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Ischemia stroke

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https://www.readbyqxmd.com/read/28088349/stroke-biomarkers-in-clinical-practice-a-critical-appraisal
#1
REVIEW
Geelyn J L Ng, Amy M L Quek, Christine Cheung, Thiruma V Arumugam, Raymond C S Seet
Biomarkers provide critical mechanistic insights to key biologic processes that occur during cerebral ischemia which, when carefully applied, can improve clinical decision-making in acute stroke management. The translation of a blood-based biomarker in ischemic stroke to clinical practice is challenging, in part, due to the complexity of ischemic stroke pathogenesis and the presence of a blood-brain barrier that restricts the release of brain-specific markers into the circulation. The pathologic and clinical aspects of ischemic stroke are described in this review, where a non-exhaustive list of biomarkers that interrogate different aspects of ischemic stroke such as oxidative damage, inflammation, thrombus formation, cardiac function and brain injury are described...
January 11, 2017: Neurochemistry International
https://www.readbyqxmd.com/read/28087807/field-validation-of-the-los-angeles-motor-scale-as-a-tool-for-paramedic-assessment-of-stroke-severity
#2
Joon-Tae Kim, Pil-Wook Chung, Sidney Starkman, Nerses Sanossian, Samuel J Stratton, Marc Eckstein, Frank D Pratt, Robin Conwit, David S Liebeskind, Latisha Sharma, Lucas Restrepo, May-Kim Tenser, Miguel Valdes-Sueiras, Jeffrey Gornbein, Scott Hamilton, Jeffrey L Saver
BACKGROUND AND PURPOSE: The Los Angeles Motor Scale (LAMS) is a 3-item, 0- to 10-point motor stroke-deficit scale developed for prehospital use. We assessed the convergent, divergent, and predictive validity of the LAMS when performed by paramedics in the field at multiple sites in a large and diverse geographic region. METHODS: We analyzed early assessment and outcome data prospectively gathered in the FAST-MAG trial (Field Administration of Stroke Therapy-Magnesium phase 3) among patients with acute cerebrovascular disease (cerebral ischemia and intracranial hemorrhage) within 2 hours of onset, transported by 315 ambulances to 60 receiving hospitals...
January 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28087473/salvianolic-acids-for-injection-safi-suppresses-inflammatory-responses-in-activated-microglia-to-attenuate-brain-damage-in-focal-cerebral-ischemia
#3
Pengwei Zhuang, Yanjun Wan, Shihan Geng, Ying He, Bo Feng, Zhengliang Ye, Dazheng Zhou, Dekun Li, Hongjun Wei, Hongyan Li, Yanjun Zhang, Aichun Ju
BACKGROUND: Inflammatory reactions induced by microglia in the brain play crucial roles in ischemia/reperfusion (I/R) cerebral injuries. Microglia activation has been shown to be closely related to TLR4/NF-κB signal pathways. Salvianolic acids for injection (SAFI) have been used in clinical practice to treat ischemic stroke with reported neuroprotective effects; however, the underlying mechanisms are still uncertain. OBJECTIVE AND METHODS: First, we studied the effect of SAFI on inflammatory responses in LPS-stimulated BV-2 microglia...
January 10, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28081467/oxidative-stress-and-mrna-expression-of-acetylcholinesterase-in-the-leukocytes-of-ischemic-patients
#4
Mesut Işık, Şükrü Beydemir, Aslan Yılmaz, Muhammet Emin Naldan, Hatice Esra Aslan, İlhami Gülçin
BACKGROUND: Pathogenesis of ischemic brain injury is occurred by crucial metabolic reasons. For instance, oxidative stress from free radical generation is causing to the thrombotic cerebrovascular stroke. In this case, the measurement of the oxidative stress is very important for a better understanding of the stroke pathophysiology. Because, the oxidative stress in stroke is generally assumed as one of the mechanisms taking part in neuronal damage. Thus, oxidative stress has a vital role in the cholinergic system...
January 9, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28079313/postischemic-inflammation-in-acute-stroke
#5
REVIEW
Simone Vidale, Arturo Consoli, Marco Arnaboldi, Domenico Consoli
Cerebral ischemia is caused by arterial occlusion due to a thrombus or an embolus. Such occlusion induces multiple and concomitant pathophysiological processes that involve bioenergetic failure, acidosis, loss of cell homeostasis, excitotoxicity, and disruption of the blood-brain barrier. All of these mechanisms contribute to neuronal death, mainly via apoptosis or necrosis. The immune system is involved in this process in the early phases after brain injury, which contributes to potential enlargement of the infarct size and involves the penumbra area...
