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Cardioembolic stroke

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https://www.readbyqxmd.com/read/29691787/the-role-of-circle-of-willis-anatomy-variations-in-cardio-embolic-stroke-a-patient-specific-simulation-based-study
#1
Debanjan Mukherjee, Neel D Jani, Jared Narvid, Shawn C Shadden
We describe a patient-specific simulation based investigation on the role of Circle of Willis anatomy in cardioembolic stroke. Our simulation framework consists of medical image-driven modeling of patient anatomy including the Circle, 3D blood flow simulation through patient vasculature, embolus transport modeling using a discrete particle dynamics technique, and a sampling based approach to incorporate parametric variations. A total of 24 (four patients and six Circle anatomies including the complete Circle) models were considered, with cardiogenic emboli of varying sizes and compositions released virtually and tracked to compute distribution to the brain...
April 24, 2018: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/29661647/which-ischemic-stroke-subtype-is-associated-with-hyperhomocysteinemia
#2
Levent Gungor, Murat Polat, Mehlika Berra Ozberk, Bahattin Avci, Ummet Abur
BACKGROUND: Stroke is still a major global health problem in both developed and developing countries. Defining stroke subtype and underlying etiologies is a major step to choose the best method for prophylaxis. Homocysteine is an endothelial toxin and elevated levels have been associated with stroke risk. In this study, we hypothesized that serum total homocysteine level may be related with specific atherothrombotic ischemic stroke subtypes and aimed to find if high serum homocysteine levels are correlated with any specific ischemic stroke subtype...
April 13, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29629263/a-biatrial-myxoma-with-triple-ripples
#3
Ramachandra Barik
Cardiac myxoma is a benign tumor, but it is known for its space-occupying effect at the site of origin and frequent systemic embolization. This case report highlights a biatrial myxoma of interatrial septum who presented with significant tricuspid valve regurgitation, atrial fibrillation, and cardioembolic stroke of the left parietal lobe, i.e., a biatrial myxoma with triple ripples.
January 2018: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29628339/ischemic-stroke-secondary-to-paradoxical-embolism-through-a-pulmonary-arteriovenous-malformation-case-report-and-review-of-the-literature
#4
Ryan Cappa, Jeanette Du, Joseph F Carrera, Jimmy V Berthaud, Andrew M Southerland
Paradoxical embolism due to isolated pulmonary arteriovenous malformation (AVM) is an uncommon cause of ischemic stroke, with the majority occurring in patients who have not yet been diagnosed with their malformation. We report a 32-year-old man who presented with an abrupt onset of right facial weakness and expressive aphasia. Brain magnetic resonance imaging revealed an acute infarct in the left middle cerebral artery territory and chronic infarcts in the bilateral cerebellar hemispheres. A cardioembolic mechanism was initially considered in the setting of perimyocarditis diagnosed a few months earlier...
April 5, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29627170/spontaneous-micro-aggregation-of-platelets-predicts-clinical-outcome-in-acute-ischemic-stroke
#5
Risa Kudoh, Kasumi Mikami, Maiko Kitajima, Keiko Aizu, Yui Kitajima, Joji Hagii, Hirofumi Metoki, Satoshi Seino, Yoshiko Baba, Minoru Yasujima, Tomohiro Osanai
BACKGROUNDS: Spontaneous micro-aggregation of platelets (SMAP) is frequently observed in stroke patients and is a trigger for the additional development of larger thrombi. We tested the hypothesis that SMAP may predict clinical outcome in acute ischemic stroke patients. METHODS AND RESULTS: Consecutive acute ischemic stroke patients (n = 358) who were transferred to our hospital within 24 hours after its onset were enrolled. Peripheral venous blood was sampled to measure various parameters when they arrived...
April 4, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29618553/stroke-among-young-west-africans-evidence-from-the-siren-stroke-investigative-research-and-educational-network-large-multisite-case-control-study
#6
Fred Stephen Sarfo, Bruce Ovbiagele, Mulugeta Gebregziabher, Kolawole Wahab, Rufus Akinyemi, Albert Akpalu, Onoja Akpa, Reginald Obiako, Lukman Owolabi, Carolyn Jenkins, Mayowa Owolabi
BACKGROUND AND PURPOSE: Stroke in lower and middle-income countries affects a young and productive age group. Data on factors associated with stroke in the young are sorely lacking from lower and middle-income countries. Our objective is to characterize the nature of stroke and its risk factors among young West Africans aged <50 years old. METHODS: The SIREN (Stroke Investigative Research and Educational Network) is a multicenter, case-control study involving 15 sites in Nigeria and Ghana...
