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Acute ischemic stroke

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https://www.readbyqxmd.com/read/27914908/association-between-ventilatory-settings-and-development-of-acute-respiratory-distress-syndrome-in-mechanically-ventilated-patients-due-to-brain-injury
#1
Eva Tejerina, Paolo Pelosi, Alfonso Muriel, Oscar Peñuelas, Yuda Sutherasan, Fernando Frutos-Vivar, Nicolás Nin, Andrew R Davies, Fernando Rios, Damian A Violi, Konstantinos Raymondos, Javier Hurtado, Marco González, Bin Du, Pravin Amin, Salvatore M Maggiore, Arnaud W Thille, Marco Antonio Soares, Manuel Jibaja, Asisclo J Villagomez, Michael A Kuiper, Younsuck Koh, Rui P Moreno, Amine Ali Zeggwagh, Dimitrios Matamis, Antonio Anzueto, Niall D Ferguson, Andrés Esteban
PURPOSE: In neurologically critically ill patients with mechanical ventilation (MV), the development of acute respiratory distress syndrome (ARDS) is a major contributor to morbidity and mortality, but the role of ventilatory management has been scarcely evaluated. We evaluate the association of tidal volume, level of PEEP and driving pressure with the development of ARDS in a population of patients with brain injury. MATERIALS AND METHODS: We performed a secondary analysis of a prospective, observational study on mechanical ventilation...
November 18, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27914497/acute-management-of-stroke-patients-taking-non-vitamin-k-antagonist-oral-anticoagulants-addressing-real-world-anticoagulant-management-issues-in-stroke-aramis-registry-design-and-rationale
#2
Ying Xian, Adrian F Hernandez, Tina Harding, Gregg C Fonarow, Deepak L Bhatt, Robert E Suter, Yosef Khan, Lee H Schwamm, Eric D Peterson
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs, dabigatran, rivaroxaban, apixaban, and edoxaban) have been increasingly used as alternatives to warfarin for stroke prophylaxis in patients with atrial fibrillation. Yet there is substantial lack of information on how patients on NOACs are currently treated when they have an acute ischemic stroke and the best strategies for treating intracerebral hemorrhage for those on chronic anticoagulation with warfarin or a NOAC. These are critical unmet needs for real world clinical decision making in these emergent patients...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27914161/streptococcus-agalactiae-native-valve-endocarditis-uncommon-presentation-of-multiple-myeloma
#3
Ana Pinho Oliveira, Anne Delgado, Cláudia Martins, Pedro Gama
Adults with chronic immunosuppressive conditions are at an increased risk for Streptococcus agalactiae endocarditis, which is typically characterized by acute onset, presence of large vegetations, rapid valvular destruction and frequent complications. We report a rare case of a 74 years old man presenting with fever, renal infarction, ischemic stroke and uveitis. Infective endocarditis was diagnosed and Streptococcus agalactiae was isolated in blood cultures. A multiple myeloma Ig G-K was also diagnosed. The infective endocarditis was successfully treated with a course of benzylpenicillin and gentamicin...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27914011/activation-of-alpha-7-nicotinic-acetylcholine-receptor-reduces-brain-edema-in-mice-with-ischemic-stroke-and-bone-fracture
#4
Dingquan Zou, Man Luo, Zhenying Han, Lei Zhan, Wan Zhu, Shuai Kang, Chen Bao, Zhao Li, Jeffrey Nelson, Rui Zhang, Hua Su
Stroke is an important risk factor for bone fracture. We showed previously that bone fracture at the acute stage of ischemic stroke worsens, and activation of α-7 nicotinic acetylcholine receptor (α-7 nAchR) improves, stroke recovery by attenuating inflammation. We hypothesized that activation of α-7 nAchR also improves the blood-brain barrier (BBB) integrity. Permanent distal middle cerebral artery occlusion (pMCAO) was performed on C57BL/6J mice followed by tibia fracture 1 day later. Mice were treated with 0...
