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JOURNAL ARTICLE
Farzaneh Sadeghi, Ferenc Sarkady, Katalin S Zsóri, István Szegedi, Rita Orbán-Kálmándi, Edina G Székely, Nikolett Vasas, Ervin Berényi, László Csiba, Zsuzsa Bagoly, Amir H Shemirani
(1) Background: Ischemic stroke is one of the leading causes of death and disability. An inflammatory response is observed in multiple stages of cerebral ischemia, particularly in the acute phase. Recent publications revealed that the neutrophil-lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR) may be used to predict long-term prognosis in acute ischemic stroke (AIS) after thrombolysis. To test whether there is a relationship between the combination of these parameters and long-term prognosis, we analyzed the NLR-LMR combination in AIS patients treated with intravenous recombinant tissue plasminogen activator (rtPA); (2) Methods: The study included 285 adults with a diagnosis of AIS and rtPA treatment within a 4...
July 27, 2022: Journal of Personalized Medicine
#22
JOURNAL ARTICLE
Jenny M Gandhi, P Mathew Cherian, Pankaj Mehta, Shriram Vardhraj, P Santosh, S Elango
Background/Purpose: Following endovascular intervention for stroke, hyperattenuated areas are common in brain parenchyma and it is difficult to differentiate on non-contrast CT whether it is contrast staining or reperfusion hemorrhage. Differentiation between contrast staining from reperfusion hemorrhage is of paramount importance for early initiation of antiplatelets and/or anticoagulants to prevent reocclusion of vessel. This study demonstrates signal characteristics of contrast-staining and reperfusion hemorrhage on susceptibility weighted MRI and its role to differentiate between two...
May 2022: Neurology India
#23
JOURNAL ARTICLE
Huan Liu, Tianxiao Li, Yonghong Ding, Liangfu Zhu, Ferdinand K Hui, Tengfei Zhou, Juha Antero Hernesniemi, Yanyan He, Yingkun He
Background: Hemorrhagic transformation (HT) of acute ischemic stroke (AIS) is associated with poor outcome. Previous studies only reported the association of mean ischemic severity or total infarct volume with HT after endovascular therapy (EVT). We aimed to investigate the predictive value of preoperative apparent diffusion coefficient (ADC) map for HT by combinated ischemic severity and corresponding volume in AIS after successful recanalization with EVT. Methods: We retrospectively analyzed 119 consecutive cases of AIS with large vessel occlusion of anterior circulation within 24 hours after symptom onset and successful recanalization after EVT...
May 2022: Annals of Translational Medicine
#24
MULTICENTER STUDY
Valerian L Altersberger, Lukas S Enz, Gerli Sibolt, Christian Hametner, Stefania Nannoni, Mirjam R Heldner, Jeffrey Stolp, Dejana R Jovanovic, Andrea Zini, Alessandro Pezzini, Susanne Wegener, Carlo W Cereda, George Ntaios, Silja Räty, Christoph Gumbinger, Miriam Heyse, Alexandros A Polymeris, Annaelle Zietz, Anna Schaufelbuehl, Davide Strambo, Giovanna Padlina, Nedelina Slavova, Marjaana Tiainen, Kati Valkonen, Twan J van Velzen, Guido Bigliardi, Predrag Stanarcevic, Mauro Magoni, Andreas Luft, Yannick Bejot, Laura Vandelli, Visnja Padjen, Paul J Nederkoorn, Marcel Arnold, Patrik Michel, Peter A Ringleb, Sami Curtze, Stefan T Engelter, Henrik Gensicke
OBJECTIVE: To investigate the prognostic value of white blood cell count (WBC) on functional outcome, mortality and bleeding risk in stroke patients treated with intravenous thrombolysis (IVT). METHODS: In this prospective multicenter study from the TRISP registry, we assessed the association between WBC on admission and 3-month poor outcome (modified Rankin Scale 3-6), mortality and occurrence of symptomatic intracranial hemorrhage (sICH; ECASS-II-criteria) in IVT-treated stroke patients...
October 2022: Journal of Neurology
#25
JOURNAL ARTICLE
Yuan Yang, Ting Cui, Xueling Bai, Anmo Wang, Xuening Zhang, Jincheng Wan, Changyi Wang, Kun Lu, Fayun Hu, Bo Wu
BACKGROUND/OBJECTIVE: Systemic immune-inflammation index (SII) is a novel inflammatory factor, which may be involved in the destruction of the blood-brain barrier (BBB) after acute ischemic stroke (AIS); however, the association between SII and symptomatic intracranial hemorrhage (sICH) in AIS patients undergoing endovascular treatment (EVT) remains unclear. METHODS: Patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO) who underwent EVT were consecutively enrolled...