April 4, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29617449/assessment-of-veins-in-t2-weighted-mr-angiography-predicts-infarct-growth-in-hyperacute-ischemic-stroke
#7
Susumu Yamaguchi, Nobutaka Horie, Minoru Morikawa, Yohei Tateishi, Takeshi Hiu, Yoichi Morofuji, Tsuyoshi Izumo, Kentaro Hayashi, Takayuki Matsuo
BACKGROUND AND PURPOSE: T2*-weighted magnetic resonance angiography (SWAN) detects hemodynamic insufficiency as hypointense areas in medullary or cortical veins. We therefore investigated whether SWAN can help predict ischemic penumbra-like lesions in patients with acute ischemic stroke (AIS). MATERIALS AND METHODS: Magnetic resonance imaging (MRI) records-including SWAN, diffusion-weighted imaging (DWI), and magnetic resonance angiography (MRA)-of consecutive patients with major vessel occlusion within 6 h from AIS onset were analyzed...
2018: PloS One
https://www.readbyqxmd.com/read/29609876/covert-atrial-fibrillation-and-atrial-high-rate-episodes-as-a-potential-cause-of-embolic-strokes-of-undetermined-source-their-detection-and-possible-management-strategy
#8
REVIEW
Hirofumi Tomita, Shingo Sasaki, Joji Hagii, Norifumi Metoki
Cryptogenic ischemic stroke, defined as stroke of undetermined etiology, accounts for 7-25% of all ischemic strokes. Stroke severity is reported to be less severe than cardioembolic stroke and similar to large-artery atherosclerosis. Because its etiology is believed to be mostly an embolic type, it is often called "embolic strokes of undetermined source" (ESUS). In patients with ESUS, it is of significant importance to seek an embolic source with intensive diagnostic assessment, which mostly originates from the heart...
March 30, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29607895/seasonal-variations-in-neurological-severity-and-outcomes-of-ischemic-stroke-5-year-single-center-observational-study
#9
Kazunori Toyoda, Masatoshi Koga, Hiroshi Yamagami, Chiaki Yokota, Shoichiro Sato, Manabu Inoue, Tomotaka Tanaka, Kaoru Endo, Jun Fujinami, Masafumi Ihara, Kazuyuki Nagatsuka, Kazuo Minematsu
BACKGROUND: Seasonal variations in the severity and outcomes of stroke remain unclarified.Methods and Results:A total of 2,965 acute ischemic stroke patients from a single-center prospective registry were studied. Among the total patients, stroke onset did not vary by season, though it varied with a peak in winter when limited to patients >75 years old (P=0.026), when limited to patients with moderate-to-severe initial neurological deficits (National Institutes of Health Stroke Scale Score ≥10, P=0...
March 31, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29607570/incidence-and-etiology-of-microinfarcts-in-patients-with-ischemic-stroke
#10
Jamary Oliveira-Filho, Hakan Ay, Ashkan Shoamanesh, Kwang Yeol Park, Ross Avery, Mine Sorgun, Gyeong-Moon Kim, Pedro T Cougo, Steven M Greenberg, M Edip Gurol
BACKGROUND AND PURPOSE: Cerebral microinfarcts (CMI) are associated with intracerebral hemorrhage due to small vessel disease (SVD) in studies not including an ischemic etiologic workup. We aimed to determine their incidence and potential causes in a large ischemic stroke (IS) cohort. METHODS: Consecutive patients with MRI-confirmed IS within 72 hours of onset were enrolled. Subjects had either single high-risk embolic source (cardioembolic or large vessel disease) or no embolic source...
