3,201 results match your criteria Cerebrovascular Diseases[Journal]


Long-Term Complications and Influence on Outcome in Patients Surviving Spontaneous Subarachnoid Hemorrhage.

Cerebrovasc Dis 2020 Jul 3:1-9. Epub 2020 Jul 3.

Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany.

Background: While the short-term clinical outcome of patients with subarachnoid hemorrhage (SAH) is well described, there are limited data on long-term complications and their impact on social reintegration. This study aimed to assess the frequency of complications post-SAH and to investigate whether these complications attribute to functional and self-reported outcomes as well as the ability to return to work in these patients.

Methods: This retrospective single-center study included patients with atraumatic SAH over a 5-year period at a tertiary care center. Read More

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http://dx.doi.org/10.1159/000508577DOI Listing

Intramural Hematoma Shape and Acute Cerebral Infarction in Intracranial Artery Dissection: A High-Resolution Magnetic Resonance Imaging Study.

Cerebrovasc Dis 2020 Jul 3:1-8. Epub 2020 Jul 3.

Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea,

Background: Intracranial artery dissection (IAD) is gaining recognition as an important cause of stroke, but limited information is available about the morphology of the dissection. This study aimed to investigate the relationship between acute cerebral infarctions and the shape of hematoma in patients with IADs using high-resolution magnetic resonance imaging (HRMRI).

Methods: We enrolled consecutive patients who presented with vascular headaches, transient ischemic attacks, or ischemic strokes with acute IAD confirmed by HRMRI using key pathognomonic radiological findings of IAD, including intimal flap, intramural hematoma (IMH), and double lumen. Read More

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http://dx.doi.org/10.1159/000508027DOI Listing

Intravenous Thrombolysis Guided by Perfusion CT with Alteplase in >4.5 Hours from Stroke Onset.

Cerebrovasc Dis 2020 Jul 2:1-6. Epub 2020 Jul 2.

Stroke Unit, University Hospital Virgen del Rocío, Sevilla, Spain,

Introduction: The benefit of intravenous thrombolysis (IVT) in wake-up stroke (WUS), stroke of unknown time of onset (SUKO), or when time exceeds 4.5 h from last-seen-normal (LSN) guided by CT perfusion (CTP) or MRI has been recently suggested. However, there is limited information of IVT in those patients in real-world studies. Read More

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http://dx.doi.org/10.1159/000509013DOI Listing

Intravenous Thrombolysis Is Not Associated with Increased Time to Endovascular Treatment.

Cerebrovasc Dis 2020 Jul 2:1-7. Epub 2020 Jul 2.

Department of Neurology, St. Antonius Hospital, Nieuwegein, The Netherlands.

Background: Endovascular treatment (EVT) with or without intravenous thrombolysis (IVT) is effective and safe in is-chemic stroke caused by large vessel occlusion, but IVT might delay time to EVT or increase risk of intracranial hemorrhage (ICH). We assessed the influence of prior IVT on time to treatment and risk of ICH in patients treated with EVT.

Methods: We analyzed data from the MR CLEAN Registry and included patients with an anterior circulation occlusion treated with EVT who presented directly to an intervention center, between 2014 and 2017. Read More

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http://dx.doi.org/10.1159/000508898DOI Listing

Intensive Blood Pressure Lowering in Patients with Moderate to Severe Grade Acute Cerebral Hemorrhage: Post Hoc Analysis of Antihypertensive Treatment of Acute Cerebral Hemorrhage (ATACH)-2 Trial.

Cerebrovasc Dis 2020 Jun 25:1-9. Epub 2020 Jun 25.

Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, Johns Hopkins University School of Medicine Baltimore, Baltimore, Maryland, USA.

Objective: To study the effect of intensive blood pressure reduction in patients with moderate to severe intracerebral hemorrhage (ICH) within the subjects recruited in Antihypertensive Treatment of Acute Cerebral Hemorrhage 2 trial.

Design: Randomized, multicenter, 2 group, open-label clinical trial.

Setting: A total of 110 sites in the USA, Japan, China, Taiwan, South Korea, and Germany. Read More

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http://dx.doi.org/10.1159/000506358DOI Listing

Aeromedical Retrieval for Stroke in Australia.

Cerebrovasc Dis 2020 Jun 24:1-7. Epub 2020 Jun 24.

Royal Melbourne Hospital, Parkville, Melbourne, Victoria, Australia.

Introduction: Rural, remote, and Indigenous stroke patients have worse stroke outcomes than urban Australians. This may be due to lack of timely access to expert facilities.

Objectives: We aimed to describe the characteristics of patients who underwent aeromedical retrieval for stroke, estimate transfer times, and investigate if flight paths corresponded with the locations of stroke units (SUs) throughout Australia. Read More

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http://dx.doi.org/10.1159/000508578DOI Listing

Frequency of Screening and Prevalence of Neurosyphilis in Stroke Population.

