3,185 results match your criteria Lacunar Syndromes


Late functional improvement and 5-year poststroke outcomes: a population-based cohort study.

J Neurol Neurosurg Psychiatry 2020 Jun 23. Epub 2020 Jun 23.

Wolfson Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK

Background: Late functional improvement between 3 and 12 months poststroke occurs in about one in four patients with ischaemic stroke, more commonly in lacunar strokes. It is unknown whether this late improvement is associated with better long-term clinical or health economic outcomes.

Methods: In a prospective, population-based cohort of 1-year ischaemic stroke survivors (Oxford Vascular Study; 2002-2014), we examined changes in functional status (modified Rankin Scale (mRS), Rivermead Mobility Index (RMI), Barthel Index (BI)) from 3 to 12 months poststroke. Read More

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http://dx.doi.org/10.1136/jnnp-2019-322365DOI Listing

Incidence and characteristics of spontaneous platelet macro-aggregation in acute ischemic stroke.

J Thromb Thrombolysis 2020 Jun 15. Epub 2020 Jun 15.

Hirosaki Stroke and Rehabilitation Center, Hirosaki, Japan.

Spontaneous platelet aggregation is a trigger for additional development of larger thrombi. Micro-aggregation is observed in 10% of diabetes approximately and blocked by P2Y12 inhibitors, whereas macro-aggregation is associated with overexpression of platelet α-adrenoreceptors and is not blocked by conventional anti-platelet medicines. We examined the incidence of spontaneous platelet macro-aggregation (SPMA) in acute ischemic stroke and analyzed its clinical characteristics. Read More

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http://dx.doi.org/10.1007/s11239-020-02185-6DOI Listing

Sex influence in ischemic stroke severity and outcome among metabolically unhealthy overweight patients.

J Neurol Sci 2020 May 30;416:116955. Epub 2020 May 30.

Neurological Clinic, Marche Polytechnic University, via Conca 1, 60020 Ancona, Italy. Electronic address:

Introduction: The role of metabolically unhealthy (MU) overweight in influencing stroke prognosis has not been fully assessed and conclusive data about the impact of sex are lacking. Aim of this study was to evaluate the possible correlations among MU overweight, sex and ischemic stroke severity and outcome.

Methods: All consecutive patients with acute non-lacunar ischemic stroke observed over a one-year period were considered. Read More

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http://dx.doi.org/10.1016/j.jns.2020.116955DOI Listing

Frequency and factors linked to refractory hypertension among stroke survivors in Ghana.

J Neurol Sci 2020 Jun 5;415:116976. Epub 2020 Jun 5.

Department of Neurology, University of California, San Francisco, USA.

Background: Refractory hypertension (RfH) is a rare, severe phenotype of resistant hypertension, linked to higher risk of adverse cardiovascular outcomes. Little is known about the association of RfH with stroke type and subtype.

Objective: To determine the prevalence and predictors of RfH among stroke survivors in Ghana. Read More

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http://dx.doi.org/10.1016/j.jns.2020.116976DOI Listing

Screening of Embolic Sources by Point-of-Care Ultrasound in the Acute Phase of Ischemic Stroke.

Ultrasound Med Biol 2020 Jun 9. Epub 2020 Jun 9.

Stroke Unit, Department of Neurology, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Barcelona, Spain; Department de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain.

Our objective was to evaluate hand-held echocardiography as point of care ultrasound scanning (POCUS) to detect sources of embolism in the acute phase of stroke. Prospective, unicentric observational cohort study of non-lacunar ischemic stroke patients evaluated by V Scan device. The main sources of embolism (MSEs) were classified into embolic valvulopathies and severe ventricular dysfunction. Read More

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http://dx.doi.org/10.1016/j.ultrasmedbio.2020.05.009DOI Listing

Blood pressure variability and microvascular dysfunction: the Maastricht Study.

J Hypertens 2020 Jun 6. Epub 2020 Jun 6.

Department of Internal Medicine, Maastricht University Medical Centre.

Background: Microvascular dysfunction (MVD) contributes to stroke, dementia, depression, retinopathy and chronic kidney disease. However, the determinants of MVD are incompletely understood. Greater blood pressure variability (BPV) may be one such determinant. Read More

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http://dx.doi.org/10.1097/HJH.0000000000002444DOI Listing

Ambulatory Blood Pressure Levels in the Prediction of Progression of Cerebral Small Vessel Disease.

J Am Geriatr Soc 2020 Jun 8. Epub 2020 Jun 8.

Neurovascular Research Lab, Vall Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.

Objectives: We aimed to study the value of ambulatory blood pressure monitoring (ABPM) in predicting the global progression of cerebral small vessel disease (cSVD).

Design: Longitudinal cohort study.

