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https://www.readbyqxmd.com/read/28646558/neurology-concepts-young-women-and-ischemic-stroke-evaluation-and-management-in-the-emergency-department
#1
Bernard P Chang, Charles Wira, Joseph Miller, Murtaza Akhter, Bradley E Barth, Joshua Willey, Lauren Nentwich, Tracy Madsen
OBJECTIVE: Ischemic stroke is a leading cause of morbidity and mortality worldwide. While the incidence of ischemic stroke is highest in older populations, incidence of ischemic stroke in adults has been rising particularly rapidly among young (e.g. premenopausal) women. The evaluation and timely diagnosis of ischemic stroke in young women presents a challenging situation in the emergency department, due to a range of sex-specific risk factors and to broad differentials. The goals of this concepts paper are to summarize existing knowledge regarding the evaluation and management of young women with ischemic stroke in the acute setting...
June 24, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28646445/update-on-neurocritical-care-of-stroke
#2
Jason Siegel, Michael A Pizzi, J Brent Peel, David Alejos, Nnenne Mbabuike, Benjamin L Brown, David Hodge, W David Freeman
PURPOSE OF REVIEW: This review will highlight the recent advancements in acute ischemic stroke diagnosis and treatment, with special attention to new features and recommendations of stroke care in the neurocritical care unit. RECENT FINDINGS: New studies suggest that pre-hospital treatment of stroke with mobile stroke units and telestroke technology may lead to earlier stroke therapy with intravenous tissue plasminogen activator (tPA), and recent studies show tPA can be given in previously contraindicated situations...
August 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28646330/-imaging-of-vessels-supplying-the-brain
#3
REVIEW
S M Schellong, N Abolmaali, B Voigts, C Stelzner
Nowadays, several technically validated modalities are available for imaging both the extracranial and intracranial segments of arteries supplying blood to the brain. In the acute stroke setting, computed tomography (CT) angiography is of utmost importance because it provides the key diagnostic criteria indicative for the use of catheter-based recanalization techniques. Ultrasound imaging of extracranial arteries is most suitable for detecting an underlying stenosis of the internal carotid artery (ICA) in patients with stroke, transient ischemic attacks (TIA), retinal vessel occlusion and amaurosis fugax...
June 23, 2017: Der Internist
https://www.readbyqxmd.com/read/28645938/practice-patterns-for-acute-ischemic-stroke-workup-a-longitudinal-population-based-study
#4
Matthew C Loftspring, Brett M Kissela, Matthew L Flaherty, Jane C Khoury, Kathleen Alwell, Charles J Moomaw, Dawn O Kleindorfer, Daniel Woo, Opeolu Adeoye, Simona Ferioli, Joseph P Broderick, Pooja Khatri
BACKGROUND: We examined practice patterns of inpatient testing to identify stroke etiologies and treatable risk factors for acute ischemic stroke recurrence. METHODS AND RESULTS: We identified stroke cases and related diagnostic testing from four 1-year study periods (July 1993 to June 1994, 1999, 2005, and 2010) of the Greater Cincinnati/Northern Kentucky Stroke Study. Patients aged ≥18 years were included. We focused on evaluation of extracranial arteries for carotid stenosis and assessment of atrial fibrillation because randomized controlled trials supported treatment of these conditions for stroke prevention across all 4 study periods...
June 23, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28645902/the-cause-of-the-stroke-a-diagnostic-uncertainty
#5
Abhishek Dattani, Ava Jackson
A 39-year-old man with a history of sickle cell disease (SCD) presented with left leg weakness. He had a normal CT head and CT angiogram, but MRI head showed multiple acute bilateral cortical infarcts including in the right precentral gyrus. The MRI findings were more in keeping with an embolic source rather than stroke related to SCD, although it could not be ruled out. He also had an echocardiogram which revealed a patent foramen ovale. He was treated with antiplatelet therapy and also had red blood cell exchange transfusion...
June 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28645895/multiparity-improves-outcomes-after-cerebral-ischemia-in-female-mice-despite-features-of-increased-metabovascular-risk
#6
Rodney M Ritzel, Anita R Patel, Monica Spychala, Rajkumar Verma, Joshua Crapser, Edward C Koellhoffer, Anna Schrecengost, Evan R Jellison, Liang Zhu, Venugopal Reddy Venna, Louise D McCullough
Females show a varying degree of ischemic sensitivity throughout their lifespan, which is not fully explained by hormonal or genetic factors. Epidemiological data suggest that sex-specific life experiences such as pregnancy increase stroke risk. This work evaluated the role of parity on stroke outcome. Age-matched virgin (i.e., nulliparous) and multiparous mice were subjected to 60 min of reversible middle cerebral artery occlusion and evaluated for infarct volume, behavioral recovery, and inflammation. Using an established mating paradigm, fetal microchimeric cells present in maternal mice were also tracked after parturition and stroke...
