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Masaki Naganuma, Yuichiro Inatomi, Makoto Nakajima, Toshiro Yonehara, Yukio Ando
BACKGROUND: Uric acid (UA), an antioxidant with neuroprotective effects, favorably affects stroke outcome. However, the effect has not been examined in patients treated with edaravone, a frequently used free radical scavenger. We investigated whether the use of edaravone affected the relationship between UA levels and outcome in acute ischemic stroke. METHODS: We retrospectively evaluated 1,114 consecutive ischemic stroke patients with premorbid modified Rankin Scale (mRS) scores <2 admitted within 24 h of onset (mean, 74 years; median UA levels, 333 μmol/L)...
March 20, 2018: Cerebrovascular Diseases
Jan Pawel Bembenek, Michal Adam Karlinski, Iwona Kurkowska-Jastrzebska, Anna Czlonkowska
We aimed to provide a descriptive analysis of embolic stroke of undetermined etiology (ESUS) population based on a long-term prospective stroke registry. We retrospectively analyzed data collected in a detailed registry regarding consecutive patients admitted for first-ever ischemic stroke (IS) between January 2001 and December 2015. We used Org 10172 in Acute Stroke Treatment classification supplemented with ESUS criteria proposed by the Cryptogenic Stroke/ESUS International Working Group. Within the ESUS group, we additionally compared patients ≤ 60 and > 60 years of age...
March 19, 2018: Neurological Sciences
Yuichiro Ohya, Noriko Makihara, Kayo Wakisaka, Takao Morita, Tetsuro Ago, Takanari Kitazono, Hitonori Takaba
Whether idarucizumab, an antidote of dabigatran, can be used effectively and safely before thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) in patients with stroke undergoing treatment with dabigatran remains unknown. We herein describe a 57-year-old man who developed severe cardioembolic stroke with a National Institutes of Health Stroke Scale score of 22 in the left middle cerebral artery territory while undergoing treatment with dabigatran for nonvalvular atrial fibrillation and who was treated with rt-PA after the reversal of dabigatran with idarucizumab...
March 16, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Charlotte Spicher, Ruth Schneider, Peter Mönnings, Christiane Schneider-Gold, Dennis Kallenberg, Bilal Cevik, Carsten Lukas, Ralf Gold, Christos Krogias
Background: Duchenne muscular dystrophy (DMD) is an X-linked recessive skeletal muscle myopathy which is caused by mutations in the dystrophin gene. Lack of dystrophin also results to cardiomyopathy, which raises significantly the stroke risk in DMD-patients. However, data about therapeutic opportunities in the acute setting are scarce in literature. So far, only two cases receiving IV thrombolysis are described, one of them with fatal outcome. Method: Case report of a case of successful mechanical thrombectomy (MTE) in an acute ischemic stroke (AIS) patient with DMD and associated dilatative cardiomyopathy...
2018: Therapeutic Advances in Neurological Disorders
Yamaan S Saadeh, Luis E Savastano, Julian L Gendreau, Aditya S Pandey
Optimal management of patients with stroke due to symptomatic carotid artery disease coexistent with bacterial endocarditis is still not well established. We report the case of a patient who presented with multifocal left middle cerebral artery stroke in the setting of Enterococcus faecalis endocarditis and was found to have near-occlusive ipsilateral carotid artery stenosis in stroke workup. Carotid artery endarterectomy was performed, and atheroma material demonstrated complicated plaque with cultures positive for E...
March 15, 2018: BMJ Case Reports
Gabriel DeVela, J Michael Taylor, Bin Zhang, Luke L Linscott, Alan M Chen, Kunal B Karani, Andrew Furthmiller, James L Leach, Sudhakar Vadivelu, Todd Abruzzo
BACKGROUND AND PURPOSE: Quantitative arterial tortuosity (QAT) is a ratio of vessel length between 2 points to the shortest linear distance between same points. QAT has been reported as an imaging biomarker of arteriopathy in pediatric arterial ischemic stroke (AIS) because of dissection and transient cerebral arteriopathy. We sought to determine whether QAT abnormalities are present in other subtypes of pediatric AIS. METHODS: Children with AIS-absent conventional biomarkers of arteriopathy and case-controls who underwent magnetic resonance angiography were classified by stroke mechanism...
March 14, 2018: Stroke; a Journal of Cerebral Circulation
Vinícius Viana Abreu Montanaro, Thiago Falcão Hora, Creuza Maria da Silva, Carla Verônica de Viana Santos, Maria Inacia Ruas Lima, Edson Marcio Negrão, Daniele Sebestyan Martins Ribeiro, Eleonora Maria de Jesus Oliveira, Gabriel R de Freitas
BACKGROUND: Chagas disease is related to ischemic stroke (IS), although few epidemiological studies have evaluated the associated mortality and recurrence. Our objective is to determine factors associated with mortality and recurrence of IS in patients with IS and Chagas disease. METHODS: We retrospectively studied data obtained from electronic medical records of patients admitted at SARAH Hospitals across Brazil between 2009 and 2013. Using Cox regression analysis for mortality and logistic regression for recurrence, we assessed primary population characteristics and statistical associations between risk factors and outcomes...
