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The Utility of the Markers of Coagulation and Hemostatic Activation Profile in the Management of Embolic Strokes of Undetermined Source J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2021-01-14 Michael Liu; Deandrea Ellis; Alexander Duncan; Samir Belagaje; Trina Belair; Laura Henriquez; Srikant Rangaraju; Fadi Nahab
Background Potential causes of embolic stroke of undetermined source (ESUS) include occult malignancy, venous thrombosis (VTE) with paradoxical embolism, and hypercoagulable disorders. Given the association of markers of coagulation and hemostatic activation (MOCHA) with these causes, the objective of this study was to validate the utility of the MOCHA profile in identifying the underlying cause of
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Continuous Glibenclamide Prevents Hemorrhagic Transformation in a Rodent Model of Severe Ischemia-Reperfusion J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2021-01-12 Takahiro Igarashi; Cristina Sastre; Zoe Wolcott; W. Taylor Kimberly
Background Endovascular thrombectomy (EVT) is highly effective but may also lead to hemorrhagic transformation (HT) and edema, which may be more pronounced in severe ischemia. We sought to determine whether glibenclamide can attenuate HT and edema in a severe ischemia-reperfusion model that reflects EVT. Methods Using a transient middle cerebral artery occlusion (tMCAo) rodent model of stroke, we studied
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Elevated Levels of Inflammation Markers Predict Poor Outcomes in Acute Ischemic Stroke Patients After Intravenous Thrombolysis J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2021-01-12 Dan Hu; Caixia Ding; Xuemei Jiang; Jing Xiao; Chuanyou Li; Lankun Zhang; Tingting Li; Yun Ji; Yuan Peng; Xun Luo; Lei Sheng; Qingmei Wang; Haoxin Wu
Objectives Inflammation is associated with the occurrence and prognosis of ischemic stroke. The aim of this study was to evaluate the association between inflammatory biomarkers and the short-term clinical outcomes of acute ischemic stroke (AIS) patients after intravenous thrombolysis (IVT). Materials and Methods A total of 208 AIS patients treated with IVT were enrolled in this retrospective study
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Determination of Cerebrovascular Accident Predictors in Patients with New-Onset Atrial Fibrillation After Coronary Artery Bypass Graft Surgery J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2021-01-12 Ali Riza Demir; Omer Celik; Begum Uygur; Mustafa Umut Somuncu; Emre Yilmaz; Yalcin Avci; Muhammed Bayram; Mehmet Erturk
Background Postoperative atrial fibrillation (POAF) is associated with an increased risk of short and long-term stroke. Our aim is to identify the independent predictors of cerebrovascular accident (CVA) development in the patients who underwent isolated coronary artery bypass graft (CABG) surgery and developed POAF which lasted within 48 h. Method 301 consecutive patients who underwent isolated CABG
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Impact of the Perioperative Blood Pressure on Clinical Outcome after Thrombectomy in Acute Basilar Artery Occlusion J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2021-01-09 Bin Han; Xuan Sun; Raynald; Xu Tong; Baixue Jia; Dapeng Mo; Xiaoqing Li; Gang Luo; Zhongrong Miao
Aim: Optimal blood pressure (BP) management in vertebrobasilar circulation stroke patients undergoing thrombectomy remains undetermined. We aimed to evaluate the impact of perioperative BP on clinical outcome after MT in acute basilar artery occlusion (BAO) patients. Methods: We retrospectively analyzed all consecutive patients hospitalized with acute basilar artery occlusion administered endovascular
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Bilateral Large Vessel Occlusion Causing Massive Ischemic Stroke in a COVID-19 Patient J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2021-01-08 Luis A. Robles
The case of a 70-year-old male presenting an ischemic stroke related to COVID-19 infection is described. He was initially admitted to the hospital with respiratory insufficiency syndrome secondary to pneumonia caused by SARS Co2. In the next days, he developed rapid neurological deterioration characterized by drowsiness which progressed to deep coma. D-dimer was elevated. Brain CT scan showed bilateral
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An fMRI, DTI and Neurophysiological Examination of Atypical Organization of Motor Cortex in Ipsilesional Hemisphere Following Post-Stroke Recovery J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2021-01-09 Layla Gould; Shaylyn Kress; Josh Neudorf; Katherine Gibb; Amit Persad; Kotoo Meguro; Jonathan Norton; Ron Borowsky
Objectives We report a 61-year-old woman who developed left hemiparesis following a right frontal stroke. She underwent rehabilitation and regained function of the left side of her body. Three years after her first stroke, she developed a large left subdural hematoma and again presented with left hemiparesis. Materials and Methods Prior to the cranioplasty, an fMRI scan involving left and right hand
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Carotid Endarterectomy is often not Possible after an Unheralded Stroke: Unheralded Stroke in Carotid Artery Stenosis J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2021-01-08 Rodolfo Pini; Gianluca Faggioli; Antonio Muscari; Cristina Rocchi; Sergio Palermo; Andrea Vacirca; Enrico Gallitto; Mauro Gargiulo