December 2, 2016: Molecular Neurobiology
https://www.readbyqxmd.com/read/27913263/experience-with-adapt-for-thrombectomy-in-distal-cerebral-artery-occlusions-causing-acute-ischemic-stroke
#5
Jan Vargas, Alex M Spiotta, Kyle Fargen, Raymond D Turner, Imran Chaudry, Aquilla Turk
BACKGROUND: Thromboembolic occlusion of distal branches in anterior and posterior circulation may produce severe clinical deficits. The ADAPT technique is a simple, fast method for achieving good angiographic and clinical outcomes using large bore catheters in large vessel occlusions. OBJECTIVE: We present our results using the ADAPT technique with distal cerebral artery occlusions. METHODS: Thirty-five patients with acute ischemic stroke with thrombus in the distal MCA, ACA, or PCA were treated with the ADAPT technique...
November 29, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27909732/early-vegf-inhibition-attenuates-blood-brain-barrier-disruption-in-ischemic-rat-brains-by-regulating-the-expression-of-mmps
#6
Hai-Tao Zhang, Ping Zhang, Yi Gao, Chen-Long Li, Hong-Jun Wang, Ling-Chao Chen, Yan Feng, Rui-Yan Li, Yong-Li Li, Chuan-Lu Jiang
Vascular endothelial growth factor (VEGF) inhibition has been demonstrated to be an effective strategy in preserving the integrity of the blood-brain barrier (BBB) in patients with acute ischemic stroke. Loss of the BBB is the key event associated with morbidity and mortality in these patients. However, the underlying mechanisms remain poorly understood. In the present study, the effects of VEGF inhibition and the possible mechanism that underlies acute cerebral ischemia in rats was investigated. Following the induction of transient middle cerebral artery occlusion for a 90‑min period, either an anti‑VEGF neutralizing antibody (RB‑222; 5 or 10 µg), or IgG (control), was administered by intracerebroventricular injection at 1 h following reperfusion...
November 29, 2016: Molecular Medicine Reports
https://www.readbyqxmd.com/read/27909474/efficacy-high-procedural-safety-and-rapid-optimization-of-cryoballoon-atrial-fibrillation-ablation-in-the-hands-of-a-new-operator
#7
Eberhard Scholz, Patrick Lugenbiel, Patrick A Schweizer, Panagiotis Xynogalos, Claudia Seyler, Edgar Zitron, Rüdiger Becker, Hugo A Katus, Dierk Thomas
BACKGROUND: Cryoballoon (CB) ablation is successful in eliminating atrial fibrillation (AF). PURPOSE: The purpose of this study was to assess procedural efficacy and safety of CB ablation performed by a newly trained operator. METHODS: Forty patients with documented paroxysmal AF (58 ± 11 years, 26 male) undergoing CB catheter ablation were prospectively enrolled. RESULTS: Electrical pulmonary vein (PV) isolation was achieved in all patients (156 PVs)...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909385/biomarkers-of-inflammation-in-pediatric-arterial-ischemic-stroke
#8
COMMENT
Mary Dunbar, Aleksandra Mineyko
Investigators from Switzerland studied inflammatory markers in children and neonates with acute arterial ischemic stroke (AIS).
November 2016: Pediatric neurology briefs
https://www.readbyqxmd.com/read/27909265/prevention-of-the-collapse-of-pial-collaterals-by-remote-ischemic-perconditioning-during-acute-ischemic-stroke
#9
Junqiang Ma, Yonglie Ma, Bin Dong, Mischa V Bandet, Ashfaq Shuaib, Ian R Winship
Collateral circulation is a key variable determining prognosis and response to recanalization therapy during acute ischemic stroke. Remote ischemic perconditioning (RIPerC) involves inducing peripheral ischemia (typically in the limbs) during stroke and may reduce perfusion deficits and brain damage due to cerebral ischemia. In this study, we directly investigated pial collateral flow augmentation due to RIPerC during distal middle cerebral artery occlusion (MCAo) in rats. Blood flow through pial collaterals between the anterior cerebral artery (ACA) and the MCA was assessed in male Sprague Dawley rats using in vivo laser speckle contrast imaging (LSCI) and two photon laser scanning microscopy (TPLSM) during distal MCAo...
