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https://www.readbyqxmd.com/read/27871507/use-of-gabaergic-sedatives-after-subarachnoid-hemorrhage-is-associated-with-worse-outcome-preliminary-findings
#1
Daniel N Hertle, Christopher Beynon, Jan O Neumann, Edgar Santos, Renan Sánchez-Porras, Andreas W Unterberg, Oliver W Sakowitz
STUDY OBJECTIVE: Recent experimental evidence identified GABAergic sedation as a possible cause for deprived neuroregeneration and poor outcome after acute brain injury. Patients with aneurysmal subarachnoid hemorrhage are often sedated, and GABAergic sedation, such as midazolam and propofol, is commonly used. DESIGN: Retrospective cohort study based on a prospectively established database. SETTING: Single-center neurointensive care unit. PATIENTS: Twenty-nine patients after subarachnoid hemorrhage...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871451/aneurysm-rebleeding-after-poor-grade-aneurysmal-subarachnoid-hemorrhage-predictors-and-impact-on-clinical-outcomes
#2
Bing Zhao, Yilin Fan, Ye Xiong, Rong Yin, Kuang Zheng, Zequn Li, Xianxi Tan, Hua Yang, Ming Zhong
BACKGROUND: Aneurysm rebleeding is a major cause of morbidity and mortality after aneurysmal subarachnoid hemorrhage (aSAH) and more often occurs in patients with poor-grade aSAH. Limited data on predictors of rebleeding in these patients are available. OBJECTIVE: To investigate predictors of aneurysm rebleeding after poor-grade aSAH and the association of rebleeding with clinical outcomes. METHODS: A multicenter poor-grade aneurysm study was a prospective and observational registry of consecutive patients who presented with poor-grade aSAH defined as a World Federation of Neurosurgical Societies (WFNS) grade of IV or V...
December 15, 2016: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/27871449/botulinum-toxin-as-early-intervention-for-spasticity-after-stroke-or-non-progressive-brain-lesion-a-meta-analysis
#3
Raymond L Rosales, Fran Efendy, Ericka Sa Teleg, Mary Md Delos Santos, Mary Ce Rosales, Marc Ostrea, Michelle J Tanglao, Arlene R Ng
Spasticity is a functionally limiting disorder that commonly occurs following stroke or severe brain injury, and may lead to disability and pain. In tandem with neurorehabilitation, botulinum toxin type A (BoNT-A) is the recommended first-line treatment for spasticity and, to date, the majority of trials have reported BoNT-A use in patients >6months after ictus. The present meta-analysis aimed to evaluate the effects of early BoNT-A injection for post-stroke spasticity on improvements in hypertonicity, disability, function and associated pain...
December 15, 2016: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/27846309/use-of-antihypertensive-drugs-and-ischemic-stroke-severity-is-there-a-role-for-angiotensin-ii
#4
Wen Yea Hwong, Michiel L Bots, Sharmini Selvarajah, Zariah Abdul Aziz, Norsima Nazifah Sidek, Wilko Spiering, L Jaap Kappelle, Ilonca Vaartjes
BACKGROUND: The increase in angiotensin II (Ang II) formation by selected antihypertensive drugs is said to exhibit neuroprotective properties, but this translation into improvement in clinical outcomes has been inconclusive. We undertook a study to investigate the relationship between types of antihypertensive drugs used prior to a stroke event and ischemic stroke severity. We hypothesized that use of antihypertensive drugs that increase Ang II formation (Ang II increasers) would reduce ischemic stroke severity when compared to antihypertensive drugs that suppress Ang II formation (Ang II suppressors)...
2016: PloS One
https://www.readbyqxmd.com/read/27845349/granulocyte-colony-stimulating-factor-g-csf-for-stroke-an-individual-patient-data-meta-analysis
#5
Timothy J England, Nikola Sprigg, Andrey M Alasheev, Andrey A Belkin, Amit Kumar, Kameshwar Prasad, Philip M Bath
Granulocyte colony stimulating factor (G-CSF) may enhance recovery from stroke through neuroprotective mechanisms if administered early, or neurorepair if given later. Several small trials suggest administration is safe but effects on efficacy are unclear. We searched for randomised controlled trials (RCT) assessing G-CSF in patients with hyperacute, acute, subacute or chronic stroke, and asked Investigators to share individual patient data on baseline characteristics, stroke severity and type, end-of-trial modified Rankin Scale (mRS), Barthel Index, haematological parameters, serious adverse events and death...
