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Stroke mimics

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https://www.readbyqxmd.com/read/28932374/stroke-mimics-in-patients-with-clinical-signs-of-stroke
#1
Mozafar Hosseininezhad, Reza Sohrabnejad
BACKGROUND: Stroke mimic is a major diagnostic challenge and may be difficult to distinguish from real strokes. The aim of this study was to evaluate the relative frequency of stroke mimics in patients with clinical signs of stroke. METHODS: In this cross sectional-study, the medical records of 1985 patients with stroke admitted to Poursina Hospital were enrolled using the census technique. Data collection tool was a checklist which include age, sex, imaging results (MRI and CT scan and primary and final diagnoses...
2017: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/28923103/moderate-sensitivity-and-high-specificity-of-emergency-department-administrative-data-for-transient-ischemic-attacks
#2
Amy Y X Yu, Hude Quan, Andrew McRae, Gabrielle O Wagner, Michael D Hill, Shelagh B Coutts
BACKGROUND: Validation of administrative data case definitions is key for accurate passive surveillance of disease. Transient ischemic attack (TIA) is a condition primarily managed in the emergency department. However, prior validation studies have focused on data after inpatient hospitalization. We aimed to determine the validity of the Canadian 10th International Classification of Diseases (ICD-10-CA) codes for TIA in the national ambulatory administrative database. METHODS: We performed a diagnostic accuracy study of four ICD-10-CA case definition algorithms for TIA in the emergency department setting...
September 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28912212/risk-stratification-using-the-cha2ds2-vasc-score-in-takotsubo-syndrome-data-from-the-takotsubo-italian-network
#3
Guido Parodi, Fernando Scudiero, Rodolfo Citro, Angelo Silverio, Benedetta Bellandi, Concetta Zito, Francesco Antonini-Canterin, Fausto Rigo, Chiara Zocchi, Eduardo Bossone, Jorge Salerno-Uriarte, Federico Piscione, Carlo Di Mario
BACKGROUND: The CHA2DS2-VASc score predicts stroke in patients with atrial fibrillation and has been reported to have a prognostic role even in acute coronary syndrome patients. The Takotsubo syndrome is a condition that mimics acute coronary syndrome and may present several complications including stroke. We sought to assess the ability of CHA2DS2-VASc score to predict adverse events in Takotsubo syndrome patients. METHODS AND RESULTS: Overall, 371 Takotsubo syndrome patients were enrolled in a prospective registry...
September 14, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28903119/multimodal-brain-analysis-of-functional-neurological-disorders-a-functional-stroke-mimic-case-series
#4
Enrico Premi, Alberto Benussi, Silvia Compostella, Nicola Gilberti, Veronica Vergani, Ilenia Delrio, Raffaella Spezi, Massimo Gamba, Angelo Costa, Roberto Gasparotti, Mauro Magoni, Alessandro Padovani, Barbara Borroni
No abstract text is available yet for this article.
September 14, 2017: Psychotherapy and Psychosomatics
https://www.readbyqxmd.com/read/28894512/treatment-effects-of-ischemic-stroke-by-berberine-baicalin-and-jasminoidin-from-huang-lian-jie-du-decoction-hljdd-explored-by-an-integrated-metabolomics-approach
#5
Qian Zhang, Xiaowei Fu, Junsong Wang, Minghua Yang, Lingyi Kong
Berberine, baicalin, and jasminoidin were major active ingredients of Huang-Lian-Jie-Du-Decoction (HLJDD), a famous prescription of traditional Chinese medicine (TCM), which has been used for the treatment of ischemic stroke. The aim of the present study was to classify their roles in the treatment effects of ischemic stroke. A rat model of middle cerebral artery occlusion (MCAO) was constructed to mimic ischemic stroke and treatment effects of berberine, baicalin, and jasminoidin, and HLJDD was assessed by neurologic deficit scoring, infarct volume, histopathology, immunohistochemistry, biochemistry, quantitative real-time polymerase chain reaction (qRT-PCR), and Western blotting...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/28893906/n-terminal-splicing-extensions-of-the-human-myo1c-gene-fine-tune-the-kinetics-of-the-three-full-length-myosin-ic-isoforms
#6
Lilach Zattelman, Ronit Regev, Marko Ušaj, Patrick Y A Reinke, Sven Giese, Abraham O Samson, Manuel H Taft, Dietmar J Manstein, Arnon Henn
The MYO1C gene produces three alternatively spliced isoforms, differing only in their N-terminal regions (NTRs). These isoforms, which exhibit both specific and overlapping nuclear and cytoplasmic functions, have different expression levels and nucleo-cytoplasmic partitioning. To investigate the effect of NTR extensions on the enzymatic behavior of individual isoforms, we over-expressed and purified the three full-length human isoforms from suspension-adapted HEK cells. MYO1C(C) favored the actomyosin closed state (AM(C)), MYO1C(16) populated the actomyosin open state (AM(O)) and AM(C) equally, and MYO1C(35) favored the AM(O) state...
