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https://www.readbyqxmd.com/read/28229893/safety-and-efficacy-of-natalizumab-in-patients-with-acute-ischaemic-stroke-action-a-randomised-placebo-controlled-double-blind-phase-2-trial
#1
Jacob Elkins, Roland Veltkamp, Joan Montaner, S Claiborne Johnston, Aneesh B Singhal, Kyra Becker, Maarten G Lansberg, Weihua Tang, Ih Chang, Kumar Muralidharan, Sarah Gheuens, Lahar Mehta, Mitchell S V Elkind
BACKGROUND: In animal models of acute ischaemic stroke, blocking of the leukocyte-endothelium adhesion by antagonism of α4 integrin reduces infarct volumes and improves outcomes. We assessed the effect of one dose of natalizumab, an antibody against the leukocyte adhesion molecule α4 integrin, in patients with acute ischaemic stroke. METHODS: In this double-blind, phase 2 study, patients with acute ischaemic stroke (aged 18-85 years) from 30 US and European clinical sites were randomly assigned (1:1) to 300 mg intravenous natalizumab or placebo with stratification by treatment window and baseline infarct size...
March 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28228657/repetitive-hyperbaric-oxygen-treatment-increases-insulin-sensitivity-in-diabetes-patients-with-acute-intracerebral-hemorrhage
#2
Qian Xu, Yi-Ting Wei, Shuang-Bo Fan, Liang Wang, Xiao-Ping Zhou
AIM: The role of hyperbaric oxygen therapy (HBOT) in the treatment of acute ischemic stroke is controversial. This study aims to investigate whether the peripheral insulin sensitivity of type 2 diabetes patients suffering from intracerebral hemorrhage can be increased after HBOT. METHODS: Fifty-two type 2 diabetes participants were recruited after being diagnosed with intracerebral hemorrhage in our hospital. Insulin sensitivity was measured by the glucose infusion rate during a hyperinsulinemic euglycemic clamp (80 mU m(-2) min(-1)) at baseline and 10 and 30 days after HBOT sessions...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28228323/evaluation-of-the-role-of-susceptibility-weighted-imaging-in-thrombolytic-therapy-for-acute-ischemic-stroke
#3
Guangjian Zhao, Ling Sun, Ziran Wang, Liquan Wang, Zhongrong Cheng, Hongyan Lei, Daiqun Yang, Yansen Cui, Shirui Zhang
We inspected low-intensity venous signals and microbleeds in patients with acute ischemic stroke (AIS) using susceptibility-weighted imaging (SWI) before and after administration of within-thrombolytic-time-window thrombolytic therapies, and observed their prognosis and safety, in order to guide individualized thrombolytic therapies. Patients with AIS were divided into groups A or B according to the presence of symmetric or asymmetric veins on SWI, and were re-inspected by SWI after intravenous thrombolysis using recombinant tissue plasminogen activator (rt-PA)...
February 19, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28224695/distal-hyperintense-vessel-sign-is-associated-with-neurological-deterioration-in-acute-ischaemic-stroke
#4
K-W Nam, H-M Kwon, S-W Park, J-S Lim, M-K Han, Y-S Lee
BACKGROUND AND PURPOSE: The aim was to evaluate the relationship between distal hyperintense vessel sign (HVS) and early neurological deterioration (END) in acute ischaemic stroke with large vessel steno-occlusion. METHODS: Acute ischaemic stroke patients with symptomatic severe steno-occlusion in the middle cerebral artery or internal carotid artery were recruited within 24 h from symptom onset. Stroke outcomes were evaluated using the National Institutes of Health Stroke Scale (NIHSS) score at the time of admission and at 72 h and 7 days...
February 22, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28224419/a-retrospective-study-of-branch-atheromatous-disease-analyses-of-risk-factors-and-prognosis
#5
Yang Liu, Yuan-Teng Fan, Yu-Min Liu, Tao Wang, Hong-Liang Feng, Guang-Zhi Liu, Bin Mei
The theory of branch atheromatous disease (BAD) has been commonly underused in clinical practice and research since it was proposed in 1989. In this study, we sought to explore clinical characteristics of its substypes and biomarkers for prognosis of BAD. A total of 176 consecutive patients with BAD were classified into two groups: paramedianpontine artery group (PPA group, n=70) and lenticulostriate artery group (LSA group, n=106). Bivariate analyses were used to explore the relationship between white matter hyperintensities (WMHs), National Institutes of Health Stroke Scale (NIHSS) scores and prognosis evaluated by the modified Rank Scale (mRS) at 6th month after stroke...