Objectives The ongoing literature recommends carotid endarterectomy (CEA) primarily for patients with neurological symptoms, however CEA can be precluded by the onset of a severe stroke or a total carotid occlusion. The present study aims to evaluate the effect of unheralded strokes in patients with a previously asymptomatic carotid stenosis (ACS) possibly considered for CEA. Materials and Methods
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Intracranial Hemorrhage in COVID-19 Patients J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2021-01-08 Sanskriti Mishra; Murray Choueka; Qiang Wang; Chloe Hu; Stephanie Visone; Michael Silver; Evan G. Stein; Steven R. Levine; Qingliang T. Wang
Objective To describe the clinical, laboratory, temporal, radiographic, and outcome features of acute Intracranial Hemorrhage (ICH) in COVID-19 patients. Methods Retrospective, observational, consecutive case series of patients admitted with ICH to Maimonides Medical Center from March 1 through July 31, 2020, who had confirmed or highly suspected COVID-19. Demographic, clinical, laboratory, imaging
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The Association between Cerebral Small Vessel Disease and the Gut Microbiome: A Cross-Sectional Analysis J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2021-01-07 Naoki Saji; Kenta Murotani; Takayoshi Hisada; Tsuyoshi Tsuduki; Taiki Sugimoto; Ai Kimura; Shumpei Niida; Kenji Toba; Takashi Sakurai
Background Recent studies have demonstrated an association between the gut microbiome and cognitive function. However, the associations between the gut microbiome and brain parenchyma damage, and their underlying mechanisms, remain unclear. Materials and Methods We performed a cross-sectional sub-analysis using data from our prospective cohort study to determine the association between the gut microbiome
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Adoption of the Transradial Approach for Neurointerventions: A National Survey of Current Practitioners J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2021-01-06 Somnath Das; Sunidhi Ramesh; Lohit Velagapudi; Ahmad Sweid; Reid Gooch; Stavropoula Tjoumakaris; Robert H. Rosenwasser; Pascal Jabbour
Objectives The transradial approach (TRA) is technically feasible for both diagnostic and therapeutic neurointerventions. It improves patient comfort and is not associated with increased procedural complications when compared to the transfemoral approach (TFA). To date, no studies have looked at barriers to adoption of TRA in the neurointerventionalist community. This study aims to obtain neurointerventionalist
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Clinical Trial of the New Stent Retriever Tron FX for both Proximal and Distal Intracranial Large Vessel Occlusions J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2021-01-05 Hirotoshi Imamura; Nobuyuki Sakai; Hiroshi Yamagami; Tetsu Satow; Yasushi Matsumoto; Keisuke Imai; Shinzo Ota; Nobutaka Horie; Rei Kondo; Yukiko Enomoto; Shinichi Yoshimura; Masaru Hirohata; Masunari Shibata; Yuji Matsumaru; Nobuyuki Ohara; Chiaki Sakai
Background In all of randomized controlled trials of mechanical thrombectomy, the target vessels were proximal. Herein we report a clinical trial of the Tron FX stent retriever, including the smallest size of 2/15 mm for distal intracranial large vessel occlusion (LVO). Objective Eligible patients presented within 8 h of onset with proximal or distal LVOs, and the Tron FX 4/20 mm or 2/15 mm were used
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Association Between the Angiotensin-Converting Enzyme I/D Polymorphism and Risk of Cerebral Small Vessel Disease: a Meta-Analysis Based on 7186 Subjects J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2021-01-04 Cheng Su; Wen-Chen Liu; Guo-Ming Li; Yan Huang
Introduction Cerebral small vessel disease (CSVD) causes a quarter of all strokes and is the most common pathology underlying vascular dementia. However, the mechanism of CSVD remains unclear. Numerous studies have investigated whether the angiotensin-converting enzyme (ACE) intersection/deletion (I/D) polymorphism influences the risk of CSVD, but the results are controversial. Methods We searched
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Factor XII Concentrations and Risk of Intracerebral Haemorrhage. A Prospective Case-Referent Study J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2021-01-04 Kristina Johansson; Lars Johansson; Torbjörn K. Nilsson; Marcus M. Lind
Objectives In a previous pilot study, we found an association between high factor XII levels and risk of haemorrhagic stroke suggesting that factor XII is a risk marker for intracerebral haemorrhage (ICH). The aim of this study was to further investigate the association between factor XII and risk of ICH in a larger population. Materials and Methods This study was conducted as a prospective nested
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Adherence to Acute Care Measures Affects Mortality in Patients with Ischemic Stroke: The Florida Stroke Registry J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2021-01-05 Hannah Gardener; Tatjana Rundek; Judith Lichtman; Erica Leifheit; Kefeng Wang; Negar Asdaghi; Jose G Romano; Ralph L Sacco
Objectives How race/ethnic disparities in acute stroke care contribute to disparities in outcomes is not well-understood. We examined the relationship between acute stroke care measures with mortality within the first year and 30-day hospital readmission by race/ethnicity. Materials and methods The study included fee-for-service Medicare beneficiaries age ≥65 with ischemic stroke in 2010–2013 treated
