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wake-up stroke

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https://www.readbyqxmd.com/read/27890763/positional-occlusion-of-vertebral-artery-due-to-cervical-spondylosis-as-rare-cause-of-wake-up-stroke-report-of-2-cases
#1
Hirofumi Nishikawa, Fumitaka Miya, Yotaro Kitano, Genshin Mori, Shigetoshi Shimizu, Hidenori Suzuki
BACKGROUND: Positional compression of the vertebral artery (VA) due 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 case was a 78-year-old woman who presented with vertigo and vomiting lasting from waking up. Magnetic resonance (MR) images 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...
November 24, 2016: 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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/27476340/intravenous-tissue-plasminogen-activator-for-wake-up-stroke-a-propensity-score-matched-analysis
#8
James E Anaissie, Dominique J Monlezun, James E Siegler, Elizabeth D Waring, Lauren N Dowell, Alyana A Samai, Alexander J George, Tara Kimbrough, Jimmy Berthaud, Sheryl Martin-Schild
GOAL: To evaluate the safety and efficacy of intravenous (IV) tissue plasminogen activator (tPA) in the treatment of wake-up stroke (WUS) using propensity score (PS) analysis. MATERIALS AND METHODS: Consecutive acute ischemic stroke patients meeting inclusion criteria were retrospectively identified from our stroke registry between July 2008 and May 2014, and classified as stroke onset less than or equal to 4.5 hours treated with tPA (control; n = 369), tPA-treated WUS (n = 46), or nontreated WUS (n = 154)...
July 28, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27475092/polysomnographic-indicators-of-mortality-in-stroke-patients
#9
Laura B Ponsaing, Helle K Iversen, Poul Jennum
PURPOSE: The purpose of the study was to assess polysomnographic indicators of increased mortality risk in patients with stroke or a transient ischemic attack (TIA). METHODS: We performed polysomnographies in 63 acute stroke/TIA patients. Mortality data were collected from a national database after a 19-37-month follow-up period. RESULTS: Of the 57 stroke and 6 TIA patients, 9 stroke patients died during follow-up. All nine had moderate or severe sleep-related breathing disorders (SRBDs)...
July 30, 2016: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/27333749/-the-future-perspective-of-acute-thrombolytic-therapy-for-acute-ischemic-stroke
#10
REVIEW
Takayuki Matsuki, Kazunori Toyoda
Intravenous (IV) thrombolysis with recombinant tissue-type plasminogen activator (rt-PA) is the evidence-based treatment for acute ischemic stroke patients, and its position as the standard therapy remains unchanged even though newer clinical evidences of the endovascular therapies emerged. In Japan, IV rt-PA was approved in 2005. One of the problems is the limited therapeutic time range, but it was extended from 3 hours to 4.5 hours after stroke onset in 2012 based on the pooled-data analysis of the major clinical trials...
April 2016: Nihon Rinsho. Japanese Journal of Clinical Medicine
https://www.readbyqxmd.com/read/27282301/mechanical-thrombectomy-in-acute-ischemic-stroke-patients-with-wake-up-stroke-and-the-elderly-may-benefit-as-well
#11
Åsa Kuntze Söderqvist, Tommy Andersson, Nils Wahlgren, Magnus Kaijser
BACKGROUND: We have assessed to what extent age, sex, preintervention infarct size, time to groin puncture, and stroke severity are associated with outcome of mechanical thrombectomy in patients treated for acute ischemic stroke. METHODS: All 192 patients treated with mechanical thrombectomy for acute ischemic stroke from September 2005 to December 2011 were included in this observational study. Main outcomes were independence, defined as a modified Rankin Scale score of 0-2, an improvement in stroke severity score post-thrombectomy, and the occurrence of symptomatic hemorrhage...
September 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27273860/prospective-open-label-safety-study-of-intravenous-recombinant-tissue-plasminogen-activator-in-wake-up-stroke
#12
Andrew D Barreto, Christopher V Fanale, Andrei V Alexandrov, Kevin C Gaffney, Farhaan S Vahidy, Claude B Nguyen, Amrou Sarraj, Mohammad Rahbar, James C Grotta, Sean I Savitz
OBJECTIVE: It is estimated that one of four ischemic strokes are noticed upon awakening and are not candidates for intravenous recombinant tissue plasminogen activator (rtPA) because their symptoms are >3 hours from last seen normal (LSN). We tested the safety of rtPA in a multicenter, single-arm, prospective, open-label study (NCT01183533) in patients with wake-up stroke (WUS). METHODS: We aimed to enroll 40 WUS patients with disabling deficits. Patients were 18 to 80 years of age, National Institutes of Health Stroke Scale (NIHSS) ≤25, and selected only on the appearance of noncontrast computed tomography (ie, over one-third middle cerebral artery territory hypodensity)...
August 2016: Annals of Neurology
https://www.readbyqxmd.com/read/27222527/nocturnal-desaturation-in-the-stroke-unit-is-associated-with-wake-up-ischemic-stroke
#13
Tae Jung Kim, Sang-Bae Ko, Han-Gil Jeong, Ji Sung Lee, Chi Kyung Kim, Yerim Kim, Kiwoong Nam, Heejung Mo, Sang Joon An, Huimahn Alex Choi, Byung-Woo Yoon
BACKGROUND AND PURPOSE: Wake-up stroke (WUS) represents a quarter of all ischemic strokes and may be a specific subgroup. Nocturnal desaturation secondary to sleep-disordered breathing is an independent risk factor for stroke, but the association between nocturnal desaturation and WUS remains unclear. We investigated the relationship between nocturnal desaturation using oxygen desaturation index and WUS in patients with acute stroke in the stroke unit. METHODS: A total of 298 patients admitted for acute ischemic stroke to the stroke unit between July 2013 and May 2015 were enrolled...
