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https://www.readbyqxmd.com/read/27896904/contrast-induced-encephalopathy-following-cardiac-catheterization
#1
Roberto Spina, Neil Simon, Romesh Markus, David Wm Muller, Krishna Kathir
OBJECTIVES: To describe the epidemiology, pathophysiology, clinical presentation, and management of contrast-induced encephalopathy (CIE) following cardiac catheterization. BACKGROUND: CIE is an acute, reversible neurological disturbance directly attributable to the intra-arterial administration of iodinated contrast medium. METHODS: The PubMed database was searched and all cases in the literature were retrieved and reviewed. RESULTS: 52 reports of CIE following cardiac catheterization were found...
November 29, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27887976/the-establishment-of-a-telestroke-service-using-multimodal-ct-imaging-decision-assistance-turning-on-the-fog-lights
#2
REVIEW
Jelle Demeestere, Claire Sewell, Jennifer Rudd, Timothy Ang, Louise Jordan, James Wills, Carlos Garcia-Esperon, Ferdinand Miteff, Venkatesh Krishnamurthy, Neil Spratt, Longting Lin, Andrew Bivard, Mark Parsons, Christopher Levi
Telestroke services have been shown to increase stroke therapy access in rural areas. The implementation of advanced CT imaging for patient assessment may improve patient selection and detection of stroke mimics in conjunction with telestroke. We implemented a telestroke service supported by multimodal CT imaging in a rural hospital in Australia. Over 21months we conducted an evaluation of service activation, thrombolysis rates and use of multimodal imaging to assess the feasibility of the service. Rates of symptomatic intracranial haemorrhage and 90-day modified Rankin Score were used as safety outcomes...
November 22, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27884966/setting-up-a-neuroscience-stroke-and-rehabilitation-centre-in-brunei-darussalam-by-a-transcontinental-on-site-and-telemedical-cooperation
#3
U Meyding-Lamadé, B Bassa, E Craemer, C Jacobi, C Chan, W Hacke, B Kress
Due to the world-wide aging population, there is a need for specialist neurological knowledge, treatment and care. Stroke treatment is effective in reducing mortality and disability, but it is still not available in many areas of the world. We describe the set-up process of a specialized Neuroscience, Stroke and Rehabilitation Centre in Brunei Darussalam (BNSRC) in cooperation with a German hospital. This study details the setup of a stroke-, neurological intensive care- and neurorehabilitation unit, laboratories and a telemedical network to perform all evidence-based stroke treatments...
November 24, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27881450/glial-fibrillary-acidic-protein-serum-levels-distinguish-between-intracerebral-hemorrhage-and-cerebral-ischemia-in-the-early-phase-of-stroke
#4
Sebastian Luger, Jens Witsch, Andreas Dietz, Gerhard F Hamann, Jens Minnerup, Hauke Schneider, Matthias Sitzer, Katja E Wartenberg, Marion Niessner, Christian Foerch
BACKGROUND: Recent studies have suggested that glial fibrillary acidic protein (GFAP) serum concentrations distinguish between intracerebral hemorrhage (ICH) and ischemic stroke (IS) shortly after symptom onset. In this prospective multicenter trial we validated GFAP in an independent patient cohort and assessed the quantitative relationship between GFAP release, bleeding size, and localization. METHODS: We included patients with a persistent neurological deficit (NIH Stroke Scale ≥4) suggestive of stroke within 6 h of symptom onset...
November 23, 2016: Clinical Chemistry
https://www.readbyqxmd.com/read/27879445/agreement-among-stroke-faculty-and-fellows-in-treating-ischemic-stroke-patients-with-tissue-type-plasminogen-activator-and-thrombectomy
#5
Ahmad-Riad Ramadan, Mary Carter Denny, Farhaan Vahidy, Jose-Miguel Yamal, Tzu-Ching Wu, Amrou Sarraj, Sean Savitz, James Grotta
BACKGROUND AND PURPOSE: The aim of this study is to determine agreement among vascular neurology fellows and faculty in treating patients with acute ischemic stroke with intravenous tissue-type plasminogen activator and intra-arterial thrombectomy (IAT). METHODS: Patients were evaluated simultaneously by at least 2 vascular neurology. Agreement was determined using kappa (κ) and intraclass correlation coefficients. RESULTS: In 60 patients, agreement was substantial for tissue-type plasminogen activator (κ=0...
