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https://www.readbyqxmd.com/read/28087807/field-validation-of-the-los-angeles-motor-scale-as-a-tool-for-paramedic-assessment-of-stroke-severity
#1
Joon-Tae Kim, Pil-Wook Chung, Sidney Starkman, Nerses Sanossian, Samuel J Stratton, Marc Eckstein, Frank D Pratt, Robin Conwit, David S Liebeskind, Latisha Sharma, Lucas Restrepo, May-Kim Tenser, Miguel Valdes-Sueiras, Jeffrey Gornbein, Scott Hamilton, Jeffrey L Saver
BACKGROUND AND PURPOSE: The Los Angeles Motor Scale (LAMS) is a 3-item, 0- to 10-point motor stroke-deficit scale developed for prehospital use. We assessed the convergent, divergent, and predictive validity of the LAMS when performed by paramedics in the field at multiple sites in a large and diverse geographic region. METHODS: We analyzed early assessment and outcome data prospectively gathered in the FAST-MAG trial (Field Administration of Stroke Therapy-Magnesium phase 3) among patients with acute cerebrovascular disease (cerebral ischemia and intracranial hemorrhage) within 2 hours of onset, transported by 315 ambulances to 60 receiving hospitals...
January 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28087346/patterns-of-retinal-hemorrhage-associated-with-pediatric-cerebral-sinovenous-thrombosis
#2
Gil Binenbaum, Julia E Reid, David L Rogers, Anne Jensen, Lori L Billinghurst, Brian J Forbes
BACKGROUND: Cerebral sinovenous thrombosis (CSVT) has been proposed as an alternative cause of retinal hemorrhage (RH) in children being evaluated for abusive head trauma. This study investigated the prevalence and characteristics of RH in children with CSVT. METHODS: The medical records of children >6 weeks of age with newly diagnosed CSVT and fundus examination by an ophthalmologist were examined retrospectively. Primary outcomes were presence and patterns of RH...
January 10, 2017: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/28081270/outcome-and-treatment-effects-in-stroke-associated-with-acute-cervical-ica-occlusion
#3
Michael Gliem, John-Ih Lee, Aurica Barckhan, Bernd Turowski, Hans-Peter Hartung, Sebastian Jander
BACKGROUND: Endovascular therapy (EVT) with stent retrievers in addition to i.v. thrombolysis (IVT) has proven effective in acute stroke patients with middle cerebral artery (MCA, M1 segment) and distal internal carotid artery (ICA) occlusion. Limited data exist concerning acute cervical ICA occlusion, either alone or in combination with intracranial ICA occlusion (tandem occlusion). Therefore we analyzed outcome and treatment effects in stroke associated with cervical ICA occlusion, with specific focus on the impact of intracranial ICA or M1 patency...
2017: PloS One
https://www.readbyqxmd.com/read/28081031/intracranial-hemorrhage-recurrence-on-vitamin-k-antagonist-severity-of-the-first-episode-and-hasbled-score-fail-to-identify-high-risk-patients-from-the-chirone-study
#4
Daniela Poli, Emilia Antonucci, Francesco Dentali, Sophie Testa, Gualtiero Palareti
The most feared complication of vitamin K antagonists (VKAs) treatment is intracranial hemorrhage (ICH). The previously published CHIRONE Study fails to identify risk factors associated with ICH recurrence after VKAs resumption. The aim of this secondary analysis of the study is to evaluate if patients who need surgery or with severe neurological sequelae after the first episode show a higher risk of ICH recurrence. The HASBLED score was used to stratify bleeding risk and to evaluate the distribution of recurrence in relation to each class of risk...
January 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28077416/platelet-secretion-is-crucial-to-prevent-bleeding-in-the-ischemic-brain-but-not-in-the-inflamed-skin-or-lung-in-mice
#5
Carsten Deppermann, Peter Kraft, Julia Volz, Michael K Schuhmann, Sarah Beck, Karen Wolf, David Stegner, Guido Stoll, Bernhard Nieswandt
Platelets maintain hemostasis after injury, but also during inflammation. Recent studies have shown that platelets prevent inflammatory bleeding through (hem)ITAM-dependent mechanisms irrespective of aggregation during skin and lung inflammation. While the exact mechanisms underlying this process remain unknown, it was speculated that mediators released from platelet granules might be involved. Maintaining cerebral hemostasis during stroke treatment is of high clinical relevance as hemorrhage may aggravate the disease state and increase mortality...
