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https://www.readbyqxmd.com/read/28644924/intravenous-thrombolysis-for-acute-ischemic-stroke-a-bridge-between-two-centuries
#1
Georgios Tsivgoulis, Odysseas Kargiotis, Andrei Alexandrov
Intravenous tissue-plasminogen activator (tPA) remains the only approved systemic reperfusion therapy suitable for most patients presenting timely with acute ischemic stroke. Accumulating real-word experience for over 20 years regarding tPA safety and effectiveness lead to re-appraisal of original contraindications for intravenous thrombolysis (IVT). Areas covered: This narrative review focuses on fast yet appropriate selection of patients for safe administration of tPA per recently expanded indications. Novel strategies for rapid patient assessment will be discussed...
June 23, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28643997/brain-monitoring-in-adult-and-pediatric-ecmo-patients-the-importance-of-early-and-late-assessments
#2
Roberto Lorusso, Fabio S Taccone, Mirko Belliato, Thijs Delnoij, Paolo Zanatta, Mirjana Cvetkovic, Mark Davidson, Jan Belohlavek, Nashwa Matta, Carl Davis, Hanneke Ijsselstijn, Thomas Mueller, Ralf Muellenbach, Dirk Donker, Piero David, Matteo DI Nardo, Dirk Vlasselaers, Dinis Dos Reis Miranda, Aparna Hoskote
Monitoring brain integrity and neuro-cognitive function is a new and important target for the management of a patient treated with extracorporeal membrane oxygenation (ECMO), in particular because of the increasing awareness of cerebral abnormalities that may potentially occur in this setting. Continuous regular monitoring, as well as repeated assessment for cerebral complications has become an essential element of the ECMO patient management. Besides well-known complications, like bleeding, ischemic stroke, seizures, and brain hypoperfusion, other less defined yet relevant injury and clinical manifestations are increasingly reported and impacting on ECMO patient prognosis at short term...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28643802/optogenetic-rewiring-of-thalamocortical-circuits-to-restore-function-in-the-stroke-injured-brain
#3
Kelly A Tennant, Stephanie L Taylor, Emily R White, Craig E Brown
To regain sensorimotor functions after stroke, surviving neural circuits must reorganize and form new connections. Although the thalamus is critical for processing and relaying sensory information to the cortex, little is known about how stroke affects the structure and function of these connections, or whether a therapeutic approach targeting these circuits can improve recovery. Here we reveal with in vivo calcium imaging that stroke in somatosensory cortex dampens the excitability of surviving thalamocortical circuits...
June 23, 2017: Nature Communications
https://www.readbyqxmd.com/read/28643616/advanced-neuroimaging-of-carbon-monoxide-poisoning
#4
Marco Varrassi, Alessandra Di Sibio, Camilla Gianneramo, Marco Perri, Giorgia Saltelli, Alessandra Splendiani, Carlo Masciocchi
Carbon monoxide (CO) inhalation is nowadays the most common cause of fatal poisoning worldwide. CO binds to haemoglobin 230-270 times more avidly than oxygen, thus leading to formation of carboxyhaemoglobin with subsequent reduction of tissue oxygenation. Brain is mainly affected due to its high oxygen requirement. Up to two-thirds of patients who survive the acute phase of this pathology present a delayed leukoencephalopathy, usually in a period ranging from two to 40 days. White matter damage closely relates to long-term prognosis of these patients...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28643603/stroke-like-migraine-attacks-after-radiation-therapy-syndrome-case-report-and-review-of-the-literature
#5
Achint K Singh, Bundhit Tantiwongkosi, Anna-Marieta Moise, Wilson B Altmeyer
A 26-year-old female presented with vision loss accompanied by migraine-like headaches. A contrast-enhanced magnetic resonance imaging of the brain was performed which revealed findings suggestive of stroke-like migraine attacks after radiation therapy (SMART) syndrome. SMART syndrome is a delayed complication of brain radiation characterized by neurologic symptoms including migraine-like headaches, seizures, and hemispheric impairment. The purpose of this article is to make the readers aware of this rare complication of brain irradiation...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28642018/clinical-study-of-27-patients-with-medial-medullary-infarction
#6
Takayoshi Akimoto, Katsuhiko Ogawa, Akihiko Morita, Yutaka Suzuki, Satoshi Kamei
BACKGROUND: Medial medullary infarction (MMI) is a rare ischemic stroke. Frequency of each neurological finding in MMI was different in each study. METHODS: We retrospectively evaluated the medical records of patients with cerebral infarction who were admitted between March 1998 and October 2015. Patients in our study were diagnosed as having MMI by magnetic resonance image examination. RESULTS: Of 2727 patients with ischemic stroke, 27 patients (20 males and 7 females) had MMI...
