BACKGROUND AND PURPOSE: Population-based information on the epidemiology of ischemic stroke (IS) subtypes is scant. In this study, we characterized IS subtypes in terms of incidence, time trend, and risk factor profiles in a community-based population. METHODS: We obtained data from the Takashima Stroke Registry on approximately 55 000 residents ...

We defined whether resveratrol administration during the acute phase of ischemic stroke reduces brain injury in mice. Infarct volumes were decreased significantly in both sexes with different doses of resveratrol (5mg/kg for males and 1mg/kg for females) administered 3h after ischemic stroke. Administration of resveratrol 6h after insult was also ...

Brainstem strokes affecting the periaqueductal gray matter of the midbrain can cause vertical ophthalmoplegia. Accompanying clinical features are frequently associated and reflect the involvement of other brainstem structures. We report on an adolescent presenting with vertical gaze palsy and left mydriatic pupil as the only clinical expression of a small ...

Stroke in young adults is not a rare entity, and often provides difficult management decisions for neurologists. The knowledge gained from stroke in older adults does not transfer easily to this younger group given the different causes of stroke observed. Cardiac causes of stroke are common in this group, but ...

Embolism of cardiac origin accounts for around 15-30% of ischaemic strokes. Strokes due to cardioembolism are generally severe and early and long-term recurrence and mortality are high. The diagnosis of a cardioembolic source of stroke is frequently uncertain and relies on the identification of a potential cardiac source of embolism ...

Angiopoietin-2 has been reported to regulate the inflammation process, which is associated with recurrence of stroke. The purpose of this study was to test the hypothesis that plasma levels of angiopoietin-2 and variants of angiopoietin-2 will confer risk of stroke recurrence. The association of plasma angiopoietin-2 (determined by using ELISA) ...

Matrix metalloproteinase-9 (MMP-9) is a possible marker for acute ischemic stroke (AIS). In animal models of cerebral ischemia, MMP expression was significantly increased and was related to blood-brain barrier disruption, vasogenic edema formation, and hemorrhagic transformation. The definition of the exact role of MMPs after ischemic stroke will have important ...

The maximum left atrial volume index (LAVI) has been shown to be of prognostic values, but previous studies have largely been limited to older patients with specific cardiovascular conditions. We examined the independent prognostic values of LAVI in a large unselected series of predominantly younger patients in sinus rhythm followed ...

Carotid intima-media thickness (IMT) has been associated with an increased risk of ischemic stroke. To better understand this association, we evaluated the relationships of vascular risk factors, including carotid IMT and carotid plaque, and large territory cerebral infarction and small vessel stroke. A total of 502 patients with acute ischemic ...

Extending the duration of continuous electrocardiography after ischemic stroke detects more new cases of atrial fibrillation, which is an important and treatable cause of stroke, but the cost-effectiveness of this approach is unknown. Therefore, we performed a cost-utility analysis of outpatient cardiac monitoring after ischemic stroke. Using a Markov model, ...

BACKGROUND AND PURPOSE: Watershed ischemia is a significant cause of stroke in severe carotid disease, but its pathophysiology is unsettled. Although hemodynamic compromise has long been regarded as the main mechanism-particularly with deep watershed infarction-there is some contradictory evidence from clinical and pathological studies for a role of microembolism, thought ...

BACKGROUND: The ventricular stroke work refers to the work done by the left or right ventricle to eject the volume of blood during one cardiac cycle, called stroke volume. Sarnoff and Berglund were one of the first to calculate the stroke work from the pressure volume diagram in 1954. However, ...

BACKGROUND: The detection of biomarkers such as ischemia-modified albumin (IMA) and heart fatty acid-binding protein (HFABP) is used in the early diagnosis of acute myocardial infarction. As these biomarkers are not organ specific, we tested them in the neurovascular field. METHODS: A total of 41 patients with acute stroke were ...

Acute ischemic stroke is a potentially devastating condition. What follows is a true narration of the experience of a doctor-patient during his treatment for acute ischemic stroke and how the experience changed him. Described is the temporal sequence of events, starting from home to infusion of tissue plasminogen activator, which, ...

Multimodal magnetic resonance imaging of acute stroke provides predictive value that can be used to guide stroke therapy. A flexible artificial neural network (ANN) algorithm was developed and applied to predict ischemic tissue fate on three stroke groups: 30-, 60-minute, and permanent middle cerebral artery occlusion in rats. Cerebral blood ...

To evaluate whether in hypertensive patients the risk of cardiovascular disease is greater in association with the metabolic syndrome (MetS) or the sum of its individual components. Cox regression analysis models were developed to assess the influence of age, sex, ethnicity, and the individual components of MetS on risk associated ...

Cortical infarction presenting with pure dysarthria is rarely reported. Previous studies have reported pure dysarthria due to cortical stroke at the precentral gyrus or middle frontal gyrus. We report a 72-year-old man who developed pure dysarthria caused by an acute cortical infarction in the insular cortex. The role of the ...

Sequence variants on chromosome 9p21.3 are implicated in coronary artery disease and myocardial infarction, but studies in ischemic stroke have produced inconsistent results. We investigated whether these conflicting findings were due to false-positive studies confounded by population stratification or false-negative studies that failed to account for effects specific to certain ...