Setting: Data from the population-based Investigating Silent Strokes in Hypertensives study. Read More

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http://dx.doi.org/10.1111/jgs.16568DOI Listing

Efficacy and Safety of Prasugrel by Stroke Subtype: A Sub-Analysis of the PRASTRO-I Randomized Controlled Trial.

J Atheroscler Thromb 2020 Jun 4. Epub 2020 Jun 4.

Department of Neurosurgery, Iwate Medical University.

Aims: The efficacy of antiplatelet therapy may vary among different disease subtypes. Prasugrel is generally a more potent, consistent, and fast-acting platelet inhibitor than clopidogrel. This sub-analysis of the phase III comparison of PRAsugrel and clopidogrel in Japanese patients with ischemic STROke (PRASTRO-I) trial aimed to assess the differences in efficacy of these treatments for each stroke subtype. Read More

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http://dx.doi.org/10.5551/jat.56093DOI Listing

Prevalence and Atypical Clinical Characteristics of Mutations Among Patients Admitted for Acute Lacunar Infarctions.

Front Aging Neurosci 2020 14;12:130. Epub 2020 May 14.

Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan.

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common hereditary small vessel disease, with reported frequencies of 2-5/100,000 individuals. Recently, it has been reported that some patients with gene mutations show atypical clinical symptoms of CADASIL. Assuming that CADASIL is underdiagnosed in some cases of lacunar infarction, this study was designed to examine the prevalence of gene mutations in the patients at highest risk who were admitted for lacunar infarctions. Read More

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http://dx.doi.org/10.3389/fnagi.2020.00130DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7240022PMC

Stroke in the patient with diabetes (part 1) - Epidemiology, etiology, therapy and prognosis.

Diabetes Res Clin Pract 2020 Jun 20;164:108193. Epub 2020 May 20.

Southside Endocrinology, Diabetes and Thyroid Associates, Birmingham, AL, United States. Electronic address:

There is a higher incidence of stroke in both the type 2 diabetic and the non-diabetic insulin resistant patient which is accompanied by higher morbidity and mortality. The increase in the frequency of stroke is due to an increase in cerebral infarction, mainly lacunar infarcts, with the incidence of cerebral hemorrhage being less frequent. The major risk factors for stroke in the type 2 diabetic patient are age, hypertension, the number of features of the Metabolic Syndrome, the presence of diabetic nephropathy in both the type 1 and type 2 patient, the presence of peripheral and coronary artery disease and especially the presence of atrial fibrillation. Read More

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http://dx.doi.org/10.1016/j.diabres.2020.108193DOI Listing

The Potential Value of D-Dimer to Fibrinogen Ratio in Diagnosis of Acute Ischemic Stroke.

J Stroke Cerebrovasc Dis 2020 May 16:104918. Epub 2020 May 16.

Department of Laboratory Medicine, Clinical Medical College, Hunan University of Chinese Medicine, Changsha, Hunan 410208, PR China; Clinical Laboratory, The Second People's Hospital of Hunan Province, 427 Furong Road, Changsha, Hunan 410007, PR China. Electronic address:

Introduction And Objective: At present, there is no hematology marker with high specificity to the diagnosis and differential diagnosis of acute ischemic stroke (AIS). How to use the existing test items to improve the diagnosis efficiency worthy of discussion. D-Dimer (DD) and fibrinogen (FIB) were the common indicators in thrombotic diseases, but D-dimer to fibrinogen ratio (D/F) in AIS has not been used in clinical practice. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.104918DOI Listing
May 2020
1.993 Impact Factor

Relationship between white matter hyperintensities and chronic kidney disease in patients with acute lacunar stroke.

Neurol Sci 2020 May 16. Epub 2020 May 16.

Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, No. 8, South Gongti Road, Beijing, 100020, People's Republic of China.

Background And Purpose: Previous studies have revealed a relationship between chronic kidney disease (CKD) and white matter hyperintensities (WMH). However, studies on the WMH and CKD in acute stroke patients are rare, and the conclusion is consistent. Our study aimed to investigate the relationship between the severity of WMH and CKD in acute lacunar infarction patients. Read More

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http://dx.doi.org/10.1007/s10072-020-04397-3DOI Listing

Clinical RoPE (cRoPE) score predicts patent foramen ovale detection among stroke patients: a multicenter observational study.

Neurol Sci 2020 May 9. Epub 2020 May 9.

Neurology Unit, G. Jazzolino Hospital, Vibo Valentia, Italy.

Backgroud: The role of patent foramen ovale (PFO) in cryptogenic stroke (CS) is debated. Tools to predict PFO occurrence and attributable fraction are needed to guide cost-effective diagnostics and treatment. Risk of Paradoxical Embolism (RoPE) score relies on neuroimaging findings, which might be inconclusive in up to 30% of cases. Read More

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http://dx.doi.org/10.1007/s10072-020-04386-6DOI Listing
May 2020
1.495 Impact Factor

Sex differences in acute ischaemic stroke patients: clinical presentation, causes and outcomes.

