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https://www.readbyqxmd.com/read/28646445/update-on-neurocritical-care-of-stroke
#1
Jason Siegel, Michael A Pizzi, J Brent Peel, David Alejos, Nnenne Mbabuike, Benjamin L Brown, David Hodge, W David Freeman
PURPOSE OF REVIEW: This review will highlight the recent advancements in acute ischemic stroke diagnosis and treatment, with special attention to new features and recommendations of stroke care in the neurocritical care unit. RECENT FINDINGS: New studies suggest that pre-hospital treatment of stroke with mobile stroke units and telestroke technology may lead to earlier stroke therapy with intravenous tissue plasminogen activator (tPA), and recent studies show tPA can be given in previously contraindicated situations...
August 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28642575/reactive-astrocytes-function-as-phagocytes-after-brain-ischemia-via-abca1-mediated-pathway
#2
Yosuke M Morizawa, Yuri Hirayama, Noubuhiko Ohno, Shinsuke Shibata, Eiji Shigetomi, Yang Sui, Junichi Nabekura, Koichi Sato, Fumikazu Okajima, Hirohide Takebayashi, Hideyuki Okano, Schuichi Koizumi
Astrocytes become reactive following various brain insults; however, the functions of reactive astrocytes are poorly understood. Here, we show that reactive astrocytes function as phagocytes after transient ischemic injury and appear in a limited spatiotemporal pattern. Following transient brain ischemia, phagocytic astrocytes are observed within the ischemic penumbra region during the later stage of ischemia. However, phagocytic microglia are mainly observed within the ischemic core region during the earlier stage of ischemia...
June 22, 2017: Nature Communications
https://www.readbyqxmd.com/read/28639376/mfat-1-transgene-protects-cultured-adult-neural-stem-cells-against-cobalt-chloride-mediated-hypoxic-injury-by-activating-nrf2-are-pathways
#3
Junfeng Yu, Haiyuan Yang, Bin Fang, Zhengwei Zhang, Ying Wang, Yifan Dai
Ischemic stroke is a devastating neurological disorder and one of the leading causes of death and serious disability in adults. Adult neural stem cell (NSC) replacement therapy is a promising treatment for both structural and functional neurological recovery. However, for the treatment to work, adult NSCs must be protected against hypoxic-ischemic damage in the ischemic penumbra. In the present study, we aimed to investigate the neuroprotective effects of the mfat-1 transgene on cobalt chloride (CoCl2 )-induced hypoxic-ischemic injury in cultured adult NSCs as well as its underlying mechanisms...
June 22, 2017: Journal of Neuroscience Research
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
#4
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/28616910/-effects-of-limb-ischemic-postconditioning-on-behavioral-improvement-and-proliferation-of-neural-cells-in-rats-with-transient-cerebral-ischemia
#5
Dan Huang, Hong-Hong Liu, Zhen Yang, Yun Qu
OBJECTIVES: To determine the effects of non-invasive limb ischemic postconditioning (NLIP) on the behavioral performance and the expression and distribution of neural cells in rats with ischemic cortex. METHODS: Rats were randomly divided into 3 groups: sham group (n=10), ischemia/reperfusion (I/R) group (n=50), and NLIP group (n=50). Focal cerebral ischemia was induced by intraluminal MCAO in the rats in the I/R and NLIP groups, while no suture was inserted in the sham-operated rats...
May 2017: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/28600481/optimal-thresholds-for-ischemic-penumbra-predicted-by-computed-tomography-perfusion-in-patients-with-acute-ischemic-stroke-treated-with-mechanical-thrombectomy
#6
Katsuharu Kameda, Junji Uno, Ryosuke Otsuji, Nice Ren, Shintaro Nagaoka, Kazushi Maeda, Yoshiaki Ikai, Hidefuku Gi
BACKGROUND AND PURPOSE: Optimal thresholds for ischemic penumbra detected by CT perfusion (CTP) in patients with acute ischemic stroke (AIS) have not been elucidated. In this study we investigated optimal thresholds for salvageable ischemic penumbra and the risk of hemorrhagic transformation (HT). METHODS: A total of 156 consecutive patients with AIS treated with mechanical thrombectomy (MT) at our hospital were enrolled. Absolute (a) and relative (r) CTP parameters including cerebral blood flow (aCBF and rCBF), cerebral blood volume (aCBV and rCBV), and mean transit time (aMTT and rMTT) were evaluated for their value in detecting ischemic penumbra in each of seven arbitrary regions of interest defined by the major supplying blood vessel...
