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https://www.readbyqxmd.com/read/29100856/recanalization-after-extracranial-dissection-effect-of-antiplatelet-compared-with-anticoagulant-therapy
#1
Preethi Ramchand, Michael T Mullen, Aaron Bress, Robert Hurst, Scott E Kasner, Brett L Cucchiara, Steven R Messé
BACKGROUND: Cervical arterial dissection is a leading cause of stroke in young patients, yet optimal management remains controversial. Existing studies focusing on recurrent stroke were underpowered to demonstrate differences between antithrombotic strategies. Vessel recanalization is a more prevalent outcome and is potentially clinically important. We aimed to assess recanalization rates with anticoagulation compared with antiplatelet therapy. METHODS: We studied a single-center retrospective cohort of patients with extracranial carotid or vertebral artery dissection...
October 31, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29090661/patent-foramen-ovale-closure-with-gore-helex-or-cardioform-septal-occluder-vs-antiplatelet-therapy-for-reduction-of-recurrent-stroke-or-new-brain-infarct-in-patients-with-prior-cryptogenic-stroke-design-of-the-randomized-gore-reduce-clinical-study
#2
Scott E Kasner, Lars Thomassen, Lars Søndergaard, John F Rhodes, Coby C Larsen, Joth Jacobson
Rationale The utility of patent foramen ovale (PFO) closure for secondary prevention in patients with prior cryptogenic stroke is uncertain despite multiple randomized trials completed to date. Aims The Gore REDUCE Clinical Study (REDUCE) aims to establish superiority of patent foramen ovale closure in conjunction with antiplatelet therapy over antiplatelet therapy alone in reducing the risk of recurrent clinical ischemic stroke or new silent brain infarct in patients who have had a cryptogenic stroke. Methods and design This controlled, open-label trial randomized 664 subjects with cryptogenic stroke at 63 multinational sites in a 2:1 ratio to either antiplatelet therapy plus patent foramen ovale closure (with GORE® HELEX® Septal Occluder or GORE® CARDIOFORM Septal Occluder) or antiplatelet therapy alone...
December 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29021776/sex-differences-in-rt-pa-utilization-at-hospitals-treating-stroke-the-national-inpatient-sample
#3
Amelia K Boehme, Brendan G Carr, Scott Eric Kasner, Karen C Albright, Michael J Kallan, Mitchell S V Elkind, Charles C Branas, Michael T Mullen
BACKGROUND AND PURPOSE: Sex and race disparities in recombinant tissue plasminogen activator (rt-PA) use have been reported. We sought to explore sex and race differences in the utilization of rt-PA at primary stroke centers (PSCs) compared to non-PSCs across the US. METHODS: Data from the National (Nationwide) Inpatient Sample (NIS) 2004-2010 was utilized to assess sex differences in treatment for ischemic stroke in PSCs compared to non-PSCs. RESULTS: There were 304,152 hospitalizations with a primary diagnosis of ischemic stroke between 2004 and 2010 in the analysis: 75,160 (24...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28929392/preventing-early-bouncebacks-to-the-neurointensive-care-unit-a-retrospective-analysis-and-quality-improvement-pilot
#4
David G Coughlin, Monisha A Kumar, Neha N Patel, Rebecca L Hoffman, Scott E Kasner
BACKGROUND: Early unplanned readmissions of "bouncebacks" to intensive care units are a healthcare quality metric and result in higher mortality and greater cost. Few studies have examined bouncebacks to the neurointensive care unit (neuro-ICU), and we sought to design and implement a quality improvement pilot to reduce that rate. METHODS: First, we performed a retrospective chart review of 504 transfers to identify potential bounceback risk factors. Risk factors were assessed on the day of transfer by the transferring physician identifying patients as "high risk" or "low risk" for bounceback...
