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Hemispheric stroke

Jose E Cohen, John M Gomori, Ronen R Leker
BACKGROUND AND AIMS: Stent retriever-based thrombectomy (SRT) may be beneficial in patients with large hemispheric stroke. Previous studies concluded that favorable outcomes are far less frequent after endovascular therapy in older patients but have not explored outcomes in the era of newer-generation stent retrievers. MATERIALS AND METHODS: Consecutive patients with large hemispheric stroke treated with SRT were included. We compared neurological and functional outcomes between patients younger and older than 80...
September 2016: Interventional Neurology
Chao-Ying Chen, Tonya L Rich, Jessica M Cassidy, Bernadette T Gillick
Transcranial magnetic stimulation (TMS) can be used as an assessment or intervention to evaluate or influence brain activity in children with hemiparetic cerebral palsy (CP) commonly caused by perinatal stroke. This communication report analyzed data from two clinical trials using TMS to assess corticospinal excitability in children and young adults with hemiparetic CP. The results of this communication revealed a higher probability of finding a motor evoked potential (MEP) on the non-lesioned hemisphere compared to the lesioned hemisphere (p = 0...
October 20, 2016: Brain Sciences
Lulu Xie, Hongyi Kang, Maiken Nedergaard
BACKGROUND: Stroke is one of the leading causes of death and disability worldwide. As a consequence, several excellent rodent models have been developed to gain insight into the pathophysiology of stroke and testing the efficacy of neuroprotective interventions. However, one potential problem is that albeit roughly 80% of strokes occur in awake patients, all existing murine stroke models employ anesthesia. Moreover, epidemiological studies have shown that stroke injury is more severe in the minority of patients that suffer stroke while asleep...
2016: Journal of Nature and Science
Jing Qiu, Min Wang, Jun Zhang, Qing Cai, Dan Lu, Yansong Li, Yushu Dong, Tianzhi Zhao, Huisheng Chen
Neuroinflammation remains the primary cause of morbidity and mortality in stroke-induced secondary brain injury. The NOD-like receptor pyrin 3 (NLRP3) inflammasome is involved in diverse inflammatory diseases, including cerebral ischemia, and is thus considered an effective therapeutic target. In the present study, we investigated the neuroprotection of Sinomenine (SINO), a potent natural anti-apoptotic and anti-inflammatory molecule, against cerebral ischemia in a mouse model of middle cerebral artery occlusion (MCAO) in vivo and in an oxygen glucose deprivation (OGD)-treated astrocytes/microglia model in vitro...
October 18, 2016: International Immunopharmacology
Rangaswamy, V Ranjith, L Vikas, R Santosh
Fahr's disease or Fahr's syndrome is a rare neurodegenerative disorder characterized by abnormal symmetrical calcifications of the basal ganglia, thalami, sub-cortical hemispheric white matter and deep cerebellar nuclei. It can be idiopathic or associated with an endocrinopathy, frequently with parathyroid disorder. Clinical spectrum of the disease is wide ranging from neurological features like seizure, syncope, stroke like events, extra-pyramidal symptoms often combined with frontal sub-cortical pattern of behavioural dysfunction and psychiatric symptoms such as psychosis, mood disorder and dementia...
August 2016: Journal of the Association of Physicians of India
Yasheng Chen, Rajat Dhar, Laura Heitsch, Andria Ford, Israel Fernandez-Cadenas, Caty Carrera, Joan Montaner, Weili Lin, Dinggang Shen, Hongyu An, Jin-Moo Lee
Although cerebral edema is a major cause of death and deterioration following hemispheric stroke, there remains no validated biomarker that captures the full spectrum of this critical complication. We recently demonstrated that reduction in intracranial cerebrospinal fluid (CSF) volume (∆ CSF) on serial computed tomography (CT) scans provides an accurate measure of cerebral edema severity, which may aid in early triaging of stroke patients for craniectomy. However, application of such a volumetric approach would be too cumbersome to perform manually on serial scans in a real-world setting...
2016: NeuroImage: Clinical
Lei Cao, Wei Fu, Yanming Zhang, Su Huo, JuBao Du, Lin Zhu, Weiqun Song
Functional connectivity changes in the attention network are viewed as a physiological signature of visual spatial neglect (VSN). The left dorsal lateral prefrontal cortex (LDLPFC) is known to initiate and monitor top-down attentional control and dynamically adjust behavioral performance. This study aimed to investigate whether increasing the activity of the LDLPFC through intermittent θ burst stimulation (iTBS) could modulate the resting-state functional connectivity in the attention network and facilitate recovery from VSN...