April 1, 2018: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/29606886/influence-of-abcb1-and-cyp3a5-gene-polymorphisms-on-pharmacokinetics-of-apixaban-in-patients-with-atrial-fibrillation-and-acute-stroke
#11
Alexander Valerevich Kryukov, Dmitry Alekseevich Sychev, Denis Anatolevich Andreev, Kristina Anatolievna Ryzhikova, Elena Anatolievna Grishina, Anastasia Vladislavovna Ryabova, Mark Alekseevich Loskutnikov, Valeriy Valerevich Smirnov, Olga Dmitrievna Konova, Irina Andreevna Matsneva, Pavel Olegovich Bochkov
Introduction: Difficulties in non-vitamin K anticoagulant (NOAC) administration in acute stroke can be associated with changes in pharmacokinetic parameters of NOAC such as biotransformation, distribution, and excretion. Therefore, obtaining data on pharmacokinetics of NOAC and factors that affect it may help develop algorithms for personalized use of this drug class in patients with acute cardioembolic stroke. Patients and methods: Pharmacokinetics of apixaban in patients with acute stroke was studied earlier by Kryukov et al...
2018: Pharmacogenomics and Personalized Medicine
https://www.readbyqxmd.com/read/29600887/prognosis-of-dolichoectasia-in-non-cardioembolic-transient-ischemic-attack-and-minor-stroke
#12
Xinmiao Zhang, Jing Jing, Xingquan Zhao, Liping Liu, Xia Meng, Anxin Wang, Yuesong Pan, David Wang, Yilong Wang, Yongjun Wang
Objectives This study aimed to estimate the prognosis of dolichoectasia in non-cardioembolic transient ischemic attack (TIA) and minor stroke patients. Methods Data were derived from the imaging subgroup of patients in the Clopidogrel in High-risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial. Dolichoectasia was defined as ectasia (basilar artery diameter >4.5 mm) and dolichosis (either basilar artery bifurcation above the suprasellar cistern or lateral to the margin of the clivus or dorsum sellae)...
March 30, 2018: Neurological Research
https://www.readbyqxmd.com/read/29595639/an-overlooked-cause-in-a-patient-with-recurrent-ischemic-stroke-a-case-report
#13
Xunzhe Yang, Mingsheng Liu, Yicheng Zhu, Xiaobo Zhang, Shan Gao, Jun Ni
RATIONALE: The majority of ischemic strokes are due to cardioembolism, large vessel atherothromboembolism, small vessel occlusive disease, or other unusual mechanisms. In most clinical settings, many strokes without a well-defined etiology requires a thorough diagnostic evaluation, otherwise the underlying cause might be easily overlooked. Here we report on the rare cause of a patient with recurrent stroke. PATIENT CONCERNS: A 50-year-old female patient had a 4-year history of recurrent acute onset of neurological deficits...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29590386/surgical-management-of-the-left-atrial-appendage-a-must-or-a-myth
#14
Thorsten Hanke
Surgical treatment of the left atrial appendage (LAA) has increased over the past few years. The most serious complication of atrial fibrillation is a cerebral cardioembolic stroke. In most patients with atrial fibrillation, the LAA is the anatomical source of the embolism. Several surgical techniques for occluding the LAA using different devices have been developed with different prospects of success. It is still not clear which of these techniques represents the optimum treatment for reducing the incidence of stroke in patients with atrial fibrillation...
April 1, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29581343/risk-factors-for-poststroke-cognitive-decline-the-regards-study-reasons-for-geographic-and-racial-differences-in-stroke
#15
Deborah A Levine, Virginia G Wadley, Kenneth M Langa, Frederick W Unverzagt, Mohammed U Kabeto, Bruno Giordani, George Howard, Virginia J Howard, Mary Cushman, Suzanne E Judd, Andrzej T Galecki
BACKGROUND AND PURPOSE: Poststroke cognitive decline causes disability. Risk factors for poststroke cognitive decline independent of survivors' prestroke cognitive trajectories are uncertain. METHODS: Among 22 875 participants aged ≥45 years without baseline cognitive impairment from the REGARDS cohort (Reasons for Geographic and Racial Differences in Stroke), enrolled from 2003 to 2007 and followed through September 2015, we measured the effect of incident stroke (n=694) on changes in cognitive functions and cognitive impairment (Six-Item Screener score <5) and tested whether patient factors modified the effect...
