard-dose r-tPA, not receiving endovascular therapy, were randomized to receive no argatroban or argatroban (100 μg/kg bolus) followed by infusion of either 1 (low dose) or 3 μg/kg per minute (high dose) for 48 hours...
May 15, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28501873/comparisons-of-risk-factors-for-intracerebral-hemorrhage-versus-ischemic-stroke-in-chinese-patients
#5
Chung-Fen Tsai, Jiann-Shing Jeng, Niall Anderson, Cathie L M Sudlow
BACKGROUND: Chinese populations have a higher stroke incidence, a higher proportion of intracerebral hemorrhage (ICH), and a lower proportion of ischemic stroke (IS) as compared with white populations. The reasons are not fully understood. METHODS: To evaluate the differences of major risk factors between ICH and IS in Chinese stroke patients, we analysed acute ICH and IS patients consecutively recruited in National Taiwan University Hospital Stroke Registry from 2006 to 2011...
May 13, 2017: Neuroepidemiology
https://www.readbyqxmd.com/read/28497642/estimating-lifetime-medical-costs-from-censored-claims-data
#6
Jing-Shiang Hwang, Tsuey-Hwa Hu, Lukas Jyuhn-Hsiarn Lee, Jung-Der Wang
Claims databases consisting of routinely collected longitudinal records of medical expenditures are increasingly utilized for estimating expected medical costs of patients with a specific condition. Survival data of the patients of interest are usually highly censored, and observed expenditures are incomplete. In this study, we propose a survival-adjusted estimator for estimating mean lifetime costs, which integrates the product of the survival function and the mean cost function over the lifetime horizon. The survival function is estimated by a new algorithm of rolling extrapolation, aided by external information of age- and sex-matched referents simulated from national vital statistics...
May 12, 2017: Health Economics
https://www.readbyqxmd.com/read/28495831/clinical-correlates-ethnic-differences-and-prognostic-implications-of-perivascular-spaces-in-transient-ischemic-attack-and-ischemic-stroke
#7
Kui-Kai Lau, Linxin Li, Caroline E Lovelock, Giovanna Zamboni, Tsz-Tai Chan, Man-Fung Chiang, Kin-Ting Lo, Wilhelm Küker, Henry Ka-Fung Mak, Peter M Rothwell
BACKGROUND AND PURPOSE: Perivascular spaces (PVSs) are considered markers of small vessel disease. However, their long-term prognostic implications in transient ischemic attack/ischemic stroke patients are unknown. Ethnic differences in PVS prevalence are also unknown. METHODS: Two independent prospective studies were conducted, 1 comprising predominantly whites with transient ischemic attack/ischemic stroke (OXVASC [Oxford Vascular] study) and 1 comprising predominantly Chinese with ischemic stroke (University of Hong Kong)...
May 11, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28494694/antagonizing-dabigatran-by-idarucizumab-in-cases-of-ischemic-stroke-or-intracranial-hemorrhage-in-germany-a-national-case-collection
#8
Pawel Kermer, Christoph C Eschenfelder, Hans-Christoph Diener, Martin Grond, Yasser Abdalla, Katharina Althaus, Jörg Berrouschot, Hakan Cangür, Michael Daffertshofer, Sebastian Edelbusch, Klaus Gröschel, Claus G Haase, Andreas Harloff, Valentin Held, Andreas Kauert, Peter Kraft, Arne Lenz, Wolfgang Müllges, Mark Obermann, Someieh Partowi, Jan Purrucker, Peter A Ringleb, Joachim Röther, Raluca Rossi, Niklas Schäfer, Andreas Schneider, Ramona Schuppner, Rüdiger J Seitz, Kristina Szabo, Robert Wruck
Background Idarucizumab is a monoclonal antibody fragment with high affinity for dabigatran that reverses its anticoagulant effects within minutes. It may exhibit the potential for patients under dabigatran therapy suffering ischemic stroke to regain eligibility for thrombolysis with rt-PA and may inhibit lesion growth in patients with intracerebral hemorrhage on dabigatran. Aims To provide insights into the clinical use of idarucizumab in patients under effective dabigatran anticoagulation presenting with signs of ischemic stroke or intracranial hemorrhage...
