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Turner Jennifer J Maidstone and Tunbridge Wells NHS Trust, Tunbridge Wells Hospital, Kent, - - 2014
This case series highlights two patients seen in the same stroke centre presenting with unusual symptoms. They were later diagnosed with bilateral thalamic infarcts, probably related to an unusual anatomical variant. The difficulties in establishing the diagnoses due to their relative rarity and complexity could have impacted on patient outcomes.
Lee Jeong Hyun JH Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA - - 2014
Rho-associated kinase (ROCK) is a key regulator of numerous processes in multiple cell types relevant in stroke pathophysiology. ROCK inhibitors have improved outcome in experimental models of acute ischemic or hemorrhagic stroke. However, the relevant ROCK isoform (ROCK1 or ROCK2) in acute stroke is not known. We characterized the pharmacodynamic ...
Pinto Antonio - - 2014
Stroke is the second cause of death worldwide and one of the leading cause of disability. Due to the high rate of recurrence, in high risk-patients (eg patients affected by atherosclerotic vascular disease), long-term antiplatelet therapy reduces the risk of vascular events such as non-fatal myocardial infarction, non-fatal stroke, or ...
Di Raimondo Domenico - - 2014
Among the different subtypes of ischaemic strokes, almost 20 % are of cardiac origin. Different are the causes of cardioembolic stroke, but the most common is the atrial fibrillation, a supraventricular arrhythmia. Appropriate use of antiplatelet drugs and anticoagulants after transient ischaemic attack (TIA) or ischaemic stroke depends on whether ...
Whitlock Richard R Department of Surgery, McMaster University, Hamilton, Canada ; ; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Canada - - 2014
Occlusion of the left atrial appendage (LAA) is a promising approach to stroke prevention in atrial fibrillation (AF). However, evidence of its efficacy and safety to date is lacking. We herein describe the rationale and design of a definitive LAA occlusion trial in cardiac surgical patients with AF. We plan ...
Satow Takeshi T Department of Neurosurgery, Nagahama City Hospital, Nagahama, - - 2014
Astasia is a rare presenting symptom of stroke, usually known as 'thalamic astasia', induced by a lesion in the ventrolateral thalamus. We report a case of caudal cingulate infarction manifesting astasia. A 58-year-old male presented with inability to sit, stand and walk (astasia). No apparent motor weakness was noticed in ...
Taina Mikko M Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland; Unit of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland; Unit of Radiology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, - - 2014
Left atrial appendage (LAA) volume has been shown to be increased in patients with acute cryptogenic stroke. Atrial fibrillation (AF) is a well-recognized risk factor but it is not the only one associated with LAA enlargement. The aim of the study was to clarify the multifactorial etiology of LAA enlargement ...
Kim Joon-Tae JT Department of Neurology, Cerebrovascular Center, Chonnam National University Hospital, Gwangju, Korea ; Biomedical Research Institute, Chonnam National University Hospital, Gwangju, - - 2014
There have been neither appropriate guidelines nor clinical studies about the use of antithrombotics after hemorrhagic transformation (HT). We sought to find whether the use of antithrombotics after hemorrhagic infarction might be associated with aggravation of HT and neurological deterioration. This retrospective study included prospectively registered consecutive patients with acute ...
Harston George W J GW Radcliffe Department of Medicine, Oxford, - - 2014
Lacunar infarction is traditionally ascribed to lipohyalinosis or microatheroma. We report the case of 40-year-old man, without traditional risk factors for ischemic stroke, who presented to the Emergency Department with recurrent episodes of transient right-sided weakness and paresthesia. Lacunar infarction was confirmed on diffusion-weighted MRI and blood tests showed a ...
Sabashnikov Anton - - 2013
A two-stage explantation of a left ventricular assist device (LVAD) was performed on 47 year old afro-american gentlemen with non-ischemic dilated cardiomyopathy (DCM) who was successfully bridged to recovery. After he suffered a stroke caused by a VAD thrombosis with embolisation, the VAD outflow graft was first ligated using minimally-invasive ...