April 6, 2022: Current Neurovascular Research
#26
REVIEW
Hyun Jeong Kim, Hong Gee Roh
Clinical trials on acute ischemic stroke have demonstrated the clinical effectiveness of revascularization treatments within an appropriate time window after stroke onset: intravenous thrombolysis (NINDS and ECASS-III) through the administration of tissue plasminogen activator within a 4.5-hour time window, endovascular thrombectomy (ESCAPE, REVASCAT, SWIFT-PRIME, MR CLEAN, EXTEND-IA) within a 6-hour time window, and extending the treatment time window up to 24 hours for endovascular thrombectomy (DAWN and DEFUSE 3)...
March 2022: Neurointervention
#27
JOURNAL ARTICLE
Yuan Shao, Yuyun Xu, Yumei Li, Xuehua Wen, Xiaodong He
Background: Postinterventional cerebral hyperdensity (PCHD) is commonly seen in acute ischemic patients after mechanical thrombectomy. We propose a new classification of PCHD to investigate its correlation with hemorrhagic transformation (HT). The clinical prognosis of PCHD was further studied. Methods: Data from 189 acute stroke patients were analyzed retrospectively. According to the European Cooperative Acute Stroke Study criteria (ECASS), HT was classified as hemorrhagic infarction (HI-1 and HI-2) and parenchymal hematoma (pH-1 and pH-2)...
2021: Neural Plasticity
#28
JOURNAL ARTICLE
Jyri Juhani Virta, Daniel Strbian, Jukka Putaala, Miikka Korja
BACKGROUND AND OBJECTIVES: Unruptured intracranial aneurysms (UIAs) are considered to be a relative contraindication for IV thrombolysis (IVT) in acute ischemic stroke (AIS). Currently, however, data are limited on the risk of UIA rupture after IVT. Our objective was to assess whether IVT for AIS can lead to a UIA rupture and intracranial hemorrhages (ICHs) in patients with unruptured UIAs. METHODS: This was a prospective cohort study of consecutive patients treated in a comprehensive stroke center between 2005 and 2019...
November 2, 2021: Neurology
#29
JOURNAL ARTICLE
Kosmas Macha, Philip Hoelter, Gabriela Siedler, Ruihao Wang, Michael Knott, Svenja Stoll, Tobias Engelhorn, Arnd Doerfler, Stefan Schwab, Iris Mühlen, Bernd Kallmünzer
Background: rt-PA for ischemic stroke in the unknown or extended time window beyond the first 4. 5 h after symptom onset is safe and effective for certain patients after selection by multimodal neuroimaging. However, the evidence for this approach comes mainly from patients with anterior circulation stroke (ACS), while the data on posterior circulation stroke (PCS) are scarce. Methods: Ischemic stroke patients treated with IV-thrombolysis in the unknown or extended time window between January 2011 and May 2019 were identified from an institutional registry...
2021: Frontiers in Neurology
#30
JOURNAL ARTICLE
Ashkan Mowla, Banafsheh Shakibajahromi, Ashish Arora, Ali Seifi, Robert N Sawyer, Peyman Shirani
OBJECTIVES: Safety of intravenous thrombolysis (IVT) within 3-4.5 hours of stroke onset in patients ≥80 years is still disputable. We evaluated the association of symptom onset-to-treatment time (SOTT) with the symptomatic intracranial hemorrhage (sICH), poor outcome, and mortality in patients≥80 years. MATERIALS AND METHODS: In a retrospective study, patients treated with IVT following stroke were registered. Outcomes were poor outcome (mRS>2), sICH/ECASS-2, and in-hospital mortality...
December 2021: Acta Neurologica Scandinavica
#31
JOURNAL ARTICLE
Hongquan Guo, Wei Xu, Xiaohao Zhang, Shuai Zhang, Zheng Dai, Shun Li, Yi Xie, Yingle Li, Jianzhong Xue, Xinfeng Liu
Background and Aims: A reliable predictive score system to identify the risk of symptomatic intracranial hemorrhage (sICH) after intravenous thrombolysis (IVT) in acute ischemic stroke patients is of great essence. We aimed to develop a nomogram for predicting the risk of sICH after IVT in Chinese patients. Methods: We recruited acute ischemic stroke patients who were treated with IVT from five advanced stroke centers in China from April 2014 to November 2020. sICH was diagnosed according to the European Cooperative Acute Stroke Study II (ECASS-II) definition...
