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Manuel Cappellari, Gianni Turcato, Stefano Forlivesi, Nicola Micheletti, Giampaolo Tomelleri, Bruno Bonetti, Giovanni Merlino, Roberto Eleopra, Monia Russo, Roberto L'Erario, Alessandro Adami, Carolina Gentile, Anna Gaudenzi, Sandro Bruno, Paolo Bovi
In clinical practice, direct oral anticoagulants (DOACs) are often started earlier (≤ 7 days) than in randomized clinical trials after stroke. We aimed to develop a nomogram model incorporating time of DOAC introduction ≤ 7 days of stroke onset in combination with different degrees of stroke radiological/neurological severity at the time of treatment to predict the probability of unfavorable outcome. We conducted a multicenter prospective study including 344 patients who started DOAC 1-7 days after atrial fibrillation-related stroke onset...
June 15, 2018: Journal of Thrombosis and Thrombolysis
Stephen Dj Makin, Fergus N Doubal, Terence J Quinn, Philip Mw Bath, Martin S Dennis, Joanna M Wardlaw
Background: Endpoints that are commonly used in trials of moderate/severe stroke may be less frequent in patients with minor, non-disabling stroke thus inflating sample sizes. We tested whether trial efficiency might be improved with composite endpoints. Methods: We prospectively recruited patients with lacunar and minor non-lacunar ischaemic stroke (NIHSS ≤ 7) and assessed recurrent vascular events (stroke, transient ischaemic attack (TIA), ischemic heart disease (IHD)), modified Rankin Score (mRS) and cognitive testing with the Addenbrooke's Cognitive Examination (ACE-R) one year post-stroke...
March 2018: European stroke journal
Rosanna Squitti, Mariacristina Siotto, Giovanni Assenza, Nadia M Giannantoni, Mauro Rongioletti, Filippo Zappasodi, Franca Tecchio
The clinical course after ischemic stroke can vary considerably despite similar lesions and clinical status at the onset of symptoms, suggesting that individual factors modulate clinical recovery. Here, we sought to test the working hypothesis that elevated copper values provide prognostic information, and specifically predict worse clinical recovery. We further sought to support previous findings regarding metal metabolism in acute stroke. We assessed total antioxidant status, oxidative stress factors (peroxides) and metal metabolism markers (iron, copper, ceruloplasmin concentration and activity, ferritin, and transferrin) in the acute phase (2-10 days from symptom onset) in 30 patients affected by unilateral middle cerebral artery (MCA) stroke...
2018: Frontiers in Neurology
Sheng Zhang, Jungen Zhang, Meixia Zhang, Genlong Zhong, Zhicai Chen, Longting Lin, Min Lou
Intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (rt-PA) can improve clinical outcome in eligible patients with acute ischemic stroke (AIS). However, its efficacy is strongly time-dependent. This study was aimed to examine whether prehospital notification by emergency medical service (EMS) providers could reduce onset to needle time (ONT) and improve neurological outcome in AIS patients who received IVT. We prospectively collected the consecutive clinical and time data of AIS patients who received IVT during one year after the initiation of prehospital notification procedure (PNP)...
June 2018: Aging and Disease
Ufuk Emre, Taskin Gunes, Irem Pinar, Furuzan Kokturk, Esengul Liman, Orhan Yağiz
Background and purpose: In cancer patients, an ischemic stroke can be seen as both a direct effect of cancer and a complication of treatment. This condition can negatively affect the follow-up and treatment of these patients. For this research, we aimed to evaluate the clinical features, stroke types and etiological features of ischemic stroke patients with histories of cancer or found to have cancer during the aetiological investigation. Methods: We retrospectively evaluated 100 patients (57 males, 43 females) who were hospitalized with acute stroke and determined to have the presence of cancer or a cancer history during the aetiological investigation between 2011 and 2016...
May 30, 2018: Ideggyógyászati Szemle
Vaclav Prochazka, Tomas Jonszta, Daniel Czerny, Jan Krajca, Martin Roubec, Jirka Macak, Petr Kovar, Petra Kovarova, Martin Pulcer, Renata Zoubkova, Ivo Lochman, Veronika Svachova, Lubomir Pavliska, Adela Vrtkova, David Kasprak, Jaromir Gumulec, John W Weisel
BACKGROUND The aim of the study was to investigate the role of von Willebrand factor (vWF), the vWF-cleaving protease, ADAMTS13, the composition of thrombus, and patient outcome following mechanical cerebral artery thrombectomy in patients with acute ischemic stroke. MATERIAL AND METHODS A prospective cohort study included 131 patients with ischemic stroke (<6 hours) with or without intravenous thrombolysis. Interventional procedure parameters, hemocoagulation markers, vWF, ADAMTS13, and histological examination of the extracted thrombi were performed...