September 19, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28902580/patent-foramen-ovale-closure-or-antiplatelet-therapy-for-cryptogenic-stroke
#5
RANDOMIZED CONTROLLED TRIAL
Lars Søndergaard, Scott E Kasner, John F Rhodes, Grethe Andersen, Helle K Iversen, Jens E Nielsen-Kudsk, Magnus Settergren, Christina Sjöstrand, Risto O Roine, David Hildick-Smith, J David Spence, Lars Thomassen
BACKGROUND: The efficacy of closure of a patent foramen ovale (PFO) in the prevention of recurrent stroke after cryptogenic stroke is uncertain. We investigated the effect of PFO closure combined with antiplatelet therapy versus antiplatelet therapy alone on the risks of recurrent stroke and new brain infarctions. METHODS: In this multinational trial involving patients with a PFO who had had a cryptogenic stroke, we randomly assigned patients, in a 2:1 ratio, to undergo PFO closure plus antiplatelet therapy (PFO closure group) or to receive antiplatelet therapy alone (antiplatelet-only group)...
September 14, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28844834/what-makes-new-ischemic-lesions-symptomatic-after-aortic-valve-replacement
#6
Ronen R Leker, Steven R Messé, Guray Erus, Michel Bilello, Molly Fanning, Michael Acker, Allie Massaro, Scott E Kasner, Thomas Floyd
BACKGROUND: Acute cerebral infarctions on diffusion-weighted magnetic resonance imaging (MRI) are common after cardiothoracic surgery. However, most are asymptomatic and we aimed to identify features associated with clinical stroke symptoms. METHODS: Patients over 65 years of age undergoing surgical aortic valve replacement (AVR) for calcific stenosis were prospectively recruited (N = 196). All patients underwent neurological evaluation preoperatively and on postoperative days 1, 3, and 7, and MRI on planned postoperative day 5...
August 24, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28817503/interprovider-communication-using-a-scheduled-provider-alert-response-communication-system-in-3-inpatient-neurology-units
#7
James E Siegler, Dan Finegan, Scott E Kasner, Raymond S Price
BACKGROUND: Nonemergent communications between nursing staff and residents often occur randomly throughout the workday at teaching institutions, resulting in inefficiency and interruptions of scheduled resident educational conferences or periods of overnight rest. OBJECTIVE: The aim of this study was to determine whether a quality improvement communication strategy can reduce interruptive notifications during scheduled resident didactic sessions. METHODS: We conducted a prospective, mixed-methods trial of a communication strategy between nurses and residents in 3 neurology units of an academic institution...
October 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28720658/ticagrelor-versus-aspirin-in-acute-embolic-stroke-of-undetermined-source
#8
RANDOMIZED CONTROLLED TRIAL
Pierre Amarenco, Gregory W Albers, Hans Denison, J Donald Easton, Scott R Evans, Peter Held, Michael D Hill, Jenny Jonasson, Scott E Kasner, Per Ladenvall, Kazuo Minematsu, Carlos A Molina, Yongjun Wang, K S Lawrence Wong, S Claiborne Johnston
BACKGROUND AND PURPOSE: Ticagrelor is an effective antiplatelet therapy among patients with atherosclerotic disease and, therefore, could be more effective than aspirin in preventing recurrent stroke and cardiovascular events among patients with embolic stroke of unknown source (ESUS), which includes patients with ipsilateral stenosis <50% and aortic arch atherosclerosis. METHODS: We randomized 13 199 patients with a noncardioembolic, nonsevere ischemic stroke or high-risk transient ischemic attack to ticagrelor (180 mg loading dose on day 1 followed by 90 mg twice daily for days 2-90) or aspirin (300 mg on day 1 followed by 100 mg daily for days 2-90) within 24 hours of symptom onset...