Eur J Neurol 2020 May 8. Epub 2020 May 8.

From the Stroke Center, Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland.

Background And Purpose: The aim was to investigate sex differences in the causes, clinical presentation, outcome and stroke recurrences in a large cohort of consecutive acute ischaemic stroke patients.

Methods: Patients from the Acute Stroke Registry and Analysis of Lausanne were included from March 2003 to April 2016. Multivariate analysis of clinical, pathophysiological and biological variables was conducted. Read More

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http://dx.doi.org/10.1111/ene.14299DOI Listing

Functional health and white matter hyperintensities as effect modifiers of blood pressure-lowering on cognitive function and vascular events in older Secondary Prevention of Small Subcortical Strokes trial participants.

J Hypertens 2020 May 5. Epub 2020 May 5.

Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA.

Objective: To determine whether cerebral small vessel disease or disability modify the effect of SBP treatment on cognitive and vascular outcomes in older patients with recent lacunar stroke.

Methods: Participants aged at least 65 years of the Secondary Prevention of Small Subcortical Strokes Trial were randomized to a higher (130-149 mmHg) or lower (<130 mmHg) SBP target. The primary outcome was change in cognitive function (Cognitive Abilities Screening Instrument); secondary outcomes were incident mild cognitive impairment, stroke, major vascular events (all-stroke, myocardial infarction), and all-cause death. Read More

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http://dx.doi.org/10.1097/HJH.0000000000002440DOI Listing

Relevance of Carotid Intima-Media Thickness and Plaque Morphology in the Risk Assessment of Patients with Acute Ischemic Cerebral Infarcts: A Case-Control Study of Large Series from a Single Center.

Authors:
Reddy Ravikanth

J Med Ultrasound 2020 Jan-Mar;28(1):29-34. Epub 2019 Jul 12.

Department of Radiology, Holy Family Hospital, Thodupuzha, Kerala, India.

Background: Carotid atherosclerosis is not only a marker of systemic atherosclerosis but also a predictor of ischemic stroke. The purpose of this study is to correlate the relationship between atherosclerotic risk factors, plaque categories, percentage of stenosis, stroke subtypes, and carotid intima-media thickness (CIMT) in patients with acute ischemic stroke.

Methods: This case-control study was conducted over 4 years from December 2014 to December 2018. Read More

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http://dx.doi.org/10.4103/JMU.JMU_5_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7194428PMC

The Use of Random Forests to Identify Brain Regions on Amyloid and FDG PET Associated With MoCA Score.

Clin Nucl Med 2020 Jun;45(6):427-433

Department of Medicine (Neurology), Sunnybrook Health Sciences Centre and Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.

Purpose: The aim of this study was to evaluate random forests (RFs) to identify ROIs on F-florbetapir and F-FDG PET associated with Montreal Cognitive Assessment (MoCA) score.

Materials And Methods: Fifty-seven subjects with significant white matter disease presenting with either transient ischemic attack/lacunar stroke or mild cognitive impairment from early Alzheimer disease, enrolled in a multicenter prospective observational trial, had MoCA and F-florbetapir PET; 55 had F-FDG PET. Scans were processed using the MINC toolkit to generate SUV ratios, normalized to cerebellar gray matter (F-florbetapir PET), or pons (F-FDG PET). Read More

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http://dx.doi.org/10.1097/RLU.0000000000003043DOI Listing

Low grade albuminuria as a risk factor for subtypes of stroke - the HUNT Study in Norway.

BMC Neurol 2020 May 2;20(1):170. Epub 2020 May 2.

Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.

Background And Purpose: Albuminuria is a marker for endothelial dysfunction and knowledge on its association with stroke and stroke subtypes are limited.

Methods: Corresponding data from 7261 participants of the population-based HUNT2 study (1995-1997) was linked with hospital records, identified all patients registered and diagnosed with a first-time stroke. Each diagnosis was validated by reviewal of the medical record appertaining to the individual. Read More

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http://dx.doi.org/10.1186/s12883-020-01746-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7196218PMC
May 2020
2.040 Impact Factor

Large vessel occlusion is independently associated with atrial fibrillation detection.

Eur J Neurol 2020 Apr 29. Epub 2020 Apr 29.

Stroke Unit, Neurology Department and Medicine Department, Vall d'Hebrón Hospital and Autonomous University of Barcelona, Barcelona, Spain.

Background And Purpose: Covert paroxysmal atrial fibrillation (pAF) is the most frequent cause of cardiac embolism. Our goal was to discover parameters associated with early pAF detection with intensive cardiac monitoring.

