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Hemorrhagic transformation

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https://www.readbyqxmd.com/read/28812045/soluble-st2-predicts-outcome-and-hemorrhagic-transformation-after-acute-stroke
#1
Zoe Wolcott, Ayush Batra, Matthew B Bevers, Cristina Sastre, Jane Khoury, Matthew Sperling, Brett C Meyer, Kyle B Walsh, Opeolu Adeoye, Joseph P Broderick, W Taylor Kimberly
OBJECTIVE: ST2 is a member of the toll-like receptor superfamily that can alter inflammatory signaling of helper T-cells. We investigated whether soluble ST2 (sST2) could independently predict outcome and hemorrhagic transformation (HT) in the setting of stroke. METHODS: We measured sST2 in patients enrolled in the Specialized Program of Translational Research in Acute Stroke (SPOTRIAS) network biomarker study. 646 patients had plasma samples collected at the time of hospital admission and 210 patients had a second sample collected 48 h after stroke onset...
August 2017: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/28798356/low-serum-albumin-level-as-a-predictor-of-hemorrhage-transformation-after-intravenous-thrombolysis-in-ischemic-stroke-patients
#2
Ruiwen Che, Xiaoqin Huang, Wenbo Zhao, Fang Jiang, Longfei Wu, Zhen Zhang, Tingting Bian, Qingfeng Ma, Zhipeng Yu, Qian Zhang, Kai Dong, Haiqing Song, Xunming Ji
Serum albumin levels has been shown to predict outcome in ischemic stroke patients. We aimed to investigate the relationship between serum albumin levels and hemorrhagic transformation (HT) after intravenous thrombolysis (IVT) in patients with acute stroke. 428 patients receiving intravenous rt-PA therapy were included from 2013 to 2016 and were categorized into two groups: low level (<35 mmol/L) and normal level (35-55 mmol/L) group. Demographic, clinical and laboratory information, HT and functional outcomes were analyzed...
August 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28797689/can-the-benefits-of-rtpa-treatment-for-stroke-be-improved
#3
REVIEW
D Vivien
Tissue-type plasminogen activator (tPA) is a serine protease well known to promote fibrinolysis. This is why: its recombinant form (rtPA) can be used, either alone or combined with thrombectomy, to promote recanalization/reperfusion following ischemic stroke. However, its overall benefits are counteracted by some of its side-effects, including incomplete lysis of clots, an increased risk of hemorrhagic transformation and the possibility of neurotoxicity. Nevertheless, better understanding of the mechanisms by which tPA influences brain function and promotes its alteration may help in the design of new strategies to improve stroke therapy...
August 7, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28796572/endoglin-and-alk1-as-therapeutic-targets-for-hereditary-hemorrhagic-telangiectasia
#4
Lidia Ruiz-Llorente, Eunate Gallardo-Vara, Elisa Rossi, David M Smadja, Luisa M Botella, Carmelo Bernabeu
Hereditary Haemorrhagic Telangiectasia (HHT) is as an autosomal dominant trait characterized by frequent nose bleeds, mucocutaneous telangiectases, arteriovenous malformations (AVMs) of the lung, liver and brain, and gastrointestinal bleedings due to telangiectases. HHT is originated by mutations in genes whose encoded proteins are involved in the transforming growth factor β (TGF-β) family signalling of vascular endothelial cells. In spite of the great advances in the diagnosis as well as in the molecular, cellular and animal models of HHT, the current treatments remain just at the palliative level...
August 10, 2017: Expert Opinion on Therapeutic Targets
https://www.readbyqxmd.com/read/28794365/successful-delayed-aortic-surgery-for-a-patient-with-ischemic-stroke-secondary-to-aortic-dissection
#5
Ryuta Morihara, Toru Yamashita, Kentaro Deguchi, Keiichiro Tsunoda, Yasuhiro Manabe, Yoshiaki Takahashi, Taijun Yunoki, Kota Sato, Yumiko Nakano, Syoichiro Kono, Yasuyuki Ohta, Nozomi Hishikawa, Koji Abe
The diagnosis of aortic dissection (AD) is sometimes difficult within the limited time window of recombinant tissue plasminogen activator (tPA) for ischemic stroke (IS). A 60-year-old man developed sudden left hemiparesis due to IS. During tPA infusion, his blood pressure dropped and consciousness declined. After transfer to our hospital, carotid duplex ultrasonography led to a diagnosis of AD. Emergency surgery was postponed because of the risk of hemorrhagic transformation. The patient successfully underwent aortic surgery on day 5 and was discharged with a remarkable improvement in his symptoms...