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Temporal Evolution and Outcomes of Non-Traumatic Intracerebral Hemorrhage in Hospitalized Patients J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2021-01-04 Andrea Loggini; Faten El Ammar; Issam A. Awad; Christos Lazaridis; Christopher L. Kramer; Christi Kordeck; Cedric McKoy; Fernando D. Goldenberg; Ali Mansour
Objective To investigate the radiographic features, temporal evolution, and outcome of patients who develop non-traumatic intracerebral hemorrhage (ICH) while hospitalized for other causes. Methods We retrospectively reviewed consecutive Emergency Department ICH (ED-ICH) and in-hospital ICH (IH-ICH) over an 8-year period. Variables including demographics, medical history, lab values, lead time to diagnosis
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4-Hydroxyl-2-Nonenal Localized Expression Pattern in Retrieved Clots is Associated with Large Artery Atherosclerosis in Stroke Patients J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2021-01-04 Yosuke Osakada; Toru Yamashita; Ryuta Morihara; Namiko Matsumoto; Ryo Sasaki; Koh Tadokoro; Emi Nomura; Yuko Kawahara; Yoshio Omote; Nozomi Hishikawa; Mami Takemoto; Yasuyuki Ohta; Yasuki Suruga; Takayuki Nagase; Yuji Takasugi; Satoshi Inoue; Kyoichi Watanabe; Kentaro Deguchi; Koji Abe
Objectives The relationship between stroke etiology and clot pathology remains controversial. Materials and Methods We performed histological analysis of clots retrieved from 52 acute ischemic stroke patients using hematoxylin and eosin staining and immunohistochemistry (CD42b and oxidative/hypoxic stress markers). The correlations between clot composition and the stroke etiological group (i.e., cardioembolic
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Traumatic Distal Anterior Cerebral Artery Aneurysms – Pathomechanism and Revascularisation Strategies J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2021-01-02 Julia Velz; Giuseppe Esposito; Luca Regli
Traumatic intracranial aneurysms (TICA) of the distal anterior cerebral artery (dACA) are exceptionally rare and display therapeutic challenges due to their angioanatomical characteristics. The objective of this work was to discuss the mechanisms of TICA formation of the dACA and to elucidate the best treatment and revascularization strategies in these patients based on two illustrative cases. Case
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Effective Combined Assessments of Weight Bearing Ratio and Four Square Step Test in Predicting Falls in Discharged Stroke Patients J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-30 Yoshinobu Yoshimoto; Mamoru Tanaka; Asuka Sakamoto
Background We aimed to determine whether combined assessments of single movement tasks could predict falls in community dwelling people with stroke and it was more precision than the berg balance Scale consists of 14 movements. Methods This prospective cohort study performed at five rehabilitation hospitals in Japan. Participants comprised 78 patients with ambulatory stroke. The single movement task
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Gaze Deviation and Paresis Score (GPS) Sufficiently Predicts Emergent Large Vessel Occluding Strokes J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-31 Benedikt Johannes; Pardes Habib; Kolja Schürmann; Omid Nikoubashman; Martin Wiesmann; Jörg B. Schulz; Arno Reich
Objectives The prognosis of patients with acute ischemic stroke (AIS) essentially depends on both prompt diagnosis and appropriate treatment. Endovascular stroke therapy (EST) proved to be highly efficient in the treatment of emergent large vessel occluding (ELVO) strokes in the anterior circulation. To achieve a timely diagnosis, a robust combination of few and simple signs to identify ELVOs in AIS
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Cilostazol Versus Aspirin for Secondary Stroke Prevention: Systematic Review and Meta-Analysis J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-31 Michelle P. Lin; James F. Meschia; Neethu Gopal; Kevin M. Barrett; Owen A. Ross; Nilüfer Ertekin-Taner; Thomas G. Brott
Objectives Cilostazol has promise as an alternative to aspirin for secondary stroke prevention given its vasodilatory and anti-inflammatory properties in addition to platelet aggregation inhibition. We aimed to conduct a systematic review and meta-analysis to estimate the efficacy and safety of cilostazol compared to aspirin for stroke prevention in patients with previous stroke or transient ischemic
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White Matter Acute Infarct Volume After Thrombectomy for Anterior Circulation Large Vessel Occlusion Stroke is Associated with Long Term Outcomes J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-29 Robert W. Regenhardt; Mark R. Etherton; Alvin S. Das; Markus D. Schirmer; Joshua A. Hirsch; Christopher J. Stapleton; Aman B. Patel; Thabele M. Leslie-Mazwi; Natalia S. Rost
Objectives Despite the proven efficacy of endovascular thrombectomy (EVT) for large vessel occlusion stroke, over half treated remain functionally disabled or die. Infarct topography may have implications for prognostication, patient selection, and the development of tissue-specific neuroprotective agents. We sought to quantify white matter injury in anterior circulation acute infarcts post-EVT to
