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hemorrhagic transformation ischemic stroke

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https://www.readbyqxmd.com/read/29433932/racial-and-ethnic-disparities-in-hospital-mortality-among-ischemic-stroke-patients-in-hawaii
#1
Trevor R Ideta, Eunjung Lim, Kazuma Nakagawa, Matthew A Koenig
BACKGROUND: We evaluated disparities in in-hospital mortality rates among whites, Native Hawaiians and other Pacific Islanders (NHOPI), Filipinos, and other Asian groups in Hawaii who were hospitalized for acute ischemic stroke. MATERIALS AND METHODS: Using a statewide hospital claims database, we performed a retrospective study including sequential acute ischemic stroke patients between 2010 and 2015. We compared in-hospital mortality rates among whites, NHOPI, Filipinos, other Asian groups excluding Filipinos, and other races (Blacks, Hispanics, Native Americans, mixed race)...
February 9, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29431886/impact-of-anemia-on-in-hospital-complications-after-ischemic-stroke
#2
Chen-Chen Wei, Shu-Ting Zhang, Ge Tan, Shi-Hong Zhang, Ming Liu
BACKGROUND: In-hospital complications after stroke represent barriers of optimal recovery and are even potentially life-threatening. Anemia is common in stroke patients and is related to poor outcome after stroke. Less is known, however, of the association of anemia with complications. We aimed to investigate the impact of anemia on a series of in-hospital complications after ischemic stroke. METHODS: Consecutive patients with ischemic stroke within 7 days were included...
February 12, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29406889/endothelial-progenitor-cells-influence-acute-and-subacute-stroke-hemodynamics
#3
João Sargento-Freitas, Sezin Aday, César Nunes, Miguel Cordeiro, Ana Gouveia, Fernando Silva, Cristina Machado, Bruno Rodrigues, Gustavo Cordeiro Santo, Carlos Ferreira, Miguel Castelo-Branco, Lino Ferreira, Luís Cunha
BACKGROUND: Endothelial Progenitor Cells (EPCs) are a circulating stem cell population with in vivo capacity of promoting angiogenesis after ischemic events. Despite the promising preclinical data, their potential integration with reperfusion therapies and hemodynamic evolution of stroke patients is still unknown. Our aim was to determine the association of EPCs with acute, subacute and chronic hemodynamic features. METHODS: In this prospective study, we included consecutive patients with ages between 18 and 80years and non-lacunar ischemic stroke within the territory of a middle cerebral artery...
February 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29402765/computed-tomography-perfusion-derived-blood-brain-barrier-permeability-does-not-yet-improve-prediction-of-hemorrhagic-transformation
#4
Alexander D Horsch, Edwin Bennink, Tom van Seeters, L Jaap Kappelle, Yolanda van der Graaf, Willem P T M Mali, Hugo W A M de Jong, Birgitta K Velthuis, Jan Willem Dankbaar
INTRODUCTION: Hemorrhagic transformation (HT) in acute ischemic stroke can occur as a result of reperfusion treatment. While withholding treatment may be warranted in patients with increased risk of HT, prediction of HT remains difficult. Nonlinear regression analysis can be used to estimate blood-brain barrier permeability (BBBP). The aim of this study was to identify a combination of clinical and imaging variables, including BBBP estimations, that can predict HT. MATERIALS AND METHODS: From the Dutch acute stroke study, 545 patients treated with intravenous recombinant tissue plasminogen activator and/or intra-arterial treatment were selected, with available admission extended computed tomography (CT) perfusion and follow-up imaging...
January 8, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29399044/correlation-of-hyperglycemia-with-mortality-after-acute-ischemic-stroke
#5
Donghua Mi, Pingli Wang, Bo Yang, Yuehua Pu, Zhonghua Yang, Liping Liu
Background: Hyperglycemia has been considered a predictor of stroke outcomes. In this article we study the correlation between blood glucose levels within the first 24 h after stroke onset and patients' outcomes in mortality and hemorrhagic transformations. Methods: Ninety-one non-diabetic patients with acute ischemic stroke admitted to a neurological intensive unit were recruited. Their blood glucose was measured twice within 6 h (baseline) and at every hour after stroke onset...
