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Cardioembolic stroke

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https://www.readbyqxmd.com/read/28439774/albumin-induced-neuroprotection-in-focal-cerebral-ischemia-in-the-alias-trial-does-severity-mechanism-and-time-of-infusion-matter
#1
Rakesh Khatri, Mohammad Rauf Afzal, Gustavo J Rodriguez, Alberto Maud, Muhammad Shah Miran, Mohtashim Arbaab Qureshi, Salvador Cruz-Flores, Adnan I Qureshi
OBJECTIVE: To determine whether there is any differential benefit of albumin administration within 2 h of onset of ischemia and in settings (severe ischemia with reperfusion in cardioembolic strokes with National Institutes of Health Stroke Scale [NIHSS] ≥15), most representative of experimental models of cerebral ischemia in which albumin was effective in reducing neurological injury. BACKGROUND: High-dose intravenous (IV) albumin treatment for acute ischemic stroke (ALIAS) trial did not show overall clinical benefit in ischemic stroke patients in contrast to preclinical studies; however, models of preclinical studies were not completely followed...
April 24, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28438866/soluble-urokinase-type-plasminogen-activator-receptor-predicts-all-cause-5-year-mortality-in-ischemic-stroke-and-tia
#2
Juha Onatsu, Mikko Taina, Pirjo Mustonen, Marja Hedman, Antti Muuronen, Otso Arponen, Miika Korhonen, Pekka Jäkälä, Ritva Vanninen, Kari Pulkki
AIM: We evaluated soluble urokinase-type plasminogen activator receptor (suPAR) levels in different stroke subtypes and assessed their prognostic value regarding 5-year outcomes. MATERIALS AND METHODS: The study included 117 stroke patients (81 males; mean=age 61±11 years) with suspected cardioembolic stroke whose plasma suPAR concentration was assessed. Altogether, 20 (17.1%) patients suffered from stroke as a result of cardioembolism, 12 (10.3%) from large-artery atherosclerosis, 9 (7...
May 2017: In Vivo
https://www.readbyqxmd.com/read/28432712/stroke-etiology-and-collaterals-atheroembolic-strokes-have-greater-collateral-recruitment-than-cardioembolic-strokes
#3
L C Rebello, M Bouslama, D C Haussen, J A Grossberg, S Dehkharghani, A Anderson, S R Belagaje, N A Bianchi, M Grigoryan, M R Frankel, R G Nogueira
BACKGROUND AND PURPOSE: Chronic hypoperfusion from athero-stenotic lesions is thought to lead to better collateral recruitment compared to cardioembolic strokes. It was sought to compare collateral flow in stroke patients with atrial fibrillation (AF) versus stroke patients with cervical atherosclerotic steno-occlusive disease (CASOD). METHOD: This was a retrospective review of a prospectively collected endovascular database. Patients with (i) anterior circulation large vessel occlusion stroke, (ii) pre-treatment computed tomography angiography (CTA) and (iii) intracranial embolism from AF or CASOD were included...
April 21, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28432264/prediction-of-stroke-subtype-and-recanalization-using-susceptibility-vessel-sign-on-susceptibility-weighted-magnetic-resonance-imaging
#4
Dong-Wan Kang, Han-Gil Jeong, Do Yeon Kim, Wookjin Yang, Seung-Hoon Lee
BACKGROUND AND PURPOSE: The susceptibility vessel sign (SVS) is a hypointense signal visualized because of the susceptibility effect of thrombi, sensitively detected on susceptibility-weighted magnetic resonance imaging. The relationship of SVS parameters with the stroke subtype and recanalization status after endovascular treatment remains uncertain. METHODS: The data from 89 patients with acute stroke caused by anterior circulation infarcts who underwent susceptibility-weighted magnetic resonance imaging before endovascular treatment were examined...