January 2017: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/28079139/blood-occludin-level-as-a-potential-biomarker-for-early-blood-brain-barrier-damage-following-ischemic-stroke
#6
Rong Pan, Kewei Yu, Theodore Weatherwax, Handong Zheng, Wenlan Liu, Ke Jian Liu
Concern about intracerebral hemorrhage (ICH) is the primary reason for withholding tPA therapy from patients with ischemic stroke. Early blood brain barrier (BBB) damage is the major risk factor for fatal post-thrombolysis ICH, but rapidly assessing BBB damage before tPA administration is highly challenging. We recently reported that ischemia induced rapid degradation of tight junction protein occludin in cerebromicrovessels. The present study investigates whether the cleaved occludin is released into the blood stream and how blood occludin levels correlate to the extent of BBB damage using a rat model of ischemic stroke...
January 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28078626/time-course-investigation-of-blood-brain-barrier-permeability-and-tight-junction-protein-changes-in-a-rat-model-of-permanent-focal-ischemia
#7
Peng Liu, Rui Zhang, Danyang Liu, Jinling Wang, Chunling Yuan, Xuemei Zhao, Yinjie Li, Xuefei Ji, Tianyan Chi, Libo Zou
Permanent middle cerebral artery occlusion (pMCAO) is an animal model that is widely used to simulate human ischemic stroke. However, the timing of the changes in the expression of tight junction (TJ) proteins and synaptic proteins associated with pMCAO remain incompletely understood. Therefore, to further explore the characteristics and mechanisms of blood-brain barrier (BBB) damage during cerebral ischemic stroke, we used a pMCAO rat model to define dynamic changes in BBB permeability within 120 h after ischemia in order to examine the expression levels of the TJ proteins claudin-5 and occludin and the synaptic proteins synaptophysin (SYP) and postsynaptic density protein 95 (PSD95)...
January 11, 2017: Journal of Physiological Sciences: JPS
https://www.readbyqxmd.com/read/28077455/symptomatic-carotid-occlusion-is-frequently-associated-with-microembolization
#8
Ava L Liberman, Ali Zandieh, Caitlin Loomis, Jonathan M Raser-Schramm, Christina A Wilson, Jose Torres, Koto Ishida, Swaroop Pawar, Rebecca Davis, Michael T Mullen, Steven R Messé, Scott E Kasner, Brett L Cucchiara
BACKGROUND AND PURPOSE: Symptomatic carotid artery disease is associated with significant morbidity and mortality. The pathophysiologic mechanisms of cerebral ischemia among patients with carotid occlusion remain underexplored. METHODS: We conducted a prospective observational cohort study of patients hospitalized within 7 days of ischemic stroke or transient ischemic attack because of ≥50% carotid artery stenosis or occlusion. Transcranial Doppler emboli detection was performed in the middle cerebral artery ipsilateral to the symptomatic carotid...
January 11, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28077334/the-neuroprotective-compound-p7c3-a20-promotes-neurogenesis-and-improves-cognitive-function-after-ischemic-stroke
#9
Zachary B Loris, Andrew A Pieper, W Dalton Dietrich
Ischemic stroke is a devastating condition with few therapeutic interventions available. The neuroprotective compound P7C3-A20 inhibits mature neuronal cell death while also increasing the net magnitude of postnatal neurogenesis in models of neurodegeneration and acute injury. P7C3 compounds enhance flux of nicotinamide adenine dinucleotide (NAD) in mammalian cells, a proposed therapeutic approach to treating cerebral ischemia. The effectiveness of P7C3-A20 treatment on chronic histopathological and behavioral outcomes and neurogenesis after ischemic stroke has not previously been established...
