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Acute ischemic stroke

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https://www.readbyqxmd.com/read/28448422/iterative-reconstruction-designed-for-brain-ct-a-correlative-study-with-filtered-back-projection-for-the-diagnosis-of-acute-ischemic-stroke
#1
Yuji Iyama, Takeshi Nakaura, Seitaro Oda, Masafumi Kidoh, Daisuke Utsunomiya, Morikatsu Yoshida, Hideaki Yuki, Kenichiro Hirata, Yoshinori Funama, Kazunori Harada, Kazuo Awai, Toshinori Hirai, Yasuyuki Yamashita
OBJECTIVES: The objective of this study is to evaluate the usefulness of iterative model reconstruction designed for brain computed tomography (CT) (IMR-Neuro) for the diagnosis of acute ischemic stroke. METHODS: This retrospective study included 20 patients with acute middle cerebral artery infarction who have undergone brain CT and 20 nonstroke patients (control). We reconstructed axial images with filtered back projection (FBP) and IMR-Neuro (slice thickness, 1 and 5 mm)...
April 26, 2017: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/28448418/effects-of-b-value-on-quantification-of-rapid-diffusion-kurtosis-imaging-in-normal-and-acute-ischemic-brain-tissues
#2
Ming-Chung Chou, Cheng-Wen Ko, Yu-Hsien Chiu, Hsiao-Wen Chung, Ping-Hong Lai
PURPOSE: Diffusion kurtosis imaging (DKI) has been widely used to characterize brain tissue alterations. Diffusion-weighting factor or b value plays an important role in the measurement of rapid DKI and may have influential effects on them. The purpose of this study was to investigate the effects of b value on rapid DKI indices in normal and acute ischemic brain tissues. MATERIALS AND METHODS: This study enrolled 10 healthy subjects and 4 acute ischemic stroke patients...
April 26, 2017: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/28448189/effect-of-antihypertensive-treatment-on-the-long-term-outcome-of-patients-discharged-after-acute-ischemic-stroke
#3
Konstantinos Tziomalos, Vasilios Giampatzis, Stella D Bouziana, Marianna Spanou, Stavroula Kostaki, Maria Papadopoulou, Stella-Maria Angelopoulou, Eleni Margariti, Christos Savopoulos, Apostolos I Hatzitolios
We aimed to evaluate the effects of the five main classes of antihypertensive agents on the long-term outcome of 313 consecutive patients discharged after acute ischemic stroke (36.4% males, age 78.5 ± 6.3 years). One year after discharge, the functional status [evaluated with the modified Rankin scale (mRS)], the occurrence of cardiovascular events, and vital status were recorded. Patients prescribed angiotensin receptor blockers (ARBs) had lower mRS than patients not prescribed ARBs (1.7 ± 2.0 vs. 2.9 ± 2...
2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/28447929/five-year-follow-up-on-transplanted-organs-from-donors-after-brain-death-after-acute-stroke
#4
Vera Spatenkova, Eva Pokorna, Petr Suchomel
OBJECTIVES: Efficient intensive care donor management can help alleviate the shortage of organs for transplant. The aim of this study was to investigate the efficiency of management of donors after brain death from our neurointensive care unit. MATERIALS AND METHODS: We conducted a prospective observational 5-year follow-up on 29 transplanted organs from 14 brain-dead donors after acute stroke (7 subarachnoid and 4 intracerebral hemorrhages, 3 ischemic strokes)...
April 27, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28447627/short-term-blood-pressure-variability-and-long-term-blood-pressure-variability-which-one-is-a-reliable-predictor-for-recurrent-stroke
#5
Y Tao, J Xu, B Song, X Xie, H Gu, Q Liu, L Zhao, Y Wang, Y Xu, Y Wang
The relationship between blood pressure variability (BPV) and stroke recurrence is controversial. This study aimed to evaluate the predictive value of short-term and long-term BPV for stroke recurrence. The data from blood pressure and clinical outcome in TIA or ischemic stroke (BOSS) study included participants with acute ischemic stroke or transient ischemic attack (TIA) within 7 days after onset. Short-term BPV was measured by 24-h ambulatory BP measurement during hospitalisation. Long-term BPV, based on home blood pressure measurement, was measured by patients or their families from discharge to 90 days after qualifying events onset (twice daily)...