April 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29581340/arterial-wall-imaging-in-pediatric-stroke
#16
Nomazulu Dlamini, Ivanna Yau, Prakash Muthusami, David J Mikulis, Jorina Elbers, Mahmoud Slim, Rand Askalan, Daune MacGregor, Gabrielle deVeber, Manohar Shroff, Mahendranath Moharir
BACKGROUND AND PURPOSE: Arteriopathy is common in childhood arterial ischemic stroke (AIS) and predicts stroke recurrence. Currently available vascular imaging techniques mainly image the arterial lumen rather than the vessel wall and have a limited ability to differentiate among common arteriopathies. We aimed to investigate the value of a magnetic resonance imaging-based technique, namely noninvasive arterial wall imaging (AWI), for distinguishing among arteriopathy subtypes in a consecutive cohort of children presenting with AIS...
April 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29577862/increased-arterial-stiffness-is-associated-with-poor-collaterals-in-acute-ischemic-stroke-from-large-vessel-occlusion
#17
Maurizio Acampa, Daniele Giuseppe Romano, Pietro Enea Lazzerini, Sara Leonini, Francesca Guideri, Rossana Tassi, Tommaso Casseri, Sandra Bracco, Giuseppe Martini
BACKGROUND: Cerebral collateral circulation is a network of arterial anastomotic channels capable of providing supplementary perfusion to brain regions in response to ischemic insults. Arterial stiffness could negatively affect collateral circulation development, by means of its effects on structural intracerebral vasculature. OBJECTIVE: The aim of our study is to investigate a possible link between arterial stiffness and presence of collateral circulation in patients with acute ischemic stroke...
March 25, 2018: Current Neurovascular Research
https://www.readbyqxmd.com/read/29569402/use-of-neutrophil-lymphocyte-ratio-for-risk-stratification-and-relationship-with-time-in-therapeutic-range-in-patients-with-nonvalvular-atrial-fibrillation-a-pilot-study
#18
Kahraman Cosansu, Mehmet Bulent Vatan, Huseyin Gunduz, Ramazan Akdemir
BACKGROUND: Atrial fibrillation is one of the most common abnormal heart rhythms. Neutrophil-lymphocyte ratio (NLR) has emerged as a potential marker for the level of inflammation in cardiac disorders. HYPOTHESIS: NLR might be associated with thrombosis and bleeding risk scores and might predict cardioembolic risk in nonvalvular atrial fibrillation (NVAF) patients within the therapeutic international normalized ratio (INR). METHODS: We enrolled 272 patients taking warfarin for NVAF and classified them into 2 groups: Group A consisted of patients (n = 132) whose time in therapeutic range (TTR) was ≥65%, and Group B comprised patients (n = 139) whose TTR was <65%...
March 22, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29567985/trends-in-stroke-subtypes-and-vascular-risk-factors-in-a-stroke-center-in-china-over-10-years
#19
Danyang Tian, Qiong Yang, Quan Dong, Nan Li, Bernard Yan, Dongsheng Fan
Rapid economic development in China has caused marked changes in people's lifestyles and medical technology. Exploration of stroke subtype trends is necessary to provide physicians with vital insight for early diagnosis and treatment. We included stroke patients admitted from 2006 to 2015. Trends in stroke subtypes and vascular risk factors were investigated. There were 5521 patients, including 4534 (82.1%) ischemic stroke (IS), 813 (14.7%) intracerebral hemorrhage (ICH) and 174 (3.2%) subarachnoid hemorrhage (SAH) patients...
March 22, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29567118/cortical-hand-knob-stroke-report-of-25-cases
#20
Péter Orosz, Ildikó Szőcs, Gábor Rudas, András Folyovich, Dániel Bereczki, Ildikó Vastagh
BACKGROUND: Although uncommon, cortical hand knob territory stroke is a well-defined stroke entity that mimics peripheral nerve damage. Atherosclerosis and hypertension are the most prevalent risk factors for the disease. Embolic origin, either artery-to-artery or cardioembolic, has been suggested as the most probable underlying mechanism. MATERIALS AND METHODS: Twenty-five patients with isolated hand palsy due to central origin were admitted to our department between 2006 and 2016...
March 19, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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