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https://www.readbyqxmd.com/read/28431610/duration-of-paroxysmal-atrial-fibrillation-in-cryptogenic-stroke-is-not-associated-with-stroke-severity-and-early-outcomes
#1
Chrissoula Liantinioti, Konstantinos Tympas, Aristeidis H Katsanos, John Parissis, Maria Chondrogianni, Christina Zompola, Georgios Papadimitropoulos, Michael Ioakeimidis, Sokratis Triantafyllou, Andromaxi Roussopoulou, Konstantinos Voumvourakis, John Lekakis, Gerasimos Filippatos, Leonidas Stefanis, Georgios Tsivgoulis
The current definition of paroxysmal atrial fibrillation (PAF) requires an arbitrary cut-off of >30s, but in clinical practice cryptogenic stroke (CS) patients with PAF duration of ≤30s are not usually excluded from anticoagulation therapy. We sought to evaluate the clinical relevance of short-duration (≤30s) PAF in CS. Consecutive CS patients with no prior AF history and sinus-rhythm on baseline electrocardiography (ECG) were prospectively evaluated over a three-year period. Baseline stroke severity was assessed by NIHSS-scores...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28424785/the-impact-of-homocysteine-vitamin-b12-and-vitamin-d-levels-on-functional-outcome-after-first-ever-ischaemic-stroke
#2
Merdin Markišić, Aleksandra M Pavlović, Dragan M Pavlović
We explored the relationship between acute ischaemic stroke (IS) early functional outcome and serum levels of homocysteine, vitamin B12, and D in a noninterventional prospective clinical study. We enrolled 50 patients with first-ever IS and performed laboratory tests and functional assessment at three time points: on admission and three and six months after stroke. Modified Rankin Scale (mRS), NIHSS scale, and Barthel index (BI) scores were assessed in all participants by trained examiner blinded to laboratory data...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28424044/emergent-carotid-thromboendarterectomy-for-acute-symptomatic-occlusion-of-the-extracranial-internal-carotid-artery
#3
Igor Gunka, Dagmar Krajickova, Michal Lesko, Stanislav Jiska, Jan Raupach, Miroslav Lojik, Radovan Maly
BACKGROUND: Strokes secondary to acute internal carotid artery (ICA) occlusion are associated with an extremely poor prognosis. The best treatment approach in this setting is still unknown. The aim of our study was to evaluate the efficacy, safety, and outcomes of emergent surgical revascularization of acute extracranial ICA occlusion in patients with minor to severe ischemic stroke. METHODS: A retrospective analysis was performed using prospectively collected data of consecutive patients who underwent carotid thromboendarterectomy for symptomatic acute ICA occlusion during the period from January 2013 to December 2015...
May 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28422955/low-cholesterol-level-associated-with-severity-and-outcome-of-spontaneous-intracerebral-hemorrhage-results-from-taiwan-stroke-registry
#4
Yu-Wei Chen, Chen-Hua Li, Chih-Dong Yang, Chung-Hsiang Liu, Chih-Hung Chen, Jau-Jiuan Sheu, Shinn-Kuang Lin, An-Chih Chen, Ping-Kun Chen, Po-Lin Chen, Chung-Hsin Yeh, Jiunn-Rong Chen, Yu-Jen Hsiao, Ching-Huang Lin, Shih-Pin Hsu, Tsang-Shan Chen, Sheng-Feng Sung, Shih-Chieh Yu, Chih-Hsin Muo, Chi Pang Wen, Fung-Chang Sung, Jiann-Shing Jeng, Chung Y Hsu
The relationship between cholesterol level and hemorrhagic stroke is inconclusive. We hypothesized that low cholesterol levels may have association with intracerebral hemorrhage (ICH) severity at admission and 3-month outcomes. This study used data obtained from a multi-center stroke registry program in Taiwan. We categorized acute spontaneous ICH patients, based on their baseline levels of total cholesterol (TC) measured at admission, into 3 groups with <160, 160-200 and >200 mg/dL of TC. We evaluated risk of having initial stroke severity, with National Institutes of Health Stroke Scale (NIHSS) >15 and unfavorable outcomes (modified Rankin Scale [mRS] score >2, 3-month mortality) after ICH by the TC group...
