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https://www.readbyqxmd.com/read/28620756/preliminary-data-on-utility-of-subcutaneous-unfractionated-heparin-in-patients-with-deep-cerebral-venous-thrombosis
#1
Girish Baburao Kulkarni, Abbas Masoom Mirza, Subasree Ramakrishnan, Veerendrakumar Mustare
Subcutaneous unfractionated heparin (SCUFH) has been proved effective in puerperal cerebral venous thrombosis (CVT), but its efficacy in the more serious form of the disease such as deep CVT patients (DCVT) unreported. We describe the outcomes of 37 (isolated:combined: 11:26) patients of DCVT diagnosed by MRI, treated with SCUFH in a tertiary care stroke unit. It was a prospective observational cohort study using 5000 U of SCUFH every 6 hourly for 10 days with oral Acenocoumarol started on day 7, with monitoring...
June 15, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28615896/maintenance-of-normoglycemia-may-improve-outcome-in-acute-ischemic-stroke
#2
Sruthi S Nair, P N Sylaja, Sapna Erat Sreedharan, Sankara Sarma
INTRODUCTION: Several studies have shown that high admission glucose is associated with poor outcomes after stroke, but the impact of maintenance of normoglycemia on functional outcome during hospitalization for acute ischemic stroke is less well established. AIMS: The aim of this study was to examine the independent association of postadmission glycemic status in the 1(st) week with 3-month functional outcome in patients with acute ischemic stroke. METHODS: Patients with acute ischemic stroke admitted within 48 h of symptom onset with National Institutes of Health Stroke Scale (NIHSS) of ≥4 were selected from a prospectively maintained database by chart review...
April 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28611832/comparison-of-3-month-stroke-disability-and-quality-of-life-across-modified-rankin-scale-categories
#3
Srikant Rangaraju, Diogo Haussen, Raul G Nogueira, Fadi Nahab, Michael Frankel
BACKGROUND AND PURPOSE: Modified Rankin Scale (mRS) score 0-2 has been used to define "good outcome" while stroke patients with mRS 3 are grouped with mRS 4-6 as having "poor outcome." Long-term data comparing quality of life (QoL), particularly across the mRS 2, 3, and 4 subgroups, are sparse. METHODS: Participants in the Interventional Management of Stroke 3 (IMS3) trial with documented 3-month mRS, functional disability (Barthel index [BI]), and self-reported EQ5D-3L QoL questionnaires at 3 months after stroke were included...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28611830/endovascular-therapy-demonstrates-benefit-over-intravenous-recombinant-tissue-plasminogen-activator-based-on-repeatedly-measured-national-institutes-of-health-stroke-scale
#4
Liqiong Fan, Sharon D Yeatts, Lydia D Foster, Pooja Khatri, Thomas Tomsick, Joseph P Broderick, Yuko Y Palesch
BACKGROUND AND PURPOSE: The Interventional Management of Stroke (IMS) III trial was a randomized controlled trial designed to compare the effect of endovascular therapy after intravenous recombinant tissue plasminogen activator (i.v. rt-PA) as compared to i.v. rt-PA alone. The primary outcome was modified Rankin Scale at 90 days. Secondary outcomes included National Institutes of Health Stroke Scale (NIHSS), which was assessed repeatedly through 90 days. The objective of this analysis is to evaluate the treatment effect of endovascular therapy over time on NIHSS...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28611828/heads-up-a-novel-provocative-maneuver-to-guide-acute-ischemic-stroke-management
#5
Latisha K Ali, Julius K Weng, Sidney Starkman, Jeffrey L Saver, Doojin Kim, Bruce Ovbiagele, Brian H Buck, Nerses Sanossian, Paul Vespa, Oh Young Bang, Reza Jahan, Gary R Duckwiler, Fernando Viñuela, David S Liebeskind
BACKGROUND: A common dilemma in acute ischemic stroke management is whether to pursue recanalization therapy in patients with large vessel occlusions but minimal neurologic deficits. We describe and report preliminary experience with a provocative maneuver, i.e. 90-degree elevation of the head of bed for 30 min, which stresses collaterals and facilitates decision-making. METHODS: A prospective cohort study of <7.5 h of acute anterior circulation territory ischemia patients with minimal deficits despite middle cerebral artery (MCA) or internal carotid artery (ICA) occlusive disease...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28605743/incomplete-large-vessel-occlusions-in-mechanical-thrombectomy-an-independent-predictor-of-favorable-outcome-in-ischemic-stroke
#6
Volker Maus, Seunghwa You, Alev Kalkan, Jan Borggrefe, Christoph Kabbasch, Utako Birgit Barnikol, Henning Stetefeld, Christian Dohmen, Thomas Liebig, Gereon Rudolf Fink, Anastasios Mpotsaris
BACKGROUND AND PURPOSE: Cerebral large vessel occlusion (LVO) in acute ischemic stroke (AIS) may be complete (CLVO) or incomplete (ILVO). The influence of ILVO on clinical outcome after mechanical thrombectomy (MT) remains unclear. We investigated primarily the clinical outcome in patients with AIS due to ILVO or CLVO. METHODS: Five hundred three consecutive AIS patients with LVO treated with stent-retriever or direct aspiration-based MT between 2010 and 2016 were analyzed...