Acute ischemic stroke due to thromboembolism from the left ventricle is a serious complication following myocardial infarction (MI). Despite the attention given to acute stroke intervention, peri-MI ischemic stroke is an underappreciated condition. Here, we describe a case of acute cardiac thromboembolic occlusion of the middle cerebral artery with preceding ...

Intravenous recombinant tissue plasminogen activator remains the only US FDA-approved treatment for acute ischemic stroke. However, the very limited time window for its administration restricts its usefulness. Furthermore, it is becoming increasingly clear that, given the numerous pathways via which cerebral ischemia causes cell death, the capacity to inhibit multiple ...

BACKGROUND AND PURPOSE: To evaluate the strength of the in vivo evidence of relationships between flavonoids and risk of stroke. METHODS: We reviewed the literature more broadly for flavonoids and stroke and conducted an evidence-based review of original publication experiments on tea or tea components on induced coronary occlusion in ...

OBJECTIVE: Cerebral embolisation constitutes the main source of complications during transfemoral carotid artery stenting (CAS) and is associated with a high incidence of silent brain infarction. The goal of this study is to evaluate the incidence of new ischaemic cerebral lesions following transcervical CAS with carotid flow reversal for neuroprotection. ...

BACKGROUND: A substantial proportion of ischemic strokes have an embolic mechanism, but the source of embolism is not detected. Coexistence of subdiaphragmatic visceral infarction (SDVI; e.g., renal, splenic, hepatic, bowel infarction) may be a suggestion of a common source of embolism. One large autopsy study found SDVI in 21.5% of ...

The field of thrombocardiology, dealing with the delicate balance between thrombotic complications and bleeding, is thought to be increasingly important in modern cardiology. Dramatic thromboembolic complications, such as myocardial infarction and stroke, have stimulated the development of a series of active drugs with inherent predisposition to serious bleeding. The EuroThrombosis ...

CTP has a growing role in evaluating stroke. It can be performed immediately following NCCT and has advantages of accessibility and speed. Differentiation of salvageable ischemic penumbra from unsalvageable core infarct may help identify patients most likely to benefit from thrombectomy or thrombolysis. Still, CTP interpretation can be complex. We ...

BACKGROUND AND PURPOSE: Deep intracerebral hemorrhage (ICH) and lacunar infarcts are the result of small vessel disease, whereas nonlacunar infarcts are often caused by large artery atherosclerosis or cardiac embolism. We hypothesized that patients with deep ICH and lacunar infarcts have similar retinal microvascular signs and that these differ from ...

Reperfusion of the ischemic territory forms the basis of most acute stroke treatments. This overview of the literature relating to reperfusion in acute ischemic stroke published within the last year provides a snapshot of a rapidly evolving aspect of cerebrovascular disease. Arterial revascularization from systemic thrombolysis to combination endovascular procedures ...

Randomized clinical studies have demonstrated that tissue plasminogen activator thrombolytic therapy improves functional outcomes. Recently the time window for tissue plasminogen activator thrombolytic therapy has been extended from 3 to 4.5h after ischemic stroke onset, which will allow more ischemic stroke patients to benefit from this treatment. Healthcare providers should ...

BACKGROUND AND PURPOSE: Noncoronary forms of atherosclerosis (including transient ischemic attacks or stroke of carotid origin or >50% stenosis of the carotid artery) are associated with a 10-year vascular risk of >20% and are considered as a coronary heart disease (CHD) -risk equivalent from the standpoint of lipid management. The ...

OBJECTIVES: To show that echocardiographic left atrial enlargement (Echo-LAE) and electrocardiographic left atrial abnormalities (ECG-LAA) may be probable new risk factors for ischemic and hemorrhagic stroke. METHODS: This descriptive prospective case study included 140 CT or MRI-confirmed hemorrhagic and ischemic stroke patients, who were admitted to Rizgary Teaching Hospital, Erbil, ...

Valvular strands are known to be a potential source of cardioembolism but the natural history of native valvular strands has not yet been fully outlined. We report a case of ischemic stroke in a patient with a native valvular strand of the aortic valve and the patient's clinical course. A ...

All combination hormone replacement regimens contain estrogen and a progestational agent. The Women's Health Initiative trial demonstrated that taking the combination of conjugated estrogen and medroxyprogesterone resulted in a higher risk of myocardial infarction and stroke in the study population. However, not all progestational agents are alike in their cardiovascular ...

OBJECTIVE: To assess the cerebral vasomotor response to ipsilesional repetitive transcranial magnetic stimulation (rTMS) on transcranial Doppler (TCD) in patients with recent ischemic stroke without carotid occlusive disease, and to compare this response in patients with cortical and subcortical infarcts. METHODS: Consecutive patients with first-ever anterior circulation acute ischemic stroke ...

BACKGROUND: Up to 20% of lacunar infarcts are clinically misdiagnosed as cortical infarcts and vice versa. The reasons for this discrepancy are unclear. We assessed clinical and imaging features which might explain this 'clinical-imaging dissociation' (C-ID). METHODS: Patients with an acute stroke syndrome (cortical or lacunar) underwent magnetic resonance imaging ...