Cerebrovasc Dis 2020 Jun 22:1-6. Epub 2020 Jun 22.

Neurology and Stroke Unit Service, Nossa Senhora da Conceição Hospital, Porto Alegre, Brazil.

Background And Aims: Syphilis and stroke are high prevalent diseases in south Brazil and estimates of concomitance and possible role of syphilis in acute stroke are lacking. Our aims are to estimate the prevalence of syphilis and neurosyphilis (NS) in a cohort of tertiary stroke center.

Methods: We reviewed all hospital records of stroke/transitory ischemic attack (TIA) using International Classification of Diseases, 10th revision, at discharge, frequency of syphilis screen, serology positivity, cerebrospinal fluid (CSF) analysis, and prevalence of NS in this stroke population applying CDC criteria. Read More

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http://dx.doi.org/10.1159/000508491DOI Listing

Left Atrial Volume Index Predicts New-Onset Atrial Fibrillation and Stroke Recurrence in Patients with Embolic Stroke of Undetermined Source.

Cerebrovasc Dis 2020 Jun 17:1-7. Epub 2020 Jun 17.

Division of Neurology, Department of Medicine, National University Health System, Singapore, Singapore.

Introduction: It is unclear which surrogate of atrial cardiopathy best predicts the risk of developing a recurrent ischemic stroke in embolic stroke of undetermined source (ESUS). Left atrial diameter (LAD) and LAD index (LADi) are often used as markers of left atrial enlargement in current ESUS research, but left atrial volume index (LAVi) has been found to be a better predictor of cardiovascular outcomes in other patient populations.

Objective: We aim to compare the performance of LAVi, LAD, and LADi in predicting the development of new-onset atrial fibrillation (AF) and stroke recurrence in ESUS. Read More

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http://dx.doi.org/10.1159/000508211DOI Listing
June 2020
3.754 Impact Factor

Diffusion-Weighted Imaging-Fluid-Attenuated Inversion Recovery Mismatch Is Associated with 90-Day Functional Outcomes in Patients Undergoing Mechanical Thrombectomy.

Cerebrovasc Dis 2020 Jun 16:1-9. Epub 2020 Jun 16.

Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan,

Background And Purpose: Diffusion-weighted imaging-fluid-attenuated inversion recovery (DWI-FLAIR) mismatch is an early sign of acute ischemic stroke. DWI-FLAIR mismatch was reported to be valuable to select patients with unknown onset stroke who are eligible to receive intravenous thrombolysis (IVT), but its utility is less studied in patients undergoing mechanical thrombectomy (MT) for acute large vessel occlusion (LVO). We thus investigated the functional outcomes at 90 days between patients with DWI-FLAIR mismatch and those with match who underwent MT for LVO. Read More

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http://dx.doi.org/10.1159/000508369DOI Listing

Adjustment of Stent Retriever Length to Clot Extent Affects First-Pass Reperfusion in Endovascular Treatment of Acute Ischemic Stroke.

Cerebrovasc Dis 2020 Jun 16:1-8. Epub 2020 Jun 16.

Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany.

Background: Stent retriever technology has evolved, and significantly longer devices have become available for mechanical thrombectomy (MT) of large cerebral vessel occlusions in ischemic stroke. We hypothesized that increased stent retriever length may improve the rate of complete angiographic reperfusion and decrease the respective number of attempts, resulting in a better clinical outcome.

Methods: Retrospective analysis of patients with large vessel occlusion in the anterior and posterior circulation treated with stent retriever MT. Read More

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http://dx.doi.org/10.1159/000508028DOI Listing

Severe Leukoaraiosis Is Associated with Poor Outcome after Successful Recanalization of M1 Middle Cerebral Artery Occlusion Strokes.

Cerebrovasc Dis 2020 Jun 12:1-9. Epub 2020 Jun 12.

Department of Neurology, Paracelsus Medical University, Salzburg, Austria.

Background: Severe leukoaraiosis (LA) is an established risk factor for poor outcome after mechanical thrombectomy (MT) for large vessel occlusion stroke. There is uncertainty whether this association also applies to successfully recanalized patients with M1 segment middle cerebral artery (MCA) occlusions.

Methods: A retrospective single-centre study of patients with successful reperfusion (thrombolysis in cerebral infarction, TICI 2b or 3) after MT for an M1 MCA occlusion was performed over a 7-year period. Read More

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http://dx.doi.org/10.1159/000508209DOI Listing

Are Genetic Variants Associated with the Location of Cerebral Arterial Lesions in Stroke Patients?

Cerebrovasc Dis 2020 Jun 11:1-7. Epub 2020 Jun 11.

Stroke Center and Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea,

Background: Genetic variants may play a role in determining the location of cerebral atherosclerosis. We aimed to investigate the association between RNF213, MMP2, and genetic polymorphisms linked to vascular tortuosity with the location of cerebral arterial atherosclerosis.