September 11, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28890524/diagnosis-and-management-of-patients-with-paroxysmal-sympathetic-hyperactivity-following-acute-brain-injuries-using-a-consensus-based-diagnostic-tool-a-single-institutional-case-series
#7
Shigeo Godo, Shigemi Irino, Atsuhiro Nakagawa, Yu Kawazoe, Motoo Fujita, Daisuke Kudo, Ryosuke Nomura, Hiroaki Shimokawa, Shigeki Kushimoto
Paroxysmal sympathetic hyperactivity (PSH) is a distinct syndrome of episodic sympathetic hyperactivities following severe acquired brain injury, characterized by paroxysmal transient fever, tachycardia, hypertension, tachypnea, excessive diaphoresis and specific posturing. PSH remains to be an under-recognized condition with a diagnostic pitfall especially in the intensive care unit (ICU) settings due to the high prevalence of concomitant diseases that mimic PSH. A consensus set of diagnostic criteria named PSH-Assessment Measure (PSH-AM) has been developed recently, which is consisted of two components: a diagnosis likelihood tool derived from clinical characteristics of PSH, and a clinical feature scale assigned to the severity of each sympathetic hyperactivity...
2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28877562/rate-of-stroke-mimics-over-telestroke
#8
Dong In Sinn, Sami Al Kasab, Chirantan Banerjee, Shelly Ozark
No abstract text is available yet for this article.
September 6, 2017: Journal of Stroke
https://www.readbyqxmd.com/read/28864702/design-and-validation-of-a-clinical-scale-for-prehospital-stroke-recognition-severity-grading-and-prediction-of-large-vessel-occlusion-the-shortened-nih-stroke-scale-for-emergency-medical-services
#9
Jan Christoph Purrucker, Florian Härtig, Hardy Richter, Andreas Engelbrecht, Johannes Hartmann, Jonas Auer, Christian Hametner, Erik Popp, Peter Arthur Ringleb, Simon Nagel, Sven Poli
OBJECTIVE: To develop an NIH Stroke Scale (NIHSS)-compatible, all-in-one scale for rapid and comprehensive prehospital stroke assessment including stroke recognition, severity grading and progression monitoring as well as prediction of large vessel occlusion (LVO). METHODS: Emergency medical services (EMS) personnel and stroke physicians (n=326) rated each item of the NIHSS regarding suitability for prehospital use; best rated items were included. Stroke recognition was evaluated retrospectively in 689 consecutive patients with acute stroke or stroke mimics, prediction of LVO in 741 consecutive patients with ischaemic stroke with acute vessel imaging independent of admission NIHSS score...
September 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/28859026/reexpression-of-prior-stroke-symptoms-in-adults-when-is-a-mimic-a-mimic
#10
James E Siegler, Alexander J George, Sheryl Martin-Schild
A "stroke mimic" refers to any clinical condition that causes neurological symptoms clinically indistinguishable from a cerebral lesion that affects a vascular distribution, but is not caused by ischemia. One subtype of stroke mimic, termed stroke reexpression, is a form of mimicry in which previously recovered or improved stroke symptoms recur in the setting of a neurological disturbance (seizure, hypoperfusion state) or a systemic disturbance (toxic, metabolic, infectious). Many reports of stroke reexpression exist in the literature and are well known to clinicians, but there has been no consensus regarding terminology that has been published to date...