December 1, 2016: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/27909202/prediction-of-blood-brain-barrier-disruption-and-intracerebral-hemorrhagic-infarction-using-arterial-spin-labeling-magnetic-resonance-imaging
#10
Takeya Niibo, Hajime Ohta, Shirou Miyata, Ichiro Ikushima, Kazuchika Yonenaga, Hideo Takeshima
BACKGROUND AND PURPOSE: Arterial spin-labeling magnetic resonance imaging is sensitive for detecting hyperemic lesions (HLs) in patients with acute ischemic stroke. We evaluated whether HLs could predict blood-brain barrier (BBB) disruption and hemorrhagic transformation (HT) in acute ischemic stroke patients. METHODS: In a retrospective study, arterial spin-labeling was performed within 6 hours of symptom onset before revascularization treatment in 25 patients with anterior circulation large vessel occlusion on baseline magnetic resonance angiography...
December 1, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27909201/infarct-pattern-and-collateral-status-in-adult-moyamoya-disease-a-multimodal-magnetic-resonance-imaging-study
#11
Dong Yeop Kim, Jeong Pyo Son, Je Young Yeon, Gyeong-Moon Kim, Jong-Soo Kim, Seung-Chyul Hong, Oh Young Bang
BACKGROUND AND PURPOSE: Moyamoya disease (MMD) is a unique cerebrovascular disease characterized by the progressive stenosis of large intracranial arteries and a hazy network of basal collaterals, called moyamoya vessels. Although hemodynamic studies have been applied in MMD patients, the mechanisms of stroke in MMD are still unclear. The present study evaluated the infarct pattern and collateral status using multimodal magnetic resonance imaging in MMD patients. METHODS: Adult MMD patients with acute ischemic stroke were prospectively recruited, and infarct pattern on diffusion-weighted imaging was evaluated...
December 1, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27909098/reversible-disruption-of-neuronal-mitochondria-by-ischemic-and-traumatic-injury-revealed-by-quantitative-two-photon-imaging-in-the-neocortex-of-anesthetized-mice
#12
Mikhail Kislin, Jeremy Sword, Ioulia V Fomitcheva, Deborah Croom, Evgeny Pryazhnikov, Eero Lihavainen, Dmytro Toptunov, Heikki Rauvala, Andre S Ribeiro, Leonard Khiroug, Sergei A Kirov
: Mitochondria play a variety of functional roles in cortical neurons, from metabolic support and neuroprotection to the release of cytokines that trigger apoptosis. In dendrites, mitochondrial structure is closely linked to their function, and fragmentation (fission) of the normally elongated mitochondria indicates loss of their function under such pathological conditions as stroke and brain trauma. Using in vivo two-photon microscopy in mouse brain, we quantified mitochondrial fragmentation in a full spectrum of cortical injuries ranging from severe to mild...
December 1, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/27908894/contraction-of-blood-clots-is-impaired-in-acute-ischemic-stroke
#13
Valerie Tutwiler, Alina D Peshkova, Izabella A Andrianova, Dina R Khasanova, John W Weisel, Rustem I Litvinov
OBJECTIVE: Obstructive thrombi or thrombotic emboli are the pathogenic basis of ischemic stroke. In vitro blood clots and in vivo thrombi can undergo platelet-driven contraction (retraction), resulting in volume shrinkage. Clot contraction can potentially reduce vessel occlusion and improve blood flow past emboli or thrombi. The aim of this work was to examine a potential pathogenic role of clot contraction in ischemic stroke. APPROACH AND RESULTS: We used a novel automated method that enabled us to quantify time of initiation and extent and rate of clot contraction in vitro...
December 1, 2016: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/27908279/co-existing-intracranial-and-extracranial-carotid-artery-atherosclerotic-plaques-and-recurrent-stroke-risk-a-three-dimensional-multicontrast-cardiovascular-magnetic-resonance-study
#14
Yilan Xu, Chun Yuan, Zechen Zhou, Le He, Donghua Mi, Rui Li, Yuanyuan Cui, Yilong Wang, Yongjun Wang, Gaifen Liu, Zhuozhao Zheng, Xihai Zhao
BACKGROUND: As a systemic disease, atherosclerosis commonly affects intracranial and extracranial carotid arteries simultaneously which is defined as co-existing plaques. Previous studies demonstrated that co-existing atherosclerotic diseases are significantly associated with ischemic cerebrovascular events. The aim of this study was to investigate the characteristics of co-existing intracranial and extracranial carotid atherosclerotic plaques and their relationships with recurrent stroke by using 3D multi-contrast magnetic resonance (MR) vessel wall imaging...