June 20, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28641922/diffusion-weighted-imaging-and-time-in-acute-ischemic-stroke-is-there-any-relation
#7
Daniel Mantilla-García, Isabelle Mourand, Gregory Gascou, Carlos Riquelme, Cyril Dargazanli, Patricio López-Jaramillo, Paul A Camacho, Omer Eker, Alain Bonafé, Vincent Costalat
BACKGROUND AND PURPOSE: Diffusion-weighted MRI (DWI) is useful for patient selection during the first 6hours after stroke onset. The main aim of this study was to investigate the relationship between the time from stroke symptom onset and stroke volume assessed using DWI. MATERIALS AND METHODS: We evaluated 203 patients with anterior circulation stroke who were admitted to Montpellier's Stroke Unit and for whom a DWI ASPECT score (DWI-ASPECTS) was obtained during the first 6hours from symptom onset...
June 19, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28641383/neuroprotection-in-stroke-the-importance-of-collaboration-and-reproducibility
#8
Ain A Neuhaus, Yvonne Couch, Gina Hadley, Alastair M Buchan
Acute ischaemic stroke accounts for 6.5 million deaths per year, and by 2030 will result in the annual loss of over 200 million disability-adjusted life years globally. There have been considerable recent advances in the gold standard of acute ischaemic stroke treatment, some aspects of which-aspirin to prevent recurrence, and treating patients in specialized stroke wards-are widely applicable. Recanalization of the occluded artery through thrombolysis and/or endovascular thrombectomy is restricted to only a small proportion of patients, due to contra-indications and the costs associated with establishing the infrastructure to deliver these treatments...
June 20, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28641278/astragaloside-iv-alleviates-heat-induced-inflammation-by-inhibiting-endoplasmic-reticulum-stress-and-autophagy
#9
Zhiwei Dong, Jian Zhou, Ying Zhang, Yajie Chen, Zichen Yang, Guangtao Huang, Yu Chen, Zhiqiang Yuan, Yizhi Peng, Tongtong Cao
BACKGROUND: Thermal injury is the main cause of pulmonary disease in stroke after burn and can be life threatening. Heat-induced inflammation is an important factor that triggers a series of induces pathological changes. However, this mechanism underlying heat-induced inflammation in thermal inhalation injury remains unclear. Studies have revealed that astragaloside-IV (AS-IV), a natural compound extracted from Astragalus membranaceus, has protective effects in inflammatory diseases. Here, we investigated whether the protective effects of AS-IV occur because of the suppression of heat-induced endoplasmic reticulum (ER) stress and excessive autophagy Methods: AS-IV was administered to Wistar rats after thermal inhalation injury and 16HBE140-cells were treated with AS-IV...
June 23, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28640874/risk-factors-are-different-for-deep-and-lobar-remote-hemorrhages-after-intravenous-thrombolysis
#10
Luis Prats-Sanchez, Alejandro Martínez-Domeño, Pol Camps-Renom, Raquel Delgado-Mederos, Daniel Guisado-Alonso, Rebeca Marín, Laura Dorado, Salvatore Rudilosso, Alejandra Gómez-González, Francisco Purroy, Manuel Gómez-Choco, David Cánovas, Dolores Cocho, Moises Garces, Sonia Abilleira, Joan Martí-Fàbregas
BACKGROUND AND PURPOSE: Remote parenchymal haemorrhage (rPH) after intravenous thrombolysis is defined as hemorrhages that appear in brain regions without visible ischemic damage, remote from the area of ischemia causing the initial stroke symptom. The pathophysiology of rPH is not clear and may be explained by different underlying mechanisms. We hypothesized that rPH may have different risk factors according to the bleeding location. We report the variables that we found associated with deep and lobar rPH after intravenous thrombolysis...