June 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28487959/identification-of-six-polymorphisms-as-novel-susceptibility-loci-for-ischemic-or-hemorrhagic-stroke-by-exome-wide-association-studies
#9
Yoshiji Yamada, Jun Sakuma, Ichiro Takeuchi, Yoshiki Yasukochi, Kimihiko Kato, Mitsutoshi Oguri, Tetsuo Fujimaki, Hideki Horibe, Masaaki Muramatsu, Motoji Sawabe, Yoshinori Fujiwara, Yu Taniguchi, Shuichi Obuchi, Hisashi Kawai, Shoji Shinkai, Seijiro Mori, Tomio Arai, Masashi Tanaka
In this study, we performed exome-wide association studies (EWASs) to identify genetic variants that confer susceptibility to ischemic stroke, intracerebral hemorrhage (ICH), or subarachnoid hemorrhage (SAH). EWAS for ischemic stroke was performed using 1,575 patients with this condition and 9,210 controls, and EWASs for ICH and SAH were performed using 673 patients with ICH, 265 patients with SAH and 9,158 controls. Analyses were performed with Illumina HumanExome-12 DNA Analysis BeadChip or Infinium Exome-24 BeadChip arrays...
June 2017: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/28487340/dietary-protein-intake-and-stroke-risk-in-a-general-japanese-population-the-hisayama-study
#10
Mio Ozawa, Daigo Yoshida, Jun Hata, Tomoyuki Ohara, Naoko Mukai, Mao Shibata, Kazuhiro Uchida, Masashi Nagata, Takanari Kitazono, Yutaka Kiyohara, Toshiharu Ninomiya
BACKGROUND AND PURPOSE: The influence of dietary protein intake on stroke risk is an area of interest. We investigated the association between dietary protein intake and stroke risk in Japanese, considering sources of protein. METHODS: A total of 2400 subjects aged 40 to 79 years were followed up for 19 years. Dietary protein intake was estimated using a 70-item semiquantitative food frequency questionnaire. The risk estimates for incident stroke and its subtypes were calculated using a Cox proportional hazards model...
May 9, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28485276/left-atrial-appendage-occlusion-versus-standard-medical-care-in-patients-with-atrial-fibrillation-and-intracerebral-hemorrhage-a-propensity-score-matched-follow-up-study
#11
Jens Erik Nielsen-Kudsk, Søren Paaske Johnsen, Per Wester, Dorte Damgaard, Juhani Airaksinen, Juha Lund, Ole De Backer, Sami Pakarinen, Jacob Odenstedt, Saila Vikman, Magnus Settergren, Ole Kongstad, Mårten Rosenqvist, Derk W Krieger
AIMS: The aim of this study was to investigate the prognosis in patients with atrial fibrillation (AF) and intracerebral hemorrhage (ICH) having a left atrial appendage occlusion (LAAO) versus patients receiving standard medical therapy. METHODS AND RESULTS: A total of 151 patients from the Nordic countries with AF and previous ICH who underwent LAAO using the Amplatzer Cardiac Plug or the Amplatzer Amulet were compared to a propensity score matched group of 151 patients receiving standard medical therapy...