April 27, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/28446746/peripheral-blood-akap7-expression-as-an-early-marker-for-lymphocyte-mediated-post-stroke-blood-brain-barrier-disruption
#6
Grant C O'Connell, Madison B Treadway, Ashley B Petrone, Connie S Tennant, Noelle Lucke-Wold, Paul D Chantler, Taura L Barr
Our group recently identified 16 genes whose peripheral blood expression levels are differentially regulated in acute ischemic stroke. The purpose of this study was to determine whether the early expression levels of any of these 16 genes are predictive for post-stroke blood brain barrier (BBB) disruption. Transcriptional expression levels of candidate genes were measured in peripheral blood sampled from ischemic stroke patients at emergency department admission, and BBB permeability was assessed at 24 hour follow up via perfusion-weighted imaging...
April 26, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28446625/use-of-noncontrast-computed-tomography-and-computed-tomographic-perfusion-in-predicting-intracerebral-hemorrhage-after-intravenous-alteplase-therapy
#7
Connor Batchelor, Pooneh Pordeli, Christopher D d'Esterre, Mohamed Najm, Fahad S Al-Ajlan, Mari E Boesen, Connor McDougall, Lisa Hur, Enrico Fainardi, Jai Jai Shiva Shankar, Marta Rubiera, Alexander V Khaw, Michael D Hill, Andrew M Demchuk, Tolulope T Sajobi, Mayank Goyal, Ting-Yim Lee, Richard I Aviv, Bijoy K Menon
BACKGROUND AND PURPOSE: Intracerebral hemorrhage is a feared complication of intravenous alteplase therapy in patients with acute ischemic stroke. We explore the use of multimodal computed tomography in predicting this complication. METHODS: All patients were administered intravenous alteplase with/without intra-arterial therapy. An age- and sex-matched case-control design with classic and conditional logistic regression techniques was chosen for analyses. Outcome was parenchymal hemorrhage on 24- to 48-hour imaging...
April 26, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28445914/clinical-significance-of-intraluminal-contrast-enhancement-in-patients-with-spontaneous-cervical-artery-dissection-a%C3%A2-black-blood-mri-study
#8
Eva Coppenrath, Olga Lenz, Nora Sommer, Nina Lummel, Jennifer Linn, Karla Treitl, Fabian Bamberg, Maximilian Reiser, Thomas Pfefferkorn, Tobias Saam
Purpose Recent studies have suggested that intraluminal thrombi show contrast enhancement on carotid black-blood T1w MRI. The aim of this study was to evaluate the significance of intraluminal contrast enhancement (iCE) regarding symptom status in patients with spontaneous cervical artery dissection (sCAD). Methods 33 consecutive patients (19 men) with sCAD received a brain MRI (DIFF, T2w, T2*w, FLAIR) and a multi-sequence 3T-MRI with fat-saturated high-resolution black-blood T1w-sequences pre- and post-contrast, contrast-enhanced MR angiography and TOF images of carotid and vertebral arteries...
April 26, 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/28445600/caplacizumab-reduces-the-frequency-of-major-thromboembolic-events-exacerbations-and-death-in-patients-with-acquired-thrombotic-thrombocytopenic-purpura
#9
F Peyvandi, M Scully, J A Kremer Hovinga, P Knöbl, S Cataland, K De Beuf, F Callewaert, H De Winter, R K Zeldin
BACKGROUND: Acquired thrombotic thrombocytopenic purpura (aTTP) is a life-threatening autoimmune thrombotic microangiopathy. In spite of treatment with plasma exchange and immunosuppression, patients remain at risk for thrombotic complications, exacerbations and death. In the Phase II TITAN study, treatment with caplacizumab, an anti-vWF Nanobody(®) , was shown to reduce the time to confirmed platelet count normalization and exacerbations during treatment. OBJECTIVE: The clinical benefit of caplacizumab was further investigated in a post-hoc analysis of the incidence of major thromboembolic events and exacerbations during the study drug treatment period and TTP-related death during the study...
