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Ischaemic stroke

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https://www.readbyqxmd.com/read/29140557/withdrawn-pharmacological-cardioversion-for-atrial-fibrillation-and-flutter
#1
REVIEW
John Cordina, Gillian E Mead
BACKGROUND: Atrial fibrillation is the commonest cardiac dysrhythmia. It is associated with significant morbidity and mortality. There are two approaches to the management of atrial fibrillation: controlling the ventricular rate or converting to sinus rhythm in the expectation that this would abolish its adverse effects. OBJECTIVES: To assess the effects of pharmacological cardioversion of atrial fibrillation in adults on the annual risk of stroke, peripheral embolism, and mortality...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29139276/preventing-stroke-and-assessing-risk-in-women
#2
Tracey Keteepe-Arachi, Sanjay Sharma
Ischaemic stroke is rare in premenopausal women but risk increases with advancing age and doubles in the ten years following the menopause. Up to the age of 75 years men have a 25% higher risk of suffering a stroke compared with women. However, the increased life expectancy of women ultimately results in a higher overall incidence. Twice as many women die from stroke compare with breast cancer. Women with cerebrovascular disease are more likely to present with atypical symptoms than men. Altered mental status (including unresponsiveness, confusion and behavioural change) is the most common nonconventional symptom, and is reported by 23% of women compared with 15% of men...
March 2017: Practitioner
https://www.readbyqxmd.com/read/29134984/evaluation-of-neuroprotective-effect-of-hibiscus-sabdariffa-linn-aqueous-extract-against-ischaemic-reperfusion-insult-by-bilateral-common-carotid-artery-occlusion-in-adult-male-rats
#3
Olatunde Owoeye, Micheal Oluwatosin Gabriel
Ischaemic brain injury continues to be devastating, causing social, medical and relationship disruption. Oxidativedamage has been reported to be one of the mechanisms for brain damage following ischaemic stroke. The antioxidant activityof Hibiscus sabdariffa L. was investigated for a possible protective effect against ischaemia-induced brain damage in rats.Adult male Wistar rats (n=35) were divided into five groups of 7 rats per group. Group 1 served as control was given tapwater; Group 2: 500 mg/kg daily of Hibiscus sabdariffa L...
June 30, 2017: Nigerian Journal of Physiological Sciences: Official Publication of the Physiological Society of Nigeria
https://www.readbyqxmd.com/read/29134350/subtraction-multiphase-ct-angiography-a-new-technique-for-faster-detection-of-intracranial-arterial-occlusions
#4
Danielle Byrne, John P Walsh, Gavin Sugrue, Emma Stanley, Michael Marnane, Cathal D Walsh, Peter Kelly, Sean Murphy, Eoin C Kavanagh, Peter J MacMahon
OBJECTIVE: To describe and evaluate a novel technical development to improve detection of intracranial vessel occlusions using multiphase CT angiography (MPCTA). MATERIALS AND METHODS: The institutional ethics committee approved the study. Fifty patients (30 consecutive distal (M2 or smaller) anterior circulation occlusions, ten M1 occlusions, ten cases without occlusion) presenting with suspected AIS who underwent MPCTA were included. Post-processing of MPCTA studies created "subtraction" and "delayed enhancement" (DE) datasets...
November 13, 2017: European Radiology
https://www.readbyqxmd.com/read/29130973/frequency-aetiology-and-outcome-of-small-cerebellar-infarction
#5
Zeljka Calic, Cecilia Cappelen-Smith, Ramesh Cuganesan, Craig S Anderson, Miriam Welgampola, Dennis J Cordato
BACKGROUND AND PURPOSE: Strokes due to small (<2 cm) cerebellar infarction are under-recognised, and their profile and aetiology have not been well characterised. We aimed to determine the frequency, clinical features, aetiology, and outcome of small as compared to large cerebellar infarction. METHODS: This study is a retrospective analysis of clinical and imaging features of a prospectively assessed series of 108 consecutive patients with acute cerebellar infarction admitted to Liverpool Hospital, Sydney, NSW, Australia, during 2011-2015...
