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Cardio Embolic Strokes

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https://www.readbyqxmd.com/read/27909536/screening-for-atrial-fibrillation-in-the-community-using-a-novel-ecg-recorder
#1
Irma Battipaglia Md, Katrina Gilbert BSc, Andrew J Hogarth Md PhD, Muzahir H Tayebjee Md
Aims: MyDiagnostick (MDK) is a novel portable ECG recorder. We conducted this study to evaluate its role in screening for atrial fibrillation (AF). Methods: The device is a cylindrical rod with metallic electrodes at both ends recording electrocardiogram (ECG) when both electrodes are held. Individuals were requested to hold the device for approximately 15 s, the device was then connected to a laptop (with proprietary software downloaded) and analysed. Anonymised ECGs were stored for further analysis. A total of 855 ECGs were recorded and analysed offline by two arrhythmia specialists assessing ECG quality, in particular the level of noise...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27688000/nonbacterial-thrombotic-endocarditis-involving-both-the-tricuspid-and-aortic-valves
#2
Bhaskar Bhardwaj, Ata Bajwa, Amit Sharma, Arooge Towheed, Bakul V Sanghani, A Iain McGhie
A 71-year-old male presented after sudden onset of confusion and expressive aphasia. MRI head revealed multiple ischemic lesions consistent with cardio-embolic pathophysiology. A computed tomography angiography of lung showed peripheral pulmonary emboli. He underwent a transesophageal echocardiogram as a part of the stroke workup and was found to have vegetations on both aortic and tricuspid valves. The blood cultures did not show any growth, and the patient remained afebrile during the course of hospitalization...
September 30, 2016: Echocardiography
https://www.readbyqxmd.com/read/27593970/acute-bithalamic-infarct-manifesting-as-sleep-like-coma-a-diagnostic-challenge
#3
Asaf Honig, Ruth Eliahou, Roni Eichel, Ari Aharon Shemesh, Tamir Ben-Hur, Eitan Auriel
Bilateral thalamic infarction (BTI) typically presents as a sleep-like coma (SLC) without localizing signs, posing a diagnostic challenge that may lead the treating physician to search for toxic or metabolic causes and delay treatment. We review our experience with BTI of different etiologies, and emphasize the critical role of timely imaging, diagnosis, and management in a series of 12 patients with a presentation of SLC and acute BTI who were managed in our Medical Centers from 2006-2015. In 11/12, urgent head CT scans showed normal brain tissue, while diffusion-weighted (DWI) MRI revealed symmetric bilateral thalamic hyperintense lesions with variable degrees of brainstem involvement...
September 1, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27367268/computational-assessment-of-the-relation-between-embolism-source-and-embolus-distribution-to-the-circle-of-willis-for-improved-understanding-of-stroke-etiology
#4
Debanjan Mukherjee, Neel D Jani, Kartiga Selvaganesan, Christopher L Weng, Shawn C Shadden
Stroke caused by an embolism accounts for about a third of all stroke cases. Understanding the source and cause of the embolism is critical for diagnosis and long-term treatment of such stroke cases. The complex nature of the transport of an embolus within large arteries is a primary hindrance to a clear understanding of embolic stroke etiology. Recent advances in medical image-based computational hemodynamics modeling have rendered increasing utility to such techniques as a probe into the complex flow and transport phenomena in large arteries...
August 1, 2016: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/27356657/risk-factors-and-subtypes-of-acute-ischemic-stroke-a-study-at-king-fahd-hospital-of-the-university
#5
Azra Zafar, Fahd A Al-Khamis, Aishah I Al-Bakr, Abdulla A Alsulaiman, Amir H Msmar
OBJECTIVE: To identify the different subtypes of acute ischemic stroke, and estimate the frequency of various risk factors among these patients. METHODS: In this retrospective, cross-sectional study, we reviewed the medical records of patients admitted with the diagnosis of acute ischemic stroke at King Fahd Hospital of the University, Al-Khobar, Saudi Arabia from March 2008 till December 2015. The demographic characteristics, subtypes of stroke, risk factors (hypertension, diabetes mellitus, hyperlipidemia, coronary artery disease, atrial fibrillation, valvular heart disease) and other relevant data were documented on pre-defined data sheets...