Methods: A prospective case-control study was conducted on patients with ischemic stroke and age- and sex-matched stroke-free controls. Read More

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http://dx.doi.org/10.1159/000508301DOI Listing

Stroke in COVID-19 and SARS-CoV-1.

Cerebrovasc Dis 2020 May 26:1-2. Epub 2020 May 26.

Department of Neurology, Universitätsmedizin Mannheim, Mannheim, Germany.

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http://dx.doi.org/10.1159/000508370DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316642PMC

Critique on the Use of Early Short-Term Dual Antiplatelet Therapy Following Minor Acute Cerebral Ischemic Events.

Cerebrovasc Dis 2020 May 5:1-7. Epub 2020 May 5.

Department of Neurology, Cerebrovascular Division, State University of New York Downstate Medical Center, Brooklyn, New York, USA.

Background: Two recent cerebrovascular studies, Clopidogrel (Clo) in High-risk patients with Acute Nondisabling Cerebrovascular Events (CHANCE) and Platelet-Oriented Inhibition in New TIA and minor ischemic stroke (POINT), have purportedly demonstrated the superiority of early dual antiplatelet therapy (DAPT), using aspirin (ASA) plus Clo, in comparison to ASA alone following the occurrence of acute minor cerebral infarction or transient ischemic attack. However, limitations to these trials exist that may not have been adequately explored and presented in the literature, and which may impact the overall efficacy and benefit of DAPT in these situations. Herein we provide a detailed and extensive critique of these 2 trials and of a combined analysis, with particular attention to study data and analyses pertaining to hemorrhagic complications. Read More

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http://dx.doi.org/10.1159/000508026DOI Listing

Cavernous Malformation Hemorrhagic Presentation at Diagnosis Associated with Low 25-Hydroxy-Vitamin D Level.

Cerebrovasc Dis 2020 29;49(2):216-222. Epub 2020 Apr 29.

Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA.

Background: Cavernous malformations (CM) are angiographically occult vascular malformations that may be incidental or present with intracerebral or spinal hemorrhage, seizures, or nonhemorrhagic focal neurologic deficit (FND). Recently in vitro data have suggested vitamin D may play a role in stabilizing CCM2 endothelial cells. Little is known about the effect of vitamin D in human CM disease. Read More

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http://dx.doi.org/10.1159/000507789DOI Listing

Bridging versus Direct Mechanical Thrombectomy in Acute Ischemic Stroke: A Subgroup Pooled Meta-Analysis for Time of Intervention, Eligibility, and Study Design.

Cerebrovasc Dis 2020 24;49(2):223-232. Epub 2020 Apr 24.

Department of Neurology, Niguarda Ca' Granda Hospital, Milan, Italy.

Background And Aim: The risk/benefit profile of intravenous thrombolysis (IVT) prior to endovascular thrombectomy (EVT) in acute ischemic stroke is still unclear. We provide a systematic review and meta-analysis including studies comparing direct EVT (dEVT) vs. bridging treatment (IVT + EVT), defining the impact of treatment timing and eligibility to IVT on functional status and mortality. Read More

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http://dx.doi.org/10.1159/000507844DOI Listing

Blood Pressure and Anticoagulation Reversal Management during Off-Hours in Oral Anticoagulation-Associated Intracerebral Hemorrhage.

Cerebrovasc Dis 2020 22;49(2):177-184. Epub 2020 Apr 22.

Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany.

Background: Prevention of hematoma enlargement in oral anticoagulation-associated intracerebral hemorrhage (OAC-ICH) focuses on blood pressure (BP) reduction and OAC reversal. We investigated whether treatment efficiency and clinical outcomes differ between OAC-ICH patients admitted outside versus during regular working hours.

Methods: Based on pooled data of multicenter cohort studies, we grouped OAC-ICH patients (vitamin K antagonist [VKA], non-vitamin K oral anticoagulant [NOAC]) according to on- vs. Read More

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http://dx.doi.org/10.1159/000507316DOI Listing

Controlling Blood Pressure Under Transcranial Doppler Guidance after Endovascular Treatment in Patients with Acute Ischemic Stroke.

Cerebrovasc Dis 2020 21;49(2):160-169. Epub 2020 Apr 21.

Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.

Objective: This study aimed to control blood pressure (BP) under transcranial Doppler (TCD) guidance in patients with anterior circulation acute ischemic stroke after endovascular treatment (EVT) to reduce the incidence of early neurological deterioration (END) and improve neurological prognosis.

Methods: This prospective randomized controlled study included 95 patients who were randomly divided into a TCD-guided BP control (TBC) group and a non-TCD-guided BP control (NBC) group. The patients were monitored by TCD within 72 h after EVT. Read More

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http://dx.doi.org/10.1159/000506855DOI Listing

Erratum.