Method: Crypto-AF was a multicentre prospective study (four Comprehensive Stroke Centres) to detect pAF in non-lacunar cryptogenic stroke continuously monitored within the first 28 days. Read More

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http://dx.doi.org/10.1111/ene.14281DOI Listing

Plasma myeloperoxidase levels in acute brain ischaemia and high grade carotid stenosis.

Eur J Neurol 2020 Apr 26. Epub 2020 Apr 26.

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Background And Purpose: Myeloperoxidase (MPO) is an important oxidative enzyme participating in different stages of cardiovascular disease and predicts prognosis. Little is known about its role in acute cerebrovascular events and carotid plaque vulnerability. In this study, the aim was to assess plasma MPO levels in acute stroke patients and their correlation to stroke severity and stroke outcome. Read More

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http://dx.doi.org/10.1111/ene.14279DOI Listing

Cerebral Small Vessel Disease in Standard Pre-operative Imaging Reports Is Independently Associated with Increased Risk of Cardiovascular Death Following Carotid Endarterectomy.

Eur J Vasc Endovasc Surg 2020 Jun 21;59(6):872-880. Epub 2020 Apr 21.

Department of Vascular Surgery, Division of Surgical Specialties, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands. Electronic address:

Objective: Cerebral white matter lesions (WMLs) and lacunar infarcts are surrogates of cerebral small vessel disease (SVD). WML severity as determined by trained radiologists predicts post-operative stroke or death in patients undergoing carotid endarterectomy (CEA). It is unknown whether routine pre-operative brain imaging reports as part of standard clinical practice also predict short and long term risk of stroke and death after CEA. Read More

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http://dx.doi.org/10.1016/j.ejvs.2020.02.004DOI Listing
June 2020
2.490 Impact Factor

Progression of stroke deficits in patients presenting with mild symptoms: The underlying etiology determines outcome.

PLoS One 2020 24;15(4):e0231448. Epub 2020 Apr 24.

The Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar.

Background And Purpose: Patients with acute stroke and mild or rapidly improving symptoms frequently show progression. The role of reperfusion treatment in such patients is not clear. We hypothesized that progression was most likely in patients with cortical localization and such patients may benefit from thrombolysis. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0231448PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7182193PMC

Cerebral Computed Tomography Scan Demonstrating Ischemic Stroke in a Filly After Intravenous Antibiotic Administration.

J Equine Vet Sci 2020 May 14;88:102953. Epub 2020 Feb 14.

Clinique Equine de la Boisrie, Chailloué, France.

Performing a brain computerized tomography scan (CT scan) on a foal requires specific equipment and anesthesia for large animals. However, the information obtained may demonstrate lesions responsible for the neurological deficits. Especially, CT scan findings may help to understand a mechanism of cerebral ischemia. Read More

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http://dx.doi.org/10.1016/j.jevs.2020.102953DOI Listing

Supracardiac atherosclerosis in embolic stroke of undetermined source: the underestimated source.

Eur Heart J 2020 Apr 16. Epub 2020 Apr 16.

Stroke Center, Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital, Rue du Bugnon 46, Lausanne CH-1011, Switzerland.

The term 'embolic stroke of undetermined source' (ESUS) is used to describe patients with a non-lacunar ischaemic stroke without any identified embolic source from the heart or the arteries supplying the ischaemic territory, or any other apparent cause. When the ESUS concept was introduced, covert atrial fibrillation was conceived to be the main underlying cause in the majority of ESUS patients. Another important embolic source in ESUS is the atherosclerotic plaque in the carotid, vertebrobasilar, and intracranial arteries, or the aortic arch-collectively described as supracardiac atherosclerosis. Read More

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http://dx.doi.org/10.1093/eurheartj/ehaa218DOI Listing

Improving Clinical Detection of Acute Lacunar Stroke: Analysis From the IST-3.

Stroke 2020 May 9;51(5):1411-1418. Epub 2020 Apr 9.

Division of Neuroimaging Sciences, Brain Research Imaging Centre, University of Edinburgh, United Kingdom (G.M., J.M.W.).

Background and Purpose- We aim to identify factors associated with imaging-confirmed lacunar strokes and improve their rapid clinical identification early after symptom onset using data from the IST-3 (Third International Stroke Trial). Methods- We selected patients likely to have lacunar infarcts as those presenting with: Oxfordshire Community Stroke Project lacunar syndrome; a random sample with National Institutes of Health Stroke Scale (NIHSS) score <7; and recent lacunar infarct identified on imaging by IST-3 central blinded expert panel. An independent reviewer rated brain scans of this sample and classified visible infarcts according to type, size, and location. Read More

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http://dx.doi.org/10.1161/STROKEAHA.119.028402DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7185055PMC

Relationship Between Venules and Perivascular Spaces in Sporadic Small Vessel Diseases.

Stroke 2020 May 8;51(5):1503-1506. Epub 2020 Apr 8.