September 29, 2016: Neuroreport
Lucy C Thomas, Lesley Ann Hall, John R Attia, Elizabeth G Holliday, Hugh S Markus, Christopher R Levi
BACKGROUND: Cervical artery dissection (CAD) is a leading cause of stroke among middle-aged adults, but the etiology is unclear. Some reports of seasonal variation in CAD incidence have been suggested but may reflect extreme climatic conditions. Seasonal variation may implicate more transient seasonal causes such as proinflammatory or hypercoagulable states. This study aimed to assess whether CAD incidence varied with season between UK and Australian sites. Also, this study aimed to determine whether there was a different pattern of seasonal variation between arteries (carotid and vertebral) and any association between CAD incidence and clinical factors...
October 10, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Yash V Tiwari, Jianfei Lu, Qiang Shen, Bianca Cerqueira, Timothy Q Duong
Diffusion-weighted arterial spin labeling magnetic resonance imaging has recently been proposed to quantify the rate of water exchange (Kw) across the blood-brain barrier in humans. This study aimed to evaluate the blood-brain barrier disruption in transient (60 min) ischemic stroke using Kw magnetic resonance imaging with cross-validation by dynamic contrast-enhanced magnetic resonance imaging and Evans blue histology in the same rats. The major findings were: (i) at 90 min after stroke (30 min after reperfusion), group Kw magnetic resonance imaging data showed no significant blood-brain barrier permeability changes, although a few animals showed slightly abnormal Kw Dynamic contrast-enhanced magnetic resonance imaging confirmed this finding in the same animals...
October 14, 2016: Journal of Cerebral Blood Flow and Metabolism
Sangeetha Madhavan, James W Stinear, Neeta Kanekar
Objective. High intensity interval treadmill training (HIITT) has been gaining popularity for gait rehabilitation after stroke. In this study, we examined the changes in excitability of the lower limb motor cortical representation (M1) in chronic stroke survivors following a single session of HIITT. We also determined whether exercise-induced changes in excitability could be modulated by transcranial direct current stimulation (tDCS) enhanced with a paretic ankle skill acquisition task. Methods. Eleven individuals with chronic stroke participated in two 40-minute treadmill-training sessions: HIITT alone and HITT preceded by anodal tDCS enhanced with a skill acquisition task (e-tDCS+HIITT)...
2016: Neural Plasticity
Nari Choi, Jee-Eun Yoon, Byoung-Won Park, Won-Ho Chang, Hyun-Jo Kim, Kyung Bok Lee
We report a case of aortic dissection masquerading as acute ischemic stroke followed by intravenous thrombolysis. A 59-year-old man presented with dizziness. After examination, the patient had a seizure with bilateral Babinski signs. Soon after identifying multiple acute infarctions in both hemispheres on diffusion-weighted brain magnetic resonance (MR) imaging, tissue plasminogen activator (t-PA) was administered. Both common carotid arteries were invisible on MR angiography, and subsequent chest computed tomography revealed an aortic dissection...
October 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Junya Hatakeyama, Toshiharu Yanagisawa, Erina Kudo, Shuntaro Togashi, Hiroaki Shimizu
Progressive cerebral infarction in patients with hemorrhagic onset of moyamoya disease is rare, and a treatment strategy is not well established. Here, we report a case that was successfully treated with emergency bypass surgery. A 58-year-old woman presented with a sudden disturbance of consciousness and right-sided hemiparesis. Computed tomography(CT)showed intraventricular hemorrhage involving the head of the left caudate nucleus. Ventricular drainage was immediately performed, and the patient was treated conservatively...
October 2016: No Shinkei Geka. Neurological Surgery
Jae-Young Han, Jae-Hong Kim, Ju-Hyung Park, Min-Yeong Song, Min-Keun Song, Dong-Joo Kim, Young-Nim You, Gwang-Cheon Park, Jin-Bong Choi, Myung-Rae Cho, Jeong-Cheol Shin, Ji-Hyun Cho
BACKGROUND: Scalp acupuncture (SA) and repetitive transcranial magnetic stimulation (rTMS) are effective for treating cerebral infarction. This study aims to examine the efficacy and safety of SA and electromagnetic convergence stimulation (SAEM-CS), which was developed through collaboration between conventional medical physicians and doctors who practice traditional Korean medicine. SAEM-CS was designed to improve function in patients with cerebral infarction, compared to the improvement after conventional stroke rehabilitation, SA, and rTMS therapeutic approaches...
October 11, 2016: Trials
Gustavo José Luvizutto, Gabriela Rizzo Soares Rizzati, Marcelo Ortolani Fogaroli, Rodrigo Thomazi Rodrigues, Priscila Watson Ribeiro, Hélio Rubens de Carvalho Nunes, Gabriel Pereira Braga, Rafael Dalle Molle da Costa, Silméia Garcia Zanati Bazan, Luiz Antônio de Lima Resende, Adriana Bastos Conforto, Rodrigo Bazan
BACKGROUND: Unilateral spatial neglect (USN) is characterized by the inability to report or respond to people or objects that are presented in the spatial hemisphere that is contralateral to the lesioned hemisphere of the brain. USN has been associated with poor functional outcomes and long stays in hospitals and rehabilitation centers. Noninvasive brain stimulation, such as transcranial direct current stimulation (tDCS), has been used in people who have been affected by USN after stroke...