May 9, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28483775/age-specific-vascular-risk-factor-profiles-according-to-stroke-subtype
#12
Allard J Hauer, Ynte M Ruigrok, Ale Algra, Ewoud J van Dijk, Peter J Koudstaal, Gert-Jan Luijckx, Paul J Nederkoorn, Robert J van Oostenbrugge, Marieke C Visser, Marieke J Wermer, L Jaap Kappelle, Catharina J M Klijn
BACKGROUND: Ischemic and hemorrhagic stroke are increasingly recognized as heterogeneous diseases with distinct subtypes and etiologies. Information on variation in distribution of vascular risk factors according to age in stroke subtypes is limited. We investigated the prevalence of vascular risk factors in stroke subtypes in relation to age. METHODS AND RESULTS: We studied a prospective multicenter university hospital-based cohort of 4033 patients. For patients with ischemic stroke caused by large artery atherosclerosis, small vessel disease, or cardioembolism and for patients with spontaneous intracerebral hemorrhage or aneurysmal subarachnoid hemorrhage, we calculated prevalences of vascular risk factors in 4 age groups: <55, 55 to 65, 65 to 75, and ≥75 years, and mean differences with 95% CIs in relation to the reference age group...
May 8, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28479465/safety-of-early-carotid-endarterectomy-after-intravenous-thrombolysis-in-acute-ischemic-stroke
#13
Igor Gunka, Dagmar Krajickova, Michal Lesko, Ondrej Renc, Jan Raupach, Stanislav Jiska, Miroslav Lojik, Vendelin Chovanec, Radovan Maly
BACKGROUND: The timing of carotid endarterectomy (CEA) after intravenous thrombolysis (IVT) is still a controversial issue. The aim of this study was to assess the safety of early carotid interventions in patients treated with thrombolysis for acute ischemic stroke. MATERIAL AND METHODS: A retrospective analysis was performed using prospectively collected data from consecutive patients who underwent CEA for symptomatic internal carotid artery stenosis within 14 days after the index neurological event during the period from January 2013 to July 2016...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28473340/impact-of-anesthesia-on-the-outcome-of-acute-ischemic-stroke-after-endovascular-treatment-with-the-solitaire-stent-retriever
#14
A Slezak, R Kurmann, L Oppliger, A Broeg-Morvay, J Gralla, G Schroth, H P Mattle, M Arnold, U Fischer, S Jung, R Greif, F Neff, P Mordasini, M-L Mono
BACKGROUND AND PURPOSE: General anesthesia during endovascular treatment of acute ischemic stroke may have an adverse effect on outcome compared with conscious sedation. The aim of this study was to examine the impact of the type of anesthesia on the outcome of patients with acute ischemic stroke treated with the Solitaire stent retriever, accounting for confounding factors. MATERIALS AND METHODS: Four-hundred one patients with consecutive acute anterior circulation stroke treated with a Solitaire stent retriever were included in this prospective analysis...
May 4, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28473091/acr-appropriateness-criteria-%C3%A2-cerebrovascular%C3%A2-disease
#15
Michael B Salmela, Shabnam Mortazavi, Bharathi D Jagadeesan, Daniel F Broderick, Judah Burns, Tejaswini K Deshmukh, H Benjamin Harvey, Jenny Hoang, Christopher H Hunt, Tabassum A Kennedy, Alexander A Khalessi, William Mack, Nandini D Patel, Joel S Perlmutter, Bruno Policeni, Jason W Schroeder, Gavin Setzen, Matthew T Whitehead, Rebecca S Cornelius, Amanda S Corey
Diseases of the cerebral vasculature represent a heterogeneous group of ischemic and hemorrhagic etiologies, which often manifest clinically as an acute neurologic deficit also known as stroke or less commonly with symptoms such as headache or seizures. Stroke is the fourth leading cause of death and is a leading cause of serious long-term disability in the United States. Eighty-seven percent of strokes are ischemic, 10% are due to intracerebral hemorrhage, and 3% are secondary to subarachnoid hemorrhage. The past two decades have seen significant developments in the screening, diagnosis, and treatment of ischemic and hemorrhagic causes of stroke with advancements in CT and MRI technology and novel treatment devices and techniques...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28471961/efficacy-and-safety-of-desmoteplase-in-acute-ischemic-stroke-patients-a-systematic-review-and-meta-analysis
