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hemorrhagic transformation ischemic stroke

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https://www.readbyqxmd.com/read/29929036/evaluation-of-common-housekeeping-proteins-under-ischemic-conditions-and-or-rt-pa-treatment-in-bend-3-cells
#1
Pau Comajoan, Carme Gubern, Gemma Huguet, Joaquín Serena, Elisabet Kádár, Mar Castellanos
Thrombolysis with recombinant tissue plasminogen activator (rt-PA) is the only pharmacological approved treatment for ischemic stroke, despite its associated increasing risk of hemorrhagic transformation. Since many of rt-PA effects in blood-brain barrier (BBB) are not well characterized, the study of protein changes in BBB cells after rt-PA administration may help to understand its adverse effects. Our aim was to analyze protein levels of four commonly used housekeeping proteins: β-Actin, α-Tubulin, GAPDH and HPRT in bEnd...
June 18, 2018: Journal of Proteomics
https://www.readbyqxmd.com/read/29921716/acute-complement-inhibition-potentiates-neurorehabilitation-and-enhances-tpa-mediated-neuroprotection
#2
Ali Alawieh, Meredith Andersen, DeAnna L Adkins, Stephen Tomlinson
Since complement activation in the subacute or chronic phase after stroke was recently shown to stimulate neural plasticity, we investigated how complement activation and complement inhibition in the acute phase after murine stroke interacts with subsequent rehabilitation therapy to modulate neuroinflammation and neural remodeling. We additionally investigated how complement and complement inhibition interacts with tissue plasminogen activator (tPA), the other standard of care therapy for stroke, and an FDA preclinical requirement for translation of an experimental stroke therapy...
June 19, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29909558/blood-brain-barrier-permeability-assessed-by-perfusion-computed-tomography-predicts-hemorrhagic-transformation-in-acute-reperfusion-therapy
#3
Taewon Kim, Jaseong Koo, Seong-Hoon Kim, In-Uk Song, Sung-Woo Chung, Kwang-Soo Lee
Hemorrhagic transformation (HT) is one of the most feared complications of acute recanalization therapies. The aim of this study was to evaluate whether blood-brain barrier permeability (BBBP) imaging can predict HT in the setting of acute recanalization therapy and to determine the sensitivity and specificity of BBBP for the prediction of HT according to the type of reperfusion therapy. We assessed a total of 46 patients who received recanalization therapy (intravenous (IV) recombinant tissue plasminogen activator (tPA), mechanical thrombectomy with a stent retriever or both) for acute ischemic stroke within the internal carotid artery or middle cerebral artery...
June 16, 2018: Neurological Sciences
https://www.readbyqxmd.com/read/29909454/inhibition-of-toll-like-receptor-4-tlr-4-improves-neurobehavioral-outcomes-after-acute-ischemic-stroke-in-diabetic-rats-possible-role-of-vascular-endothelial-tlr-4
#4
Yasir Abdul, Mohammed Abdelsaid, Weiguo Li, R Clinton Webb, Jennifer C Sullivan, Guangkuo Dong, Adviye Ergul
Diabetes increases the risk of occurrence and poor functional recovery after ischemic stroke injury. Previously, we have demonstrated greater hemorrhagic transformation (HT), edema, and more severe functional deficits after stroke in diabetic animals that also presented with cerebral vasoregression and endothelial cell death in the recovery period. Given that Toll-like receptor 4 (TLR-4) activation in microvascular endothelial cells triggers a robust inflammatory response, we hypothesized that inhibition of TLR-4 signaling prevents endothelial cell death and improves outcomes after stroke...
June 16, 2018: Molecular Neurobiology
https://www.readbyqxmd.com/read/29903733/t-cells-prevent-hemorrhagic-transformation-in-ischemic-stroke-by-p-selectin-binding
#5
Angélica Salas-Perdomo, Francesc Miró-Mur, Xabier Urra, Carles Justicia, Mattia Gallizioli, Yashu Zhao, Vanessa H Brait, Carlos Laredo, Raúl Tudela, Andrés Hidalgo, Ángel Chamorro, Anna M Planas
OBJECTIVE: Hemorrhagic transformation is a serious complication of ischemic stroke after recanalization therapies. This study aims to identify mechanisms underlying hemorrhagic transformation after cerebral ischemia/reperfusion. APPROACH AND RESULTS: We used wild-type mice and Selplg-/- and Fut7-/- mice defective in P-selectin binding and lymphopenic Rag2-/- mice. We induced 30-minute or 45-minute ischemia by intraluminal occlusion of the middle cerebral artery and assessed hemorrhagic transformation at 48 hours with a hemorrhage grading score, histological means, brain hemoglobin content, or magnetic resonance imaging...