June 9, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28596967/prdx6-upregulation-by-curcumin-attenuates-ischemic-oxidative-damage-via-sp1-in-rats-after-stroke
#7
Gongwei Jia, Botao Tan, Jingxi Ma, Lina Zhang, Xinhao Jin, Changqing Li
BACKGROUND: The role of Peroxiredoxin 6 (Prdx6) in brain ischemia remains unclear. Curcumin (Cur) treatment elicits neuroprotective effects against cerebral ischemic injury, and the associated mechanisms may involve Prdx6. In this study, we investigated whether Prdx6 and the transcription factor specific protein 1 (SP1) were involved in the antioxidant effect of Cur after stoke. METHODS: Focal cerebral ischemic injury was induced by transient middle cerebral artery occlusion for 2 hours in male Sprague-Dawley rats treated with or without Prdx6 siRNA...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28592261/trem2-protects-against-cerebral-ischemia-reperfusion-injury
#8
Rong Wu, Xiangpen Li, Pengfei Xu, Likui Huang, Jinping Cheng, Xiaolong Huang, Jingru Jiang, Long-Jun Wu, Yamei Tang
Although post-ischemic inflammation induced by the innate immune response is considered an essential step in the progression of cerebral ischemia injury, the role of triggering receptor expressed on myeloid cells 2 (TREM2) in the pathogenesis of ischemic stroke remains to be elucidated. Here, we found that the transcriptional and post-transcriptional levels of TREM2 were increased in cultured primary microglia after oxygen-glucose deprivation and reoxygenation and in the ischemic penumbra of the cerebral cortex after middle cerebral artery occlusion (MCAO) and reperfusion in mice...
June 7, 2017: Molecular Brain
https://www.readbyqxmd.com/read/28584682/safe-time-duration-for-temporary-middle-cerebral-artery-occlusion-in-aneurysm-surgery-based-on-motor-evoked-potential-monitoring
#9
Jun Tanabe, Tatsuya Ishikawa, Junta Moroi
BACKGROUND: Temporary vessel occlusion of the parent artery is an essential technique for aneurysm surgery. Our aim was to clarify the safe time for temporary occlusion for aneurysm surgery, that is the "safe time duration" (STD), in which brain tissue exposed to ischemia will almost never fall into even the ischemic penumbra during temporary occlusion of the middle cerebral artery (MCA), and even transient postoperative motor impairment will be rare using intraoperative motor-evoked potentials (MEP)...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28569122/rationale-and-design-of-combination-of-an-immune-modulator-fingolimod-with-alteplase-bridging-with-mechanical-thrombectomy-in-acute-ischemic-stroke-famtais-trial
#10
Sheng Zhang, Ying Zhou, Ruiting Zhang, Meixia Zhang, Bruce Campbell, Longting Lin, Fu-Dong Shi, Min Lou
Rationale In acute ischemic stroke patients with large vessel occlusion, although reperfusion within 6 h after stroke onset using combined intravenous alteplase and mechanical thrombectomy (bridging therapy) can improve functional outcome, still approximately 50% patients suffer disability which may result from reperfusion injury. Proof-of-concept clinical trials have indicated that the sphingosine-1-phosphate receptor modulator fingolimod may be efficacious in attenuating brain inflammation and improving clinical outcomes in acute ischemic stroke patients as a single therapy beyond 4...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28547529/toll-like-receptor-4-tlr4-and-triggering-receptor-expressed-on-myeloid-cells-2-trem-2-activation-balance-astrocyte-polarization-into-a-proinflammatory-phenotype
#11
Gerardo Rosciszewski, Vanesa Cadena, Veronica Murta, Jeronimo Lukin, Alejandro Villarreal, Thierry Roger, Alberto Javier Ramos
Astrocytes react to brain injury with a generic response known as reactive gliosis, which involves activation of multiple intracellular pathways including several that may be beneficial for neuronal survival. However, by unknown mechanisms, reactive astrocytes can polarize into a proinflammatory phenotype that induces neurodegeneration. In order to study reactive gliosis and astroglial polarization into a proinflammatory phenotype, we used cortical devascularization-induced brain ischemia in Wistar rats and primary astroglial cell cultures exposed to oxygen-glucose deprivation (OGD)...