2017: PloS One
https://www.readbyqxmd.com/read/28640873/healthy-aging-of-the-left-ventricle-in-relationship-to-cardiovascular-risk-factors-the-multi-ethnic-study-of-atherosclerosis-mesa
#11
Chia-Ying Liu, Shenghan Lai, Nadine Kawel-Boehm, Harjit Chahal, Bharath Ambale-Venkatesh, Joao A C Lima, David A Bluemke
BACKGROUND: Understanding the relationship of cardiovascular structure and function to age is confounded by the high prevalence of traditional risk factors in the United States. The purpose of the study is to compare left ventricular (LV) and aortic structural, and functional parameters in individuals with and without traditional risk factors in a population-based cohort. METHODS AND RESULTS: 3015 study participants (48% men, age 55-94, mean 69.01±9.17 years) in the Multi-Ethnic Study of Atherosclerosis (MESA) underwent cardiovascular magnetic resonance (CMR) imaging from 2010-2012...
2017: PloS One
https://www.readbyqxmd.com/read/28639721/trpv4-channels-contribute-to-calcium-transients-in-astrocytes-and-neurons-during-peri-infarct-depolarizations-in-a-stroke-model
#12
Cordula Rakers, Matthias Schmid, Gabor C Petzold
Stroke is one of the leading causes of death and long-term disability. In the penumbra, that is, the area surrounding the infarct core, peri-infarct depolarizations (PIDs) are accompanied by strong intracellular calcium elevations in astrocytes and neurons, thereby negatively affecting infarct size and clinical outcome. The dynamics of PIDs and the cellular pathways that are involved during PID formation and progression remain incompletely understood. We have previously shown that inositol triphosphate-gated calcium release from internal stores is a major component of PID-related astroglial calcium signals, but whether external calcium influx through membrane-localized channels also contributes to PIDs has remained unclear...
June 22, 2017: Glia
https://www.readbyqxmd.com/read/28639301/improving-the-detection-sensitivity-of-ph-weighted-amide-proton-transfer-mri-in-acute-stroke-patients-using-extrapolated-semisolid-magnetization-transfer-reference-signals
#13
Hye-Young Heo, Yi Zhang, Tina M Burton, Shanshan Jiang, Yansong Zhao, Peter C M van Zijl, Richard Leigh, Jinyuan Zhou
PURPOSE: To quantify amide protein transfer (APT) effects in acidic ischemic lesions and assess the spatial-temporal relationship among diffusion, perfusion, and pH deficits in acute stroke patients. METHODS: Thirty acute stroke patients were scanned at 3 T. Quantitative APT (APT(#) ) effects in acidic ischemic lesions were measured using an extrapolated semisolid magnetization transfer reference signal technique and compared with commonly used MTRasym (3.5ppm) or APT-weighted parameters...
June 21, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28638704/lipid-and-hyperglycemia-factors-in-first-ever-penetrating-artery-infarction-a-comparison-between-different-subtypes
#14
Shaoyang Sun, Yanqiang Wang, Yuge Wang, Xuejiao Men, Jian Bao, Xueqiang Hu, Zhengqi Lu
BACKGROUND: The pathogenesis and progression of branch atheromatous disease (BAD), which differs from lipohyalinotic degeneration (LD), remains controversial. Few studies have investigated the lipid indices and glycometabolism status factors for BAD in first-ever penetrating artery infarction (PAI). METHODS: We retrospectively examined acute stroke patients with PAI admitted within 3 days after stroke. All patients underwent diffusion weight magnetic resonance imaging (DWI) and magnetic resonance angiography (MRA) and/or computed tomography angiography (CTA)...
June 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28638293/septic-embolic-stroke-resulting-from-staphylococcus-lugdunensis-endocarditis
#15
Htoo Kyaw, Atif Z Shaikh, Gokul Yaratha, Misra Deepika
BACKGROUND: Staphylococcus lugdunensis, a member of the coagulase-negative staphylococci (CoNS), has been recognized as a causal organism for infective endocarditis since the 1980s. Although most CoNS have an insidious and chronic nature, they are involved in a variety of systemic infections. S lugdunensis infective endocarditis is a rare entity but is as catastrophic as Staphylococcus aureus infective endocarditis and requires aggressive antibiotic therapy and, typically, valve replacement...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28637412/vascular-lesion-thickness-in-the-lenticulostriate-artery-region-serves-as-a-biomarker-for-early-neurological-deterioration
#16
Yuan Gao, Bo Song, Lu Zhao, Hui Fang, Yan Ji, Quan Yong, Zhengrong Wu, Yuming Xu
Background:Early neurological deterioration (END) was common in single small subcortical infarction (SSSI). Distal type of SSSI (dSSSI) was reported to have a lower risk of END than proximal type of SSSI(pSSSI) in lenticulostriate artery(LSA) territory. However, dSSSIs with different lesion thickness might have different risks of END. Objective:In this prospective cohort study, we aimed to investigate whether dSSSIs visible on ≥3 serial axial diffusion weighted imaging(DWI) slices were also imaging markers for END...
