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Stroke mimics

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https://www.readbyqxmd.com/read/28641383/neuroprotection-in-stroke-the-importance-of-collaboration-and-reproducibility
#1
Ain A Neuhaus, Yvonne Couch, Gina Hadley, Alastair M Buchan
Acute ischaemic stroke accounts for 6.5 million deaths per year, and by 2030 will result in the annual loss of over 200 million disability-adjusted life years globally. There have been considerable recent advances in the gold standard of acute ischaemic stroke treatment, some aspects of which-aspirin to prevent recurrence, and treating patients in specialized stroke wards-are widely applicable. Recanalization of the occluded artery through thrombolysis and/or endovascular thrombectomy is restricted to only a small proportion of patients, due to contra-indications and the costs associated with establishing the infrastructure to deliver these treatments...
June 20, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28640874/risk-factors-are-different-for-deep-and-lobar-remote-hemorrhages-after-intravenous-thrombolysis
#2
Luis Prats-Sanchez, Alejandro Martínez-Domeño, Pol Camps-Renom, Raquel Delgado-Mederos, Daniel Guisado-Alonso, Rebeca Marín, Laura Dorado, Salvatore Rudilosso, Alejandra Gómez-González, Francisco Purroy, Manuel Gómez-Choco, David Cánovas, Dolores Cocho, Moises Garces, Sonia Abilleira, Joan Martí-Fàbregas
BACKGROUND AND PURPOSE: Remote parenchymal haemorrhage (rPH) after intravenous thrombolysis is defined as hemorrhages that appear in brain regions without visible ischemic damage, remote from the area of ischemia causing the initial stroke symptom. The pathophysiology of rPH is not clear and may be explained by different underlying mechanisms. We hypothesized that rPH may have different risk factors according to the bleeding location. We report the variables that we found associated with deep and lobar rPH after intravenous thrombolysis...
2017: PloS One
https://www.readbyqxmd.com/read/28598212/blood-protein-biomarkers-as-diagnostic-tool-for-ischemic-stroke-a-systematic-review
#3
Thomas Monbailliu, Joline Goossens, Saϊd Hachimi-Idrissi
AIM: This systematic review provides a summary of the blood protein biomarkers that have been studied for the diagnosis of acute ischemic stroke. MATERIALS & METHODS: An extensive MEDLINE (using PubMed) and Web of Knowledge search was performed. From the 354 articles found, 42 were eligible for further analysis and 25 protein biomarkers were examined. RESULTS: Though many candidate blood-based protein biomarkers were examined, only two could significantly differentiate ischemic stroke patients from healthy controls, stroke mimics and hemorrhagic stroke patients...
June 9, 2017: Biomarkers in Medicine
https://www.readbyqxmd.com/read/28587406/neuroprotective-mechanisms-of-mir-124-activating-pi3k-akt-signaling-pathway-in-ischemic-stroke
#4
Changming Wang, Zhijie Wei, Guohong Jiang, Haijun Liu
The neuroprotective mechanisms of miR-124 activating phosphoinositide 3-kinase (PI3K)/Akt signaling pathway in ischemic stroke were investigated. The oxygen-glucose deprivation model of nerve cells induced by PC12 cells was established in vitro, then miR-124 mimics or inhibitor was transfected and synthesized by liposome. Cells were divided into the blank control, model, mimics and inhibitor groups, and the apoptotic rate was determined using flow cytometry. Additionally, the expression levels of PI3K, Akt, Bax, Bcl-2, caspase-3 mRNA and protein were tested by quantitative PCR and western blot analysis at 0, 3, 6, 12 and 24 h, respectively...
June 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28585898/circulating-extracellular-dna-levels-are-acutely-elevated-in-ischaemic-stroke-and-associated-with-innate-immune-system-activation
#5
Grant C O'Connell, Ashley B Petrone, Connie S Tennant, Noelle Lucke-Wold, Yasser Kabbani, Abdul R Tarabishy, Paul D Chantler, Taura L Barr
OBJECTIVE: The objective of this work was to assess the ability of peripheral blood cell-free DNA (cfDNA) levels to identify ischaemic stroke early in the acute phase of care, as well as to examine the relationship between peripheral blood cfDNA levels and stroke-induced innate immune system activation. METHODS: Upon emergency department admission, peripheral blood samples were obtained from 43 patients experiencing acute ischaemic stroke and 20 patients identified as stroke mimics...
