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acute ischemic stroke treatment

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https://www.readbyqxmd.com/read/28088807/posterior-versus-anterior-circulation-stroke-in-young-adults-a-comparative-study-of-stroke-aetiologies-and-risk-factors-in-stroke-among-young-fabry-patients-sifap1
#1
Bettina von Sarnowski, Ulf Schminke, Ulrike Grittner, Christian Tanislav, Tobias Böttcher, Michael G Hennerici, Turgut Tatlisumak, Jukka Putaala, Manfred Kaps, Franz Fazekas, Christian Enzinger, Arndt Rolfs, Christof Kessler
BACKGROUND: Although 20-30% of all strokes occur in the posterior circulation, few studies have explored the characteristics of patients with strokes in the posterior compared to the anterior circulation so far. Especially data on young patients is missing. METHODS: In this secondary analysis of data of the prospective multi-centre European sifap1 study that investigated stroke and transient ischemic attack (TIA) patients aged 18-55 years, we compared vascular risk factors, stroke aetiology, presence of white matter hyperintensities (WMH) and cerebral microbleeds (CMB) between patients with ischaemic posterior circulation stroke (PCS) and those having suffered from anterior circulation stroke (ACS) based on cerebral MRI...
January 14, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28088798/the-intracranial-b2leed3s-score-and-the-risk-of-intracranial-hemorrhage-in-ischemic-stroke-patients-under-antiplatelet-treatment
#2
Pierre Amarenco, Leila Sissani, Julien Labreuche, Eric Vicaut, Marie Germaine Bousser, Angel Chamorro, Marc Fisher, Ian Ford, Kim M Fox, Michael G Hennerici, Heinrich Mattle, Peter M Rothwell, Philippe Gabriel Steg, Hans-Christoph Diener, Ralph L Sacco, Jacoba P Greving, Ale Algra
BACKGROUND: Chronic antiplatelet therapy in the post-acute phase of non-cardioembolic ischemic stroke is limited by the risk of intracranial hemorrhage (ICH) complications. METHODS: We developed an ICH risk score based on the PERFORM trial cohort (n = 19,100), which included patients with a non-cardioembolic ischemic stroke or transient ischemic attack, and externally validated this score in one contemporary trial of very similar size and inclusion criteria, the PRoFESS trial (n = 20,332 patients)...
January 14, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28087825/incidence-and-predictors-of-epilepsy-after-pediatric-arterial-ischemic-stroke
#3
Lori L Billinghurst, Lauren A Beslow, Nicholas S Abend, Michael Uohara, Laura Jastrzab, Daniel J Licht, Rebecca N Ichord
OBJECTIVE: To determine the cumulative incidence and clinical predictors of remote symptomatic seizures and epilepsy after pediatric arterial ischemic stroke (AIS). METHODS: We performed a retrospective analysis of 218 participants with neonatal AIS (NAIS), presumed perinatal AIS (PPAIS), and childhood AIS (CAIS) from a single-center prospective consecutive cohort enrolled from 2006 to 2014. Medical records were reviewed for timing, semiology, and treatment of acute symptomatic seizures, remote symptomatic seizures (RSS), and epilepsy...
January 13, 2017: Neurology
https://www.readbyqxmd.com/read/28077495/left-ventricular-wall-motion-abnormalities-are-associated-with-stroke-recurrence
#4
Jeong-Yoon Choi, Jaehyung Cha, Jin-Man Jung, Woo-Keun Seo, Kyungmi Oh, Kyung-Hee Cho, Sungwook Yu
OBJECTIVE: To investigate the role of left ventricular wall motion abnormalities (LVWMA), unrelated to high-risk cardioembolic conditions, in stroke recurrence. METHODS: This study included consecutive acute ischemic stroke patients. Transthoracic echocardiography was performed as a routine evaluation for stroke patients. The outcomes were the time to recurrent any stroke and ischemic stroke. RESULTS: Among 4,316 acute ischemic stroke patients, 430 had LVWMA without high-risk cardioembolic sources...