August 10, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28794072/ruxolitinib-versus-best-available-therapy-for-et-intolerant-or-resistant-to-hydroxycarbamide-in-a-randomized-trial
#6
Claire N Harrison, Adam J Mead, Anesh Panchal, Sonia Fox, Christina Yap, Emmanouela Gbandi, Aimee Houlton, Samah Alimam, Joanne Ewing, Marion Wood, Frederick Chen, Jason Coppell, Nicki Panoskaltsis, Steven Knapper, Sahra Ali, Angela Hamblin, Ruben Scherber, Amylou C Dueck, Nicholas C P Cross, Ruben Mesa, Mary Frances McMullin
Treatments for high-risk essential thrombocythemia (ET) address thrombocytosis, disease-related symptoms, as well as risks of thrombosis, hemorrhage, transformation to myelofibrosis and leukemia. Patients resistant/intolerant to hydroxycarbamide (HC) have a poor outlook. MAJIC (ISRCTN61925716) is a randomized phase II trial of ruxolitinib (JAK1/2 inhibitor) vs Best Available Therapy (BAT) in ET and polycythemia vera (PV) patients resistant or intolerant to HC. Here findings of MAJIC-ET are reported, where the modified intention-to-treat population included 58 & 52 patients randomized to receive ruxolitinib or BAT respectively...
August 9, 2017: Blood
https://www.readbyqxmd.com/read/28775139/permeability-surface-of-deep-middle-cerebral-artery-territory-on-computed-tomographic-perfusion-predicts-hemorrhagic-transformation-after-stroke
#7
Qiao Li, Xinyi Gao, Zhenwei Yao, Xiaoyuan Feng, Huijin He, Jing Xue, Peiyi Gao, Lumeng Yang, Xin Cheng, Weijian Chen, Yunjun Yang
BACKGROUND AND PURPOSE: Permeability surface (PS) on computed tomographic perfusion reflects blood-brain barrier permeability and is related to hemorrhagic transformation (HT). HT of deep middle cerebral artery (MCA) territory can occur after recanalization of proximal large-vessel occlusion. We aimed to determine the relationship between HT and PS of deep MCA territory. METHODS: We retrospectively reviewed 70 consecutive acute ischemic stroke patients presenting with occlusion of the distal internal carotid artery or M1 segment of the MCA...
August 3, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28758099/platelet-expression-of-pkcepsilon-oncoprotein-in-myelofibrosis-is-associated-with-disease-severity-and-thrombotic-risk
#8
Elena Masselli, Cecilia Carubbi, Giulia Pozzi, Silvia Martini, Franco Aversa, Daniela Galli, Giuliana Gobbi, Prisco Mirandola, Marco Vitale
BACKGROUND: Myelofibrosis (MF) is the most aggressive Philadelphia-negative chronic myeloproliferative neoplasm (MPN) with high morbidity and mortality due to thrombo-hemorrhagic complications and leukemic transformation. MF is characterized by profound alterations of megakaryocytopoiesis, with consequent abnormalities in platelet number and function. We recently showed that the overexpression of the oncoprotein PKCepsilon plays a key role in the aberrant differentiation of MF megakaryocyte clone and that its levels correlate with disease burden...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28756015/mechanical-thrombectomy-in-acute-stroke-five-years-of-experience-in-poland
#9
