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https://www.readbyqxmd.com/read/29167390/early-elevated-troponin-levels-after-ischemic-stroke-suggests-a-cardioembolic-source
#1
Shadi Yaghi, Andrew D Chang, Brittany A Ricci, Mahesh V Jayaraman, Ryan A McTaggart, Morgan Hemendinger, Priya Narwal, Katarina Dakay, Brian MacGrory, Shawna M Cutting, Tina M Burton, Christopher Song, Emile Mehanna, Matthew Siket, Tracy E Madsen, Michael Reznik, Alexander E Merkler, Michael P Lerario, Hooman Kamel, Mitchell S V Elkind, Karen L Furie
BACKGROUND AND PURPOSE: Elevated cardiac troponin is a marker of cardiac disease and has been recently shown to be associated with embolic stroke risk. We hypothesize that early elevated troponin levels in the acute stroke setting are more prevalent in patients with embolic stroke subtypes (cardioembolic and embolic stroke of unknown source) as opposed to noncardioembolic subtypes (large-vessel disease, small-vessel disease, and other). METHODS: We abstracted data from our prospective ischemic stroke database and included all patients with ischemic stroke during a 22-month period...
November 22, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29163351/computed-tomography-perfusion-alberta-stroke-program-early-computed-tomography-score-is-associated-with-hemorrhagic-transformation-after-acute-cardioembolic-stroke
#2
Lan Liu, Bo Wu, Jinglong Zhao, Yanyan Cao, Nikita Dedhia, Louis R Caplan, Qiaoshu Wang
Alberta Stroke Program Early Computed Tomography (CT) score (ASPECTS) has been applied to CT perfusion (CTP) with good interrater agreement to predict early ischemic stroke, and it can be useful in decision making in acute ischemic stroke. The aim of the present study was to assess the predictive value of CTP ASPECTS of hemorrhagic transformation (HT) in acute cardioembolic stroke. This is a single-enter, retrospective study. All patients hospitalized with acute cardioembolic stroke from January 2008 to September 2013 were included...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29161693/long-term-outcomes-of-ischemic-stroke-of-undetermined-mechanism-a-population-based-prospective-cohort
#3
Negar Morovatdar, Amanda G Thrift, Moira K Kapral, Réza Behrouz, Hamidreza Saber, Amin Amiri, Mohammad Taghi Farzadfard, Naghmeh Mokhber, Saverio Stranges, Mahmoud Reza Azarpazhooh
BACKGROUND AND PURPOSE: Little is known about the short- and long-term outcomes of ischemic stroke of undetermined mechanism (ISUM). METHODS: Subjects were recruited from the Mashhad Stroke Incidence Study. Ischemic stroke (IS) was classified on the basis of the TOAST criteria. We further categorized patients with ISUM into ISUMneg (negative clinical/test results for large artery, small artery) and ISUMinc (incomplete investigations). Cox proportional hazard models and the competing-risk regression model were used to compare 1 and 5 years mortality (all-causes) and recurrent rate among IS subtypes...
November 21, 2017: Neuroepidemiology
https://www.readbyqxmd.com/read/29142621/mechanical-thrombectomy-with-solitaire-stent-retrieval-for-acute-cardioembolic-stroke
#4
Hokyun Han, Hyunho Choi, Keun-Tae Cho, Byong-Cheol Kim
Objective: Few studies have reported the outcome of mechanical thrombectomy with Solitaire stent retrival (MTSR) in subtypes of acute ischemic stroke. The purpose of this study was to evaluate the efficacy and result of MTSR in acute cardioembolic stroke. Methods: Twenty consecutive patients with acute cardioembolic stroke were treated by MTSR. The angiographic outcome was assessed by thrombolysis in cerebral infarction (TICI) grade. TICI grade 2a, 2b, or 3 with a measurable thrombus that was retrieved was considered as a success when MTSR was performed in the site of primary vessel occlusion, and TICI grade 2b or 3 was considered as a success when final result was reported...
