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Cardioembolic stroke

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https://www.readbyqxmd.com/read/28318443/cardiac-ct-imaging-for-ischemic-stroke-current-and-evolving-clinical-applications
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/28279550/tale-of-2-health-care-systems-disparities-in-demographic-and-clinical-characteristics-between-2-ischemic-stroke-populations-in-los-angeles-county
#4
Amytis Towfighi, Erica Patel, Nerses Sanossian, Natalie P Valle, Bruce Ovbiagele
BACKGROUND: Individuals who present to the emergency departments of safety-net systems often have poorly controlled risk factors due to lack of primary care. Little is known about potential differences in presenting characteristics, discharge medications, and discharge destinations of patients with acute ischemic stroke (AIS) who present to safety-net settings versus university medical centers (UMCs). METHODS: Demographic characteristics, medical history, premorbid medication use, stroke severity, discharge medications, and discharge destination were assessed among consecutive admissions for AIS over a 2-year period at a UMC (n = 385) versus 2 university-affiliated safety-net hospitals (SNHs) (n = 346) in Los Angeles County...
March 6, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28275245/prevalence-of-fabry-disease-and-gla-c-196g-c-variant-in-japanese-stroke-patients
#5
Kiyoshiro Nagamatsu, Yoshiki Sekijima, Katsuya Nakamura, Kimitoshi Nakamura, Kiyoko Hattori, Masao Ota, Yusaku Shimizu, Fumio Endo, Shu-Ichi Ikeda
Fabry disease is an important underlying disease in young cryptogenic stroke patients. However, little is known regarding the frequency of Fabry disease in the general stroke population, especially in elderly patients. A total of 588 stroke patients (61.7% men; average age 74.1±12.5 years) were enrolled in this prospective study. Blood samples were obtained to produce blood spots to determine α-galactosidase A (α-GalA) activity and for GLA gene analysis. One 65-year-old female patient had a known GLA gene mutation, c...
March 9, 2017: Journal of Human Genetics
https://www.readbyqxmd.com/read/28272264/the-elevated-lipoprotein-associated-phospholipase-a2-activity-is-associated-with-the-occurrence-and-recurrence-of-acute-cerebral-infarction
#6
Lingli Wei, Zunyu Ke, Yu Zhao, Zhiyou Cai
There is a strong association between lipoprotein-associated phospholipase A2 (Lp-PLA2) levels and atherosclerosis-related diseases. The aim of this study was to investigate the role of Lp-PLA2 in the ischemic stroke and further offer clinical evidence that measuring Lp-PLA2 helps predict the risk of stroke occurrence and recurrence. A total of 328 hospitalized patients were recruited, including 179 cases of acute cerebral infarction (ACI) and 149 non-ACI controls. The serum level of Lp-PLA2 in ACI was significantly higher than non-ACI...
March 7, 2017: Neuroreport
https://www.readbyqxmd.com/read/28262563/greater-risk-of-stroke-of-undetermined-etiology-in-a-contemporary-hiv-infected-cohort-compared-with-uninfected-individuals
#7
Felicia C Chow, Richard W Price, Priscilla Y Hsue, Anthony S Kim
BACKGROUND: Although ischemic stroke risk is increased among people living with HIV infection, little is known about the epidemiology of ischemic stroke subtypes in contemporary HIV-infected cohorts. We examined the distribution of ischemic stroke subtypes among predominantly treated HIV-infected individuals to determine if and how the distribution differs from that of the general population. METHODS: We studied 60 HIV-infected and 60 HIV-uninfected adults with a history of first-ever ischemic stroke between 2000 and 2012...
March 2, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28262132/ischemic-stroke-associated-with-the-use-of-a-synthetic-cannabinoid-spice
#8
Sebastian Moeller, Caroline Lücke, Tobias Struffert, Bernhard Schwarze, Stefan T Gerner, Stefan Schwab, Martin Köhrmann, Kristin Machold, Alexandra Philipsen, Helge H Müller
Synthetic cannabinoids, i.e. "spice", are psychoactive drugs with increasing use worldwide. Spice may have harmful neuropsychiatric and physical side effects. Here, we present the case of a 25-year-old man with ischemic stroke after smoking spice on the previous evening. Diagnostic work-up was negative for other common causes of stroke. Toxicology screen unveiled the cannabimimetic ADB-FUBINACA in the drug sample and in patient's urine. The cardiac sympathomimetic effect of spice might have triggered an unnoticed episode of tachyarrhythmia and resulted in stroke via cardioembolic etiology...
