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Neurology stroke

Oluwaseun O Akinduro, Eric W Nottmeier
We describe the operative approach and management for thoracic metastatic disease in a 78-yr-old man with worsening mechanical lower back and left-sided thoracic radicular pain. Imaging of the thoracic spine revealed an osteolytic T11 mass with destruction of the left T11 pedicle and transverse process. Biopsy confirmed spinal metastasis from the liver. Preoperative angiogram was completed for localization of the artery of Adamkewicz and microparticle embolization of the left T11 intercostal artery. Surgical resection was supplemented with electrophysiological monitoring and neuronavigation...
December 14, 2018: Operative Neurosurgery (Hagerstown, Md.)
Amer Harky, Chris Ho Ming Wong, Jeffrey Shi Kai Chan, Shady Zaki, Saied Froghi, Mohamad Bashir
OBJECTIVE: The innominate artery is considered an alternative site for establishing cardiopulmonary bypass in surgical procedures involving the thoracic aorta. This systematic review examines the use of innominate artery cannulation in aortic surgery. METHODS: A systematic literature search was undertaken among the four major databases (PubMed, Embase, Scopus, and Ovid) to identify all studies that utilized innominate artery cannulation for establishing cardiopulmonary bypass and providing cerebral perfusion in thoracic aortic surgery...
December 12, 2018: Journal of Cardiac Surgery
Eriko Suzuki, Naoko Nishimura, Tetsuya Yoshikawa, Yudai Kunikiyo, Keiko Hasegawa, Keiji Hasumi
SMTP-7 ( Stachybotrys microspora triprenyl phenol-7) is a small molecule that promotes thrombolysis and suppresses inflammation possibly through plasminogen modulation and soluble epoxide hydrolase (sEH) inhibition, respectively. Here, we demonstrate an efficacy of SMTP-7 in a severe embolic stroke model in monkeys. The middle cerebral artery was embolized by an autologous blood clot. Saline, SMTP-7, or tissue-type plasminogen activator (t-PA) (n = 5 in each group) was given after 3 hours, and neurologic deficit scoring and infarct characterization were performed after 24 hours...
December 2018: Pharmacology Research & Perspectives
Claudia Cristina Ferreira Ramos, Daniel Krempel Amado, Conrado Regis Borges, Eduardo Bergamaschi, Ricardo Nitrini, Sonia Maria Dozzi Brucki
Cognitive impairment is very common in stroke patients and underdiagnosed. Symptoms such as language, praxis, visuospatial, visuoconstructive and memory impairment are prominent. The screening cognitive tests available do not address some specific characteristics of stroke patients and have major limitations in relation to the most impaired cognitive domains. Objective: To test the applicability of a Brazilian version of the Oxford Cognitive Screen in a convenience sample of individuals with normal cognition...
October 2018: Dementia & Neuropsychologia
Sakina H Sojar, Joshua S V Goldner, Kalpathy Krishnamoorthy, Sarah A Murphy, Peter T Masiakos, Jean E Klig
A healthy 17-year-old boy with a high-functioning pervasive developmental disorder presented to the emergency department after having a 4-minute episode of seizure-like activity in the setting of presumed viral gastroenteritis. Within an hour of emergency department arrival, he developed a forehead-sparing facial droop, right-sided ptosis, and expressive aphasia, prompting stroke team assessment and urgent neuroimaging. Laboratory results later revealed a serum sodium of 119 mmol/L. Neurologic deficits self-resolved, and a full physical examination revealed diffuse abdominal tenderness in the lower abdomen with rebound tenderness in the right-lower quadrant...
December 13, 2018: Pediatrics
Karolina Machowska-Sempruch, Anna Bajer-Czajkowska, Karol Makarewicz, Karolina Zaryczańska, Adam Koryzma, Przemysław Nowacki
Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a genetically determined disease of the cerebral vessels, characterized by recurrent ischemic strokes, dementia, and degeneration of the cerebral white matter. The condition is caused by a mutation in the NOTCH3 gene, whose product plays a great role in the development and physiology of the cardiovascular system. Magnetic resonance imaging reveals multiple hyperintensive lesions of the white matter in the T2-weighted images also in asymptomatic carriers of CADASIL and can be detected even 10-15 years prior to clinical signs...
December 10, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Satoshi Shoji, Shun Kohsaka, Hiraku Kumamaru, Mitsuaki Sawano, Yasuyuki Shiraishi, Ikuko Ueda, Shigetaka Noma, Masahiro Suzuki, Yohei Numasawa, Kentaro Hayashida, Shinsuke Yuasa, Hiroaki Miyata, Keiichi Fukuda
BACKGROUND: Periprocedural stroke is a rare but life-threatening complication of percutaneous coronary intervention (PCI). Transradial intervention (TRI) is more beneficial than transfemoral intervention for periprocedural bleeding and acute kidney injuries, but its effect on periprocedural stroke has not been fully investigated. Our study aimed to assess risk predictors of periprocedural stroke according to PCI access site. METHODS AND RESULTS: Between 2008 and 2016, 17 966 patients undergoing PCI were registered in a prospective multicenter database...
