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wake up stroke

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https://www.readbyqxmd.com/read/28425349/clinical-characteristics-of-unknown-symptom-onset-stroke-patients-with-and-without-diffusion-weighted-imaging-and-fluid-attenuated-inversion-recovery-mismatch
#1
Götz Thomalla, Florent Boutitie, Jochen B Fiebach, Claus Z Simonsen, Salvador Pedraza, Robin Lemmens, Norbert Nighoghossian, Pascal Roy, Keith W Muir, Martin Ebinger, Ian Ford, Bastian Cheng, Ivana Galinovic, Tae-Hee Cho, Josep Puig, Vincent Thijs, Matthias Endres, Jens Fiehler, Christian Gerloff
Background Diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) mismatch was suggested to identify stroke patients with unknown time of symptom onset likely to be within the time window for thrombolysis. Aims We aimed to study clinical characteristics associated with DWI-FLAIR mismatch in patients with unknown onset stroke. Methods We analyzed baseline MRI and clinical data from patients with acute ischemic stroke proven by DWI from WAKE-UP, an investigator-initiated, randomized, placebo-controlled trial of MRI-based thrombolysis in stroke patients with unknown time of symptom onset...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28424312/archer-fish-jumping-prey-capture-kinematics-and-hydrodynamics
#2
Anna M Shih, Leah Mendelson, Alexandra H Techet
Smallscale archer fish, Toxotes microlepis, are best known for spitting jets of water to capture prey, but also hunt by jumping out of the water to heights of up to 2.5 body lengths. In this study, high-speed imaging and particle image velocimetry were used to characterize the kinematics and hydrodynamics of this jumping behavior. Jumping used a set of kinematics distinct from those of in-water feeding strikes and was segmented into three phases: (1) hovering to sight prey at the surface, (2) rapid upward thrust production and (3) gliding to the prey once out of the water...
April 15, 2017: Journal of Experimental Biology
https://www.readbyqxmd.com/read/28361615/unclear-onset-intracerebral-hemorrhage-clinical-characteristics-hematoma-features-and-outcomes
#3
Yasuteru Inoue, Fumio Miyashita, Masatoshi Koga, Kazuo Minematsu, Kazunori Toyoda
Background and purpose Although unclear-onset ischemic stroke, including wake-up ischemic stroke, is drawing attention as a potential target for reperfusion therapy, acute unclear-onset intracerebral hemorrhage has been understudied. Clinical characteristics, hematoma features, and outcomes of patients who developed intracerebral hemorrhage during sleep or those with intracerebral hemorrhage who were unconscious when witnessed were determined. Methods Consecutive intracerebral hemorrhage patients admitted within 24 hours after onset or last-known normal time were classified into clear-onset intracerebral hemorrhage and unclear-onset intracerebral hemorrhage groups...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28359617/fluid-attenuated-inversion-recovery-flair-signal-intensity-can-identify-stroke-within-6-and-8-hours
#4
John Legge, Ada Graham, Shailesh Male, David Copeland, Richard Lee, Nitin Goyal, Ramin Zand
BACKGROUND: Patients with wake-up or unknown time of onset stroke are usually excluded from recanalization. However, a few studies indicate that some magnetic resonance sequences can help predict time from symptom onset (SxO). Our goal was to assess the value of fluid-attenuated inversion recovery (FLAIR) signal intensity ratio (SIR) in identifying patients within 6 and 8 hours of stroke onset. MATERIALS AND METHODS: We studied consecutive acute stroke patients with known time of onset who underwent magnetic resonance imaging (MRI) within 48 hours of SxO...
March 27, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28343220/hemorrhagic-transformations-after-thrombectomy-risk-factors-and-clinical-relevance
#5
Johannes Kaesmacher, Mirjam Kaesmacher, Christian Maegerlein, Claus Zimmer, Alexandra S Gersing, Silke Wunderlich, Benjamin Friedrich, Tobias Boeckh-Behrens, Justus F Kleine
BACKGROUND: Hemorrhagic transformation (HT) is a major complication of acute ischemic stroke, potentially associated with clinical deterioration. We attempted to identify risk factors and evaluated clinical relevance of minor and major HTs following endovascular thrombectomy (ET) in isolated middle cerebral artery (MCA) occlusions. METHODS: This is a retrospective single-center analysis of 409 patients with isolated MCA occlusion treated with ET. Patients' and procedural characteristics, severity of HT according to the European Cooperative Acute Stroke Study criteria, and clinical outcomes were analyzed...