2017: PloS One
https://www.readbyqxmd.com/read/28422279/efficacy-and-safety-of-mechanical-thrombectomy-in-older-adults-with-acute-ischemic-stoke
#5
Fabrizio Sallustio, Giacomo Koch, Caterina Motta, Marina Diomedi, Fana Alemseged, Vittoria C D'Agostino, Simone Napolitano, Domenico Samà, Alessandro Davoli, Daniel Konda, Daniele Morosetti, Enrico Pampana, Roberto Floris, Roberto Gandini
OBJECTIVES: To evaluate the safety and efficacy of endovascular therapy in elderly adults treated for acute ischemic stroke. DESIGN: Retrospective cohort study. SETTING: Comprehensive Stroke Center, University of Tor Vergata, Rome, Italy. PARTICIPANTS: Elderly adults treated for acute ischemic stroke (N = 219). MEASUREMENTS: Participants were divided into two groups based on their age (n = 62, ≥80; n = 157, <80)...
April 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28419988/neutrophil-to-lymphocyte-ratio-is-an-independent-predictor-for-in-hospital-mortality-in-spontaneous-intracerebral-hemorrhage
#6
Antje Giede-Jeppe, Tobias Bobinger, Stefan T Gerner, Jochen A Sembill, Maximilian I Sprügel, Vanessa D Beuscher, Hannes Lücking, Philip Hoelter, Joji B Kuramatsu, Hagen B Huttner
BACKGROUND AND PURPOSE: Stroke-associated immunosuppression and inflammation are increasingly recognized as factors that trigger infections and thus, potentially influence the outcome after stroke. Several studies demonstrated that elevated neutrophil-to-lymphocyte ratio (NLR) is a significant predictor of adverse outcomes in patients with ischemic stroke. However, little is known about the impact of NLR on short-term mortality in intracerebral hemorrhage (ICH). METHODS: This observational study included 855 consecutive ICH-patients...
April 19, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28417611/factors-enhancing-activities-of-daily-living-after-stroke-in-specialized-rehabilitation-an-observational-multicenter-study-within-the-sunnaas-international-network
#7
Birgitta Langhammer, Katharina S Sunnerhagen, Åsa Lundgren-Nilsson, Susanne Sällström, Frank Becker, Johan K Stanghelle
BACKGROUND: Stroke may lead to serious, long-term disability. Consequently, many individuals with stroke will be in need of rehabilitation, and some of specialized rehabilitation. The content and organization of rehabilitation vary within and between countries, reflecting the preferences, customs, traditions, and values of a society or community, that may have an impact on outcomes. AIM: The main aim of the present study was to evaluate the influence of team models in specialized rehabilitation on outcomes as measured by stroke patients' performance in ADL, at a standardized time and at discharge in the various specialized rehabilitation clinics...
April 14, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28416783/predictive-and-prognostic-role-of-mean-platelet-volume-in-patients-with-first-ever-acute-ischemic-stroke
#8
Ugur Lok, Umut Gulacti, Burcu Ekmekci, Taner Bulut, Murat Celik
OBJECTIVE: To investigate any possible effects of mean platelet volume (MPV) on short-term stroke prognosis and functional outcome in patients with first-ever acute ischemic stroke (FEAIS). METHODS: This retrospective cross-sectional study included 798 FEAIS patients admitted to the emergency department of a tertiary care hospital in Adiyaman, Turkey between January 2013 and June 2015. The data were evaluated according to whether alive or dead, MPV levels, modified Rankin scale (MRS) scores, National Institutes of Health Stroke Scale (NIHSS) scores...
April 2017: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/28416406/acute-stroke-despite-dabigatran-anticoagulation-treated-with-idarucizumab-and-intravenous-tissue-plasminogen-activator
#9
David Bissig, Rashmi Manjunath, Brittany R Traylor, David P Richman, Kwan L Ng
Dabigatran is a direct thrombin inhibitor used to reduce the risk of stroke in patients with nonvalvular atrial fibrillation. For patients who present with an acute stroke despite dabigatran therapy, clinical data on the use of intravenous tissue plasminogen activator (IV-tPA) is limited. There is an anticipated increased risk of symptomatic intracranial hemorrhage (sICH) when using IV-tPA in patients on dabigatran therapy. In 2015, the humanized monoclonal antibody fragment idarucizumab was approved for rapid (minutes) reversal of anticoagulant effects of dabigatran...