June 6, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28582318/recent-advances-in-childhood-vasculitis
#6
Seza Ozen, Nazire Pinar Acar-Ozen
PURPOSE OF REVIEW: The review aims to summarize the recent findings in vasculitis that may have an impact in our understanding or management of these diseases. RECENT FINDINGS: We are learning more about monogenic diseases that closely mimic the pediatric vasculitides. Deficiency of adenosine deaminase 2 can present with a polyarteritis nodosa (PAN)-like picture and should be included in the differential of all pediatric cases of PAN with a family history or in cases with early stroke, or in cases resistant to conventional therapy...
June 2, 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28576916/fabry-heterozygote-mimicking-multiple-sclerosis
#7
Wai Yan Yau, Marzena J Fabis-Pedrini, Allan G Kermode
Fabry's disease (FD) is a recognised mimic of multiple sclerosis (MS). It is an X-linked storage lysosomal disorder with deficiency of α-galactosidase A and enzyme replacement therapy is available. Patients with FD may satisfy modified McDonald criteria if the diagnosis of FD has not been pursued. We present a case of FD in a 65-year-old woman masquerading as benign MS for 40 years. She has recurrent posterior circulation stroke-like symptoms, hearing loss and acroparaesthesia, but typical radiological features of MS on MRI brain...
June 2, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28567027/transient-vestibulopathy-in-wallenberg-s-syndrome-pathologic-analysis
#8
Jorge C Kattah, Ali S Saber Tehrani, Sigrun Roeber, Meena Gujrati, Sarah E Bach, David E Newman Toker, Ari M Blitz, Anja K E Horn
OBJECTIVE: To report an unusual lateral medullary stroke (LMS) associated with transient unidirectional horizontal, nystagmus, and decreased horizontal vestibulo-ocular reflex (h-VOR) gain that mimicked a peripheral vestibulopathy. MRI suggested involvement of caudal medial vestibular nucleus (MVN); however, the rapid resolution of the nystagmus and improved h-VOR gain favored transient ischemia without infarction. Decreased h-VOR gain is expected with peripheral vestibular lesions within the labyrinth or superior vestibular nerve; less frequently lateral pontine strokes involving the vestibular root entry, the vestibular fascicle, or neurons within the MVN may be responsible...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28559833/acute-intravenous-calcium-antagonist-for-suspected-hemiplegic-migraine-a-case-story
#9
Charlotte Lützhøft Rath, Jun He, Mette Maria Nordling, Troels Wienecke
Stroke mimics, like attacks of hemiplegic migraine, are challenging in acute stroke evaluation. We present a 28-year-old woman with a suspected hemiplegic migraine attack with left-sided hemiparalysis. Brain CT with perfusion imaging 1 h 54 min after symptom onset revealed hypoperfusion in the right hemisphere. The patient was treated with intravenous recombinant tissue plasminogen activator (rtPA) with no effect. After a subsequent intravenous verapamil infusion, the patient gained full motor function within 10 min...
January 2017: Case Reports in Neurology
https://www.readbyqxmd.com/read/28553165/gsk-3%C3%AE-as-a-target-for-protection-against-transient-cerebral-ischemia
#10
Wei Wang, Mingchang Li, Yuefei Wang, Zhongyu Wang, Wei Zhang, Fangxia Guan, Qianxue Chen, Jian Wang
Stroke remains the leading cause of death and disability worldwide. This fact highlights the need to search for potential drug targets that can reduce stroke-related brain damage. We showed recently that a glycogen synthase kinase-3β (GSK-3β) inhibitor attenuates tissue plasminogen activator-induced hemorrhagic transformation after permanent focal cerebral ischemia. Here, we examined whether GSK-3β inhibition mitigates early ischemia-reperfusion stroke injury and investigated its potential mechanism of action...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28551302/acute-stroke-differential-diagnosis-stroke-mimics
#11
Pedro Vilela
Stroke mimics (SM) are non-vascular conditions that present with an acute neurological deficit simulating acute ischemic stroke and represent a significant percentage of all acute stroke hospital admissions. The most common clinical SM includes conversion/functional (psychiatric disorder); seizures and postictal paralysis; toxic-metabolic disturbances; brain tumours; infections, and migraine. Imaging is essential for SM recognition, being Diffusion weighted imaging (DWI), perfusion imaging and angiographic studies very useful...
