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posterior circulation stroke

Victoria A Chang, Dawn M Meyer, Brett C Meyer
BACKGROUND: Acute stroke codes may be activated for anisocoria, but how often these codes lead to a final stroke diagnosis or alteplase treatment is unknown. The purpose of this study was to assess the frequency of anisocoria in stroke codes that ultimately resulted in alteplase administration. METHODS: We retrospectively assessed consecutive alteplase-treated patients from a prospectively-collected stroke registry between February 2015 and July 2018. Based on the stroke code exam, patients were categorized as having isolated anisocoria [A+(only)], anisocoria with other findings [A+(other)], or no anisocoria [A-]...
October 13, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Jing-Ye Wang, Gao-Jia Zhang, Sheng-Xia Zhuo, Kai Wang, Xiao-Peng Hu, Hui Zhang, Lin-di Qu
BACKGROUND: The patterns and mechanisms underlying stroke in cancer patients differ from those of the conventional etiology. In this study, we further investigated the characteristics distinguishing cancer-associated ischemic stroke (CAIS) and the relationship of D-dimer value with CAIS. METHODS: Sixty-one acute ischemic stroke patients with cancer (cancer group) and 76 stroke patients without cancer (control group) were recruited. Cerebrovascular distribution was divided into 3 circulations and 23 vascular territories, and acute multiple brain infarcts (AMBIs) were defined as discrete MRI diffusion-weighted imaging (DWI) lesions in >1 vascular territory...
November 2018: Neurological Research
Dan He, Qian Li, Guangjin Xu, Zheng Hu, Xuefei Li, Yinping Guo, Shabei Xu, Wei Wang, Xiang Luo
INTRODUCTION: Right-to-left shunt (RLS) induced by a patent foramen ovale (PFO) is associated with an increased risk of cryptogenic stroke (CS). However, little is known about the relationship between the amount of RLS and the stroke pattern. In this study, we aimed to evaluate the distinct clinical features of PFO-related CS in different RLS degrees resulting from PFO. METHODS: This is a cohort study of 222 CS patients admitted to the Tongji Hospital from 1st May 2014 to 31st April 2017...
October 11, 2018: Brain and Behavior
David Fiorella, Alan Boulos, Aquilla S Turk, Adnan H Siddiqui, Adam S Arthur, Orlando Diaz, Demetrius K Lopes
INTRODUCTION: The LVIS stent system (LVIS and LVIS Junior) is a self-expanding, retrievable, microstent system indicated for the treatment of wide-necked cerebral aneurysms (WNAs). The present pivotal study was performed to evaluate the safety and effectiveness of this device. METHODS: The US LVIS pivotal trial was a prospective, multicenter, single-arm, interventional study conducted at 21 US centers. The study enrolled 153 adults with WNAs of the anterior and posterior circulations...
October 8, 2018: Journal of Neurointerventional Surgery
Karen Chen, Elisabeth B Marsh
OBJECTIVE: Post-stroke fatigue (PSF) is a debilitating complication of stroke recovery. Contributing risk factors, whether they are modifiable, and if they change over time remain understudied. We determine factors associated with PSF and how they evolve from the subacute through chronic phases of recovery. PATIENTS AND METHODS: A consecutive series of patients presenting to our comprehensive stroke center with acute stroke were seen in follow-up within 6 months of infarct and administered the Functional Assessment of Chronic Illness Therapy (FACIT) fatigue scale to evaluate for PSF...
September 17, 2018: Clinical Neurology and Neurosurgery
Rajeswari Aghoram, Sunil K Narayan
Context: Intracranial atherosclerosis is a common cause of stroke in India. Transcranial Doppler (TCD) provides a noninvasive way to study basal intracranial blood vessels. The Oxfordshire Community Stroke Project (OCSP) classification is a simple clinical stroke classification system that has prognostic significance and has been associated with size and location of the infarct. Aim: This study was undertaken to identify patterns of TCD abnormalities in our stroke population particularly in relation to the OCSP classification...
July 2018: Annals of Indian Academy of Neurology
Ramiro Castro-Apolo, Josephine F Huang, Myrian Vinan-Vega, William O Tatum
PURPOSE: To evaluate clinical, radiographic, and electrophysiological features in the development and prognosis of ischemic post-stroke seizures (PSS). METHOD: A retrospective study of 1119 patient records was performed between January 2006 and December 2016. After selection, 42 patients with seizures due to ischemic stroke were matched to a control group of 60 patients where seizures were absent. Stroke size and severity were analyzed using ASPECTS and NIHSS, respectively...