January 11, 2017: Blood
https://www.readbyqxmd.com/read/28076834/risk-factors-for-posttraumatic-epilepsy-a-systematic-review-and-meta-analysis
#6
REVIEW
Tao Xu, Xinyuan Yu, Shu Ou, Xi Liu, Jinxian Yuan, Hao Huang, Juan Yang, Liang He, Yangmei Chen
OBJECTIVE: A systematic review and meta-analysis was performed to identify risk factors for posttraumatic epilepsy (PTE). METHODS: Two electronic databases (Medline and Embase) were searched to identify studies with a cohort, case-control, or cross-sectional design reporting on epidemiologic evidence regarding risk factors for PTE. RESULTS: Men had a higher risk of developing PTE than women [relative ratio (RR), 1.32; 95% confidence interval (CI), 1...
January 8, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28072740/keyhole-approach-in-the-neuroendoscopic-treatment-for-hydrocephalus
#7
Qiang Cai, Xiangyang Zhang, Long Wang, Shulan Huang, Zhibiao Chen, Qianxue Chen
The aim of the study was to explore keyhole approach and dura suture in the neuroendoscopic treatment for hydrocephalus.Twelve cases of hydrocephalus patients who were treated with neuroendoscope by this approach were analyzed retrospectively from April 2015 to April 2016 in our department. The basic steps of this procedure was using drill and milling cutter to form a small bone flap instead of burr hole, and then making a cruciate incision on the dura. After endoscopic third ventriculostomy or endoscopic third ventriculostomy + ventriculocystostomy finished, dura was sutured and the bone flap was reset...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28072696/cerebroretinal-microangiopathy-with-calcifications-and-cysts-a-case-report
#8
Wenrui Xu, Jiuliang Zhao, Yicheng Zhu, Weihong Zhang
RATIONAL: Cerebroretinal microangiopathy with calcifications and cysts (CRMCC) is believed to be an autosomal recessive genetic disease, with disorders in multisystem organs. Its characteristic neurological disorders manifested on neuroimaging are a triad of leukoencephalopathy, intracranial calcifications, and parenchymal cysts. In this paper, we report a CRMCC patient with multisystem involvement, focusing on the neuroimaging features, to get a better understanding of the rare disease and improve our diagnostic ability...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28072691/the-effectiveness-and-safety-of-dual-antiplatelet-therapy-in-ischemic-cerebrovascular-disease-with-intracranial-and-extracranial-arteriostenosis-in-chinese-patients-a-randomized-and-controlled-trail
#9
Feng-Tong Zuo, Hui Liu, Hui-Jun Wu, Na Su, Jie-Qiong Liu, Ai-Qin Dong
BACKGROUND: There are limited data on the effect of dual antiplatelet treatment with clopidogrel plus aspirin in patients with ischemic cerebrovascular disease and intracranial and extracranial arteriostenosis. The aim of our study was to evaluate the efficacy and safety of aspirin plus clopidogrel in the treatment of ischemic cerebrovascular disease with intracranial and extracranial arteriostenosis. METHODS: Patients with clinically evident acute cerebral infarction or transient ischemic attack combined with intracranial and extracranial arteriostenosis (greater than 50%) who were unsuitable or reluctance to perform stent implantation were enrolled in this study...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28071818/safety-profile-of-the-direct-oral-anticoagulants-an-analysis-of-the-who-database-of-adverse-drug-reactions
#10
Luca Monaco, Chiara Biagi, Valentino Conti, Mauro Melis, Monia Donati, Mauro Venegoni, Alberto Vaccheri, Domenico Motola
AIM: Direct oral anticoagulants (DOACs) have shown non-inferiority to warfarin for stroke prevention in non-valvular atrial fibrillation (AF) and a more promising safety profile. Unanswered safety aspects remain to addressed and available evidence on the risk associated with these drugs are conflicting. In order to contribute to the debate on their safety profile, we conducted a comparative analysis of the reports of suspected adverse drug reactions (ADRs) associated with DOACs in VigiBase...