June 23, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28645805/pre-admission-cha2ds2-vasc-score-and-outcome-of-patients-with-acute-cerebrovascular-events
#7
Guy Topaz, David Pereg, Mony Shuvy, Stefan Mausbach, Itzhak Kimiagar, Gregory Telman, Yona Kitay-Cohen, Dina Vorobeichik, Nir Shlomo, David Tanne
BACKGROUND: The CHA2DS2-VASc score has been recommended for the assessment of thromboembolic risk in patients with atrial fibrillation. Data regarding the association between the pre-admission CHA2DS2-VASc score and the outcome of patients with stroke and TIA are scarce. We aimed to assess the predictive value of pre-admission CHA2DS2-VASc score for early risk stratification of patients with acute cerebrovascular event. METHODS: The study group consisted of 8309 patients (53% males, mean age of 70±13...
June 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28645780/salvia-miltiorrhiza-bunge-danshen-extract-attenuates-permanent-cerebral-ischemia-through-inhibiting-platelet-activation-in-rats
#8
Yu-Xiang Fei, Si-Qi Wang, Li-Jian Yang, Yan-Ying Qiu, Yi-Ze Li, Wen-Yuan Liu, Tao Xi, Wei-Rong Fang, Yun-Man Li
ETHNOPHARMACOLOGICAL RELEVANCE: Danshen is a crude herbal drug isolated from dried roots of Salvia miltiorrhiza Bunge. This plant is widely used in oriental medicine for the treatment of cardiovascular and cerebrovascular diseases. The supercritical CO2 extract from Danshen (SCED) (57.85%, 5.67% and 4.55% for tanshinone IIA, tanshinone I and cryptotanshinone respectively) was studied in this article, whose potential molecular mechanism remains unclear, especially in anti-thrombosis. AIM OF THE STUDY: The present study was designed to observe the protective effect of SCED on ischemic stroke in rats and to explore the underlying anti-thrombosis mechanism...
June 20, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28645588/long-term-outcomes-of-mechanical-thrombectomy-for-the-treatment-of-acute-ischemic-stroke
#9
David McCarthy, Christian Theodotou, Samir Sur, Brian Snelling, Stephanie Chen, Eric C Peterson, Robert M Starke
No abstract text is available yet for this article.
June 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28645587/dawn-of-an-even-newer-era-mechanical-thrombectomy-for-acute-ischemic-stroke-beyond-6-to-8-hours
#10
Christoph J Griessenauer, Clemens M Schirmer
No abstract text is available yet for this article.
June 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28645523/elevated-serum-high-mobility-group-box-1-protein-level-is-associated-with-poor-functional-outcome-in-ischemic-stroke
#11
Toshiyuki Tsukagawa, Ryu Katsumata, Mitsugu Fujita, Keizo Yasui, Cassim Akhoon, Kenjiro Ono, Kenji Dohi, Toru Aruga
BACKGROUND: In experimental models, inhibition of high-mobility group box-1 (HMGB1) signaling has been reported to protect against the sequelae of ischemic stroke. Here, we determined the clinical significance of serum HMGB1 levels in patients with acute ischemic stroke. METHODS: We enrolled 183 patients (114 men, 69 women; mean age: 72.7 years) over 6 consecutive months. On admission and day 7, we recorded the National Institutes of Health Stroke Scale scores and measured serum high-sensitivity C-reactive protein (hs-CRP) and HMGB1 levels...
June 20, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28645107/effects-of-liraglutide-on-hemodynamic-parameters-in-patients-with-heart-failure
#12
Jin Ying Zhang, Xin Yun Wang, Xiang Wang
Glucagon-like peptide-1 analogues improve left ventricular function in patients with acute myocardial infarction. This study aimed to evaluate the effects of liraglutide on hemodynamic parameters in patients with heart failure. A total of 78 patients with heart failure were enrolled in this study between August 2014 and November 2015. Of these, 52 patients were randomized 1:1 to receive either liraglutide or placebo for 7 days. Hemodynamic measurements were made using transpulmonary thermodilution and arterial pulse contour analysis...
June 19, 2017: Oncotarget
https://www.readbyqxmd.com/read/28644924/intravenous-thrombolysis-for-acute-ischemic-stroke-a-bridge-between-two-centuries
#13
Georgios Tsivgoulis, Odysseas Kargiotis, Andrei Alexandrov
Intravenous tissue-plasminogen activator (tPA) remains the only approved systemic reperfusion therapy suitable for most patients presenting timely with acute ischemic stroke. Accumulating real-word experience for over 20 years regarding tPA safety and effectiveness lead to re-appraisal of original contraindications for intravenous thrombolysis (IVT). Areas covered: This narrative review focuses on fast yet appropriate selection of patients for safe administration of tPA per recently expanded indications. Novel strategies for rapid patient assessment will be discussed...
June 23, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28644260/intravenous-alteplase-for-acute-stroke-and-pulmonary-embolism-in-a-patient-with-recent-abdominoplasty
#14
Michael E Christiansen, Gyanendra Kumar, Raman C Mahabir, Richard A Helmers, Bernard R Bendok, Cumara B O'Carroll
INTRODUCTION: Major surgery in the past 14 days is a relative contraindication to treatment of acute stroke with intravenous (IV) alteplase. The 2016 American Heart Association/American Stroke Association scientific statement discussing inclusion and exclusion criteria for alteplase in acute stroke allows for provider judgment citing a lack of evidence to support surgery as an absolute contraindication. CASE REPORT: A 59-year-old woman presented with acute left hemiparesis, dysarthria, and acute respiratory failure...