Agnieszka Słowik, Marcin Wnuk, Paweł Brzegowy, Joanna Chrzanowska-Waśko, Aleksandra Golenia, Bartłomiej Łasocha, Dorota Włoch-Kopeć, Antoni Ferens, Wojciech Serednicki, Piotr Jarocki, Halina Bartosik-Psujek, Rafał Kaczorowski, Edward Filip, Monika Grzegorzak, Jarosław Homa, Janusz Darocha, Daniel Dudek, Wiesław Guz, Konrad Rejdak, Piotr Luchowski, Joanna Wojczal, Michał Sojka, Michał Górnik, Sylwia Stachowicz, Jacek Jaworski, Kinga Buraczyńska, Remigiusz Ficek, Anna Szczepańska-Szerej, Tomasz Jargiełło, Małgorzata Szczerbo-Trojanowska, Anetta Lasek-Bal, Przemysław Puz, Aldona Warsz-Wianecka, Arkadiusz Stęposz, Krzysztof Ziaja, Wacław Kuczmik, Tomasz Urbanek, Damian Ziaja, Witold Tomalski, Adam Kobayashi, Przemysław Richter, Andrzej Płoński, Marcin Kotkowski, Wojciech Czepiel, Iwona Kurkowska-Jastrzębska, Halina Sienkiewicz-Jarosz, Anna Członkowska, Beata BłażejewskaHyżorek, Danuta Ryglewicz, Magdalena Konopko, Edyta Brelak, Jacek Antecki, Igor Szydłowski, Maciej Włosek, Adam Stępień, Krzysztof Brzozowski, Jacek Staszewski, Piotr Piasecki, Piotr Zięcina, Izabela Wołoszyńska, Norbert Kolmaga, Jerzy Narloch, Tomasz Hasiec, Jacek Gawłowicz, Monika Pędracka, Jacek Porębiak, Bogumił Grzechnik, Vadym Matsibora, Michał Frąszczak, Marcin Leus, Maciej Mazgaj, Violetta Palacz-Duda, Grzegorz Meder, Wojciech Skura, Piotr Płeszka, Milena Świtońska, Krzysztof Słomiński, Józef Kościelniak, Paulina Sobieszak-Skura, Magdalena Konieczna-Brazis, Olgierd Rowiński, Andrzej Opuchlik, Anatol Mickielewicz, Beata Szyluk, Piotr Szczudlik, Anna Kostera-Pruszczyk, Maciej Jaworski, Rafał Maciąg, Jarosław Żyłkowski, Bożena Adamkiewicz, Wojciech Szubert, Jarosław Chrząstek, Marek Raźniewski, Agnieszka Pawelec, Paweł Wilimborek, Ryszard Wagner, Paweł Pilarski, Paweł Gierach, Jan Baron, Wojciech Gruszka, Stanisław Ochudło, Agnieszka Krzak-Kubica, Monika Rudzińska-Bar, Miłosz Zbroszczyk, Kamila Smulska, Michał Arkuszewski, Dorota Różański, Dariusz Koziorowski, Izabela Meisner-Kramarz, Stanisław Szlufik, Artur Zaczyński, Krzysztof Kądziołka, Kazimierz Kordecki, Michał Zawadzki, Mirosław Ząbek, Bartosz Karaszewski, Dariusz Gąsecki, Paweł Łowiec, Waldemar Dorniak, Tomasz Gorycki, Edyta Szurowska, Ewa Wierzchowska-Cioch, Tomasz Smyk, Beata Szajnoga, Marcin Bachta, Kajetan Mazurek, Magdalena Piwowarska, Wojciech Kociemba, Artur Drużdż, Adrian Dąbrowski, Michał Glonek, Małgorzata Wawrzyniak, Radosław Kaźmierski, Robert Juszkat, Witold Tomalski, Adam Heliosz, Adam Ryszczyk, Jacek Zwiernik, Grzegorz Wasilewski, Andrzej Tutaj, Grzegorz Dałek, Krzysztof Nosek, Sławomir Bereza, Katarzyna Lubkowska, Jerzy Kamienowski, Piotr Sobolewski, Adam Bielecki, Maciej Miś, Marcin Miś, Maria Krużewska-Orłowska, Jan Kochanowicz, Zenon Mariak, Marta Jakoniuk, Grzegorz Turek, Urszula Łebkowska, Andrzej Lewszuk, Kazimierz Kordecki, Tomasz Dziedzic, Tadeusz Popiela
OBJECTIVES: Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. METHODS AND RESULTS: We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. RESULTS: Most of the CSCs (74%) were founded at University Hospitals and most (65...
July 5, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28747037/increased-arterial-stiffness-is-an-independent-risk-factor-for-hemorrhagic-transformation-in-ischemic-stroke-undergoing-thrombolysis
#10
Maurizio Acampa, Silvia Camarri, Pietro Enea Lazzerini, Francesca Guideri, Rossana Tassi, Raffaella Valenti, Alessandra Cartocci, Giuseppe Martini
BACKGROUND: Hemorrhagic transformation (HT) is a multifactorial phenomenon and represents a possible complication of ischemic stroke, especially after thrombolytic treatment. Increased arterial stiffness has been associated with intracranial hemorrhage, but there is no evidence of association with HT after thrombolytic therapy. The aim of our study is to investigate a possible link between arterial stiffness and HT occurrence after thrombolytic therapy in patients with ischemic stroke...
