62,248 results match your criteria Acute Stroke Management

Protecting the Brain, From the Heart: Safely Mitigating the Consequences of Thrombosis in Intracerebral Hemorrhage Survivors With Atrial Fibrillation.

Stroke 2022 Jul 27;53(7):2152-2160. Epub 2022 Jun 27.

Optimal antithrombotic management after intracerebral hemorrhage remains one of the central unresolved issues for patients who survive, especially for those patients with atrial fibrillation. Given the observational nature of the studies regarding anticoagulation resumption after intracerebral hemorrhage, there is uncertainty regarding resumption of oral anticoagulation therapy and its timing. There is limited high-quality evidence to guide clinical practice, leading to significant practice variation and uncertainty for patients and providers. Read More

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Pooled incidence and case-fatality of acute stroke in Mainland China, Hong Kong, and Macao: A systematic review and meta-analysis.

PLoS One 2022 27;17(6):e0270554. Epub 2022 Jun 27.

Rural Department of Community Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.

Background: Stroke incidence and case-fatality in Mainland China, Hong Kong, and Macao vary by geographic region and rates often differ across and within regions. This systematic review and meta-analysis (SR) estimated the pooled incidence and short-term case-fatality of acute first ever stroke in mainland China, Hong Kong, and Macao.

Methods: Longitudinal studies published in English or Chinese after 1990 were searched in PubMed/Medline, EMBASE, CINAHL, Web of Science, SinoMed and CQVIP. Read More

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[Clinical case of MELAS syndrom].

Zh Nevrol Psikhiatr Im S S Korsakova 2022 ;122(6):152-158

Mechnikov North-Western State Medical University, St. Petersburg, Russia.

Clinical case of mitochondrial encephalomyopathy manifested with lactic acidosis and stroke-like episodes was presented. The patient diagnosis was performed in childhood, based on clinical manifestation, and was confirmed with molecular genetic test (mutation m.3243A>G in gene was revealed). Read More

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January 2022

Management strategies of unanticipated intracranial stenosis during mechanical thrombectomy for acute stroke: A survey of academic neurointerventionalists.

Interv Neuroradiol 2022 Jun 26:15910199221110971. Epub 2022 Jun 26.

Department of Neurosurgery, 3989Baylor College of Medicine, Houston, TX, USA.

Background: The optimal approach to the management of intracranial atherosclerotic disease (ICAD) at the time of mechanical thrombectomy (MT) for large vessel occlusion (LVO) remains controversial. The goal of this study is to characterize current practices concerning this challenging clinical situation in a survey of practicing neurointerventionalists.

Methods: An electronic questionnaire was sent to a cross-section of North American academic neurointerventionalists using publicly available contact information and departmental websites. Read More

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What is important in supporting self-management in community stroke rehabilitation? A Q methodology study.

Disabil Rehabil 2022 Jun 25:1-9. Epub 2022 Jun 25.

School of Health & Life Sciences/Research Centre for Health, Glasgow Caledonian University, Glasgow, UK.

Purpose: Supported self-management (SSM) is an important part of adapting to life after stroke however it is a complex concept. It is unclear what SSM in stroke consists of or how stroke survivors, families, and clinicians can most effectively work together to support person-centred self-management. In this study, we aimed to explore what was most important in making SSM work in community stroke rehabilitation. Read More

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Convulsive-like symptoms as initial indications of basilar artery occlusion: A case series study.

eNeurologicalSci 2022 Sep 16;28:100410. Epub 2022 Jun 16.

Department of Neurosurgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe 650-0047, Japan.

Background: There is little evidence regarding relevant clinical findings for the early diagnosis of basilar artery occlusion (BAO) in the prehospital setting. We focused on "convulsive-like symptoms", including convulsive seizures and other convulsive-like movements, and examined the frequency and clinical characteristics of patients with BAO having these symptoms as an initial symptom.