January 11, 2017: Neurology
https://www.readbyqxmd.com/read/28077334/the-neuroprotective-compound-p7c3-a20-promotes-neurogenesis-and-improves-cognitive-function-after-ischemic-stroke
#5
Zachary B Loris, Andrew A Pieper, W Dalton Dietrich
Ischemic stroke is a devastating condition with few therapeutic interventions available. The neuroprotective compound P7C3-A20 inhibits mature neuronal cell death while also increasing the net magnitude of postnatal neurogenesis in models of neurodegeneration and acute injury. P7C3 compounds enhance flux of nicotinamide adenine dinucleotide (NAD) in mammalian cells, a proposed therapeutic approach to treating cerebral ischemia. The effectiveness of P7C3-A20 treatment on chronic histopathological and behavioral outcomes and neurogenesis after ischemic stroke has not previously been established...
January 8, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28074981/-thrombolysis-in-stroke-mimics-experience-in-10-cases
#6
Alejandro M Brunser, Arnold Hoppe, Paula Muñoz, Pablo M Lavados, Sergio Illanes, Violeta Díaz, Verónica V Olavarría
BACKGROUND: The effectiveness of intravenous thrombolysis (IVT) in cerebral ischemia is time dependent. Stroke mimics (SM) are frequent in emergency rooms. The effort to reduce door to needle time, can lead to administer thrombolytics to SM. AIM: To describe the frequency and prognosis of SM treated with IVT. MATERIAL AND METHODS: Prospective analysis of all patients evaluated in a Chilean private clinic between December 2004 and July 2015 with a suspected acute ischemic stroke (AIS)...
October 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28072733/efficacy-and-safety-of-puerarin-injection-in-curing-acute-ischemic-stroke-a-meta-analysis-of-randomized-controlled-trials
#7
Qing-Hua Zheng, Xiao-Li Li, Zhi-Gang Mei, Li Xiong, Qing-Xian Mei, Jin-Feng Wang, Ling-Jing Tan, Song-Bai Yang, Zhi-Tao Feng
BACKGROUND: Previous studies indicated that the puerarin injection has been widely employed in China for the treatment of acute ischemic stroke. We aim to evaluate the efficacy and safety of the puerarin injection for the treatment of acute ischemic stroke. METHODS: A systematic literature search was performed in PUBMED, EMBASE, SPRINGER LINK, Scopus, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP Journals Database, Wanfang database and the China Biological Medicine database before November 2016, randomized controlled clinical trials (RCTs) of puerarin injection treating acute ischemic stroke were included...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28072691/the-effectiveness-and-safety-of-dual-antiplatelet-therapy-in-ischemic-cerebrovascular-disease-with-intracranial-and-extracranial-arteriostenosis-in-chinese-patients-a-randomized-and-controlled-trail
#8
Feng-Tong Zuo, Hui Liu, Hui-Jun Wu, Na Su, Jie-Qiong Liu, Ai-Qin Dong
BACKGROUND: There are limited data on the effect of dual antiplatelet treatment with clopidogrel plus aspirin in patients with ischemic cerebrovascular disease and intracranial and extracranial arteriostenosis. The aim of our study was to evaluate the efficacy and safety of aspirin plus clopidogrel in the treatment of ischemic cerebrovascular disease with intracranial and extracranial arteriostenosis. METHODS: Patients with clinically evident acute cerebral infarction or transient ischemic attack combined with intracranial and extracranial arteriostenosis (greater than 50%) who were unsuitable or reluctance to perform stent implantation were enrolled in this study...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28068952/interaction-among-cox-2-p2y1-and-gpiiia-gene-variants-is-associated-with-aspirin-resistance-and-early-neurological-deterioration-in-chinese-stroke-patients
#9
Xingyang Yi, Chun Wang, Qiang Zhou, Jing Lin
BACKGROUND: The effect of genetic variants on aspirin resistance (AR) remains controversial. We sought to assess the association of genetic variants with AR and early clinical outcomes in patients with acute ischemic stroke (IS). METHODS: A total of 850 acute IS patients were consecutively enrolled. Platelet aggregation was measured before and after a 7-10 day aspirin treatment. The sequences of 14 variants of COX-1, COX-2, GPIb, GPIIIa, P2Y1 and P2Y12 were determined using matrix-assisted laser desorption/ionization time of flight mass spectrometry...