April 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28413700/endovascular-stroke-treatment-in-a-small-volume-stroke-center
#10
Gry N Behzadi, Lars Fjetland, Rajiv Advani, Martin W Kurz, Kathinka D Kurz
INTRODUCTION: Our purpose was to evaluate the safety and efficacy of endovascular treatment (EVT) of stroke caused by large vessel occlusions (LVO) performed by general interventional radiologists in cooperation with stroke neurologists and neuroradiologists at a center with a limited annual number of procedures. We aimed to compare our results with those previously reported from larger stroke centers. PATIENTS AND METHODS: A total of 108 patients with acute stroke due to LVO treated with EVT were included...
April 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28412316/differentiating-stroke-and-seizure-in-acute-setting-perfusion-computed-tomography
#11
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/28411967/utility-of-relative-adc-ratio-in-patient-selection-for-endovascular-revascularization-of-large-vessel-occlusion
#12
Narihide Shinoda, Shinya Hori, Kazuyuki Mikami, Toshiaki Bando, Daisuke Shimo, Takahiro Kuroyama, Yoji Kuramoto, Masato Matsumoto, Osamu Hirai, Yasushi Ueno
PURPOSE: The relative apparent diffusion coefficient (ADC) ratio on magnetic resonance imaging (MRI) can be used to evaluate the degree of ischemia. Here, we assessed the predictability of ischemic reversibility and the risk of hemorrhagic transformation using the relative ADC ratio. METHODS: This single-center retrospective study analyzed 56 patients with acute occlusion of the internal carotid artery (ICA) or the middle cerebral artery (M1) with endovascular revascularization...
April 12, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28411261/feasibility-and-diagnostic-value-of-cardiovascular-magnetic-resonance-imaging-after-acute-ischemic-stroke-of-undetermined-origin
#13
Karl Georg Haeusler, Christian Wollboldt, Laura Zu Bentheim, Juliane Herm, Sebastian Jäger, Claudia Kunze, Holger-Carsten Eberle, Claudia Christina Deluigi, Oliver Bruder, Carolin Malsch, Peter U Heuschmann, Matthias Endres, Heinrich J Audebert, Andreas J Morguet, Christoph Jensen, Jochen B Fiebach
BACKGROUND AND PURPOSE: Etiology of acute ischemic stroke remains undetermined (cryptogenic) in about 25% of patients after state-of-the-art diagnostic work-up. METHODS: One-hundred and three patients with magnetic resonance imaging (MRI)-proven acute ischemic stroke of undetermined origin were prospectively enrolled and underwent 3-T cardiac MRI and magnetic resonance angiography of the aortic arch in addition to state-of-the-art diagnostic work-up, including transesophageal echocardiography (TEE)...
April 14, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28409234/clinical-role-of-von-willebrand-factor-in-acute-ischemic-stroke
#14
Marija Menih, Miljenko Križmarić, Tanja Hojs Fabjan
BACKGROUND: An elevated level of von Willebrand factor (VWF) is associated with an increased risk for coronary heart disease and ischemic stroke. The objective of the study was to determine whether the level of VWF is associated with the cardioembolic subtype of ischemic stroke, stroke severity, and clinical outcome. PATIENTS AND METHODS: In this study 108 patients suffering from acute ischemic stroke (AIS) were included. According to the etiology of the stroke, patients were classified into the subtype of cardioembolic (CE) stroke and the group with non-CE stroke...
April 13, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28408941/clinical-evaluation-of-acupuncture-as-treatment-for-complications-of-cerebrovascular-accidents-a-randomized-sham-controlled-subject-and-assessor-blind-trial
#15
Hsien-Yin Liao, Wen-Chao Ho, Chun-Chung Chen, Jaung-Geng Lin, Chia-Chi Chang, Liang-Yu Chen, De-Chih Lee, Yu-Chen Lee
Background and Purpose. The effect of acupuncture as treatment for poststroke complications is questionable. We performed a randomized, sham-controlled double-blind study to investigate it. Methods. Patients with first-time acute stroke were randomized to receive 24 sessions of either real or sham acupuncture during an eight-week period. The primary outcome measure was change in National Institute of Health Stroke Scale (NIHSS) score. Secondary outcome measures included changes in Barthel Index (BI), Instrumental Activities of Daily Living (IADL), Hamilton Depression Rating Scale (HAM-D), and Visual Analogue Scale (VAS) for pain scores...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28408627/minor-stroke-syndromes-in-large-vessel-occlusions-mechanical-thrombectomy-or-thrombolysis-only
#16
M P Messer, S Schönenberger, M A Möhlenbruch, J Pfaff, C Herweh, P A Ringleb, S Nagel
While mechanical thrombectomy for large-vessel occlusions is now an evidence-based treatment, its efficacy and safety in minor stroke syndromes (NIHSS ≤ 5) is not proved. We identified, in our prospective data base, 378 patients with minor strokes in the anterior circulation; 54 (14.2%) of these had proved large-vessel occlusions. Eight of 54 (14.8%) were immediately treated with mechanical thrombectomy, 6/54 (11.1%) after early neurologic deterioration, and the rest were treated with standard thrombolysis only...