December 2018: Circulation. Cardiovascular Interventions
Weijie Xie, Ping Zhou, Yifan Sun, Xiangbao Meng, Ziru Dai, Guibo Sun, Xiaobo Sun
Cerebral ischemia-reperfusion is a complicated pathological process. The injury and cascade reactions caused by cerebral ischemia and reperfusion are characterized by high mortality, high recurrence, and high disability. However, only a limited number of antithrombotic drugs, such as recombinant tissue plasminogen activator (r-TPA), aspirin, and heparin, are currently available for ischemic stroke, and its safety concerns is inevitable which associated with reperfusion injury and hemorrhage. Therefore, it is necessary to further explore and examine some potential neuroprotective agents with treatment for cerebral ischemia and reperfusion injury to reduce safety concerns caused by antithrombotic drugs in ischemic stroke...
December 12, 2018: Cells
Yang Liu, ShiYu Jia, Xue Liang, MeiXue Dong, XiaoMin Xu, ChangQi Lu, YouDong Wei
BACKGROUND: The blood-brain barrier is impaired in patients with stroke. The release of protein markers such as Sirtuin1 (SIRTl) into circulation may be useful to assess the prognosis of patients with cerebrovascular disease. In this study, we investigated the predictive value of SIRT1 levels in acute ischemic stroke (AIS) patients. METHODS: In all, 101 AIS patients and 38 healthy controls were enrolled, and blood samples were collected within 72 hours of stroke onset...
December 2018: Medicine (Baltimore)
Abbas Al-Qamari, Ibukunoluwa Adeleke, Adam Kretzer, Charles W Hogue
PURPOSE OF REVIEW: Central pulse pressure (PP), a marker of vascular stiffness, is a novel indicator of risk for perioperative morbidity including ischemic stroke. Appreciation for the mechanism by which vascular stiffness leads to organ dysfunction along with understanding its clinical detection may lead to improved patient management. RECENT FINDINGS: Vascular stiffness is associated with increased mortality and neurologic, cardiac, and renal injury in nonsurgical and surgical patients...
December 12, 2018: Current Opinion in Anaesthesiology
Karolina Dorobisz, Tadeusz Dorobisz, Dariusz Janczak, Tomasz Krecicki
Stenosis of arteries that supplies blood to the brain is one of the main causes of ischemic stroke which is the third most common cause of deaths in Europe. Atherosclerosis of carotid and vertebral arteries is responsible for 20% of the ischemic stroke cases. Stenosis may be either asymptomatic or manifested with typical neurological symptoms including motor and sensory disturbances as well as disturbances in vision and speech. However, discrete non-specific symptoms of ischemia, including headaches and vertigo, tinnitus and hearing loss, are also quite common...
December 12, 2018: Acta Neurologica Belgica
Anna Portale, Agata Fiumara, Luisa Scalora, Filippo Greco, Pierluigi Smilari, Valeria Venti, Elena Pustorino, Piero Pavone
INTRODUCTION: Stroke is the clinical designation for a rapidly developing loss of brain function due to an interruption in the blood supply to all or part of the brain. It is the third cause of death in adults and one of the top 10 causes in pediatric age. The perinatal period of onset is the second only to adult age group in the incidence of stroke. Arterial ischemic stroke during childhood occurs most frequently in the perinatal period with an incidence of 1 out 2300-5000 live infant births...
December 12, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Feng Tan, Jian Wang, Jing Xian Liu, Chen Wang, Miaodan Li, Yong Gu
Electroacupuncture (EA) may stimulate neurogenesis in animal models of ischemic stroke; however, the associated mechanisms are not clear. The present study aimed to evaluate the neurogenesis efficacy of EA on ischemic stroke and the underlying associated mechanisms. A model of middle cerebral artery occlusion (MCAO) was employed as the rat model of brain ischemia and reperfusion. EA treatment at the GV20 (Baihui) and GV14 (Dazhui) acupoints was conducted for 30 min daily following MCAO. Immunofluorescence was performed to measure the number of bromodeoxyuridine (BrdU)/nestin- or BrdU/doublecortin (DCX)-positive cells in the sham, MCAO and MCAO + EA groups...
