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Acute ischemic stroke

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https://www.readbyqxmd.com/read/28815313/epidemiology-and-cerebrovascular-events-related-to-cervical-and-intracranial-arteries-dissection-the-experience-of-the-city-of-pisa
#1
N Giannini, L Ulivi, M Maccarrone, V Montano, G Orlandi, E Ferrari, C Cravcenco, U Bonuccelli, M Mancuso
Spontaneous dissection of cervical arteries (sCAD) is a major cause of ischemic stroke in young patients, with an incidence varying from 1.7 to 3/100,000/year for extracranial internal carotid artery (ICAD) and 1 to 1.9/100,000/year for extracranial vertebral artery (VAD). Reliable epidemiological data on stroke incidence related to sCAD are scarce in Italy. This study aims to evaluate the incidence, clinical features, and outcome of cerebrovascular events related to sCAD and spontaneous intracranial arteries dissections (sIAD) in the city of Pisa (Italy)...
August 16, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28815120/integrating-temporal-pattern-mining-in-ischemic-stroke-prediction-and-treatment-pathway-discovery-for-atrial-fibrillation
#2
Shijing Guo, Xiang Li, Haifeng Liu, Ping Zhang, Xin Du, Guotong Xie, Fei Wang
Atrial fibrillation (AF) is associated with an increased risk of acute ischemic stroke (AIS). Accurately predicting AIS and planning effective treatment pathways for AIS prevention are crucial for AF patients. Because of the temporality of patients' disease progressions, sequential disease and treatment patterns have the potential to improve risk prediction performance and contribute to effective treatment pathways. This paper integrates temporal pattern mining into the AF study of AIS prediction and treatment pathway discovery...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28815091/-spice-synthetic-marijuana-induced-acute-myocardial-infarction-a-case-series
#3
E Ul Haq, A Shafiq, A A Khan, A A Awan, S Ezad, W J Minteer, B Omar
Marijuana is the most widely abused "recreational" substance in the United States, with highest prevalence in young adults. It is reported to cause ischemic strokes, hepatitis, anxiety, and psychosis. Although it is associated with dose dependent tachycardia and can lead to coronary vasospasm, it has not been directly related to acute myocardial infarction (AMI). Marijuana induced coronary vasospasm can result in endothelial denudation at the site of a vulnerable atherosclerotic plaque in response to hemodynamic stressors, potentially causing an AMI...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28814273/add-on-neurological-benefits-of-antiviral-therapy-in-hcv-patients-with-chronic-kidney-disease-a-nationwide-cohort-study
#4
Ming-Shyan Lin, Tien-Hsing Chen, Wey-Yil Lin, Chi-Hung Liu, Yung-Yu Hsieh, Wen-Nan Chiu, Chih-Hsiang Chang, Mei-Yen Chen, Chang-Min Chung, Yu-Sheng Lin
BACKGROUND: Hepatitis C virus (HCV)-infected patients with chronic kidney disease (CKD) have rarely been studied because they rarely accept interferon-based therapy (IBT) and have been difficult to follow up. We investigated long-term outcomes of IBT on the population. METHODS: This population-based cohort study used the Taiwan National Health Insurance Research Database as its data source. HCV patients diagnosed with CKD between Jan. 1, 2003, and Dec. 31, 2013, were selected...
August 16, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28814097/prominent-deep-medullary-veins-a-predictive-biomarker-for-stroke-risk-from-transient-ischemic-attack
#5
Yang Duan, Zhihua Xu, Hongyi Li, Xiaonan Cai, Cancan Chang, Benqiang Yang
Background Deep medullary veins (DMVs) are a biomarker of severity and prognosis in patients with acute cerebral infarction. However, their clinical significance remains unclear in patients with transient ischemic attack (TIA). Purpose To determine whether prominent deep medullary veins (PDMVs) are a predictive biomarker for stroke risk after TIA. Material and Methods Clinical and imaging data of 49 patients with TIA and 49 sex- and age-matched controls were studied. PDMVs were defined as DMVs with a score of 3 (TDMVs) or asymmetric DMVs (ADMVs), and the relationship between PDMVs and clinical features was analyzed...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28813741/a-case-of-an-acute-myocardial-infarction-post-thrombolytic-treatment-of-ischemic-stroke-a-management-dilemma
#6
Kalyan Wagle, Jimmy Yee, Vishesh Kumar, Amornpol Anuwatworn, Tomasz Stys, Adam Stys, Christopher Stanton
Acute ischemic stroke and myocardial infarction are emergency clinical events that require prompt intervention. Concurrent occurrence of both events magnifies the complexity of the clinical management. We present a case of a patient who presented with acute ischemic stroke, complicated by acute myocardial infarction shortly after thrombolytic was administered. This case highlights the importance of individualization of management especially in complex cases where there are no clear specific guidelines to follow...