June 21, 2017: Current Neurovascular Research
https://www.readbyqxmd.com/read/28636607/three-dimensional-cell-shapes-and-arrangements-in-human-sweat-glands-as-revealed-by-whole-mount-immunostaining
#17
Ryuichiro Kurata, Sugiko Futaki, Itsuko Nakano, Fumitaka Fujita, Atsushi Tanemura, Hiroyuki Murota, Ichiro Katayama, Fumihiro Okada, Kiyotoshi Sekiguchi
Because sweat secretion is facilitated by mechanical contraction of sweat gland structures, understanding their structure-function relationship could lead to more effective treatments for patients with sweat gland disorders such as heat stroke. Conventional histological studies have shown that sweat glands are three-dimensionally coiled tubular structures consisting of ducts and secretory portions, although their detailed structural anatomy remains unclear. To better understand the details of the three-dimensional (3D) coiled structures of sweat glands, a whole-mount staining method was employed to visualize 3D coiled gland structures with sweat gland markers for ductal luminal, ductal basal, secretory luminal, and myoepithelial cells...
2017: PloS One
https://www.readbyqxmd.com/read/28633398/a-novel-system-for-the-treatment-of-aortic-annular-dilation-an-ex-vivo-investigation
#18
Pallav Shah, Claudia Romagnoni, Michal Jaworek, Federico Lucherini, Monica Contino, Alan Menkis, Guido Gelpi, Gianfranco B Fiore, Carlo Antona, Riccardo Vismara
OBJECTIVES: The main reason for aortic repair failures is recurrent annular dilatation. The fibrous portion of left ventricular outflow tract dilates. A novel device was designed to tackle this problem. METHODS: The device consists of an internal ring applied at the aortic annulus plus an external flexible band at the level of the aortic root. The internal ring has a semi-rigid portion (40%, placed at ventriculo-arterial junction) and a flexible portion to allow it to conform along the curves of the non-coronary/right coronary leaflet and right coronary/left coronary leaflet commissures...
June 15, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28630235/ultrasound-markers-of-carotid-atherosclerosis-and-cognition-the-northern-manhattan-study
#19
Hannah Gardener, Michelle R Caunca, Chuanhui Dong, Ying Kuen Cheung, Mitchell S V Elkind, Ralph L Sacco, Tatjana Rundek, Clinton B Wright
BACKGROUND AND PURPOSE: Ultrasound markers of carotid atherosclerosis may be related to cognitive status. We hypothesized that individuals with greater carotid intima-media thickness (cIMT) and carotid plaque burden would exhibit worse cognition. METHODS: One thousand one hundred sixty-six stroke-free participants from the NOMAS (Northern Manhattan Study) underwent carotid ultrasound and neuropsychological examination. Among them, 826 underwent a second neuropsychological examination an average of 5 years later...
June 19, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28630234/multiparametric-model-for-penumbral-flow-prediction-in-acute-stroke
#20
Michelle Livne, Tabea Kossen, Vince I Madai, Olivier Zaro-Weber, Walter Moeller-Hartmann, Kim Mouridsen, Wolf-Dieter Heiss, Jan Sobesky
BACKGROUND AND PURPOSE: Identification of salvageable penumbra tissue by dynamic susceptibility contrast magnetic resonance imaging is a valuable tool for acute stroke patient stratification for treatment. However, prior studies have not attempted to combine the different perfusion maps into a predictive model. In this study, we established a multiparametric perfusion imaging model and cross-validated it using positron emission tomography perfusion for detection of penumbral flow. METHODS: In a retrospective analysis of 17 subacute stroke patients with consecutive magnetic resonance imaging and H2O15 positron emission tomography scans, perfusion maps of cerebral blood flow, cerebral blood volume, mean transit time, time-to-maximum, and time-to-peak were constructed and combined using a generalized linear model (GLM)...
June 19, 2017: Stroke; a Journal of Cerebral Circulation
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