April 21, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28428899/watershed-infarct-in-beta-thalassemia-major-patient
#5
Behnaz Ansari, Mohammad Saadatnia, Ali Asghar Okhovat
Background. The mechanism of stroke in beta-thalassemia was reported previously as cardioembolic and hypercoagulable state. However, there is no report of watershed infarct in beta-thalassemia anemia. Method. We present an adult β-thalassemia major patient with manifest asymptomatic chronic left carotid occlusion who suffered watershed infarct. Result. In the presence of asymptomatic chronic left internal carotid occlusion, we assumed that severe anemia (hemoglobin = 3) at admission leads to watershed infarct...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28409234/clinical-role-of-von-willebrand-factor-in-acute-ischemic-stroke
#6
Marija Menih, Miljenko Križmarić, Tanja Hojs Fabjan
BACKGROUND: An elevated level of von Willebrand factor (VWF) is associated with an increased risk for coronary heart disease and ischemic stroke. The objective of the study was to determine whether the level of VWF is associated with the cardioembolic subtype of ischemic stroke, stroke severity, and clinical outcome. PATIENTS AND METHODS: In this study 108 patients suffering from acute ischemic stroke (AIS) were included. According to the etiology of the stroke, patients were classified into the subtype of cardioembolic (CE) stroke and the group with non-CE stroke...
April 13, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28392099/cerebrovascular-dissemination-in-time-and-space-as-a-predictor-of-cardioembolism
#7
João André Sousa, Mafalda Mendes-Pinto, João Sargento-Freitas, Fernando Silva, Carla Cecília, Carmo Macário, Ana Gouveia, Cristina Machado, Bruno Rodrigues, Gustavo C Santo, Ana Lima, Ricardo Veiga, Luís Cunha, António Freire-Gonçalves
BACKGROUND: Cardioembolism has tendency to recur and cause lesions in distinct cerebrovascular territories. Using the imaging characteristics of cerebral lesions to determine dissemination in time and space (DTS) is a concept already used in other neurologic conditions; however, it has never been applied as a diagnostic tool in ischemic stroke etiology. AIM: This study aimed to assess DTS as a diagnostic marker of cardioembolism. METHODS: We enrolled consecutive patients with acute ischemic stroke of various etiologies admitted in a cerebrovascular disease nursery from a university hospital in a retrospective cohort study...
April 6, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28381199/2014-chinese-guidelines-for-secondary-prevention-of-ischemic-stroke-and-transient-ischemic-attack
#8
Yongjun Wang, Ming Liu, Chuanqiang Pu
Ischemic stroke and transient ischemic attack (TIA) are the most common cerebrovascular disorder and leading cause of death in China. The Effective secondary prevention is the vital strategy for reducing stroke recurrence. The aim of this guideline is to provide the most updated evidence-based recommendation to clinical physicians from the prior version. Control of risk factors, intervention for vascular stenosis/occlusion, antithrombotic therapy for cardioembolism, and antiplatelet therapy for noncardioembolic stroke are all recommended, and the prevention of recurrent stroke in a variety of uncommon causes and subtype provided as well...
April 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28380323/a-retrospective-analysis-of-254-acute-stroke-cases-admitted-to-two-university-hospitals-in-beirut-classification-and-associated-factors
#9
N Lahoud, Marie-Helene Abbas, Pascale Salameh, N Saleh, Samer Abes, Hassan Hosseini, Souheil Gebeily
Lebanon is a developing country where the prevalence of stroke subtypes and their correlation with risk factors have not been studied, even though stroke management is an ongoing major national healthcare challenge. In a retrospective study conducted in two university hospitals, data were collected on all stroke cases admitted in 2012 and 2013. Ischemic strokes were then classified according to a modified TOAST classification. A total of 254 inpatients (mean age 68.41 years ±13.34, 55.1% males) was included in the study; of these, 15% had had a hemorrhagic stroke and was therefore excluded...