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The Efficacy of Colchicine on Carotid Intima-Media Thickness: A Prospective Comparative Study J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-30 Ebru Yilmaz; Kadriye Halli Akay
Objectives Inflammation plays an important role in the development of atherosclerotic vascular disease, which is the leading cause of morbidity and mortality in the adult population. Several clinical trials have shown that suppression of the inflammatory response can delay or decrease the atherosclerotic process. The aim of this study was to investigate carotid intima-media thickness (CIMT) between
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Malignant Left Atrial Appendage Morphology: Current Classification vs H-L System J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-30 Paloma Parra-Díaz; Luisa Salido-Tahoces; Ana Pardo-Sanz; Álvaro Beltrán-Corbellini; Fernando Rodríguez-Jorge; Juan Luis Chico-García; Sebastián García-Madrona; Consuelo Matute-Lozano; Rocío Vera-Lechuga; Antonio Cruz-Culebras; Jaime Masjuan; Alicia DeFelipe-Mimbrera
Introduction In previous studies the risk of stroke recurrence has been associated with the left atrial appendage (LAA) morphology (non-chicken wing (NCW)), knowing those with a greater risk as malignant LAA. Recently, a simpler morphological classification has been suggested with two categories: Low-risk (LAA-L) and High-risk (LAA-H); which could be easier to apply and may correlate better with the
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Predictive Model of Early Neurological Deterioration in Patients with Acute Ischemic Stroke: A Retrospective Cohort Study J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-30 Xiaohua Xie; Jingyi Xiao; Yunyun Wang; Lu Pan; Jiahui Ma; Liping Deng; Jie Yang; Lijie Ren
Objective This study aimed to develop a predictive model of early neurological deterioration (END) in patients with acute ischemic stroke (AIS). Methods The present retrospective cohort study considered patients with AIS who were admitted to a tertiary hospital in Shenzhen, China between January 2014 and December 2018. An increase of 2 points or more on the National Institute of Health Stroke Scale
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Patient Characteristics and Outcomes Associated with Decline in Stroke Volumes during the Early COVID-19 Pandemic J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-26 Adam N. Wallace; Kaiz S. Asif; Daniel H. Sahlein; Steven J. Warach; Timothy Malisch; E. Francis LaFranchise; Scott Geraghty; K. Derek Kreitel; Marian P. Lamonte; Jefferson T. Miley; Daniel P. Gibson; Krishna Amuluru
Background and Purpose Delayed evaluation of stroke may contribute to COVID-19 pandemic-related morbidity and mortality. This study evaluated patient characteristics, process measures and outcomes associated with the decline in stroke presentation during the early pandemic. Methods Volumes of stroke presentations, intravenous thrombolytic administrations, and mechanical thrombectomies from 52 hospitals
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Brain Computed Tomography Angiography Maximum Intensity Projection Images for ASPECTS Derivation and Detection of Large Infarct Volumes: Preliminary Study J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-23 Yu-Ming Chang; Mary Tenenbaum; Yunyun Xiong; Magdy Selim; Rafeeque Bhadelia; Lotfi Hacein-Bey; Vladimir Ivanovic
Purpose Non-contrast CT ASPECTS (NCCTasp) has an established role in determining eligibility for mechanical thrombectomy in centers without ready access to perfusion or DWI. Moreover, it has been suggested that CTA source ASPECTS (CTAasp) may be superior to NCCTasp in predicting final infarct volume (FIV). In this study, we hypothesized that CTA maximum intensity projection ASPECTS (MIPSasp) would
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Elevated Urinary Titin and its Associated Clinical Outcomes after Acute Stroke J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-24 Manabu Ishihara; Nobuto Nakanishi; Rie Tsutsumi; Kanako Hara; Kyoka Machida; Nobuaki Yamamoto; Yasuhisa Kanematsu; Hiroshi Sakaue; Jun Oto; Yasushi Takagi
Introduction Urinary titin is a biomarker of muscle atrophy, which is a serious complication after stroke. However, there are currently no clinical data regarding urinary titin in stroke patients. Methods Consecutive stroke patients admitted to the stroke care unit were included. Spot urine samples were collected immediately after admission, and on days 3, 5, and 7. The primary outcome was the trend
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Comparison Between Three Commonly Used Large-Bore Aspiration Catheters in Terms of Successful Recanalization and First-Passage Effect J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-24 Vittorio Semeraro; Iacopo Valente; Pietro Trombatore; Maria Porzia Ganimede; Alessandra Briatico; Carmine Di Stasi; Nicola Burdi; Giovanni Boero; Maria Pia Prontera; Prof Roberto Gandini; Sofia Vidali; Prof Marina Diomedi; Fabrizio Sallustio; Francesco D'Argento; Andrea Alexandre; Andrea Romi; Alessandro Pedicelli; Prof Alfredo Berardelli; Emilio Lozupone
Objectives To compare three commonly used large-bore aspiration catheters in terms of final successful recanalization rate and first-passage successful and complete recanalization rates (the so called “first-passage effect”). Materials and methods it is an observational retrospective multicenter study conducted in three Italian high-volume tertiary stroke centers between January 2017 and May 2019.
