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Ischaemic stroke

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https://www.readbyqxmd.com/read/28095412/intensive-versus-guideline-blood-pressure-and-lipid-lowering-in-patients-with-previous-stroke-main-results-from-the-pilot-prevention-of-decline-in-cognition-after-stroke-trial-podcast-randomised-controlled-trial
#1
Philip M Bath, Polly Scutt, Daniel J Blackburn, Sandeep Ankolekar, Kailash Krishnan, Clive Ballard, Alistair Burns, Jonathan Mant, Peter Passmore, Stuart Pocock, John Reckless, Nikola Sprigg, Rob Stewart, Joanna M Wardlaw, Gary A Ford
BACKGROUND: Stroke is associated with the development of cognitive impairment and dementia. We assessed the effect of intensive blood pressure (BP) and/or lipid lowering on cognitive outcomes in patients with recent stroke in a pilot trial. METHODS: In a multicentre, partial-factorial trial, patients with recent stroke, absence of dementia, and systolic BP (SBP) 125-170 mmHg were assigned randomly to at least 6 months of intensive (target SBP <125 mmHg) or guideline (target SBP <140 mmHg) BP lowering...
2017: PloS One
https://www.readbyqxmd.com/read/28094851/blood-transfusion-for-preventing-primary-and-secondary-stroke-in-people-with-sickle-cell-disease
#2
REVIEW
Lise J Estcourt, Patricia M Fortin, Sally Hopewell, Marialena Trivella, Winfred C Wang
BACKGROUND: Sickle cell disease is one of the commonest severe monogenic disorders in the world, due to the inheritance of two abnormal haemoglobin (beta globin) genes. Sickle cell disease can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Stroke affects around 10% of children with sickle cell anaemia (HbSS). Chronic blood transfusions may reduce the risk of vaso-occlusion and stroke by diluting the proportion of sickled cells in the circulation...
January 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28094089/use-of-emergency-medical-transport-and-impact-on-time-to-care-in-patients-with-ischaemic-stroke
#3
A Olascoaga Arrate, M M Freijo Guerrero, C Fernández Maiztegi, I Azkune Calle, R Silvariño Fernández, M Fernández Rodríguez, P Vazquez Naveira, A Anievas Elena, I Iturraspe González, Y Pérez Díez, R Ruiz Fernández
INTRODUCTION: According to numerous studies, using emergency medical services (EMS) to transport stroke patients to hospitals decreases diagnostic and treatment delays. OBJECTIVES: To determine the frequency of use of EMS by stroke patients in Bizkaia (Spain), analyse the factors associated with using EMS, and study the impact of EMS on time to care. METHODS: We gathered data from 545 patients hospitalised for acute ischaemic stroke and recruited consecutively...
January 13, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28089539/reperfusion-therapy-in-patients-with-acute-ischaemic-stroke-caused-by-cervical-artery-dissection
#4
L A Crespo Araico, R Vera Lechuga, A Cruz-Culebras, C Matute Lozano, A de Felipe Mimbrera, P Agüero Rabes, E Viedma Guiard, C Estévez Fraga, J Masjuan Vallejo
INTRODUCTION: Cervical artery dissection (CAD) is responsible for up to 20% of all ischaemic strokes in patients younger than 45. The benefits of acute-phase reperfusion therapy in these patients have yet to be confirmed. METHODS: We conducted a retrospective review of patients with CAD admitted to a comprehensive stroke centre between 2010 and 2015. We recorded baseline clinical characteristics, treatments, functional outcomes, and mortality. RESULTS: We identified 35 cases of CAD (23 carotid/12 vertebral); mean age was 43...
January 12, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28088807/posterior-versus-anterior-circulation-stroke-in-young-adults-a-comparative-study-of-stroke-aetiologies-and-risk-factors-in-stroke-among-young-fabry-patients-sifap1
#5
Bettina von Sarnowski, Ulf Schminke, Ulrike Grittner, Christian Tanislav, Tobias Böttcher, Michael G Hennerici, Turgut Tatlisumak, Jukka Putaala, Manfred Kaps, Franz Fazekas, Christian Enzinger, Arndt Rolfs, Christof Kessler
BACKGROUND: Although 20-30% of all strokes occur in the posterior circulation, few studies have explored the characteristics of patients with strokes in the posterior compared to the anterior circulation so far. Especially data on young patients is missing. METHODS: In this secondary analysis of data of the prospective multi-centre European sifap1 study that investigated stroke and transient ischemic attack (TIA) patients aged 18-55 years, we compared vascular risk factors, stroke aetiology, presence of white matter hyperintensities (WMH) and cerebral microbleeds (CMB) between patients with ischaemic posterior circulation stroke (PCS) and those having suffered from anterior circulation stroke (ACS) based on cerebral MRI...