Authors:

Cerebrovasc Dis 2020 15;49(2):151. Epub 2020 Apr 15.

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http://dx.doi.org/10.1159/000507384DOI Listing

Clinical Usefulness of Serial Duplex Ultrasound in Cervical Artery Dissection Patients.

Cerebrovasc Dis 2020 14;49(2):206-215. Epub 2020 Apr 14.

Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.

Purpose: To study the clinical usefulness of serial color-coded duplex ultrasound (DUS) examinations in cervical artery dissection (CeAD) patients.

Methods: Single-center, CeAD registry-based re-review of serial, routine DUS exams in consecutive CeAD patients treated at the Stroke Center Basel, Switzerland (2009-2015). Two experienced raters reassessed all DUS for the occurrence of new arterial findings during follow-up, that is. Read More

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http://dx.doi.org/10.1159/000507485DOI Listing

The Closure of Patent Foramen Ovale in Preventing Subsequent Neurological Events: A Bayesian Network Meta-Analysis to Identify the Best Device.

Cerebrovasc Dis 2020 14;49(2):124-134. Epub 2020 Apr 14.

Department of Neurology, San Bortolo Hospital, Vicenza, Italy.

Background: Randomized-controlled trials (RCTs) reported a finding on the safety and efficacy of percutaneous patent foramen ovale (PFO) closure to prevent stroke recurrence. It showed that the Amplatzer (AMP) device appears to be superior to medical therapy (MT) in preventing strokes and episodes of atrial fibrillation (AF), than other devices. We performed a network meta-analysis (NMA) to evaluate the closure of PFO in preventing subsequent neurological events while investigating the results obtained by specific devices. Read More

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http://dx.doi.org/10.1159/000507317DOI Listing

Risk Factors for Distal Clot Migration during Mechanical Thrombectomy of Anterior Circulation Large Vessel Occlusion.

Cerebrovasc Dis 2020 30;49(2):185-191. Epub 2020 Mar 30.

Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA,

Introduction: Distal clot migration (DCM) is a known complication of mechanical thrombectomy (MT), but neither risk factors for DCM nor ways of how it might affect clinical outcomes have been extensively studied to date.

Methods: To identify risk factors for and outcomes in the setting of DCM, the records of all patients with acute ischemic stroke due to anterior circulation large vessel occlusion (LVO) treated with MT at a single center between May 2016 and June 2018 were retrospectively reviewed. Uni- and multivariable analyses were performed to evaluate predictors of DCM and good functional outcome (90-day modified Rankin Scale; mRS 0-2). Read More

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http://dx.doi.org/10.1159/000507341DOI Listing

Association of a Multigenetic Pro-Inflammatory Profile with Ischaemic Stroke.

Cerebrovasc Dis 2020 25;49(2):170-176. Epub 2020 Mar 25.

Department of Neurology, Klinikum Ludwigshafen, Ludwigshafen, Germany.

Objective: A multigenetic pro-inflammatory profile may increase stroke risk. We investigated whether a higher number of pro-inflammatory genetic variants are associated with ischaemic stroke risk and whether other risk factors further elevate this risk.

Methods: In a case-control study with 470 ischaemic stroke patients (cases) and 807 population controls, we investigated 23 haplotypes or alleles in 16 inflammatory genes (interleukin [IL]1A, IL1B, IL1 receptor antagonist, IL6, IL6 receptor, IL10, tumour necrosis factor-a; C-C motif chemokine ligand 2, C-C motif chemokine receptor 5, C-reactive protein (CRP), intercellular adhesion molecule 1, transforming growth factor β1, E-Selectin, selenoprotein S, cluster determinant 14, histone deacetylase 9 [HDAC9]). Read More

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http://dx.doi.org/10.1159/000507042DOI Listing

Safety and Efficacy of Prasugrel in Elderly/Low Body Weight Japanese Patients with Ischemic Stroke: Randomized PRASTRO-II.

Cerebrovasc Dis 2020 24;49(2):152-159. Epub 2020 Mar 24.

Department of Neurosurgery, Iwate Medical University, Iwate, Japan.

Introduction: The safety of prasugrel in elderly and/or low body weight Japanese patients with ischemic stroke who have a relatively high bleeding risk with antiplatelet therapy remains unknown.

Objective: We aimed to investigate the safety and efficacy of long-term prasugrel monotherapy for stroke prevention compared with clopidogrel in elderly and/or low body weight Japanese patients with non-cardioembolic ischemic stroke.

Methods: In this randomized, double-blind, comparative, phase III study, elderly (age ≥75 years) and/or low body weight (≤50 kg) Japanese patients with a previous history of non-cardioembolic ischemic stroke were assigned to a prasugrel 3. Read More

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http://dx.doi.org/10.1159/000506825DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265764PMC

White Matter High Signals Interfere with Noncontrast Computed Tomography in the Early Identification of Cerebral Infarction.