January 9, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28068417/preserved-collateral-blood-flow-in-the-endovascular-m2cao-model-allows-for-clinically-relevant-profiling-of-injury-progression-in-acute-ischemic-stroke
#10
Philip Little, Ola Kvist, Rikard Grankvist, Stefan Jonsson, Peter Damberg, Michael Söderman, Fabian Arnberg, Staffan Holmin
Interventional treatment regimens have increased the demand for accurate understanding of the progression of injury in acute ischemic stroke. However, conventional animal models severely inhibit collateral blood flow and mimic the malignant infarction profile not suitable for treatment. The aim of this study was to provide a clinically relevant profile of the emergence and course of ischemic injury in cases suitable for acute intervention, and was achieved by employing a M2 occlusion model (M2CAO) that more accurately simulates middle cerebral artery (MCA) occlusion in humans...
2017: PloS One
https://www.readbyqxmd.com/read/28068049/medical-devices-neurological-devices-classification-of-the-neurovascular-mechanical-thrombectomy-device-for-acute-ischemic-stroke-treatment-final-order
#11
(no author information available yet)
The Food and Drug Administration (FDA) is classifying the neurovascular mechanical thrombectomy device for acute ischemic stroke treatment into class II (special controls). The special controls that will apply to the device are identified in this order and will be part of the codified language for the neurovascular mechanical thrombectomy device for acute ischemic stroke treatment's classification. The Agency is classifying the device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device...
23, 2016: Federal Register
https://www.readbyqxmd.com/read/28065663/antithrombotic-treatment-in-anticoagulated-atrial-fibrillation-patients-undergoing-percutaneous-coronary-intervention
#12
REVIEW
Csaba András Dézsi, Balázs Bence Dézsi, Döme András Dézsi
: Coronary artery disease coexists in a clinically relevant number of patients with atrial fibrillation and it often requires percutaneous coronary intervention. These patients represent a particular challenge for clinicians in terms of antithrombotic management. They require combined antiplatelet-anticoagulant therapy to reduce the risk of recurrent ischemic cardiac events and stroke; however, this antithrombotic strategy is associated with an increased risk of bleeding complications...
January 5, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28065616/experience-on-mechanical-thrombectomy-for-acute-stroke-treatment-in-a-brazilian-university-hospital
#13
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/28061506/role-of-rem-sleep-melanin-concentrating-hormone-and-orexin-hypocretin-systems-in-the-sleep-deprivation-pre-ischemia
#14
Marta Pace, Antoine Adamantidis, Laura Facchin, Claudio Bassetti
STUDY OBJECTIVES: Sleep reduction after stroke is linked to poor recovery in patients. Conversely, a neuroprotective effect is observed in animals subjected to acute sleep deprivation (SD) before ischemia. This neuroprotection is associated with an increase of the sleep, melanin concentrating hormone (MCH) and orexin/hypocretin (OX) systems. This study aims to 1) assess the relationship between sleep and recovery; 2) test the association between MCH and OX systems with the pathological mechanisms of stroke...
2017: PloS One
https://www.readbyqxmd.com/read/28060307/lateral-chronic-cranial-window-preparation-enables-in-vivo-observation-following-distal-middle-cerebral-artery-occlusion-in-mice
#15
Simon H Bayerl, Melina Nieminen-Kelhä, Thomas Broggini, Peter Vajkoczy, Vincent Prinz
Focal cerebral ischemia (i.e., ischemic stroke) may cause major brain injury, leading to a severe loss of neuronal function and consequently to a host of motor and cognitive disabilities. Its high prevalence poses a serious health burden, as stroke is among the principal causes of long-term disability and death worldwide(1). Recovery of neuronal function is, in most cases, only partial. So far, treatment options are very limited, in particular due to the narrow time window for thrombolysis(2,3). Determining methods to accelerate recovery from stroke remains a prime medical goal; however, this has been hampered by insufficient mechanistic insights into the recovery process...