January 2017: Functional Neurology
https://www.readbyqxmd.com/read/28373985/association-of-chads2-and-cha2ds2-vasc-scores-with-left-atrial-thrombus-with-nonvalvular-atrial-fibrillation-a-single-center-based-retrospective-study-in-a-cohort-of-2695-chinese-subjects
#10
J Huang, S L Wu, Y M Xue, H W Fei, Q W Lin, S Q Ren, H T Liao, X Z Zhan, X H Fang, L Xu
The main mechanism of the CHADS2 and CHA2DS2-VASc scores to predict stroke in nonvalvular atrial fibrillation (NVAF) is still controversial. We evaluated the association of the CHADS2 and CHA2DS2-VASc scores with left atrial thrombus (LAT) as detected by transesophageal echocardiographic (TEE) and compared the predictive ability of these risk stratification schemes with nonvalvular atrial fibrillation (NVAF). Data from 2,695 consecutive NVAF patients in whom TEE was performed for screening LAT from July 2007 to February 2014 were analyzed...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28373302/predictors-for-symptomatic-intracranial-hemorrhage-after-endovascular-treatment-of-acute-ischemic-stroke
#11
Yonggang Hao, Dong Yang, Huaiming Wang, Wenjie Zi, Meng Zhang, Yu Geng, Zhiming Zhou, Wei Wang, Haowen Xu, Xiguang Tian, Penghua Lv, Yuxiu Liu, Yunyun Xiong, Xinfeng Liu, Gelin Xu
BACKGROUND AND PURPOSE: Symptomatic intracranial hemorrhage (SICH) pose a major safety concern for endovascular treatment of acute ischemic stroke. This study aimed to evaluate the risk and related factors of SICH after endovascular treatment in a real-world practice. METHODS: Patients with stroke treated with stent-like retrievers for recanalizing a blocked artery in anterior circulation were enrolled from 21 stroke centers in China. Intracranial hemorrhage was classified as symptomatic and asymptomatic ones according to Heidelberg Bleeding Classification...
April 3, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28372708/acute-stroke-and-transient-ischemic-attack-in-the-outpatient-clinic
#12
REVIEW
Salvador Cruz-Flores
Ischemic stroke is cause of substantial death and disability in the United States. Transient ischemic attack, a precursor to ischemic stroke, conveys a high risk of recurrent stroke within 90 days from event. These conditions are highly preventable and treatable. The cause is heterogenous and includes atherothrombosis, cardioembolism, lacunar disease, or cryptogenic, and some uncommon causes, such as arterial dissection and prothrombotic states. The emergent evaluation includes establishing time of onset, vital signs, glucose level, and severity of the deficit...
May 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28366662/association-of-paroxysmal-supraventricular-tachycardia-with-ischemic-stroke-a-national-case-control-study
#13
Jui-Kun Chiang, Hsueh-Hsin Kao, Yee-Hsin Kao
BACKGROUND AND PURPOSE: Cardioembolic stroke accounts for approximately 15%-20% of all ischemic strokes. Atrial fibrillation constitutes one-half to two-thirds of all cardioembolic stroke events. The association of paroxysmal supraventricular tachycardia (PSVT) with ischemic stroke remains unclear. A national case-control study was conducted to identify the risk factors, including PSVT, for ischemic stroke in Taiwan. METHODS: We designed a national case-control study comprising patients diagnosed with ischemic stroke (n = 5633) from 1997 to 2011; each patient from the case group was randomly matched with the control group (n = 30,895) in Taiwan...
March 30, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28364953/comparison-of-morphologic-features-and-flow-velocity-of-the-left-atrial-appendage-among-patients-with-atrial-fibrillation-alone-transient-ischemic-attack-and-cardioembolic-stroke
#14
Yonggu Lee, Hwan-Cheol Park, Youkyung Lee, Soon-Gil Kim
The left atrial appendage (LAA) is a major source of emboli responsible for cardioembolic stroke (CES). We hypothesized that there could be differences in the morphologic and functional features of LAAs among patients with atrial fibrillation (AF) alone, patients with cardioembolic transient ischemic attack (CETIA), and patients with CES. Patients with AF and CETIA/CES were included in either a CETIA group or a CES group. Patients with AF without past histories of stroke were included in an AF/non-CVA (cerebrovascular accident) group...
March 19, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28352633/bay%C3%A3-s-syndrome-and-acute-cardioembolic-ischemic-stroke
#15
REVIEW
Adrià Arboix, Lucía Martí, Sebastien Dorison, María José Sánchez
Bayés syndrome is an under-recognized clinical condition characterized by advanced interatrial block. Bayés syndrome is a subclinical disease that manifests electrocardiographically as a prolonged P wave duration > 120 ms with biphasic morphology ± in the inferior leads. The clinical relevance of Bayés syndrome lies in the fact that is a clear arrhythmological syndrome and has a strong association with supraventricular arrhythmias, particularly atypical atrial flutter and atrial fibrillation. Likewise, Bayés syndrome has been recently identified as a novel risk factor for non-lacunar cardioembolic ischemic stroke and vascular dementia...