Cerebrovasc Dis 2020 24;49(2):135-143. Epub 2020 Mar 24.

Department of Neurology, Minhang Hospital, Fudan University, Shanghai, China,

Background: We developed an image patch classification-based method to detect early ischemic stroke. The accuracy of this method was >75%. We aimed to analyze patients' image data to identify interference factors that would affect its accuracy. Read More

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http://dx.doi.org/10.1159/000505807DOI Listing

The Significance to Determine Factors Related to Postoperative Cerebral Infarction in Patients with Moyamoya Disease.

Cerebrovasc Dis 2020 23;49(2):233-234. Epub 2020 Mar 23.

Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China,

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http://dx.doi.org/10.1159/000506856DOI Listing

Carotid Artery Stenosis Is Associated with Better Intracranial Collateral Circulation in Stroke Patients.

Cerebrovasc Dis 2020 20;49(2):200-205. Epub 2020 Mar 20.

Vascular and Interventional Radiology Center, Tampere University Hospital, Tampere, Finland,

Background: Adequate collateral circulation improves the clinical outcome of ischemic stroke patients. We evaluated the influence of ipsilateral carotid stenosis on intracranial collateral circulation in acute stroke patients.

Methods: We collected the data of 385 consecutive acute stroke patients who underwent mechanical thrombectomy after multimodal computed tomography (CT) imaging in a single high-volume stroke center. Read More

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http://dx.doi.org/10.1159/000506826DOI Listing

Avoiding Stroke: A Continuous Monitoring Challenge.

Cerebrovasc Dis 2020 20;49(2):121-123. Epub 2020 Mar 20.

Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom,

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http://dx.doi.org/10.1159/000506680DOI Listing

Frequency and Clinical Impact of Serious Adverse Events on Post-Stroke Recovery with NeuroAiD (MLC601) versus Placebo: The CHInese Medicine Neuroaid Efficacy on Stroke Recovery Study.

Cerebrovasc Dis 2020 3;49(2):192-199. Epub 2020 Mar 3.

Department of Pharmacology, National University of Singapore, Clinical Research Centre, Singapore, Singapore.

Background: Most comparative clinical trials are designed to assess the treatment effect for efficacy endpoints, with less emphasis on the analysis of safety outcomes. However, an extensive analysis of safety data could demonstrate beneficial results in terms of effectiveness by reducing serious adverse events (SAEs), and their unfavourable clinical impact on the study population. We aimed to conduct an exploratory analysis of the CHInese Medicine Neuroaid Efficacy on Stroke recovery (CHIMES) study safety database comparing the frequency of SAEs and their clinical impacts among subjects having received MLC601 or placebo during the first 3 months post-stroke. Read More

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http://dx.doi.org/10.1159/000506070DOI Listing

Morphometric Features of Patent Foramen Ovale as a Risk Factor of Cerebrovascular Accidents: A Systematic Review and Meta-Analysis.

Cerebrovasc Dis 2020 25;49(1):1-9. Epub 2020 Feb 25.

Department of Anatomy, HEART, Heart Embryology and Anatomy Research Team, Jagiellonian University Medical College, Kraków, Poland.

Introduction: It is still disputable whether specific morphometric features of the patent foramen ovale (PFO) may stratify patients by the related probability that a discovered PFO is incidental or stroke related.

Objective: We aimed to determine whether certain morphometrical characteristics of PFO are associated with an increased risk of cerebrovascular accidents, using a meta-analytical approach.

Methods: We performed a systematic review of electronic databases for studies that compared morphometric parameters of PFO assessed by transesophageal echocardiography (TEE) in subjects with cryptogenic cerebrovascular accidents (Group 1) and control (Group 2). Read More

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http://dx.doi.org/10.1159/000506433DOI Listing
February 2020

Choice of Initial Brain Imaging in Patients with Suspected Acute Stroke: STROKE69, a Population-Based Study.

Cerebrovasc Dis 2020 25;49(1):110-118. Epub 2020 Feb 25.

Université de Lyon, Université Claude Bernard Lyon 1, HESPER EA 7425, Lyon, France,

Background: In patients with suspected stroke, brain imaging is recommended in the acute phase for appropriate management and treatment. Both computed tomography (CT) and magnetic resonance imaging (MRI) are considered reasonable choices for initial brain imaging. When both techniques are available, choosing one or the other might be associated with specific factors related either to patients, stroke symptoms, and severity or management organization. Read More

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http://dx.doi.org/10.1159/000505960DOI Listing
February 2020

Gradient of Tissue Injury after Stroke: Rethinking the Infarct versus Noninfarcted Dichotomy.

Cerebrovasc Dis 2020 18;49(1):32-38. Epub 2020 Feb 18.

Departments of Medicine and Neurology, Melbourne Brain Centre at Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia.