December 29, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28060219/multicenter-study-of-adverse-events-after-intravenous-tissue-type-plasminogen-activator-treatment-of-acute-ischemic-stroke
#16
Hannah Fernandez-Gotico, Tiffany Lightfoot, Melissa Meighan
BACKGROUND AND PURPOSE: The approved treatment by the Food and Drug Administration for acute ischemic stroke is intravenous tissue-type plasminogen activator (IV tPA). After IV tPA administration, patients are monitored for adverse events using an American Heart Association/American Stroke Association guideline instituted in 1996. There is limited evidence describing the safest and most efficient method to monitor patients during the first 24 hours after tPA administration. Although the overall rates of adverse events have been reported, the time when patients may be at most risk for an event has not been studied...
February 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28059705/emergent-endovascular-management-of-long-segment-and-flow-limiting-carotid-artery-dissections-in-acute-ischemic-stroke-intervention-with-multiple-tandem-stents
#17
S A Ansari, A L Kühn, A R Honarmand, M Khan, M C Hurley, M B Potts, B S Jahromi, A Shaibani, M J Gounis, A K Wakhloo, A S Puri
BACKGROUND AND PURPOSE: Although most cervical dissections are managed medically, emergent endovascular treatment may become necessary in the presence of intracranial large-vessel occlusions, flow-limiting and long-segment dissections with impending occlusion, and/or hypoperfusion-related ischemia at risk of infarction. We investigated the role of emergent endovascular stenting of long-segment carotid dissections in the acute ischemic stroke setting. MATERIALS AND METHODS: We retrospectively studied long-segment carotid dissections requiring stent reconstruction with multiple tandem stents (≥3 stents) and presenting with acute (<12 hours) ischemic stroke symptoms (NIHSS score, ≥4)...
November 10, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28054643/network-based-approach-to-identify-potential-targets-and-drugs-that-promote-neuroprotection-and-neurorepair-in-acute-ischemic-stroke
#18
Yiwei Wang, Hailong Liu, Yongzhong Lin, Guangming Liu, Hongwei Chu, Pengyao Zhao, Xiaohan Yang, Tiezheng Zheng, Ming Fan, Xuezhong Zhou, Jun Meng, Changkai Sun
Acute ischemic stroke (AIS) accounts for more than 80% of the approximately 610,000 new stroke cases worldwide every year. Both ischemia and reperfusion can cause death, damage, and functional changes of affected nerve cells, and these alterations can result in high rates of disability and mortality. Therefore, therapies aimed at increasing neuroprotection and neurorepair would make significant contributions to AIS management. However, with regard to AIS therapies, there is currently a large gap between experimental achievements and practical clinical solutions (EC-GAP-AIS)...
January 5, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28053821/microrna-181c-exacerbates-brain-injury-in-acute-ischemic-stroke
#19
Qingfeng Ma, Haiping Zhao, Zhen Tao, Rongliang Wang, Ping Liu, Ziping Han, Shubei Ma, Yumin Luo, Jianping Jia
MicroRNA-181 (miR-181) is highly expressed in the brain, and downregulated in miRNA expression profiles of acute ischemic stroke patients. However, the roles of miR-181c in stroke are not known. The clinical relevance of miR-181c in acute stroke patients was evaluated by real-time PCR and correlation analyses. Proliferation and apoptosis of BV2 microglial cells and Neuro-2a cells cultured separately or together under oxidative stress or inflammation were assessed with the Cell Counting Kit-8 and by flow cytometry, respectively...
December 2016: Aging and Disease
https://www.readbyqxmd.com/read/28053009/progressive-rural-urban-disparity-in-acute-stroke-care
#20
Sergio Gonzales, Michael T Mullen, Leslie Skolarus, Dylan P Thibault, Uduak Udoeyo, Allison W Willis
OBJECTIVE: To explore rural-urban differences and trends in tissue plasminogen activator (tPA) utilization among acute ischemic stroke (AIS) patients and examine the association between primary stroke center (PSC) growth and geographic disparity in tPA use. METHODS: We used hospital discharge data from the National Inpatient Sample (NIS) from 2000 to 2010 and indicators of tPA utilization and describe temporal trends in geographic disparities in AIS care during PSC growth...
January 4, 2017: Neurology
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