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Yiming Deng, Baixue Jia, Xiaochuan Huo, Ya Peng, Yibin Cao, Shengli Chen, Meng Zhang, Changchun Jiang, Xiaoxiang Peng, Cunfeng Song, Liping Wei, Qiyi Zhu, Zaiyu Guo, Li Liu, Hang Lin, Hua Yang, Wei Wu, Hui Liang, Anding Xu, Kangning Chen, David S Liebeskind, Xingquan Zhao, Anxin Wang, Liping Liu, Yilong Wang, Yongjun Wang, Feng Gao, Xuan Sun, Lian Liu, Dapeng Mo, Ning Ma, Ligang Song, Zhongrong Miao
BACKGROUND: To estimate the association of different etiologies of cardioembolism (CE), intracranial arterial stenosis (ICAS) or combination of these conditions with the outcomes of mechanical thrombectomy (MT) in acute ischemic stroke (AIS). METHODS: We analyzed data from the intervention group of the Endovascular Therapy for Acute Ischemic Stroke Trial (EAST). Different etiology statuses for CE, ICAS, neither or both were identified for each individual. The primary outcome was a favorable outcome at 90 days (modified Rankin Scale score of 0-2), and secondary outcomes included successful reperfusion (modified thrombolysis in cerebrovascular infarction scores of 2b-3), symptomatic intracerebral hemorrhage (sICH), and 90-day mortality...
September 19, 2018: World Neurosurgery
Guanghui Zhang, Pin Meng, Zhenwei Guo, Na Liu, Niu Ji, Xiaomin Li, Shan Geng, Mingli He
BACKGROUND The optimal medical regimen for managing hypertension during acute phase of lacunar infarcts has not yet been clarified in real world setting. The aim of this study was to evaluate blood pressure lowering regimens on neurological progression and clinical outcomes during the acute phase of lacunar infarcts. MATERIAL AND METHODS For this study, 411 patients with first-episode lacunar infarcts and hypertension within 24 hours of symptom onset were included. All patients received antihypertension therapies, with different regimens, as well as routine medication during first 7 days after onset...
September 22, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Yves Berthezène, Omer Eker, Nikolaos Makris, Maxime Bettan, Adeline Mansuy, Aurélie Chabrol, Irene K Mikkelsenm, Marc Hermier, Laura Mechtouff, Elodie Ong, Laurent Derex, Lise-Prune Berner, Roxana Ameli, Salvador Pedraza, Gotz Thomalla, Leif Østergaard, Jean-Claude Baron, Tae-Hee Cho, Norbert Nighoghossian
OBJECTIVES: The aim of the present study was to assess the association between collateral status and DWI-FLAIR mismatch in patients with acute ischemic stroke within the 4.5 h time-window. METHODS: We analysed DWI, FLAIR, and PWI data in patients within 4.5 h after symptom onset from the I-KNOW European database. Collateral flow maps were graded by analyzing contrast 'staining' extent over the early, mid and late perfusion phases. ADC values, DWI lesion volume, and normalised perfusion parameters (CBV,Tmax) within DWI lesions were determined...
September 12, 2018: Journal of the Neurological Sciences
Jia Liang, Peiyi Gao, Yan Lin, Ligang Song, Haiqiang Qin, Binbin Sui
Objective This study aimed to investigate the association between abnormal signs on susceptibility-weighted imaging (SWI) and post-treatment outcome in the early stage in patients with acute ischemic stroke. Methods Thirty-seven patients with middle cerebral artery territory infarction were recruited. Baseline and 24-hour follow-up magnetic resonance imaging was performed. Pre- and 24-hour post-treatment clinical conditions were assessed with the National Institutes of Health Stroke Scale (NIHSS) score. Prominent vessel sign (PVS) on SWI and infarcted areas on diffusion-weighted imaging (DWI) were assessed using the Alberta Stroke Program Early CT (ASPECT) score system...
September 21, 2018: Journal of International Medical Research
Thomas Lillicrap, Carlos Garcia-Esperon, Frederick Rohan Walker, Lin Kooi Ong, Michael Nilsson, Neil Spratt, Christopher R Levi, Mark Parsons, Jörgen Isgaard, Andrew Bivard
Introduction: The incidence of pituitary dysfunction after severe ischemic stroke is unknown, however given the increasing attention to pituitary dysfunction after neurological injuries such as traumatic brain injury, this may represent a novel area of research in stroke. Methods: We perform an arginine and human growth hormone releasing hormone challenge on ischemic stroke patients within a week of symptom onset. Results: Over the study period, 13 patients were successfully tested within a week of stroke (baseline NIHSS 10, range 7-16)...
2018: Frontiers in Neurology
Jie Li, Ping Zhang, Simiao Wu, Xingyang Yi, Chun Wang, Ming Liu
BACKGROUND: Large hemispheric infarction (LHI) is a devastating condition with high mortality and poor functional outcome in most conservatively treated patients. The purpose of this study was to explore factors associated with favorable outcome in patients with LHI. METHODS: We prospectively enrolled consecutive patients with LHI. Favorable outcome was defined as a modified Rankin Scale (mRS) score of 0 to 3 at 90 days. Multivariate logistic regression analysis was employed to identify the independent factors associated with favorable outcome...