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Regulatory Mechanism of MicroRNA-30b on Neonatal Hypoxic-Ischemic Encephalopathy (HIE) J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-24 Weiwei Wang; Lifang Jia
Objective This study is to investigate the role of microRNA (miR)-30b in the pathogenesis of hypoxic-ischemic encephalopathy (HIE) in neonates. Methods Totally 26 cases of neonatal HIE were included in this study. The protein expression levels of CD26P and PAI-1 were detected with ELISA. Serum levels of miR-30b and PAI-1 mRNA was measured by quantitative real-time PCR. Human brain microvascular endothelial
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Electric Acupuncture Treatment Promotes Angiogenesis in Rats with Middle Cerebral Artery Occlusion Through EphB4/EphrinB2 Mediated Src/PI3K Signal Pathway J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-24 Yuanhua Wu; Rong Hu; Xiuyan Zhong; Anbang Zhang; Bo Pang; Xiuqi Sun; Guangqi Zhu
Background Cerebral infarction is one of the most common causes of disability and death worldwide. It is reported that electric acupuncture was able to improve the prognosis of cerebral infarction by promoting angiogenesis. However, the corresponding signal pathways of angiogenesis promotes by electric acupuncture treatment needs to be further explored. Methods MCAO rat was employed as the animal model
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Multiple Cerebrovascular Insults in Pseudoxanthoma Elasticum J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-24 N. Abimbola Sunmonu
Pseudoxanthoma elasticum (PXE) is a rare systemic genetic disorder and an uncommon cause of ischaemic and haemorrhagic strokes. Its rarity and variable presentation may delay recognition and diagnosis of the primary disorder or associated conditions. Here, we describe a patient of European ancestry diagnosed with PXE in her 20s who presented in her 50s with a haemorrhagic stroke. Subsequent workup
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The Incidence and Mortality Ratio of Ischemic Cerebrovascular Accidents in COVID-19 Cases: A Systematic Review and Meta-Analysis J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-17 Sina Parsay; Armin Vosoughi; Aytak Khabbaz; Saeed Sadigh-Eteghad
Objectives Coronavirus disease 2019 (COVID-19) is primarily known as a respiratory illness; however, a wide variety of symptoms and complications of the central nervous system (CNS), such as ischemic cerebrovascular accidents (CVA) have been reported. Hereby, we provide a systematic review and a meta-analysis of the literature, investigating the incidence of ischemic CVA and the mortality due to it
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Intravenous Thrombolysis in Acute Ischemic Stroke Patients with Unsuspected Infective Endocarditis J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-23 Mangala Gopal; Sushil Lakhani; Vivien H. Lee
Objective Infective endocarditis (IE) is considered to be an absolute contraindication for intravenous tissue plasminogen activator treatment (IVtPA) in acute ischemic stroke (AIS). However, during the hyperacute stroke evaluation, the exclusion of IE may be difficult. We sought to report the prevalence of undiagnosed IE in AIS patients who received IVtPA. Methods We reviewed consecutive patients hospitalized
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Current Advances in Endovascular Treatment of Intracranial Atherosclerotic Disease and Future Prospective J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-22 Mostafa Jafari; Thanh N. Nguyen; Santiago Ortega-Gutierrez; Muhammad Shazam Hussain; Ameer E. Hassan; Asad Ikram; Javed Khader Eliyas; Gustavo J. Rodriguez; Afshin A. Divani
Objectives/Background Medical therapy is the first line of treatment for intracranial atherosclerotic disease (ICAD). Percutaneous transluminal angioplasty and stenting (PTAS) are mainly considered for those patients with severe stenosis and recurrent events despite aggressive medical therapy. In this review, we discuss the application of PTAS as a treatment option for ICAD and its future prospect
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Impact of Intracranial Pressure Monitor–Guided Therapy on Neurologic Outcome After Spontaneous Nontraumatic Intracranial Hemorrhage J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-22 Sarah T. Menacho; Ramesh Grandhi; Alen Delic; Mohammad Anadani; Wendy C. Ziai; Issam A. Awad; Daniel F. Hanley; Adam de Havenon
Objectives: Intracranial pressure (ICP) monitors have been used in some patients with spontaneous intracranial hemorrhage (ICH) to provide information to guide treatment without clear evidence for its use in this population. We assessed the impact of ICP monitor placement, including external ventricular drains and intraparenchymal monitors, on neurologic outcome in this population. Materials and Methods
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Inhibitory Effects of P2Y12 Receptor Antagonist on PAR1- and PAR4-AP-Induced Platelet Aggregation in Patients with Stroke or TIA J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-22 Asami Kamada; Mie Shimizu; Kazumasa Oura; Makiko Yoshida; Keisuke Tsuda; Kiyotaka Oi; Yoko Ishigaku; Tatsunori Natori; Shinsuke Narumi; Ryo Itabashi; Tetsuya Maeda; Yasuo Terayama