June 11, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Yuzo Araki, Masahiro Furuichi, Hiroaki Nokura, Tatsuo Iwata
BACKGROUND AND PURPOSE: The present study determined the effects of pre-existing cognitive impairment (PreCI) on the rehabilitation outcomes in patients with cerebral infarction. METHODS: From June 2013 to August 2015, we classified 52 patients with unilateral cerebral hemispheric infarction into the PreCI and non-PreCI group based on three-dimensional stereotactic surface projection (3D-SSP) cerebral blood flow (CBF) decrease images and the past history of dementia...
June 2018: Brain and Nerve, Shinkei Kenkyū No Shinpo
Marco Duering, Marek J Konieczny, Steffen Tiedt, Ebru Baykara, Anil Man Tuladhar, Esther van Leijsen, Philippe Lyrer, Stefan T Engelter, Benno Gesierich, Melanie Achmüller, Christian Barro, Ruth Adam, Michael Ewers, Martin Dichgans, Jens Kuhle, Frank-Erik de Leeuw, Nils Peters
BACKGROUND AND PURPOSE: Neurofilament light chain (NfL) is a blood marker for neuroaxonal damage. We assessed the association between serum NfL and cerebral small vessel disease (SVD), which is highly prevalent in elderly individuals and a major cause of stroke and vascular cognitive impairment. METHODS: Using a cross-sectional design, we studied 53 and 439 patients with genetically defined SVD (Cerebral Autosomal-Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy [CADASIL]) and sporadic SVD, respectively, as well as 93 healthy controls...
May 2018: Journal of Stroke
Jialiang Xu, Xiaohong Chen, Muhui Lin
BACKGROUND MRI FLAIR hyperintense vessels sign (FHVs) is a special imaging marker that plays a key role in acute infarction imaging and diagnosis. However, FHVs have not been studied in the context of progressive posterior circulation infarction (PPCI), and little is known about the association of hyperintense endo-vessels sign (HEVs) on transverse section MRI with infarction. Thus, our objective here was to investigate the clinical significance of transverse MRI T2 HEVs in patients with PPCI. MATERIAL AND METHODS In this retrospective, case-control study, we enrolled 100 consecutive posterior circulation infarction patients...
June 8, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Carla Bentes, Hugo Martins, Ana Rita Peralta, Carlos Morgado, Carlos Casimiro, Ana Catarina Franco, Ana Catarina Fonseca, Ruth Geraldes, Patrícia Canhão, Teresa Pinho E Melo, Teresa Paiva, José M Ferro
Objective: Electroencephalography (EEG) can identify biomarkers of epileptogenesis and ictogenesis. However, few studies have used EEG in the prediction of poststroke seizures. Our primary aim was to evaluate whether early EEG abnormalities can predict poststroke epilepsy. Methods: A prospective study of consecutive acute anterior circulation ischemic stroke patients, without previous epileptic seizures, who were admitted to a stroke unit over 24 months and followed for 1 year...
June 2018: Epilepsia open
Junyan Yue, Jie Chen, Qingwu Wu, Xiaohuan Liu, Meixia Li, Zheng Li, Yanjun Gao
OBJECTIVE: This study was aimed to explore whether the omentin-1, a novel adipokine marker, could be a biomarker for stroke, as well as its association with stroke severity. METHODS: This study included 239 patients with ischemic stroke. The serum omentin-1 level was determined and the stroke was evaluated when the patients were hospitalized. The control groups consisted of 108 patients with matched age, gender and prior vascular risk factors and 120 health control with matched age and gender...
June 4, 2018: Cytokine
Qi Yang, Chang Li, Le Wang, Bo Wei
BACKGROUND: To investigate the relationships of the changes of serum N-Terminal Pro-B-Type Natriuretic Peptide (NT-proBNP) level with the severity of the disease [infarct size, amount of bleeding, national institutes of health stroke scale (NIHSS)score and Glasgow coma scale(GCS) score] and prognosis in acute cerebral stroke patients. METHODS: Acute cerebral stroke patients admitted to our hospital from August 2015 to August 2017 were enrolled in this study. The NT-proBNP level, infarct size, amount of bleeding, NIHSS score, GCS score and Modified Rankin Scale (MRS) score at 3 months after onset in patients in cerebral infarction group and cerebral hemorrhage group were observed at 24 h, (5±2) d and (12±2) d...
June 7, 2018: Panminerva Medica
Wei Sun, Guangsheng Li, Xiangjun Zeng, Zhaohui Lai, Mingqi Wang, Yi Ouyang, Guoyong Zeng, Jidong Peng, Junyuan Zhong, Daoxiong Xiao, Zhiping Huang, Xiaofen Guo
AIMS: Nonvalvular atrial fibrillation often occurs in combination with carotid atherosclerosis, but less is known about it in combination with cerebral artery stenosis. This study investigated the characteristics of cerebral infarction in patients with nonvalvular atrial fibrillation with or without cerebral artery stenosis. METHODS: A retrospective analysis was conducted on 172 cerebral infarction patients with nonvalvular atrial fibrillation hospitalized at the Affiliated Ganzhou Hospital of Nanchang University between December 2011 and January 2016...