September 20, 2018: BMC Neurology
Wei Huang, Hai-Bo Wu, Lun-Dong Feng, Dong-Mei Liang, Zuo-Xuan Wu
OBJECTIVE: To investigate the therapeutic effect of acupuncture combined with rehabilitation and neuro-immune functional activities in elderly patients with stroke. METHODS: A total of 196 elderly stroke patients were randomly divided into control (rehabilitation exercise) and observation(acupuncture+ rehabilitation exercise)groups ( n =98 in each). Patients of the control group were treated by general healing treatment including good limb placement, timely conversion of body position, joint-motor exercise, sitting balance exercise, sitting-standing-walking, walking up and down stairs, daily life ability exercise, etc...
September 25, 2018: Zhen Ci Yan Jiu, Acupuncture Research
Malin Reinholdsson, Annie Palstam, Katharina S Sunnerhagen
OBJECTIVE: To investigate the influence of prestroke physical activity (PA) on acute stroke severity. METHODS: Data from patients with first stroke were retrieved from registries with a cross-sectional design. The variables were PA, age, sex, smoking, diabetes, hypertension and statin treatment, stroke severity, myocardial infarction, new stroke during hospital stay, and duration of inpatient care at stroke unit. PA was assessed with Saltin-Grimby's 4-level Physical Activity Level Scale, and stroke severity was assessed with the National Institutes of Health Stroke Scale (NIHSS)...
September 19, 2018: Neurology
Halvor Naess, Lars Thomassen, Ulrike Waje-Andreassen, Solveig Glad, Christopher E Kvistad
BACKGROUND AND PURPOSE: We aimed to evaluate factors associated with neurological worsening among patients with lacunar or non-lacunar infarction admitted within 3 hours and between 3-24 hours after stroke onset. METHODS: All patients admitted to Haukeland university hospital between 2006-2016 with acute cerebral infarction on MRI and admission within 24 hours were included. Repeated National Institute of Health Stroke Scale (NIHSS) scoring was performed in all patients whenever possible...
September 19, 2018: Acta Neurologica Scandinavica
Q-S Zhao, W Li, D Li, T Liu, J-H Wang, Y Gao, L Yi, R-K Zhao
OBJECTIVE: This study aims to compare clinical efficiency of mechanical thrombectomy combined with rhPro-UK thrombolysis on moderate or severe acute brain infarction. PATIENTS AND METHODS: A total of 90 acute cerebral infarction patients due to artery stenosis or blockade from May 2016 to May 2017 were recruited and randomly assigned into thrombolysis group (N = 30), mechanical thrombectomy (N = 30), and combined treatment group (N = 30). Clinical information was collected...
September 2018: European Review for Medical and Pharmacological Sciences
Zeqin Xu, Yongquan Gu, Jianxin Li, Chunmei Wang, Rong Wang, Ying Huang, Jian Zhang
OBJECTIVE: Stroke is the most common neurological disease that is associated with deglutition disorders. The aim of this study was to analyze dysphagia and aspiration pneumonia risk factors in post-stroke elderly inpatients. METHOD: We consecutively enrolled 212 stroke patients over sixty years of age from July 2014 to June 2015. Seventeen patients were eliminated. Stroke patients' demographics, clinical symptoms and biochemistry data were collected. Modified water swallowing test was used for the assessment of deglutition difficulty...
September 6, 2018: Journal of Back and Musculoskeletal Rehabilitation
Adam Andrew Dmytriw, Thomas Joseph Sorenson, Jonathan M Morris, Patrick J Nicholson, Christopher Alan Hilditch, Christopher S Graffeo, Waleed Brinjikji
OBJECTIVE: Twitter is a popular social media platform among physicians. Neurointerventionalists frequently document their lifesaving mechanical thrombectomy cases on Twitter with very favorable results. We fear that there may be some social media publication bias to tweeted mechanical thrombectomy cases with neurointerventionalists being more likely to tweet cases with favorable outcomes. We used these publicly documented cases to analyze post-intervention Twitter-reported outcomes and compared these outcomes with the data provided in the gold standard literature...
September 15, 2018: Journal of Neurointerventional Surgery
Ralph Weber, Jens Minnerup, Hannes Nordmeyer, Jens Eyding, Christos Krogias, Jeffrie Hadisurya, Klaus Berger
BACKGROUND: In contrast to anterior circulation stroke (ACS), there is no evidence from randomized trials that mechanical thrombectomy (MT) with modern stent retrievers or thromboaspiration is safe and effective in posterior circulation stroke (PCS). METHODS: The present analysis was based on the prospective multicenter Registry on Revascularization in Ischemic Stroke Patients (REVASK) in Germany. We compared demographic data, periprocedural times and complications, recanalization rates, and functional outcome at discharge and after 3 months between 139 consecutive patients with PCS (84...