March 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28348599/a-rare-case-of-stroke-secondary-to-iron-deficiency-anemia-in-a-young-female-patient
#16
Kavitha Gopalratnam, Kevin Andrew Woodson, Jigarkumar Rangunwala, Kanaga Sena, Manisha Gupta
Ischemic strokes occur when there is a sudden obstruction of an artery supplying blood flow to an area of the brain, leading to a focal neurological deficit. Strokes can be thrombotic or embolic in etiology and are associated with underlying conditions such as hypertension and atherosclerosis. Possible etiologies of strokes include cardioembolic disease, hematologic disorders, connective tissue disorders, and substance abuse or can be cryptogenic. Most stroke cases are seen in patients over 65 years of age...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28343849/oral-anticoagulant-therapy-for-older-patients-with-atrial-fibrillation-a-review-of-current-evidence
#17
REVIEW
Mario Bo, Enrica Grisoglio, Enrico Brunetti, Yolanda Falcone, Niccolò Marchionni
Atrial fibrillation is more frequent in older patients, who have a higher risk of cardioembolic stroke and thromboembolism. Oral anticoagulant therapy is the standard of treatment for stroke prevention; however, under-prescription is still very common in older patients. The reasons underlying this phenomenon have not been systematically investigated, and true contraindications only partially account for it. An intimate skepticism on the real benefit-risk balance of oral anticoagulant therapy in the oldest patients seems to derive from the fact that most studies supporting it were conducted decades ago and included younger patients, with overall better functional and clinical status...
March 24, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28318443/cardiac-ct-imaging-for-ischemic-stroke-current-and-evolving-clinical-applications
#18
Jin Hur, Byoung Wook Choi
While the etiology of ischemic stroke is heterogeneous, approximately 20%-40% of all stroke cases result from cardiac or aortic origin. Transesophageal echocardiography (TEE) has become the reference standard modality for the detection of potential sources of cerebral embolism. Because of the advances in computed tomographic (CT) technology, cardiac CT can be used in the evaluation of potential cardioembolic sources. During the past decade, cardiac CT has been tested and compared with TEE for the diagnosis of cardioembolic sources...
April 2017: Radiology
https://www.readbyqxmd.com/read/28294394/cardioembolic-strokes-resulting-from-a-self-inflicted-needle-puncture-involving-both-sides-of-the-heart
#19
Mark Zheng Yi Tan, Annemarie Brunswicker, Shamsaldeen Abdelraheem, Alison Sheehan
Foreign bodies in the heart are rare occurrences with a limited evidence base to guide recommendations on management. We report a case of multiple cardioembolic strokes as a result of a self-inflicted sewing needle puncture from the anterior chest through the right ventricle and interventricular septum with its tip in the left ventricle close to the subvalvular apparatus in a 39-year-old psychiatric patient. We discuss issues surrounding decision making and ongoing care and highlight the importance of further follow-up and reporting of cases to form a robust evidence base to guide future recommendations...
March 14, 2017: Echocardiography
https://www.readbyqxmd.com/read/28288200/morphological-features-of-the-left-atrial-appendage-in-consecutive-coronary-computed-tomography-angiography-patients-with-and-without-atrial-fibrillation
#20
Miika Korhonen, Johannes Parkkonen, Marja Hedman, Antti Muuronen, Juha Onatsu, Pirjo Mustonen, Ritva Vanninen, Mikko Taina
The majority of intracardiac thrombi form in the left atrial appendage (LAA). Enlargement of this structure, together with certain morphological features, may indicate a predisposition to the formation of thrombi and subsequent cardioembolic stroke. Thus far, studies on LAA morphology have largely focused on those patients with atrial fibrillation (AF). Taking a different approach, we investigated the variation in LAA morphology in a consecutive patient population with and without AF. We evaluated 808 consecutive patients (529 females; mean age 52...
2017: PloS One
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