From the Centre for Clinical Brain Sciences (A.C.C.J., G.W.B., M.S.S., M.J.T., U.C., F.M.C., R.B., D.J.G., O.K.L.H., A.G.M., I.M., K.H., S.W., T.M., M.C.V.-H., F.N.D., J.M.W.), University of Edinburgh, Scotland.

Background and Purpose- Perivascular spaces (PVS) around venules may help drain interstitial fluid from the brain. We examined relationships between suspected venules and PVS visible on brain magnetic resonance imaging. Methods- We developed a visual venular quantification method to examine the spatial relationship between venules and PVS. Read More

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http://dx.doi.org/10.1161/STROKEAHA.120.029163DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7185057PMC

Elevated serum pentraxin 3 levels might predict the diagnosis of branch atheromatous disease at a very early stage.

Eur J Neurol 2020 Jul 28;27(7):1279-1284. Epub 2020 Apr 28.

Department of Neurology, Brain Research Institute, Niigata University, Niigata, Japan.

Background And Purpose: Branch atheromatous disease (BAD) is one of the stroke subtypes caused by occlusion at the origin of a deep penetrating artery of the brain and is associated with a microatheroma or a junctional plaque. Patients with BAD often develop progressive worsening of neurologic deficits, although these patients often present minor stroke with clinical characteristics of lacunar syndrome at the onset. Pentraxin 3 (PTX3) is known to be a key molecule involved in the pathogenesis of atherosclerosis. Read More

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http://dx.doi.org/10.1111/ene.14249DOI Listing

Collateral Recruitment Is Impaired by Cerebral Small Vessel Disease.

Stroke 2020 May 6;51(5):1404-1410. Epub 2020 Apr 6.

Department of Neurology (R.F.G.), Johns Hopkins University School of Medicine, Baltimore, MD.

Background and Purpose- Cerebral small vessel disease (SVD) is associated with increased stroke risk and poor stroke outcomes. We aimed to evaluate whether chronic SVD burden is associated with poor recruitment of collaterals in large-vessel occlusive stroke. Methods- Consecutive patients with middle cerebral artery or internal carotid artery occlusion presenting within 6 hours after stroke symptom onset who underwent thrombectomy from 2012 to 2017 were included. Read More

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http://dx.doi.org/10.1161/STROKEAHA.119.027661DOI Listing

Stroke and HIV in Botswana: A prospective study of risk factors and outcomes.

J Neurol Sci 2020 Jun 26;413:116806. Epub 2020 Mar 26.

Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA.

Objective: HIV is associated with an increased risk of stroke, but there are sparse data on risk factors for stroke in people living with HIV in Sub-Saharan African. The goal of this study was to identify HIV-specific stroke characteristics and risk factors among adults in Botswana.

Methods: We conducted a prospective cohort study in Gaborone, Botswana from June 2015 to June 2017 comparing risk factors and outcomes among adults with and without HIV admitted for acute stroke. Read More

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http://dx.doi.org/10.1016/j.jns.2020.116806DOI Listing
June 2020
2.474 Impact Factor

Differentiation of Pontine Infarction by Size.

Open Med (Wars) 2020 8;15:160-166. Epub 2020 Mar 8.

Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, No. 8, South Gongti Road, Beijing 100020, China.

Purpose: We hypothesized that the current criteria may be unsuitable for lacunar pontine infarctions (LPI) diagnosis and that size criteria may indicate different stroke mechanisms.

Methods: A total of 102 patients with isolated pontine infarctions were divided into a parent artery disease (PAD) and non-PAD groups according to stenosis of basilar artery. Further, 86 patients from the non-PAD group were divided into paramedian pontine infarction (PPI) and LPI groups. Read More

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http://dx.doi.org/10.1515/med-2020-0025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7065441PMC

Cerebral microvascular complications of type 2 diabetes: stroke, cognitive dysfunction, and depression.

Lancet Diabetes Endocrinol 2020 Apr 2;8(4):325-336. Epub 2020 Mar 2.

Department of Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, Netherlands. Electronic address:

Adults with type 2 diabetes are at an increased risk of developing certain brain or mental disorders, including stroke, dementia, and depression. Although these disorders are not usually considered classic microvascular complications of diabetes, evidence is growing that microvascular dysfunction is one of the key underlying mechanisms. Microvascular dysfunction is a widespread phenomenon in people with diabetes, including effects on the brain. Read More

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http://dx.doi.org/10.1016/S2213-8587(19)30405-XDOI Listing

A Patient with Combined CADASIL and MTHFR Homozygosity.

Case Rep Neurol Med 2020 17;2020:4980847. Epub 2020 Feb 17.

American University of Beirut Medical Center, Department of Neurology, Beirut, Lebanon.