September 15, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Wan-Qian Ge, Jie Chen, Hong Pan, Fei Chen, Cheng-Ye Zhou
BACKGROUND: The purpose of this study was to analyze the risk factors of hemorrhagic transformation (HT) after intravenous thrombolysis using a recombinant tissue plasminogen activator (r-tPA) in acute ischemic stroke (AIS). METHODS: We included 199 consecutive patients in the First Affiliated Hospital of Wenzhou Medical University from January 2016 to October 2017 with a diagnosis of AIS. The patients were divided into 2 groups: HT and non-HT. The related risk factors were recruited before and after receiving r-tPA thrombolysis...
September 11, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Jianati Anniwaer, Meng-Zhuang Liu, Ke-Dong Xue, Abuduzhayier Maimaiti, Aersilan Xiamixiding
PURPOSE: Although hyperhomocysteinemia (Hhcy) is a risk factor for cerebral infarction, its effect on recurrent cerebral infarction is less-defined. We aimed to investigate the association of Hhcy and increased risk of recurrent cerebral infarct. MATERIALS AND METHODS: From 2011-2013, we recruited 231 primary cerebral infarct patients that were divided to a Hhcy group (n = 105) and a control group (n = 126) according to plasma homocysteinemia (Hcy) levels exceeding 15μmol/L...
September 14, 2018: International Journal of Neuroscience
Xianliang Meng, Renying Wen, Xiao Li
Values of low density lipoprotein (LDL) and procalcitonin (PCT) levels in evaluating the condition and prognosis of patients with acute cerebral infarction (ACI) were investigated. According to the volume of cerebral infarction, 150 patients with ACI (observation group) were divided into the mild infarction group (n=50), moderate infarction group (n=50), and severe infarction group (n=50). Besides, another 50 healthy subjects were enrolled during the same period as the control group. The levels of serum LDL and PCT on admission and at the 1st, 3rd, 7th and 10th day after treatment were detected, which were compared with those in the control group...
October 2018: Experimental and Therapeutic Medicine
Mustafa Çetiner, Hasan Emre Aydin, Merve Güler, Sibel Canbaz Kabay, Yaşar Zorlu
The objective of our study is to detect the patient group that will most benefit from intravenous (IV) thrombolytic therapy by showing predictive factors of good functional outcomes. The present study covers 88 patients who were admitted to our clinic within the first 4.5 hours from the onset of stroke symptoms, diagnosed with acute ischemic stroke and who received IV thrombolytic therapy between May 2014 and June 2017 as a result of a retrospective analysis of a database prospectively collected. The patients with a score of ≤2 on modified Rankin scale within 3 months were accepted as good functional outcome and those with a score of >2 were accepted as poor functional outcome...
September 13, 2018: Clinical and Applied Thrombosis/hemostasis
Jose Díaz-Pérez, Guillermo Parrilla, Mariano Espinosa de Rueda, Jose María Cabrera-Maqueda, Blanca García-Villalba, Maria Teresa Alba-Isasi, Ana Morales, Joaquín Zamarro
BACKGROUND: Strokes due to carotid artery occlusion (CAO) are associated with bad clinical prognosis and poor response to intravenous thrombolysis. Several studies in the past have shown the benefits of mechanical thrombectomy (MT) and compared bridging therapy (BT) and primary MT (PMT) in large vessel occlusions, but only a few studies have focused on the specific population of CAO and their response to endovascular treatment. METHODS: Retrospective review of patients treated at our center between January 2010 and June 2017 that (1) presented with acute ischemic stroke caused by CAO in the first 4...
September 13, 2018: Cerebrovascular Diseases
Louis Viannay, Julie Haesebaert, Fannie Florin, Roberto Riva, Laura Mechtouff, Benjamin Gory, Elodie Ong, Paul-Emile Labeyrie, Laurent Derex, Marc Hermier, Leila Chamard, Lise-Prune Berner, Roxana Ameli, Yves Berthezène, Francis Turjman, Norbert Nighoghossian, Tae-Hee Cho
Introduction: Randomized trials (RT) have recently validated the superiority of thrombectomy over standard medical care, including intravenous thrombolysis (IVT). However, data on their impact on routine clinical care remains scarce. Methods: Using a prospective observational registry, we assessed: (1) the clinical and radiological characteristics of all consecutive patients treated with thrombectomy; (2) the outcome of all patients with M1 occlusion (treated with thrombectomy or IVT alone). Two periods were compared: before (2013-2014) and after (2015-2016) the publication of RT...
2018: Frontiers in Neurology
Tamar Abzhandadze, Lena Rafsten, Åsa Lundgren-Nilsson, Katharina S Sunnerhagen
Objective: To investigate the feasibility of assessing cognitive function using the Montreal Cognitive Assessment (MoCA) given 36-48 h post stroke to explain dependence in activities of daily living (ADL). Methods: This is a cross-sectional, exploratory study. Cognitive function and basic ADL were assessed with the MoCA and the Barthel Index (BI), respectively, within 36-48 h of admission. Neurological functions were assessed with the National Institute of Health Stroke Scale (NIHSS) upon admittance to the hospital...
2018: Frontiers in Neurology
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