2018: Therapeutic Advances in Neurological Disorders
https://www.readbyqxmd.com/read/29398533/cerebral-microbleeds-are-an-independent-predictor-of-hemorrhagic-transformation-following-intravenous-alteplase-administration-in-acute-ischemic-stroke
#6
Nandakumar Nagaraja, Nudrat Tasneem, Amir Shaban, Sudeepta Dandapat, Uzair Ahmed, Bruno Policeni, Heena Olalde, Hyungsub Shim, Edgar A Samaniego, Connie Pieper, Santiago Ortega-Gutierrez, Enrique C Leira, Harold P Adams
BACKGROUND AND PURPOSE: Intravenous alteplase (rt-PA) increases the risk of hemorrhagic transformation of acute ischemic stroke. The objective of our study was to evaluate clinical, laboratory, and imaging predictors on forecasting the risk of hemorrhagic transformation following treatment with rt-PA. We also evaluated the factors associated with cerebral microbleeds that increase the risk of hemorrhagic transformation. METHODS: Consecutive patients with acute ischemic stroke admitted between January 1, 2009 and December 31, 2013 were included in the study if they received IV rt-PA, had magnetic resonance imaging (MRI) of the brain on admission, and computed tomography or MRI of the brain at 24 (18-36) hours later to evaluate for the presence of hemorrhagic transformation...
February 2, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29390574/a-case-report-of-parenchymal-hematoma-after-intravenous-thrombolysis-in-a-rivaroxaban-treated-patient-is-it-a-true-rivaroxaban-hemorrhagic-complication
#7
Eugenia Rota, Gianluca Bruzzone, Sergio Agosti, Roberto Pastorino, Nicola Morelli
RATIONALE: To date, the only treatment approved for acute ischemic strokes is thrombolysis. Whether intravenous thrombolysis may be safe in patients taking direct oral anticoagulants (DOACs) is currently a matter of debate. PATIENT CONCERNS: A 74-year-old woman, who was on rivaroxaban 20 mg/d for nonvalvular atrial fibrillation, was admitted to our stroke unit with left-sided hemiparesis and aphasia. The onset of neurologic deficits had occurred 5 hours after the last rivaroxaban dose...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29288496/cha2-ds2-vasc-scores-for-outcomes-prediction-in-acute-ischemic-stroke
#8
Chun-Hung Su, Teng-Fu Tsao, An-Chih Chen, Kai-Wei Chang, Yi-Sun Yang, Kwo-Chang Ueng, Chin-Feng Tsai
BACKGROUND: The CHADS2 and CHA2 DS2 -VASc scores are clinical risk stratification instruments that are used clinically to assess the risk of stroke in patients with atrial fibrillation (AF). The aim of this study was to evaluate whether the pre-stroke CHADS2 and CHA2 DS2 -VASc scores could be useful for predicting infarction severity and long-term outcomes in patients of acute ischemic stroke. MATERIALS AND METHODS: This prospective study included all 1494 patients who had acute ischemic stroke without hemorrhagic transformation which were evidenced with magnetic resonance (MR) imaging during hospitalization...
December 29, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29288487/association-between-hemorrhagic-transformation-after-endovascular-therapy-and-poststroke-seizures
#9
Arthur Thevathasan, Jillian Naylor, Leonid Churilov, Peter J Mitchell, Richard J Dowling, Bernard Yan, Patrick Kwan
OBJECTIVE: Endovascular therapy has recently become standard therapy for select patients with acute ischemic stroke. Infarcted brain tissue may undergo hemorrhagic transformation (HT) after endovascular therapy. We investigated the association between HT and occurrence of poststroke seizures in patients treated with endovascular therapy. METHODS: Consecutive patients treated with endovascular therapy for acute anterior circulation ischemic stroke were included. HT was assessed with computed tomography/magnetic resonance imaging (CT/MRI) at 24 h after stroke onset...
December 30, 2017: Epilepsia
https://www.readbyqxmd.com/read/29288062/the-degree-of-leukoaraiosis-predicts-clinical-outcomes-and-prognosis-in-patients-with-middle-cerebral-artery-occlusion-after-intravenous-thrombolysis
#10
Yanyan Liu, Min Zhang, Yuan Chen, Ping Gao, Wenwei Yun, Xianju Zhou
Leukoaraiosis (LA) is common in elderly patients with ischemic stroke on magnetic resonance imaging. In this study, we investigate whether the degree of LA is associated with clinical outcomes and prognosis of patients with middle cerebral artery occlusion following intravenous thrombolytic. Ninety-seven patients were recruited and divided into three groups based on the degree of LA (no, mild and moderate to severe LA) by the Fazekas scale. Clinical outcomes, recurrent stroke, Fugl-Meyer rating scale (FMS) and complications of intravenous thrombolysis were assessed...