February 2017: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/28205227/impact-of-obstructive-sleep-apnea-on-neurological-recovery-after-ischemic-stroke-a-prospective-study
#6
D Menon, S Sukumaran, R Varma, A Radhakrishnan
OBJECTIVES: The presence of obstructive sleep apnea (OSA) has been found to adversely affect the neurological recovery after acute ischemic stroke (AIS) in previous observational studies. However, in most of these studies, diagnosis of OSA was based on oximetry data alone, raising concern in the accuracy of diagnosis as well as estimation of severity. Purpose of our study was to determine the prevalence and severity of OSA (based on polysomnography and American Association of Sleep Medicine [AASM] criteria) in patients with AIS and to compare the post-stroke neurological and functional outcome, in those with and without OSA...
February 15, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28205065/spontaneous-recovery-of-upper-extremity-motor-impairment-after-ischemic-stroke-implications-for-stem-cell-based-therapeutic-approaches
#7
Hossein Delavaran, Joseph Aked, Håkan Sjunnesson, Olle Lindvall, Bo Norrving, Zaal Kokaia, Arne Lindgren
Preclinical studies suggest that stem cell therapy (SCT) may improve sensorimotor recovery after stroke. Upper extremity motor impairment (UEMI) is common after stroke, often entailing substantial disability. To evaluate the feasibility of post-stroke UEMI as a target for SCT, we examined a selected sample of stroke patients potentially suitable for SCT, aiming to assess the frequency and recovery of UEMI, as well as its relation to activity limitations and participation restrictions. Patients aged 20-75 years with first-ever ischemic stroke, and National Institutes of Health Stroke Scale (NIHSS) scores 1-18, underwent brain diffusion-weighted MRI within 4 days of stroke onset (n = 108)...
February 15, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28194477/maximizing-first-pass-complete-reperfusion-with-save
#8
Volker Maus, Daniel Behme, Christoph Kabbasch, Jan Borggrefe, Ioannis Tsogkas, Omid Nikoubashman, Martin Wiesmann, Michael Knauth, Anastasios Mpotsaris, Marios Nikos Psychogios
BACKGROUND: Endovascular techniques for treatment of large vessel occlusions (LVO) in patients with acute ischemic stroke (AIS) have advanced in recent years. We report a multicenter experience using a combined aspiration and stent retriever technique for mechanical thrombectomy (MT). METHODS: We retrospectively analyzed 32 consecutive MT patients using a novel, combined approach of Stent retriever Assisted Vacuum-locked Extraction (SAVE) by 3 operators at 3 stroke centers...
February 13, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28191861/the-effect-of-self-management-education-following-mild-stroke-an-exploratory-randomized-controlled-trial
#9
Timothy J Wolf, Meredith J Spiers, Meghan Doherty, Emily V Leary
BACKGROUND: Mild stroke comprises 53% of stroke hospital admissions; however, the majority of those with mild stroke patients receive little support to address chronic symptoms following stroke. OBJECTIVES: To evaluate the feasibility and preliminary effect of the Chronic Disease Self-Management Program (CDSMP) for use with individuals immediately post mild-stroke. METHODS: Single-blind, exploratory, randomized controlled trial with participants who sustained a mild stroke (NIHSS <6)...
February 13, 2017: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/28190826/leukoaraiosis-is-associated-with-worse-short-term-functional-and-cognitive-recovery-after-minor-stroke
#10
Zheng Zhang, Wenwei Ren, Bei Shao, Huiqin Xu, Jianhua Cheng, Qiongzhang Wang, Yingying Gu, Beilei Zhu, Jincai He
Whether leukoaraiosis burden retards short-term recovery after minor stroke is unclear. We investigated the association between leukoaraiosis and early recovery of neurological function after a first minor ischemic stroke in 217 acute stroke patients (National Institutes of Health Stroke Scale (NIHSS) score ≤5). Leukoaraiosis severity was graded according to the Fazekas scale and categorized into none to mild (0-2; n = 143) or severe (3-6; n = 74) groups. NIHSS and Minimum Mental State Examination (MMSE) were assessed at baseline and at 30 days...