May 25, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28537507/electroacupuncture-alleviated-brain-damages-through-mir-191a-5p-targeting-neuronal-calcium-sensor-1-after-ischemic-stroke
#12
Heng Zhou, Ceng Yang, Fuhai Bai, Zhi Ma, Jingyi Wang, Feng Wang, Feng Li, Qiang Wang, Lize Xiong
Electroacupuncture (EA) administration before or after cerebral ischemia has been shown to afford protection against ischemic injury. However, the underlying mechanism of EA-mediated protection is still unclear. Functional microRNAs (miRNAs) are believed to play important roles in neuroprotection and synaptic plasticity during and after ischemia. In a previous study, we identified 20 miRNAs that are expressed in the penumbra and are significantly changed after EA treatment. Here, we used bioinformatics analysis to predict the biological functions and gene-networks of these miRNAs...
May 24, 2017: Rejuvenation Research
https://www.readbyqxmd.com/read/28531910/extracranial-carotid-disease-and-effect-of-intra-arterial-treatment-in-patients-with-proximal-anterior-circulation-stroke-in-mr-clean
#13
Olvert A Berkhemer, Jordi Borst, Manon Kappelhof, Albert J Yoo, Lucie A van den Berg, Puck S S Fransen, Debbie Beumer, Wouter J Schonewille, Paul J Nederkoorn, Marieke J H Wermer, Henk A Marquering, Hester F Lingsma, Yvo B W E M Roos, Robert J van Oostenbrugge, Diederik W J Dippel, Wim H van Zwam, Charles B L M Majoie, Bart J Emmer, Aad van der Lugt
Background: The presence of extracranial carotid disease (ECD) is associated with less favorable clinical outcomes a in patients with acute ischemic stroke caused by intracranial proximal occlusion. Acute intra-arterial treatment (IAT) in the setting of extracranial and intracranial lesions is considered challenging, and whether it yields improved outcomes remains uncertain. Objective: To examine whether the presence of ECD modified the effect of IAT for intracranial proximal anterior circulation occlusion...
May 23, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28523299/three-dimensional-organ-scanning-reveals-brain-edema-reduction-in-a-rat-model-of-stroke-treated-with-an-aquaporin-4-inhibitor
#14
Elena Silvia Popescu, Ionica Pirici, Raluca Niculina Ciurea, Tudor Adrian Bălşeanu, Bogdan Cătălin, Claudiu Mărgăritescu, LaurenŢiu Mogoantă, Sorin Hostiuc, Daniel Pirici
Stroke is one of the most important cause of death and disability, especially when considering the increasing life expectancy worldwide, with ischemic stroke being much more common than hemorrhages. In the physiopathological chain of ischemic stroke, brain edema is one first element that if attended to might reduce tissue necrosis, penumbra, and increase functional recovery. Aquaporin 4 (AQP4) has been found to be the most important water channel in the brain, and its inhibition before inducing focal ischemia in an animal model of stroke proved to alleviate the pathology and improve clinical recovery...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28508117/single-center-experience-using-the-3max-reperfusion-catheter-for-the-treatment-of-acute-ischemic-stroke-with-distal-arterial-occlusions
#15
Kévin Premat, Bruno Bartolini, Flore Baronnet-Chauvet, Eimad Shotar, Vincent Degos, Paul Muresan, Federico Di Maria, Joseph Gabrieli, Charlotte Rosso, Silvia Pistocchi, Jacques Chiras, Nader Sourour, Sonia Alamowitch, Yves Samson, Frédéric Clarençon
PURPOSE: Most recent guidelines recommend the use of stent retriever devices in endovascular treatment of acute ischemic stroke with large vessel occlusion (LVO). Recently published data reported convincing results with thromboaspiration devices such as the Penumbra System (Penumbra, Alameda, CA, USA) combined with supple reperfusion catheters by using the ADAPT (A Direct Aspiration First-Pass Thrombectomy) technique. The aim of this study was to report our initial experience with the 3MAX (3...