Objectives The inhibitory effects of P2Y12 receptor antagonist on PAR1- and PAR4-activating peptide (AP)-induced platelet aggregation have not been fully elucidated. The present study aimed to investigate the inhibitory effects of P2Y12 receptor antagonist on PAR1- and PAR4-AP-induced platelet aggregation using platelet-rich plasma (PRP) from individuals including patients with stroke or transient
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Optic Nerve and Perioptic Sheath Diameter (ONSD), Eyeball Transverse Diameter (ETD) and ONSD/ETD Ratio on MRI in Large Middle Cerebral Artery Infarcts: A Case-Control Study J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-22 Vincent Legros; Sophie Lefour; Mathieu Bard; Guillaume Giordano-Orsini; Damien Jolly; Lukshe Kanagaratnam
Background Despite recent progress in the multidisciplinary management of large middle cerebral artery infarcts, the neurological prognosis remains worrying in a non-negligible number of cases. The objective of this study is to analyze the contribution of optic nerve and perioptic sheath measurement on MRI to the acute phase of large middle cerebral artery infarcts. Methods A retrospective case-control
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Down-Regulation of miR-181a-5p Prevents Cerebral Ischemic Injury by Upregulating En2 and Activating Wnt/β-catenin Pathway J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-22 Xiaoming Song; Yongming Xue; Hairui Cai
Purpose Cerebral ischemic injury contributes to severe dysfunction of the brain, which triggers extremely high mortality and disability. The role of microRNA (miR)-181a-5p is documented in cerebral ischemic injury. Therefore, this study intended to further figure out the mechanism of miR-181a-5p in cerebral ischemic injury. Methods miR-181a-5p expression in middle cerebral artery occlusion (MCAO) mouse
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A Rare Case of Oculomotor Nerve Palsy after Endovascular Treatment in a Patient with Internal Carotid Artery Dissection J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-22 Seunguk Jung; Changhyo Yoon
Background The oculomotor nerve has two major fibers: the outer autonomic fiber innervates the ciliary muscles and sphincter pupillae involved in pupil constriction, and the inner somatic fiber innervates the levator palpebrae superioris in the eyelid and four extraocular muscles involved in oculomotor dysfunction. We present a rare case of oculomotor nerve palsy with internal carotid artery (ICA)
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A High Resolution MRI Study of the Relationship Between Plaque Enhancement and Perforator Stroke after Stenting for Symptomatic Vertebrobasilar Artery Stenosis J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-18 Xuanzhen Lu; Cuicui Li; Changhua Qu; Jing Huang; Qunfeng Wang; Bing Qiu; Changyin Wang; Sirui Li; Haibo Xu; Yumin Liu
Background and Purpose Perforator stroke is one of the most common complications of vertebrobasilar arterial stenting. We investigated whether perforator stroke after vertebrobasilar arterial stenting is associated with plaque enhancement in patients with severe vertebrobasilar artery stenosis. Methods We studied patients with symptomatic vertebrobasilar arterial stenosis who underwent stenting from
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Changes in Informed Consent Policy and Treatment Delays in Stroke Thrombolysis J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-19 Hanzhang Xu; Deidre Anne De Silva; Fung Peng Woon; Marcus Eng Hock Ong; David B. Matchar; Janet Prvu Bettger; Daniel T. Laskowitz; Ying Xian
Objectives The efficacy of thrombolytic therapy with tissue plasminogen activator (tPA) is highly time dependent. Although clinical guidelines do not recommend written informed consent as it may cause treatment delays, local policy can supersede and require it. From 2014 to 2017, three out of five public hospitals in Singapore changed from written to verbal consent at different time points. We aimed
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Stroke as a Neurological Complication of COVID-19: A Systematic Review and Meta-Analysis of Incidence, Outcomes and Predictors J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-15 Isabel Siow; Keng Siang Lee; John J.Y. Zhang; Seyed Ehsan Saffari; Adeline Ng; Barnaby Young
Introduction COVID-19 is a multi-system infection which predominantly affects the respiratory system, but also causes systemic inflammation, endothelialitis and thrombosis. The consequences of this include renal dysfunction, hepatitis and stroke. In this systematic review, we aimed to evaluate the epidemiology, clinical course, and outcomes of patients who suffer from stroke as a complication of COVID-19
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Downregulation of lncRNA GAS5 Alleviates Hippocampal Neuronal Damage in Mice with Depression-Like Behaviors Via Modulation of MicroRNA-26a/EGR1 Axis J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-18 Yigao Wu; Wei Rong; Qin Jiang; Ruiquan Wang; Huilan Huang
