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https://www.readbyqxmd.com/read/29792264/paradoxical-brain-embolism-shadowing-massive-pulmonary-embolism
#1
François Bagate, Alexandre Bedet, Armand Mekontso Dessap, Guillaume Carteaux
Patent foramen ovale is frequently observed in the general population. In case of massive pulmonary embolism, the sudden increase in the right heart cavity's pressure may cause a right-to-left shunting across this foramen, which could be associated with conflicting outcomes. Herein, we report a case of reversible cardiac arrest preceded by seizures, and followed by hemodynamic stability without any vasopressor. A brain CT-scan showed a limited ischemic stroke. Initial echocardiographic assessment revealed an acute cor pulmonale and a right-to-left intracardiac shunt across a large patent foramen ovale, suggesting the diagnosis of massive pulmonary embolism that was lately confirmed by a multidetector CT-angiography...
May 20, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29792042/imaging-predictors-of-outcome-in-acute-spontaneous-subarachnoid-hemorrhage-a-review-of-the-literature
#2
Isabel Fragata, Patrícia Canhão
Spontaneous subarachnoid hemorrhage (SAH) accounts for about 5% of strokes, but has a very high morbidity and mortality. Many survivors are left with important cognitive impairment and are severely incapacitated. Prediction of complications such as vasospasm and delayed cerebral ischemia, and of clinical outcome after SAH, is challenging. Imaging studies are essential in the initial evaluation of SAH patients and are increasingly relevant in assessing for complications and prognosis. In this article, we reviewed the role of imaging studies in evaluating early brain injury and predicting complications as well as clinical and neuropsychological prognosis after acute SAH...
January 1, 2018: Acta Radiologica
https://www.readbyqxmd.com/read/29791947/global-burden-of-stroke
#3
Mira Katan, Andreas Luft
Stroke is the second leading cause of death and a major cause of disability worldwide. Its incidence is increasing because the population ages. In addition, more young people are affected by stroke in low- and middle-income countries. Ischemic stroke is more frequent but hemorrhagic stroke is responsible for more deaths and disability-adjusted life-years lost. Incidence and mortality of stroke differ between countries, geographical regions, and ethnic groups. In high-income countries mainly, improvements in prevention, acute treatment, and neurorehabilitation have led to a substantial decrease in the burden of stroke over the past 30 years...
April 2018: Seminars in Neurology
https://www.readbyqxmd.com/read/29790788/no-association-of-moon-phase-with-stroke-occurrence
#4
Jori O Ruuskanen, Jussi O T Sipilä, Päivi Rautava, Ville Kytö
Stroke occurrence shows strong correlations with sleep disorders and even subtle sleep disturbances have been shown to affect ischemic stroke (IS) occurrence. Chronobiology also exerts effects, like the morning surge in IS occurrence. Lunar cycles have also been shown to affect sleep and other physiological processes, but studies on moon phases and its possible association with occurrence of stroke are rare and nonconclusive. Therefore, we studied the effects of moon phases on stroke hospitalizations and in-hospital mortality nationwide in Finland in 2004-2014...
May 23, 2018: Chronobiology International
https://www.readbyqxmd.com/read/29790456/evaluation-of-neuroimaging-findings-of-central-nervous-system-complications-in-heart-transplant-recipients
#5
Hale Turnaoglu, Ahmet Muhtesem Agildere, Feride Kural Rahatli, Fuldem Yildirim Donmez, Ruhsen Ocal, Taner Sezer, Ufuk Can, Atilla Sezgin, Sait Aslamaci
OBJECTIVES: In this study, we presented neuroradiologic findings and diagnoses of neurologic complications in a series of heart transplant recipients. MATERIALS AND METHODS: A retrospective review was conducted at Başkent University Hospital. We searched the hospital and radiology databases and identified 109 heart transplant recipients. Thirty-one of these recipients had neuroradiologic evaluations secondary to presentation of neurologic symptoms after heart transplant, with 18 patients evaluated with computed tomography and 22 patients evaluated with magnetic resonance imaging (overlap of imaging-defined groups occurred in 9 recipients)...