October 3, 2016: Trials
Tuo Lin, Lisheng Jiang, Zulin Dou, Cheng Wu, Feng Liu, Guangqing Xu, Yue Lan
BACKGROUND: Continuous theta burst stimulation (cTBS) and intermittent TBS (iTBS) are powerful patterns of repetitive transcranial magnetic stimulation (rTMS), with substantial potential for motor function rehabilitation post-stroke. However, TBS of suprahyoid motor cortex excitability has not been investigated. This study investigated TBS effects on suprahyoid motor cortex excitability and its potential mechanisms in healthy subjects. METHODS: Thirty-five healthy subjects (23 females; mean age = 21...
August 24, 2016: Brain Stimulation
Nela V Ilić, Emilija Dubljanin-Raspopović, Una Nedeljković, Sanja Tomanović-Vujadinović, Sladjan D Milanović, Ivana Petronić-Marković, Tihomir V Ilić
BACKGROUND: A growing body of evidence supports the effectiveness of using transcranial direct current stimulation (tDCS) in patients with chronic hand motor impairment resulting from stroke. OBJECTIVE: In this study, we investigate and compare the combined effects of anodal tDCS and occupational therapy (OT) to sham stimulation with OT (control) on fine motor skill deficits of chronic stroke patients. METHODS: A total of 26 stroke patients (at ≥ 9 months) were randomly assigned to an active treatment or a control group in a double-blinded, sham-controlled, parallel design study...
September 29, 2016: Restorative Neurology and Neuroscience
Georg Kägi, Natascha Leisi, Marian Galovic, Marlise Müller-Baumberger, Werner Krammer, Bruno Weder
BACKGROUND: Up to 50% of ischaemic stroke patients show initial dysphagia, which may persist for months. Guidelines recommend switching nasogastric (NG) to percutaneous endoscopic gastrostomy (PEG) tube feeding at the second week after the stroke if impaired deglutition is expected for another 4 weeks. Precise prognostic criteria are lacking. We hypothesised that the Parramatta Hospitals' Assessment of Dysphagia (PAHD) performed 8 to 10 days after the stroke predicts impaired deglutition for another 4 weeks...
2016: Swiss Medical Weekly
Aurelien Hugues, Julie Di Marco, Perrine Janiaud, Isabelle Bonan, Francois Gueyffier, Gilles Rode
OBJECTIVE: Balance disorders are frequently seen after stroke resulting in limited physical activities. The effects of current physical rehabilitations aiming at reducing postural imbalance are varied with low levels of evidence. OBJECTIVES: i) to determine the efficiency of physical rehabilitation methods on the recovery of postural imbalance in patients after stroke; ii) to assess which method is more effective when compared with one another. MATERIAL/PATIENTS AND METHODS: Search strategy: we searched Medline, Embase, Pedro, Cochrane Central Register of Controlled Trials, Pascal and Francis from inception to October 2015...
September 2016: Annals of Physical and Rehabilitation Medicine
Karima Bakhti, Makii Muthalib, Stephane Perrey, Jerome Froger, Isabelle Laffont, Denis Mottet
OBJECTIVE: The majority of stroke survivors do not use their paretic arm in daily life activities, and this is, in part, because they learned to not use their paretic arm before recovering. In seated reaching, the difference between spontaneous arm use (as in daily activities) and forced arm use of the paretic arm (when trunk movements are not allowed) provides the percentage of learned non- use of the paretic arm. Here, we sought for neural correlates of the learned non-use behaviour using fNIRS neuroimaging...
September 2016: Annals of Physical and Rehabilitation Medicine
Monica Baciu, Audrey Acher, Louise Kauffmann, Emilie Cousin, Claire Boilley, Thomas Hueber, Pierre Badin, Pascal Perrier, Diandra Fabre, Assia Jaillard, Olivier Detante, Dominique Perennou
OBJECTIVE: To assess the efficiency of Visual Feedback (VF) on language recovery and plasticity in three chronic non-fluent aphasic patients. VF is based on language-action interaction, thus, language skills are improved by rehabilitation strategies based on execution and observation of motor actions. VF is an ultrasound system coupled with video images, allowing patients to 'see their own lips and tongue at work' during speech and improve their awareness of their lingual and labial movements and their ability to coordinate and combine phonemes and syllables...
September 2016: Annals of Physical and Rehabilitation Medicine
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