June 13, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28605741/electroencephalography-patterns-and-prognosis-in-acute-ischemic-stroke
#7
Fabricio O Lima, João A G Ricardo, Ana C Coan, Diogo C Soriano, Wagner M Avelar, Li L Min
BACKGROUND AND PURPOSE: The prognostic significance of interictal epileptiform discharges (IED) and periodic patterns (PP) after ischemic stroke has not been assessed. We sought to test whether IED and PP, detected on standard Electroencephalography (EEG) performed during the acute phase of ischemic stroke are associated with a worse functional outcome. METHODS: One-hundred-fifty-seven patients 18 years or older with a diagnosis of acute ischemic stroke presenting within 72 h from stroke onset were prospectively enrolled and followed...
June 13, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28605557/practice-patterns-for-neurosurgical-utilization-and-outcome-in-acute-intracerebral-hemorrhage-intensive-blood-pressure-reduction-in-acute-cerebral-hemorrhage-trials-1-and-2-studies
#8
Rui Guo, David J Blacker, Xia Wang, Hisatomi Arima, Pablo M Lavados, Richard I Lindley, John Chalmers, Craig S Anderson, Thompson Robinson
BACKGROUND: The prognosis in acute spontaneous intracerebral hemorrhage (ICH) is related to hematoma volume, where >30 mL is commonly used to define large ICH as a threshold for neurosurgical decompression but without clear supporting evidence. OBJECTIVES: To determine the factors associated with large ICH and neurosurgical intervention among participants of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trials (INTERACT). METHODS: We performed pooled analysis of the pilot INTERACT1 (n = 404) and main INTERACT2 (n = 2839) studies of ICH patients (<6 h of onset) with elevated systolic blood pressure (SBP, 150-220 mm Hg) who were randomized to intensive (target SBP < 140 mm Hg) or contemporaneous guideline-recommended (target SBP < 180 mm Hg) management...
June 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28597318/the-relationship-between-progressive-motor-deficits-and-lesion-location-in-patients-with-single-infarction-in-the-lenticulostriate-artery-territory
#9
Yasumasa Yamamoto, Yoshinari Nagakane, Yasuhiro Tomii, Shintaro Toda, Ichiro Akiguchi
As the corticospinal tracts cross the lenticulostriate artery (LSA) territory at the posterior segment, we hypothesized that posteriorly located infarctions of the LSA may be associated with progressive motor deficits. We prospectively studied 519 consecutive patients with LSA infarctions who entered our hospital within 24 h after onset. We categorized patients into two groups in terms of progress: no progress and progress. Progress was defined as worsening by 1 point or more in the National Institutes of Health Stroke Scale (NIHSS), some of which recovered afterward or thoroughly progressed...
June 8, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28596509/serum-galectin-3-level-not-galectin-1-is-associated-with-the-clinical-feature-and-outcome-in-patients-with-acute-ischemic-stroke
#10
Han Dong, Zhi-Hao Wang, Na Zhang, Si-Da Liu, Jian-Jun Zhao, Song-Yan Liu
AIM: To study the diagnostic and prognostic role of serum galectin-1 (Gal-1) and -3 (Gal-3) in acute ischemic stroke (AIS) patients. METHODS: We enrolled 233 patients with first-ever acute ischemic stroke and 252 healthy controls in this study. The AIS severity was evaluated by National Institutes of Health Stroke Scale (NIHSS) scores. The serum Gal-1 and -3 levels were determined. All patients were followed for 1 years and the functional outcome were evaluated by modified Rankin Scale (mRS) scores...