May 23, 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29789903/stabilization-of-symptomatic-carotid-atherosclerotic-plaques-by-statins-a-clinico-pathological-analysis
#6
Takao Konishi, Naohiro Funayama, Tadashi Yamamoto, Daisuke Hotta, Ryota Nomura, Yusuke Nakagaki, Takeo Murahashi, Kenji Kamiyama, Tetsuyuki Yoshimoto, Takeshi Aoki, Shinya Tanaka
Human and animal studies have revealed a stabilization of atherosclerotic plaques by statins. However, the stabilization of human carotid plaques has not been thoroughly described pathologically. This analysis explored the relationship between statin therapy and plaque stability in carotid endarterectomy (CEA) specimens. We analyzed specimens harvested between May 2015 and February 2017, from 79 consecutive patients presenting with > 70% carotid artery stenoses, of whom 66 were untreated (group 1) and 13 treated (group 2) with a statin...
May 22, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29789872/endovascular-thrombectomy-for-large-vessel-occlusion-strokes-with-preexisting-intracranial-aneurysms
#7
Tengfei Zhou, Tianxiao Li, Liangfu Zhu, Ziliang Wang, Weixing Bai, Jiangyu Xue, Guang Feng
OBJECTIVE: This study aimed to investigate the safety of endovascular thrombectomy in acute ischemic stroke with preexisting intracranial aneurysms. METHODS: Patients with acute ischemic stroke due to large-artery occlusion combined with intracranial aneurysms, who received endovascular treatment, were analyzed retrospectively, and the procedure-related data were recorded. RESULTS: Among the 124 patients who suffered acute large-artery occlusion and received endovascular recanalization therapy, intracranial aneurysms were found in seven patients (5...
May 22, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29789214/emergent-carotid-endarterectomy-versus-stenting-in-acute-stroke-patients-with-tandem-occlusion
#8
Diana E Slawski, Mouhammad A Jumaa, Hisham Salahuddin, Julie Shawver, M Junaid Humayun, Todd Russell, Andrew Seiwert, David Paolini, Jihad Abbas, Munier Nazzal, Gretchen E Tietjen, Aixa Espinosa-Morales, Andrea Korsnack, Syed F Zaidi
OBJECTIVE: Acute stroke due to tandem cervical internal carotid artery (ICA) and intracranial large-vessel occlusion (ILVO) has a high rate of morbidity and mortality. The most appropriate treatment strategy for the extracranial culprit lesion remains unclear. In this study, we report our institutional outcomes with two approaches: emergent carotid endarterectomy (CEA) and carotid artery stenting (CAS). METHODS: Patients with tandem ICA-ILVO were identified in a prospective mechanical thrombectomy (MT) database between July 2012 and April 2016...
May 19, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29789199/survival-after-in-hospital-cardiac-arrest-among-cerebrovascular-disease-patients
#9
REVIEW
Corey R Fehnel, Alissa Trepman, Dale Steele, Muhib A Khan, Brian Silver, Susan L Mitchell
Stroke is a leading cause of death and disability, and while preferences for cardiopulmonary resuscitation (CPR) are frequently discussed, there is limited evidence detailing outcomes after CPR among acute cerebrovascular neurology (inclusive of stroke, subarachnoid hemorrhage (SAH)) patients. Systematic review and meta-analysis of PubMed and Cochrane libraries from January 1990 to December 2016 was conducted among stroke patients undergoing in-hospital CPR. Primary data from studies meeting inclusion criteria at two levels were extracted: 1) studies reporting survival to hospital discharge after CPR with cerebrovascular primary admitting diagnosis, and 2) studies reporting survival to hospital discharge after CPR with cerebrovascular comorbidity...
May 19, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29789105/oral-anticoagulation-in-chronic-kidney-disease-and-atrial-fibrillation
#10
Gunnar H Heine, Vincent Brandenburg, Stephan H Schirmer
BACKGROUND: Cardiological societies recommend, in their guidelines, that patients with atrial fibrillation and an intermediate (or higher) risk of stroke and systemic embolization should be treated with oral anticoagulant drugs. For patients who do not have mitral valve stenosis or a mechanical valve prosthesis, non-vitamin-K dependent oral anticoagulants (NOAC) are preferred over vitamin K antagonists (VKA) for this purpose. It is unclear, however, whether patients with chronic kidney disease and atrial fibrillation benefit from oral anticoagulation to the same extent as those with normal kidney function...