Lin Yinyao Y Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, Guangdong 510630, - - 2013
To evaluate the features of risk factors and etiological subtypes of brainstem infarctions (BSIs) patients in China. One hundred and ninety-nine cerebral infarction patients with brainstem involvement were categorized into five groups according to Trial of Org 10172 in Acute Stroke Treatment classification: large artery disease (LAD), cardioembolism (CE), small ...
Friedrich B B Departments of Neuroradiology and Neurology, Klinikum Rechts der Isar, Munich, - - 2013
BACKGROUND AND PURPOSE:In acute stroke, CTP is often used to visualize the endangered brain areas, including the ischemic core and the penumbra. Our goal was to assess the evolution of the infarct after mechanical thrombectomy and to analyze the interventional factors determining the fate of the penumbra.MATERIALS AND METHODS:All patients ...
Cotter Gad G Momentum Research, Inc., Durham, NC, USA, - - 2013
Acute heart failure (AHF) is one of the most common causes of hospital admission. Despite the very high short-term morbidity and mortality and high costs associated with the condition, little progress has been made toward an understanding of the complex mechanisms of AHF, and particularly the spike in mortality after ...
Guinot P-G PG Anaesthesiology and Critical Care Department, Amiens University Hospital, Place Victor Pauchet, Amiens 80054, - - 2013
/st>This study was designed to assess the ability of the stroke volume respiratory variation (ΔrespSV) determined by oesophageal Doppler monitoring (ODM) to predict the response to volume expansion (VE) during pneumoperitoneum. The predictive value of ΔrespSV was evaluated according to the concept of the 'grey zone'. /st>Patients operated on laparoscopy ...
Toma Mustafa M Division of Cardiology, St. Paul's Hospital, University of British Columbia, Vancouver, - - 2013
Acute decompensated heart failure (ADHF) is associated with significant morbidity and mortality but the relationship between LVEF and outcomes is unclear. We explored the association between LVEF and 30 and 180 day mortality in 7007 ADHF patients enrolled in the Acute Studies of Nesiritide in Decompensated Heart Failure (ASCEND-HF) trial. We ...
Hannan Edward L EL University at Albany, State University of New York, Albany, New York. Electronic address: - - 2013
Several randomized controlled trials and observational studies have compared outcomes of percutaneous coronary interventions (PCIs) with drug-eluting stents (DESs) and coronary artery bypass grafting (CABG), but they have not thoroughly investigated the relative difference in outcomes for patients aged ≥75 years. In this study, a total of 3,864 patients receiving DES ...
Kurzepa Jacek - - 2013
Abstract There is a continuous urgent need to explore the pathogenesis and biochemical changes within the infarcted area during acute ischemic stroke (IS). Matrix metalloproteinases (MMPs), prevailing extracellular endopeptideses, can digest proteins located extracellulary proteins, eg. collagen, proteoglycans, elastin or fibronectin. Among MMPs, gelatinases (MMP-2 and MMP-9) are the most ...
Ishibashi Akira - - 2013
A novel free radical scavenger, edaravone, has been demonstrated to exert a neuroprotective effect and improve outcomes in acute ischemic stroke, but there have been few clinical studies. Therefore, we investigated retrospectively whether the administration of edaravone at the acute stage of ischemic stroke can improve outcomes of the disease ...
Gupta Deepak K - - 2013
The complex relationship between left atrial (LA) structure and function, electrical burden of atrial fibrillation (AF) and stroke risk is not well understood. We aimed to describe LA structure and function in AF. Left atrial structure and function was assessed in 971 subjects enrolled in the echocardiographic substudy of ENGAGE ...