November 2, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/29130000/knowledge-of-stroke-risk-factors-and-warning-signs-in-patients-with-recurrent-stroke-or-recurrent-transient-ischaemic-attack-in-thailand
#6
Jittima Saengsuwan, Pathitta Suangpho, Somsak Tiamkao
Stroke is a global burden. It is not known whether patients who are most at risk of stroke (recurrent stroke or recurrent transient ischaemic attack) have enough knowledge of stroke risk factors and warning signs. The aim of this study was to assess the knowledge of stroke risk factors and warning signs in this high-risk population. We performed a cross-sectional questionnaire-based study of patients with recurrent stroke or recurrent TIA admitted to Srinagarind Hospital and Khon Kaen Hospital, Thailand. A total of 140 patients were included in the study (age 65...
2017: Neurology Research International
https://www.readbyqxmd.com/read/29129562/preoperative-use-of-oral-beta-adrenergic-blocking-agents-and-the-incidence-of-new-onset-atrial-fibrillation-after-cardiac-surgery-a-systematic-review-and-meta-analysis
#7
REVIEW
Paul Min Thein, Kyle White, Khyati Banker, Carole Lunny, Sam Mirzaee, Arthur Nasis
BACKGROUND: Current epidemiological data suggests that postoperative atrial fibrillation or atrial flutter (POAF) causes significant morbidity and mortality after cardiac surgery. The literature for prophylactic management of POAF is limited, resulting in the lack of clear guidelines on management recommendations. AIM: To examine the efficacy of prophylactic rate control agents in reducing the incidence of new-onset POAF in patients undergoing elective cardiac surgery...
October 19, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29128343/post-stroke-depression-mechanisms-and-pharmacological-treatment
#8
REVIEW
Roberto Federico Villa, Federica Ferrari, Antonio Moretti
Depression, the most frequent psychiatric disorder following ischaemic stroke, negatively affects survivals' functional outcome, response to rehabilitation and quality of life. Approximately, one-third of them are affected by post-stroke depression (PSD), making it a serious social and public health problem and anti-depressant preventive and curative therapies worth investigating. However, a two-way association between depression and stroke has been also established: stroke increases the risk of PSD, but depression is an independent risk factor for stroke...
November 8, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29127079/effect-of-acupuncture-and-chinese-herbal-medicine-on-subacute-stroke-outcomes-a-single-centre-randomised-controlled-trial
#9
Jianqiao Fang, Crystal Lynn Keeler, Lifang Chen, Ruijie Ma, Chao Wang, Shouyu Xu
OBJECTIVE: To determine whether integrative medicine, combining acupuncture and Chinese herbal medicine with conventional rehabilitation during subacute stroke, is an effective comprehensive rehabilitation strategy for daily life activities, neurological deficits, motor dysfunction, cognitive impairment and depression. DESIGN: Randomised controlled trial: patients were randomly assigned to a conventional rehabilitation (CR) group or an integrative medicine rehabilitation (IMR) group with CR plus acupuncture and Chinese herbal medicine...
November 10, 2017: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
https://www.readbyqxmd.com/read/29126156/antithrombotic-therapy-after-myocardial-infarction-in-patients-with-atrial-fibrillation-undergoing-percutaneous-coronary-intervention
#10
Gorav Batra, Leif Friberg, David Erlinge, Stefan James, Tomas Jernberg, Bodil Svennblad, Lars Wallentin, Jonas Oldgren
Aims: Optimal antithrombotic therapy after percutaneous coronary intervention (PCI) in patients with myocardial infarction and atrial fibrillation is uncertain. In this study, we compared antithrombotic regimes with regard to a composite cardiovascular outcome of all-cause mortality, myocardial infarction or ischaemic stroke and major bleeds. Methods and results: Patients between October 2005 and December 2012 were identified in Swedish registries, n = 7,116...
November 6, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/29126112/risk-scoring-to-guide-anti-platelet-therapy-post-percutaneous-coronary-intervention-pci-for-acute-coronary-syndrome-acs-results-in-improved-clinical-outcomes
#11
S Antoniou, M Colicchia, O Guttmann, K Rathod, P Wright, S Fhadil, C Knight, A K Jain, E J Smith, A Mathur, R Weerackody, A Wragg, D A Jones
Objective: To use the GRACE and CRUSADE scores to risk stratify anti-platelet treatment post Acute Coronary Syndrome (ACS). Methods: This was a prospective registry of 3374 patients undergoing PCI for ACS between 2013-2015 at a UK cardiac centre. Patients with either low GRACE or high CRUSADE risk scores were stratified to clopidogrel therapy otherwise ticagrelor was used. The primary end-point was major adverse cardiac events (MACE) defined as death, non-fatal myocardial infarction, stroke, or target vessel revascularization with bleeding rates as a secondary outcome, assessed at a median follow-up of 1...