December 2018: Experimental and Therapeutic Medicine
Wei-Yuan Huang, Gang Wu, Feng Chen, Meng-Meng Li, Jian-Jun Li
BACKGROUND: Melioidosis is a tropical disease caused by Burkholderia pseudomallei (B. pseudomallei). It can infect any organ system and lead to multiple abscesses. A few studies reported that central nervous system (CNS) is also involved. We present a diabetic patient with multi-systemic melioidosis that affected the CNS, thorax, and spleen. The aim was to study the clinical and radiological features of melioidosis and enhance understanding of the disease. CASE PRESENTATION: A 38-year-old male presented with cough and expectoration mixed with blood for several days...
December 12, 2018: BMC Infectious Diseases
Rong Huang, Juan Ma, Bo Niu, Jin Li, Jian Chang, Yanrui Zhang, Peng Liu, Xinping Luan
Ischemic stroke is one of the leading causes of death and disability globally and has been regarded as a major public health problem. Understanding the mechanism of ischemia/reperfusion (I/R)-induced oxidative stress injury may provide new treatment for ischemic stroke. Kelch-like ECH-associated protein 1 (Keap1)/ NF-E2-related factor 2 (Nrf2)/ antioxidant response elements (ARE) signaling pathway has been considered to be the major cellular defense against oxidative stress. In the present study, our objective is to evaluate the molecular mechanism of miR-34b/Keap1 in modulating focal cerebral I/R induced oxidative injury...
January 2019: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Manuel Yepes
The plasminogen activation (PA) system was originally thought to exclusively promote the degradation of fibrin by catalyzing the conversion of plasminogen into plasmin via two serine proteinases: tissue-type plasminogen activator (tPA) and urokinase-type plasminogen activator (uPA). However, experimental evidence accumulated over the last 30 years indicates that tPA and uPA are also found in the central nervous system (CNS), where they have a plethora of functions that not always require plasmin generation or fibrin degradation...
December 11, 2018: Current Drug Targets
Jiri Polivka, Jiri Polivka, Vladimir Rohan
The model of centralized stroke care in the Czech Republic was created in 2010-2012 by Ministry of Health (MH) in cooperation with professional organization-Cerebrovascular Section of the Czech Neurological Society (CSCNS). It defines priorities of stroke care, stroke centers, triage of suspected stroke patients, stroke care quality indicators, their monitoring, and reporting. Thirteen complex cerebrovascular centers (CCC) provide sophisticated stroke care, including intravenous thrombolysis (IVT), mechanical thrombectomy (MTE), as well as other endovascular (stenting, coiling) and neurosurgical procedures...
December 2018: EPMA Journal
Jian Qian, Luna Wang, Qiming Li, Dujuan Sha, Jun Wang, Jun Zhang, Peng Xu, Guofeng Fan
To investigate the role of ultrasound-targeted microbubbles in the homing effect of bone marrow-derived mesenchymal stem cells (BMSCs) and in the therapeutic efficacy of BMSCs on the ischemic stroke. A middle cerebral artery occlusion (MCAO) model was induced by plug wire preparation. Seventy-two hours after MCAO, the treatment of BMSCs with ultrasound-targeted microbubble was assessed via modified neurological severity score (mNSS), infarct volumes, and cerebral edema. In addition, immunofluorescence was performed to analyze the homing effect of BMSCs with ultrasound-targeted microbubble...
December 9, 2018: Journal of Cellular Biochemistry
Helle Al-Hakem, Søren H Sindrup, Henning Andersen, Charlotte Dornonville de la Cour, Lisbeth L Lassen, Bianca van den Berg, Bart C Jacobs, Thomas Harbo
OBJECTIVES: To describe the epidemiology and clinical heterogeneity of Guillain-Barré syndrome (GBS) in Denmark and to compare a population-based cohort to prospectively included patients in the International GBS Outcome Study (IGOS). METHODS: The incidence rate (IR) of GBS in Denmark from September 2012 to December 2015, applying the National Institute of Neurological Disorders and Stroke (NINDS) diagnostic criteria, was estimated and the level of diagnostic certainty was described with the Brighton criteria...
December 7, 2018: Journal of Neurology
Bedriye Müge Sönmez, Murat Doğan İşcanlı, Selçuk Parlak, Yasin Doğan, Hilmi Gökhan Ulubay, Emirhan Temel
Altered consciousness and accompanying neurological symptoms are both complex and challenging cases for emergency physicians. These are not specific and may be a sign of a variety of medical conditions including stroke and delayed neurological sequelae (DNS) is a recurrent transient neuropsychiatric consequence of CO intoxication. DNS produces a spectrum of varying symptoms and the diagnosis is primarily made on the basis of clinical features and radiological findings from CT and conventional MRI. In clinical practice, serious CO intoxication is treated only with oxygen therapy although no effective treatment exists...
December 2018: Turkish Journal of Emergency Medicine
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