February 10, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28185970/risk-factors-for-hemorrhagic-transformation-following-intravenous-thrombolysis-in-acute-cerebral-infarction-a-retrospective-single-center-study
#11
Xiahong Xu, Changsong Li, Ting Wan, Xiaobo Gu, Wenxia Zhu, Junjie Hao, Huan Bao, Lian Zuo, Hui Hu, Gang Li
OBJECTIVE: To investigate the risk factors for the hemorrhagic transformation (HT) following intravenous thrombolysis using a recombinant tissue plasminogen activator (r-tPA) in acute cerebral infarction. METHODS: Acute cerebral infarction patients receiving r-tPA thrombolysis in Shanghai Eastern Hospital were retrospectively studied. Based upon the cranial CT or MRI examination, after the intravenous thrombolysis, the patients were divided into two groups: HT group and non-HT group...
February 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28185942/the-effects-of-pharmaceutical-thrombolysis-and-multi-modal-therapy-on-patients-with-acute-posterior-circulation-ischemic-stroke-results-of-a-one-center-retrospective-study
#12
Yang Yang, Chunyang Liang, Chunsen Shen, Hao Tang, Shang Ma, Qiang Zhang, Mou Gao, Qin Dong, Ruxiang Xu
BACKGROUND: The treatment method for acute ischemic stroke is rapidly developing, and the effects of endovascular modalities, when used alone or in combination, needs to be studied. We aimed to identify the difference between pharmaceutical thrombolysis and multi-modal therapy (MMT) used in acute posterior circulation ischemic stroke (APCIS) patients and also to detect the predictors for successful recanalization and favorable outcomes. METHODS: A retrospective analysis of patients with APCIS who received thrombolytic pharmaceuticals and MMT from 2011 to 2016 was performed at the stroke center...
February 7, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28178407/predictive-factors-for-good-outcome-and-mortality-after-stent-retriever-thrombectomy-in-patients-with-acute-anterior-circulation-stroke
#13
Woong Yoon, Seul Kee Kim, Man Seok Park, Byung Hyun Baek, Yun Young Lee
BACKGROUND AND PURPOSE: Predictive factors associated with stent-retriever thrombectomy for patients with acute anterior circulation stroke remain to be elucidated. This study aimed to investigate clinical and procedural factors predictive of good outcome and mortality after stent-retriever thrombectomy in a large cohort of patients with acute anterior circulation stroke. METHODS: We analyzed clinical and procedural data in 335 patients with acute anterior circulation stroke treated with stent-retriever thrombectomy...
January 2017: Journal of Stroke
https://www.readbyqxmd.com/read/28178299/a-simple-prediction-score-system-for-malignant-brain-edema-progression-in-large-hemispheric-infarction
#14
KwangWook Jo, Suhas S Bajgur, Hoon Kim, Huimahn A Choi, Pil-Woo Huh, Kiwon Lee
Malignant brain edema (MBE) due to hemispheric infarction can result in brain herniation, poor outcomes, and death; outcome may be improved if certain interventions, such as decompressive craniectomy, are performed early. We sought to generate a prediction score to easily identify those patients at high risk for MBE. 121 patients with large hemispheric infarction (LHI) (2011 to 2014) were included. Patients were divided into two groups: those who developed MBE and those who did not. Independent predictors of MBE were identified by logistic regression and a score was developed...
2017: PloS One
https://www.readbyqxmd.com/read/28170316/medical-university-of-south-carolina-telestroke-a-telemedicine-facilitated-network-for-stroke-treatment-in-south-carolina-a-progress-report
#15
Sami Al Kasab, Robert J Adams, Ellen Debenham, David J Jones, Christine Ann Holmstedt
BACKGROUND: Patients in rural communities lack access to acute stroke therapies. Rapid administration of lytic therapy increases the likelihood of favorable functional outcome in acute ischemic stroke (AIS). At the Medical University of South Carolina (MUSC), we implemented a Web-based telestroke program that allows patients presenting with AIS at a rural hospital to receive expert stroke consultation within minutes. This increases their chances of receiving lytic therapy, and therefore increases the likelihood of good functional outcome...
