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Stroke mimics

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https://www.readbyqxmd.com/read/28438906/novel-screening-tool-for-stroke-using-artificial-neural-network
#1
Vida Abedi, Nitin Goyal, Georgios Tsivgoulis, Niyousha Hosseinichimeh, Raquel Hontecillas, Josep Bassaganya-Riera, Lucas Elijovich, Jeffrey E Metter, Anne W Alexandrov, David S Liebeskind, Andrei V Alexandrov, Ramin Zand
BACKGROUND AND PURPOSE: The timely diagnosis of stroke at the initial examination is extremely important given the disease morbidity and narrow time window for intervention. The goal of this study was to develop a supervised learning method to recognize acute cerebral ischemia (ACI) and differentiate that from stroke mimics in an emergency setting. METHODS: Consecutive patients presenting to the emergency department with stroke-like symptoms, within 4.5 hours of symptoms onset, in 2 tertiary care stroke centers were randomized for inclusion in the model...
April 24, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28433650/long-noncoding-rna-malat1-is-a-potent-autophagy-inducer-protecting-brain-microvascular-endothelial-cells-against-oxygen-glucose-deprivation-reoxygenation-induced-injure-by-sponing-mir-26b-and-upregulating-ulk2-expression
#2
Zhijun Li, Jing Li, Na Tang
Brain microvascular endothelial cell (BMEC) injury induced by ischemia-reperfusion (I/R) is the initial stage of blood-brain barrier (BBB) disruption, which results in a poor prognosis in ischemic stroke patients. Autophagy has been shown to have protective effects on BMECs against cerebral ischemic insults. However, molecular mechanism of BMEC autophagy during I/R is unclear. Long noncoding RNAs (lncRNAs) are emerging as new factors involved in cell autophagy. LncRNA Malat1 is one of the most highly upregulated I/R or OGD/R-responsive endothelial lncRNA and plays a protective role in BMECs against cerebral ischemic insults...
April 19, 2017: Neuroscience
https://www.readbyqxmd.com/read/28430522/impact-of-naturalistic-lighting-on-hospitalized-stroke-patients-in-a-rehabilitation-unit-design-and-measurement
#3
Anders West, Poul Jennum, Sofie Amalie Simonsen, Birgit Sander, Milena Pavlova, Helle K Iversen
INTRODUCTION AND RATIONALE: Stroke is a major cause of acquired cerebral disability among adults, frequently accompanied by depression, anxiety, cognitive impairment, disrupted sleep and fatigue. New ways of intervention to prevent these complications are therefore needed. The major circadian regulator, the suprachiasmatic nucleus, is mainly controlled by natural daylight, and the blue spectrum is considered the most powerful. During stroke rehabilitation, patients typically are mostly indoors and therefore not exposed to the natural daytime variation in light intensity...
April 21, 2017: Chronobiology International
https://www.readbyqxmd.com/read/28412316/differentiating-stroke-and-seizure-in-acute-setting-perfusion-computed-tomography
#4
Katarzyna Kubiak-Balcerewicz, Urszula Fiszer, Ewa Nagańska, Cezary Siemianowski, Aleksander Sobieszek, Agnieszka Witak-Grzybowska, Aldona Kosińska-Szot
BACKGROUND: Perfusion computed tomography (PCT) is part of acute stroke protocol in many hospitals; however, its clinical utility is still being disputed. Beyond its use in core and penumbra estimation, there is also a question about PCT role in stroke mimics diagnosis. Case series or small, retrospective studies showed equivocal results. This is the first published prospective, comparative study on PCT in differentiating stroke and seizure in acute setting. METHODS: Patients with acute focal neurologic deficits and without acute ischemic lesions on routine CT underwent PCT and electroencephalography (EEG) within 12 hours after symptom onset...
April 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28399897/prehospital-ambulance-stroke-test-pilot-study-of-a-novel-stroke-test
#5
Gunnar Andsberg, Magnus Esbjörnsson, Arne Olofsson, Arne Lindgren, Bo Norrving, Mia von Euler
BACKGROUND: There is a need for a prehospital stroke test that in addition to high sensitivity for stroke, also is able to communicate stroke severity similar to the National Institute of Health Stroke Scale (NIHSS). METHODS: The PreHospital Ambulance Stroke Test (PreHAST), an eight item test based on NIHSS, which scores stroke severity from 0-19 points, was designed and adapted for the ambulance services. In the pilot study the ambulance nurses used PreHAST to assess patients with suspected stroke in the prehospital setting...
April 11, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28392840/elucidation-of-exosome-migration-across-the-blood-brain-barrier-model-in-vitro
#6
Claire C Chen, Linan Liu, Fengxia Ma, Chi W Wong, Xuning E Guo, Jenu V Chacko, Henry P Farhoodi, Shirley X Zhang, Jan Zimak, Aude Ségaliny, Milad Riazifar, Victor Pham, Michelle A Digman, Egest J Pone, Weian Zhao
The delivery of therapeutics to the central nervous system (CNS) remains a major challenge in part due to the presence of the blood-brain barrier (BBB). Recently, cell-derived vesicles, particularly exosomes, have emerged as an attractive vehicle for targeting drugs to the brain, but whether or how they cross the BBB remains unclear. Here, we investigated the interactions between exosomes and brain microvascular endothelial cells (BMECs) in vitro under conditions that mimic the healthy and inflamed BBB in vivo...