February 2017: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/28241134/risk-of-ischemic-stroke-and-transient-ischemic-attack-is-increased-up-to-90-days-after-non-carotid-and-non-cardiac-surgery
#9
Armin J Grau, Martin Eicke, Christoph Burmeister, Roland Hardt, Eberhard Schmitt, Sieghard Dienlin
BACKGROUND: The risk of stroke after cardiac and carotid surgery is well established. In contrast, stroke risk in association with non-cardiac and non-carotid surgery and its time course are insufficiently known. We investigated the prevalence of recent and planned surgery among patients with stroke and transient ischemic attack (TIA), time dependency of stroke risk, stroke etiology, and interruption of antithrombotic medication in association with surgery. METHODS: Data on type and date of surgery and similar interventions within the last year or planned for the next 2 weeks were anonymously collected together with demographic data, vascular risk factors, stroke severity, handicap before stroke and stroke etiology within a state-wide, mandatory, hospital-based acute stroke care quality monitoring project (Rhineland-Palatinate, Germany) for 1 year (2010)...
February 28, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28238711/efficacy-and-safety-of-ticagrelor-versus-aspirin-in-acute-stroke-or-transient-ischaemic-attack-of-atherosclerotic-origin-a-subgroup-analysis-of-socrates-a-randomised-double-blind-controlled-trial
#10
Pierre Amarenco, Gregory W Albers, Hans Denison, J Donald Easton, Scott R Evans, Peter Held, Michael D Hill, Jenny Jonasson, Scott E Kasner, Per Ladenvall, Kazuo Minematsu, Carlos A Molina, Yongjun Wang, K S Lawrence Wong, S Claiborne Johnston
BACKGROUND: Ticagrelor is an effective antiplatelet therapy for patients with coronary atherosclerotic disease and might be more effective than aspirin in preventing recurrent stroke and cardiovascular events in patients with acute cerebral ischaemia of atherosclerotic origin. Our aim was to test for a treatment-by-ipsilateral atherosclerotic stenosis interaction in a subgroup analysis of patients in the Acute Stroke or Transient Ischaemic Attack Treated with Aspirin or Ticagrelor and Patient Outcomes (SOCRATES) trial...
February 23, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28229050/association-between-beta-fibrinogen-c148t-gene-polymorphism-and-risk-of-ischemic-stroke-in-a-north-indian-population-a-case-control-study
#11
Amit Kumar, Shubham Misra, Pradeep Kumar, Ram Sagar, Kameshwar Prasad
BACKGROUND AND PURPOSE: Stroke is a multifactorial disease influenced by both genetic and environmental factors. The aim of this case-control study was to determine the association between β-fibrinogen C148T (rs1800787) gene polymorphism and susceptibility to ischemic stroke (IS) in a North Indian population. METHODS: In the present case-control study, genotyping was performed using the PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) method on 250 IS patients and 250 age- and sex-matched controls...
January 2017: Pulse (Basel, Switzerland)
https://www.readbyqxmd.com/read/28224399/can-neuroimaging-differentiate-pfo-and-af-related-cardioembolic-stroke-from-the-other-embolic-sources-clinical-radiological-correlation-on-a-retrospective-study
#12
Alessandro Stecco, Martina Quagliozzi, Eleonora Soligo, Andrea Naldi, Alessia Cassarà, Lorenzo Coppo, Roberta Rosso, Angelo Sante Bongo, Paola Amatuzzo, Francesco Buemi, Elena Guenzi, Alessandro Carriero
PURPOSE: The aim of this retrospective study was to map the specific ischemic lesion patterns of distribution in patent foramen ovale-related stroke (PFO-stroke) and atrial fibrillation-related stroke (AF-stroke) in patients with idiopatic ischemic stroke. MATERIALS AND METHODS: 750 ischaemic strokes were screened on basis of diagnostic imaging and tests: patients with known causes were excluded. 171 patients with unknown cause were selected and divided in two groups: AF-stroke (43 patients) and PFO-stroke (128 patients)...
February 21, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28212133/potential-uselessness-and-futility-of-left-atrial-appendage-occlusion-and-patent-foramen-ovale-closure-in-cardioembolic-stroke
#13
Gian L Nicolosi
International guidelines indicate that interventional closure of left atrial appendage and patent foramen ovale may be considered in selected patients for stroke prevention. These procedures appear, however, from the published literature, at high risk of uselessness and futility in the single case, if not even capable to induce harm and adverse events. In fact, all reported systematic reviews and meta-analyses have not shown in a convincing manner the superiority of these procedures in stroke prevention, taking into account the occurrence of possible complications also, as compared with alternative medical treatment...
February 16, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28209460/pharmacologic-cardioversion-with-intravenous-amiodarone-is-likely-safe-in-neurocritically-ill-patients
#14
Michael Su, David Seki, Asma M Moheet
Neurological injury is often associated with cardiac abnormalities, including electrophysiological issues. Cardioversion of acute atrial fibrillation (<48h' duration) without anticoagulation carries about a 0.7% risk of thromboembolism. There is limited data on managing acute atrial fibrillation specifically in the neuroscience intensive care unit (NSICU) setting. We sought to determine the safety of using intravenous (IV) amiodarone for restoring sinus rhythm in patients with presumed new onset atrial or ventricular tachycardia after neurological injury...
