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hemorrhagic transformation ischemic stroke

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https://www.readbyqxmd.com/read/28975464/peroxynitrite-induced-tyrosine-nitration-contributes-to-matrix-metalloprotease-3-activation-relevance-to-hyperglycemic-ischemic-brain-injury-and-tissue-plasminogen-activator
#1
Sherif Hafez, Mohammed Abdelsaid, Susan C Fagan, Adviye Ergul
Matrix metalloprotease-3 (MMP3) activation mediates the tissue plasminogen activator (tPA)-induced hemorrhagic transformation after stroke. Hyperglycemia (HG) further exacerbates this outcome. We have recently shown that HG increases MMP3 activity in the brain after stroke. However, the combined HG-tPA effect on MMP3 activation, and the mechanisms through which MMP3 is activated were not previously reported. Accordingly, this study tested the hypothesis that tPA and HG increases MMP3 activity in the brain after stroke through peroxynitrite induced tyrosine nitration...
October 3, 2017: Neurochemical Research
https://www.readbyqxmd.com/read/28950737/hyper-attenuating-brain-lesions-on-ct-after-ischemic-stroke-and-thrombectomy-are-associated-with-final-brain-infarction
#2
F B Cabral, L H Castro-Afonso, G S Nakiri, L M Monsignore, Src Fábio, A C Dos Santos, O M Pontes-Neto, D G Abud
Purpose Hyper-attenuating lesions, or contrast staining, on a non-contrast brain computed tomography (NCCT) scan have been investigated as a predictor for hemorrhagic transformation after endovascular treatment of acute ischemic stroke (AIS). However, the association of hyper-attenuating lesions and final ischemic areas are poorly investigated in this setting. The aim of the present study was to assess correlations between hyper-attenuating lesions and final brain infarcted areas after thrombectomy for AIS...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28939303/early-partial-recanalization-after-intravenous-thrombolysis-leads-to-prediction-of-favorable-outcome-in-cases-of-acute-ischemic-stroke-with-major-vessel-occlusion
#3
Jun Young Chang, Hyun Park, Se Young Jang, Seunguk Jung, Hee-Joon Bae, O-Ki Kwon, Moon-Ku Han
We investigated the association between early recanalization degree after intravenous thrombolysis (IVT), occurrence of hemorrhagic transformation, and functional outcome. We also evaluated whether recombinant tissue plasminogen activator (rTPA) dosing error could influence the outcome. Patients with ischemic stroke with major vessel occlusion (n=256) who underwent IVT were included. Recanalization status (no recanalization, partial recanalization, and complete recanalization) was confirmed by subsequent magnetic resonance or conventional angiography...
September 19, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28934363/sex-related-differences-in-the-risk-factors-for-in-hospital-mortality-and-outcomes-of-ischemic-stroke-patients-in-rural-areas-of-taiwan
#4
Cheung-Ter Ong, Yi-Sin Wong, Sheng-Feng Sung, Chi-Shun Wu, Yung-Chu Hsu, Yu-Hsiang Su, Ling-Chien Hung
BACKGROUND AND PURPOSE: Sex-related differences in the clinical presentation and outcomes of stroke patients are issues that have attracted increased interest from the scientific community. The present study aimed to investigate sex-related differences in the risk factors for in-hospital mortality and outcome in ischemic stroke patients. METHODS: A total of 4278 acute ischemic stroke patients admitted to a stroke unit between January 1, 2007 and December 31, 2014 were included in the study...
2017: PloS One
https://www.readbyqxmd.com/read/28906581/is-there-a-benefit-of-mechanical-thrombectomy-in-patients-with-large-stroke-dwi-aspects-%C3%A2-5
#5
P-F Manceau, S Soize, M Gawlitza, G Fabre, S Bakchine, C Durot, I Serre, G-E Metaxas, L Pierot
BACKGROUND AND PURPOSE: Whether to withhold mechanical thrombectomy when the diffusion-weighted imaging (DWI) lesion exceeds a given volume is undetermined. Our aim was to identify markers that will help to select patients with large DWI lesions [DWI-Alberta Stroke Program Early Computed Tomography Score (DWI-ASPECTS) ≤ 5] that may benefit from thrombectomy. METHODS: From May 2010 to November 2016, 82 acute ischaemic stroke patients with DWI-ASPECTS ≤5 (43 men, 64...