June 14, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/29895534/neurologic-outcome-predictors-in-pediatric-intracerebral-hemorrhage-a-prospective-study
#6
Giulia S Porcari, Lauren A Beslow, Rebecca N Ichord, Daniel J Licht, Jonathan T Kleinman, Lori C Jordan
BACKGROUND AND PURPOSE: Intracerebral hemorrhage is a considerable source of morbidity and mortality. This 3-center study describes outcomes of pediatric intracerebral hemorrhage and identifies 2-year neurological outcome predictors. METHODS: Children 29 days to 18 years of age presenting with intracerebral hemorrhage from March 2007 to May 2015 were enrolled prospectively. Exclusion criteria included trauma; intracranial tumor; hemorrhagic transformation of arterial ischemic stroke or cerebral sinovenous thrombosis; isolated subdural, epidural, or subarachnoid hemorrhage; and abnormal baseline neurological function...
June 12, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29857523/extension-of-tissue-plasminogen-activator-treatment-window-by-granulocyte-colony-stimulating-factor-in-a-thromboembolic-rat-model-of-stroke
#7
Ike C Dela Peña, Samuel Yang, Guofang Shen, Hsiao Fang Liang, Sara Solak, Cesar V Borlongan
When given beyond 4.5 h of stroke onset, tissue plasminogen activator (tPA) induces deleterious side effects in the ischemic brain, notably, hemorrhagic transformation (HT). We examined the efficacy of granulocyte-colony stimulating factor (G-CSF) in reducing delayed tPA-induced HT, cerebral infarction, and neurological deficits in a thromboembolic (TE) stroke model, and whether the effects of G-CSF were sustained for longer periods of recovery. After stroke induction, rats were given intravenous saline (control), tPA (10 mg/kg), or G-CSF (300 μg/kg) + tPA 6 h after stroke...
May 31, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29850586/pinocembrin-protects-blood-brain-barrier-function-and-expands-the-therapeutic-time-window-for-tissue-type-plasminogen-activator-treatment-in-a-rat-thromboembolic-stroke-model
#8
YinZhong Ma, Li Li, LingLei Kong, ZhiMei Zhu, Wen Zhang, JunKe Song, Junlei Chang, GuanHua Du
Tissue-type plasminogen activator (t-PA) remains the only approved therapy for acute ischemic stroke but has a restrictive treatment time window of 4.5 hr. Prolonged ischemia causes blood-brain barrier (BBB) damage and increases the incidence of hemorrhagic transformation (HT) secondary to reperfusion. In this study, we sought to determine the effect of pinocembrin (PCB; a pleiotropic neuroprotective agent) on t-PA administration-induced BBB damage in a novel rat thromboembolic stroke model. By assessing the leakage of Evans blue into the ischemic hemisphere, we demonstrated that PCB pretreatment 5 min before t-PA administration significantly reduced BBB damage following 2 hr, 4 hr, 6 hr, and even 8 hr ischemia...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29804167/serum-magnesium-but-not-calcium-was-associated-with-hemorrhagic-transformation-in-stroke-overall-and-stroke-subtypes-a-case-control-study-in-china
#9
Ge Tan, Ruozhen Yuan, ChenChen Wei, Mangmang Xu, Ming Liu
Association between serum calcium and magnesium versus hemorrhagic transformation (HT) remains to be identified. A total of 1212 non-thrombolysis patients with serum calcium and magnesium collected within 24 h from stroke onset were enrolled. Backward stepwise multivariate logistic regression analysis was conducted to investigate association between calcium and magnesium versus HT. Calcium and magnesium were entered into logistic regression analysis in two models, separately: model 1, as continuous variable (per 1-mmol/L increase), and model 2, as four-categorized variable (being collapsed into quartiles)...
May 26, 2018: Neurological Sciences
https://www.readbyqxmd.com/read/29798982/-the-efficacy-of-systemic-thrombolysis-in-patients-with-cardioembolic-stroke
#10
S V Kotov, E V Isakova, Yu A Belova, A V Zmislinskiy, I G Kolchu, M V Kucheryavaya, Ya A Pustinnikov, L V Smetana, V V Sashin, N P Chernih
AIM: To compare the efficacy and safety of systemic thrombolytic therapy (STLT) in patients with cardioembolic stroke (CE) versus other pathogenic subtypes of ischemic stroke (IS). MATERIAL AND METHODS: The study included 147 patients, 62 women and 85 men (mean age - 62.9±0.8 years) including 37 patients (25.2%) with CE subtype of IS (group 1) and 110 patients with other pathogenetic subtypes of IS (group 2). NIHSS and Rankin scale were used to assess patient's neurological status...