March 14, 2018: European Neurology
I Indurawa, E Amis, N Hannon, K Khadjooi
Background Atrial fibrillation is a major risk factor for ischaemic stroke. We investigated whether active screening for atrial fibrillation in secondary care, followed by careful evaluation of risk factors and communication to general practitioners from stroke specialists, could increase appropriate anticoagulation prescription. Methods Between 1/9/14 and 28/2/15 all acute medical admissions were screened for atrial fibrillation at Cambridge University Hospital. Individualised letters were sent to the general practitioners of patients who it was felt would benefit from anticoagulation...
December 2017: Journal of the Royal College of Physicians of Edinburgh
George Hindy, Gunnar Engström, Susanna C Larsson, Matthew Traylor, Hugh S Markus, Olle Melander, Marju Orho-Melander
BACKGROUND AND PURPOSE: Statin therapy is associated with a lower risk of ischemic stroke supporting a causal role of low-density lipoprotein (LDL) cholesterol. However, more evidence is needed to answer the question whether LDL cholesterol plays a causal role in ischemic stroke subtypes. In addition, it is unknown whether high-density lipoprotein cholesterol and triglycerides have a causal relationship to ischemic stroke and its subtypes. Our aim was to investigate the causal role of LDL cholesterol, high-density lipoprotein cholesterol, and triglycerides in ischemic stroke and its subtypes through Mendelian randomization (MR)...
March 13, 2018: Stroke; a Journal of Cerebral Circulation
Raffaele Ornello, Diana Degan, Cindy Tiseo, Caterina Di Carmine, Laura Perciballi, Francesca Pistoia, Antonio Carolei, Simona Sacco
BACKGROUND AND PURPOSE: Preventive strategies, together with demographic and socioeconomic changes, might have modified the worldwide distribution of ischemic stroke (IS) subtypes. We investigated those changes by means of a systematic review and meta-analysis. METHODS: We evaluated all population- and hospital-based studies reporting the distribution of IS etiologic subtypes according to the TOAST criteria (Trial of ORG 10172 in Acute Stroke Treatment). Studies were identified by searching articles indexed on PubMed and Scopus from January 1, 1993, to June 30, 2017...
March 13, 2018: Stroke; a Journal of Cerebral Circulation
David R Holmes, Robert S Schwartz, George G Latus, Robert A Van Tassel
A new era in antiembolic therapy has been initiated by the growing numbers of device-based therapies. Early concerns surrounding eliminating this enigmatic structure have not proven true. Other benefits are being further evaluated. Many other questions remain, such as whether there is a device-specific outcome effect or whether it is a class effect. Other questions include other devices, what head-to-head studies will show, and the impact of residual leak. Left atrial appendage using the Watchman ablation strategy can reduce cardioembolic stroke, with comparable or fewer adverse effects by device technology than obtained by long-term anticoagulation with its attendant bleeding risks...
April 2018: Interventional Cardiology Clinics
Kosuke Matsuzono, Masayuki Suzuki, Naoto Arai, Younhee Kim, Tadashi Ozawa, Takafumi Mashiko, Haruo Shimazaki, Reiji Koide, Shigeru Fujimoto
Some stroke patients with the acute aortic dissection receiving thrombolysis treatment resulted in fatalities. Thus, the concurrent acute aortic dissection is the contraindication for the intravenous recombinant tissue-type plasminogen activator. However, the safety and the effectiveness of the intravenous recombinant tissue-type plasminogen activator therapy are not known in patients with stroke some days after acute aortic dissection treatment. Here, we first report a case of a man with a cardioembolism due to the nonvalvular atrial fibrillation, who received the intravenous recombinant tissue-type plasminogen activator therapy 117 days after the traumatic Stanford type A acute aortic dissection operation...
March 7, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Chenglin Tian, Xiangyu Cao, Jun Wang
Various mechanisms underlie causative large artery occlusion (LAO) in patients with acute ischaemic stroke. Cardioembolic and atherosclerotic occlusions are the two most common types. The pathophysiological changes and responses to mechanical thrombectomy (MT) and antithrombotic treatments including thrombolysis, antiplatelet and anticoagulation therapy may vary among patients with different aetiological mechanisms of occlusion. Atherosclerotic occlusion is inclined to have relatively abundant collaterals and larger area of penumbra, hence a relatively wider time window for reperfusion therapy, while poor response to medical thrombolysis and MT...