August 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28811213/hemodynamic-characteristics-of-suspected-stroke-in-the-emergency-department
#7
Joseph B Miller, Richard M Nowak, Brian P Reed, Salvatore DiSomma, Prabath Nanayakkara, Michele Moyer, Scott Millis, Harish Kinni, Phillip Levy
BACKGROUND: Systemic hemodynamic characteristics of patients with suspected acute ischemic stroke are poorly described. The objective of this study was to identify baseline hemodynamic characteristics of emergency department (ED) patients with suspected acute stroke. METHODS: This was a planned analysis of the stroke cohort from a multicenter registry of hemodynamic profiling of ED patients. The registry prospectively collected non-invasive hemodynamic measurements of patients with suspicion for acute stroke within 12h of symptom onset...
August 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28811005/regulatory-effects-of-mir-146a-b-on-the-function-of-endothelial-progenitor-cells-in-acute-ischemic-stroke-in-mice
#8
Zeng-Feng Su, Zhong-Wu Sun, Ying Zhang, Shu Wang, Qi-Gui Yu, Ze-Bing Wu
The study aims to explore how microRNA-146a/b (miR-146a/b) regulates the function of endothelial progenitor cells (EPCs) in acute ischemic stroke in mice. Eighty male SPF C57BL/6J mice were evenly divided into the model-6 h, model-12 h, model-24 h (mice suffered from middle cerebral artery occlusion [MCAO] for 6 h, 12 h and model-24 h) and normal groups. EPCs were transfected and assigned into the control, MCAO, MCAO-miR-146a, MCAO-miR-146b and MCAO-miR-146a/b groups. The qRT-PCR was used to detect miR-146a/b expression in EPCs...
August 2017: Kaohsiung Journal of Medical Sciences
https://www.readbyqxmd.com/read/28810239/the-prevalence-of-and-factors-related-to-vascular-hyperintensity-on-t1-weighted-imaging-in-acute-ischemic-stroke
#9
Yuki Sakamoto, Seiji Okubo, Chikako Nito, Satoshi Suda, Noriko Matsumoto, Arata Abe, Junya Aoki, Takashi Shimoyama, Kanako Muraga, Takuya Kanamaru, Kentaro Suzuki, Yuki Go, Masahiro Mishina, Kazumi Kimura
BACKGROUND: Thrombus visualization in patients with acute ischemic stroke has been detected and reported using various imaging modalities. T1-weighted imaging (T1-WI) can depict thrombi as hyperintense signals within vessels. Moreover, in addition to thrombi, T1-WI hyperintensities in arteries may suggest arterial dissection. However, the frequency of and factors related to the T1-hyperintense vessel sign (T1-HVS) are not fully known. The aim of this study was to clarify the prevalence of and related factors for the T1-HVS in patients with acute ischemic stroke...
August 16, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28808918/idarucizumab-in-dabigatran-treated-patients-with-acute-ischemic-stroke-receiving-alteplase-a-systematic-review-of-the-available-evidence
#10
REVIEW
Slaven Pikija, Laszlo K Sztriha, J Sebastian Mutzenbach, Stefan M Golaszewski, Johann Sellner
BACKGROUND AND PURPOSE: Current guidelines do not recommend the use of intravenous recombinant tissue plasminogen activator in patients with acute ischemic stroke who receive direct oral anticoagulants. While the humanized monoclonal antibody idarucizumab can quickly reverse the anticoagulant effects of the thrombin inhibitor dabigatran, safety data for subsequent tissue plasminogen activator treatment are sparse. Here, we review current knowledge about dabigatran reversal prior to systemic reperfusion treatment in acute ischemic stroke...