September 14, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28892526/rivaroxaban-vs-warfarin-sodium-in-the-ultra-early-period-after-atrial-fibrillation-related-mild-ischemic-stroke-a-randomized-clinical-trial
#6
RANDOMIZED CONTROLLED TRIAL
Keun-Sik Hong, Sun U Kwon, Sang Hun Lee, Ji Sung Lee, Yong-Jae Kim, Tae-Jin Song, Young Dae Kim, Man-Seok Park, Eung-Gyu Kim, Jae-Kwan Cha, Sang Min Sung, Byung-Woo Yoon, Oh Young Bang, Woo-Keun Seo, Yang-Ha Hwang, Seong Hwan Ahn, Dong-Wha Kang, Hyun Goo Kang, Kyung-Ho Yu
Importance: In atrial fibrillation (AF)-related acute ischemic stroke, the optimal oral anticoagulation strategy remains unclear. Objective: To test whether rivaroxaban or warfarin sodium is safer and more effective for preventing early recurrent stroke in patients with AF-related acute ischemic stroke. Design, Setting, and Participants: A randomized, multicenter, open-label, blinded end point evaluation, comparative phase 2 trial was conducted from April 28, 2014, to December 7, 2015, at 14 academic medical centers in South Korea among patients with mild AF-related stroke within the previous 5 days who were deemed suitable for early anticoagulation...
October 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28882130/the-hemorrhagic-transformation-index-score-a-prediction-tool-in-middle-cerebral-artery-ischemic-stroke
#7
Mikhail N Kalinin, Dina R Khasanova, Murat M Ibatullin
BACKGROUND: We aimed to develop a tool, the hemorrhagic transformation (HT) index (HTI), to predict any HT within 14 days after middle cerebral artery (MCA) stroke onset regardless of the intravenous recombinant tissue plasminogen activator (IV rtPA) use. That is especially important in the light of missing evidence-based data concerning the timing of anticoagulant resumption after stroke in patients with atrial fibrillation (AF). METHODS: We retrospectively analyzed 783 consecutive MCA stroke patients...
September 7, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28881267/gamma-glutamyltransferase-and-cardiovascular-mortality-in-korean-adults-a-cohort-study
#8
Sang-Wook Yi, Sang-Hun Lee, Hee-Jin Hwang, Jee-Jeon Yi
BACKGROUND AND AIMS: Insufficient evidence has been reported on the associations between gamma-glutamyltransferase (GGT) and cardiovascular disease (CVD) mortality from studies with an adequate number of participants. METHODS: 512,990 Korean adults who participated in routine health examinations during the period 2002-2003 were followed up until 2013. Hazard ratios (HRs) were calculated after adjusting for potential confounders. RESULTS: Each 1-unit higher natural-log-transformed GGT (LogeGGT) level was associated with approximately 30-50% higher mortality risk of CVD (HR = 1...
August 26, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28836238/protective-effects-of-autologous-bone-marrow-mononuclear-cells-after-administering-t-pa-in-an-embolic-stroke-model
#9
Bing Yang, Weilang Li, Nikunj Satani, Duyen M Nghiem, XiaoPei Xi, Jaroslaw Aronowski, Sean I Savitz
Tissue plasminogen activator (t-PA) is the only FDA-approved drug for acute ischemic stroke but poses risk for hemorrhagic transformation (HT). Cell therapy has been investigated as a potential therapy to improve recovery after stroke by the modulation of inflammatory responses and the improvement of blood-brain barrier (BBB) integrity, both of which are associated with HT after t-PA. In our present study, we studied the effect of autologous bone marrow mononuclear cells (MNCs) in an embolic stroke model. We administered MNCs in a rat embolic stroke 2 h after administering t-PA...
August 23, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28830843/inhibition-of-tpa-induced-hemorrhagic-transformation-involves-adenosine-a2b-receptor-activation-after-cerebral-ischemia
#10
Qiang Li, Xiaoning Han, Xi Lan, Xiaohua Hong, Qian Li, Yufeng Gao, Tianqi Luo, Qingwu Yang, Raymond C Koehler, Yu Zhai, Jinyuan Zhou, Jian Wang
Tissue plasminogen activator (tPA) is administered after ischemic stroke to dissolve intravascular clots, but its use can lead to hemorrhagic transformation (HT). Therapeutic strategies to reduce hemorrhagic complications of tPA might be of benefit for stroke patients. Adenosine A2b receptor (A2bR) plays pivotal roles in regulating vascular protection in peripheral organs. This study explored whether A2bR agonist BAY 60-6583 reduces hemorrhage risk after tPA usage. Using a rat transient middle cerebral artery occlusion model, we showed that mRNA and protein expression of A2bR increased to a greater extent after ischemia-reperfusion than did expression of the other three adenosine receptors (A1, A2a, and A3)...