February 13, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28208130/factors-related-to-cardioembolism-as-major-predictors-of-poor-survival-after-first-ever-middle-cerebral-artery-stroke-treated-with-thrombolysis
#15
Renata Dal-Prá Ducci, Marcos Christiano Lange, Viviane de Hiroki Flumignan Zétola, Tatjana Rundek
BACKGROUND AND PURPOSE: Prognostic factors related to mortality rates after stroke have been reported; however, most studies included different treatments and did not focus solely on ischemic stroke. The study aimed to report the short- and long-term survival and predictors of death in patients with first-ever ischemic stroke in the middle cerebral artery (MCA) territory, submitted to intravenous thrombolysis (IVT). METHODS: A prospective observational cohort study of patients with first-ever ischemic stroke in the MCA territory treated with IVT from March 2010 to February 2015 was conducted, and patients were followed up until May 2015...
February 17, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28199366/micrornas-regulating-cluster-of-differentiation-46-cd46-in-cardioembolic-and-non-cardioembolic-stroke
#16
Jun Rong Tan, Kay Sin Tan, Fung Lin Yong, Arunmozhiarasi Armugam, Chee Woon Wang, Kandiah Jeyaseelan, Peter Tsun-Hon Wong
Ischemic stroke is a major cause of mortality and morbidity globally. Among the ischemic stroke subtypes, cardioembolic stroke is with poor functional outcome (Modified Rankin score ≥ 2). Early diagnosis of cardioembolic stroke will prove beneficial. This study examined the microRNAs targeting cluster of differentiation 46 (CD46), a potential biomarker for cardioembolic stroke. CD46 mRNA level was shown to be differentially expressed (p < 0.001) between cardioembolic stroke (median = 1.32) and non-cardioembolic stroke subtypes (large artery stroke median = 5...
2017: PloS One
https://www.readbyqxmd.com/read/28195503/pro-atrial-natriuretic-peptide-and-prediction-of-atrial-fibrillation-and-stroke-the-malm%C3%A3-preventive-project
#17
John Berntsson, J Gustav Smith, Peter M Nilsson, Bo Hedblad, Olle Melander, Gunnar Engström
Background The increasing prevalence of atrial fibrillation and novel therapeutic tools to prevent cardioembolic stroke has increased the need for risk markers. Objectives This study explored the relationship between the midregional sequence of pro-atrial natriuretic peptide (MR-proANP) levels with the risk of atrial fibrillation and stroke, and whether measurement of MR-proANP improves the prediction of these outcomes. Methods MR-proANP was measured in fasting blood samples of 5130 subjects (69% men, mean age 69...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28190604/the-fate-of-acute-lacunar-lesions-in-terms-of-shape-and-size
#18
Ki Jeong Lee, Hyeyoung Jung, Yoon-Sang Oh, Eun Ye Lim, A-Hyun Cho
BACKGROUND: The description of lacunar infarcts on imaging is widely variable. In particular, there are fewer agreements on lacunar lesion size and the presence of cavitation. In this regard, we investigated the changes in size and shape of acute ischemic lesion that is possibly considered as small vessel occlusion on long-term follow-up. METHODS: Patients with acute single subcortical ischemic lesion on penetrating arterial territories and without definite cause of cardioembolism and large vessel disease were included...
February 9, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28188400/-juvenile-stroke-what-is-important
#19
M Fischer, B Eckert, J Röther
Stroke in young adults is a diagnostic and therapeutic challenge for all persons involved. Approximately 15% of ischemic strokes occur in young adults. Lack of awareness of the symptoms in emergency departments often results in delayed diagnosis and access to specific therapeutic options, such as revascularization. The causes are often heterogeneous and necessitate specific investigations. The etiology of juvenile stroke includes drug abuse, vasculitis and arteriopathies, such as reversible vasoconstriction syndrome and posterior reversible encephalopathy syndrome, although the prevalence of classical vascular risk factors is high...
February 10, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28178140/utility-of-duranta-a-wireless-patch-type-electrocardiographic-monitoring-system-developed-in-japan-in-detecting-covert-atrial-fibrillation-in-patients-with-cryptogenic-stroke-a-case-report
#20
Hisanao Akiyama, Saki Nukui, Takashi Araga, Masashi Hoshino, Keita Tanaka, Satoru Kashima, Rie Sasaki, Kenji Uchino, Yasuhiro Hasegawa
RATIONALE: Subcutaneous implantable electrocardiographs are highly effective in detecting covert atrial fibrillation (AF) in cryptogenic stroke. However, these invasive devices are not indicated for all cryptogenic stroke patients, and noninvasive improvements over conventional Holter-type ambulatory electrocardiography are needed. We evaluated the clinical application and effectiveness of Duranta (ImageONE Co., Ltd.), a wireless patch-type electrocardiographic monitoring system developed in Japan for chronically ill patients or home-based patients at the end of life...
February 2017: Medicine (Baltimore)
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