September 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28261153/non-invasive-respiratory-impedance-enhances-cerebral-perfusion-in-healthy-adults
#9
Christopher G Favilla, Ashwin B Parthasarathy, John A Detre, Arjun G Yodh, Michael T Mullen, Scott E Kasner, Kimberly Gannon, Steven R Messé
Optimization of cerebral blood flow (CBF) is the cornerstone of clinical management in a number of neurologic diseases, most notably ischemic stroke. Intrathoracic pressure influences cardiac output and has the potential to impact CBF. Here, we aim to quantify cerebral hemodynamic changes in response to increased respiratory impedance (RI) using a non-invasive respiratory device. We measured cerebral perfusion under varying levels of RI (6 cm H2O, 9 cm H2O, and 12 cm H2O) in 20 healthy volunteers. Simultaneous measurements of microvascular CBF and middle cerebral artery mean flow velocity (MFV), respectively, were performed with optical diffuse correlation spectroscopy and transcranial Doppler ultrasound...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28238711/efficacy-and-safety-of-ticagrelor-versus-aspirin-in-acute-stroke-or-transient-ischaemic-attack-of-atherosclerotic-origin-a-subgroup-analysis-of-socrates-a-randomised-double-blind-controlled-trial
#10
RANDOMIZED CONTROLLED TRIAL
Pierre Amarenco, Gregory W Albers, Hans Denison, J Donald Easton, Scott R Evans, Peter Held, Michael D Hill, Jenny Jonasson, Scott E Kasner, Per Ladenvall, Kazuo Minematsu, Carlos A Molina, Yongjun Wang, K S Lawrence Wong, S Claiborne Johnston
BACKGROUND: Ticagrelor is an effective antiplatelet therapy for patients with coronary atherosclerotic disease and might be more effective than aspirin in preventing recurrent stroke and cardiovascular events in patients with acute cerebral ischaemia of atherosclerotic origin. Our aim was to test for a treatment-by-ipsilateral atherosclerotic stenosis interaction in a subgroup analysis of patients in the Acute Stroke or Transient Ischaemic Attack Treated with Aspirin or Ticagrelor and Patient Outcomes (SOCRATES) trial...
April 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28102428/plasma-adamts13-activity-and-von-willebrand-factor-antigen-and-activity-in-patients-with-subarachnoid-haemorrhage
#11
Monisha Kumar, Wenjing Cao, Jenny K McDaniel, Huy P Pham, Dheeraj Raju, Kelsey Nawalinski, Suzanne Frangos, David Kung, Eric Zager, Scott E Kasner, Joshua M Levine, X Long Zheng
Increased von Willebrand factor (VWF) and reduced ADAMTS13 activity are associated with arterial thrombosis. This may also be the culprit mechanism implicated in delayed cerebral ischaemia after aneurysmal subarachnoid haemorrhage (SAH). It was our objective to determine plasma VWF and ADAMTS13 in patients with SAH and healthy subjects; and to explore the levels of those markers and outcome after SAH. Forty consecutive patients were enrolled between September 2007 and April 2014 in a pilot study. Plasma samples were collected from SAH patients on post-bleed day (PBD) 0, 1, 3, 5, 7 and 10 and healthy controls...
April 3, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28077455/symptomatic-carotid-occlusion-is-frequently-associated-with-microembolization
#12
Ava L Liberman, Ali Zandieh, Caitlin Loomis, Jonathan M Raser-Schramm, Christina A Wilson, Jose Torres, Koto Ishida, Swaroop Pawar, Rebecca Davis, Michael T Mullen, Steven R Messé, Scott E Kasner, Brett L Cucchiara
BACKGROUND AND PURPOSE: Symptomatic carotid artery disease is associated with significant morbidity and mortality. The pathophysiologic mechanisms of cerebral ischemia among patients with carotid occlusion remain underexplored. METHODS: We conducted a prospective observational cohort study of patients hospitalized within 7 days of ischemic stroke or transient ischemic attack because of ≥50% carotid artery stenosis or occlusion. Transcranial Doppler emboli detection was performed in the middle cerebral artery ipsilateral to the symptomatic carotid...