January 14, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28086932/spontaneous-ischaemic-stroke-lesions-in-a-dog-brain-neuropathological-characterisation-and-comparison-to-human-ischaemic-stroke
#6
Barbara Blicher Thomsen, Hanne Gredal, Martin Wirenfeldt, Bjarne Winther Kristensen, Bettina Hjelm Clausen, Anders Elm Larsen, Bente Finsen, Mette Berendt, Kate Lykke Lambertsen
BACKGROUND: Dogs develop spontaneous ischaemic stroke with a clinical picture closely resembling human ischaemic stroke patients. Animal stroke models have been developed, but it has proved difficult to translate results obtained from such models into successful therapeutic strategies in human stroke patients. In order to face this apparent translational gap within stroke research, dogs with ischaemic stroke constitute an opportunity to study the neuropathology of ischaemic stroke in an animal species...
January 13, 2017: Acta Veterinaria Scandinavica
https://www.readbyqxmd.com/read/28079628/interleukin-6-is-increased-in-plasma-and-cerebrospinal-fluid-of-community-dwelling-domestic-dogs-with-acute-ischaemic-stroke
#7
Hanne Gredal, Barbara B Thomsen, Antonio Boza-Serrano, Laurent Garosi, Clare Rusbridge, Daniel Anthony, Arne Møller, Bente Finsen, Tomas Deierborg, Kate L Lambertsen, Mette Berendt
Inflammatory cytokines are potential modulators of infarct progression in acute ischaemic stroke, and are therefore possible targets for future treatment strategies. Cytokine studies in animal models of surgically induced stroke may, however, be influenced by the fact that the surgical intervention itself contributes towards the cytokine response. Community-dwelling domestic dogs suffer from spontaneous ischaemic stroke, and therefore, offer the opportunity to study the cytokine response in a noninvasive set-up...
January 10, 2017: Neuroreport
https://www.readbyqxmd.com/read/28077466/tea-consumption-and-risk-of-ischaemic-heart-disease
#8
Xia Li, Canqing Yu, Yu Guo, Zheng Bian, Jiahui Si, Ling Yang, Yiping Chen, Xiaolan Ren, Ge Jiang, Junshi Chen, Zhengming Chen, Jun Lv, Liming Li
OBJECTIVE: To prospectively examine the association between tea consumption and the risk of ischaemic heart disease (IHD). METHODS: Prospective study using the China Kadoorie Biobank; participants from 10 areas across China were enrolled during 2004-2008 and followed up until 31 December 2013. After excluding participants with cancer, heart disease and stroke at baseline, the present study included 199 293 men and 288 082 women aged 30-79 years at baseline...
January 11, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28073863/revisiting-sex-differences-in-outcomes-in-non-valvular-atrial-fibrillation-a-population-based-cohort-study
#9
Christel Renoux, Janie Coulombe, Samy Suissa
AIMS: In patients with non-valvular atrial fibrillation (NVAF), it is uncertain whether the higher risk of ischaemic stroke in women reported in some studies is due to residual confounding. We assessed this association using standard time-fixed and more accurate time-dependent adjustment for confounders. METHODS AND RESULTS: Using the computerized databases of the Régie de l'assurance maladie du Québec (RAMQ), we identified a cohort of patients with NVAF during 2000-2009 and RAMQ medication coverage...
January 10, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28065948/correlation-of-serum-calcium-with-severity-of-acute-ischaemic-stroke
#10
Muhammad Ishfaq, Fahim Ullah, Saima Akbar, Fawad Rahim, Ayesha Khan Afridi
OBJECTIVE: To determine the correlation of serum calcium with severity of acute ischaemic stroke. METHODS: This cross-sectional study was conducted at the Khyber Teaching Hospital, Peshawar, Pakistan, from January to September 2013, and comprised patients who had suffered ischaemic stroke. All patients aged above 18 years who had been diagnosed to have suffered ischaemic stroke through history, physical examination and computed tomography scan, and who were admitted within the first 72 hours of the onset of the illness were included...