March 25, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28318954/computed-tomography-perfusion-based-decision-making-for-acute-ischemic-stroke-missing-the-mismatch
#6
J A Molad, M Findler, E Auriel
The emerging use of mechanical thrombectomy for acute ischemic stroke treatment focuses on the importance of patient selection. Computed tomography perfusion (CTP) is one of widely used techniques. However, the accuracy and reliability of this modality is in debate among vascular neurologists. We present a case of an 80-year-old man admitted because of acute ischemic stroke. CT angiography demonstrated left proximal M2 occlusion. As CTP demonstrated signs of large ischemic core with no significant penumbra, mechanical thrombectomy was not performed following tPA administration...
March 15, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28318953/mechanical-thrombectomy-in-wake-up-strokes-a-case-series-using-alberta-stroke-program-early-ct-score-aspects-for-patient-selection
#7
Angelos Aristeidis Konstas, Artin Minaeian, Ian B Ross
BACKGROUND: There is lack of published studies on mechanical thrombectomy with stent retrievers for wake-up stroke (WUS). OBJECTIVE: To report the outcomes of WUS patients with large vessel occlusions, selected for intervention based on Alberta Stroke Program Early CT Score (ASPECTS) and treated with stent retrievers or primary aspiration thrombectomy. METHODS: Data were collected retrospectively for each consecutive WUS patient undergoing mechanical thrombectomy with a stent retriever or primary aspiration catheter between February 2015 and September 2016...
March 15, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28277462/wake-up-stroke-current-understanding
#8
Jenny P Tsai, Gregory W Albers
Patients with wake-up strokes account for approximately 1 in 5 individuals presenting with an acute ischemic stroke. However, they are commonly excluded from acute stroke treatment. This article reviews the current understanding of wake-up strokes. A comparison of wake-up and awake-onset strokes demonstrated that they are physiologically, clinically, and radiologically similar. Use of advanced CT and MRI techniques may help extend acute stroke treatment options to patients with wake-up stroke.
March 8, 2017: Topics in Magnetic Resonance Imaging: TMRI
https://www.readbyqxmd.com/read/28277445/thrombolytic-therapy-in-wake-up-stroke-patients
#9
Gretchen M Stern, Nicholas Van Hise, Lindsay M Urben, Matthew J Korobey, Jamie M Pitlick, Andrew J Crannage
OBJECTIVE: The aim of the study is to review existing and ongoing trial data on wake-up stroke (WUS) patients for thrombolytic therapy. METHODS: A literature search was conducted in PubMed (conception-October 2016) using the terms wake-up stroke, acute ischemic stroke, wake-up thrombolysis, computed tomography imaging in wake-up stroke, and magnetic resonance imaging in wake-up stroke. Ongoing trials were found using the ClinicalTrials.gov website. RESULTS: The search yielded 61 articles in PubMed and 7 ongoing trials...
March 9, 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28262403/clinical-predictors-for-favorable-outcomes-from-endovascular-recanalization-in-wake-up-stroke
#10
Sang Min Sung, Tae Hong Lee, Han Jin Cho, Gi Yong Cho, Dae Soo Jung, Jae Il Lee, Jun Kyeung Ko, Samuel Yip
BACKGROUND AND PURPOSE: Patients who have acute stroke symptoms present on awakening are ineligible for standard intravenous thrombolysis due to the unclear onset time of symptoms. Some of these wake-up stroke (WUS) patients may benefit from endovascular recanalization. This study aimed to evaluate clinical predictors of outcomes from endovascular recanalization in WUS patients. METHODS: Forty-one WUS patients with internal carotid (ICA) or middle cerebral artery (MCA) occlusion treated with endovascular recanalization were reviewed...