August 14, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28806993/successful-intravenous-thrombolysis-for-ischemic-stroke-after-reversal-of-dabigatran-anticoagulation-with-idarucizumab-a-case-report
#11
Sergio Agosti, Laura Casalino, Enrico Rocci, Gabriele Zaccone, Eugenia Rota
BACKGROUND: Non-vitamin K antagonist oral anticoagulants, including dabigatran, are currently widely used for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation. Recently, idarucizumab, a monoclonal antibody fragment for immediate reversal of dabigatran-induced anticoagulation, has been introduced into the market to be used in life-threatening bleeding or urgent surgery, allowing for rapid normalization of clotting parameters. The use of idarucizumab is not yet well established in patients presenting with acute ischemic stroke on dabigatran who are candidates for thrombolytic therapy...
August 15, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28806209/refractory-intracranial-hypertension-the-role-of-decompressive-craniectomy
#12
Martin Smith
Raised intracranial pressure (ICP) is associated with worse outcomes after acute brain injury, and clinical guidelines advocate early treatment of intracranial hypertension. ICP-lowering therapies are usually administered in a stepwise manner, starting with safer first-line interventions, while reserving higher-risk options for patients with intractable intracranial hypertension. Decompressive craniectomy is a surgical procedure in which part of the skull is removed and the underlying dura opened to reduce brain swelling-related raised ICP; it can be performed as a primary or secondary procedure...
August 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28804899/coronary-artery-disease-and-risk-of-adverse-cardiac-events-and-stroke
#13
Kevin Kris Warnakula Olesen, Morten Madsen, Gregory Lip, Gro Egholm, Troels Thim, Lisette Okkels Jensen, Bent Raungaard, Jens Cosedis Nielsen, Hans Erik, Henrik Toft Sørensen, Michael Maeng
BACKGROUND: Patients with acute myocardial infarction are at increased risk of ischemic stroke. Previous myocardial infarction is an important part of risk assessment for ischemic stroke. However, there is a lack of information regarding the association between the severity and extent of coronary artery disease and long-term risk of ischemic stroke. MATERIALS AND METHODS: A cohort study of coronary angiographies performed in Western Denmark from January 1, 2003 to December 31, 2012...
August 14, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28804875/prehospital-pathways-of-occipital-stroke-patients-with-mainly-visual-symptoms
#14
S Räty, K Silvennoinen, T Tatlisumak
OBJECTIVES: Occipital ischemic strokes typically cause homonymous visual field defects, for which means of rehabilitation are limited. Intravenous thrombolysis is increasingly and successfully used for their acute treatment. However, recognition of strokes presenting with mainly visual field defects is challenging for both patients and healthcare professionals. We studied prehospital pathways of occipital stroke patients with mainly visual symptoms to define obstacles in their early recognition...
August 13, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28804736/urokinase-type-plasminogen-activator-upa-and-its-receptor-upar-promote-neurorepair-in-the-ischemic-brain
#15
Paola Merino, Ariel Diaz, Manuel Yepes
Despite the fact that ischemic stroke has been considered a leading cause of mortality in the world, recent advances in our understanding of the pathophysiological mechanisms underlying the ischemic injury and the treatment of acute ischemic stroke patients have led to a sharp decrease in the number of stroke deaths. However, this decrease in stroke mortality has also led to an increase in the number of patients that survive the acute ischemic injury with different degrees of disability. Unfortunately, to this date we do not have an effective therapeutic strategy to promote neurological recovery in these growing population of stroke survivors...