April 13, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28408066/derivation-and-validation-of-a-scoring-system-for-intravenous-tissue-plasminogen-activator-use-in-asian-patients
#17
Leonard L L Yeo, Shih-Chao Chien, Jr-Rung Lin, Chia-Wei Liow, Jiann-Der Lee, Tsung-I Peng, Teoh Hock Luen, Vijay Sharma, Bernard Chan, Tsong-Hai Lee
BACKGROUND AND PURPOSE: As Chinese Asian populations have an increased risk of intracerebral hemorrhage (ICH) after intravenous tissue plasminogen activator (IV tPA), we aimed to design a rapid, clinically applicable risk scoring system to predict ICH and functional outcomes after IV tPA treatment in Asian ischemic stroke patients. METHODS: From January 2009 to December 2012, consecutive acute ischemic stroke patients treated with IV tPA recruited from the Stroke Registry in Chang Gung Healthcare System (SRICHS) in Taiwan and the National University Hospital of Singapore (NUHS) acute stroke database were used to create and validate a scoring system...
April 10, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28406964/granulocyte-colony-stimulating-factor-therapy-for-stroke-a-pairwise-meta-analysis-of-randomized-controlled-trial
#18
Xin Huang, Yu Liu, Shuang Bai, Lidan Peng, Boai Zhang, Hong Lu
Granulocyte colony-stimulating factor (G-CSF) is atherapeutic candidate for stroke that has demonstrated anti-inflammatory and neuroprotective properties. Data from preclinical and clinical studies have suggested the safety and efficacy of G-CSF in stroke; however, the exact effects and utility of this cytokine in patients remain disputed. We performed a meta-analysis of randomized controlled trials of G-CSF in ischemic and hemorrhagic stroke to assess its clinical safety and efficacy. Electronic databases were searched for relevant publications in English and Chinese...
2017: PloS One
https://www.readbyqxmd.com/read/28406123/utilization-of-glial-fibrillary-acidic-protein-and-galectin-3-in-the-diagnosis-of-cerebral-infarction-patients-with-normal-cranial-tomography
#19
E Ekingen, M Yilmaz, M Yildiz, M Atescelik, M C Goktekin, M Gurger, O D Alatas, M Basturk, N Ilhan
OBJECTIVE: It was aimed to determine whether levels of glial fibrillary acidic protein (GFAP) and Galectin-3 contribute to the diagnosis of cerebral infarction in clinically suspected ischemic stroke patients with normal computerized cranial tomography (CCT) in the emergency department. MATERIALS AND METHODS: In this study, patients above the age of 18 years who presented to emergency department of Firat University between December 2011-November 2012 and were diagnosed with cerebral infarction were included...
April 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28400900/conjugate-eye-deviation-on-ct-associated-with-worse-outcomes-despite-iv-thrombolysis
#20
Nirav H Shah, Nirav Bhatt, Anita Tipirneni, Diego Condes, Priyank Khandelwal, Jose G Romano
INTRODUCTION: Rapid stroke management has significant implications in patient outcomes. Ipsilateral computed tomography conjugate eye deviation (CT-CED) has been associated with worse outcomes but has never been evaluated as predictive of vascular occlusion. To test the hypothesis that CT-CED is a marker for vascular occlusion, we evaluated patients treated with intravenous tissue plasminogen activator (IV tPA). METHODS: We performed a retrospective analysis of patients with acute ischemic stroke treated with IV tPA at a large tertiary care hospital over an 18-month period...
April 2017: Neurohospitalist
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