March 2, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28174327/stroke-with-unknown-time-of-symptom-onset-baseline-clinical-and-magnetic-resonance-imaging-data-of-the-first-thousand-patients-in-wake-up-efficacy-and-safety-of-mri-based-thrombolysis-in-wake-up-stroke-a-randomized-doubleblind-placebo-controlled-trial
#11
Götz Thomalla, Florent Boutitie, Jochen B Fiebach, Claus Z Simonsen, Norbert Nighoghossian, Salvador Pedraza, Robin Lemmens, Pascal Roy, Keith W Muir, Martin Ebinger, Ian Ford, Bastian Cheng, Ivana Galinovic, Tae-Hee Cho, Josep Puig, Vincent Thijs, Matthias Endres, Jens Fiehler, Christian Gerloff
BACKGROUND AND PURPOSE: We describe clinical and magnetic resonance imaging (MRI) characteristics of stroke patients with unknown time of symptom onset potentially eligible for thrombolysis from a large prospective cohort. METHODS: We analyzed baseline data from WAKE-UP (Efficacy and Safety of MRI-Based Thrombolysis in Wake-Up Stroke: A Randomized, Doubleblind, Placebo-Controlled Trial), an investigator-initiated, randomized, placebo-controlled trial of MRI-based thrombolysis in stroke patients with unknown time of symptom onset...
March 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28065616/experience-on-mechanical-thrombectomy-for-acute-stroke-treatment-in-a-brazilian-university-hospital
#12
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/27925041/wake-up-stroke-clinical-characteristics-sedentary-lifestyle-and-daytime-sleepiness
#13
Deborath Lucia de Oliveira Diniz, Pedro Rodrigues Barreto, Pedro Felipe Carvalhedo de Bruin, Veralice Meireles Sales de Bruin
Objective: Wake-up stroke (WUS) is defined when the exact time of the beginning of the symptoms cannot be determined, for the deficits are perceived upon awakening. Sleep alterations are important risk factors for stroke and cardiovascular diseases. This study evaluates the characteristics of patients with and without WUS, the presence of daytime sleepiness, and associated risk factors. Method: Patients with ischemic stroke were investigated about the presence of WUS...
October 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27890763/positional-occlusion-of-vertebral-artery-due-to-cervical-spondylosis-as-rare-cause-of-wake-up-stroke-report-of-two-cases
#14
Hirofumi Nishikawa, Fumitaka Miya, Yotaro Kitano, Genshin Mori, Shigetoshi Shimizu, Hidenori Suzuki
BACKGROUND: Positional compression of the vertebral artery (VA) owing to cervical spondylosis is an uncommon cause of stroke. We report two cases of cervical spondylosis causing wake-up stroke, which is extremely rare. CASE DESCRIPTION: The first patient was a 78-year-old woman with vertigo and vomiting lasting from waking up. Magnetic resonance imaging (MRI) and angiography documented right cerebellar infarction, and stenosis of the right cervical VA. Dynamic angiography revealed that the right VA was occluded when her neck was extended or rotated to the right...
February 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27878926/the-effects-of-dwi-infarct-lesion-volume-on-dwi-flair-mismatch-is-there-a-need-for-size-stratification
#15
Seyedmehdi Payabvash, Shayandokht Taleb, John C Benson, Jeffrey B Rykken, Mark C Oswood, Alexander M McKinney, Benjamin Hoffman
BACKGROUND: The lack of fluid-attenuated inversion-recovery (FLAIR) hyperintensity in areas of diffusion-weighted imaging (DWI) high signal, or DWI-FLAIR mismatch, is a potential imaging biomarker for timing of stroke onset. We aimed to determine the effects of DWI infarct lesion volume on DWI-FLAIR mismatch and its accuracy for identification of strokes within intravenous (IV) the thrombolytic therapy window. METHODS: Acute ischemic stroke patients with magnetic resonance imaging scan within 12 hours of witnessed stroke were included...
November 23, 2016: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/27823712/sleep-apnea-syndrome-and-patent-foramen-ovale-a-dangerous-association-in-ischemic-stroke
#16
Silvia Tur, Mónica de la Peña, Bárbara Vives, Ana Belén Martínez, Arantza Gorospe, Inés Legarda, Maria José Torres, Carmen Jiménez, Joan B Soriano
BACKGROUND: The coexistence of patent foramen ovale (PFO) and sleep apnea syndrome (SAS) might be related to the pathogenesis of cryptogenic stroke (CS). We aimed to determine the prevalence of SAS in patients with cryptogenic stroke and PFO. METHODS: This is a prospective case-control study in which we included ischemic stroke patients consecutively admitted to our hospital's Acute Stroke Unit. Contrast transcranial Doppler (c-TCD) and sleep polygraphy within the first 72 h after stroke onset were performed to detect PFO and SAS...