December 26, 2017: Brain Research
https://www.readbyqxmd.com/read/29277912/a-hemorrhagic-transformation-model-of-mechanical-stroke-therapy-with-acute-hyperglycemia-in-mice
#11
David Couret, Steeve Bourane, Aurélie Catan, Brice Nativel, Cynthia Planesse, Anne-Claire Dorsemans, Imade Ait-Arsa, Maxime Cournot, Philippe Rondeau, Jessica Patche, Alexy Tran-Dinh, Gilles Lambert, Nicolas Diotel, Olivier Meilhac
Clinical benefit for mechanical thrombectomy (MT) in stroke was recently demonstrated in multiple large prospective studies. Acute hyperglycemia (HG) is an important risk factor of poor outcome in stroke patients, including those that underwent MT. The aim of this therapy is to achieve a complete reperfusion in a short time, given that reperfusion damage is dependent on the duration of ischemia. Here, we investigated the effects of acute HG in a mouse model of ischemic stroke induced by middle cerebral artery occlusion (MCAO)...
December 26, 2017: Journal of Comparative Neurology
https://www.readbyqxmd.com/read/29275501/baicalin-attenuates-blood-brain-barrier-disruption-and-hemorrhagic-transformation-and-improves-neurological-outcome-in-ischemic-stroke-rats-with-delayed-t-pa-treatment-involvement-of-onoo-mmp-9-pathway
#12
Hansen Chen, Binghe Guan, Xi Chen, Xingmiao Chen, Caiming Li, Jinhua Qiu, Dan Yang, Ke Jian Liu, Suhua Qi, Jiangang Shen
Tissue plasminogen activator (t-PA) has a restrictive therapeutic window within 4.5 h after ischemic stroke with the risk of hemorrhagic transformation (HT) and neurotoxicity when it is used beyond the time window. In the present study, we tested the hypothesis that baicalin, an active compound of medicinal plant, could attenuate HT in cerebral ischemia stroke with delayed t-PA treatment. Male Sprague-Dawley rats were subjected to middle cerebral artery occlusion (MCAO) for 4.5 h and then continuously received t-PA infusion (10 mg/kg) for 0...
December 23, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/29273597/intravenous-thrombolysis-for-stroke-and-presumed-stroke-in-human-immunodeficiency-virus-infected-adults-a-retrospective-multicenter-us-study
#13
Mahmoud A AbdelRazek, Jose Gutierrez, David Mampre, Anna Cervantes-Arslanian, Cora Ormseth, Diogo Haussen, Kiran T Thakur, Jennifer L Lyons, Bryan R Smith, Owen O'Connor, Joshua Z Willey, Farrah J Mateen
BACKGROUND AND PURPOSE: Human immunodeficiency virus (HIV) infection has been shown to increase both ischemic and hemorrhagic stroke risks, but there are limited data on the safety and outcomes of intravenous thrombolysis with tPA (tissue-type plasminogen activator) for acute ischemic stroke in HIV-infected patients. METHODS: A retrospective chart review of intravenous tPA-treated HIV patients who presented with acute stroke symptoms was performed in 7 large inner-city US academic centers (various search years between 2000 and 2017)...
January 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29246591/the-effect-of-metabolic-syndrome-and-obesity-on-outcomes-of-acute-ischemic-stroke-patients-treated-with-systemic-thrombolysis
#14
Demet Funda Bas, Atilla Ozcan Ozdemir
Metabolic syndrome (MetS) is associated with increased risk of ischemic stroke; while central obesity has controversial effects on ischemic stroke. We investigated effects of MetS and obesity on clinical courses and outcomes of patients treated with intravenous recombinant tissue-type plasminogen activator (iv rt-PA). 319 patients treated with intravenous thrombolysis were included to our study. Metabolic syndrome was determined if ≥3 of following criteria are present: elevated waist circumference; elevated triglycerides; reduced high density-lipoprotein cholesterol (HDL-C); elevated blood pressure; elevated fasting glucose...