November 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29138753/lesion-pattern-mechanisms-and-long-term-prognosis-in-patients-with-monoparetic-stroke-a-comparison-with-nonmonoparetic-stroke
#5
Seung-Jae Lee, Dong-Geun Lee, Hye-Jin Moon, Tae-Kyeong Lee
Background: Monoparetic stroke is rare but could be misdiagnosed as peripheral neuropathy. We investigated the prevalence, lesion pattern, stroke mechanism, and long-term prognosis in patients with monoparetic stroke. Methods: 586 acute ischemic stroke patients (including 31 with monoparesis) were studied. Monoparetic stroke was defined as a motor deficit in either an arm or a leg but without facial weakness or speech disturbance. Median follow-up period was 32...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29131288/mechanisms-of-cardioembolic-stroke-revisited-atrial-cardiopathy
#6
Justyna Mączyńska, Iwona Kurkowska-Jastrzębska, Rafał Dąbrowski
There has been only moderate progress in our understanding of potential relation between atrial arrhythmia and stroke over years. Current approach is still based on a hypothesis that atrial contractile dysfunction due to fibrillation causes blood stasis, which accompanied by other factors acting together as Virchow's triad produces thrombus and embolism to the brain. In this review we would like to discuss a relatively new concept of atrial cardiopathy. It assumes that risk of thromboembolism is increased regardless of atrial rhythm, being largely driven by atrial tissue abnormalities, such as fibrosis, endothelial and myocytes dysfunction and atrial dilatation...
November 13, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29130973/frequency-aetiology-and-outcome-of-small-cerebellar-infarction
#7
Zeljka Calic, Cecilia Cappelen-Smith, Ramesh Cuganesan, Craig S Anderson, Miriam Welgampola, Dennis J Cordato
BACKGROUND AND PURPOSE: Strokes due to small (<2 cm) cerebellar infarction are under-recognised, and their profile and aetiology have not been well characterised. We aimed to determine the frequency, clinical features, aetiology, and outcome of small as compared to large cerebellar infarction. METHODS: This study is a retrospective analysis of clinical and imaging features of a prospectively assessed series of 108 consecutive patients with acute cerebellar infarction admitted to Liverpool Hospital, Sydney, NSW, Australia, during 2011-2015...
November 2, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/29127270/low-dose-tirofiban-improves-functional-outcome-in-acute-ischemic-stroke-patients-treated-with-endovascular-thrombectomy
#8
Wenbo Zhao, Ruiwen Che, Shuyi Shang, Chuanjie Wu, Chuanhui Li, Longfei Wu, Jian Chen, Jiangang Duan, Haiqing Song, Hongqi Zhang, Feng Ling, Yuping Wang, David Liebeskind, Wuwei Feng, Xunming Ji
BACKGROUND AND PURPOSE: Chinese patients largely experience acute ischemic stroke (AIS) because of large artery atherosclerosis rather than cardioembolism, and whether tirofiban is safe and effective in these patients treated with endovascular thrombectomy (ET) is unknown. This study evaluated the safety and efficacy of tirofiban in Chinese patients with AIS treated with ET. METHODS: This observational study is based on a single-center prospective registry study...
November 10, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29111002/free-fatty-acid-as-a-determinant-of-ischemic-lesion-volume-in-nonarterial-origin-embolic-stroke
#9
Jong-Won Chung, Woo-Keun Seo, Gyeong-Moon Kim, Chin-Sang Chung, Kwang Ho Lee, Oh Young Bang
GOALS: This study aimed to determine whether the plasma levels of free fatty acid (FFA) are associated with ischemic lesion characteristics in nonarterial-origin embolic stroke. MATERIALS AND METHODS: We prospectively recruited 254 patients with acute cerebral infarction caused by cardioembolic stroke (CES, n=121) or with embolic stroke of undetermined source (ESUS, n=133). Plasma levels of FFA were measured during the acute stage (median of 2days after stroke onset)...