#16
Xiaoqiang Li, Li Ling, Chuqiao Li, Qiujie Ma
BACKGROUND: Pending results from double-blind, multicenter, parallel-group, randomized trials, the benefit and safety of the novel plasminogen activator, desmoteplase remain undetermined. The aim of this meta-analysis was to help evaluate desmoteplase's efficacy and safety. METHODS: A thorough search was performed of the Cochrane Library, PubMed, and Embase from the inception of electronic data to March 2017, and double-blind, multicenter, parallel-group, randomized trials were chosen...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28471607/patient-outcomes-with-stent-retriever-thrombectomy-for-anterior-circulation-stroke-a-meta-analysis-and-review-of-the-literature
#17
Rotem Sivan-Hoffmann, Benjamin Gory, Muriel Rabilloud, Dorin N Gherasim, Xavier Armoiry, Roberto Riva, Paul-Emile Labeyrie, Udi Gonike-Sadeh, Islam Eldesouky, Francis Turjman
Mechanical thrombectomy with stent retrievers is now the reference therapy for acute ischemic stroke (AIS) in the anterior circulation in association with thrombolysis. We conducted an extensive systematic review and meta-analysis to evaluate the clinical and angiographic outcomes of stent-retriever thrombectomy in patients with acute anterior circulation stroke. Available literature published to date on observational studies and three randomized trials (MR CLEAN, ESCAPE, and EXTEND-IA) involving the stent-retriever device were reviewed...
September 2016: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28465405/the-golden-35%C3%A2-min-of-stroke-intervention-with-adapt-effect-of-thrombectomy-procedural-time-in-acute-ischemic-stroke-on-outcome
#18
Ali Alawieh, Alyssa K Pierce, Jan Vargas, Aquilla S Turk, Raymond D Turner, M Imran Chaudry, Alejandro M Spiotta
INTRODUCTION: In acute ischemic stroke (AIS), extending mechanical thrombectomy procedural times beyond 60 min has previously been associated with an increased complication rate and poorer outcomes. OBJECTIVE: After improvements in thrombectomy methods, to reassess whether this relationship holds true with a more contemporary thrombectomy approach: a direct aspiration first pass technique (ADAPT). METHODS: We retrospectively studied a database of patients with AIS who underwent ADAPT thrombectomy for large vessel occlusions...
May 2, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28447929/five-year-follow-up-on-transplanted-organs-from-donors-after-brain-death-after-acute-stroke
#19
Vera Spatenkova, Eva Pokorna, Petr Suchomel
OBJECTIVES: Efficient intensive care donor management can help alleviate the shortage of organs for transplant. The aim of this study was to investigate the efficiency of management of donors after brain death from our neurointensive care unit. MATERIALS AND METHODS: We conducted a prospective observational 5-year follow-up on 29 transplanted organs from 14 brain-dead donors after acute stroke (7 subarachnoid and 4 intracerebral hemorrhages, 3 ischemic strokes)...
April 27, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28446625/use-of-noncontrast-computed-tomography-and-computed-tomographic-perfusion-in-predicting-intracerebral-hemorrhage-after-intravenous-alteplase-therapy
#20
Connor Batchelor, Pooneh Pordeli, Christopher D d'Esterre, Mohamed Najm, Fahad S Al-Ajlan, Mari E Boesen, Connor McDougall, Lisa Hur, Enrico Fainardi, Jai Jai Shiva Shankar, Marta Rubiera, Alexander V Khaw, Michael D Hill, Andrew M Demchuk, Tolulope T Sajobi, Mayank Goyal, Ting-Yim Lee, Richard I Aviv, Bijoy K Menon
BACKGROUND AND PURPOSE: Intracerebral hemorrhage is a feared complication of intravenous alteplase therapy in patients with acute ischemic stroke. We explore the use of multimodal computed tomography in predicting this complication. METHODS: All patients were administered intravenous alteplase with/without intra-arterial therapy. An age- and sex-matched case-control design with classic and conditional logistic regression techniques was chosen for analyses. Outcome was parenchymal hemorrhage on 24- to 48-hour imaging...
April 26, 2017: Stroke; a Journal of Cerebral Circulation
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