April 26, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28443389/neuroscience-intermediate-level-care-units-staffed-by-intensivists-clinical-outcomes-and-cost-analysis
#10
Kwadwo Kyeremanteng, Ariel Hendin, Kalpana Bhardwaj, Kednapa Thavorn, Dave Neilipovitz, Dalibour Kubelik, Gianni D'Egidio, Grant Stotts, Erin Rosenberg
INTRODUCTION: With an aging population and increasing numbers of intensive care unit admissions, novel ways of providing quality care at reduced cost are required. Closed neurointensive care units improve outcomes for patients with critical neurological conditions, including decreased mortality and length of stay (LOS). Small studies have demonstrated the safety of intermediate-level units for selected patient populations. However, few studies analyze both cost and safety outcomes of these units...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28443061/a-linear-temporal-increase-in-thrombin-activity-and-loss-of-its-receptor-in-mouse-brain-following-ischemic-stroke
#11
Doron Bushi, Efrat Shavit Stein, Valery Golderman, Ekaterina Feingold, Orna Gera, Joab Chapman, David Tanne
BACKGROUND: Brain thrombin activity is increased following acute ischemic stroke and may play a pathogenic role through the protease-activated receptor 1 (PAR1). In order to better assess these factors, we obtained a novel detailed temporal and spatial profile of thrombin activity in a mouse model of permanent middle cerebral artery occlusion (pMCAo). METHODS: Thrombin activity was measured by fluorescence spectroscopy on coronal slices taken from the ipsilateral and contralateral hemispheres 2, 5, and 24 h following pMCAo (n = 5, 6, 5 mice, respectively)...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28441928/canadian-stroke-best-practice-recommendations-telestroke-best-practice-guidelines-update-2017
#12
Dylan Blacquiere, M Patrice Lindsay, Norine Foley, Colleen Taralson, Susan Alcock, Catherine Balg, Sanjit Bhogal, Julie Cole, Marsha Eustace, Patricia Gallagher, Antoinette Ghanem, Alexander Hoechsmann, Gary Hunter, Khurshid Khan, Alier Marrero, Brian Moses, Kelley Rayner, Andrew Samis, Elisabeth Smitko, Marilyn Vibe, Gord Gubitz, Dariush Dowlatshahi, Stephen Phillips, Frank L Silver
Every year, approximately 62,000 people with stroke and transient ischemic attack are treated in Canadian hospitals. The 2016 update of the Canadian Stroke Best Practice Recommendations Telestroke guideline is a comprehensive summary of current evidence-based and consensus-based recommendations appropriate for use by all healthcare providers and system planners who organize and provide care to patients following stroke across a broad range of settings. These recommendations focus on the use of telemedicine technologies to rapidly identify and treat appropriate patients with acute thrombolytic therapies in hospitals without stroke specialized expertise; select patients who require to immediate transfer to stroke centers for Endovascular Therapy; and for the patients who remain in community hospitals to facilitate their care on a stroke unit and provide remote access to stroke prevention and rehabilitation services...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28440589/prime-movers-advanced-practice-professionals-in-the-role-of-stroke-coordinator
#13
Nicholas A Rattray, Teresa M Damush, Cherie Luckhurst, Catherine J Bauer-Martinez, Barbara J Homoya, Edward J Miech
BACKGROUND AND PURPOSE: Following a stroke quality improvement clustered randomized trial and a national acute ischemic stroke (AIS) directive in the Veterans Health Administration in 2011, this comparative case study examined the role of advanced practice professionals (APPs) in quality improvement activities among stroke teams. METHODS: Semistructured interviews were conducted at 11 Veterans Affairs medical centers annually over a 3-year period. A multidisciplinary team analyzed interviews from clinical providers through a mixed-methods, data matrix approach linking APPs (nurse practitioners and physician assistants) with Consolidated Framework for Implementation Research constructs and a group organization measure...
April 25, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28439774/albumin-induced-neuroprotection-in-focal-cerebral-ischemia-in-the-alias-trial-does-severity-mechanism-and-time-of-infusion-matter
#14
Rakesh Khatri, Mohammad Rauf Afzal, Gustavo J Rodriguez, Alberto Maud, Muhammad Shah Miran, Mohtashim Arbaab Qureshi, Salvador Cruz-Flores, Adnan I Qureshi
OBJECTIVE: To determine whether there is any differential benefit of albumin administration within 2 h of onset of ischemia and in settings (severe ischemia with reperfusion in cardioembolic strokes with National Institutes of Health Stroke Scale [NIHSS] ≥15), most representative of experimental models of cerebral ischemia in which albumin was effective in reducing neurological injury. BACKGROUND: High-dose intravenous (IV) albumin treatment for acute ischemic stroke (ALIAS) trial did not show overall clinical benefit in ischemic stroke patients in contrast to preclinical studies; however, models of preclinical studies were not completely followed...