May 5, 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28549217/surface-enhanced-raman-scattering-active-gold-nanoparticles-with-enzyme-mimicking-activities-for-measuring-glucose-and-lactate-in-living-tissues
#12
Yihui Hu, Hanjun Cheng, Xiaozhi Zhao, Jiangjiexing Wu, Faheem Muhammad, Shichao Lin, Jian He, Liqi Zhou, Chengping Zhang, Yu Deng, Peng Wang, Zhengyang Zhou, Shuming Nie, Hui Wei
Gold nanoparticles (AuNPs) with simultaneous plasmonic and biocatalytic properties provide a promising approach to developing versatile bioassays. However, the combination of AuNPs' intrinsic enzyme-mimicking properties with their surface-enhanced Raman scattering (SERS) activities has yet to be explored. Here we designed a peroxidase-mimicking nanozyme by in situ growing AuNPs into a highly porous and thermally stable metal-organic framework called MIL-101. The obtained AuNPs@MIL-101 nanozymes acted as peroxidase mimics to oxidize Raman-inactive reporter leucomalachite green into the active malachite green (MG) with hydrogen peroxide and simultaneously as the SERS substrates to enhance the Raman signals of the as-produced MG...
June 1, 2017: ACS Nano
https://www.readbyqxmd.com/read/28539818/isoflurane-preconditioning-inhibits-the-effects-of-tissue-type-plasminogen-activator-on-brain-endothelial-cell-in-an-in-vitro-model-of-ischemic-stroke
#13
So Yeong Cheon, So Yeon Kim, Eun Hee Kam, Jae Hoon Lee, Jeong Min Kim, Eun Jung Kim, Tae Whan Kim, Bon-Nyeo Koo
Tissue-type plasminogen activator (tPA) is the only treatment for ischemic stroke. However, tPA could induce the intracranial hemorrhage (ICH), which is the main cause of death in ischemic stroke patient after tPA treatment. At present, there is no treatment strategy to ameliorate tPA-induced brain injury after ischemia. Therefore, we investigated the effect of pre-treated isoflurane, which is a volatile anesthetic and has beneficial effects on neurological dysfunction, brain edema and infarct volume in ischemic stroke model...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28538247/the-positive-predictive-value-of-an-ambulance-prealert-for-stroke-and-transient-ischaemic-attack
#14
Craig W Brown, Mary J Macleod
OBJECTIVE: Therapeutic options for ischaemic stroke, such as thrombolysis or thrombectomy, are time sensitive. Multiple innovations have been established to reduce the symptom-to-needle time. One such innovation is the prealerting of emergency department (ED) or stroke unit staff by prehospital personnel of suspected stroke patients. The diagnosis of stroke can sometimes be difficult, with stroke mimics being a recognized issue. The prealert mobilizes ED, stroke and imaging personnel, which, for a true-positive, improves door-to-needle times...
May 19, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28535009/microrna-let-7g-alleviates-atherosclerosis-via-the-targeting-of-lox-1-in-vitro-and-in-vivo
#15
Mingxin Liu, Guizhou Tao, Qifeng Liu, Kun Liu, Xinchun Yang
Atherosclerosis is a chronic arterial disease and the leading cause of stroke and myocardial infarction. Micro-RNAs (miRNAs or miRs) have been reported to act as essential modulators during the progression of atherosclerosis. Although miR-let-7g has been demonstrated to contribute to maintaining endothelial function and vascular homeostasis, it is not known whether miR-let-7g exerts a therapeutic effect on experimental atherosclerosis. The aim of this study was to investigate the effects of miR-let-7g on atherosclerosis in vivo and in vitro and to explore its underlying mechanisms...