September 2016: Sleep Medicine
https://www.readbyqxmd.com/read/27644162/effects-of-continuous-positive-airway-pressure-and-isocapnic-hypoxia-on-cerebral-autoregulation-in-patients-with-obstructive-sleep-apnoea
#17
Xavier Waltz, Andrew E Beaudin, Patrick J Hanly, Georgios D Mitsis, Marc J Poulin
KEY POINTS: Altered cerebral autoregulation (CA) in obstructive sleep apnoea (OSA) patients may contribute to increased stroke risk in this population; the gold standard treatment for OSA is continuous positive airway pressure, which improves cerebrovascular regulation and may decrease the risk of stroke. Isocapnic-hypoxia impairs CA in healthy subjects, but it remains unknown in OSA whether impaired CA is further exacerbated by isocapnic-hypoxia and whether it is improved by treatment with continuous positive airway pressure...
December 1, 2016: Journal of Physiology
https://www.readbyqxmd.com/read/27642014/ultra-acute-diagnostics-for-stroke-large-scale-implementation-of-prehospital-biomarker-sampling
#18
O S Mattila, H Harve, S Pihlasviita, J Ritvonen, G Sibolt, M Pystynen, D Strbian, S Curtze, M Kuisma, T Tatlisumak, P J Lindsberg
OBJECTIVES: Blood-based biomarkers could enable early and cost-effective diagnostics for acute stroke patients in the prehospital setting to support early initiation of treatments. To facilitate development of ultra-acute biomarkers, we set out to implement large-scale prehospital blood sampling and determine feasibility and diagnostic timesavings of this approach. MATERIALS AND METHODS: Emergency medical services (EMS) personnel of the Helsinki metropolitan area were trained to collect prehospital blood samples from thrombolysis candidates using a cannula adapter technique...
September 18, 2016: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/27641907/wake-up-stroke-amendable-for-thrombolysis-like-stroke-with-known-onset-time
#19
REVIEW
M W Kurz, R Advani, G N Behzadi, G Eldøen, E Farbu, K D Kurz
Patients suffering an acute ischemic stroke can be treated with intravenous thrombolysis in the absence of contraindications. A known onset time is a prerequisite as treatment, according to guidelines, has to be started within 4.5 hours. In patients awakening with a stroke, the last time they were seen without a neurological deficit is assumed to be the time of onset. Thus, despite of lack of contraindications on initial brain imaging, these patients are largely excluded from therapy. This review discusses the underlying pathophysiological, clinical, and radiological evidence surrounding wake-up stroke and its consequences for making treatment decisions...
September 18, 2016: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/27564779/smoking-and-prevalence-of-nocturia-in-japanese-patients-with-type-2-diabetes-mellitus-a-post-hoc-analysis-of-the-dogo-study
#20
Shinya Furukawa, Takenori Sakai, Tetsuji Niiya, Hiroaki Miyaoka, Teruki Miyake, Shin Yamamoto, Sayaka Kanzaki, Koutatsu Maruyama, Keiko Tanaka, Teruhisa Ueda, Hidenori Senba, Masamoto Torisu, Hisaka Minami, Morikazu Onji, Takeshi Tanigawa, Bunzo Matsuura, Yoichi Hiasa, Yoshihiro Miyake
AIMS: No evidence exists regarding the association between smoking status and nocturia among patients with type 2 diabetes mellitus. We evaluated this association among Japanese patients with type 2 diabetes mellitus by post-hoc analysis. METHODS: Study subjects were 817 Japanese patients with type 2 diabetes mellitus. Study subjects were considered to have nocturia if they answered "once or more" to the question: "Within one week, how many times do you typically wake up to urinate from sleeping at night until waking in the morning?" We used the following three outcomes: (1) nocturia was ≥1 voids per night; (2) moderate nocturia was ≥2 voids per night; and (3) severe nocturia was ≥3 voids per night...
August 26, 2016: Neurourology and Urodynamics
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