Methods: In this single-center case series from 2015 to 2020, we identified patients who underwent endovascular therapy (EVT) for BAO and presented with convulsive-like symptoms between the stroke onset and initiation of emergency medical care. Read More

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September 2022

Health and Well-Being in Surviving Congenital Heart Disease Patients: An Umbrella Review With Synthesis of Best Evidence.

Front Cardiovasc Med 2022 10;9:870474. Epub 2022 Jun 10.

MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Bristol, United Kingdom.

Background: Advances in the management of congenital heart disease (CHD) patients have enabled improvement in long-term survival even for those with serious defects. Research priorities (for patients, families and clinicians) have shifted from a focus on how to improve survival to exploring long-term outcomes in patients with CHD. A comprehensive appraisal of available evidence could inform best practice to maximize health and well-being, and identify research gaps to direct further research toward patient and clinical need. Read More

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Association of Healthy Lifestyle and Life Expectancy in Patients With Cardiometabolic Multimorbidity: A Prospective Cohort Study of UK Biobank.

Front Cardiovasc Med 2022 9;9:830319. Epub 2022 Jun 9.

Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha, China.

Background: The prevalence of cardiometabolic multimorbidity (CMM), which significantly increases the risk of mortality, is increasing globally. However, the role of healthy lifestyle in the secondary prevention of CMM is unclear.

Methods: In total, 290,795 participants with CMM, which was defined as coexistence of at least two of hypertension (HTN), diabetes mellitus (DM), coronary heart disease (CHD), and stroke (ST), and those without these four diseases at baseline were derived from UK Biobank. Read More

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Non-pulmonary complications after lung transplantation: Part I.

Indian J Thorac Cardiovasc Surg 2022 Jul 8;38(Suppl 2):280-289. Epub 2021 Oct 8.

Lung Transplant Program, University of Texas Southwestern Medical Center, 5939 Harry Hines Blvd. Suite 603, Dallas, TX 75235-8550 USA.

Lung transplantation (LT) is a viable therapeutic option in the treatment of advanced lung disease. With improvements in post-transplant survival, complications involving different organ systems after LT are increasingly seen. While non-infectious, extrapulmonary complications after LT are not frequently responsible for early post-transplant mortality, they significantly impact the quality of life and long-term survival. Read More

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The Clinical Impact of Methotrexate-Induced Stroke-Like Neurotoxicity in Paediatric Departments: An Italian Multi-Centre Case-Series.

Front Neurol 2022 10;13:920214. Epub 2022 Jun 10.

Paediatric Neurology, Paediatric Department, Santa Chiara University Hospital, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.

Introduction: Stroke-like syndrome (SLS) is a rare subacute neurological complication of intrathecal or high-dose (≥500 mg) Methotrexate (MTX) administration. Its clinical features, evoking acute cerebral ischaemia with fluctuating course symptoms and a possible spontaneous resolution, have elicited interest among the scientific community. However, many issues are still open on the underlying pathogenesis, clinical, and therapeutic management and long-term outcome. Read More

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Changes in Acute Myocardial Infarction, Stroke, and Heart Failure Hospitalizations During COVID-19 Pandemic in Tuscany-An Interrupted Time Series Study.

Int J Public Health 2022 8;67:1604319. Epub 2022 Jun 8.

OptiMedis AG, Hamburg, Germany.

We evaluate the impact of the COVID-19 pandemic on unplanned hospitalization rates for patients without COVID-19, including their length of stay, and in-hospital mortality, overall, and for acute myocardial infarction (AMI), stroke, and heart failure in the Tuscany region of Italy. We carried out a population-based controlled interrupted time series study using segmented linear regression with an autoregressive error term based on admissions data from all public hospitals in Tuscany. The primary outcome measure was weekly hospitalization rates; secondary outcomes included length of stay, and in-hospital mortality. Read More

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Aortic Thrombosis and Ischemic Stroke With Hemorrhagic Conversion in a Patient With Remote COVID-19 Infection: A Treatment Dilemma.

Cureus 2022 May 24;14(5):e25272. Epub 2022 May 24.