January 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28062433/rivaroxaban-lessens-the-number-of-thrombi-in-the-left-atrium-and-right-lower-pulmonary-vein-as-illustrated-by-transoesophageal-echocardiography-but-not-80-mdct
#11
Hidekazu Takeuchi
Stroke is a clinically important problem. A left atrial thrombus is known as a cause of ischaemic stroke. A pulmonary vein thrombus (PVT) is thought to be rare; however, PVT is common in elderly patients. Additionally, images of PVT with transoesophageal echocardiography (TEE) following treatment have not been well contrasted with that from either 64 or 80-slice multidetector CT (80-MDCT). The images of such changes depicted by TEE remain unknown. An 87-year-old man with hypertension was examined by 80-MDCT and TEE to check the cardiac thrombus...
January 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28049738/when-the-heart-rules-the-head-ischaemic-stroke-and-intracerebral-haemorrhage-complicating-infective-endocarditis
#12
REVIEW
Estabrak Jiad, Sumanjit K Gill, Maria Krutikov, David Turner, Michael H Parkinson, Carmel Curtis, David J Werring
Sir William Osler meticulously described the clinical manifestations of infective endocarditis in 1885, concluding that: 'few diseases present greater difficulties in the way of diagnosis … which in many cases are practically insurmountable'. Even with modern investigation techniques, diagnosing infective endocarditis can be hugely challenging, yet is critically important in patients presenting with stroke (both cerebral infarction and intracranial haemorrhage), its commonest neurological complication. In ischaemic stroke, intravenous thrombolysis carries an unacceptably high risk of intracranial haemorrhage, while in intracerebral haemorrhage, mycotic aneurysms require urgent treatment to avoid rebleeding, and in all cases, prompt treatment with antibiotics and valve surgery may be life-saving...
January 3, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28045369/carotid-endarterectomy-following-thrombolysis-for-acute-ischaemic-stroke
#13
Naz Ahmed, Damian Kelleher, Manmohan Madan, Sarita Sochart, George A Antoniou
BACKGROUND: Insufficient evidence exists to support the safety of carotid endarterectomy (CEA) following intravenous thrombolysis (IVT) for acute ischaemic stroke. Our study aimed to report a single-centre experience of patients treated over a five-year period. PATIENTS AND METHODS: Departmental computerised databases were interrogated to identify patients who suffered an ischaemic stroke and subsequently underwent thrombolysis followed by CEA. Mortality and stroke within 30 days of surgery were defined as the primary outcome end points...
January 3, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28043958/fluctuating-drowsiness-following-cardiac-catheterisation-artery-of-percheron-ischaemic-stroke-causing-bilateral-thalamic-infarcts
#14
Daniel Hammersley, Ankur Arora, Madhava Dissanayake, Nabarun Sengupta
An 81-year-old man underwent cardiac catheterisation to investigate breathlessness and left ventricular impairment of unknown cause. He had unobstructed coronary arteries. Immediately following the procedure, he became suddenly unresponsive with vertical gaze palsy, anisocoria and bilateral upgoing plantar responses. He made a rapid recovery to his premorbid state 25 min later with no residual focal neurological signs. He then had multiple unresponsive episodes, interspaced with complete resolution of symptoms and neurological signs...
January 2, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28041720/atrial-fibrillation-is-a-major-cause-of-stroke-in-apneic-patients-a-prospective-study
#15
M Poli, P Philip, J Taillard, S Debruxelles, P Renou, J M Orgogozo, F Rouanet, I Sibon
OBJECTIVES: Large prospective studies have established that sleep-disordered breathing (SDB) is associated with an increased incidence of cardiovascular and cerebrovascular diseases. Heterogeneous results have been published about SDB and ischaemic stroke mechanism. The aim of this study was to evaluate the relationship between poststroke apneic syndrome and stroke aetiologies according to the ASCO classification. METHODS: A total of 134 patients with acute ischaemic cerebrovascular events were prospectively included...