2021: Neuropsychiatric Disease and Treatment
#32
JOURNAL ARTICLE
A Karam, N Bricout, M Khyeng, C Cordonnier, X Leclerc, H Henon, B Casolla
BACKGROUND: The net clinical benefit of mechanical thrombectomy (MT) in patients with anterior circulation ischaemic stroke associated with large vessel occlusion (AIS-LVO) related to carotid artery dissection (CAD) is uncertain. The aim of the study was to investigate the safety and clinical outcomes of patients treated by MT for a CAD-related stroke. METHODS: We included consecutive patients with AIS-LVO treated by MT between 1st 2015 and January 1st 2020 at Lille University Hospital...
February 2022: Journal of Neurology
#33
Qianmei Jiang, Jie Hou, Jian Ge, Zhichao Huang, Huaishun Wang, Zhiliang Guo, Yongjun Cao, Shoujiang You, Guodong Xiao
OBJECTIVE: We performed a systematic review and meta-analysis to investigate the clinical significance of hyperdense area after thrombectomy in patients with acute ischemic stroke (AIS). METHODS: We searched Ovid MEDLINE(R) and Epub Ahead of Print, In-Process and other Non-Indexed, Cochrane Library Clinical Controlled Trials and Embase from inception to September 2020 and collected the cohort and case-control studies about the clinical significance of hyperdense area on different types of computed tomography (CT) after thrombectomy in patients with AIS...
May 27, 2021: Cerebrovascular Diseases
#34
JOURNAL ARTICLE
Miguel Tábuas-Pereira, Orlando Galego, Maria Rosário Almeida, José Tomás, Ricardo Félix-Morais, Fernando Silva, Bruno Rodrigues, Gustavo Cordeiro, João Sargento-Freitas
BACKGROUND: APOE ε4 is independently associated with lobar intracranial hemorrhages (ICH). Although the ε4 allele enhances amyloid deposition in blood vessels, the ε2 allele predisposes to vasculopathic changes leading to rupture of amyloid laden vessels. Thus, ε4 and ε2 carriers might have increased susceptibility to ICH. We aimed to study the impact of the apolipoprotein E alleles in the development of symptomatic ICH (sICH). METHODS: We included 384 consecutive ischemic anterior circulation stroke patients submitted to thrombolysis between January 2014 and March 2016...
June 2021: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
#35
MULTICENTER STUDY
M A Soldatov, N A Marskaya, K A Barsegova, O V Androfagina, D N Borisov, D Yu Karpov, M V Kishinevsky, M V Kucheryavaya, S V Tabakman, Yu A Telyatnik, A S Fadeeva, D S Khan, A N Chirkov, N A Shamalov
OBJECTIVE: To assess the safety and efficacy of Revelisa in patients with ischemic stroke in real-world clinical practice. MATERIAL AND METHODS: The interim analysis of an open-label, prospective, multicenter, non-interventional study IVT-AIS-R included 223 patients (50.2% women and 49.8% men, mean age 66.6 (13.5) years) with ischemic stroke who were admitted to the study sites since July 2019 and who, in the absence of contraindications, underwent thrombolytic therapy (TLT) with Revelisa within the first 4...
2021: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
#36
RANDOMIZED CONTROLLED TRIAL
Greg Rubin, Fiona M Walter, Jon Emery, Willie Hamilton, Zoe Hoare, Jenny Howse, Catherine Nixon, Tushar Srivastava, Chloe Thomas, Obioha C Ukoumunne, Juliet A Usher-Smith, Sophie Whyte, Richard D Neal
OBJECTIVE: To determine the feasibility of a definitive trial in primary care of electronic clinical decision support (eCDS) for possible oesophago-gastric (O-G) cancer. DESIGN AND SETTING: Feasibility study in 42 general practices in two regions of England, cluster randomised controlled trial design without blinding, nested qualitative and health economic evaluation. PARTICIPANTS: Patients aged 55 years or older, presenting to their general practitioner (GP) with symptoms associated with O-G cancer...