November 8, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29123937/a-systematic-review-of-the-causes-and-management-of-ischaemic-stroke-caused-by-nontissue-emboli
#12
REVIEW
Ciaran Judge, Sarah Mello, David Bradley, Joseph Harbison
Introduction: The inadvertent or purposeful introduction of foreign bodies or substances can lead to cerebral infarction if they embolize to the brain. Individual reports of these events are uncommon but may increase with the increased occurrences of their risk factors, for example, intra-arterial procedures. Method: We searched EMBASE and MEDLINE for articles on embolic stroke of nontissue origin. 1889 articles were identified and screened and 216 articles were ultimately reviewed in full text and included in qualitative analysis...
2017: Stroke Research and Treatment
https://www.readbyqxmd.com/read/29122931/outcome-of-left-atrial-appendage-occlusion-in-high-risk-patients
#13
Ahmed Masoud, Stefano Bartoletti, Timothy Fairbairn, Ayush Khurana, Periaswamy Velavan, William Lindsay Morrison, Afshin Khalatbari, Suneil Aggarwal, Nikhill Sharma, Paulus Kirchhof, Dhiraj Gupta
OBJECTIVE: Percutaneous left atrial appendage (LAA) occlusion can be an interventional alternative to oral anticoagulation for stroke prevention in patients with atrial fibrillation. METHODS: We delivered LAA occlusion therapy using a standardised approach to patient referral, multidisciplinary team assessment, implant criteria, imaging and follow-up. We analysed patient characteristics, efficacy and safety of the implant procedure, and 12-month outcomes. RESULTS: Of 143 referrals from October 2014 to December 2016, 83 patients (age 76±8 years, 32...
November 9, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29120327/capillary-pericytes-mediate-coronary-no-reflow-after-myocardial-ischaemia
#14
Fergus M O'Farrell, Svetlana Mastitskaya, Matthew Hammond-Haley, Felipe Freitas, Wen Rui Wah, David Attwell
After cardiac ischaemia, a prolonged decrease of coronary microvascular perfusion often occurs even after flow is restored in an upstream artery. This 'no-reflow' phenomenon worsens patient prognosis. In the brain, after stroke, a similar post-ischaemic 'no-reflow' has been attributed to capillary constriction by contractile pericytes. We now show that occlusion of a rat coronary artery, followed by reperfusion, blocks 40% of cardiac capillaries and halves perfused blood volume within the affected region. Capillary blockages colocalised strongly with pericytes, where capillary diameter was reduced by 37%...
November 9, 2017: ELife
https://www.readbyqxmd.com/read/29118796/a-comparison-of-mechanical-thrombectomy-in-the-m1-and-m2-segments-of-the-middle-cerebral-artery-a-review-of-585-consecutive-patients
#15
Pervinder Bhogal, Philipp Bücke, Muhammad AlMatter, Oliver Ganslandt, Hansjörg Bäzner, Hans Henkes, Marta Aguilar Pérez
Background: Mechanical thrombectomy for anterior-circulation large-vessel occlusion has shown benefit; however, the question of whether this technique is safe and effective in the distal vasculature remains unanswered. We sought to compare the outcome data from mechanical thrombectomy of the M2 branches of the middle cerebral artery (MCA) with those of the M1 segment. Methods: We performed a retrospective analysis of prospectively collected data of patients with acute ischaemic stroke undergoing mechanical thrombectomy of isolated M1 or M2 branches of the MCA between August 2008 and August 2016...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29103136/a-study-of-the-opinions-of-swedish-healthcare-personnel-regarding-acceptable-outcome-following-decompressive-hemicraniectomy-for-ischaemic-stroke
#16
Magnus Olivecrona, Stephen Honeybul
BACKGROUND: Decompressive hemicraniectomy (DC) is an established lifesaving treatment for malignant infarction of the middle cerebral artery (mMCAI). However, surgical decompression will not reverse the effects of the stroke and many survivors will be left severely disabled. The objective of this study was to assess what neurological outcome would be considered acceptable in these circumstances amongst Swedish healthcare workers. METHOD: Healthcare workers were invited to participate in a presentation that outlined the pathophysiology of mMCAI, the rationale behind DC and outcome data from randomised controlled trials that have investigated efficacy of the procedure...