January 8, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28076634/immediate-versus-delayed-treatment-for-recently-symptomatic-carotid-artery-stenosis
#10
Vladimir Vasconcelos, Nicolle Cassola, Edina Mariko Koga da Silva, José Carlos Costa Baptista-Silva
BACKGROUND: The timing of surgery for recently symptomatic carotid artery stenosis remains controversial. Early cerebral revascularization may prevent a disabling or fatal ischemic recurrence, but it may also increase the risk of hemorrhagic transformation, or of dislodging a thrombus. This review examined the randomized controlled evidence that addressed whether the increased risk of recurrent events outweighed the increased benefit of an earlier intervention. OBJECTIVES: To assess the risks and benefits of performing very early cerebral revascularization (within two days) compared with delayed treatment (after two days) for people with recently symptomatic carotid artery stenosis...
November 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28074981/-thrombolysis-in-stroke-mimics-experience-in-10-cases
#11
Alejandro M Brunser, Arnold Hoppe, Paula Muñoz, Pablo M Lavados, Sergio Illanes, Violeta Díaz, Verónica V Olavarría
BACKGROUND: The effectiveness of intravenous thrombolysis (IVT) in cerebral ischemia is time dependent. Stroke mimics (SM) are frequent in emergency rooms. The effort to reduce door to needle time, can lead to administer thrombolytics to SM. AIM: To describe the frequency and prognosis of SM treated with IVT. MATERIAL AND METHODS: Prospective analysis of all patients evaluated in a Chilean private clinic between December 2004 and July 2015 with a suspected acute ischemic stroke (AIS)...
October 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28069373/memantine-attenuates-cell-apoptosis-by-suppressing-the-calpain-caspase-3-pathway-in-an-experimental-model-of-ischemic-stroke
#12
Bin Chen, Guoxiang Wang, Weiwei Li, Weilin Liu, Ruhui Lin, Jing Tao, Min Jiang, Lidian Chen, Yun Wang
Ischemic stroke, the second leading cause of death worldwide, leads to excessive glutamate release, over-activation of N-methyl-D-aspartate receptor (NMDAR), and massive influx of calcium (Ca(2+)), which may activate calpain and caspase-3, resulting in cellular damage and death. Memantine is an uncompetitive NMDAR antagonist with low-affinity/fast off-rate. We investigated the potential mechanisms through which memantine protects against ischemic stroke in vitro and in vivo. Middle cerebral artery occlusion-reperfusion (MCAO) was performed to establish an experimental model of ischemic stroke...
January 6, 2017: Experimental Cell Research
https://www.readbyqxmd.com/read/28067615/intracranial-atherosclerosis-from-anatomy-to-pathophysiology
#13
Yuehua Pu, Linfang Lan, Xinyi Leng, Lawrence Ks Wong, Liping Liu
Background Intracranial atherosclerotic stenosis is an important etiology subtype of ischemic stroke. Stenosis severity was thought to be the main reference index for clinical treatment and research. However, stenosis could not reflect the ischemia risk completely, instead the hemodynamic state across the lesion, the extent of collateral circulation, and perfusion impairment downstream the stenosis are more important. Aims We write this review aimed to summarize novel angiographic methods applied in the evaluation of functional severity of ICAS, and commented on their limitations and prospects in future research...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28065781/ischemic-brain-injury-new-insights-on-the-protective-role-of-melatonin
#14
REVIEW
Eva Ramos, Paloma Patiño, Russel J Reiter, Emilio Gil-Martín, José Marco-Contelles, Esther Parada, Cristobal de Los Rios, Alejandro Romero, Javier Egea
Stroke represents one of the most common causes of brain's vulnerability for many millions of people worldwide. The plethora of physiopathological events associated with brain ischemia are regulate through multiple signaling pathways leading to the activation of oxidative stress process, Ca(2+) dyshomeostasis, mitochondrial dysfunction, proinflammatory mediators, excitotoxicity and/or programmed neuronal cell death. Understanding this cascade of molecular events is mandatory in order to develop new therapeutic strategies for stroke...
January 6, 2017: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/28065779/effects-of-panax-notoginseng-ginsenoside-rb1-on-abnormal-hippocampal-microenvironment-in-rats
#15
Shiyun Wang, Minghong Li, Ying Guo, Chen Li, Lanou Wu, Xin-Fu Zhou, Yaohui Luo, Dong An, Shude Li, Haiyun Luo, Lijin Pu
: Cerebral ischemia damages central neurons, and abnormal microenvironment in ischemic condition is the key factor to the damages. The increase of local concentration of glutamic acid, the overload of Ca(2+), and the mitochondrial stress caused by release of cytochrome C are important factors of abnormal microenvironment in cerebral ischemia. In this study ginsenoside Rb1, a compound from Panax Notoginseng, was used to intervene abnormal environment of neurons in the hippocampal CA1 region in two animal models (microperfusion model and photothrombosis model)...