November 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29105494/causes-of-death-in-different-subtypes-of-ischemic-and-hemorrhagic-stroke
#10
Chi-Hung Liu, Jr-Rung Lin, Chia-Wei Liou, Jiann-Der Lee, Tsung-I Peng, Meng Lee, Tsong-Hai Lee
Causes of death in both ischemic stroke (IS) and hemorrhagic stroke (HS) subtypes are not comprehensively studied. Between 2008 and 2011, we enrolled 11 215 first-ever stroke patients from the Stroke Registry of Chang-Gung Healthcare System and linked these data to the national death registry. The main causes of death in each stroke subtype were assessed. Patients with HS had higher overall mortality than IS (32.0% vs 18.1%, P < .001). In IS subtypes, large-artery atherosclerosis plus cardioembolism had the worst mortality (40...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/29102390/comorbidities-clinical-features-and-prognostic-implications-of-cancer-patients-with-cerebrovascular-disease
#11
Bernardo Cacho-Díaz, Nydia A Lorenzana-Mendoza, Héctor Spínola-Maroño, Gervith Reyes-Soto, Carlos Cantú-Brito
PURPOSE: The objective of this study was to identify and describe the comorbidities, clinical features, and prognostic implications of cancer patients with cerebrovascular disease. MATERIALS AND METHODS: All patients with cerebrovascular disease (CVD) seen in the neuro-oncology unit at a cancer referral center from April 2010 to November 2016 were included; demographic, oncologic diagnosis, risk factors, and prognostic considerations were presented as well. RESULTS: We report on 256 patients with CVD and cancer, of whom 66% were women...
October 25, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29102234/acute-treatment-of-stroke-due-to-spontaneous-calcified-cerebral-emboli-causing-large-vessel-occlusion
#12
REVIEW
Muhammad Faraz Raghib, Johannes Sebastian Mutzenbach, Cornelia Rösler, Ferdinand Otto, Mark Mc Coy, Erasmia Müller-Thies-Broussalis, Slaven Pikija
INTRODUCTION: Calcified cerebral emboli (CCE) are rarely responsible for large vessel occlusion (LVO) in acute anterior stroke, and therefore therapeutic experience is scarce. We sought to expand current knowledge upon therapeutic options with three new cases and a review of current literature. METHODS: Systematic search of patients with acute anterior stroke due to LVO in one comprehensive stroke center throughout a 4 year period. Literature search for reported cases of CCE...
October 25, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29096760/alox5ap-rs10507391-polymorphism-and-the-risk-of-ischemic-stroke-in-caucasians-an-update-meta-analysis
#13
K-L Li, C-Y Chen, M Xu, X-Q Zhu, X-J Yang
Some reports evaluated the association between ALOX5AP rs10507391 polymorphism and the risk of ischemic stroke in Caucasians. The results remained unknown. Thus, we did a meta-analysis to evaluate this association. Nine case-control studies with 4198 patients and 3699 controls were included in this meta-analysis. A significant association was found between ALOX5AP rs10507391 polymorphism and ischemic stroke risk in Caucasians (OR=1.18; 95%CI, 1.08-1.28; P=0.0002). ALOX5AP rs10507391 polymorphism was associated with ischemic stroke risk in Caucasians from Europe (OR=1...
October 31, 2017: Cellular and Molecular Biology
https://www.readbyqxmd.com/read/29075836/clinical-implications-of-ct-hyperdense-artery-sign-in-patients-with-acute-middle-cerebral-artery-occlusion-in-the-era-of-modern-mechanical-thrombectomy
#14
Seul Kee Kim, Byung Hyun Baek, Yun Young Lee, Woong Yoon
The clinical implications of the CT hyperdense artery sign have yet to be established in the new era of modern mechanical thrombectomy. This study aimed to investigate prognostic implications of the CT hyperdense middle cerebral artery sign (HMCAS) on treatment outcomes after mechanical thrombectomy for acute MCA occlusions. A retrospective analysis of CT and clinical data from 212 patients with acute MCA occlusions who underwent mechanical thrombectomy was conducted. HMCAS was determined with visual assessment by consensus of two readers...
December 2017: Journal of Neurology
https://www.readbyqxmd.com/read/29053913/morphological-changes-of-the-internal-carotid-artery-prevalence-and-characteristics-a-clinic-and-ultrasonographic-study-in-a-series-of-19-804-patients-over-25-years-old
#15
Hugo F G Martins, Alexandra Mayer, Paulo Batista, Fátima Soares, Vanessa Almeida, Ana Júlia Pedro, Victor Oliveira
BACKGROUND: Morphological changes of the internal carotid arteries (McICA) are frequently found during cervical ultrasound studies. However, McICA's etiology remains controversial. During this study, the prevalence and demographic characteristics of McICA such as kinking, coiling or looping, identified by Doppler ultrasound, were analysed and its relationship with vascular risk factors and stroke was assessed. METHODS: A retrospective study was performed by analysing 19,804 patients between Jan 2000 and Jun 2012 who were submitted to cervical ultrasonographic study...