Aim: To evaluate the degree of variability in microstructural injury within and adjacent to regions identified as infarcted tissue using diffusion tensor imaging (DTI).

Methods: In this prospective longitudinal study, 18 patients presenting within 12 h of anterior circulation acute ischemic stroke who underwent CT perfusion (CTP) at baseline followed by fluid-attenuated inversion recovery (FLAIR) and DTI 1-month were analyzed. Four regions of interest (ROI) corresponding to the severity of hypoperfusion on CTP within and beyond the radiological infarct lesion defined on FLAIR were segmented. Read More

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http://dx.doi.org/10.1159/000505847DOI Listing
February 2020

Chronic Small Cortical Cerebellar Infarctions on MRI are Associated with Patent Foramen Ovale in Young Cryptogenic Stroke.

Cerebrovasc Dis 2020 14;49(1):105-109. Epub 2020 Feb 14.

Department of Neurology, Nîmes University Hospital, Nîmes, France.

Background: In acute infarction patients, small cortical cerebellar infarctions (SCCI) on MRI (assessed on diffusion-weighted imaging, with SCCI often chronic and asymptomatic) are associated with acute cardioembolic infarction. In young cryptogenic stroke patients, patent foramen ovale (PFO) is thought to be a potential source of cardioembolic infarction. We hypothesize that SCCI on MRI would be associated with PFO in young cryptogenic stroke patients. Read More

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http://dx.doi.org/10.1159/000505959DOI Listing
February 2020

Late Neurological Deterioration after Acute Intracerebral Hemorrhage: A post hoc Analysis of the ATACH-2 Trial.

Cerebrovasc Dis 2020 11;49(1):26-31. Epub 2020 Feb 11.

Department of Neurology, University of Missouri, Columbia, Missouri, USA.

Background: Neurological deterioration (ND) has a major influence on the prognosis of intracerebral hemorrhage (ICH); however, factors associated with ND occurring after 24 h of ICH onset are unknown.

Methods: We performed exploratory analyses of data from the Antihypertensive Treatment of Acute Cerebral Hemorrhage 2 trial, which compared intensive and standard blood pressure lowering treatment in ICH. NDs were captured on the adverse event case report form. Read More

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http://dx.doi.org/10.1159/000506117DOI Listing
February 2020

Computed Tomography Angiography in Acute Stroke Patients Receiving Recombinant Tissue Plasminogen Activator: Outcome and Safety Evaluations in an Asian Population.

Cerebrovasc Dis 2020 5;49(1):62-69. Epub 2020 Feb 5.

Department of Neurology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan City, Taiwan,

Introduction: The multiphase computed tomography angiography (mCTA) is superior to the noncontrast computed tomography (NCCT) in selecting patients that would benefit from mechanical thrombectomy following an acute ischemic stroke (AIS). It remains unclear whether the longer examination time of mCTA worsens outcomes of intravenous recombinant tissue plasminogen activator (IV r-tPA) or increases the risk of hemorrhagic transformation (HT) compared to NCCT in Asian stroke patients.

Methods: Between January 2011 and December 2017, 199 AIS patients receiving IV r-tPA with initial National Institute of Health Stroke Scale (NIHSS) scores between 6 and 25 were enrolled in a single medical center. Read More

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http://dx.doi.org/10.1159/000504776DOI Listing
February 2020

Frequent Premature Atrial Contractions in Cryptogenic Stroke Predict Atrial Fibrillation Detection with Insertable Cardiac Monitoring.

Cerebrovasc Dis 2020 5;49(2):144-150. Epub 2020 Feb 5.

Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan.

Objective: To determine whether frequent premature atrial contractions (PAC) predict atrial fibrillation (AF) in cryptogenic stroke patients, we analyzed the association between frequent PACs in 24-h Holter electrocardiogram recording and AF detected by insertable cardiac monitoring (ICM).

Methods: We retrospectively analyzed a database of 66 consecutive patients with cryptogenic stroke who received ICM implantation between October 2016 and March 2018 at 5 stroke centers. We included the follow-up data until June 2018 in this analysis. Read More

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http://dx.doi.org/10.1159/000505958DOI Listing
February 2020

Depressive Symptoms in Stroke Patients: Are There Sex Differences?

Cerebrovasc Dis 2020 5;49(1):19-25. Epub 2020 Feb 5.

College of Nursing, The Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea.

Background: We aimed to examine sex differences in symptom characteristics and pharmacological responses in post-stroke depressive (PSD) symptoms.

Methods: This is a post hoc analysis of EMOTION (ClinicalTrials.gov, NCT01278498), a randomized, placebo-controlled, double-blind trial that examined the efficacy of escitalopram for 3 months on depression in patients with acute stroke. Read More

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http://dx.doi.org/10.1159/000506116DOI Listing
February 2020

Isolated Insular Stroke: Clinical Presentation.