January 10, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28070645/middle-cerebral-artery-aneurysms-with-intracerebral-hematoma-the-impact-of-side-and-volume-on-final-outcome
#11
Ondrej Navratil, Kamil Duris, Vilem Juran, Eduard Neuman, Karel Svoboda, Martin Smrcka
BACKGROUND: Middle cerebral artery aneurysms (MCA aneurysms) belong to the most frequent type of intracranial aneurysms forming an intracerebral hematoma. The consequences of the hematoma-the laterality, the impact of ICH volume and size of the aneurysm with the final outcome of these patients had not been studied in detail in this location, and we focused on the analysis of these factors. METHODS: Patients with MCA aneurysms and associated intracerebral hematomas with a volume ≥10 ml were studied; these were treated from January 2006 to December 2015...
January 9, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28065616/experience-on-mechanical-thrombectomy-for-acute-stroke-treatment-in-a-brazilian-university-hospital
#12
Guilherme S Nakiri, Luis H Castro-Afonso, Lucas M Monsignore, Francisco A Dias, Frederico F Alessio-Alves, Soraia Ramos C Fabio, Millene R Camilo, Pedro T Cougo-Pinto, Octavio M Pontes-Neto, João Pereira Leite, Daniel G Abud
BACKGROUND: Brazil is a developing country struggling to reduce its extreme social inequality, which is reflected on shortage of health-care infrastructure, mainly to the low-income class, which depends exclusively on the public health system. In Brazil, less than 1% of stroke patients have access to intravenous thrombolysis in a stroke unit, and constraints to the development of mechanical thrombectomy in the public health system increase the social burden of stroke. OBJECTIVE: Report the feasibility of mechanical thrombectomy as part of routine stroke care in a Brazilian public university hospital...
January 5, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28064294/primary-versus-secondary-immune-thrombocytopenia-in-adults-a-comparative-analysis-of-clinical-and-laboratory-attributes-in-newly-diagnosed-patients-in-southern-pakistan
#13
S Sultan, S J Ahmed, S Murad, S M Irfan
BACKGROUND: Immune thrombocytopenic purpura (ITP) is a hemorrhagic diathesis, characterized by platelets destruction alongside impaired production. Patients from Asian regions often exhibit distinctive characteristics in comparison to the western patients. We accomplished this study to evaluate the prevalence of primary versus secondary ITP along with the comparative analysis between them. The secondary objective was to determine the etiological spectrum of secondary ITP. METHODS: We illustrate the results of a large cohort of newly diagnosed adults ITP from southern Pakistan...
October 2016: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28062861/incidence-locations-and-longitudinal-course-of-cerebral-microbleeds-in-european-moyamoya
#14
Holger Wenz, Ralf Wenz, Máté Maros, Gregory Ehrlich, Mansour Al-Zghloul, Christoph Groden, Alex Förster
BACKGROUND AND PURPOSE: Cerebral microbleeds (cMBs) have previously been linked with especially high incidence in Asian patients with moyamoya together with high tendency to bleed. This, presumably, is characteristic of patients with moyamoya. Herein, we, therefore, investigate retrospectively the frequency, location, and longitudinal course of cMBs in a large German cohort. METHODS: We included all patients with moyamoya who underwent standard magnetic resonance imaging, including T2*-weighted images, in our department between 1998 and 2015...
January 6, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28059705/emergent-endovascular-management-of-long-segment-and-flow-limiting-carotid-artery-dissections-in-acute-ischemic-stroke-intervention-with-multiple-tandem-stents
#15
S A Ansari, A L Kühn, A R Honarmand, M Khan, M C Hurley, M B Potts, B S Jahromi, A Shaibani, M J Gounis, A K Wakhloo, A S Puri
BACKGROUND AND PURPOSE: Although most cervical dissections are managed medically, emergent endovascular treatment may become necessary in the presence of intracranial large-vessel occlusions, flow-limiting and long-segment dissections with impending occlusion, and/or hypoperfusion-related ischemia at risk of infarction. We investigated the role of emergent endovascular stenting of long-segment carotid dissections in the acute ischemic stroke setting. MATERIALS AND METHODS: We retrospectively studied long-segment carotid dissections requiring stent reconstruction with multiple tandem stents (≥3 stents) and presenting with acute (<12 hours) ischemic stroke symptoms (NIHSS score, ≥4)...