Internal Medicine, Icahn School of Medicine at Mount Sinai Beth Israel, New York, USA.

Coronavirus disease 2019 (COVID-19) is primarily known to affect the lungs; however, several studies indicate that it can be a multisystem disease. There is documentation detailing different sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Patients affected with this virus have been seen to develop a hypercoagulable state leading to systemic thrombosis in some cases or embolism leading to catastrophic outcomes in others. Read More

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Clinical Problem-Solving: 72-Year-Old Woman With Multifocal Strokes and an Intracardiac Mass.

Neurohospitalist 2022 Jul 26;12(3):516-519. Epub 2022 Apr 26.

Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA.

We present the case of a 72-year-old female with multifocal strokes found to have multiple, mobile intracardiac masses. We discuss the differential diagnosis and evaluation of intracardiac masses, and the challenges in management of the ultimately diagnosed etiology of stroke in this patient. Read More

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Web Browsing: High-Speed Diagnosis and Treatment of Carotid Artery Web.

Neurohospitalist 2022 Jul 5;12(3):498-503. Epub 2022 May 5.

Department of Neurology, University of South Florida Morsani College of Medicine, Tampa, FL,USA.

Although carotid artery web (CaW) was initially described in 1973 as a potential etiology of ischemic stroke, it still remains underrecognized. Because CaW is a membrane affixed perpendicularly from the carotid wall that projects out into the lumen above the bifurcation, it typically is not stenotic, and hence, utilizing only 1 vessel imaging modality during conventional stroke workup may instead lead to a diagnosis of ESUS: embolic stroke of undetermined source. The term ESUS was created in 2014 by researchers to define a subset of cryptogenic, nonlacunar (embolic-appearing) strokes without clear cardiac or vascular cause. Read More

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Concurrent Coronary, Left Ventricle, and Cerebral Thrombosis - A Trilogy.

Int J Appl Basic Med Res 2022 Apr-Jun;12(2):130-133. Epub 2022 May 10.

Departments of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India.

Left ventricular (LV) thrombus is a known complication of acute myocardial infarction (AMI), especially anterior wall MI and leads to systemic thromboembolism. However, increase in the rates of coronary perfusion either by thrombolysis or percutaneous interventions have reduced its incidence. Concurrent stroke and MI are seen in 0. Read More

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Inclusion, characteristics, and outcomes of male and female participants in large international perioperative studies.

Br J Anaesth 2022 Jun 23. Epub 2022 Jun 23.

School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.

Background: We compared baseline characteristics and outcomes and evaluated the subgroup effects of randomised interventions by sex in males and females in large international perioperative trials.

Methods: Nine randomised trials and two cohort studies recruiting adult patients, conducted between 1995 and 2020, were included. Baseline characteristics and outcomes common to six or more studies were evaluated. Read More

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Impact of COVID-19 on the Volume of Acute Stroke Admissions: A Nationwide Survey in Japan.

Neurol Med Chir (Tokyo) 2022 Jun 24. Epub 2022 Jun 24.

Department of Neurosurgery, Kobe City Medical Center General Hospital.

This study aimed to measure the impact of the COVID-19 pandemic on the volumes of annual stroke admissions compared with those before the pandemic in Japan. We conducted an observational, retrospective nationwide survey across 542 primary stroke centers in Japan. The annual admission volumes for acute stroke within 7 days from onset between 2019 as the pre-pandemic period and 2020 as the pandemic period were compared as a whole and separately by months during which the epidemic was serious and prefectures of high numbers of infected persons. Read More

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Factors influencing the hospitalization cost for stroke patients in J district, Shanghai.

Zhong Nan Da Xue Xue Bao Yi Xue Ban 2022 May;47(5):628-638

Shanghai Health Development Research Center (Shanghai Institute of Medical Science and Technology Information), Shanghai 200040, China.

Objectives: Stroke is the main cause of death in Chinese residents, bringing a heavy economic burden to patients. This study aims to explore the characteristics and the factors influencing the hospitalization cost for stroke, and to provide scientific evidence for reducing the economic burden on stroke patients.