November 22, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27878137/mitochondrial-cytopathy-with-common-melas-mutation-presenting-as-multiple-system-atrophy-mimic
#6
Anne-Katrin Pröbstel, André Schaller, Johanna Lieb, Juergen Hench, Stephan Frank, Peter Fuhr, Ludwig Kappos, Michael Sinnreich
Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome(1) is one of the most frequently inherited mitochondrial disorders. MELAS syndrome is a systemic disease with multiple organ involvement.(2) The most common mutation in MELAS is the m.3243A>G mutation in the MT-TL1 gene.(2).
December 2016: Neurology. Genetics
https://www.readbyqxmd.com/read/27866732/impact-of-a-direct-admission-stroke-pathway-on-delays-of-admission-care-and-rates-of-intravenous-thrombolysis
#7
REVIEW
C Mouthon-Reignier, I Bonnaud, M Gaudron, S Vannier-Bernard, J-F Bodin, J-P Cottier, B De Toffol, S Debiais
INTRODUCTION: This study examined the impact of a "direct potential thrombolysis" pathway with direct admission to a neurological stroke unit (SU) on delays of admission, stroke care and proportion of patients with ischemic stroke (IS) treated with intravenous (IV) rtPA. METHODS: This prospective study included all patients admitted in the intensive SU for potential thrombolysis over a 2-month period. Data collected included the time of symptom onset, mode of transport, National Institutes of Health Stroke Scale (NIHSS) score on arrival, delays of care, delays of imaging and modalities, diagnosis and therapeutic data...
November 17, 2016: Revue Neurologique
https://www.readbyqxmd.com/read/27854089/serial-neuroimaging-of-a-patient-with-minor-stroke-due-to-isolated-cortical-vein-thrombosis-and-convexal-subarachnoid-hemorrhage
#8
Pei-Ya Chen, Kun-Eng Lim, Shinn-Kuang Lin
PURPOSE: Convexal subarachnoid hemorrhage (cSAH) comprises less than 5% of cases of nontraumatic SAH and frequently presents as a focal and transient neurological deficits that mimics transient ischemic attack (TIA). Isolated cortical vein thrombosis (ICVT) is rare and accounts for only 6.3% of cerebral venous thrombosis. We present a case of minor stroke due to cSAH secondary to ICVT, and alos put emphasis on the chronological change of those serial imagings. CASE REPORT: An 87-year-old man presented with episodes of numbness and dropping of his left arm, which had lasted for three days...
September 15, 2016: Acta Neurologica Taiwanica
https://www.readbyqxmd.com/read/27847681/language-barriers-between-physicians-and-patients-are-not-associated-with-thrombolysis-of-stroke-mimics
#9
Sara K Rostanski, Olajide Williams, Joshua I Stillman, Randolph S Marshall, Joshua Z Willey
BACKGROUND: Acute stroke is a time-sensitive condition in which rapid diagnosis must be made in order for thrombolytic treatment to be administered. A certain proportion of patients who receive thrombolysis will be found on further evaluation to have a diagnosis other than stroke, so-called "stroke mimics." Little is known about the role of language discordance in the emergency department diagnosis of acute ischemic stroke. METHODS: This is a retrospective analysis of all acute ischemic stroke patients who received IV tissue plasminogen activator (tPA) in our emergency department between July 2011 and December 2015...
October 2016: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/27845874/initial-single-center-experience-with-the-fully-repositionable-transfemoral-lotus-aortic-valve-system
#10
Kai-Uwe Jarr, Florian Leuschner, Benjamin Meder, Hugo A Katus, Raffi Bekeredjian, Emmanuel Chorianopoulos
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has become the standard therapy for patients with severe symptomatic aortic stenosis and unacceptable high risk for surgical aortic valve replacement. Several different devices for TAVR have been introduced so far, each of them with unique features. AIMS: To analyze our first real-world experience with the second- generation, mechanically expanded, fully repositionable transfemoral Lotus TAVR device (Boston Scientific)...