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is an inherited disorder caused by a mutation in the NOTCH 3 gene, characterized by early onset of subcortical lacunar infarcts in the absence of vascular risk factors and cerebral microbleeds. Homozygosity for the factor Methylenetetrahydrofolate Reductase (MTHFR) is also associated with lacunar stroke risk and cerebral small-vessel disease regardless of the homocysteine level. The coexistence of MTHFR C677T homozygosity and NOTCH 3 mutation has never been reported in the literature previously, and that brings up the challenge of antithrombotic treatment in the presence of cerebral microbleeds. Read More

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http://dx.doi.org/10.1155/2020/4980847DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7048904PMC
February 2020

Reduced Cognitive Assessment Scores Among Individuals With Magnetic Resonance Imaging-Detected Vascular Brain Injury.

Stroke 2020 Apr 4;51(4):1158-1165. Epub 2020 Mar 4.

Hotchkiss Brain Institute, Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (E.E.S.).

Background and Purpose- Little is known about the association between covert vascular brain injury and cognitive impairment in middle-aged populations. We investigated if scores on a cognitive screen were lower in individuals with higher cardiovascular risk, and those with covert vascular brain injury. Methods- Seven thousand five hundred forty-seven adults, aged 35 to 69 years, free of cardiovascular disease underwent a cognitive assessment using the Digital Symbol Substitution test and Montreal Cognitive Assessment, and magnetic resonance imaging (MRI) to detect covert vascular brain injury (high white matter hyperintensities, lacunar, and nonlacunar brain infarctions). Read More

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http://dx.doi.org/10.1161/STROKEAHA.119.028179DOI Listing

Clinical Features of Embolic Stroke of Undetermined Source.

Front Neurol 2020 5;11:58. Epub 2020 Feb 5.

Department of Neurology, Beijing Haidian Hospital, Beijing Haidian Section of Peking University Third Hospital, Beijing, China.

One-third of ischemic strokes have no identifiable cause following standard evaluation. In 2014, researchers have proposed the concept of Embolic Stroke of Undetermined Source (ESUS). The purpose of this study was to report the clinical characteristics of ESUS and its difference from cardiogenic embolism (CE), large-artery atherosclerosis (LA), and small-artery occlusion lacunar (SA). Read More

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http://dx.doi.org/10.3389/fneur.2020.00058DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7013046PMC
February 2020

Modeling Mixed Vascular and Alzheimer's Dementia Using Focal Subcortical Ischemic Stroke in Human ApoE4-TR:5XFAD Transgenic Mice.

Transl Stroke Res 2020 Feb 21. Epub 2020 Feb 21.

Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, 635 Charles E. Young Dr. South, Neuroscience Research Building, Rm 415, Los Angeles, CA, 90095, USA.

Subcortical white matter ischemic lesions are increasingly recognized to have pathologic overlap in individuals with Alzheimer's disease (AD). The interaction of white matter ischemic lesions with amyloid pathology seen in AD is poorly characterized. We designed a novel mouse model of subcortical white matter ischemic stroke and AD that can inform our understanding of the cellular and molecular mechanisms of mixed vascular and AD dementia. Read More

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http://dx.doi.org/10.1007/s12975-020-00786-0DOI Listing
February 2020

Race and Ethnic Disparities in Stroke Incidence in the Northern Manhattan Study.

Stroke 2020 Apr 12;51(4):1064-1069. Epub 2020 Feb 12.

Department of Neurology, College of Physicians and Surgeons (M.S.V.E.), Columbia University, New York.

Background and Purpose- An excess incidence of strokes among blacks versus whites has been shown, but data on disparities related to Hispanic ethnicity remain limited. This study examines race/ethnic differences in stroke incidence in the multiethnic, largely Caribbean Hispanic, NOMAS (Northern Manhattan Study), and whether disparities vary by age. Methods- The study population included participants in the prospective population-based NOMAS, followed for a mean of 14±7 years. Read More

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http://dx.doi.org/10.1161/STROKEAHA.119.028806DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7093213PMC

Recurrent ischemic stroke in patients with atrial fibrillation ablation and prior stroke: A study based on etiological classification.

J Arrhythm 2020 Feb 3;36(1):95-104. Epub 2019 Dec 3.

Tokyo Medical and Dental University Tokyo Japan.

Background: Different subtypes of ischemic stroke may have different risk factors, clinical features, and prognoses. This study investigated the incidence and mode of stroke recurrence in patients with a history of stroke who underwent atrial fibrillation (AF) ablation.

Methods: Of 825 patients who underwent AF ablation from 2006 to 2016, 77 patients (9. Read More

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http://dx.doi.org/10.1002/joa3.12285DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011801PMC
February 2020

Impact of obstructive sleep apnea on silent cerebral small vessel disease: a systematic review and meta-analysis.

Sleep Med 2020 04 16;68:80-88. Epub 2019 Dec 16.

King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.