December 2016: Cellular and Molecular Bioengineering
https://www.readbyqxmd.com/read/28382611/parkinsonism-or-other-movement-disorders-presenting-as-stroke-mimics
#7
Cheng-Yang Hsieh, Chih-Hung Chen, Sheng-Feng Sung, Wen-Juh Hwang
PURPOSE: Patients with parkinsonism or other movement disorders may visit the emergency department due to acute deterioration of neurological status or consciousness disturbance. Under such circumstances, patients may be misdiagnosed as having a hyperacute stroke, i.e. stroke mimic. The purpose of the present study was to explore the clinical features and consequences of patients with parkinsonism or other movement disorders presenting as stroke mimics with activation of a stroke code...
December 15, 2016: Acta Neurologica Taiwanica
https://www.readbyqxmd.com/read/28380464/heat-stress-induces-intestinal-injury-through-lysosome-and-mitochondria-dependent-pathway-in-vivo-and-in-vitro
#8
Gao Yi, Li Li, Meijuan Luo, Xuan He, Zhimin Zou, Zhengtao Gu, Lei Su
Damage to the small intestine secondary to heat stroke is a major factor in heat stroke-related morbidity and mortality. However, the underlying mechanisms by which heat stroke causes small intestinal lesions and dysfunction remain unclear. To explore the pathogenesis of small intestinal tissue and epithelial cell injury, the SW480 cell heat stress model and the mice heat stroke model were established to mimic heat stroke. Morphologic changes in intestinal tissue and increased TUNEL-positive index were induced by heat stress in vivo...
March 28, 2017: Oncotarget
https://www.readbyqxmd.com/read/28372429/modeling-and-test-of-a-kinaesthetic-actuator-based-on-mr-fluid-for-haptic-applications
#9
Tae-Heon Yang, Jeong-Hoi Koo, Sang-Youn Kim, Dong-Soo Kwon
Haptic display units have been widely used for conveying button sensations to users, primarily employing vibrotactile actuators. However, the human feeling for pressing buttons mainly relies on kinaesthetic sensations (rather than vibrotactile sensations), and little studies exist on small-scale kinaesthetic haptic units. Thus, the primary goals of this paper are to design a miniature kinaesthetic actuator based on Magneto-Rheological (MR) fluid that can convey various button-clicking sensations and to experimentally evaluate its haptic performance...
March 2017: Review of Scientific Instruments
https://www.readbyqxmd.com/read/28366057/development-of-a-recalcitrant-large-clot-burden-bifurcation-occlusion-model-for-mechanical-thrombectomy
#10
Visish M Srinivasan, Stephen R Chen, Kevin M Camstra, Gouthami Chintalapani, Peter Kan
OBJECTIVE Stroke is a major cause of disability and death in adults. Several large randomized clinical trials have shown the significant benefit of mechanical thrombectomy with modern stent retrievers in the treatment of large-vessel occlusions. However, large clots located at bifurcations remain challenging to treat. An in vivo model of these recalcitrant clots needs to be developed to test future generations of devices. METHODS Autologous blood was drawn from anesthetized swine via a femoral sheath. Blood was then mixed with thrombin, calcium chloride, and saline, and injected into silicone tubing to form cylindrical clots in the standard fashion...
April 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28365641/stroke-mimic-diagnoses-presenting-to-a-hyperacute-stroke-unit
#11
Russell Lane, Angus Nisbet
No abstract text is available yet for this article.
April 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28365629/mimics-and-chameleons-in-stroke
#12
Sujo Anathhanam, Ahamad Hassan
Ischaemic stroke is a treatable medical emergency. In an era of time-dependent reperfusion techniques, it is crucial that an accurate and prompt diagnosis is made. Approximately 30% of patients admitted to hyperacute stroke units are subsequently found not to have a final diagnosis of acute stroke although some of these patients do have incidental or previously symptomatic cerebrovascular disease. These patients do not benefit from thrombolysis and may require the input of other specialists or treatments. Meanwhile, a proportion of patients with acute stroke have unusual presentations and are sometimes initially admitted to general medical admissions units prior to accessing stroke unit care...