Hedna Vishnumurthy S VS Department of Neurology, University of Florida, Gainesville, - - 2013
The development of effective neurobiological adjuvants to rehabilitation of paresis caused by stroke will depend on understanding mechanisms of paresis. Our objective was to determine the extent to which upper-limb (UL) paresis after nonlacunar ischemic middle cerebral artery (MCA) distribution stroke is caused by infarction of posterior periventricular white matter ...
Kefer Joëlle J Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium. - - 2013
The aim of the present study was to evaluate the procedural feasibility, the safety and the 1-year outcome following left atrial appendage (LAA) closure using the Amplatzer cardiac plug (ACP) in Belgium. Data were prospectively collected among 90 consecutive patients, undergoing LAA closure with an ACP in 7 Belgian centres ...
Wu Teddy Y - - 2013
We examined the impact of major earthquakes on acute stroke admissions by a retrospective review of stroke admissions in the 6weeks following the 4 September 2010 and 22 February 2011 earthquakes. The control period was the corresponding 6weeks in the previous year. In the 6weeks following the September 2010 earthquake ...
Tietze Anna - - 2013
Chemical exchange saturation transfer (CEST)-derived, pH-weighted, amide proton transfer (APT) MRI has shown promise in animal studies for the prediction of infarction risk in ischemic tissue. Here, APT MRI was translated to patients with acute stroke (1-24 h post-symptom onset), and assessments of APT contrast, perfusion, diffusion, disability and final infarct ...
Athappan Ganesh - - 2013
Studies have suggested that the early excess risk of stroke in coronary artery bypass grafting (CABG) may be compensated for by a slow but progressive catch-up phenomenon in patients undergoing percutaneous coronary intervention (PCI). We therefore undertook this analysis to compare the temporal stroke risk between PCI and CABG in ...
Piccini Jonathan P - - 2013
Atrial fibrillation increases the risks of stroke, heart failure, and death, and anticoagulation therapy increases the risk of gastrointestinal haemorrhage. However, the relative event rates for these outcomes are not well described. We sought to define the risks of major clinical events in older adults after a new diagnosis of ...
Lau K K - - 2013
Both blood pressure (BP) and its variability (BPV) are established risk factors for development of atherosclerotic disease and are associated with an increased risk for cardiovascular and all-cause mortality. The prognostic implications of outpatient clinic visit-to-visit BPV amongst patients with lacunar infarction are nevertheless unknown. The clinical outcome of 281 ...
Kohli Payal - - 2013
Nonsteroidal anti-inflammatory drugs (NSAIDs) other than aspirin have been linked to heart failure, salt retention, adverse ventricular remodeling, and thrombosis. We therefore sought to assess their impact on cardiovascular events in outpatients with stable atherothrombotic disease. We analyzed 44,095 patients in the REduction of Atherothrombosis for Continued Health (REACH) registry ...
Picanço Miguel R - - 2013
The currently proven time window for thrombolysis in ischemic stroke is 4·5 h. Beyond this, the risks and benefits of thrombolysis are uncertain. To determine whether thrombolysis and reperfusion were beneficial after 4·5 h, we examined clinical and radiological outcomes in patients treated with tissue plasminogen activator or placebo within 4·5-6 h, using ...
Andersson Charlotte - - 2013
IMPORTANCE Clinical guidelines have been criticized for encouraging the use of β-blockers in noncardiac surgery despite weak evidence. Relevant clinical trials have been small and have not convincingly demonstrated an effect of β-blockers on hard end points (ie, perioperative myocardial infarction, ischemic stroke, cardiovascular death, and all-cause death). OBJECTIVE To ...
Arboix Adrià A Adrià Arboix, Sebastià González-Peris, Emili Comes, Cerebrovascular Division, Department of Neurology, Hospital Universitari del Sagrat Cor., Universitat de Barcelona, E-08029 Barcelona, - - 2013
We present a 29-year-old woman with a long history of attacks of migraine with and without visual aura. She was a heavy smoker (20 cigarettes/d) and was currently taking oral contraceptives. During a typical migraine attack with aura, she developed dysarthria, left brachial hemiparesis and hemihypoesthesia and brief and autolimited ...