Methods: The data were mainly obtained from the Shanghai Statistics Center for Health. Read More

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Experiences of Multidisciplinary Working: Perspectives from the Wessex Ghana Stroke Partnership.

West Afr J Med 2022 Jun;39(6):641-645

Queen Alexandra Hospital, Southwick Hill, Portsmouth, UK.

Introduction: Substantial gaps remain in our understanding of stroke in Africa as well as in stroke care, practice and policy on the continent. The effective organization of preventative, therapeutic and rehabilitative stroke services continue to be challenging in many African countries.

Methodology: In this article we define the nature, function and benefits of effective multidisciplinary team (MDT) working. Read More

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Cerebrovascular intervention therapy worked positively in one patient with severe cerebral venous sinus thrombosis due to hyperthyroidism: a case report and review of the literature.

J Med Case Rep 2022 Jun 26;16(1):250. Epub 2022 Jun 26.

Department of Neurology, Shanghai Xuhui District Central Hospital, 966 Middle Huaihai Road, Xuhui District, Shanghai, China.

Background: With further understanding of cerebral venous sinus thrombosis, hyperthyroidism has gradually been revealed as a rare predisposing factor for cerebral venous sinus thrombosis, which may present as more compact clots and resistance to fibrinolysis, also known as a predictor of worse outcomes. For patients with severe cerebral venous sinus thrombosis, proper treatment method should be initiated as soon as possible since they may deteriorate rapidly.

Case Presentation: In this case report, we present a 32-year-old Mongoloid woman admitted with progressive headache, impaired consciousness, and right limb weakness, diagnosed with cerebral venous sinus thrombosis caused by hyperthyroidism. Read More

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Phagocytic microglia and macrophages in brain injury and repair.

CNS Neurosci Ther 2022 Jun 25. Epub 2022 Jun 25.

Geriatric Research, Education and Clinical Center, Veterans Affairs Pittsburgh Health Care System, Pittsburgh, Pennsylvania, USA.

Aims: Phagocytosis is the cellular digestion of extracellular particles, such as pathogens and dying cells, and is a key element in the evolution of central nervous system (CNS) disorders. Microglia and macrophages are the professional phagocytes of the CNS. By clearing toxic cellular debris and reshaping the extracellular matrix, microglia/macrophages help pilot the brain repair and functional recovery process. Read More

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Clinical characteristics of a large cohort of patients with narcolepsy candidate for pitolisant: a cross-sectional study from the Italian PASS Wakix® Cohort.

Neurol Sci 2022 Jun 25. Epub 2022 Jun 25.

Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Università di Modena e Reggio-Emilia, Modena, Italy.

Introduction: Narcolepsy is a chronic and rare hypersomnia of central origin characterized by excessive daytime sleepiness and a complex array of symptoms as well as by several medical comorbidities. With growing pharmacological options, polytherapy may increase the possibility of a patient-centered management of narcolepsy symptoms. The aims of our study are to describe a large cohort of Italian patients with narcolepsy who were candidates for pitolisant treatment and to compare patients' subgroups based on current drug prescription (drug-naïve patients in whom pitolisant was the first-choice treatment, switching to pitolisant from other monotherapy treatments, and adding on in polytherapy). Read More

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Thrombolysis, time-to-treatment and in-hospital outcomes among young adults with ischaemic stroke in China: findings from a nationwide registry study in China.

BMJ Open 2022 Jun 24;12(6):e055055. Epub 2022 Jun 24.

China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

Background And Purpose: We aimed to determine whether young adults (<50 years) with acute ischaemic stroke (AIS) are more likely to receive intravenous tissue plasminogen activator (IV tPA) and have shorter time to treatment than older patients with stroke.

Methods: We analysed data from the Chinese Stroke Center Alliance registry for patients with AIS hospitalised between August 2015 and July 2019. Patients were classified into two groups according to age: young adults (<50 years of age) and older adults (≥50 years of age). Read More

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Atrial fibrillation prevalence and predictors in patients with diabetes: a cross-sectional screening study.