April 24, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28439614/internal-carotid-artery-stenosis-and-collateral-recruitment-in-stroke-patients
#15
Jan W Dankbaar, Kelly G P Kerckhoffs, Alexander D Horsch, Irene C van der Schaaf, L Jaap Kappelle, Birgitta K Velthuis
PURPOSE: Leptomeningeal collaterals improve outcome in stroke patients. There is great individual variability in their extent. Internal carotid artery (ICA) stenosis may lead to more extensive recruitment of leptomeningeal collaterals. The purpose of this study was to evaluate the association of pre-existing ICA stenosis with leptomeningeal collateral filling visualized with computed tomography perfusion (CTP). METHODS: From a prospective acute ischemic stroke cohort, patients were included with an M1 middle cerebral artery (MCA) occlusion and absent ipsilateral, extracranial ICA occlusion...
April 24, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28439183/race-ethnic-disparities-in-hospital-arrival-time-after-ischemic-stroke
#16
Mellanie V Springer, Daniel L Labovitz, Ethan C Hochheiser
OBJECTIVE: Conflicting reports exist about hospital arrival time after stroke onset in Hispanics compared with African Americans and Caucasians. Our current study investigates race-ethnic disparities in hospital arrival times after stroke onset. METHODS: We performed a retrospective analysis of hospital arrival times in Hispanic, African American, and Caucasian acute ischemic stroke patients (N=1790) presenting to a tertiary-care hospital in the Bronx, New York...
2017: Ethnicity & Disease
https://www.readbyqxmd.com/read/28438894/flow-diverter-treatment-of-intracranial-vertebral-artery-dissecting-pseudoaneurysms
#17
REVIEW
Russell Cerejo, Mark Bain, Nina Moore, Julian Hardman, Andrew Bauer, M Shazam Hussain, Thomas Masaryk, Peter Rasmussen, Gabor Toth
INTRODUCTION: Intracranial vertebral dissecting pseudoaneurysms are a rare, but increasingly recognized, cause of subarachnoid hemorrhage and ischemic stroke. The risks of aneurysm re-rupture and associated morbidity are high. The use of flow diverter stents for the treatment of these aneurysms has not been well studied. OBJECTIVE: To report our data and provide a summarized review of literature using flow diverter stents for the treatment of intracranial vertebral artery dissecting pseudoaneurysms...
April 24, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28438739/reporting-clinical-end-points-and-safety-events-in-an-acute-coronary-syndrome-trial-results-with-integrated-collection
#18
Patrícia O Guimarães, Renato D Lopes, Susanna R Stevens, André Zimerman, Lisa Wruck, Stefan K James, Ghazala Haque, Roberto Rocha C V Giraldez, John H Alexander, Karen P Alexander
BACKGROUND: End points and adverse events (AEs) are collected separately in clinical trials, yet regulatory requirements for serious AE reporting vary across regions, so classifying end points according to seriousness criteria can be useful in global trials. METHODS AND RESULTS: In the Apixaban for Prevention of Acute Ischemic Events 2 (APPRAISE-2) trial, patients with a recent acute coronary syndrome were randomized to apixaban or placebo for the prevention of recurrent ischemic events...
April 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28438735/comparative-effectiveness-and-safety-of-dabigatran-and-rivaroxaban-in-atrial-fibrillation-patients
#19
Chao-Lun Lai, Ho-Min Chen, Min-Tsun Liao, Ting-Tse Lin, K Arnold Chan
BACKGROUND: We aimed to examine the comparative effectiveness and safety between dabigatran and rivaroxaban in atrial fibrillation patients. METHODS AND RESULTS: We conducted a population-based, retrospective, new-user cohort study based on the National Health Insurance claims database in Taiwan. Adult atrial fibrillation patients who initiated dabigatran (N=10 625) or rivaroxaban (N=4609) between June 1, 2012 and May 31, 2014 were identified as the overall population...
April 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28438515/intravenous-thrombolysis-for-acute-ischemic-stroke-in-patients-with-thrombocytopenia
#20
Ashkan Mowla, Haris Kamal, Navdeep S Lail, Caila Vaughn, Peyman Shirani, Sandhya Mehla, Hamidreza Rajabzadeh-Oghaz, Christopher Deline, Marilou Ching, Annemarie Crumlish, Robert N Sawyer
OBJECTIVE: To determine the safety of intravenous (IV) recombinant tissue plasminogen activator (rtPA) in patients with acute ischemic stroke (AIS) who had a platelet count <100,000 /mm(3). METHODS: We reviewed the charts of all patients who received IV rtPA for AIS during a 9.6-year period at our stroke center. Those with platelets <100,000/mm(3) were identified. Head computed tomography scans performed in 24-36 hours postthrombolysis were reviewed to evaluate the rate of symptomatic intracranial hemorrhage (sICH)...
April 21, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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