Background: Cerebral small vessel disease (CSVD) is a well-known cause of vascular dementia, a leading medical morbidity in the aging population. Obstructive sleep apnea (OSA) has been validated as a cardiovascular risk factor. However, the relationship between these two clinical syndromes is not well established. Read More

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http://dx.doi.org/10.1016/j.sleep.2019.11.1262DOI Listing

[Characteristics of single subcortical small infarction in the middle cerebral artery territory].

Zhonghua Yi Xue Za Zhi 2020 Jan;100(3):202-206

Department of Neurology, the People's Hospital of Zhengzhou City, Zhengzhou 450003, China.

To investigate the characteristics and possible mechanisms of differtent stroke patterns of single subcortical small infarction (SSSI) in the middle cerebral artery (MCA) territory. The clinical and imaging data of patients with acute SSSI in MCA territory admitted to the Neurology Department of People's Hospital of Zhengzhou City from January 2016 to December 2017 were retrospectively analyzed. According to the presence of MCA stenosis and whether the lesion sites on axial DWI-MRI involved the lowest basal ganglia, SSSl were divided into different patterns. Read More

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http://dx.doi.org/10.3760/cma.j.issn.0376-2491.2020.03.009DOI Listing
January 2020

Risk factors associated with progressive lacunar strokes and benefit from dual antiplatelet therapy.

Eur J Neurol 2020 May 18;27(5):817-824. Epub 2020 Feb 18.

Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany.

Background And Purpose: Early neurological deterioration (END) occurs in 20%-30% of patients with lacunar stroke and challenges their clinical management. This retrospective cohort study analyzed clinical and neuroimaging risk factors predicting the occurrence of END, the functional outcome after END and potential benefit from dual antiplatelet therapy (DAPT) in patients with lacunar strokes.

Methods: Factors associated with END and benefit from DAPT were retrospectively analyzed in 308 patients with lacunar stroke symptoms and detected lacunar infarction by magnetic resonance imaging. Read More

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http://dx.doi.org/10.1111/ene.14159DOI Listing

The study on analysis of risk factors for severity of white matter lesions and its correlation with cerebral microbleeds in the elderly with lacunar infarction.

Medicine (Baltimore) 2020 Jan;99(4):e18865

Department of Emergency, Jining NO.1 People's Hospital, Jining, Shandong, China.

This study aimed to explore the risk factors for severity of white matter lesions and its correlation with in the elderly with lacunar infarction.Patients (range, 70-85 years) with lacunar infarction treated in a hospital in China from 2016 to 2017were enrolled. Fazekas rating scale (0-6 points) was used to assess severity of white matter lesions. Read More

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http://dx.doi.org/10.1097/MD.0000000000018865DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004709PMC
January 2020

Retinal Vascular Signs and Cerebrovascular Diseases.

J Neuroophthalmol 2020 Mar;40(1):44-59

Singapore Eye Research Institute (THR, AWJT, HHSY, TYW), Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP) (THR, TYW), Duke-NUS Medical School, Singapore; and Department of Ophthalmology and Visual Sciences (CYC), The Chinese University of Hong Kong, Hong Kong.

Background: Cerebrovascular disease (CeVD), including stroke, is a leading cause of death globally. The retina is an extension of the cerebrum, sharing embryological and vascular pathways. The association between different retinal signs and CeVD has been extensively evaluated. Read More

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http://dx.doi.org/10.1097/WNO.0000000000000888DOI Listing

The Association Between Coronary Artery Calcification and Subclinical Cerebrovascular Diseases in Men: An Observational Study.

J Atheroscler Thromb 2020 Jan 22. Epub 2020 Jan 22.

Department of Public Health, Shiga University of Medical Science.

Aim: Coronary artery calcification (CAC) is an independent predictor of stroke and dementia, in which subclinical cerebrovascular diseases (SCVDs) play a vital pathogenetic role. However, few studies have described the association between CAC and SCVDs. Therefore, the aim of this study was to assess the clinical relationship between CAC and SCVDs in a healthy Japanese male population. Read More

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http://dx.doi.org/10.5551/jat.51284DOI Listing
January 2020
2.733 Impact Factor

Genetic determinants of blood lipids and cerebral small vessel disease: role of high-density lipoprotein cholesterol.

Brain 2020 02;143(2):597-610

Institute for Stroke and Dementia Research (ISD), University Hospital of Ludwig-Maximilians-University (LMU), Munich, Germany.

Blood lipids are causally involved in the pathogenesis of atherosclerosis, but their role in cerebral small vessel disease remains largely elusive. Here, we explored associations of genetic determinants of blood lipid levels, lipoprotein particle components, and targets for lipid-modifying drugs with small vessel disease phenotypes. We selected genetic instruments for blood levels of high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides, for cholesterol and triglycerides components of size-defined lipoprotein particles, and for lipid-modifying drug targets based on published genome-wide association studies (up to 617 303 individuals). Read More

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http://dx.doi.org/10.1093/brain/awz413DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7009571PMC
February 2020

Clinical Characteristics of Driving-related Stroke Occurring as a Recurrent Stroke.