November 15, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27834742/results-of-the-ictus-2-trial-intravascular-cooling-in-the-treatment-of-stroke-2
#6
Patrick Lyden, Thomas Hemmen, James Grotta, Karen Rapp, Karin Ernstrom, Teresa Rzesiewicz, Stephanie Parker, Mauricio Concha, Syed Hussain, Sachin Agarwal, Brett Meyer, Julie Jurf, Irfan Altafullah, Rema Raman
BACKGROUND AND PURPOSE: Therapeutic hypothermia is a potent neuroprotectant approved for cerebral protection after neonatal hypoxia-ischemia and cardiac arrest. Therapeutic hypothermia for acute ischemic stroke is safe and feasible in pilot trials. We designed a study protocol to provide safer, faster therapeutic hypothermia in stroke patients. METHODS: Safety procedures and 4°C saline infusions for faster cooling were added to the ICTuS trial (Intravascular Cooling in the Treatment of Stroke) protocol...
December 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27834594/clinical-course-of-untreated-thalamic-cavernous-malformations-hemorrhage-risk-and-neurological-outcomes
#7
Kai-Bing Tian, Jing-Jie Zheng, Jun-Peng Ma, Shu-Yu Hao, Liang Wang, Li-Wei Zhang, Zhen Wu, Jun-Ting Zhang, Da Li
OBJECTIVE The natural history of cerebral cavernous malformations (CMs) has been widely studied, but the clinical course of untreated thalamic CMs is largely unknown. Hemorrhage of these lesions can be devastating. The authors undertook this study to obtain a prospective hemorrhage rate and provide a better understanding of the prognosis of untreated thalamic CMs. METHODS This longitudinal cohort study included patients with thalamic CMs who were diagnosed between 2000 and 2015. Clinical data were recorded, radiological studies were extensively reviewed, and follow-up evaluations were performed...
November 11, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27818312/loss-of-consciousness-at-onset-of-aneurysmal-subarachnoid-hemorrhage-is-associated-with-functional-outcomes-in-good-grade-patients
#8
Justin Wang, Naif M Alotaibi, Muhammad Ali Akbar, Oliver G S Ayling, George M Ibrahim, R Loch Macdonald
BACKGROUND: Transient loss of consciousness (LOC) is one of the most common presentations of aneurysmal subarachnoid hemorrhage (SAH) and may be an indicator of early brain injury. The aim of the current study was to examine the association of LOC to functional outcomes in patients with good-grade SAH. METHODS: We searched the Subarachnoid Hemorrhage International Trialists Repository for patients that presented with LOC at ictus of SAH. A propensity score analysis was performed on good-grade patients (defined as World Federation of Neurosurgical Societies grades 1-3) to balance selected covariates between those with and without LOC...
November 3, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27811309/baseline-characteristics-of-the-3096-patients-recruited-into-the-triple-antiplatelets-for-reducing-dependency-after-ischemic-stroke-trial
#9
Philip Mw Bath, Jason P Appleton, Maia Beridze, Hanne Christensen, Robert A Dineen, Lelia Duley, Timothy J England, Stan Heptinstall, Marilyn James, Kailash Krishnan, Hugh S Markus, Stuart Pocock, Annemarei Ranta, Thompson G Robinson, Katie Flaherty, Polly Scutt, Graham S Venables, Lisa J Woodhouse, Nikola Sprigg
BACKGROUND: The risk of recurrence following ischemic stroke or transient ischemic attack is highest immediately after the event. Antiplatelet agents are effective in reducing the risk of recurrence and two agents are superior to one in the early phase after ictus. DESIGN: The triple antiplatelets for reducing dependency after ischemic stroke trial was an international multicenter prospective randomized open-label blinded-endpoint trial that assessed the safety and efficacy of short-term intensive antiplatelet therapy with three agents (combined aspirin, clopidogrel and dipyridamole) as compared with guideline treatment in acute ischemic stroke or transient ischemic attack...
November 3, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27807280/blood-biomarkers-associated-with-neurological-deterioration-in-patients-with-acute-penetrating-artery-territory-infarction-a-multicenter-prospective-observational-study
#10
Tomohiro Kawano, Kotaro Miyashita, Mariko Takeuchi, Yoshinari Nagakane, Yasumasa Yamamoto, Kenji Kamiyama, Yasuhiro Manabe, Kenichi Todo, Norifumi Metoki, Yasuhisa Akaiwa, Kazunori Toyoda, Kazuyuki Nagatsuka
BACKGROUND AND PURPOSE: Neurological deterioration in acute penetrating artery territory infarction is unpredictable and associated with unfavorable clinical outcomes. The aim of this prospective study was to clarify the cause of neurological worsening and predict clinical outcomes using blood biomarkers. METHODS: Eight Japanese stroke centers participated. Blood samples were obtained within 24 h (the first sampling) and on day 7 in hospital (the second sampling) in patients with penetrating artery territory infarction, arriving within two days of stroke onset...