April 27, 2018: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29788381/the-role-of-apathy-and-depression-on-verbal-learning-and-memory-performance-after-stroke
#11
Keera N Fishman, Andrea R Ashbaugh, Krista L Lanctôt, Megan L Cayley, Nathan Herrmann, Brian J Murray, Michelle Sicard, Karen Lien, Demetrios J Sahlas, Richard H Swartz
Objective: Psychiatric symptoms, including depression and apathy, may significantly impede functional and cognitive capabilities following a cerebrovascular event. This study examined the role of apathy and depression on learning and memory performance in stroke patients. Method: Stroke patients (n = 140 [119 ischemic, 21 hemorrhagic], mean age = 60.6 [SD = 15.1]) completed the Apathy Evaluation Scale (AES), the Center for Epidemiologic Studies Depression Scale (CES-D), and the California Verbal Learning Test-Second Edition (CVLT-II)...
May 18, 2018: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/29787871/spontaneous-intracerebral-hemorrhage-in-a-plateau-area-a-study-based-on-the-tibetan-population
#12
Ruiqi Chen, Anqi Xiao, Chao You, Lu Ma
OBJECTIVE: To reveal characteristics of spontaneous intracerebral hemorrhage (sICH) in a plateau area based on the Tibetan population. METHODS: Data of Tibetan and Han patients (control group) with sICH treated at our center from January 2013 to April 2017 were retrospectively reviewed. RESULTS: A total of 122 Tibetan and 927 Han patients were included. Compared with Han patients, Tibetan patients were older (54.7±11.2 VS 50.9±18.3 years, P=0...
May 19, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29787575/safety-of-intravenous-alteplase-within-4-5-hours-for-patients-awakening-with-stroke-symptoms
#13
Victor C Urrutia, Roland Faigle, Steven R Zeiler, Elisabeth B Marsh, Mona Bahouth, Mario Cerdan Trevino, Jennifer Dearborn, Richard Leigh, Susan Rice, Karen Lane, Mustapha Saheed, Peter Hill, Rafael H Llinas
BACKGROUND: Up to 25% of acute stroke patients first note symptoms upon awakening. We hypothesized that patients awaking with stroke symptoms may be safely treated with intravenous alteplase (IV tPA) using non-contrast head CT (NCHCT), if they meet all other standard criteria. METHODS: The SAfety of Intravenous thromboLytics in stroke ON awakening (SAIL ON) was a prospective, open-label, single treatment arm, pilot safety trial of standard dose IV tPA in patients who presented with stroke symptoms within 0-4...
2018: PloS One
https://www.readbyqxmd.com/read/29786577/post-stroke-fatigue-and-its-dimensions-over-the-second-half-year-after-stroke
#14
Mykhaylo Y Delva, Iryna I Delva, Nataliya V Lytvynenko
OBJECTIVE: Introduction: Post-stroke fatigue (PSF) is a common and often debilitating sequel of both ischemic and hemorrhagic strokes. The aim: Assess the rates and intensities of PSF over the second half year after stroke. PATIENTS AND METHODS: Materials and methods: There were examined 128 patients at 6, 9 and 12 months after ischemic or hemorrhagic stroke onset. PSF was measured by fatigue assessment scale (FAS), multidimensional fatigue inventory-20 (MFI-20) and fatigue severity scale (FSS)...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29786566/clinical-performance-measures-for-adults-hospitalized-with-intracerebral-hemorrhage-performance-measures-for-healthcare-professionals-from-the-american-heart-association-american-stroke-association
#15
REVIEW
J Claude Hemphill, Opeolu M Adeoye, David N Alexander, Anne W Alexandrov, Sepideh Amin-Hanjani, Mary Cushman, Mary G George, Peter D LeRoux, Stephan A Mayer, Adnan I Qureshi, Jeffrey L Saver, Lee H Schwamm, Kevin N Sheth, David Tirschwell
No abstract text is available yet for this article.