September 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28742195/the-use-of-susceptibility-weighted-imaging-to-detect-cerebral-microbleeds-after-lacunar-infarction
#11
L Shao, M Wang, X-H Ge, H-D Huang, L Gao, J-C Qin
OBJECTIVE: To study the value of susceptibility-weighted imaging (SWI) technology to detect cerebral microbleeds (CMBs) in senile cerebral lacunar infarction patients; and to evaluate the complicated cerebral hemorrhage risk after patients with CMBs took aspirin, an antiplatelet medication or received anticoagulant therapy. PATIENTS AND METHODS: MRI scanning, using GRE-T2*WI, SWI and FSE sequences (T1WI, T2WI, and T2FLAIR), was performed on the three groups: (1) a cerebral lacunar infarction group; (2) cerebral lacunar infarction with cerebral microbleeds (CMBs) group; and (3) a healthy elderly group...
July 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28735256/comparison-of-multimodal-intra-arterial-treatment-versus-intravenous-thrombolysis-for-hypertensive-patients-with-severe-large-vessel-cerebral-infarction
#12
Zuojun Tian, Geng Liao, Shaoming Li, Yuechun Shen, Changbing Chen, Lei Liu, Yiheng Li
Since intravenous thrombolysis (IVT) is often associated with poor outcomes in hypertensive patients with severe acute cerebral infarction (ACI) due to occlusions of the internal carotid, basilar, or proximal middle cerebral artery, we evaluated whether multimodal intra-arterial treatment (IAT) might improve functional outcomes in this patient population. We retrospectively reviewed the charts of eligible patients who underwent multimodal IAT including intra-arterial thrombolysis, mechanical thrombectomy, balloon and/or stent angioplasty (IAT group) or IVT alone (IVT group)...
July 21, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/28732730/thermo-responsive-hydroxybutyl-chitosan-hydrogel-as-artery-intervention-embolic-agent-for-hemorrhage-control
#13
Guohui Sun, Chao Feng, Changqing Jiang, Tingting Zhang, Zixian Bao, Yajun Zuo, Ming Kong, Xiaojie Cheng, Ya Liu, Xiguang Chen
This work targeted to investigate the potential of thermo-responsive hydroxybutyl chitosan (HBC) hydrogel using as an embolic material for occlusion of selective blood vessels. HBC hydrogel was prepared via an etherification reaction between chitosan (CS) and 1, 2-butene oxide. The hydroxybutyl groups were introduced into CS backbone, which endowed HBC hydrogel with properties of porous structure, favorable hydrophilia and rapid sol-gel interconvertibility. The gelation temperatures and gelation time respectively decreased from 30...
July 18, 2017: International Journal of Biological Macromolecules
https://www.readbyqxmd.com/read/28726570/potential-biomarkers-for-predicting-hemorrhagic-transformation-of-ischemic-stroke
#14
Guanfeng Lu, Quanwei He, Yan Shen, Fei Cao
Reperfusion therapy contributes to better clinical outcomes in patients with acute ischemic stroke but carries a more significant risk of hemorrhagic transformation (HT) compared to supportive care. Once HT occurs, the outcome is usually poor and this causes a dilemma in the treatment of ischemic stroke. Consequently, early prediction of HT would be extremely helpful for guiding precise treatment of ischemic stroke. In this review, we focus on summarizing biomarkers of HT and elucidating possible mechanisms so as to identify potential biomarkers for predicting HT...
July 20, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28726167/early-increased-bradykinin-1-receptor-contributes-to-hemorrhagic-transformation-after-ischemic-stroke-in-type-1-diabetic-rats
#15
Hongfei Sang, Zhongming Qiu, Jin Cai, Wenya Lan, Linjie Yu, Hao Zhang, Min Li, Yi Xie, Ruibing Guo, Ruidong Ye, Xinfeng Liu, Ling Liu, Renliang Zhang
Hemorrhagic transformation (HT) is a major complication of ischemic stroke and further deteriorates neurological outcomes. Bradykinin 1 receptor (B1R) has been proven to mediate vasculo-toxicity in various experimental models. However, its role in the development of HT after stroke remains unclear. We detected the B1R expression in brain tissues with or without HT in a rat model of cerebral ischemia/reperfusion (I/R) with type 1 diabetes, showing higher B1R expression in the hemorrhagic areas than the ischemic tissues...