July 2016: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/26988903/patent-foramen-ovale-pfo-stroke-and-pregnancy
#6
REVIEW
Lei Chen, Wenjun Deng, Igor Palacios, Ignacio Inglessis-Azuaje, David McMullin, Dong Zhou, Eng H Lo, Ferdinando Buonanno, MingMing Ning
Patent foramen ovale (PFO)-related stroke is increasingly recognized as an important etiology of ischemic embolic stroke-accounting for up to 50% of strokes previously considered 'cryptogenic' or with an unknown mechanism. As a 'back door to the brain,' PFO can allow venous clots to enter arterial circulation via interatrial right-to-left shunting, potentially resulting in ischemic stroke. We observe that clinically, PFO-related stroke affects women of childbearing age, and that pregnancy-owing to major changes in hemocoagulative, hormonal, and cardiovascular parameters-can enhance stroke risks...
June 2016: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/26766149/hybrid-procedure-endo-epicardial-versus-standard-manual-ablation-in-patients-undergoing-ablation-of-longstanding-persistent-atrial-fibrillation-results-from-a-single-center
#7
Zachary Edgerton, Alessandro Paoletti Perini, Rodney Horton, Chintan Trivedi, Pasquale Santangeli, Rong Bai, Carola Gianni, Sanghamitra Mohanty, J David Burkhardt, G Joseph Gallinghouse, Javier E Sanchez, Shane Bailey, Maegen Lane, Luigi DI Biase, Francesco Santoro, Justin Price, Andrea Natale
INTRODUCTION: Ablation of longstanding persistent atrial fibrillation (LSPAF) is the most challenging procedure in the treatment of AF, either by surgical or by percutaneous approach. OBJECTIVE: We investigated the difference in success and complication rates between combined surgical epicardial and endocardial catheter ablation procedure and our standard endocardial ablation procedure. METHODS AND RESULTS: Twenty-four consecutive patients (group 1) with LSPAF and enlarged left atrium (>4...
May 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/26631084/detection-of-occult-paroxysmal-atrial-fibrilation-by-implantable-long-term-electrocardiographic-monitoring-in-cryptogenic-stroke-and-transient-ischemic-attack-population-a-study-protocol-for-prospective-matched-cohort-study
#8
Andrea Petrovičová, Egon Kurča, Miroslav Brozman, Jozef Hasilla, Pavel Vahala, Peter Blaško, Andrea Andrášová, Robert Hatala, Luboš Urban, Štefan Sivák
BACKGROUND: Cardio-embolic etiology is the most frequently predicted cause of cryptogenic stroke/TIA. Detection of occult paroxysmal atrial fibrillation is crucial for selection of appropriate medication. METHODS: Enrolment of eligible cryptogenic stroke and TIA patients began in 2014 and will continue until 2018. The patients undergo long-term (12 months) ECG monitoring (implantable loop recorder) and testing for PITX2 (chromosome 4q25) and ZFHX3 (chromosome 16q22) gene mutations...
2015: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/26503023/reduction-in-estimated-glomerular-filtration-rate-egfr-results-in-an-increased-risk-of-spontaneous-hemorrhagic-transformation-in-patients-with-large-artery-atherosclerosis-stroke
#9
Bian Liu, Deren Wang, Zilong Hao, Dan Li, Junhuai Zhang, Junfeng Liu, Ming Liu
The association between chronic kidney disease and spontaneous hemorrhagic transformation (HT) in patients with acute ischemic stroke is seldom reported. We performed this study to identify whether reduced estimated glomerular filtration rate (eGFR) is associated with spontaneous HT in acute ischemic stroke patients, and examine whether the association depends on stroke etiology. Patients diagnosed with acute ischemic stroke whose serum creatinine levels at admission were available were consecutively and prospectively enrolled in the Chengdu Stroke Registry Database...
2016: Current Neurovascular Research
https://www.readbyqxmd.com/read/26422690/demethylation-of-circulating-estrogen-receptor-alpha-gene-in-cerebral-ischemic-stroke
#10
Hsiu-Fen Lin, Edward Hsi, Yi-Chu Liao, Brian Chhor, Jessica Hung, Suh-Hang H Juo, Ruey-Tay Lin
BACKGROUND: Estrogen is involved in neuron plasticity and can promote neuronal survival in stroke. Its actions are mostly exerted via estrogen receptor alpha (ERα). Previous animal studies have shown that ERα is upregulated by DNA demethylation following ischemic injury. This study investigated the methylation levels in the ERα promoter in the peripheral blood of ischemic stroke patients. METHODS: The study included 201 ischemic stroke patients, and 217 age- and sex-comparable healthy controls...