May 18, 2017: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/28522364/inhibition-of-mir-181a-protects-female-mice-from-transient-focal-cerebral-ischemia-by-targeting-astrocyte-estrogen-receptor-%C3%AE
#16
Creed M Stary, Lijun Xu, Le Li, Xiaoyun Sun, Yi-Bing Ouyang, Xiaoxing Xiong, Jing Zhao, Rona G Giffard
Whether the effect of miR-181a is sexually dimorphic in stroke is unknown. Prior work showed protection of male mice with miR-181a inhibition. Estrogen receptor-α (ERα) is an identified target of miR181 in endometrium. Therefore we investigated the separate and joint effects of miR-181a inhibition and 17β-estradiol (E2) replacement after ovariectomy. Adult female mice were ovariectomized and implanted with an E2- or vehicle-containing capsule for 14d prior to 1h middle cerebral artery occlusion (MCAO). Each group received either miR-181a antagomir or mismatch control by intracerebroventricular injection 24h before MCAO...
May 15, 2017: Molecular and Cellular Neurosciences
https://www.readbyqxmd.com/read/28504621/-a-stroke-mimic-hemichorea-associated-with-non-ketotic-hyperglycaemia
#17
Stine Munk Hald, Willy Krone, Zahid Abbas Minhas, David Gaist
An 85-year-old man with a history of diabetes was admitted with acute onset hemichorea. Laboratory findings confirmed poorly controlled diabetes. A brain computed tomography (CTC) revealed contralateral striatal hyperdensity. The findings were compatible with hyperglycaemia-induced hemichorea, and antidiabetic and symptomatic treatment was initiated. The symptoms remitted completely after six days, and a follow-up CTC showed partial resolution of the striatal changes. This case illustrates the importance of considering if hyperglycaemia is the cause of hemichorea, as early diagnosis and treatment yield an excellent prognosis...
May 8, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28495624/mechanistic-insight-into-interaction-of-sodium-dodecyl-sulphate-to-asialylated-form-of-glycoprotein-a-mimic-of-membrane-protein-lipid-system
#18
Nida Zaidi, Rizwan Hasan Khan
The SDS-glycoprotein system is mimic of membrane protein-lipid system. Fate of glycoprotein, conformation and the interactive forces involved in membrane milieu are expected to be decided by the net charge on glycoprotein that may change during acidic environment in a range of pathological states, including cancer, stroke, and ischemia. Asialofetuin (ASF; asialylated form of glycoprotein) and SDS interaction is studied when glycoprotein bears varying range of net charge (i.e. at different pH's) by steady state and time-resolved spectroscopic, calorimetric and microscopic approaches...
May 8, 2017: International Journal of Biological Macromolecules
https://www.readbyqxmd.com/read/28476507/old-stroke-as-an-independent-risk-etiology-for-todd-s-paralysis
#19
Kenichiro Sato, Noritoshi Arai, Ayumi Hida, Sousuke Takeuchi
BACKGROUND: Todd's paralysis (TP) is a well-known postictal paresis in which patients present with transient weakness in their limb(s) after seizures. Although recognized as a stroke mimic in clinical practice, the pathophysiological mechanism and clinical features of TP remain unknown. Furthermore, its diagnosis can be erroneous in neurological emergency practice. We aimed to illustrate the clinical features and identify factors associated with TP. METHODS: This single-center, retrospective observational study included consecutive adult patients who presented with convulsive seizure and were referred to an urban tertiary care emergency department between August 2010 and April 2016...
May 2, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28471061/impact-on-patient-management-of-the-implementation-of-a-magnetic-resonance-imaging-dedicated-to-neurological-emergencies
#20
Marie Girot, Jean-Baptiste Marc, Eric Wiel, Christian Vilhelm, Xavier Leclerc, Xavier Lenne, Hervé Hubert
RATIONALE, AIMS AND OBJECTIVES: Neurological emergencies consumed a high amount of resources in emergency department (ED). We aimed to study the effect of the implementation of a magnetic resonance imaging (MRI) dedicated to emergencies on the management of patients admitted in ED for neurological emergencies. METHODS: We enrolled consecutive patients who underwent computed tomography and/or MRI for neurological disorders categorized as the suspicion of stroke and other reasons, over 2 periods that differed according to the priority access to computed tomography in the first period versus priority access to MRI in the second one...
May 4, 2017: Journal of Evaluation in Clinical Practice
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