September 2017: Neurologist
https://www.readbyqxmd.com/read/28855859/%C3%AE-2-adrenergic-receptor-mediated-hif-1%C3%AE-upregulation-mediates-blood-brain-barrier-damage-in-acute-cerebral-ischemia
#11
Yanyun Sun, Xi Chen, Xinyu Zhang, Xianzhi Shen, Mengwei Wang, Xiaona Wang, Wen-Cao Liu, Chun-Feng Liu, Jie Liu, Wenlan Liu, Xinchun Jin
Disruption of the blood brain barrier (BBB) within the thrombolytic time window is an antecedent event to intracerebral hemorrhage in ischemic stroke. Our recent studies showed that 2-h cerebral ischemia induced BBB damage in non-infarcted area and secreted matrix metalloproteinase-2 (MMP-2) accounted for this disruption. However, the factors that affect MMP-2 secretion and regulate BBB damage remains unknown. Since hypoxia-inducible factor-1 alpha (HIF-1α) was discovered as a mater regulator in hypoxia, we sought to investigate the roles of HIF-1α in BBB damage as well as the factors regulating HIF-1α expression in the ischemic brain...
2017: Frontiers in Molecular Neuroscience
https://www.readbyqxmd.com/read/28854438/down-regulation-of-lncrna-malat1-attenuates-neuronal-cell-death-through-suppressing-beclin1-dependent-autophagy-by-regulating-mir-30a-in-cerebral-ischemic-stroke
#12
Dong Guo, Ji Ma, Lei Yan, Tengfei Li, Zhiguo Li, Xinwei Han, Shaofeng Shui
BACKGROUND/AIMS: LncRNA metastasis associated lung adenocarcinoma transcript 1 (MALAT1) was reported to be highly expressed in an in vitro mimic of ischemic stroke conditions. However, the exact biological role of MALAT1 and its underlying mechanism in ischemic stroke remain to be elucidated. METHODS: The roles of MALAT1 and miR-30a on cell death and infarct volume and autophagy were evaluated in experimental ischemic stroke. The relationships between miR-30a and MALAT1, Beclin1 were confirmed by luciferase reporter assay...
August 30, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28813884/design-parameters-and-torque-profile-modification-of-a-spring-assisted-hand-opening-exoskeleton-module
#13
Nik R Butler, Stephen A Goodwin, Joel C Perry
There is a growing demand for functional rehabilitation orthotics that can effectively assist in patient recovery from motor impairments after stroke. The hand in particular is a complex system that has proven difficult to mimic with current exoskeleton technologies. This paper presents data-driven design parameters to increase the functionality and improve the assistance profile of the ArmAssist-2.0 hand module. Improvements from the previous model include adjustable linkages to fulfill the largest population of users, new joint locations to more accurately represent biomechanics of the hand, and a more impairment-appropriate torque profile to assist in hand opening, adjustable through interchangeable springs...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813848/preliminary-assessment-of-a-lower-limb-exoskeleton-controller-for-guiding-leg-movement-in-overground-walking
#14
Andres Martinez, Brian Lawson, Michael Goldfarb
This paper describes the design, implementation, and preliminary validation of a controller for a powered lower-limb exoskeleton that reshapes a user's leg movement during over-ground walking. The intended application of the controller is to facilitate gait training for individuals suffering from post-stroke hemiparesis. The controller mimics a kinematic constraint between the knee and hip joints during the swing phase of gait, such that movement is not dependent on time (i.e., step time is determined entirely by the user)...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813809/development-of-elbow-spasticity-model-for-objective-training-of-spasticity-assessment-of-patients-post-stroke
#15
Jeong-Ho Park, Kwang-Jae Lee, Yong-Soon Yoon, Eun-Ji Son, Ji-Sun Oh, Si Hyun Kang, Heesang Kim, Hyung-Soon Park
Reliable assessment is essential for the management of spasticity, one of the most frequent complication of various neurological diseases. For the spasticity assessment, several clinical tools have been developed and widely used in clinics. The most popular one is modified Ashworth scale (MAS). It has a simple protocol, but is subjective and qualitative. To improve its reliability, quantitative measurement and consistent training would be needed. This study presents an elbow spasticity simulator which mimics spastic response of adult post stroke survivors...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28808511/large-endocardial-rheumatoid-nodules-a-case-report-and-review-of-the-literature
#16
Allen Vantrease, Christopher Trabue, James Atkinson, Paul McNabb
Rheumatoid nodules occur frequently in patients with rheumatoid arthritis and are the most common cutaneous manifestation of the disease. Although uncommon, rheumatoid nodules may also occur on cardiac valves, where they may be large and clinically significant. They may embolize and cause stroke. They may cause regurgitant murmurs, or they may result in valvular destruction. Echocardiographically, they may mimic an atrial myxoma or appear as a vegetation. We present a patient with seronegative rheumatoid arthritis who developed an acute embolic stroke; he had peripheral stigmata of infective endocarditis on physical examination and echocardiography revealed a mitral valve vegetation...