September 14, 2018: Seizure: the Journal of the British Epilepsy Association
Sang Hun Lee, Keun-Sik Hong, Ji Sung Lee, Yong-Jae Kim, Tae-Jin Song, Young Dae Kim, Man-Seok Park, Eung-Gyu Kim, Jae-Kwan Cha, Sang Min Sung, Byung-Woo Yoon, Oh Young Bang, Woo-Keun Seo, Yang-Ha Hwang, Seong Hwan Ahn, Dong-Wha Kang, Hyun Goo Kang, Kyung-Ho Yu, Sun U Kwon
OBJECTIVES: To investigate the predictors of hemorrhagic transformation (HT) in patients with mild atrial fibrillation-related stroke who were treated with early anticoagulation. We conducted a post-hoc subgroup analysis from Acute Cerebral Infarction Patients with Non-valvular Atrial Fibrillation (Triple AXEL) study. PATIENTS AND METHODS: The Triple AXEL study was a randomized, multicenter, open-label, blinded end-point evaluation, comparative phase 2 trial. To identify the relationship between the type of HT and risk factors...
September 9, 2018: Clinical Neurology and Neurosurgery
Benedetta Piccolo, Marina Barsacchi, Francesca Greco, Davide Cerasti, Francesca Ormitti, Francesco Pisani
Transient Cerebral Arteriopathy (TCA) is one of the main causes of childhood stroke. Here we present an unusual case of Arterial Ischemic Stroke (AIS) caused by a TCA of posterior flow and originally located in the right thalamus. The detection of enterovirus in the cerebrospinal fluid allowed us to suppose a probable post infectious etiology. The course of symptoms was self-limited and the child had a complete clinical recovery after five days. A new ischemic lesion on the antero-inferior paravermian region of the left cerebellum was revealed by a following brain Magnetic Resonance Imaging (MRI) three months later and these findings were reported by further brain MRI control performed after 15 months...
September 14, 2018: Brain & Development
Zeqin Xu, Yongquan Gu, Jianxin Li, Chunmei Wang, Rong Wang, Ying Huang, Jian Zhang
OBJECTIVE: Stroke is the most common neurological disease that is associated with deglutition disorders. The aim of this study was to analyze dysphagia and aspiration pneumonia risk factors in post-stroke elderly inpatients. METHOD: We consecutively enrolled 212 stroke patients over sixty years of age from July 2014 to June 2015. Seventeen patients were eliminated. Stroke patients' demographics, clinical symptoms and biochemistry data were collected. Modified water swallowing test was used for the assessment of deglutition difficulty...
September 6, 2018: Journal of Back and Musculoskeletal Rehabilitation
Ralph Weber, Jens Minnerup, Hannes Nordmeyer, Jens Eyding, Christos Krogias, Jeffrie Hadisurya, Klaus Berger
BACKGROUND: In contrast to anterior circulation stroke (ACS), there is no evidence from randomized trials that mechanical thrombectomy (MT) with modern stent retrievers or thromboaspiration is safe and effective in posterior circulation stroke (PCS). METHODS: The present analysis was based on the prospective multicenter Registry on Revascularization in Ischemic Stroke Patients (REVASK) in Germany. We compared demographic data, periprocedural times and complications, recanalization rates, and functional outcome at discharge and after 3 months between 139 consecutive patients with PCS (84...
September 15, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Kavitha Kothur, Christopher Troedson, Richard Webster, Sushil Bandodkar, Stephanie Chu, Louise Wienholt, Alun Pope, Mark T Mackay, Russell C Dale
Aim To determine the role of inflammation in pediatric transient focal cerebral arteriopathy using cerebrospinal fluid cytokine/chemokines as biomarkers. Methods We measured 32 cytokine/chemokines in acute cerebrospinal fluid collected from children with stroke due to focal cerebral arteriopathy (n = 5) using multiplex immunoassay and compared with two patients with arterial ischemic stroke due to other causes (non-focal cerebral arteriopathy group, vertebral dissection, n = 1; cryptogenic, n = 1), pediatric encephalitis (n = 43), and non-inflammatory neurological disease controls (n = 20)...
September 13, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Sung-Ho Ahn, Bum-Joon Kim, Yeon-Jung Kim, Dong-Wha Kang, Sun U Kwon, Jong S Kim
BACKGROUND: Clinical syndromes secondary to infarcts in the distal basilar artery (BA) area have been described as "top of the basilar" (TOB) syndrome. However, in the era of advanced imaging technology, it has been realized that the clinical and imaging features are quite diverse in patients with distal BA occlusion. The aim of the present study was to investigate the patterns and clinical outcomes of TOB assessed with modern images and categorize TOBs accordingly. Additionally, we examined the possible influence of the posterior communicating artery (PcoA) on the patterns of TOB...