2018: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/29795667/phosphorylated-recombinant-hsp27-protects-the-brain-and-attenuates-blood-brain-barrier-disruption-following-stroke-in-mice-receiving-intravenous-tissue-plasminogen-activator
#11
Yoshiaki Shimada, Hideki Shimura, Ryota Tanaka, Kazuo Yamashiro, Masato Koike, Yasuo Uchiyama, Takao Urabe, Nobutaka Hattori
Loss of integrity of the blood-brain barrier (BBB) in ischemic stroke victims initiates a devastating cascade of events causing brain damage. Maintaining the BBB is important to preserve brain function in ischemic stroke. Unfortunately, recombinant tissue plasminogen activator (tPA), the only effective fibrinolytic treatment at the acute stage of ischemic stroke, also injures the BBB and increases the risk of brain edema and secondary hemorrhagic transformation. Thus, it is important to identify compounds that maintain BBB integrity in the face of ischemic injury in patients with stroke...
2018: PloS One
https://www.readbyqxmd.com/read/29792264/paradoxical-brain-embolism-shadowing-massive-pulmonary-embolism
#12
François Bagate, Alexandre Bedet, Armand Mekontso Dessap, Guillaume Carteaux
Patent foramen ovale is frequently observed in the general population. In case of massive pulmonary embolism, the sudden increase in the right heart cavity's pressure may cause a right-to-left shunting across this foramen, which could be associated with conflicting outcomes. Herein, we report a case of reversible cardiac arrest preceded by seizures, and followed by hemodynamic stability without any vasopressor. A brain CT-scan showed a limited ischemic stroke. Initial echocardiographic assessment revealed an acute cor pulmonale and a right-to-left intracardiac shunt across a large patent foramen ovale, suggesting the diagnosis of massive pulmonary embolism that was lately confirmed by a multidetector CT-angiography...
May 20, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29785667/cerebral-autoregulation-in-stroke
#13
REVIEW
Pedro Castro, Elsa Azevedo, Farzaneh Sorond
PURPOSE OF REVIEW: Cerebral autoregulation (CA) is a mechanism that maintains cerebral blood flow constant despite fluctuations in systemic arterial blood pressure. This review will focus on recent studies that measured CA non-invasively in acute cerebrovascular events, a feature unique to the transcranial Doppler ultrasound. We will summarize the rationale for CA assessment in acute cerebrovascular disorders and specifically evaluate the existing data on the value of CA measures in relation to clinical severity, guiding management decisions, and prognostication...
May 21, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29785469/early-detection-of-cerebral-infarction-after-focal-ischemia-using-a-new-mri-indicator
#14
Yukako Nakajo, Qiang Zhao, Jun-Ichiro Enmi, Hidehiro Iida, Jun C Takahashi, Hiroharu Kataoka, Keiko Yamato, Hiroji Yanamoto
Prolongation of the T2 relaxation time, an increase in T2-weighted signal intensity (T2-SI), and a decrease in the apparent diffusion coefficient (ADC) calculated from diffusion-weighted images (DWI) on magnetic resonance imaging (MRI) are conventional indicators of the vasogenic (interstitial) or cytotoxic (cellular) cerebral edema that develops after ischemic stroke. However, these parameters obtained on stroke imaging have not given us a precise threshold at which we can determine the viability or vulnerability of the tissue, allowing us to decide on an intervention that will help reversible tissue in the acute phase...
May 21, 2018: Molecular Neurobiology
https://www.readbyqxmd.com/read/29778315/the-risk-of-hemorrhagic-transformation-after-thrombolysis-for-acute-ischemic-stroke-in-chinese-versus-north-americans-a-comparative-study
#15
Xiaomeng Xu, Deren Wang, Fang Wang, Casey Norton, Xinfeng Liu, Magdy Selim
BACKGROUND: There is a widespread belief that Asians are more susceptible to hemorrhagic transformation (HT) after receiving recombinant tissue-type plasminogen activator (rt-PA) for acute ischemic stroke (AIS). However, this has not been examined in clinical practice. This study aims to compare the incidence of symptomatic hemorrhagic transformation (SHT) among thrombolysis-treated AIS patients in China and in the United States. METHODS: We compared 212 consecutive patients receiving thrombolysis within 4...
May 16, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29770166/free-radical-damage-in-ischemia-reperfusion-injury-an-obstacle-in-acute-ischemic-stroke-after-revascularization-therapy
#16
REVIEW
Ming-Shuo Sun, Hang Jin, Xin Sun, Shuo Huang, Fu-Liang Zhang, Zhen-Ni Guo, Yi Yang
Acute ischemic stroke is a common cause of morbidity and mortality worldwide. Thrombolysis with recombinant tissue plasminogen activator and endovascular thrombectomy are the main revascularization therapies for acute ischemic stroke. However, ischemia-reperfusion injury after revascularization therapy can result in worsening outcomes. Among all possible pathological mechanisms of ischemia-reperfusion injury, free radical damage (mainly oxidative/nitrosative stress injury) has been found to play a key role in the process...