February 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28029608/higher-stroke-risk-with-lower-blood-pressure-in-hemodynamic-vertebrobasilar-disease-analysis-from-the-veritas-study
#13
MULTICENTER STUDY
Sepideh Amin-Hanjani, Tanya N Turan, Xinjian Du, Dilip K Pandey, Linda Rose-Finnell, DeJuran Richardson, Mitchell S V Elkind, Gregory J Zipfel, David S Liebeskind, Frank L Silver, Scott E Kasner, Philip B Gorelick, Fady T Charbel, Colin P Derdeyn
BACKGROUND: Despite concerns regarding hypoperfusion in patients with large-artery occlusive disease, strict blood pressure (BP) control has become adopted as a safe strategy for risk reduction of stroke. We examined the relationship between BP control, blood flow, and risk of subsequent stroke in the prospective Vertebrobasilar Flow Evaluation and Risk of Transient Ischemic Attack and Stroke (VERiTAS) study. METHODS: The VERiTAS study enrolled patients with recent vertebrobasilar (VB) transient ischemic attack or stroke and ≥50% atherosclerotic stenosis or occlusion of vertebral or basilar arteries...
February 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27980126/prevention-of-stroke-in-patients-with-silent-cerebrovascular-disease-a-scientific-statement-for-healthcare-professionals-from-the-american-heart-association-american-stroke-association
#14
REVIEW
Eric E Smith, Gustavo Saposnik, Geert Jan Biessels, Fergus N Doubal, Myriam Fornage, Philip B Gorelick, Steven M Greenberg, Randall T Higashida, Scott E Kasner, Sudha Seshadri
Two decades of epidemiological research shows that silent cerebrovascular disease is common and is associated with future risk for stroke and dementia. It is the most common incidental finding on brain scans. To summarize evidence on the diagnosis and management of silent cerebrovascular disease to prevent stroke, the Stroke Council of the American Heart Association convened a writing committee to evaluate existing evidence, to discuss clinical considerations, and to offer suggestions for future research on stroke prevention in patients with 3 cardinal manifestations of silent cerebrovascular disease: silent brain infarcts, magnetic resonance imaging white matter hyperintensities of presumed vascular origin, and cerebral microbleeds...
February 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27900543/stroke-6th-edition-pathophysiology-diagnosis-and-management-by-james-c-grotta-gregory-w-albers-joseph-p-broderick-scott-e-kasner-eng-h-lo-a-david-mendelow-ralph-l-sacco-and-lawrence-k-s-wong-2016-1504-pages-us-405-00-hardcover-isbn-9780323295444-elsevier
#15
https://www.readbyqxmd.com/read/27893460/tgf-%C3%AE-1-modulates-microglial-phenotype-and-promotes-recovery-after-intracerebral-hemorrhage
#16
Roslyn A Taylor, Che-Feng Chang, Brittany A Goods, Matthew D Hammond, Brian Mac Grory, Youxi Ai, Arthur F Steinschneider, Stephen C Renfroe, Michael H Askenase, Louise D McCullough, Scott E Kasner, Michael T Mullen, David A Hafler, J Christopher Love, Lauren H Sansing
Intracerebral hemorrhage (ICH) is a devastating form of stroke that results from the rupture of a blood vessel in the brain, leading to a mass of blood within the brain parenchyma. The injury causes a rapid inflammatory reaction that includes activation of the tissue-resident microglia and recruitment of blood-derived macrophages and other leukocytes. In this work, we investigated the specific responses of microglia following ICH with the aim of identifying pathways that may aid in recovery after brain injury...