2015: PloS One
https://www.readbyqxmd.com/read/26412471/efficiency-of-transcatheter-patent-foramen-ovale-closure-in-children-after-paradoxical-embolism-events
#11
Maciej Wawrzyńczyk, Michał Gałeczka, Blandyna Karwot, Mateusz Knop, Jacek Białkowski
BACKGROUND AND AIM: Patent foramen ovale (PFO) may result in a cerebrovascular event - a presumed paradoxical embolism (PE). However, the presence of this phenomenon among paediatric patients was rarely evaluated. Transcatheter PFO closure was considered to be a method of treatment in such patients. METHODS: For evaluation clinical data and long-term outcome, we reviewed records of patients below 18 years of age, with history of cerebrovascular event related to PE, who underwent procedure of percutaneous PFO closure in years 1999-2014 in our department...
2016: Kardiologia Polska
https://www.readbyqxmd.com/read/26409625/mediterranean-diet-in-patients-with-acute-ischemic-stroke-relationships-between-mediterranean-diet-score-diagnostic-subtype-and-stroke-severity-index
#12
Antonino Tuttolomondo, Alessandra Casuccio, Carmelo Buttà, Rosaria Pecoraro, Domenico Di Raimondo, Vittoriano Della Corte, Valentina Arnao, Giuseppe Clemente, Carlo Maida, Irene Simonetta, Giuseppe Miceli, Benedetto Lucifora, Anna Cirrincione, Danilo Di Bona, Francesca Corpora, Rosario Maugeri, Domenico Gerardo Iacopino, Antonio Pinto
BACKGROUND: Adherence to a Mediterranean Diet appears to reduce the risk of cardiovascular disease, cancer, Alzheimer's disease, and Parkinson's disease, as well as the risk of death due to cardiovascular disease. No study has addressed the association between diagnostic subtype of stroke and its severity and adherence to a Mediterranean Diet in subjects with acute ischemic stroke. AIM: To evaluate the association between Mediterranean Diet adherence, TOAST subtype, and stroke severity by means of a retrospective study...
November 2015: Atherosclerosis
https://www.readbyqxmd.com/read/26405473/thrombolysis-for-acute-ischemic-stroke-by-tenecteplase-in-the-emergency-department-of-a-moroccan-hospital
#13
Ahmed Belkouch, Said Jidane, Naoufal Chouaib, Anass Elbouti, Tahir Nebhani, Rachid Sirbou, Hicham Bakkali, Lahcen Belyamani
INTRODUCTION: Thrombolysis has radically changed the prognosis of acute ischemic stroke. Tenecteplase is a modified form of rt-PA with greater specificity for fibrin and a longer half-life. We report the experience of a Moroccan tertiary hospital in thrombolysis using Tenecteplase. METHODS: We conducted an open prospective study of all patients who were treated with Tenecteplase for an acute ischemic stroke admitted to our emergency department. Tenecteplase was administered intravenously at a dose of 0...
2015: Pan African Medical Journal
https://www.readbyqxmd.com/read/26238889/stuck-with-a-drowsy-patient-evoke-the-percheron
#14
Sanjith Aaron, Sunithi Mani, A T Prabhakar, K Karthik, Anil Kumar B Patil, P Suresh Babu, Mathew Alexander
BACKGROUND: Strokes caused by normal variants of the cerebral circulation can be difficult to diagnose, hence a high index of suspicion is needed. This case series discusses the clinical and radiological aspects of one such stroke caused by occlusion of the artery of Percheron (AOP). MATERIALS AND METHODS: Computerized discharge summaries, outpatient records and imaging from picture archiving and communication system (PACS, GE), of patients with AOP infarction over a period of 12-years (2002-2014) were identified and their clinical and radiological features analyzed...
July 2015: Neurology India
https://www.readbyqxmd.com/read/26197703/risk-of-recurrent-neurologic-stroke-or-transient-ischemic-attack-in-patients-with-cryptogenic-stroke-and-intrapulmonary-shunt
#15
Rahul S Sinha, Zeeshan Hussain, Nirmanmoh Bhatia, Marcus F Stoddard
BACKGROUND AND PURPOSE: Cardio-embolic phenomenon is believed to underlie a significant proportion of cryptogenic strokes. We recently showed that intrapulmonary shunt (IPS) was associated with cryptogenic stroke and transient ischemic attack (TIA). We hypothesized that patients with prior cryptogenic stroke or TIA that had an IPS were at a higher risk for recurrent ischemic events. METHODS: The population included subjects with cryptogenic cerebrovascular accident (CVA) or TIA...