BACKGROUND: Early neurological deterioration is common in the acute phase after stroke. We sought to investigate the correlation between the progression of microembolic signal (MES), ischemic infarcts and the neurological deficits in the acute phase of stroke patients with large artery occlusive disease. METHODS: Transient ischemic attack or stroke patients ...

Merck & Co. is developing vorapaxar (SCH 530348), a thrombin receptor antagonist, for the prevention and treatment of arterial thrombosis. Vorapaxar is currently being evaluated in two large-scale multinational phase III trials (TRA*CER and TRA 2°P-TIMI 50) for the treatment and prevention of cardiac events in almost 30,000 patients with ...

BACKGROUND AND OBJECTIVE: Infarct volume and patterns may vary according to the stroke subtype. Within each stroke subtype, however, it is not clear if the infarct volume and patterns are affected by the risk of cardioembolism (CE) and the degree of arterial stenosis. PATIENTS AND METHODS: We included consecutive patients ...

BACKGROUND: Most epidemiological studies have reported a significant association between elevated serum levels of uric acid (UA) and increased cardiovascular disease. On the other hand, UA is the most abundant antioxidant in the human body. We hypothesized that UA levels would change noticeably in association with the degree of oxidative ...

Cardiac thrombus is not an established contraindication to thrombolysis with intravenous tissue plasminogen activator in acute ischemic stroke. Recurrent ischemic stroke involving an initially unaffected arterial territory during the course of thrombolysis in stroke has been reported, but remains exceptionally rare. We present a case that developed cardioembolic stroke on ...

Conflicting data exists regarding the effect of hemispheric lateralization on acute ischemic stroke outcome. Some of this variability may be related to heterogeneous study populations, particularly with respect to the level of arterial occlusion. Furthermore, little is known about the relationship between stroke lateralization and predictors of outcome. The purpose ...

Vascular cognitive impairment, being the only treatable cause of dementia in the early stages, and having a diverse etiology, requires sensitive criteria for definition. This study aimed to study cognitive functions at 3 months post-stroke, utilising the Mini mental scale examination (MMSE) and the Frontal assessment battery (FAB), and to ...

Thrombolysis with intravenous tissue (IV) plasminogen activator (tPA) is considered for patients with acute ischemic stroke falling within the described inclusion criteria defined by The National Institute of Neurological Disorders and Stroke (NINDS) rtPA trial. Complications of IV thrombolysis with tPA are commonly related to hemorrhage, anaphylaxis, or arterial occlusion. ...

BACKGROUND AND PURPOSE: On brain imaging, lacunes, or cerebrospinal fluid-containing cavities, are common and are often counted in epidemiological studies as old lacunar infarcts. The proportion of symptomatic lacunar infarcts that progress to lacunes is unknown. Noncavitating lacunar infarcts may continue to resemble white matter lesions. METHODS: We identified patients ...

We aimed to determine if ischemia involving Broca area predicts Broca aphasia more reliably in acute or chronic stroke. We included consecutive right-hand-dominant patients with left hemisphere ischemic stroke (<48 hours from onset for acute stroke or >6 months after stroke for chronic stroke). MRI scans were analyzed for ischemic ...

Erythropoietin (EPO) has shown promise as a neuroprotectant in animal models of ischemic stroke. EPO is thought not only to protect neurons from cell death, but also to promote regeneration after stroke. Here, we report a systematic review and meta-analysis of the efficacy of EPO in animal models of focal ...

Circulating adiponectin (ADPN) has been inversely associated with the risk of coronary artery disease and ischemic stroke (IS), due to its anti-inflammatory and anti-atherosclerotic properties. Recent experimental studies have suggested that ADPN may as well exert cerebroprotective properties in brain ischemia, therefore modifying disease outcome. We investigated whether acute post-stroke ...

BACKGROUND: There is scant information on the proportion, risk factors and outcome of lacunar infarction in China. METHODS: Prospective registry data entered within 1 month after a first-ever stroke between March 2002 and March 2007 were used from 4 Chinese hospitals. Data regarding stroke risk factors and baseline characteristics were ...

BACKGROUND: Ischemic injury to the central nervous system causes cellular activation and disintegration, leading to release of cell-type-specific proteins into the cerebrospinal fluid (CSF). We investigated CSF concentrations of myelin basic protein (MBP), glial fibrillary astrocytic protein (GFAP), the calcium-binding protein S100B, and neuron-specific enolase (NSE) in acute ischemic stroke ...

OBJECTIVE: We sought to determine the in-hospital incidence and predictors of ischaemic stroke in patients with ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). METHODS: We reviewed 2638 consecutive patients undergoing 2722 pimary PCI procedures for STEMI during in-hospital stay. Stroke was defined as any new focal ...

BACKGROUND AND PURPOSE: PCT has emerged as an alternative to MR imaging for the assessment of patients with suspected acute stroke. However, 1 disadvantage of PCT is its limited anatomic coverage, which may impact the characterization of hemispheric ischemic strokes. The purpose of this study was to determine the optimal ...