February 7, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28169020/description-of-stroke-mimics-after-complete-neurovascular-assessment
#16
C Avellaneda-Gómez, A Rodríguez Campello, E Giralt Steinhauer, A Gómez González, M Serra Martínez, P de Ceballos Cerrajería, A Zabalza de Torres, E Cuadrado-Godia, A Ois Santiago, J Jiménez-Conde, J Roquer
INTRODUCTION: A considerable percentage of events initially diagnosed as ischaemic stroke have non-cerebrovascular causes; these are called stroke mimics (SM). Currently available evidence about these events is heterogeneous and comes from studies with small samples. OBJECTIVE: The purpose of our study is to identify conditions that may present as SM, define their epidemiological and clinical characteristics, and determine the percentage of cases of SM treated with intravenous fibrinolysis...
February 4, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28164562/copeptin-levels-in-cerebral-infarction-intracranial-hemorrhage-and-subarachnoid-hemorrhage
#17
Feyza Aksu, Mehtap Gurger, Mustafa Yilmaz, Metin Atescelik, Mustafa Yildiz, Nevin Ilhan, Selcuk Ilhan, Mehmet C Goktekin
BACKGROUND: To determine copeptin levels in patients with suspected intracranial events and to determine whether copeptin levels could be used in the discrimination of cerebral infarction, intracranial hemorrhage, and subarachnoid hemorrhage in the emergency room. METHODS: Blood samples were obtained from the patients prior to imaging to determine the levels of copeptin. Patients were divided into diagnostic groups after the imaging. One hundred and seventy-six participants, who were enrolled in the study, were as follows: 50 cerebral infarction (CI) patients (M/F: 24/26), 47 intracranial hemorrhage (ICH) patients (M/F: 27/20), 29 subarachnoid hemorrhage (SAH) patients (M/F: 17/12) and 50 healthy controls...
December 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28162169/-efficacy-of-intravenous-thrombolysis-in-acute-ischemic-stroke-with-hyperdense-middle-cerebral-artery-sign
#18
L Peng, Y Guo, Y Wang, Y N Lin, C H Zhang, H Y Wang, R M Yu, X P Sun
Objective: To observe the efficacy and safety of recombinant tissue-type plasminogen activator (rtPA) intravenous thrombolysis (IVT) in the treatment of acute cerebral infarction with hyperdense middle cerebral artery sign (HMCAS). Methods: Acute cerebral infarction patients with HMCAS from July 2010 to November 2015 at the First Affiliated Hospital of Dalian Medical University were collected.These patients were divided into two groups depending on whether they received IVT or not.The Nation Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were used to evaluate early and long-time therapeutic effects...
January 17, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28158211/major-vessel-occlusion-may-predict-subtherapeutic-anticoagulation-intensity-and-feasibility-of-administration-of-intravenous-thrombolytics
#19
Jun Young Chang, Seunguk Jung, Hyun Park, Moon-Ku Han
OBJECTIVE: We investigated the association between the presence of major vessel occlusion (MVO) and the intensity of the International Normalized Ratio (INR) in cardioembolic high-risk patients taking warfarin. We also evaluated whether the presence of MVO could predict the subtherapeutic range of INR ≤1.7 ensuring safe administration of intravenous thrombolytics. METHODS: The medical records of 177 cardioembolic stroke patients who were taking warfarin between April, 2008 and March, 2015 were retrospectively analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/28156253/severe-carotid-stenosis-and-delay-of-reperfusion-in-endovascular-stroke-treatment-an-interventional-management-of-stroke-iii-study
#20
Steven L Gogela, Yair M Gozal, Bin Zhang, Thomas A Tomsick, Andrew J Ringer, Joseph P Broderick, Pooja Khatri, Todd A Abruzzo
OBJECTIVE The impact of extracranial carotid stenosis on interventional revascularization of acute anterior circulation stroke is unknown. The authors examined the effects of high-grade carotid stenosis on the results of endovascular treatment of patients in the Interventional Management of Stroke (IMS)-III trial. METHODS The 278 patients in the endovascular arm of the IMS-III trial were categorized according to the degree of carotid stenosis as determined by angiography. In comparing patients with severe stenosis or occlusion (≥ 70%) to those without severe stenosis (< 70%), the authors evaluated the time to endovascular reperfusion, modified Thrombolysis in Cerebrovascular Infarction (mTICI) scores, 24-hour mean infarct volumes, symptomatic intracerebral hemorrhage rates, and modified Rankin Scale (mRS) scores at 90 days...
February 3, 2017: Journal of Neurosurgery
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