May 25, 2017: Oncotarget
https://www.readbyqxmd.com/read/28596195/e-aspects-correlates-with-and-is-predictive-of-outcome-after-mechanical-thrombectomy
#11
J Pfaff, C Herweh, S Schieber, S Schönenberger, J Bösel, P A Ringleb, M Möhlenbruch, M Bendszus, S Nagel
BACKGROUND AND PURPOSE: The e-ASPECTS software is a tool for the automated use of ASPECTS. Our aim was to analyze whether baseline e-ASPECT scores correlate with outcome after mechanical thrombectomy. MATERIALS AND METHODS: Patients with ischemic strokes in the anterior circulation who were admitted between 2010 and 2015, diagnosed by CT, and received mechanical thrombectomy were included. The ASPECTS on baseline CT was scored by e-ASPECTS and 3 expert raters, and interclass correlation coefficients were calculated...
June 8, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28596192/the-impact-of-conscious-sedation-versus-general-anesthesia-for-stroke-thrombectomy-on-the-predictive-value-of-collateral-status-a-post-hoc-analysis-of-the-siesta-trial
#12
S Schönenberger, J Pfaff, L Uhlmann, C Klose, S Nagel, P A Ringleb, W Hacke, M Kieser, M Bendszus, M A Möhlenbruch, J Bösel
BACKGROUND AND PURPOSE: Radiologic selection criteria to identify patients likely to benefit from endovascular stroke treatment are still controversial. In this post hoc analysis of the recent randomized Sedation versus Intubation for Endovascular Stroke TreAtment (SIESTA) trial, we aimed to investigate the impact of sedation mode (conscious sedation versus general anesthesia) on the predictive value of collateral status. MATERIALS AND METHODS: Using imaging data from SIESTA, we assessed collateral status with the collateral score of Tan et al and graded it from absent to good collaterals (0-3)...
June 8, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28596191/perfusion-mr-imaging-using-a-3d-pulsed-continuous-arterial-spin-labeling-method-for-acute-cerebral-infarction-classified-as-branch-atheromatous-disease-involving-the-lenticulostriate-artery-territory
#13
Y Shinohara, A Kato, K Kuya, K Okuda, M Sakamoto, H Kowa, T Ogawa
BACKGROUND AND PURPOSE: Branch atheromatous disease is a stroke subtype considered a risk factor for early neurologic deterioration. Meanwhile, crossed cerebellar diaschisis is thought to be influenced by the degree and location of supratentorial perfusion abnormalities and is associated with the clinical outcome in the case of an ischemic stroke. In this article, our aim was to clarify the utility of using a whole-brain 3D pulsed continuous arterial spin-labeling method as an imaging biomarker for predicting neurologic severity in branch atheromatous disease...
June 8, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28594795/-assessing-efficacy-of-carotid-endarterectomy-by-means-of-intraoperative-flowmetry
#14
V A Luk'ianchikov, A S Tokarev, N A Polunina, O Iu Nakhabin, E V Udodov, V A Dalibaldian, A V Sytnik, V V Krylov
AIM: The study was aimed at determining volumetric blood flow velocity (VBFV) through the internal carotid artery (ICA) and assessing functional outcomes of treatment of patients, taking into consideration the dynamics of VBFV before and after the operation. PATIENTS AND METHODS: The study comprised a total of 53 patients subjected to examination of VBFV through the ICA before and after carotid endarterectomy (CEA) assessed by means of flowmetry. Neurological deficit was evaluated by means of the NIHS Scale (the M NIHSS prior to operation equalling 2...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28592382/incidence-of-mri-detected-brain-lesions-and-neurocognitive-function-after-electrical-cardioversion-in-anticoagulated-patients-with-persistent-atrial-fibrillation
#15
B Bellmann, J B Fiebach, S Guttmann, T Lin, K G Haeusler, R Bathe-Peters, L Köhler, D Steffens, M Kasner, V Tscholl, P Nagel, M Roser, U Landmesser, A Rillig
BACKGROUND: After electrical cardioversion (eCV) in patients with atrial fibrillation (AF), the risk for clinically apparent cerebral thromboembolism is increased in the subsequent weeks. To date, there is little evidence on the incidence of acute brain lesions (ABL) detected with cerebral magnetic resonance imaging (MRI) after eCV, in particular in patients treated with the Non-Vitamin K Antagonist oral anticoagulants (NOAC). AIMS: The aim of this pilot study was to evaluate the incidence of MRI-detected ABL, as well as the neuro-cognitive function after eCV in patients with persistent AF using NOACs as compared to phenprocoumon...