Background Accumulating evidences have demonstrated the roles of several long non-coding RNAs (lncRNAs) in depression. We aim to examine the capabilities of lncRNA growth arrest-specific transcript 5 (GAS5) on mice with depression-like behaviors and the mechanism of action. Methods Fifty-six healthy mice were selected for model establishment. Morris water maze test and trapeze test were performed for
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Association of Longitudinal Glycemia with Diffusion Weighted Imaging Lesions in Spontaneous Intracerebral Hemorrhage J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-18 Rajeev K. Garg; Bichun Ouyang; Jawad Khan; Nicholas Panos; Ivan Da Silva; Deborah Hall; Starane Shepherd; Sayona John; Mehmet Kocak; Sudeep Bhabad; Rasa Kazlauskaite; Miral Jhaveri; Thomas P. Bleck
Objectives Higher glycemia on admission has been associated with diffusion weighted imaging (DWI) lesions in patients with spontaneous intracerebral hemorrhage (sICH). However, the influence of longitudinal glycemia after admission and during a patient's hospitalization on DWI lesions in sICH has not been studied. Our aim was to compare longitudinal glycemia in sICH patients with and without DWI lesions
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Changes in Quadriceps Thickness and Echo Intensity in Chronic Stroke Survivors: A 3-Year Longitudinal Study J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-17 Naoki Akazawa; Kazuhiro Harada; Naomi Okawa; Masaki Kishi; Kimiyuki Tamura; Hideki Moriyama
Objectives: The aim of the current study was to examine longitudinal changes in quadriceps muscle mass and intramuscular adipose tissue in chronic stroke survivors. Materials and Methods: In this longitudinal study included 34 chronic stroke survivors who lived in the community. Ultimately, 20 chronic stroke survivors received an after 3-year assessment. Fourteen chronic stroke survivors were lost
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Effect of Rhythm of Music Therapy on Gait in Patients with Stroke J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-17 Yao Wang; Wei-Yi Pan; Fei Li; Jun-Sheng Ge; Xiang Zhang; Xun Luo; Yu-Long Wang
Aim This study aims to analyze the effects of rhythm of music therapy on gait in patients with ischemic stroke, and explore the value of music therapy in walking training in stroke. Methods The present study is a prospective clinical study. Sixty patients with ischemic stroke, who were admitted to our hospital from October 2017 to December 2018, were enrolled. These patients were divided into two groups
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Transcranial Doppler Ultrasound Evidence of Active Cerebral Embolization in COVID-19 J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-09 Ayush Batra; Jeffrey R. Clark; Katie LaHaye; Nathan A. Shlobin; Steven C. Hoffman; Zachary S. Orban; Katharine Colton; Jane E. Dematte; Farzaneh A. Sorond; Igor J. Koralnik; Eric M. Liotta
Objective To report six consecutive patients with confirmed coronavirus disease-2019 (COVID-19) who underwent Transcranial Doppler (TCD) ultrasonography evaluation for cerebral microemboli in the setting of suspected or confirmed acute ischemic stroke. Methods Patient data were obtained from medical records from Northwestern Memorial Hospital, Chicago, IL between May and June 2020. All patients with
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Association Between Plasma Total Homocysteine Levels and Risk of Early Hemorrhagic Transformation in Patients with Acute Ischemic Stroke: A Hospital-Based Study J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-17 Xin Wang; Qiuju Cao; Yali Lai; Xindong Liu; Yi Zhou; Le Yang; Lijuan Zhang
Objects In this study, we investigated the association between plasma total homocysteine(tHcy) levels and the risk of early hemorrhagic transformation(HT) in patients with acute ischemic stroke(AIS). Methods Consecutive hospitalized participants who met the inclusion criteria were enrolled and grouped according to plasma tHcy levels. Participants were divided into a low homocysteine level(L-tHcy) group
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Insulin Resistance is Significantly Related with Worse Clinical Outcomes in Non-Diabetic Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-16 Xiaoli Yang; Chen Li; Jing Li; Duanlu Hou; Yufan Luo; Shufan Zhang; Zhi Jin; Liwei Shen; Ping Zhong; Danhong Wu
Objectives to investigate the relationship between insulin resistance (IR) and clinical outcomes in non-diabetic ischemic stroke patients treated with intravenous thrombolysis. Methods We recruited non-diabetic ischemic stroke patients treated with intravenous thrombolysis prospectively. IR was defined as homeostasis model assessment–estimated insulin resistance index ≥2.80. Initial stroke severity
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The Cerebro-Renal System- Anatomical and Physiological Considerations J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-16 Kumar Rajamani