August 19, 2017: Neurobiology of Disease
https://www.readbyqxmd.com/read/28830290/emergent-loading-dose-of-antiplatelets-for-stenting-after-iv-rt-pa-in-acute-ischemic-stroke-a-feasibility-study
#11
Yun-Fei Han, Qi-Liang Dai, Xiang-Liang Chen, Yun-Yun Xiong, Qin-Yin, Ge-Lin Xu, Wu-Sheng Zhu, Ren-Liang Zhang, Min-Min Ma, Wen-Hua Liu, Xin-Feng Liu
BACKGROUND: A loading dose of antiplatelets reduces in-stent thrombosis after stent implantation. However, whether it is safe in patients undergoing acute stenting after intravenous recombinant tissue plasminogen activator (rt-PA) is unclear. METHODS: A case series of acute ischemic stroke patients treated with intravenous rt-PA followed by emergent stenting were prospectively included in Jinling Hospital Stroke Unit. An emergent loading dose of antiplatelets (aspirin 300mg and clopidogrel 300mg) were administered to all patients through a nasogastric tube immediately before stenting...
August 23, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28829216/leukoaraiosis-as-an-outcome-predictor-in-the-acute-and-subacute-phases-of-stroke
#12
Fabio Fierini, Anna Poggesi, Leonardo Pantoni
Leukoaraiosis (LA) is one of the neuroimaging features of cerebral small vessel disease and is associated with poor long-term prognosis. Areas covered: This narrative review focuses on the predictive role of LA on the evolution of the ischemic brain damage and on the clinical outcome in the subacute phase of stroke and in the short-term period afterwards. Expert commentary: LA predicts poorer tissue outcome and clinical prognosis also in acute and subacute stroke. In acute stroke, LA is associated with a less favorable fate of brain infarct and is a marker of increased risk of thrombolysis-related hemorrhagic transformation...
September 4, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28826584/prediction-of-symptomatic-intracranial-hemorrhage-after-intravenous-thrombolysis-in-acute-ischemic-stroke-the-symptomatic-intracranial-hemorrhage-score
#13
Thanin Lokeskrawee, Sombat Muengtaweepongsa, Jayanton Patumanond, Somsak Tiamkao, Thanoot Thamangraksat, Phanyarat Phankhian, Polchai Pleumpanupat, Paworamon Sribussara, Teeraparp Kitjavijit, Anake Supap, Weerawan Rattanaphibool, Jariya Prisiri
BACKGROUND: Symptomatic intracranial hemorrhage (sICH) is common after intravenous thrombolysis in acute ischemic strokes (AISs). Available predictive scoring systems were derived mostly in the Western countries. METHODS: Retrospective data in 1 provincial and 4 regional hospitals in the northern part of Thailand were reviewed. Patients with AIS, to whom recombinant tissue plasminogen activator (rt-PA) had been prescribed, were classified into 3 groups: no intracranial hemorrhage (no ICH), asymptomatic intracranial hemorrhage (asICH) and sICH...
November 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28798356/low-serum-albumin-level-as-a-predictor-of-hemorrhage-transformation-after-intravenous-thrombolysis-in-ischemic-stroke-patients
#14
Ruiwen Che, Xiaoqin Huang, Wenbo Zhao, Fang Jiang, Longfei Wu, Zhen Zhang, Tingting Bian, Qingfeng Ma, Zhipeng Yu, Qian Zhang, Kai Dong, Haiqing Song, Xunming Ji
Serum albumin levels has been shown to predict outcome in ischemic stroke patients. We aimed to investigate the relationship between serum albumin levels and hemorrhagic transformation (HT) after intravenous thrombolysis (IVT) in patients with acute stroke. 428 patients receiving intravenous rt-PA therapy were included from 2013 to 2016 and were categorized into two groups: low level (<35 mmol/L) and normal level (35-55 mmol/L) group. Demographic, clinical and laboratory information, HT and functional outcomes were analyzed...
August 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28797689/can-the-benefits-of-rtpa-treatment-for-stroke-be-improved
#15
REVIEW
D Vivien
Tissue-type plasminogen activator (tPA) is a serine protease well known to promote fibrinolysis. This is why: its recombinant form (rtPA) can be used, either alone or combined with thrombectomy, to promote recanalization/reperfusion following ischemic stroke. However, its overall benefits are counteracted by some of its side-effects, including incomplete lysis of clots, an increased risk of hemorrhagic transformation and the possibility of neurotoxicity. Nevertheless, better understanding of the mechanisms by which tPA influences brain function and promotes its alteration may help in the design of new strategies to improve stroke therapy...