October 20, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29039838/-atrial-septal-aneurysm-evolution-of-diagnostic-and-clinical-judgements
#16
A S Rudoy, A A Bova, T A Nekhaichik
The article discusses anatomical and clinical judgements on atrial septal aneurysm (ASA) as a primary cardiac structural abnormality. It presents current approaches to the classification of ASA and its echocardiographic diagnosis. Special attention is focused on the clinical significance of ASA as an isolated anomaly and concurrent with other structural abnormalities of the heart, especially from the standpoint of a risk of cardioembolic stroke.
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/29032752/association-between-apolipoproteins-ai-and-b-and-ultrasound-indicators-of-carotid-atherosclerosis
#17
Zeljko Zivanovic, Ivana Divjak, Mirjana Jovicevic, Tamara Rabi-Zikic, Biljana Radovanovic, Svetlana Ruzicka-Kaloci, Djordje Stevan Popovic, Edita Stokic, Ksenija Gebauer-Bukurov, Katarina Zivanovic-Vujcic, Petar Slankamenac
BACKGROUND: Apolipoproteins A-I and B (apoA-I and apoB) may be better indicators of the risk of cardiovascular and cerebrovascular diseases than conventional risk factors (RFs). The onset of ischemic stroke (IS) may be preceded by the development of atherosclerotic changes in carotid arteries, which can be detected by ultrasound. Only a certain % of patients with IS have an (underlying) carotid etiology. OBJECTIVE: The aim of our study was to determine the association between ultrasound indicators of carotid atherosclerosis and the presence of apolipoproteins and other biomarkers in patients with IS...
October 10, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29025779/scorpion-bite-induced-ischaemic-stroke
#18
Rakesh Reddy C, Nandakishore Bompelli, Vikram Khardenavis, Anirudda Deshpande
We report a 54-year-old woman with scorpion bite. After 3 hours of admission, the patient developed sudden onset tachycardia with hypotension. Cardiac evaluation showed raised creatine kinase MB isoenzyme was elevated; ECG and two-dimensional echocardiography findings were suggestive of myocarditis. Subsequently, she developed transient ventricular tachycardia before developing abrupt onset, right hemiplegia, global aphasia and progressive worsening of sensorium 12 hours after the bite. MRI of brain revealed massive left middle cerebral artery (MCA) territory infarct...
October 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29020353/differential-effects-of-pcsk9-variants-on-risk-of-coronary-disease-and-ischaemic-stroke
#19
Jemma C Hopewell, Rainer Malik, Elsa Valdés-Márquez, Bradford B Worrall, Rory Collins
Aims: PCSK9 genetic variants that have large effects on low-density lipoprotein cholesterol (LDL-C) and coronary heart disease (CHD) have prompted the development of therapeutic PCSK9-inhibition. However, there is limited evidence that PCSK9 variants are associated with ischaemic stroke (IS). Methods and results: Associations of the loss-of-function PCSK9 genetic variant (rs11591147; R46L), and five additional PCSK9 variants, with IS and IS subtypes (cardioembolic, large vessel, and small vessel) were estimated in a meta-analysis involving 10 307 IS cases and 19 326 controls of European ancestry...
July 17, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28991905/the-presence-and-severity-of-cerebral-small-vessel-disease-increases-the-frequency-of-stroke-in-a-cohort-of-patients-with-large-artery-occlusive-disease
#20
Ki-Woong Nam, Hyung-Min Kwon, Jae-Sung Lim, Moon-Ku Han, Hyunwoo Nam, Yong-Seok Lee
BACKGROUND: Cerebral small vessel disease (SVD) commonly coexists with large artery atherosclerosis (LAA). AIM: We evaluate the effect of SVD on stroke recurrence in patients for ischemic stroke with LAA. METHODS: We consecutively collected first-ever ischemic stroke patients who were classified as LAA mechanism between Jan 2010 and Dec 2013. Univariate and multivariate Cox analyses were performed to evaluate the association between the 2-year recurrence and demographic, clinical, and radiological factors...
2017: PloS One
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