November 15, 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27824561/investigation-of-crossbeam-multi-receiver-configurations-for-accurate-3-d-vector-doppler-velocity-estimation
#11
Bushra Hussain, Billy Y S Yiu, Alfred C H Yu, James C Lacefield, Tamie L Poepping
An accurate estimation of low blood velocities whose Doppler shifts span the wall filter cutoff, such as near the wall in recirculation or disturbed flow regions, is important for accurate mapping of velocities to achieve improved estimations of wall shear stress and turbulence, which are known risk factors for atherosclerosis and stroke. This paper presents the comparative benefit of increasing the number of receiver beams above three for an improved estimation of low 3-D velocities. The 3-D crossbeam vector Doppler ultrasound configurations were studied in terms of the number of receiver beams, interbeam angle, and beam selection method (criterion for discriminating between tissue and blood Doppler signals) for a range of velocity orientations, which may prove useful in the design of a future 2-D array for vascular imaging...
November 2016: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
https://www.readbyqxmd.com/read/27824543/giant-cell-arteritis-and-polymyalgia-rheumatica-2016-update
#12
REVIEW
Gideon Nesher, Gabriel S Breuer
Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are both more common among people of North European decent than among Mediterranean people. Women are 2-3 times more commonly affected. Giant cell arteritis and PMR are extremely rare before age 50 years. Polymyalgia rheumatica may be "isolated" or associated with GCA. There is increased expression of inflammatory cytokines in temporal arteries of PMR patients, without overt histological evidence of arteritis. One-third of "isolated" PMR patients have vascular uptake in positron emission tomography (PET) scans, suggesting clinically unrecognized, "hidden" GCA...
October 31, 2016: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/27822669/asl-and-susceptibility-weighted-imaging-contribution-to-the-management-of-acute-ischaemic-stroke
#13
REVIEW
Sébastien Verclytte, Olivier Fisch, Lucie Colas, Olivier Vanaerde, Manuel Toledano, Jean-François Budzik
: Magnetic resonance imaging (MRI) plays a central role in the early diagnosis of cerebral vascular events. Today, MRI is used not only for the detection of acute ischaemic lesions, but also to fine tune the diagnosis and improve patient selection for early therapeutic decision-making. In this perspective, new tools such as arterial spin labelling (ASL) and susceptibility-weighted imaging (SWI) sequences have been developed. These MRI sequences enable noninvasive assessment of brain damage, providing important diagnostic and prognostic information: evaluation of cerebral parenchymal perfusion; detection and aetiological assessment of thrombi; ruling out differential diagnoses...
November 7, 2016: Insights Into Imaging
https://www.readbyqxmd.com/read/27803010/health-consequences-of-shift-work-and-insufficient-sleep
#14
REVIEW
Göran Kecklund, John Axelsson
This review summarises the literature on shift work and its relation to insufficient sleep, chronic diseases, and accidents. It is based on 38 meta-analyses and 24 systematic reviews, with additional narrative reviews and articles used for outlining possible mechanisms by which shift work may cause accidents and adverse health. Evidence shows that the effect of shift work on sleep mainly concerns acute sleep loss in connection with night shifts and early morning shifts. A link also exists between shift work and accidents, type 2 diabetes (relative risk range 1...