December 2, 2016: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/27907956/intensive-care-management-of-the-endovascular-stroke-patient
#15
Julian Bösel
Acute ischemic stroke caused by the occlusion of large brain vessels can be treated effectively by mechanical thrombectomy, as proved by recent strong and consistent evidence from high-quality randomized trials. This new era of endovascular stroke treatment, however, poses particular challenges that go far beyond the so far gold standard of intravenous thrombolysis alone. Because these stroke patients usually present with severe neurologic deficits, may be unstable from cardiac or pulmonary instability, have to endure an invasive intervention of sometimes long duration, may suffer complications and require close postinterventional follow-up, they often demand intensive care measures...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907953/management-of-the-pediatric-neurocritical-care-patient
#16
Christopher M Horvat, Haifa Mtaweh, Michael J Bell
Pediatric neurocritical care is a growing subspecialty of pediatric intensive care that focuses on the management of acute neurological diseases in children. A brief history of the field of pediatric neurocritical care is provided. Neuromonitoring strategies for children are reviewed. Management of major categories of acute childhood central neurologic diseases are reviewed, including treatment of diseases associated with intracranial hypertension, seizures and status epilepticus, stroke, central nervous system infection and inflammation, and hypoxic-ischemic injury...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27906754/management-of-acute-stroke-in-patients-on-oral-anticoagulants
#17
Jan C Purrucker, Thorsten Steiner
PURPOSE OF REVIEW: An increasing number of patients are receiving oral anticoagulants. Since non-vitamin K antagonist oral anticoagulants (NOACs) were approved, primary prevention of ischemic stroke has become simpler. However, managing ischemic stroke and intracerebral hemorrhage while on oral anticoagulation (OAC) has become more complex. This review covers the latest developments in managing ischemic and hemorrhagic stroke in patients receiving vitamin K antagonists (VKA) and NOACs...
November 30, 2016: Current Opinion in Neurology
https://www.readbyqxmd.com/read/27905989/the-histone-deacetylase-inhibitor-sodium-butyrate-exhibits-neuroprotective-effects-for-ischemic-stroke-in-middle-aged-female-rats
#18
Min Jung Park, Farida Sohrabji
BACKGROUND: Sodium butyrate (NaB) is a histone deacetylase (HDAC) inhibitor exhibiting anti-inflammatory and neuroprotective effects in a rat ischemic model of stroke as well as a myocardial ischemia model. Although clinical evidence shows that older women are at higher risk for stroke occurrence and greater stroke severity, no studies have evaluated the effectiveness of NaB either in females or in older animals. METHODS: To determine the effects of NaB on stroke in older females, acyclic middle-aged Sprague-Dawley female rats (9-11 months old, constant diestrus) were subject to middle cerebral artery occlusion (MCAo) by intracerebral injection of recombinant endothelin-1...
December 1, 2016: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/27905392/-clinical-and-stabilometric-restructuring-of-patients-stability-during-balance-therapy-from-the-first-days-of-ischemic-stroke
#19
E A Plishkina, B N Bein
AIM: To study the process of recovery of postural function during stabilometric training with biofeedback (BFB) in patients with ischemic carotid stroke. MATERIAL AND METHODS: Forty-two patients underwent 10-day stabilometric training from the onset of stroke. Clinical and stabilometric parameters were assessed at 4 points: at baseline, after 5 sessions, after 10 sessions and after 3-4 months in the early recovery stage after discharge from the hospital. RESULTS: There was no correlation between the positive regress of neurologic symptoms and trends of stabilometry indicators...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/27905388/-prognostic-biochemical-markers-of-thrombolytic-therapy-in-ischemic-stroke
#20
O A Kicherova, L I Reikhert, V G Skorikova, S A Semeshko
AIM: To assess prognostic value of endothelial dysfunction, endogenous intoxication and oxidative stress in the acute period of ischemic stroke (II) at the stage of making a decision on using thrombolytic therapy (TLT) as well during the follow-up in order to personalize treatment. MATERIAL AND METHODS: The study included 57 patients stratified into control group 1 (n=29) and TLT group (n=28). Contents of C-reactive protein (Nsrb), matrixmetalloproteinase-9 (MMP-9) erythrocyte lipid peroxidation products were measured in the blood of patients...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
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