July 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27180646/nocturia-and-prevalence-of-erectile-dysfunction-in-japanese-patients-with-type-2-diabetes-mellitus-the-dogo-study
#14
Shinya Furukawa, Takenori Sakai, Tetsuji Niiya, Hiroaki Miyaoka, Teruki Miyake, Shin Yamamoto, Koutatsu Maruyama, Keiko Tanaka, Teruhisa Ueda, Hidenori Senba, Masamoto Torisu, Hisaka Minami, Morikazu Onji, Takeshi Tanigawa, Bunzo Matsuura, Yoichi Hiasa, Yoshihiro Miyake
AIMS/INTRODUCTION: Several epidemiological studies have reported a positive association between nocturia and erectile dysfunction (ED). Yet only limited evidence exists regarding the association between nocturia and ED among patients with type 2 diabetes mellitus, although nocturia and ED are common among type 2 diabetes mellitus patients. MATERIAL AND METHODS: Study participants were 332 male Japanese patients with type 2 diabetes mellitus, aged 19-70 years, who had undergone blood tests at our institutions...
September 2016: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/27099612/international-survey-on-the-management-of-wake-up-stroke
#15
Luís Henrique de Castro-Afonso, Guilherme Seizem Nakiri, Octávio Marques Pontes-Neto, Antônio Carlos dos Santos, Daniel Giansante Abud
BACKGROUND: Patients who wake up having experienced a stroke while asleep represent around 20% of acute stroke admissions. According to international guidelines for the management of acute stroke, patients presenting with wake-up stroke are not currently eligible to receive revascularization treatments. In this study, we aimed to assess the opinions of stroke experts about the management of patients with wake-up stroke by using an international multicenter electronic survey. METHOD: This study consisted of 8 questions on wake-up stroke treatment...
January 2016: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/27056553/acute-cortical-deafness-in-a-child-with-melas-syndrome
#16
Marie P Pittet, Roni B Idan, Ilse Kern, Nils Guinand, Hélène Cao Van, Seema Toso, Joël Fluss
Auditory impairment in mitochondrial disorders are usually due to peripheral sensorineural dysfunction. Central deafness is only rarely reported. We report here an 11-year-old boy with MELAS syndrome who presented with subacute deafness after waking up from sleep. Peripheral hearing loss was rapidly excluded. A brain MRI documented bilateral stroke-like lesions predominantly affecting the superior temporal lobe, including the primary auditory cortex, confirming the central nature of deafness. Slow recovery was observed in the following weeks...
May 2016: Journal of Inherited Metabolic Disease
https://www.readbyqxmd.com/read/26995392/microvascular-complications-and-prevalence-of-nocturia-in-japanese-patients-with-type-2-diabetes-mellitus-the-dogo-study
#17
Shinya Furukawa, Takenori Sakai, Tetsuji Niiya, Hiroaki Miyaoka, Teruki Miyake, Shin Yamamoto, Koutatsu Maruyama, Keiko Tanaka, Teruhisa Ueda, Hidenori Senba, Masamoto Torisu, Hisaka Minami, Morikazu Onji, Takeshi Tanigawa, Bunzo Matsuura, Yoichi Hiasa, Yoshihiro Miyake
OBJECTIVE: To evaluate the association between microvascular complications and nocturia among Japanese patients with type 2 diabetes mellitus. METHODS: Study subjects were 731 Japanese patients with type 2 diabetes mellitus. A self-administered questionnaire was used to collect information on the variables under study. Study subjects were considered to have nocturia if they answered "once or more" to the question: "How many times do you typically wake up to urinate from sleeping at night until waking in the morning?" Diabetic neuropathy was diagnosed if the patients showed two or more of the following three characteristics: neuropathic symptoms, the absence of the Achilles reflex, or abnormal vibration perception...
July 2016: Urology
https://www.readbyqxmd.com/read/26960980/the-challenge-of-basilar-artery-occlusion-wake-up-stroke-too-late-for-intravenous-thrombolysis
#18
Pietro Caliandro, Giuseppe Reale, Tommaso Tartaglione, Paolo Maria Rossini
We describe the case of a patient carried to our emergency department, with the wake-up finding of dysarthria, right hemiplegia and worsening consciousness impairment (NIHSS 12). After performing a CT angiography, which showed complete basilar occlusion, we determined the MR DWI-FLAIR mismatch to estimate the stroke onset time. Because of the favorable mismatch (DWI hyperintensity in the left pons, no FLAIR hyperintensity in the same region), the patient underwent thrombolysis with sudden neurological improvement...
July 2016: Neurological Sciences
https://www.readbyqxmd.com/read/26951406/wake-up-call-to-identify-obstructive-sleep-apnea-in-patients-with-ischemic-strokes
#19
COMMENT
Madeleine M Grigg-Damberger
No abstract text is available yet for this article.
April 15, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/26852596/-monitoring-of-human-physiological-functions-during-the-daily-night-sleep
#20
E A Yumatov, S S Pertsov, E N Dudnik, M N Kramm, N O Strelkov
The basic somnological methodology, which is extensively used in the present time, focuses only on clinical practice. However, this approach is not appropriate for monitoring of physiological functions during natural sleep under home conditions. Our work was designed to develop a new information-and-equipment device for the reliable study of human physiological functions during sleep in the real everyday life. The information complex is a new portable microprocessor device and original software, which is constructed on the basis of PC and provides a control of vital physiological functions during sleep in the real everyday life...
July 2015: Patologicheskaia Fiziologiia i èksperimental'naia Terapiia
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