November 2, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27768752/use-of-a-diagnostic-score-to-prioritize-computed-tomographic-ct-imaging-for-patients-suspected-of-ischemic-stroke-who-may-benefit-from-thrombolytic-therapy
#11
Wen Yea Hwong, Michiel L Bots, Sharmini Selvarajah, L Jaap Kappelle, Zariah Abdul Aziz, Norsima Nazifah Sidek, Ilonca Vaartjes
BACKGROUND: A shortage of computed tomographic (CT) machines in low and middle income countries often results in delayed CT imaging for patients suspected of a stroke. Yet, time constraint is one of the most important aspects for patients with an ischemic stroke to benefit from thrombolytic therapy. We set out to assess whether application of the Siriraj Stroke Score is able to assist physicians in prioritizing patients with a high probability of having an ischemic stroke for urgent CT imaging...
2016: PloS One
https://www.readbyqxmd.com/read/27758945/uric-acid-therapy-prevents-early-ischemic-stroke-progression-a-tertiary-analysis-of-the-urico-ictus-trial-efficacy-study-of-combined-treatment-with-uric-acid-and-r-tpa-in-acute-ischemic-stroke
#12
Sergio Amaro, Carlos Laredo, Arturo Renú, Laura Llull, Salvatore Rudilosso, Víctor Obach, Xabier Urra, Anna M Planas, Ángel Chamorro
BACKGROUND AND PURPOSE: Identification of neuroprotective therapies in acute ischemic stroke is imperative. We report a predefined analysis of the URICO-ICTUS trial (Efficacy Study of Combined Treatment With Uric Acid and r-tPA in Acute Ischemic Stroke) assessing the efficacy of uric acid (UA) compared with placebo to prevent early ischemic worsening (EIW) and the relevance of collateral circulation. METHODS: URICO-ICTUS was a double-blind, placebo-controlled, phase 2b trial where a total of 411 patients treated with alteplase within 4...
November 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27752513/longitudinal-profile-of-iron-accumulation-in-good-grade-subarachnoid-hemorrhage
#13
Christoph Scherfler, Alois Josef Schiefecker, Margarete Delazer, Ronny Beer, Thomas Bodner, Georg Spinka, Mario Kofler, Bettina Pfausler, Christian Kremser, Michael Schocke, Thomas Benke, Elke R Gizewski, Erich Schmutzhard, Raimund Helbok
OBJECTIVE: MRI parameters of iron concentration (R2*, transverse relaxation rate), microstructural integrity (mean diffusivity and fractional anisotropy), as well as gray and white matter volumes were analyzed in patients with subarachnoid hemorrhage (SAH) and uncomplicated clinical course to detect the evolution of brain tissue changes 3 weeks and 12 months after ictus. METHODS: MRI scans of 14 SAH patients (aneurysm of the anterior communicating artery, n = 5; no aneurysm n = 9) were compared with 14 age-matched healthy control subjects...
October 2016: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/27729604/-emergency-bypass-surgery-for-progressive-cerebral-infarction-following-hemorrhagic-onset-of-moyamoya-disease-a-case-report
#14
Junya Hatakeyama, Toshiharu Yanagisawa, Erina Kudo, Shuntaro Togashi, Hiroaki Shimizu
Progressive cerebral infarction in patients with hemorrhagic onset of moyamoya disease is rare, and a treatment strategy is not well established. Here, we report a case that was successfully treated with emergency bypass surgery. A 58-year-old woman presented with a sudden disturbance of consciousness and right-sided hemiparesis. Computed tomography(CT)showed intraventricular hemorrhage involving the head of the left caudate nucleus. Ventricular drainage was immediately performed, and the patient was treated conservatively...
October 2016: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/27670604/refining-mild-to-moderate-alzheimer-disease-screening-a-tool-for-clinicians
#15
Natalia Del Campo, Matteo Cesari, Marco Canevelli, Emiel O Hoogendijk, Matthieu Lilamand, Eirini Kelaiditi, Maria E Soto, Pierre-Jean Ousset, Michael W Weiner, Sandrine Andrieu, Bruno Vellas
OBJECTIVES: Recent evidence suggests that a substantial minority of people clinically diagnosed with probable Alzheimer disease (AD) in fact do not fulfill the neuropathological criteria for the disease. A clinical hallmark of these phenocopies of AD is that these individuals tend to remain cognitively stable for extended periods of time, in contrast to their peers with confirmed AD who show a progressive decline. We aimed to examine the prevalence of patients clinically diagnosed with mild-to-moderate AD who do not experience the expected clinically significant cognitive decline and identify markers easily available in routine medical practice predictive of a stable cognitive prognosis in this population...