J Stroke Cerebrovasc Dis 2020 Apr 18;29(4):104634. Epub 2020 Jan 18.

Department of Neurosurgery, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan.

Background: Although the number of seemingly healthy subjects who suffer a minor stroke increases, there are no data on how frequently they sustain another stroke while driving.

Methods: A single-center, retrospective study was conducted to clarify the clinical characteristics of driving-related stroke occurring as a recurrent stroke by analyzing data prospectively acquired between January 2009 and June 2019 on 3452 acute stroke patients.

Results: One hundred-thirty five patients (85 ischemic stroke [IS] and 50 hemorrhagic stroke [HS]) had suffered a driving-related stroke. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2019.104634DOI Listing

Endothelial progenitor cells, potential biomarkers for diagnosis and prognosis of ischemic stroke: protocol for an observational case-control study.

Neural Regen Res 2020 Jul;15(7):1300-1307

Stroke, Division of Clinical Neuroscience, University of Nottingham, Clinical Sciences Building, City Hospital, Hucknall Road, NG5 1PB, UK.

Ischemic stroke is a devastating, life altering event which can severely reduce patient quality of life. Despite years of research there have been minimal therapeutic advances. Endothelial progenitor cells (EPCs), stem cells involved in both vasculogenesis and angiogenesis, may be a potential therapeutic target. Read More

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http://dx.doi.org/10.4103/1673-5374.269028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7047808PMC

A prothrombotic state and denser clot formation in patients following acute limb ischemia of unknown cause.

Thromb Res 2020 Mar 10;187:32-38. Epub 2020 Jan 10.

Krakow Center for Medical Research and Technology, John Paul II Hospital, Krakow, Poland; Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland. Electronic address:

Introduction: Fibrin clot structure differs between healthy individuals and those following thromboembolic events. Dense and poorly lysable fibrin clots have also been reported in peripheral artery disease. We studied fibrin clot properties and its determinants in individuals with a history of acute lower limb ischemia (ALI) of unknown cause. Read More

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http://dx.doi.org/10.1016/j.thromres.2020.01.008DOI Listing

Moderate Levels of N-Terminal Pro-B-Type Natriuretic Peptide is Associated with Increased Risks of Total and Ischemic Strokes among Japanese: The Circulatory Risk in Communities Study.

J Atheroscler Thromb 2020 Jan 11. Epub 2020 Jan 11.

Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba.

Aim: N-terminal pro-B-type natriuretic peptide (NT-proBNP), frequently used as a biochemical marker for detecting and monitoring heart failure, is also a risk marker for development of coronary heart disease and total stroke. However, studies that explore subtypes of ischemic stroke with regard to NT-proBNP are scarce. Here, we examined NT-proBNP and its impact upon subtypes of ischemic stroke (lacunar stroke, large-artery occlusive stroke and embolic stroke) among Japanese. Read More

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http://dx.doi.org/10.5551/jat.52241DOI Listing
January 2020

Circulating levels of vascular endothelial growth factor and post-stroke long-term functional outcome.

Acta Neurol Scand 2020 May 22;141(5):405-414. Epub 2020 Jan 22.

Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Objectives: Vascular endothelial growth factor (VEGF) acts in angiogenesis and neuroprotection, although the beneficial effects on experimental ischemic stroke (IS) have not been replicated in clinical studies. We investigated serum VEGF (s-VEGF) in the acute stage (baseline) and 3 months post-stroke in relation to stroke severity and functional outcome.

Methods: The s-VEGF and serum high-sensitivity C-reactive protein (hs-CRP) concentrations were measured in patients enrolled in the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS) at the acute time-point (median 4 days, N = 492, 36% female; mean age, 57 years) and at 3 months post-stroke (N = 469). Read More

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http://dx.doi.org/10.1111/ane.13219DOI Listing

Size, shape and location of lacunar strokes and correlation with risk factors.

Clin Neurol Neurosurg 2020 Mar 2;190:105665. Epub 2020 Jan 2.

Neurology - Stroke Unit, "A. Manzoni" Hospital, ASST Lecco, Lecco, Italy.

Objective: We evaluated a prospective cohort of 150 patients under observation in our centre for lacunar strokes. The purpose of this study was to investigate if lacunar stroke of varying size, shape and locations had different risk factors between them and possibly different mechanisms and causes.

Patients And Methods: 150 patients with a lacunar stroke were included in the present study. Read More

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http://dx.doi.org/10.1016/j.clineuro.2020.105665DOI Listing
March 2020
1.248 Impact Factor