April 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28358291/feasibility-and-utility-of-an-integrated-medical-imaging-and-informatics-smartphone-system-for-management-of-acute-stroke
#13
Kristina Shkirkova, Eftitan Y Akam, Josephine Huang, Sunil A Sheth, May Nour, Conrad W Liang, Michael McManus, Van Trinh, Gary Duckwiler, Jason Tarpley, Fernando Vinuela, Jeffrey L Saver
Background Rapid dissemination and coordination of clinical and imaging data among multidisciplinary team members are essential for optimal acute stroke care. Aim To characterize the feasibility and utility of the Synapse Emergency Room mobile (Synapse ERm) informatics system. Methods We implemented the Synapse ERm system for integration of clinical data, computerized tomography, magnetic resonance, and catheter angiographic imaging, and real-time stroke team communications, in consecutive acute neurovascular patients at a Comprehensive Stroke Center...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28297277/application-programming-in-c-environment-with-recorded-user-software-interactions-and-its-application-in-autopilot-of-vmat-imrt-treatment-planning
#14
Henry Wang, Lei Xing
An autopilot scheme of volumetric-modulated arc therapy (VMAT)/intensity-modulated radiation therapy (IMRT) planning with the guidance of prior knowledge is established with recorded interactions between a planner and a commercial treatment planning system (TPS). Microsoft (MS) Visual Studio Coded UI is applied to record some common planner-TPS interactions as subroutines. The TPS used in this study is a Windows-based Eclipse system. The interactions of our application program with Eclipse TPS are realized through a series of subroutines obtained by prerecording the mouse clicks or keyboard strokes of a planner in operating the TPS...
November 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28289923/tocilizumab-reverses-cerebral-vasculopathy-in-a-patient-with-homozygous-samhd1-mutation
#15
REVIEW
Michael Henrickson, Heng Wang
An auto-inflammatory syndrome consequent to SAMHD1 mutations involves cerebral vasculopathy characterized by multifocal stenosis and aneurysms within large arteries, moyamoya, chronic ischemia, and early-onset strokes (SAMS). While this condition involves the innate immune system, additional clinical features mimic systemic lupus erythematosus. Mutations in this gene can also cause a subset of the rare genetic condition Aicardi-Goutières syndrome. To date, no established therapy successfully prevents disease progression...
March 13, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28284968/recrudescence-of-symptoms-of-remote-ischemic-stroke-after-a-cerebral-angiogram-report-of-a-case
#16
Stephanie R Falatko, Philip G R Schmalz, Mark Harrigan
BACKGROUND: Recrudescence, or reappearance of previously resolved symptoms of ischemic stroke, may occur after physiological stress. Although this syndrome is generally thought to be uncommon, it may actually account for a significant proportion of stroke mimics. CASE DESCRIPTION: A 67-year-old man was admitted with a Hunt-Hess grade II spontaneous subarachnoid hemorrhage. He underwent a digital subtraction cerebral angiogram as part of his imaging evaluation. About 30 minutes after the procedure, he developed dysarthria, right facial droop and a right pronator drift...
March 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28251587/clinical-features-of-thalamic-stroke
#17
REVIEW
Xiang Yan Chen, Qiaoshu Wang, Xin Wang, Ka Sing Wong
The thalamus plays an important role in different brain functions including memory, emotions, sleep-wake cycle, executive functions, mediating general cortical alerting responses, processing of sensory (including taste, somatosensory, visual, and auditory) information and relaying it to the cortex, and sensorimotor control. Thalamic stroke, both in isolation and in combination with infarcts involving other structures, are not rare. The functional complexity of the thalami nuclei and the not uncommon normal variations of arteries supply the thalamus induce wide variations in presentation of thalami infarcts...
February 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28250731/blood-micrornas-as-potential-diagnostic-markers-for-hemorrhagic-stroke
#18
REVIEW
Bridget Martinez, Philip V Peplow
Proper medical treatment of a stroke victim relies on accurate and rapid differentiation between ischemic and hemorrhagic stroke, which in current practice is performed by computerized tomography (CT) or magnetic resonance imaging (MRI) scans. A panel of microRNAs could be an extremely useful clinical tool for distinguishing between hemorrhagic and ischemic stroke. This review has shown that blood miRNA profile can distinguish hemorrhagic from ischemic stroke in patients and in experimental animal models. It also seems likely they can differentiate between intracerebral and subarachnoid hemorrhage stroke...
January 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/28248914/creutzfeldt-jakob-disease-presenting-as-stroke-a-case-report-and-systematic-literature-review
#19
REVIEW
Divya K Sharma, Mike Boggild, Annemarie W van Heuven, Richard P White
BACKGROUND: Creutzfeldt-Jacob disease (CJD) is a human prion disease generally characterized by subacute changes in behavior and intellectual function, often followed by ataxia, vision changes, and myoclonus. Ten percent of cases may present atypically, both symptomatically and in respect to initial investigations. METHODS: We report a case of CJD mimicking acute stroke and review all similar cases in the magnetic resonance imaging era reported in English, identified through a PubMed and SCOPUS search...
March 2017: Neurologist
https://www.readbyqxmd.com/read/28248761/a-stroke-mimic-a-14-year-old-cancer-patient-presenting-with-acute-right-sided-weakness
#20
Natasha Thomas, Elizabeth R Alpern
No abstract text is available yet for this article.
March 2017: Pediatric Emergency Care
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