The brain and kidney both uniquely are highly susceptible to vascular injury from shared vascular risk factors. However these are not sufficient to explain the complete extent of cerebrovascular disease especially small vessel disease in its myriad presentations that patients with chronic kidney disease manifest. They both require a large amount of blood supply to function optimally. Shared anatomical
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Changes in Characteristics, Treatment and Outcome in Patients with Hemorrhagic Stroke During COVID-19 J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-15 Yuqi Chen; Fan Xia; Yunke Li; Hao Li; Lu Ma; Xin Hu; Chao You
Background and Purpose The coronavirus disease 2019 (COVID-19) pandemic has had a comprehensive impact on healthcare services worldwide. We sought to determine whether COVID-19 affected the treatment and prognosis of hemorrhagic stroke in a regional medical center in mainland China. Methods Patients with hemorrhagic stroke admitted in the Neurosurgery Department of West China Hospital from January
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Incremental Accuracy of Blood Biomarkers for Predicting Clinical Outcomes After Intracerebral Hemorrhage J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-15 Ram Sagar; Amit Kumar; Vivek Verma; Arun Kumar Yadav; Ritesh Raj; Dimple Rawat; Amarnath Yadav; Achal Kumar Srivastava; Awadh Kishor Pandit; Subiah Vivekanandhan; Arti Gulati; Garima Gupta; Kameshwar Prasad
Background Intracerebral hemorrhage (ICH) is associated with high mortality, morbidity, and recurrence. Studies have reported the accuracy of several blood biomarkers in predicting clinical outcomes; however, their independent contribution in prediction remains to be established. Aim To investigate the incremental accuracy in predicting clinical outcomes in patients with ICH in a north Indian population
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A Rare Case of Eosinophilic Granulomatosis with Polyangiitis Presenting as Ischemic Stroke and Splenic Infarction J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-14 Ryoto Inaba; Yutaro Fuse; Futoshi Kurimoto; Susumu Suzuki; Kazuhiko Watanabe
Background Eosinophilic Granulomatosis with Polyangiitis (EGPA) is a group of systemic disorders characterized by inflammation of blood vessels and eosinophilia. Simultaneous brain and splenic infarcts are extremely rare in patients with EGPA. Case description We report a case of a 61-year-old male with a history of asthma and sinusitis who presented with paresthesia and purpura in the lower extremities
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Bilateral Cerebral Hyperperfusion Syndrome Following Carotid Artery Stenting in Stroke – A Case Report J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-15 Nandakumar Nagaraja; Manuel Viamonte; Jun Yu; Stephen C. Rohrbough Jr; Anna Y. Khanna
Background Revascularization of the symptomatic carotid artery is performed with endarterectomy or stenting. Rarely, patients may develop cerebral hyperperfusion syndrome (CHS) following revascularization. This usually occurs in the cerebral hemisphere ipsilateral to revascularized carotid stenosis. CHS rarely involves the contralateral hemisphere. Objective To present a case of CHS involving bilateral
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Insights Into Direct Oral Anticoagulant Therapy Implementation of Stroke Survivors with Atrial Fibrillation in an Ambulatory Setting J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-14 Valerie Albert; Alexandros A. Polymeris; Fine Dietrich; Stefan T. Engelter; Kurt E. Hersberger; Sabine Schaedelin; Philippe A. Lyrer; Isabelle Arnet
Objectives To describe how stroke survivors with atrial fibrillation implement direct oral anticoagulant treatment and propose appropriate metrics to describe adherence. Materials and Methods Stroke patients with atrial fibrillation electronically recorded their self-administered direct oral anticoagulants (apixaban, dabigatran, edoxaban, rivaroxaban) during a 6-month observation phase after hospitalisation
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Chronic Kidney Disease and Cognitive Impairment J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-13 Asam Murtaza; Indranil Dasgupta
Chronic kidney disease (CKD) is associated with a high risk of cognitive impairment (CI). Both vascular and metabolic factors are implicated in the causation of CI in CKD. The traditional risk factors for CI are more prevalent in CKD and interact reciprocally. CI in CKD is associated with reduced functional capacity, poor quality of life and mortality. Cognition declines significantly after initiation
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Stroke Thrombolysis in Patients Taking Ticagrelor –Two Successful Cases and a Review of the Literature J. Stroke Cerebrovasc. Dis. (IF 1.787) Pub Date : 2020-12-10 David R. Landzberg; Stephen English; Michael Frankel; Digvijaya Navalkele
Background Ticagrelor is a novel antiplatelet agent that is frequently used for secondary prevention in coronary artery disease and has emerging evidence in stroke after the recent results of SOCRATES and THALES trials. The use of intravenous thrombolysis with alteplase in acute ischemic stroke (AIS) patients on ticagrelor is a topic of debate as the safety profile of ticagrelor in this setting is