December 2017: Stroke and Vascular Neurology
Juan Pablo Costabel, Enrique Galve, María Terricabras, Clara Ametrano, Ricardo Ronderos, Adrian Baranchuk, Arturo Evangelista, Gustavo Avegliano
INTRODUCTION: Atrial fibrillation (AF) occurs in about 20%-25% of patients with hypertrophic cardiomyopathy and is associated with increased risk of cardioembolism and heart failure impacting on patients' morbidity and mortality. The aim of this study was to identify echocardiographic predictors of AF in a cohort of patients with hypertrophic cardiomyopathy (HCM). METHODS: Patients were recruited from 2 centers: Buenos Aires Cardiovascular Institute and the Hospital Vall d'Hebron of Barcelona which were analyzed together...
March 5, 2018: Echocardiography
Limei Zhang, Yanhui Wu, Lili Qiu, Yanhong Liu, Qiang Li
BACKGROUND To determine whether the levels of b2-glycoprotein I (b2-GPI)/oxidized low-density lipoprotein (oxLDL) complexes are correlated with cerebral infarction in patients with type 2 diabetes mellitus (T2DM). MATERIAL AND METHODS The levels of β2-GPI/oxLDL complexes, oxLDL, routine lipid/lipoprotein parameters, oxidative stress molecules, and inflammatory factors were measured in 78 healthy controls, 82 diabetics without cerebral infarction, and 79 diabetics with cerebral infarction. Correlation, multiple linear regression, and logistic regression analyses were performed...
February 28, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Nilesh H Pawar, Oliver J Nickalls, Keng Leong Tan, Vui K Ho, Shin Yi Ng, Jiashen Loh
Streptococcus pneumoniae (S. pneumoniae) is a significant human bacterial pathogen and the major cause of pneumonia. In the post-antibiotic era, S. pneumoniae endocarditis is rare but carries a high risk of central nervous system (CNS) involvement. We present a case of invasive S. pneumoniae infection, which led to a cardioembolic stroke in a young man from septic emboli. Diagnosing a disseminated S. pneumoniae infection at an early stage is crucial and may improve patient outcomes.
December 18, 2017: Curēus
Chang Liu, Feina Shi, Zhicai Chen, Shenqiang Yan, Xinfa Ding, Min Lou
Background: Previous studies demonstrated that cardioembolism (CE) was prone to develop hemorrhagic transformation (HT), whereas hyper-permeability of blood-brain barrier (BBB) might be one reason for the development of HT. We, thus, aimed to investigate whether the BBB permeability (BBBP) was higher in CE stroke than other stroke subtypes in acute ischemic stroke (AIS) patients. Methods: This study was a retrospective review of prospectively collected clinical and imaging database of AIS patients who underwent CT perfusion...
2018: Frontiers in Neurology
Takehiko Nagao, Kazunori Toyoda, Kazuo Kitagawa, Takanari Kitazono, Hiroshi Yamagami, Shinichiro Uchiyama, Norio Tanahashi, Masayasu Matsumoto, Kazuo Minematsu, Izumi Nagata, Masakatsu Nishikawa, Shinsuke Nanto, Kenji Abe, Yasuo Ikeda, Akira Ogawa
BACKGROUND: This comparison of PRAsugrel and clopidogrel in Japanese patients with ischemic STROke (PRASTRO)-I trial investigates the noninferiority of prasugrel to clopidogrel sulfate in the prevention of recurrence of primary events (ischemic stroke, myocardial infarction, and death from other vascular causes), and the long-term safety of prasugrel in Japanese patients with non-cardioembolic stroke. RESEARCH DESIGN AND METHODS: This was an active-controlled, randomized, double-blind, double-dummy, parallel-group study conducted between July 2011 and March 2016 at multiple centers around Japan...
February 21, 2018: Expert Opinion on Pharmacotherapy
Jiang Jingwen, Jin Han, Zhang Yu, Huang Xiaojun, Zhuang Junpeng, Shen Fanxia, Liu Jianrong
OBJECTIVE: This study aimed to investigate the factors influencing the quality of life of in-hospital subacute stroke patients. METHODS: The patients of subacute stroke (within four weeks) in our institution between 2015 and 2016 were recruited. Patients' characteristics and QOL were obtained from medical charts and stroke-specific quality of life scale (SS-QOL). Associations of each domain in SS-QOL with socio-demographic, clinical factors and patient satisfaction were investigated using the linear regression models...
February 19, 2018: International Journal of Psychiatry in Clinical Practice
Philip K King, Trevor A Stump, Allyn M Walkama, Benjamin M Ash, Susana M Bowling
No abstract text is available yet for this article.
February 1, 2018: Annals of Pharmacotherapy
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