February 2016: Echocardiography
https://www.readbyqxmd.com/read/26160210/mechanism-of-procedural-stroke-following-carotid-endarterectomy-or-carotid-artery-stenting-within-the-international-carotid-stenting-study-icss-randomised-trial
#16
RANDOMIZED CONTROLLED TRIAL
A Huibers, D Calvet, F Kennedy, K R Czuriga-Kovács, R L Featherstone, F L Moll, M M Brown, T Richards, G J de Borst
OBJECTIVE: To decrease the procedural risk of carotid revascularisation it is crucial to understand the mechanisms of procedural stroke. This study analysed the features of procedural strokes associated with carotid artery stenting (CAS) and carotid endarterectomy (CEA) within the International Carotid Stenting Study (ICSS) to identify the underlying pathophysiological mechanism. MATERIALS AND METHODS: Patients with recently symptomatic carotid stenosis (1,713) were randomly allocated to CAS or CEA...
September 2015: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/26005122/-american-academy-of-neurology-washington-18-25%C3%A2-april%C3%A2-2015
#17
I Sibon, B de Toffol, J-P Azulay, F Sellal, C Thomas-Antérion, J-M Léger, C Pierrot-Deseilligny
CEREBROVASCULAR DISEASES: The benefit of the thrombectomy using stents retrievers in the acute stroke phase is now demonstrated when there is a proximal occlusion of an intracranial artery, whatever its mechanism. The place of the anticoagulants in the management of cervical artery dissections remains uncertain, while the benefit of the blood pressure control in the secondary prevention of deep and lobar intracerebral hemorrhages is critical. The development of cardiac MRI, prolonged cardiac monitoring and transcranial doppler seems to improve the diagnosis of cardio-embolic sources of stroke...
June 2015: Revue Neurologique
https://www.readbyqxmd.com/read/25925617/implications-of-female-sex-on-stroke-risk-factors-care-outcome-and-rehabilitation-an-asian-perspective
#18
Prachi Mehndiratta, Mohammad Wasay, Man Mohan Mehndiratta
BACKGROUND: Stroke affects 16.9 million people annually and the greatest burden of stroke is in low- and middle-income countries, where 69% of all strokes occur. Stroke risk factors, mortality and outcomes differ in developing countries as compared to the developed world. We performed a literature review of 28 articles pertaining to epidemiology of stroke in Asian women, stroke risk factors, gender-related differences, and stroke outcomes. SUMMARY: Asian women differ from women worldwide due to differences in stroke awareness, risk factor profile, stroke subtypes, and social issues that impact stroke care...
2015: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/25912470/percutaneous-left-atrial-appendage-occlusion-for-stroke-prevention-in-patients-with-atrial-fibrillation-and-contraindication-for-anticoagulation
#19
REVIEW
D Grosset-Janin, E Barth, B Bertrand, O Detante
BACKGROUND: Stroke, as the third cause of death in developed countries, is a public health issue. Atrial fibrillation is an important cause of ischemic stroke and its prevention is efficient with oral anticoagulation. However, oral anticoagulation can be contraindicated because of hemorrhagic risk related to these treatments. Percutaneous left atrial appendage occlusion is a new alternative of oral anticoagulation for patients with atrial fibrillation and high risk of cardio-embolic stroke but contraindicated for oral anticoagulation...
May 2015: Revue Neurologique
https://www.readbyqxmd.com/read/25897999/tobacco-smoking-strongly-modifies-the-association-of-prothrombin-g20210a-with-undetermined-stroke-consecutive-survivors-and-population-based-controls
#20
A Krajcoviechova, P Wohlfahrt, O Mayer, J Vanek, J Hajkova, D Hlinovsky, T Kvasnicka, J Tremblay, P Hamet, J Filipovsky, J Kvasnicka, R Cifkova
OBJECTIVE: Due to contradictory results of previous studies evaluating the association between ischemic stroke (IS) and thrombophilic polymorphisms, their routine screening in IS patients, particularly those older than 60 years, is not recommended. We evaluated the differences in the distribution of rs6025 and rs1799963 polymorphisms according to IS subtypes and their interaction with smoking. METHODS: We conducted a case-control study of 423 hospital-based consecutive survivors of their first-ever IS and 614 population-based controls...
June 2015: Atherosclerosis
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