March 18, 2021: BMJ Open
#37
REVIEW
Yuanmei Pan, Guowen Shi
In 1995, the results of a landmark clinical trial by National Institute of Neurological Disorders and Stroke (NINDS) made a paradigm shift in managing acute cerebral ischemic stroke (AIS) patients at critical care centers. The study demonstrated the efficacy of tissue-type plasminogen activator (tPA), alteplase in improving neurological and functional outcome in AIS patients when administered within 3 h of stroke onset. After about 12 years of efforts and the results of the ECASS-III trial, it was possible to expand the therapeutic window to 4...
2021: Frontiers in Neurology
#38
JOURNAL ARTICLE
Caty Carrera, Jara Cárcel-Márquez, Natalia Cullell, Nuria Torres-Águila, Elena Muiño, José Castillo, Tomás Sobrino, Francisco Campos, Emilio Rodríguez-Castro, Laia Llucià-Carol, Mònica Millán, Lucía Muñoz-Narbona, Elena López-Cancio, Alejandro Bustamante, Marc Ribó, José Álvarez-Sabín, Jordi Jiménez-Conde, Jaume Roquer, Eva Giralt-Steinhauer, Carolina Soriano-Tárraga, Marina Mola-Caminal, Cristófol Vives-Bauza, Rosa Díaz Navarro, Silvia Tur, Victor Obach, Juan Francisco Arenillas, Tomás Segura, Gemma Serrano-Heras, Joan Martí-Fàbregas, Raquel Delgado-Mederos, M Mar Freijo-Guerrero, Francisco Moniche, Juan Antonio Cabezas, Mar Castellanos, Cristina Gallego-Fabrega, Jonathan González-Sanchez, Jurek Krupinsky, Daniel Strbian, Turgut Tatlisumak, Vincent Thijs, Robin Lemmens, Agnieszka Slowik, Johanna Pera, Steven Kittner, John Cole, Laura Heitsch, Laura Ibañez, Carlos Cruchaga, Jin-Moo Lee, Joan Montaner, Israel Fernández-Cadenas
Haemorrhagic transformation is a complication of recombinant tissue-plasminogen activator treatment. The most severe form, parenchymal haematoma, can result in neurological deterioration, disability, and death. Our objective was to identify single nucleotide variations associated with a risk of parenchymal haematoma following thrombolytic therapy in patients with acute ischaemic stroke. A fixed-effect genome-wide meta-analysis was performed combining two-stage genome-wide association studies (n = 1904)...
September 4, 2021: Brain
#39
JOURNAL ARTICLE
Sheng-Feng Lin, Han-Hwa Hu, Bo-Lin Ho, Chih-Hung Chen, Lung Chan, Huey-Juan Lin, Yu Sun, Yung-Yang Lin, Po-Lin Chen, Shinn-Kuang Lin, Cheng-Yu Wei, Yu-Te Lin, Jiunn-Tay Lee, A-Ching Chao
Background: This study aimed to investigate the safety and efficacy of single antiplatelet, anticoagulant and Dual Antiplatelet pre-treatment (DAPP) in older, moderate to high severity acute ischemic stroke patients treated with intravenous thrombolysis (IVT). Methods: A prospective cohort study was conducted to monitor the development of symptomatic intracranial hemorrhage (SICH) and functional outcomes at 90 days. Two different dosages of alteplase were used for IVT. Logistic regression models were used for analysis of the safety and efficacy outcomes...
2021: Frontiers in Neurology
#40
JOURNAL ARTICLE
Johannes Ar Pfaff, Martin Bendszus, Geoffrey Donnan, Carlos Molina, Didier Leys, Peter D Schellinger, Stefan Schwab, Danilo Toni, Nils Wahlgren, Werner Hacke, Peter Arthur Ringleb
Introduction: To investigate the impact of a mismatch between diffusion-weighted imaging (DWI) and fluid attenuated inversion recovery (FLAIR) on functional outcome in patients with acute stroke in a prolonged time window or unknown time of symptom onset randomized to intravenous thrombolysis or placebo. Patients and Methods: We performed a post-hoc analysis of the European Cooperative Acute Stroke Study-4 (ECASS-4) trial. ECASS-4 was an investigator driven, phase 3, multi-center, double-blind, placebo-controlled study which randomized ischemic stroke patients presenting within 4...
December 2020: European Stroke Journal
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