May 21, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29785667/cerebral-autoregulation-in-stroke
#16
REVIEW
Pedro Castro, Elsa Azevedo, Farzaneh Sorond
PURPOSE OF REVIEW: Cerebral autoregulation (CA) is a mechanism that maintains cerebral blood flow constant despite fluctuations in systemic arterial blood pressure. This review will focus on recent studies that measured CA non-invasively in acute cerebrovascular events, a feature unique to the transcranial Doppler ultrasound. We will summarize the rationale for CA assessment in acute cerebrovascular disorders and specifically evaluate the existing data on the value of CA measures in relation to clinical severity, guiding management decisions, and prognostication...
May 21, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29785661/atrial-fibrillation-in-dialysis-patients-is-there-a-place-for-non-vitamin-k-antagonist-oral-anticoagulants
#17
REVIEW
Elzbieta Mlodawska, Paulina Lopatowska, Jolanta Malyszko, Maciej Banach, Bożena Sobkowicz, Adrian Covic, Anna Tomaszuk-Kazberuk
Atrial fibrillation (AF) occurs approximately in 3% of general population, with greater prevalence in elderly. Non-vitamin K-dependent oral anticoagulant agents (NOACs) according to the current European guidelines are recommended for patients with AF at high risk for stroke as a first-choice treatment. NOACs are not inferior to warfarin or some of them are better than warfarin in reducing the rate of ischemic stroke. Moreover, they significantly reduce the rate of intracranial hemorrhages, major bleedings, and mortality compared with warfarin...
May 21, 2018: International Urology and Nephrology
https://www.readbyqxmd.com/read/29785469/early-detection-of-cerebral-infarction-after-focal-ischemia-using-a-new-mri-indicator
#18
Yukako Nakajo, Qiang Zhao, Jun-Ichiro Enmi, Hidehiro Iida, Jun C Takahashi, Hiroharu Kataoka, Keiko Yamato, Hiroji Yanamoto
Prolongation of the T2 relaxation time, an increase in T2-weighted signal intensity (T2-SI), and a decrease in the apparent diffusion coefficient (ADC) calculated from diffusion-weighted images (DWI) on magnetic resonance imaging (MRI) are conventional indicators of the vasogenic (interstitial) or cytotoxic (cellular) cerebral edema that develops after ischemic stroke. However, these parameters obtained on stroke imaging have not given us a precise threshold at which we can determine the viability or vulnerability of the tissue, allowing us to decide on an intervention that will help reversible tissue in the acute phase...
May 21, 2018: Molecular Neurobiology
https://www.readbyqxmd.com/read/29785465/causes-and-treatment-of-acute-ischemic-stroke-during-pregnancy
#19
REVIEW
Ina Terón, Melissa S Eng, Jeffrey M Katz
PURPOSE OF REVIEW: Treatment recommendations for pregnancy associated ischemic stroke are scarce. This may be due to the fact that, in general, obstetricians tend not to make recommendations for stroke patients and neurologists are not commonly involved in the care of pregnant women. Herein, we review the multiple etiologies of ischemic stroke during pregnancy, considerations for diagnostic testing, and acute treatment and prevention options, including associated risks specific to the pregnant and puerperal state...
May 21, 2018: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/29784606/associated-with-ischemic-stroke-risk-reduction-after-endoscopic-thoracic-sympathectomy-for-palmar-sweating
#20
Chun-Gu Cheng, Chun-An Cheng, Wu-Chien Chien, Chi-Hsiang Chung, Jiunn-Tay Lee
BACKGROUND: Endoscopic thoracic sympathectomy (ETS) was performed to cure palmar hyperhidrosis (PH). After ETS, blood pressure decreased, and cerebral flow velocity increased within 1 month. However, no studies distinguish between subsequent ischemic and hemorrhagic stroke following ETS for PH. The association between stroke type and PH after ETS must be evaluated. METHODS: We surveyed newly diagnosed patients with PH using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic code 708...
May 18, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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