May 15, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28487326/xbp1-x-box-binding-protein-1-dependent-o-glcnacylation-is-neuroprotective-in-ischemic-stroke-in-young-mice-and-its-impairment-in-aged-mice-is-rescued-by-thiamet-g
#16
Meng Jiang, Shu Yu, Zhui Yu, Huaxin Sheng, Ying Li, Shuai Liu, David S Warner, Wulf Paschen, Wei Yang
BACKGROUND AND PURPOSE: Impaired protein homeostasis induced by endoplasmic reticulum dysfunction is a key feature of a variety of age-related brain diseases including stroke. To restore endoplasmic reticulum function impaired by stress, the unfolded protein response is activated. A key unfolded protein response prosurvival pathway is controlled by the endoplasmic reticulum stress sensor (inositol-requiring enzyme-1), XBP1 (downstream X-box-binding protein-1), and O-GlcNAc (O-linked β-N-acetylglucosamine) modification of proteins (O-GlcNAcylation)...
May 9, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28486941/neuroprotective-effect-of-salvianolate-lyophilized-injection-against-cerebral-ischemia-in-type-1-diabetic-rats
#17
Fujiang Wang, Qiansong He, Jinxin Wang, Qing Yuan, Hong Guo, Lijuan Chai, Shaoxia Wang, Limin Hu, Yue Zhang
BACKGROUND: Salvianolate lyophilized injection (SLI) has been clinically used in China for the treatment of acutely cerebral infarction. Clinical and experimental studies have shown that Diabetes mellitus (DM) not only increases the risk of ischemic stroke recurrence but also leads to poor outcomes and increases fatality rates after stroke. Our previous study has proved that SLI can reduce the infarct volume after stroke in type 1 diabetic rats. The aim of the study is to explore the mechanism of SLI on stroke outcome in type 1 diabetic (T1DM) rats...
May 10, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28486789/computed-tomographic-perfusion-to-predict-response-to-recanalization-in-ischemic-stroke
#18
Maarten G Lansberg, Soren Christensen, Stephanie Kemp, Michael Mlynash, Nishant Mishra, Christian Federau, Jenny P Tsai, Sun Kim, Raul G Nogueria, Tudor Jovin, Thomas G Devlin, Naveed Akhtar, Dileep R Yavagal, Diogo Haussen, Seena Dehkharghani, Roland Bammer, Matus Straka, Greg Zaharchuk, Michael P Marks, Gregory W Albers
OBJECTIVE: To assess the utility of computed tomographic (CT) perfusion for selection of patients for endovascular therapy up to 18 hours after symptom onset. METHODS: We conducted a multicenter cohort study of consecutive acute stroke patients scheduled to undergo endovascular therapy within 90 minutes after a baseline CT perfusion. Patients were classified as "target mismatch" if they had a small ischemic core and a large penumbra on their baseline CT perfusion...
June 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28485194/chemical-exchange-sensitive-spin-lock-mri-of-glucose-analog-3-o-methyl-d-glucose-in-normal-and-ischemic-brain
#19
Tao Jin, Hunter Mehrens, Ping Wang, Seong-Gi Kim
Glucose transport is important for understanding brain glucose metabolism. We studied glucose transport with a presumably non-toxic and non-metabolizable glucose analog, 3-O-methyl-d-glucose, using a chemical exchange-sensitive spin-lock MRI technique at 9.4 Tesla. 3-O-methyl-d-glucose showed comparable chemical exchange properties with d-glucose and 2-deoxy-d-glucose in phantoms, and higher and lower chemical exchange-sensitive spin-lock sensitivity than Glc and 2-deoxy-d-glucose in in vivo experiments, respectively...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28479590/cerebral-granulomatous-inflammation-secondary-to-hydrophilic-polymer-embolization-following-thrombectomy
#20
Craig Meiers, Yoftahe Abebe, Neville M Alberto, John Riedinger, Dane A Breker, Michael Manchak, Alexander Drofa, Corey Teigen
BACKGROUND Given the recent completion of multiple trials demonstrating the benefit of endovascular mechanical thrombectomy for select patients with proximal large artery occlusive ischemic strokes, there has been a large increase in the performance of these procedures. In the context of increased thrombectomy performance, there have also been increased reports of rare occurrences of granulomatous inflammatory response to the hydrophilic polymer which coat many of these interventional devices. CASE REPORT A 59-year-old female presented with a complete occlusion of her right proximal middle cerebral artery (MCA) and imaging showed a large area of penumbra...
May 8, 2017: American Journal of Case Reports
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