January 5, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28065616/experience-on-mechanical-thrombectomy-for-acute-stroke-treatment-in-a-brazilian-university-hospital
#16
Guilherme S Nakiri, Luis H Castro-Afonso, Lucas M Monsignore, Francisco A Dias, Frederico F Alessio-Alves, Soraia Ramos C Fabio, Millene R Camilo, Pedro T Cougo-Pinto, Octavio M Pontes-Neto, João Pereira Leite, Daniel G Abud
BACKGROUND: Brazil is a developing country struggling to reduce its extreme social inequality, which is reflected on shortage of health-care infrastructure, mainly to the low-income class, which depends exclusively on the public health system. In Brazil, less than 1% of stroke patients have access to intravenous thrombolysis in a stroke unit, and constraints to the development of mechanical thrombectomy in the public health system increase the social burden of stroke. OBJECTIVE: Report the feasibility of mechanical thrombectomy as part of routine stroke care in a Brazilian public university hospital...
January 5, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28064357/ischemic-stroke-experimental-models-and-reality
#17
REVIEW
Clemens J Sommer
The vast majority of cerebral stroke cases are caused by transient or permanent occlusion of a cerebral blood vessel ("ischemic stroke") eventually leading to brain infarction. The final infarct size and the neurological outcome depend on a multitude of factors such as the duration and severity of ischemia, the existence of collateral systems and an adequate systemic blood pressure, etiology and localization of the infarct, but also on age, sex, comorbidities with the respective multimedication and genetic background...
January 7, 2017: Acta Neuropathologica
https://www.readbyqxmd.com/read/28062508/arterial-calcification-in-diabetes-mellitus-preclinical-models-and-translational-implications
#18
John N Stabley, Dwight A Towler
Diabetes mellitus increasingly afflicts our aging and dysmetabolic population. Type 2 diabetes mellitus and the antecedent metabolic syndrome represent the vast majority of the disease burden-increasingly prevalent in children and older adults. However, type 1 diabetes mellitus is also advancing in preadolescent children. As such, a crushing wave of cardiometabolic disease burden now faces our society. Arteriosclerotic calcification is increased in metabolic syndrome, type 2 diabetes mellitus, and type 1 diabetes mellitus-impairing conduit vessel compliance and function, thereby increasing the risk for dementia, stroke, heart attack, limb ischemia, renal insufficiency, and lower extremity amputation...
December 22, 2016: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28061506/role-of-rem-sleep-melanin-concentrating-hormone-and-orexin-hypocretin-systems-in-the-sleep-deprivation-pre-ischemia
#19
Marta Pace, Antoine Adamantidis, Laura Facchin, Claudio Bassetti
STUDY OBJECTIVES: Sleep reduction after stroke is linked to poor recovery in patients. Conversely, a neuroprotective effect is observed in animals subjected to acute sleep deprivation (SD) before ischemia. This neuroprotection is associated with an increase of the sleep, melanin concentrating hormone (MCH) and orexin/hypocretin (OX) systems. This study aims to 1) assess the relationship between sleep and recovery; 2) test the association between MCH and OX systems with the pathological mechanisms of stroke...
2017: PloS One
https://www.readbyqxmd.com/read/28060307/lateral-chronic-cranial-window-preparation-enables-in-vivo-observation-following-distal-middle-cerebral-artery-occlusion-in-mice
#20
Simon H Bayerl, Melina Nieminen-Kelhä, Thomas Broggini, Peter Vajkoczy, Vincent Prinz
Focal cerebral ischemia (i.e., ischemic stroke) may cause major brain injury, leading to a severe loss of neuronal function and consequently to a host of motor and cognitive disabilities. Its high prevalence poses a serious health burden, as stroke is among the principal causes of long-term disability and death worldwide(1). Recovery of neuronal function is, in most cases, only partial. So far, treatment options are very limited, in particular due to the narrow time window for thrombolysis(2,3). Determining methods to accelerate recovery from stroke remains a prime medical goal; however, this has been hampered by insufficient mechanistic insights into the recovery process...
December 29, 2016: Journal of Visualized Experiments: JoVE
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