June 5, 2018: Journal of Atherosclerosis and Thrombosis
Anselme Alfred Dabilgou, Julie Marie Adeline Kyelem
Vascular arteriovenous malformations (VAM) are aggressive vascular diseases associated with increased haemorrhagic risk in terms of morbidity and mortality. Vascular arteriovenous malformations are usually sporadic. The main symptom of VAM is hemorrhage, in 50% of cases. We here report the case of a 28 year old patient, hospitalized with right sided motor deficit of acute onset associated with consciousness disorder in the Department of Neurology at the Yalgado Ouédraogo University Hospital Center. The patient had a history of chronic headaches treated with self-medication and of right Bravais-Jacksonian seizures...
2018: Pan African Medical Journal
Jiaojie Hui, Jianping Zhang, Xuqiang Mao, Zaiwang Li, Xinxin Li, Fengyun Wang, Tao Wang, Qingfang Yuan, Sunwei Wang, Mengjia Pu, Guangjun Xi
The association between glycemic variability and early neurological deterioration (END) in acute ischemic stroke remains unclear. This study attempted to explore whether initial glycemic variability increases END in diabetic patients with acute ischemic stroke. We enrolled type 2 diabetic patients undergoing acute ischemic stroke from November 2015 to November 2016. A total of 336 patients within 72 h from stroke onset were included. The serum glucose levels were checked four times per day during the initial 3 hospital days...
June 5, 2018: Neurological Sciences
Anke Wouters, Céline Nysten, Vincent Thijs, Robin Lemmens
Introduction: Stroke severity measured by the baseline National Institutes of Health Stroke Scale (NIHSS) is a strong predictor of stroke outcome. Early change of baseline severity may be a better predictor of outcome. Here, we hypothesized that the change in NIHSS in the first 24 h after stroke improved stroke outcome prediction. Materials and methods: Patients from the Leuven Stroke Genetics Study were included when the baseline NIHSS (B-NIHSS) was determined on admission in the hospital and NIHSS after 24 h could be obtained from patient files...
2018: Frontiers in Neurology
I A Gaponenko, E V Bakhareva, Z M Zolotareva, G I Zuev, A S Rozhdestvenskiy
AIM: To evaluate the efficacy and safety of the combination of cellex with basic therapy in patients with ischemic stroke in the acute stage. MATERIAL AND METHODS: An analytical prospective, randomized, simple, blind study included 52 patients with ischemic stroke. The main group of patients (n=26) was treated with basic therapy, which included hypotensive drugs, antiaggregants or anticoagulants depending on the concomitant pathology as well as vascular medications...
2018: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
V V Alferova, V M Shklovskij, E G Ivanova, G V Ivanov, L A Mayorova, A G Petrushevsky, S V Kuptsova, A B Guekht
AIM: To determine risk factors and factors of favorable prognosis for regression of post-stroke aphasia in the early recovery period of ischemic stroke (IS). MATERIAL AND METHODS: A cohort study was undertaken with 40 patients with different clinical forms of aphasia. The duration of study was 3-4 months of the disease. The regression of speech and non-speech cognitive impairment was assessed by the Method of a 10-point evaluation of higher mental functions. The method involves a comprehensive assessment of all mental functions with more than 90 subtests at the beginning and at the end of rehabilitation course and the calculation of the difference in the scoring of each mental function as a measure of treatment efficacy...
2018: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
H Wang, Y Tang, Y Zhang, K Xu, J B Zhao
Objective: To investigate the relationship between the maximum blood pressure fluctuation within 24 hours after admission and the prognosis at discharge. Methods: The patients with ischemic stroke admitted in Department of Neurology of the First Affiliated Hospital of Harbin Medical University within 24 hours after onset were consecutively selected from April 2016 to March 2017. The patients were grouped according to the diagnostic criteria of hypertension. Ambulatory blood pressure of the patients within 24 hours after admission were measured with bedside monitors and baseline data were collected...
May 10, 2018: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
Kartavya Sharma, Daniel J Johnson, Brenda Johnson, Steven M Frank, Robert D Stevens
BACKGROUND: There is uncertainty regarding the effect of anemia and red blood cell transfusion on functional outcome following acute ischemic stroke. We studied the relationship of hemoglobin parameters and red cell transfusion with post stroke functional outcome after adjustment for neurological severity and medical comorbidities. METHODS: Retrospective cohort study of 536 patients discharged with a diagnosis of ischemic stroke from a tertiary care hospital between January 2012 and April 2015...
June 2, 2018: BMC Neurology
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