November 1, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27788262/resveratrol-reverses-functional-chagas-heart-disease-in-mice
#15
Glaucia Vilar-Pereira, Vitor C Carneiro, Hilton Mata-Santos, Amanda R R Vicentino, Isalira P Ramos, Naira L L Giarola, Daniel F Feijó, José R Meyer-Fernandes, Heitor A Paula-Neto, Emiliano Medei, Marcelo T Bozza, Joseli Lannes-Vieira, Claudia N Paiva
Chronic chagasic cardiomyopathy (CCC) develops years after acute infection by Trypanosoma cruzi and does not improve after trypanocidal therapy, despite reduction of parasite burden. During disease, the heart undergoes oxidative stress, a potential causative factor for arrhythmias and contractile dysfunction. Here we tested whether antioxidants/ cardioprotective drugs could improve cardiac function in established Chagas heart disease. We chose a model that resembles B1-B2 stage of human CCC, treated mice with resveratrol and performed electrocardiography and echocardiography studies...
October 2016: PLoS Pathogens
https://www.readbyqxmd.com/read/27780653/clinical-mimics-an-emergency-medicine-focused-review-of-stroke-mimics
#16
Brit Long, Alex Koyfman
BACKGROUND: Stroke is a leading cause of death and disability and most commonly presents with focal neurologic deficit within a specific vascular distribution. Several other conditions may present in a similar manner. OBJECTIVES: This review provides emergency providers with an understanding of stroke mimics, use of thrombolytics in these mimics, and keys to differentiate true stroke from mimic. DISCUSSION: Stroke has significant morbidity and mortality, and the American Heart Association emphasizes rapid recognition and aggressive treatment for patients with possible stroke-like symptoms, including thrombolytics...
October 22, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27777645/targeting-glial-mitochondrial-function-for-protection-from-cerebral-ischemia-relevance-mechanisms-and-the-role-of-micrornas
#17
Le Li, Creed M Stary
Astrocytes and microglia play crucial roles in the response to cerebral ischemia and are effective targets for stroke therapy in animal models. MicroRNAs (miRs) are important posttranscriptional regulators of gene expression that function by inhibiting the translation of select target genes. In astrocytes, miR expression patterns regulate mitochondrial function in response to oxidative stress via targeting of Bcl2 and heat shock protein 70 family members. Mitochondria play an active role in microglial activation, and miRs regulate the microglial neuroinflammatory response...
2016: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/27774515/a-novel-model-of-transient-occlusion-of-the-middle-cerebral-artery-in-awake-mice
#18
Lulu Xie, Hongyi Kang, Maiken Nedergaard
BACKGROUND: Stroke is one of the leading causes of death and disability worldwide. As a consequence, several excellent rodent models have been developed to gain insight into the pathophysiology of stroke and testing the efficacy of neuroprotective interventions. However, one potential problem is that albeit roughly 80% of strokes occur in awake patients, all existing murine stroke models employ anesthesia. Moreover, epidemiological studies have shown that stroke injury is more severe in the minority of patients that suffer stroke while asleep...
2016: Journal of Nature and Science
https://www.readbyqxmd.com/read/27773791/mir363-3p-improves-ischemic-stroke-outcomes-in-female-but-not-male-rats
#19
Amutha Selvamani, Farida Sohrabji
With age, stroke prevalence is higher, and stroke outcome, worse, in women. Thus there is an urgent need to identify stroke neuroprotectants for this population. Using a preclinical stroke model, our studies focused on microRNAs (miRNAs), a class of translational repressors, as neuroprotectants. Analysis of circulating miRNA in the acute phase of stroke indicated potential neuroprotective capacity for miR363. Specifically, mir363 is elevated in serum of adult female rats that typically have small infarct volumes, but is deficient in age-matched males or middle-aged males and females, groups that have greater stroke-associated impairment...
October 20, 2016: Neurochemistry International
https://www.readbyqxmd.com/read/27763486/stroke-mimic-perfusion-magnetic-resonance-imaging-of-a-patient-with-ictal-paralysis
#20
D Sanghvi, C Goyal, J Mani
We present an uncommon case of clinically diagnosed window period stroke subsequently recognised on diffusion - perfusion MRI as ictal paralysis due to focal inhibitory seizures or negative motor seizures. This case highlights the importance of MRI with perfusion imaging in establishing the diagnosis of stroke mimics and avoiding unnecessary thrombolysis.
October 2016: Journal of Postgraduate Medicine
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