Freixa Xavier X Department of Cardiology, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, - - 2014
Stroke is a major contributor to population morbidity and mortality. Cardiac thromboembolic sources are an important potential cause of stroke. Left atrial appendage (LAA) thromboembolism in association with atrial fibrillation is a major contributor to stroke occurrence, particularly in elderly individuals. Patent foramen ovale (PFO) acts as a potential conduit ...
Pavy Bruno - - 2013
Cardiovascular mortality has decreased over the past 25 years, largely because of acute coronary syndrome care and preventive actions. Nevertheless, the rate of coronary heart disease remains high, with an annual risk of 4.7% (cardiac mortality, myocardial infarction, stroke). Cardiovascular risk factor management must be a priority in primary and ...
Lip Gregory Y H GY University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom. Electronic address: - - 2013
Antithrombotic therapy is central to the management of atrial fibrillation. This analysis from the RHYTHM-atrial fibrillation (RHYTHM-AF) registry explored the appropriateness of antithrombotic therapy in relation to stroke risk and atrial fibrillation duration in patients with atrial fibrillation. RHYTHM-AF, a prospective multinational registry, enrolled consecutive adult patients with atrial fibrillation ...
Freeman Melissa J - - 2013
To report and associate acute cerebral infarctions in 2 young, previously healthy siblings with use of the street drug known as "spice" (a synthetic marijuana product, also known as "K2"), which they independently smoked before experiencing acute embolic-appearing ischemic strokes. We present history, physical examination, laboratory data, cerebrovascular imaging, echocardiogram, ...
Vigen Rebecca R The University of Texas at Southwestern Medical Center, - - 2013
Rates of testosterone therapy are increasing and the effects of testosterone therapy on cardiovascular outcomes and mortality are unknown. A recent randomized clinical trial of testosterone therapy in men with a high prevalence of cardiovascular diseases was stopped prematurely due to adverse cardiovascular events raising concerns about testosterone therapy safety. ...
Kapur Sunil - - 2013
The left atrial appendage (LAA) is a prominent source of cardioembolic stroke in patients with nonvalvular atrial fibrillation (AF). While systemic anticoagulation is the common therapeutic choice, these medications carry many contraindications and possible complications. Epicardial and endovascular techniques for occlusion of LAA have been explored and early clinical data ...
Verheugt F W A FW Heartcenter, Department of Cardiology, Onze Lieve Vrouwe Gasthuis (OLVG), Oosterpark 9, 1091 AC, Amsterdam, the Netherlands, - - 2013
In patients with nonvalvular atrial fibrillation, oral anticoagulation with the vitamin K antagonists acenocoumarol, phenprocoumon and warfarin reduces the risk of stroke by more than 60 %, whereas single or double antiplatelet therapy is much less effective and sometimes associated with a similar bleeding risk as vitamin K antagonists. Besides bleeding, ...
Shaikh Quratulain - - 2013
Cardio embolism and cerebrovascular atherosclerosis are two major mechanisms of stroke. Studies investigating associations between advanced echocardiographic parameters and stroke mechanisms are limited. This study is a standardized review of 633 patients admitted to the stroke service of a tertiary care hospital following a standardized stroke investigation and management pathway. ...
Katnik C - - 2013
There is currently a significant lack of therapeutic options for acute ischemic stroke, and no drug has been approved for treating patients at delayed time points (≥6h post-stroke). Afobazole, an anxiolytic currently used clinically in Russia, has been shown to reduce neuronal and glial cell injury in vitro following ischemia. ...
Mosley William J WJ - - 2013
Left atrial appendage (LAA) occlusion or ligation is a novel approach to stroke prevention in atrial fibrillation that may obviate the need for long-term anticoagulation. The Lariat device has received Food and Drug Administration 510K clearance for the approximation of soft tissue and has been applied to transcatheter LAA ligation ...