March 4, 2016: Sleep Medicine
https://www.readbyqxmd.com/read/28040669/perfusion-computed-tomography-in-patients-with-stroke-thrombolysis
#16
Hiroyuki Kawano, Andrew Bivard, Longting Lin, Henry Ma, Xin Cheng, Richard Aviv, Billy O'Brien, Kenneth Butcher, Min Lou, Jingfen Zhang, Jim Jannes, Qiang Dong, Christopher R Levi, Mark W Parsons
Stroke shortens an individual's disability-free life. We aimed to assess the relative prognostic influence of pre- and post-treatment perfusion computed tomography imaging variables (e.g. ischaemic core and penumbral volumes) compared to standard clinical predictors (such as onset-to-treatment time) on long-term stroke disability in patients undergoing thrombolysis. We used data from a prospectively collected international, multicentre, observational registry of acute ischaemic stroke patients who had perfusion computed tomography and computed tomography angiography before treatment with intravenous alteplase...
December 31, 2016: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28031318/effects-of-invitation-to-participate-in-health-surveys-on-the-incidence-of-cardiovascular-disease-a-randomized-general-population-study
#17
Tea Skaaby, Torben Jørgensen, Allan Linneberg
BACKGROUND: The effects of health checks on reducing cardiovascular disease morbidity and mortality in the general population have been questioned. There are few randomized studies with long-term follow-up. We used a cohort randomly selected from a general population as a randomized trial to study the effect of repeated general health checks on the 30-year incidence of ischaemic heart disease (IHD), stroke and all-cause mortality. METHODS: The study included all persons (n = 17 845) aged 30, 40, 50 and 60 years living in 11 municipalities in Copenhagen, the capital of Denmark...
December 28, 2016: International Journal of Epidemiology
https://www.readbyqxmd.com/read/28031317/coffee-intake-cardiovascular-disease-and-all-cause-mortality-observational-and-mendelian-randomization-analyses-in-95%C3%A2-000-223%C3%A2-000-individuals
#18
Ask Tybjærg Nordestgaard, Børge Grønne Nordestgaard
BACKGROUND: Coffee has been associated with modestly lower risk of cardiovascular disease and all-cause mortality in meta-analyses; however, it is unclear whether these are causal associations. We tested first whether coffee intake is associated with cardiovascular disease and all-cause mortality observationally; second, whether genetic variations previously associated with caffeine intake are associated with coffee intake; and third, whether the genetic variations are associated with cardiovascular disease and all-cause mortality...
December 28, 2016: International Journal of Epidemiology
https://www.readbyqxmd.com/read/28031221/molecular-magnetic-resonance-imaging-discloses-endothelial-activation-after-transient-ischaemic-attack
#19
Aurélien Quenault, Sara Martinez de Lizarrondo, Olivier Etard, Maxime Gauberti, Cyrille Orset, Benoît Haelewyn, Helen C Segal, Peter M Rothwell, Denis Vivien, Emmanuel Touzé, Carine Ali
SEE SUN ET AL DOI101093/AWW306 FOR A SCIENTIFIC COMMENTARY ON THIS ARTICLE: About 20% of patients with ischaemic stroke have a preceding transient ischaemic attack, which is clinically defined as focal neurological symptoms of ischaemic origin resolving spontaneously. Failure to diagnose transient ischaemic attack is a wasted opportunity to prevent recurrent disabling stroke. Unfortunately, diagnosis can be difficult, due to numerous mimics, and to the absence of a specific test. New diagnostic tools are thus needed, in particular for radiologically silent cases, which correspond to the recommended tissue-based definition of transient ischaemic attack...
January 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28026909/plasma-d-dimer-levels-and-ischaemic-lesions-in-multiple-vascular-regions-can-predict-occult-cancer-in-patients-with-cryptogenic-stroke
#20
Y Gon, M Sakaguchi, J Takasugi, T Kawano, H Kanki, A Watanabe, N Oyama, Y Terasaki, T Sasaki, H Mochizuki
BACKGROUND AND PURPOSE: Cancer patients with cryptogenic stroke often have high plasma D-dimer levels and lesions in multiple vascular regions. Hence, if patients with cryptogenic stroke display such characteristics, occult cancer could be predicted. This study aimed to investigate the clinical characteristics of cryptogenic stroke as the first manifestation of occult cancer and to determine whether plasma D-dimer levels and lesions in multiple vascular regions can predict occult cancer in patients with cryptogenic stroke...
December 27, 2016: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
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