October 1, 2016: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/27652041/clinical-re-evaluation-of-removing-blood-stasis-therapy-in-treating-acute-intracerebral-hemorrhage-safety-and-efficacy-a-protocol-for-a-randomized-controlled-multicenter-study-crrich-trial
#16
Liling Zeng, Jianwen Guo, Jing Wang, Qixin Zhang, Haijun Li, Rongming Lin
BACKGROUND: Hypertensive intracerebral hemorrhage (HICH) is one of the most devastating forms of stroke. Currently, no specific therapies for HICH except general medical care. However, in China, medicine of promoting blood circulation (PBC) and removing blood stasis (RBS) are widely and efficiently used to treat HICH and become a potentially effective treatment for the secondary effects of HICH to alleviate brain injury, accelerate neuronal recovery, and improve the prognosis. In order to evaluate the safety and effect of PBC and RBS herbal drugs, we design a prospective, randomized, open, double-blind controlled clinical trial on the hematoma enlargement in HICH patients treating with PBC and RBS herbal medicine within 6 h time window from the symptom onset...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27639522/10-year-institutional-retrospective-case-series-of-decompressive-craniectomy-for-malignant-middle-cerebral-artery-infarction-mmcai
#17
Simon Lammy, Basel Al-Romhain, Laura Osborne, Edward J St George
A 10-year retrospective case series of patients undergoing decompressive craniectomy for malignant middle cerebral artery infarction (mMCAI) was undertaken (2005-2015). Patient demographics, co-morbidities, pre- and post-operative neurological state, operative timescales, craniectomy dimensions and Glasgow Outcome Scale (GOS) scores were analysed. Overall 40 patients underwent a decompressive craniectomy for mMCAI with a 30-day mortality of 17.5% (n=7). 17 patients (42.5%) were male with a mean age of 43yrs (range: 16-64yrs)...
September 14, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27593801/neuronavigation-assisted-aspiration-and-electro-acupuncture-for-hypertensive-putaminal-hemorrhage-a-suitable-technique-on-hemiplegia-rehabilitation
#18
Yuhai Zhang, Rami Al-Aref, Haixia Fu, Yunxue Yang, Yugong Feng, Chao Zhao, Jun Dong, Guoqing Sun
AIM: To identify whether neuronavigation-assisted aspiration (NA) combined with electro-acupuncture (EA) provides better motor recovery in events of Hypertensive Putaminal Hematoma (HPH) sized 30 to 50 ml. This study aims to examine whether NA and EA have additional value to cerebral hemorrhage motor rehabilitation. MATERIAL AND METHODS: 240 patients with HPH sized 30 to 50 ml were admitted within 6 to 10 hours after stroke ictus were included in this study. All the cases were divided into 4 groups and each group contains 60 cases equally...
January 25, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27556936/predicting-the-rate-of-cognitive-decline-in-alzheimer-disease-data-from-the-ictus-study
#19
Marco Canevelli, Eirini Kelaiditi, Natalia Del Campo, Giuseppe Bruno, Bruno Vellas, Matteo Cesari
BACKGROUND: Different rates of cognitive progression have been observed among Alzheimer disease (AD) patients. The present study aimed at evaluating whether the rate of cognitive worsening in AD may be predicted by widely available and easy-to-assess factors. METHODS: Mild to moderate AD patients were recruited in the ICTUS study. Multinomial logistic regression analysis was performed to measure the association between several sociodemographic and clinical variables and 3 different rates of cognitive decline defined by modifications (after 1 year of follow-up) of the Mini Mental State Examination (MMSE) score: (1) "slow" progression, as indicated by a decrease in the MMSE score ≤1 point; (2) "intermediate" progression, decrease in the MMSE score between 2 and 5 points; and (3) "rapid" progression, decrease in the MMSE score ≥6 points...
July 2016: Alzheimer Disease and Associated Disorders
https://www.readbyqxmd.com/read/27478977/good-collateral-circulation-predicts-favorable-outcomes-in-intravenous-thrombolysis-a-systematic-review-and-meta-analysis
#20
X Leng, L Lan, L Liu, T W Leung, K S Wong
BACKGROUND AND PURPOSE: Baseline collateral status has been correlated with outcomes of acute ischaemic stroke patients receiving intravenous thrombolysis (IVT) in previous studies. We carried out the current systematic review and meta-analysis to synthesize currently available evidence regarding such correlations. METHODS: Full-text articles published since 2000 were retrieved and screened. The overall effect sizes of good versus poor collateral status over a series of outcomes and certain baseline features were estimated by random-effects models and presented in risk ratios (RRs) or mean differences...
August 1, 2016: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
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