July 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28804561/upregulation-of-mir-130b-protects-against-cerebral-ischemic-injury-by-targeting-water-channel-protein-aquaporin-4-aqp4
#17
Yueying Zheng, Liqing Wang, Manli Chen, Aijie Pei, Liwei Xie, Shengmei Zhu
Altered microRNA regulation has been implicated in the pathogenesis of various disorders, including cerebral ischemia/reperfusion injury (I/RI). However, the regulatory mechanism of miR-130b in cerebral ischemia injury has not been reported. In this study, we explored the role of miR-130b in cerebral ischemia injury and investigated its potential mechanism. Levels of miR-130b were quantified by real-time PCR, and the protein level of AQP4 was detected by Western blotting. Cell apoptosis was detected by flow cytometry...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28803231/in-potential-stroke-patients-on-warfarin-the-international-normalized-ratio-predicts-ischemia
#18
Cathy Cao, Ashley Martinelli, Brian Spoelhof, Rafael H Llinas, Elisabeth B Marsh
BACKGROUND: Stroke can occur in patients on warfarin despite anticoagulation. Patients with a low international normalized ratio (INR) should theoretically be at greater risk for ischemia than those who are therapeutic. Therefore, INR may be able to indicate whether new neurological deficits are more likely strokes or stroke mimics in patients on warfarin. This study evaluates the association and predictive value of INR in determining the likelihood of ischemia. METHODS: Patients were identified using the acute stroke registry at a Primary Stroke Center from January 2013 through December 2014...
2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28783808/recrudescence-of-deficits-after-stroke-clinical-and-imaging-phenotype-triggers-and-risk-factors
#19
Mehmet A Topcuoglu, Esen Saka, Scott B Silverman, Lee H Schwamm, Aneesh B Singhal
Importance: Reemergence of previous stroke-related deficits (or poststroke recrudescence [PSR]) is an underrecognized and inadequately characterized phenomenon. Objective: To investigate the clinical features, triggers, and risk factors for PSR. Design, Setting, and Participants: This retrospective study incorporated a crossover cohort study to identify triggers and a case-control study to identify risk factors. The study used the Massachusetts General Hospital Research Patient Data Repository to identify patients for the period January 1, 2000, to November 30, 2015, who had a primary or secondary diagnosis of cerebrovascular disease, who underwent magnetic resonance imaging of the brain at least once, and whose inpatient or outpatient clinician note or discharge summary stated the term recrudescence...
September 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28776175/synthesis-and-identification-of-acedoxypc-a-protectin-containing-structured-phospholipid-using-liquid-chromatography-mass-spectrometry
#20
Amanda Lo Van, Baptiste Fourmaux, Madeleine Picq, Michel Guichardant, Michel Lagarde, Nathalie Bernoud-Hubac
Fatty acids have many health benefits in a great variety of diseases ranging from cardiovascular to cerebral diseases. For instance, docosahexaenoic acid (DHA), which is highly enriched in brain phospholipids, plays a major role in anti-inflammatory or neuroprotective pathways. Its effects are thought to be due, in part, to its conversion into derived mediators such as protectins. 1-Lyso,2-docosahexaenoyl-glycerophosphocholine (LysoPtdCho-DHA) is one of the physiological carrier of DHA to the brain. We previously synthesized a structured phosphatidylcholine to mimic 1-lyso,2-docosahexaenoyl-glycerophosphocholine, named AceDoPC(®) (1-acetyl,2-docosahexaenoyl-glycerophosphocholine), that is considered as a stabilized form of the physiological LysoPtdCho-DHA and that is neuroprotective in experimental ischemic stroke...
August 3, 2017: Lipids
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