July 19, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28714410/management-of-blood-pressure-and-heart-rate-in-patients-with-acute-stroke
#16
Carlo Maida, Antonino Tuttolomondo, Domenico Di Raimondo, Antonio Pinto
BACKGROUND: Stroke represent one of the most devastating of all neurological diseases, affecting about 15 million people per year and is an important cause of morbidity and mortality worldwide and currently the leading cause of adult disability in developed countries. Blood pressure and heart rate may undergo several modifications in patients with both ischemic and hemorrhagic stroke in fact raised blood pressure levels may lead to cerebral edema, hematoma expansion or hemorrhagic transformation and in contrast low blood pressure can lead to increased cerebral infarction or perihematomal ischemia...
July 14, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28705822/focal-low-and-global-high-permeability-predict-the-possibility-risk-and-location-of-hemorrhagic-transformation-following-intra-arterial-thrombolysis-therapy-in-acute-stroke
#17
Y Li, Y Xia, H Chen, N Liu, A Jackson, M Wintermark, Y Zhang, J Hu, B Wu, W Zhang, J Tu, Z Su, G Zhu
BACKGROUND AND PURPOSE: The contrast volume transfer coefficient (K(trans)), which reflects blood-brain barrier permeability, is influenced by circulation and measurement conditions. We hypothesized that focal low BBB permeability values can predict the spatial distribution of hemorrhagic transformation and global high BBB permeability values can predict the likelihood of hemorrhagic transformation. MATERIALS AND METHODS: We retrospectively enrolled 106 patients with hemispheric stroke who received intra-arterial thrombolytic treatment...
July 13, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28665168/cerebral-hyperperfusion-on-arterial-spin-labeling-mri-after-reperfusion-therapy-is-related-to-hemorrhagic-transformation
#18
Shuhei Okazaki, Hiroshi Yamagami, Takeshi Yoshimoto, Yoshiaki Morita, Haruko Yamamoto, Kazunori Toyoda, Masafumi Ihara
Early detection of hemorrhagic transformation after reperfusion therapy is crucial in acute stroke treatment. Here, we evaluated the relationship between hemorrhagic transformation and post-reperfusion hyperperfusion using pulsed arterial spin labeling (ASL) perfusion MRI and (123)I-iodoamphetamine single-photon emission-computed tomography. Patients who developed hemorrhagic transformation showed significantly higher cerebral blood flow in the affected lesion after thrombolysis and/or endovascular intervention...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28660209/intravenous-thrombolysis-in-acute-ischemic-stroke-with-active-cancer
#19
Ki-Woong Nam, Chi Kyung Kim, Tae Jung Kim, Sang Joon An, Kyungmi Oh, Sang-Bae Ko, Byung-Woo Yoon
Ischemic stroke patients with active cancer are known to have poor clinical outcomes. However, the efficacy and safety of intravenous alteplase (IV t-PA) in this group are still unclear. In this study, we aimed to evaluate whether stroke patients with cancer had poor clinical outcomes after use of IV t-PA. We reviewed ischemic stroke patients with active cancer treated with isolated IV t-PA between April 2010 and March 2015 at three national university hospitals from the registry for ischemic stroke in Korea...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28659427/effects-of-increasing-iv-tpa-treated-stroke-mimic-rates-at-ct-based-centers-on-clinical-outcomes
#20
Tina M Burton, Marie Luby, Zurab Nadareishvili, Richard T Benson, John K Lynch, Lawrence L Latour, Amie W Hsia
OBJECTIVE: To determine to what degree stroke mimics skew clinical outcomes and the potential effects of incorrect stroke diagnosis. METHODS: This retrospective analysis of data from 2005 to 2014 included IV tissue plasminogen activator (tPA)-treated adults with clinical suspicion for acute ischemic stroke who were transferred or admitted directly to our 2 hub hospitals. Primary outcome measures compared CT-based spoke hospitals' and MRI-based hub hospitals' mimic rates, hemorrhagic transformation, follow-up modified Rankin Scale (mRS), and discharge disposition...
July 25, 2017: Neurology
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