Wu Meng-Chen - - 2013
Large anterior choroidal artery (AChA) infarcts are frequently associated with stroke evolution. This study aimed to investigate the major determinants for stroke evolution in patients with large AChA infarcts. We studied 118 consecutive adult patients with acute large AChA infarcts. The diagnosis was confirmed as abnormal hyperintensities in 3 or ...
Maruyama Kenji - - 2013
Elevated serum brain natriuretic peptide (BNP) levels are associated with cardioembolic stroke mainly because of atrial fibrillation (AF). However, the mechanisms of increased serum BNP levels are hitherto unclear. We aimed to identify the factors associated with increased BNP levels in patients with acute ischemic stroke. We measured serum BNP ...
Adhyapak Srilakshmi M SM Department of Cardiology, St. John's Medical College Hospital, Bangalore, - - 2014
In some patients with ischemic cardiomyopathy, despite large increases in ventricular size with decreased cardiac output, the paradox of preserved stroke volume has been observed. Following surgical ventricular restoration, despite marked improvements clinically and in ventricular volumes and ejection fraction, a decrease in stroke volume was observed. 101 consecutive patients ...
Widimsky Petr - - 2013
The evolution of reperfusion therapy in acute myocardial infarction and acute ischaemic stroke has many similarities: thrombolysis is superior to placebo, intra-arterial thrombolysis is not superior to intravenous (i.v.), facilitated intervention is of questionable value, and direct mechanical recanalization without thrombolysis is proven (myocardial infarction) or promising (stroke) to be ...
Riba-Llena Iolanda - - 2013
Silent brain infarcts are detected by neuroimaging in up to 20% of asymptomatic patients based on population studies. They are five times more frequent than stroke in general population, and increase significantly both with advancing age and hypertension. Moreover, they are independently associated with the risk of future stroke and ...
Shantsila Eduard - - 2013
Heart failure and atrial fibrillation are major problems of modern cardiology with important clinical, prognostic, and socioeconomic implications. The risks are high morbidity, impaired quality of life, poor outcome, and increased risk of stroke. Oral anticoagulation with vitamin K antagonists or novel licensed medicines should be considered unless contraindicated. Possible ...
Palmerini Tullio - - 2013
BACKGROUND: ALTHOUGH THE REDUCTION IN MORTALITY WITH BIVALIRUDIN COMPARED WITH UNFRACTIONATED HEPARIN PLUS GLYCOPROTEIN IIB/IIIA INHIBITORS IN THE HARMONIZING OUTCOME WITH REVASCULARIZATION AND STENT IN ACUTE MYOCARDIAL INFARCTION (HORIZONS-AMI) TRIAL HAS BEEN ATTRIBUTED TO LOWER RATES OF MAJOR BLEEDING, ALTERNATIVE MECHANISMS HAVE NOT BEEN INVESTIGATED IN DEPTH. WE SOUGHT TO ...
Sambola Antonia - - 2013
Oral anticoagulation (OAC) is the recommended therapy for patients with atrial fibrillation (AF) because it reduces the risk of stroke and other thromboembolic events. Dual antiplatelet therapy (DAPT) is required after percutaneous coronary intervention and stenting (PCI-S). In patients with AF requiring PCI-S, the association of DAPT and OAC carries ...
Keum Sehoon - - 2013
During ischemic stroke, occlusion of the cerebrovasculature causes neuronal cell death (infarction), but naturally occurring genetic factors modulating infarction have been difficult to identify in human populations. In a surgically induced mouse model of ischemic stroke, we have previously mapped Civq1 to distal chromosome 7 as a quantitative trait locus ...
Jablonski Kristen L - - 2013
Vascular calcification is highly prevalent in end-stage renal disease and independently predictive of future cardiovascular events and mortality. Calcification can occur in both the intimal and medial layers of vasculature, but medial calcification is the major form in end-stage renal disease. Medial calcification increases large elastic artery stiffness and pulse-pressure, ...
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