December 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29242362/feasibility-of-permanent-stenting-with-solitaire-fr-as-a-rescue-treatment-for-the-reperfusion-of-acute-intracranial-artery-occlusion
#15
H G Woo, L Sunwoo, C Jung, B J Kim, M-K Han, H-J Bae, Y J Bae, B S Choi, J H Kim
BACKGROUND AND PURPOSE: The Solitaire FR can be used not only as a tool for mechanical thrombectomy but also as a detachable permanent stent. Our aim was to assess the feasibility and safety of permanent stent placement with the Solitaire FR compared with other self-expanding stents for intracranial artery recanalization for acute ischemic stroke. MATERIALS AND METHODS: From January 2011 through January 2016, we retrospectively selected 2979 patients with acute ischemic stroke...
December 14, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29232823/improving-cerebral-blood-flow-after-arterial-recanalization-a-novel-therapeutic-strategy-in-stroke
#16
REVIEW
Mohamad El Amki, Susanne Wegener
Ischemic stroke is caused by a disruption in blood supply to a region of the brain. It induces dysfunction of brain cells and networks, resulting in sudden neurological deficits. The cause of stroke is vascular, but the consequences are neurological. Decades of research have focused on finding new strategies to reduce the neural damage after cerebral ischemia. However, despite the incredibly huge investment, all strategies targeting neuroprotection have failed to demonstrate clinical efficacy. Today, treatment for stroke consists of dealing with the cause, attempting to remove the occluding blood clot and recanalize the vessel...
December 9, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29217457/focusing-on-claudin-5-a-promising-candidate-in-the-regulation-of-bbb-to-treat-ischemic-stroke
#17
REVIEW
Jianjun Lv, Wei Hu, Zhi Yang, Tian Li, Shuai Jiang, Zhiqiang Ma, Fulin Chen, Yang Yang
Claudin-5 is a tight junction (TJ) protein in the blood-brain barrier (BBB) that has recently attracted increased attention. Numerous studies have demonstrated that claudin-5 regulates the integrity and permeability of the BBB. Increased claudin-5 expression plays a neuroprotective role in neurological diseases, particularly in cerebral ischemic stroke. Moreover, claudin-5 might be a potential marker for early hemorrhagic transformation detection in ischemic stroke. In light of the distinctive effects of claudin-5 on the nervous system, we present the elaborate network of roles that claudin-5 plays in ischemic stroke...
December 5, 2017: Progress in Neurobiology
https://www.readbyqxmd.com/read/29182658/high-permeability-region-size-on-perfusion-ct-predicts-hemorrhagic-transformation-after-intravenous-thrombolysis-in-stroke
#18
Josep Puig, Gerard Blasco, Pepus Daunis-I-Estadella, Cecile van Eendendburg, María Carrillo-García, Carlos Aboud, María Hernández-Pérez, Joaquín Serena, Carles Biarnés, Kambiz Nael, David S Liebeskind, Götz Thomalla, Bijoy K Menon, Andrew Demchuk, Max Wintermark, Salvador Pedraza, Mar Castellanos
OBJECTIVE: Blood-brain barrier (BBB) permeability has been proposed as a predictor of hemorrhagic transformation (HT) after tissue plasminogen activator (tPA) administration; however, the reliability of perfusion computed tomography (PCT) permeability imaging for predicting HT is uncertain. We aimed to determine the performance of high-permeability region size on PCT (HPrs-PCT) in predicting HT after intravenous tPA administration in patients with acute stroke. METHODS: We performed a multimodal CT protocol (non-contrast CT, PCT, CT angiography) to prospectively study patients with middle cerebral artery occlusion treated with tPA within 4...
2017: PloS One
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
#19
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/29137863/results-and-functional-outcomes-of-acute-ischemic-stroke-patients-who-underwent-mechanical-thrombectomy-admitted-to-intensive-care-unit
#20
L Viña Soria, L Martín Iglesias, L López Amor, I Astola Hidalgo, R Rodríguez García, L Forcelledo Espina, J A Gonzalo Guerra, S de Cima Iglesias, E Murias Quintana, P Vega Valdés, S Calleja Puerta, D Escudero Augusto
PURPOSE: To study the results and complications of endovascular treatment (EVT) in acute ischemic stroke patients admitted to Intensive Care Unit (ICU). To analyse the possible factors related to mortality and level of disability at ICU discharge and one year after stroke. DESIGN: Observational prospective study. SETTING: Mixed ICU. Third level hospital. PATIENTS: Sixty adult patients. Consecutive sample. INTERVENTIONS: None...
November 11, 2017: Medicina Intensiva
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