Cerebrovasc Dis 2020 5;49(1):10-18. Epub 2020 Feb 5.

U.O.S.D. Stroke Unit, Department of Clinical and Experimental Medicine, AOU Policlinico G. Martino, University of Messina, Messina, Italy.

The symptoms related to insular ischemia have been the object of several studies in patients affected by stroke, although they are often accompanied by other ischemic alteration of adjacent brain structures supplied by the middle cerebral artery (MCA). The insula is vulnerable because of an ischemia due to thromboembolic vascular occlusion of the M1 MCA segment and the 2 main MCA branches (M2), mainly when they abruptly arise from the principal stem at a right angle. This topographical and anatomical peculiarity could enable an embolic formation, especially due to atrial fibrillation (AF), to occlude the transition pathway between M1 and M2, while the proximal origin of vascular supply protects the insula from ischemia due to hemodynamic factors. Read More

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http://dx.doi.org/10.1159/000504777DOI Listing
February 2020

Rise in Low-Density Lipoprotein Cholesterol during Hospitalization is Related with Poor Outcome at Discharge in Patients with Acute Ischemic Stroke.

Cerebrovasc Dis 2020 29;49(1):88-96. Epub 2020 Jan 29.

Department of Neurology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.

Background: The statistical association between a short-term rise in low-density lipoprotein cholesterol (LDL-C) levels and the short-term outcome of acute ischemic stroke remains unknown. We aimed to evaluate the association in acute ischemic stroke patients during hospitalization.

Methods: Patients with acute ischemic stroke who received statin at discharge were enrolled in this multicenter registry study. Read More

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http://dx.doi.org/10.1159/000505615DOI Listing
January 2020
3.754 Impact Factor

Distribution of Cardioembolic Stroke: A Cohort Study.

Cerebrovasc Dis 2020 21;49(1):97-104. Epub 2020 Jan 21.

Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands,

Background: A cardiac origin in ischemic stroke is more frequent than previously assumed, but it is not clear which patients benefit from cardiac work-up if obvious cardiac pathology is absent. We hypothesized that thromboembolic stroke with a cardiac source occurs more frequently in the posterior circulation compared with thromboembolic stroke of another etiology.

Methods: We performed a multicenter observational study in 3,311 consecutive patients with ischemic stroke who were enrolled in an ongoing prospective stroke registry of 8 University hospitals between September 2009 and November 2014 in The Netherlands. Read More

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http://dx.doi.org/10.1159/000505616DOI Listing
January 2020

Analysis of Factors Related to Cerebral Infarction after Direct Bypass Surgery in Adults with Moyamoya Disease.

Cerebrovasc Dis 2020 17;49(1):55-61. Epub 2020 Jan 17.

Department of Neurosurgery, Qilu Hospital of Shandong University and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, China,

Objective: High-risk factors of the patients with moyamoya disease (MMD) were analyzed to provide the basis for prediction and management of cerebral infarction after direct bypass surgery in adult MMD.

Methods: 1. Retrospective analysis of clinical data was collected from adult MMD patients (n = 250) following superficial temporal artery-middle cerebral artery bypass surgery performed in our hospital from July 2013 to December 2017. Read More

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http://dx.doi.org/10.1159/000504743DOI Listing
January 2020

Protective Effects of Transforming Growth Factor-β1 Knockdown in Human Umbilical Cord Mesenchymal Stem Cells against Subarachnoid Hemorrhage in a Rat Model.

Cerebrovasc Dis 2020 15;49(1):79-87. Epub 2020 Jan 15.

Department of Neurosurgery, Aviation General Hospital of China Medical University, Beijing, China,

Background: Emerging evidence indicates a beneficial effect of mesenchymal stem cell (MSC) transplantation in subarachnoid hemorrhage (SAH). Chronic hydrocephalus is a common complication after SAH, which is associated with subarachnoid fibrosis promoted by transforming growth factor-β1 (TGF-β1). This study investigated the effect of human umbilical cord derived MSCs (hUC-MSCs) with TGF-β1 knockdown on chronic hydrocephalus after SAH. Read More

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http://dx.doi.org/10.1159/000505311DOI Listing
January 2020

MicroRNA-384-5p Promotes Endothelial Progenitor Cell Proliferation and Angiogenesis in Cerebral Ischemic Stroke through the Delta-Likeligand 4-Mediated Notch Signaling Pathway.

Cerebrovasc Dis 2020 10;49(1):39-54. Epub 2020 Jan 10.