2017: Receptors & Clinical Investigation
https://www.readbyqxmd.com/read/28804475/midterm-blood-pressure-variability-is-associated-with-poststroke-cognitive-impairment-a-prospective-cohort-study
#16
Shan Geng, Na Liu, Pin Meng, Niu Ji, Yong'an Sun, Yingda Xu, Guanghui Zhang, Xiaobing He, Zenglin Cai, Bei Wang, Bei Xu, Zaipo Li, Xiaoqin Niu, Yongjin Zhang, Bingchao Xu, Xinyu Zhou, Mingli He
OBJECTIVE: The aim of this study was to investigate the relationship between blood pressure variability (BPV) and poststroke cognitive impairment (PSCI). METHODS: Seven-hundred ninety-six patients with acute ischemic stroke were included in this study. Midterm BPV was evaluated by calculating the SD and coefficient of variation (CV, 100 × SD/mean) of systolic blood pressure (SBP) and diastolic blood pressure during the 7 days after stroke onset. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) at admission and at all follow-up visits...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28803689/sun-exposure-influences-the-prognostic-power-of-components-of-mineral-metabolism-in-patients-with-coronary-artery-disease
#17
A Aceña, J A Franco-Peláez, C Gutierrez-Landaluce, A M Pello, C Cristóbal, N Tarín, A Huelmos, R Carda, M L Martín-Mariscal, J Alonso, E González-Parra, M L González-Casaus, Ó Lorenzo, L López Bescos, J Egido, J Tuñón
BACKGROUND AND AIM: Calcidiol (vitamin D metabolite) plasma levels vary with sun exposure (SE). However, it is not known if SE influences its prognostic ability. We have studied the effect of SE on plasma levels of the components of mineral metabolism (calcidiol, fibroblast growth factor-23 [FGF-23], parathormone [PTH], and phosphate [P]) and on their prognostic value in patients with coronary artery disease (CAD). METHODS AND RESULTS: We studied prospectively 704 patients with stable CAD...
June 15, 2017: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
https://www.readbyqxmd.com/read/28803639/atrial-fibrillation-and-stroke-as-initial-manifestations-of-painless-type-a-aortic-dissection
#18
Claudia Stöllberger, Lilian Schäffl-Doweik, Maria Korn, Josef Finsterer
Aortic dissection is diagnostically challenging, especially in pain-free patients. Detection of acute ischemic stroke secondary to painless aortic dissection is a challenge for emergency physicians and neurologists. We report a previously healthy 58-years old female, admitted because of nausea, dizziness, somnolence, a left-sided hemiparesis and arterial hypotension. The electrocardiogram showed atrial fibrillation with ST-elevations and ST-depressions. Perfusion CT-imaging showed a dilatation of the aortic arch and intraluminal structures indicating an intima flap of aortic dissection...
July 21, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28803458/neglect-and-aphasia-in-the-acute-phase-as-predictors-of-functional-outcome-seven-years-after-ischemic-stroke
#19
Joel Gerafi, Hans Samuelsson, Jo I Viken, Charlotte Blomgren, Lisbeth Claesson, Sakari Kallio, Christina Jern, Christian Blomstrand, Katarina Jood
BACKGROUND: Visuospatial inattention (VSI) and language impairment (LI) are often present early after stroke and associations with an unfavorable short-term functional outcome have been reported. The purpose of this study was to investigate if a screening of VSI and of LI as indicators of cortical symptoms early after stroke could predict long-term functional outcomes. METHODS: A consecutive cohort of 375 ischemic stroke patients was assessed for the occurrence of VSI, in median, 7 days after admission (interquartile range 5 days) using Star Cancellation Test (SCT) and for LI (within the first 7 days) with the language item in the Scandinavian Stroke Scale (SSS)...
August 12, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28803231/in-potential-stroke-patients-on-warfarin-the-international-normalized-ratio-predicts-ischemia
#20
Cathy Cao, Ashley Martinelli, Brian Spoelhof, Rafael H Llinas, Elisabeth B Marsh
BACKGROUND: Stroke can occur in patients on warfarin despite anticoagulation. Patients with a low international normalized ratio (INR) should theoretically be at greater risk for ischemia than those who are therapeutic. Therefore, INR may be able to indicate whether new neurological deficits are more likely strokes or stroke mimics in patients on warfarin. This study evaluates the association and predictive value of INR in determining the likelihood of ischemia. METHODS: Patients were identified using the acute stroke registry at a Primary Stroke Center from January 2013 through December 2014...
August 11, 2017: Cerebrovascular Diseases Extra
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