June 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28585898/circulating-extracellular-dna-levels-are-acutely-elevated-in-ischaemic-stroke-and-associated-with-innate-immune-system-activation
#16
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/28583459/a-retrospective-study-of-clinical-outcomes-after-endovascular-treatment-in-acute-ischemic-stroke-patients-with-complete-anterior-circulation-infarction-taci-in-the-absence-of-multimodal-ct
#17
Chenghua Xu, Anyang Tao, Peng Wang, Zhimin Wang, Yi Zhang, Xiaoxiao Tao, Huaping Xin, Xian Zheng, Jiangxian Ying
OBJECTIVE: To analyze the positive predictive value of large artery occlusion and clinical prognosis in acute ischemic stroke patients with total anterior circulation infarct (TACI) who underwent endovascular treatment in the absence of multimodal CT angiography (CTA)/ CT perfusion (CTP). METHODS: The inclusion criteria for the acute ischemic stroke patients to receive endovascular treatment were as the follows: the OCSP classification was TACI, Alberta Stroke Program Early Computed Tomography Score (ASPECTS) ≥ 6, National Institutes of Health stroke scale (NIHSS) score ≥8, and within 4...
June 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28580558/-the-determinants-of-dysphagia-in-patients-with-stroke-during-hospitalized-rehabilitation
#18
Li-Yun Szu, Suh-Ing Hsieh, Su-Mei Tseng, Tzu-Hsin Huang
BACKGROUND: Stroke was the third leading cause of death in Taiwan in 2014. A study found that 53.61% of stroke patients suffered from dysphagia disorder during the rehabilitation phase, which may result in lung aspiration and death. The determinants of dysphagia among nationally hospitalized-rehabilitation stroke patients have not been explored comprehensively. PURPOSE: To explore the incidence of dysphagia among hospitalized-rehabilitation stroke patients and the related determinants of dysphagia...
June 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28579970/predicting-disability-after-ischemic-stroke-based-on-comorbidity-index-and-stroke-severity-from-the-virtual-international-stroke-trials-archive-acute-collaboration
#19
Thanh G Phan, Benjamin B Clissold, Henry Ma, John Van Ly, Velandai Srikanth
BACKGROUND AND AIM: The availability and access of hospital administrative data [coding for Charlson comorbidity index (CCI)] in large data form has resulted in a surge of interest in using this information to predict mortality from stroke. The aims of this study were to determine the minimum clinical data set to be included in models for predicting disability after ischemic stroke adjusting for CCI and clinical variables and to evaluate the impact of CCI on prediction of outcome. METHOD: We leverage anonymized clinical trial data in the Virtual International Stroke Trials Archive...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28576782/tenecteplase-in-ischemic-stroke-offers-improved-recanalization-analysis-of-2-trials
#20
Andrew Bivard, Xuya Huang, Christopher R Levi, Neil Spratt, Bruce C V Campbell, Bharath Kumar Cheripelli, Dheeraj Kalladka, Fiona Catherine Moreton, Ian Ford, Christopher F Bladin, Stephen M Davis, Geoffrey A Donnan, Keith W Muir, Mark W Parsons
OBJECTIVE: To test whether patients with complete vessel occlusion show greater recanalization at 24 hours and have improved clinical outcomes at 24 hours and 90 days when treated with tenecteplase compared to alteplase. METHODS: Pooled clinical and imaging data from 2 phase 2 randomized trials comparing tenecteplase with alteplase allowed CT angiography (CTA) scans to be assessed centrally for occlusion status at baseline and at 24 hours post thrombolysis using the modified thrombolysis in cerebral infarction (TICI) scale...
June 2, 2017: Neurology
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