August 7, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28794365/successful-delayed-aortic-surgery-for-a-patient-with-ischemic-stroke-secondary-to-aortic-dissection
#16
Ryuta Morihara, Toru Yamashita, Kentaro Deguchi, Keiichiro Tsunoda, Yasuhiro Manabe, Yoshiaki Takahashi, Taijun Yunoki, Kota Sato, Yumiko Nakano, Syoichiro Kono, Yasuyuki Ohta, Nozomi Hishikawa, Koji Abe
The diagnosis of aortic dissection (AD) is sometimes difficult within the limited time window of recombinant tissue plasminogen activator (tPA) for ischemic stroke (IS). A 60-year-old man developed sudden left hemiparesis due to IS. During tPA infusion, his blood pressure dropped and consciousness declined. After transfer to our hospital, carotid duplex ultrasonography led to a diagnosis of AD. Emergency surgery was postponed because of the risk of hemorrhagic transformation. The patient successfully underwent aortic surgery on day 5 and was discharged with a remarkable improvement in his symptoms...
September 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28775139/permeability-surface-of-deep-middle-cerebral-artery-territory-on-computed-tomographic-perfusion-predicts-hemorrhagic-transformation-after-stroke
#17
Qiao Li, Xinyi Gao, Zhenwei Yao, Xiaoyuan Feng, Huijin He, Jing Xue, Peiyi Gao, Lumeng Yang, Xin Cheng, Weijian Chen, Yunjun Yang
BACKGROUND AND PURPOSE: Permeability surface (PS) on computed tomographic perfusion reflects blood-brain barrier permeability and is related to hemorrhagic transformation (HT). HT of deep middle cerebral artery (MCA) territory can occur after recanalization of proximal large-vessel occlusion. We aimed to determine the relationship between HT and PS of deep MCA territory. METHODS: We retrospectively reviewed 70 consecutive acute ischemic stroke patients presenting with occlusion of the distal internal carotid artery or M1 segment of the MCA...
September 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28747037/increased-arterial-stiffness-is-an-independent-risk-factor-for-hemorrhagic-transformation-in-ischemic-stroke-undergoing-thrombolysis
#18
Maurizio Acampa, Silvia Camarri, Pietro Enea Lazzerini, Francesca Guideri, Rossana Tassi, Raffaella Valenti, Alessandra Cartocci, Giuseppe Martini
BACKGROUND: Hemorrhagic transformation (HT) is a multifactorial phenomenon and represents a possible complication of ischemic stroke, especially after thrombolytic treatment. Increased arterial stiffness has been associated with intracranial hemorrhage, but there is no evidence of association with HT after thrombolytic therapy. The aim of our study is to investigate a possible link between arterial stiffness and HT occurrence after thrombolytic therapy in patients with ischemic stroke...
September 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28726570/potential-biomarkers-for-predicting-hemorrhagic-transformation-of-ischemic-stroke
#19
Guanfeng Lu, Quanwei He, Yan Shen, Fei Cao
Reperfusion therapy contributes to better clinical outcomes in patients with acute ischemic stroke but carries a more significant risk of hemorrhagic transformation (HT) compared to supportive care. Once HT occurs, the outcome is usually poor and this causes a dilemma in the treatment of ischemic stroke. Consequently, early prediction of HT would be extremely helpful for guiding precise treatment of ischemic stroke. In this review, we focus on summarizing biomarkers of HT and elucidating possible mechanisms so as to identify potential biomarkers for predicting HT...
July 20, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28726167/early-increased-bradykinin-1-receptor-contributes-to-hemorrhagic-transformation-after-ischemic-stroke-in-type-1-diabetic-rats
#20
Hongfei Sang, Zhongming Qiu, Jin Cai, Wenya Lan, Linjie Yu, Hao Zhang, Min Li, Yi Xie, Ruibing Guo, Ruidong Ye, Xinfeng Liu, Ling Liu, Renliang Zhang
Hemorrhagic transformation (HT) is a major complication of ischemic stroke and further deteriorates neurological outcomes. Bradykinin 1 receptor (B1R) has been proven to mediate vasculo-toxicity in various experimental models. However, its role in the development of HT after stroke remains unclear. We detected the B1R expression in brain tissues with or without HT in a rat model of cerebral ischemia/reperfusion (I/R) with type 1 diabetes, showing higher B1R expression in the hemorrhagic areas than the ischemic tissues...
December 2017: Translational Stroke Research
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