2018: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29753622/acute-ischemic-dissection-of-an-s-shaped-carotid-artery-the-one-stop-value-of-using-a-detachable-solitaire-ab-stent
#17
Hongchao Shi, Jiankang Hou, Wanyin Shi, Jianping Gu
This study aimed to evaluate the efficacy and safety of endovascular repair using detachable Solitaire AB stents for acute ischemic dissection of "S"-shaped carotid arteries. From May 2015 to December 2016, a total of 127 patients with acute ischemic stroke (AIS) underwent endovascular treatment in our center. Among them, five AISs were due to acute dissection of an "S"-shaped carotid artery. Coexisting carotid embolism was identified in all five patients, who first underwent successful Solitaire AB stent-based retrieval of the embolism...
May 9, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29752550/aging-alters-the-immunological-response-to-ischemic-stroke
#18
Rodney M Ritzel, Yun-Ju Lai, Joshua D Crapser, Anita R Patel, Anna Schrecengost, Jeremy M Grenier, Nickolas S Mancini, Anthony Patrizz, Evan R Jellison, Diego Morales-Scheihing, Venugopal R Venna, Julia K Kofler, Fudong Liu, Rajkumar Verma, Louise D McCullough
The peripheral immune system plays a critical role in aging and in the response to brain injury. Emerging data suggest inflammatory responses are exacerbated in older animals following ischemic stroke; however, our understanding of these age-related changes is poor. In this work, we demonstrate marked differences in the composition of circulating and infiltrating leukocytes recruited to the ischemic brain of old male mice after stroke compared to young male mice. Blood neutrophilia and neutrophil invasion into the brain were increased in aged animals...
May 11, 2018: Acta Neuropathologica
https://www.readbyqxmd.com/read/29744447/in-vivo-evaluation-of-urokinase-loaded-hollow-nanogels-for-sonothrombolysis-on-suture-embolization-induced-acute-ischemic-stroke-rat-model
#19
Yuming Teng, Haiqiang Jin, Ding Nan, Mengnan Li, Chenghe Fan, Yuanyuan Liu, Pu Lv, Wei Cui, Yongan Sun, Hongjun Hao, Xiaozhong Qu, Zhenzhong Yang, Yining Huang
The urokinase-type plasminogen activator (uPA) loaded hollow nanogels (nUK) were synthesized by a one-step reaction of glycol chitosan and aldehyde capped poly (ethylene oxide). The resultant formulation is sensitive to diagnostic ultrasound (US) of 2 MHz. Herein, we evaluated the in vivo sonothrombolysis performance of the nUK on acute ischemic stroke rat model which was established by suture embolization of middle cerebral artery (MCA). Via intravenous (i.v.) administration, the experimental data prove a controlled release of the therapeutic protein around the clots under ultrasound stimulation, leading to enhanced thrombolysis efficiency of the nUK, evidenced from smaller infarct volume and better clinical scores when compared to the i...
March 2018: Bioactive Materials
https://www.readbyqxmd.com/read/29743683/rivaroxaban-does-not-influence-hemorrhagic-transformation-in-a-diabetes-ischemic-stroke-and-endovascular-thrombectomy-model
#20
Feng-Di Liu, Rong Zhao, Xiao-Yan Feng, Yan-Hui Shi, Yi-Lan Wu, Xiao-Lei Shen, Ge-Fei Li, Yi-Sheng Liu, Ying Zhao, Xin-Wei He, Jia-Wen Yin, Mei-Ting Zhuang, Bing-Qiao Zhao, Jian-Ren Liu
Managing endovascular thrombectomy (ET) in diabetic ischemic stroke (IS) with novel anticoagulants is challenging due to putative risk of intracerebral hemorrhage. The study evaluates increased hemorrhagic transformation (HT) risk in Rivaroxaban-treated diabetic rats post ET. Diabetes was induced in male Sprague-Dawley rats by intraperitoneal injection of 60 mg/kg streptozotocin. After 4-weeks, rats were pretreated orally with 30 mg/kg Rivaroxaban/saline; prothrombin time was monitored. IS and ET was induced after 1 h, by thread-induced transient middle cerebral artery occlusion (tMCAO) that mimicked mechanical ET for proximal MCA occlusion at 60 min...
May 9, 2018: Scientific Reports
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