Br J Cardiol 2022 8;29(1). Epub 2022 Mar 8.

Director of the Centre for Ageing Research Lancaster University, Bailrigg, Lancaster, LA1 4YW.

Prevalence of atrial fibrillation (AF) and diabetes is increasing worldwide. Diabetes is a risk factor for AF and both increase stroke risk. Previous AF screening studies have recruited highrisk patient groups, but not with diabetes as the target group. Read More

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Statin prescription and CV risk assessment in adult psychiatric outpatients with intellectual disability.

Br J Cardiol 2021 30;28(4):49. Epub 2021 Nov 30.

Consultant Psychiatrist Haringey Learning Disability Partnership, Barnet, Enfield and Haringey Mental Health Trust, River Park House, Second Floor, 225 High Road, Wood Green, London, N22 8HQ.

We performed a single-centre study to assess the risk of cardiovascular disease (CVD) in psychiatry outpatients with intellectual disability (ID) using the QRISK-3 score. There were 143 patients known to the ID psychiatry clinic enrolled. Of these, 28 (19. Read More

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November 2021

Sports Imaging of COVID-19: A Multi-Organ System Review of Indications and Imaging Findings.

Sports Health 2022 Jun 23:19417381221106448. Epub 2022 Jun 23.

Department of Radiology, NYU Grossman School of Medicine, New York, New York.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified in December 2019 in Wuhan, China. Although coronavirus disease-19 (COVID-19) affects every population group, the sports community and athletes require special consideration of the effects on cardiovascular, musculoskeletal, neurologic, and respiratory systems. A comprehensive understanding of imaging indications, findings, and features of COVID-19 supports appropriate imaging utilization and effective patient management and treatment. Read More

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Botulinum Toxin Use for Modulating Neuroimmune Cutaneous Activity in Psoriasis.

Medicina (Kaunas) 2022 Jun 16;58(6). Epub 2022 Jun 16.

Department of Physical and Rehabilitation Medicine-"Elias" Emergency University Hospital, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.

Psoriasis is a complex immune-mediated inflammatory disorder that generates enormous interest within the scientific communities worldwide, with new therapeutic targets being constantly identified and tested. Despite the numerous topical and systemic medications available for the treatment of psoriasis, alternative therapies are still needed for the optimal management of some patients who present with localized, resistant lesions. Novel insights into the contribution of cutaneous neurogenic inflammation in the pathogenesis of psoriasis have yielded exciting new potential roles of nerve-targeting treatments, namely botulinum toxin type A (BoNT-A), for the management of this disease. Read More

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Physiologic Range of Myocardial Mechano-Energetic Efficiency among Healthy Subjects: Impact of Gender and Age.

J Pers Med 2022 Jun 18;12(6). Epub 2022 Jun 18.

Division of Cardiology, A Cardarelli Hospital, 80131 Naples, Italy.

Background: Myocardial mechano-energetic efficiency (MEE) is the capability of the left ventricle (LV) to convert the chemical energy obtained from the cardiac oxidative metabolism into mechanical work. The aim of present study was to establish normal non-invasive MEE and MEEi reference values.

Methods: In total, 1168 healthy subjects underwent physical examinations, clinical assessment, and standardized transthoracic echocardiographic (TTE) examination. Read More

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A Randomized Controlled Trial Evaluating Outcome Impact of Cilostazol in Patients with Coronary Artery Disease or at a High Risk of Cardiovascular Disease.

J Pers Med 2022 Jun 6;12(6). Epub 2022 Jun 6.

Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan.

Previous studies found that cilostazol has a favorable effect on glucose and lipid homeostasis, endothelial function, atherosclerosis, and vasculo-angiogenesis. However, it is poorly understood whether these effects can translate into better clinical outcomes. This study investigated the outcome effect of cilostazol in patients with coronary artery disease (CAD) or at a high risk of cardiovascular (CV) disease. Read More

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