September 10, 2018: Cerebrovascular Diseases
Kwon-Duk Seo, Sang Hyun Suh
PURPOSE: As endovascular therapy (EVT) has been approved as a treatment guideline for acute ischemic stroke (AIS), it has been increasing in Korea. We conducted a nationwide survey to evaluate the current status of EVT for patients with AIS in Korea. MATERIALS AND METHODS: An electronic survey was sent to a representative clinician at each hospital where EVT was available in Korea. A Google survey was used to distribute the questionnaires and receive responses from October 2017 to December 2017...
September 2018: Neurointervention
Jonathan D Santoro, Sarah Lee, Michael Mlynash, Thuy Nguyen, Daniel V Lazzareschi, Lironn D Kraler, Elizabeth W Mayne, Gary K Steinberg
OBJECTIVES: Individuals with Down syndrome (DS) are at risk for the development of moyamoya syndrome (MMS); MMS is often recognized only after a resulting stroke has occurred. Our goal with this study was to determine if elevations in blood pressure (BP) precede acute presentation of MMS in individuals with DS. METHODS: A single-center, retrospective case-control study was performed. Thirty patients with MMS and DS and 116 patients with DS only were identified retrospectively...
October 2018: Pediatrics
Yijin Wang, Shan Wang, Jian Wu, Yiyun Jiang, Haiying Zhang, Shujuan Li, Hongyang Liu, Changshuang Yang, Haijun Tang, Naizhou Guo, Maikel P Peppelenbosch, Lai Wei, Qiuwei Pan, Jingmin Zhao
Neurological manifestations are potentially associated with hepatitis E virus (HEV) infection in Europe, mainly attributed to genotype (GT) 3 HEV infection. In this study, we determined the frequency and causal relationship of HEV in patients with non-traumatic neurological disorders in China, where GT4 HEV is prevalent. 1117 consecutive patients diagnosed with neurological illnesses in a hospital of eastern China and 1475 healthy controls who took routine examination in the same hospital were tested for HEV by serology and molecular methods...
September 3, 2018: EBioMedicine
Shih-Yi Lin, Cheng-Li Lin, Der-Cherng Chen, Han-Chung Lee, Hsien-Te Chen, Tsung-Chih Lin, Chung-Y Hsu, Chia-Hung Kao
BACKGROUND AND AIMS: Cervical spondylosis (CS) is reported to be associated with vertebrobasilar insufficiency. However, few cohort studies have investigated the association between CS and posterior circulation ischemic stroke. METHODS: The study cohort comprised 27,990 patients aged ≥18 years with a first diagnosis of CS. The controls consisted of patients with propensity score matched for age, sex, and comorbidities at a ratio of 1:1. We investigated the relationships of CS with ischemic stroke and all-cause mortality...
August 17, 2018: Atherosclerosis
Ramon Pierik, Maarten Uyttenboogaart, Michiel E Erasmus, Thomas W L Scheeren, Walter M van den Bergh
BACKGROUND: Recent literature suggests that a cardiac origin in ischemic stroke is more frequent than previously assumed. However, it is not always clear which patients benefit from additional cardiac investigations if obvious cardiac pathology is absent. METHODS: We performed a single-center retrospective observational study in 7454 consecutive patients admitted to the ICU after cardiac surgery in the period 2006-2015 and who had postoperative brain imaging. Cerebral imaging was studied for the occurrence of stroke including subtype and involved vascular territory...
August 28, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Gavin Sugrue, Michael K O'Reilly, Danielle Byrne, Matthew T Crockett, Sean Murphy, Eoin C Kavanagh
OBJECTIVES: Computed tomography cervico-cerebral angiography (CTCCA) plays a pivotal role in the evaluation of acute stroke. Currently no evidence justifies the inclusion of the upper chest in the CTCCA field of view. The aim of this study was to assess the prevalence and clinical significance of vascular findings identified on CTCCA in the head, neck, and upper chest regions in patients presenting with acute stroke symptoms. METHODS: A retrospective review of radiology images and reports of 900 consecutive patients (425 men, 475 women; mean age 63...
August 24, 2018: Irish Journal of Medical Science
Hebun Erdur, Lennart S Milles, Jan F Scheitz, Kersten Villringer, Karl Georg Haeusler, Matthias Endres, Heinrich J Audebert, Jochen B Fiebach, Christian H Nolte
OBJECTIVES: To investigate the association between acute and chronic ischaemic lesions in a multiple territory lesion pattern (MTLP) detected by 3-Tesla MRI and stroke aetiology, specifically atrial fibrillation-associated stroke. METHODS: We analysed data from the 1000+ study - a prospective, observational 3-Tesla MRI cohort study of consecutively included acute stroke patients. Acute and chronic lesions were detected by DWI and fluid-attenuated inversion recovery, respectively...
August 23, 2018: European Radiology
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