Department of Neurology, Second Hospital of Jilin University, Changchun, China,

Background: MicroRNAs (miRs) have a crucial regulatory role in endothelial cell function and tumor angiogenesis by inhibiting the expressions of their target genes. The participation of microRNA-384-5p (miR-384-5p) has been prominently reported in various ischemia-induced diseases such as myocardial ischemia and atherosclerosis. Hence, the present study aimed at exploring the effect of miR-384-5p on proliferation, apoptosis, and angiogenesis of endothelial progenitor cells (EPCs) in cerebral ischemic stroke and investigating the associated underlying mechanism. Read More

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http://dx.doi.org/10.1159/000503950DOI Listing
January 2020

Convexity Subarachnoid Hemorrhage Accompanied by Hyperacute Ischemic Stroke.

Cerebrovasc Dis 2020 7;49(1):70-78. Epub 2020 Jan 7.

Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan.

Introduction And Objectives: The clinical characteristics of convexity subarachnoid hemorrhage (cSAH) accompanying hyperacute ischemic stroke are unknown. We aimed to investigate the incidence and clinical characteristics of cSAH with hyperacute ischemic stroke.

Methods: Participants comprised symptomatic ischemic stroke patients with ≤4. Read More

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http://dx.doi.org/10.1159/000505013DOI Listing
January 2020

Evaluation of Patients with High National Institutes of Health Stroke Scale as Thrombectomy Candidates Using the Kentucky Appalachian Stroke Registry.

Cerebrovasc Dis 2019 18;48(3-6):251-256. Epub 2019 Dec 18.

Department of Neurology, Rush University Medical Center, Chicago, Illinois, USA,

Introduction: Mechanical thrombectomy has become standard of care for emergent large vessel occlusive stroke. Estimates of incidence for thrombectomy eligibility vary significantly. National Institutes of Health Stroke Scale (NIHSS) of 10 or greater is highly predictive of large vessel occlusion. Read More

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http://dx.doi.org/10.1159/000504834DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6960339PMC

Pattern of Activated Pathways and Quality of Collateral Status in Patients with Symptomatic Internal Carotid Artery Occlusion.

Cerebrovasc Dis 2019 17;48(3-6):244-250. Epub 2019 Dec 17.

Neurological Center, Segeberger Kliniken, Bad Segeberg, Germany.

Background: Internal carotid artery occlusion (ICAO) is an important risk factor for stroke. Cerebral hemodynamics in patients with ICAO depends on the individual capacity to activate sufficient collateral pathways. Therefore, the assessment of intracranial collaterals is essential for the acute and long-term management of these patients and accurate estimation of further stroke risk. Read More

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http://dx.doi.org/10.1159/000504663DOI Listing

Risk Stratification for Ischemic Cerebrovascular Events and Mortality among Intracerebral Hemorrhage Patients with and without Atrial Fibrillation: A Nationwide Cohort Study.

Cerebrovasc Dis 2019 17;48(3-6):236-243. Epub 2019 Dec 17.

Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Faculty of Health, Aalborg University, Aalborg, Denmark.

Background: Intracerebral hemorrhage is a devastating clinical event, and secondary prevention is pivotal to avoid further cerebral complications, but no clear guidance exist for selecting high-risk patients. The CHA2DS2-VASc score is a widespread tool to assess the risk of stroke among patients with atrial fibrillation (AF).

Objectives: We investigated the ability of the CHA2DS2-VASc score for estimating cerebrovascular ischemic events in patients with recent intracerebral hemorrhage with or without comorbid AF. Read More

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http://dx.doi.org/10.1159/000504926DOI Listing

The Effect of Body Mass Index on Outcome after Endovascular Treatment in Acute Ischemic Stroke Patients: A Post Hoc Analysis of the MR CLEAN Trial.

Cerebrovasc Dis 2019 11;48(3-6):200-206. Epub 2019 Dec 11.

Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.

Background: Though obesity is a well-known risk factor for vascular disease, the impact of obesity on stroke outcome has been disputed. Several studies have shown that obesity is associated with better functional outcome after stroke. Whether obesity influences the benefit of endovascular treatment (EVT) in stroke patients is unknown. Read More

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http://dx.doi.org/10.1159/000504744DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6964319PMC

Predictors of Significant Coronary Artery Disease in Patients with Cerebral Artery Atherosclerosis.

Cerebrovasc Dis 2019 11;48(3-6):226-235. Epub 2019 Dec 11.

Department of Cardiology, Bucheon St. Mary's Hospital, The Catholic University College of Medicine, Seoul, Republic of Korea,

Objective: There are few existing data on the status of coronary artery disease (CAD) in patients with atherosclerosis of the cerebral artery detected by brain imaging studies. We aimed to analyze the predictors of asymptomatic angiographically significant CAD detected by simultaneous cerebral and coronary angiography.

Methods: This retrospective cohort study screened data obtained between August 2009 and April 2019; 11,047 patients underwent cerebral angiography for atherosclerotic change (>50% stenosis or aneurysm) seen in brain magnetic resonance angiography (MRA) or computed tomography angiography (CTA) at a single center by endovascular neurosurgeon's decision. Read More

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http://dx.doi.org/10.1159/000504927DOI Listing