November 10, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28059661/intravenous-infusion-of-mesenchymal-stem-cells-inhibits-intracranial-hemorrhage-after-recombinant-tissue-plasminogen-activator-therapy-for-transient-middle-cerebral-artery-occlusion-in-rats
#16
Masahito Nakazaki, Masanori Sasaki, Yuko Kataoka-Sasaki, Shinichi Oka, Takahiro Namioka, Ai Namioka, Rie Onodera, Junpei Suzuki, Yuichi Sasaki, Hiroshi Nagahama, Takeshi Mikami, Masahiko Wanibuchi, Jeffery D Kocsis, Osamu Honmou
OBJECTIVE Reperfusion therapy with intravenous recombinant tissue plasminogen activator (rtPA) is the standard of care for acute ischemic stroke. However, hemorrhagic complications can result. Intravenous infusion of mesenchymal stem cells (MSCs) reduces stroke volume and improves behavioral function in experimental stroke models. One suggested therapeutic mechanism is inhibition of vascular endothelial dysfunction. The objective of this study was to determine whether MSCs suppress hemorrhagic events after rtPA therapy in the acute phase of transient middle cerebral artery occlusion (tMCAO) in rats...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28059660/effects-of-decompressive-craniectomy-on-functional-outcomes-and-death-in-poor-grade-aneurysmal-subarachnoid-hemorrhage-a-systematic-review-and-meta-analysis
#17
Naif M Alotaibi, Ghassan Awad Elkarim, Nardin Samuel, Oliver G S Ayling, Daipayan Guha, Aria Fallah, Abdulrahman Aldakkan, Blessing N R Jaja, Airton Leonardo de Oliveira Manoel, George M Ibrahim, R Loch Macdonald
OBJECTIVE Patients with poor-grade aneurysmal subarachnoid hemorrhage (aSAH) (World Federation of Neurosurgical Societies Grade IV or V) are often considered for decompressive craniectomy (DC) as a rescue therapy for refractory intracranial hypertension. The authors performed a systematic review and meta-analysis to assess the impact of DC on functional outcome and death in patients after poor-grade aSAH. METHODS A systematic review and meta-analysis were performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28059659/antiplatelet-therapy-for-the-prevention-of-peri-coiling-thromboembolism-in-high-risk-patients-with-ruptured-intracranial-aneurysms
#18
Nancy J Edwards, Wesley H Jones, Aditya Sanzgiri, Juan Corona, Mark Dannenbaum, Peng Roc Chen
OBJECTIVE The most frequent procedural complication of the endovascular treatment of intracranial aneurysms is a thromboembolic event (TEE); in a subset of patients, such events will cause permanent neurological disability. In patients with unruptured aneurysms, increasing evidence supports the use of periprocedural antiplatelet therapy to prevent TEEs. The object of this study was to evaluate whether patients with ruptured aneurysms and subarachnoid hemorrhage would also benefit from periprocedural antiplatelet therapy...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28059649/quantitative-analysis-of-the-effect-of-institutional-case-volume-on-complications-after-surgical-clipping-of-unruptured-aneurysms
#19
Lorenzo Rinaldo, Brandon A McCutcheon, Meghan E Murphy, Daniel L Shepherd, Patrick R Maloney, Panagiotis Kerezoudis, Mohamad Bydon, Giuseppe Lanzino
OBJECTIVE The mechanism by which greater institutional case volume translates into improved outcomes after surgical clipping of unruptured intracranial aneurysms (UIAs) is not well established. The authors thus aimed to assess the effect of case volume on the rate of various types of complications after clipping of UIAs. METHODS Using information on the outcomes of inpatient admissions for surgical clipping of UIAs collected within a national database, the relationship of institutional case volume to the incidence of different types of complications after clipping was investigated...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28059632/pseudoaneurysm-formation-due-to-rupture-of-intracranial-aneurysms-case-series-and-literature-review
#20
Motohiro Nomura, Kentaro Mori, Akira Tamase, Tomoya Kamide, Syunsuke Seki, Yu Iida, Tatsu Nakano, Yuichi Kawabata, Taro Kitabatake, Teruyuki Nakajima, Kiyoyuki Yasutake, Kei Egami, Tatsunori Takahashi, Mitsuyuki Takahashi, Kunio Yanagimoto
Background Intracranial pseudoaneurysm formation due to a ruptured non-traumatic aneurysm is extremely rare. We describe the radiological findings and management of pseudoaneurysms due to ruptured cerebral aneurysms in our case series and previously reported cases. Patients and methods Four additional and 20 reported patients presenting with subarachnoid hemorrhage (SAH) are included. Radiological findings and clinical features of these patients were reviewed. Results In our series, three-dimensional computed tomographic angiography (3D-CTA) and/or angiography showed an irregular- or snowman-shaped cavity extending from the parent artery...
January 1, 2017: Neuroradiology Journal
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