July 2017: Neurologist
https://www.readbyqxmd.com/read/28644251/risk-factors-etiological-classification-topographical-location-and-outcome-in-medullary-infarctions
#15
Elif Gökçal, Gözde Baran, Elvin Niftaliyev, Vildan Güzel, Talip Asil
An understanding of the etiological mechanisms is important for therapeutic decisions and prognostic evaluation of patients with ischemic stroke. The object of this study was to evaluate the risk factors, etiological subtypes, and topography of lesion in patients with medullary infarctions (MIs). Besides, we also investigated early neurological deterioration, new vascular events, and functional outcome of all patients at 3-month follow-up. We analyzed our database consisting of patients who were diagnosed with acute MI and who were admitted within 24 hours of onset...
July 2017: Neurologist
https://www.readbyqxmd.com/read/28644212/worsening-atrioventricular-conduction-after-hospital-discharge-in-patients-with-st-segment-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-the-horizons-ami-trial
#16
Ioanna Kosmidou, Björn Redfors, Thomas McAndrew, Monica Embacher, Roxana Mehran, José M Dizon, Ori Ben-Yehuda, Gary S Mintz, Gregg W Stone
BACKGROUND: The chronic effects of ST-segment elevation myocardial infarction (STEMI) on the atrioventricular conduction (AVC) system have not been elucidated. This study aimed to evaluate the incidence, predictors, and outcomes of worsened AVC post-STEMI in patients treated with a primary percutaneous coronary intervention (PCI). PATIENTS AND METHODS: The current analysis included patients from the HORIZONS-AMI trial who underwent primary PCI and had available ECGs...
June 21, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28643616/advanced-neuroimaging-of-carbon-monoxide-poisoning
#17
Marco Varrassi, Alessandra Di Sibio, Camilla Gianneramo, Marco Perri, Giorgia Saltelli, Alessandra Splendiani, Carlo Masciocchi
Carbon monoxide (CO) inhalation is nowadays the most common cause of fatal poisoning worldwide. CO binds to haemoglobin 230-270 times more avidly than oxygen, thus leading to formation of carboxyhaemoglobin with subsequent reduction of tissue oxygenation. Brain is mainly affected due to its high oxygen requirement. Up to two-thirds of patients who survive the acute phase of this pathology present a delayed leukoencephalopathy, usually in a period ranging from two to 40 days. White matter damage closely relates to long-term prognosis of these patients...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28643504/direct-common-carotid-artery-puncture-for-acute-thrombectomy-against-ischemic-stroke
#18
Masahito Kawabori, Toshiya Osanai, Shuho Goto, Motoyuki Iwasaki, Yoshimasa Niiya, Shoji Mabuchi, Kiyohiro Houkin
No abstract text is available yet for this article.
June 22, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28642220/low-pulse-pressure-after-acute-ischemic-stroke-is-associated-with-unfavorable-outcomes-the-taiwan-stroke-registry
#19
Sung-Chun Tang, Jiu-Haw Yin, Chung-Hsiang Liu, Ming-Hui Sun, Jiunn-Tay Lee, Yu Sun, Chih-Shan Hsu, Mu-Chien Sun, Ching-Huang Lin, Chih-Hung Chen, Li-Ming Lien, Chih-Hsin Muo, Jiann-Shing Jeng, Chung Y Hsu
BACKGROUND: Pulse pressure (PP) is related to cardiac function, arterial stiffness, fluid status, and vascular events. This study aimed to explore the prognostic role of PP upon admission in patients with acute ischemic stroke (AIS) based on a nation-wide stroke registry. METHODS AND RESULTS: We evaluated the association between PP upon admission and outcomes 3 months after a stroke in patients who had an AIS registered in the Taiwan Stroke Registry, including 56 academic and community hospitals between 2006 and 2013...
June 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28641922/diffusion-weighted-imaging-and-time-in-acute-ischemic-stroke-is-there-any-relation
#20
Daniel Mantilla-García, Isabelle Mourand, Gregory Gascou, Carlos Riquelme, Cyril Dargazanli, Patricio López-Jaramillo, Paul A Camacho, Omer Eker, Alain Bonafé, Vincent Costalat
BACKGROUND AND PURPOSE: Diffusion-weighted MRI (DWI) is useful for patient selection during the first 6hours after stroke onset. The main aim of this study was to investigate the relationship between the time from stroke symptom onset and stroke volume assessed using DWI. MATERIALS AND METHODS: We evaluated 203 patients with anterior circulation stroke who were admitted to Montpellier's Stroke Unit and for whom a DWI ASPECT score (DWI-ASPECTS) was obtained during the first 6hours from symptom onset...
June 19, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
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