January 3, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/27530692/elevated-red-cell-distribution-width-is-associated-with-cerebral-infarction-in-aneurysmal-subarachnoid-hemorrhage
#17
James E Siegler, Christy Marcaccio, Kelsey Nawalinski, Francis Quattrone, Danielle K Sandsmark, Eileen Maloney-Wilensky, Suzanne Frangos, Joshua M Levine, Sherman C Stein, Scott E Kasner, Monisha A Kumar
BACKGROUND: Elevated red blood cell distribution width (RDW) has been associated with thrombotic disorders including myocardial infarction, venous thromboembolism, and ischemic stroke, independent of other inflammatory and coagulation biomarkers. The purpose of this study was to determine whether elevated RDW is associated with cerebral infarction and poor outcome after aneurysmal subarachnoid hemorrhage (aSAH). METHODS: In this retrospective single-center cohort of aSAH patients (October 2009-September 2014), elevated RDW was defined as a mean RDW >14...
February 2017: Neurocritical Care
https://www.readbyqxmd.com/read/27507860/global-survey-of-the-frequency-of-atrial-fibrillation-associated-stroke-embolic-stroke-of-undetermined-source-global-registry
#18
Kanjana S Perera, Thomas Vanassche, Jackie Bosch, Balakumar Swaminathan, Hardi Mundl, Mohana Giruparajah, Miguel A Barboza, Martin J O'Donnell, Maia Gomez-Schneider, Graeme J Hankey, Byung-Woo Yoon, Artemio Roxas, Philippa Lavallee, Joao Sargento-Freitas, Nikolay Shamalov, Raf Brouns, Rubens J Gagliardi, Scott E Kasner, Alessio Pieroni, Philipp Vermehren, Kazuo Kitagawa, Yongjun Wang, Keith Muir, Jonathan M Coutinho, Stuart J Connolly, Robert G Hart
BACKGROUND AND PURPOSE: Atrial fibrillation (AF) is increasingly recognized as the single most important cause of disabling ischemic stroke in the elderly. We undertook an international survey to characterize the frequency of AF-associated stroke, methods of AF detection, and patient features. METHODS: Consecutive patients hospitalized for ischemic stroke in 2013 to 2014 were surveyed from 19 stroke research centers in 19 different countries. Data were analyzed by global regions and World Bank income levels...
September 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27466464/practice-advisory-recurrent-stroke-with-patent-foramen-ovale-update-of-practice-parameter-report-of-the-guideline-development-dissemination-and-implementation-subcommittee-of-the-american-academy-of-neurology
#19
REVIEW
Steven R Messé, Gary Gronseth, David M Kent, Jorge R Kizer, Shunichi Homma, Lee Rosterman, Scott E Kasner
OBJECTIVE: To update the 2004 American Academy of Neurology guideline for patients with stroke and patent foramen ovale (PFO) by addressing whether (1) percutaneous closure of PFO is superior to medical therapy alone and (2) anticoagulation is superior to antiplatelet therapy for the prevention of recurrent stroke. METHODS: Systematic review of the literature and structured formulation of recommendations. CONCLUSIONS: Percutaneous PFO closure with the STARFlex device possibly does not provide a benefit in preventing stroke vs medical therapy alone (risk difference [RD] 0...
August 23, 2016: Neurology
https://www.readbyqxmd.com/read/27382005/pathogenesis-and-risk-factors-for-cerebral-infarct-after-surgical-aortic-valve-replacement
#20
Allie Massaro, Steven R Messé, Michael A Acker, Scott E Kasner, Jose Torres, Molly Fanning, Tania Giovannetti, Sarah J Ratcliffe, Michel Bilello, Wilson Y Szeto, Joseph E Bavaria, Emile R Mohler, Thomas F Floyd
BACKGROUND AND PURPOSE: Stroke is a potentially devastating complication of cardiac surgery. Identifying predictors of radiographic infarct may lead to improved stroke prevention for surgical patients. METHODS: We reviewed 129 postoperative brain magnetic resonance imagings from a prospective study of patients undergoing surgical aortic valve replacement. Acute infarcts were classified as watershed or embolic using prespecified criteria. RESULTS: Acute infarct on magnetic resonance imaging was seen in 79 of 129 patients (61%), and interrater reliability for stroke pathogenesis was high (κ=0...
August 2016: Stroke; a Journal of Cerebral Circulation
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