November 4, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29102976/giant-phaeochromocytoma-presenting-with-an-acute-stroke-reappraising-phaeochromocytoma-surveillance-for-the-neurofibromatosis-type-1-phakomatosis
#17
Yingshan Lee, Leon Yuan Rui Tan, Yong Howe Ho, Melvin Khee Shing Leow
Neurofibromatosis type 1 (NF1) is a multisystem genetic disorder associated with reduced lifespan attributed largely to malignancy and vascular causes. One of the tumours associated with NF1 is phaeochromocytoma. The phaeochromocytoma has earned the moniker, a 'great mimicker', due to its varied means of presentation. We present a patient with NF1 who was diagnosed with a giant 20 cm phaeochromocytoma after suffering from an ischaemic stroke. Current guidelines do not advocate surveillance of phaeochromocytoma in asymptomatic patients with NF1, unlike other genetic syndromes associated with phaeochromocytoma...
November 3, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29101264/increased-coronary-heart-disease-and-stroke-hospitalisations-from-ambient-temperatures-in-ontario
#18
Li Bai, Qiongsi Li, Jun Wang, Eric Lavigne, Antonio Gasparrini, Ray Copes, Abderrahmane Yagouti, Richard T Burnett, Mark S Goldberg, Sabit Cakmak, Hong Chen
OBJECTIVE: To assess the associations between ambient temperatures and hospitalisations for coronary heart disease (CHD) and stroke. METHODS: Our study comprised all residents living in Ontario, Canada, 1996-2013. For each of 14 health regions, we fitted a distributed lag non-linear model to estimate the cold and heat effects on hospitalisations from CHD, acute myocardial infarction (AMI), stroke and ischaemic stroke, respectively. These effects were pooled using a multivariate meta-analysis...
November 3, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29101147/protocol-for-the-happy-hearts-study-cardiovascular-screening-for-the-early-detection-of-future-adverse-cardiovascular-outcomes-in-middle-aged-and-older-women-a-prospective-observational-cohort-study
#19
Kevin F Boreskie, D Scott Kehler, Eduardo C Costa, Pedro C Cortez, Ivan Berkowitz, Naomi C Hamm, Teri L Moffatt, Andrew N Stammers, Dustin E Kimber, Brett M Hiebert, David E Kent, Denise E Cornish, Heather Blewett, Thang Nguyen, Rakesh C Arora, Shaelyn M Strachan, Brittany N Semenchuk, Jacqueline L Hay, Jay N Cohn, Todd A Duhamel
INTRODUCTION: Efforts to identify individuals at a higher risk for adverse cardiovascular outcomes focus on traditional risk factors, such as age, sex, smoking status, blood pressure and and cholesterol; however, this approach does not directly assess cardiovascular function and may underestimate the risk of experiencing adverse cardiovascular outcomes in women. This prospective, observational cohort study will examine the ability of the Heart Attack Prevention Program for You (HAPPY) Hearts screening protocol, a series of non-invasive procedures to identify middle-aged and older women who are at an elevated risk for experiencing an adverse cardiovascular event in the 5-year period after screening...
November 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/29098918/exercise-and-quality-of-life-after-first-ever-ischaemic-stroke-a-two-year-follow-up-study
#20
Lisha Hou, Xudong Du, Longmei Chen, Jijie Li, Peijing Yan, Muke Zhou, Cairong Zhu
BACKGROUND: Quality of life (QoL) post-stroke is an important health outcome. Physical deconditioning and physical inactivity are highly prevalent in stroke survivors. This study aimed to assess the long-term trends in QoL and to explore the effect of exercise on the QoL of ischaemic stroke patients. METHODS: Data for this prospective study were collected at baseline using face-to-face interviews, and telephone follow-ups were completed every 3 months from 2010 through 2014...
November 3, 2017: International Journal of Neuroscience
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