75,559 results match your criteria Medical Treatment of Stroke


Radiosurgery as a microsurgical adjunct: outcomes after microsurgical resection of intracranial arteriovenous malformations previously treated with stereotactic radiosurgery.

J Neurosurg 2021 Jun 11:1-12. Epub 2021 Jun 11.

1Department of Neurosurgery and Stanford Stroke Center, Stanford University Medical Center, Stanford.

Objective: Microsurgical resection of arteriovenous malformations (AVMs) can be aided by staged treatment consisting of stereotactic radiosurgery followed by resection in a delayed fashion. This approach is particularly useful for high Spetzler-Martin (SM) grade lesions because radiosurgery can reduce flow through the AVM, downgrade the SM rating, and induce histopathological changes that additively render the AVM more manageable for resection. The authors present their 28-year experience in managing AVMs with adjunctive radiosurgery followed by resection. Read More

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Thrombotic Pathology is not Correlated with the Prognosis of Endovascular Treatment for Acute Ischemic Stroke.

J Stroke Cerebrovasc Dis 2021 Jun 8;30(8):105755. Epub 2021 Jun 8.

Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, 400042 Chongqing, China. Electronic address:

Objective: The aim of the present study was to determine whether there is a correlation between thrombotic pathology and prognosis of endovascular treatment (EVT) for acute ischemic stroke (AIS).

Methods: Thrombi were taken from 58 patients with cerebral ischemic thrombosis who were consecutively selected for EVT for AIS. The collected thrombi then underwent hematoxylin-eosin staining for pathological examinations to determine the red blood cell (RBC) ratio and fibrin/platelet components. Read More

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SIRT1/PGC-1α signaling activation by mangiferin attenuates cerebral hypoxia/reoxygenation injury in neuroblastoma cells.

Eur J Pharmacol 2021 Jun 8:174236. Epub 2021 Jun 8.

Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, Xi'an No.3 Hospital, School of Life Sciences and Medicine, Northwest University, 10 Fengcheng Three Road, Xi'an, China; Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education. Faculty of Life Sciences, Northwest University, 229 Taibai North Road, Xi'an, China. Electronic address:

Ischemia reperfusion injury (IRI) is associated with poor prognoses in the setting of ischemic brain diseases. Silence information regulator 1 (SIRT1) is a member of the third class of nicotinamide adenine dinucleotide (NAD)-dependent sirtuins. Recently, the role of SIRT1/peroxisome proliferators-activated receptor-γ coactivator 1α (PGC-1α) pathway in organ (especially the brain) protection under various pathological conditions has been widely investigated. Read More

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Real-world safety and effectiveness of rivaroxaban using Japan-specific dosage during long-term follow-up in patients with atrial fibrillation: XAPASS.

PLoS One 2021 11;16(6):e0251325. Epub 2021 Jun 11.

Medical Affairs and Pharmacovigilance, Bayer Yakuhin, Ltd., Osaka, Japan.

Background: The Xarelto Post-Authorization Safety and Effectiveness Study in Japanese Patients with Atrial Fibrillation (XAPASS) was designed to investigate safety and effectiveness during long-term follow-up of rivaroxaban treatment, using reduced doses compared with other global regions, in Japanese patients with non-valvular atrial fibrillation in real-world clinical practice.

Methods: In this prospective, open-label, single-arm, observational study, 11,308 patients with non-valvular atrial fibrillation newly prescribed rivaroxaban (15/10 mg once daily) at 1416 sites across Japan were enrolled and followed for a mean of 2.5 years. Read More

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Repurposing of Clinically Approved Poly-(Adp-Ribose) Polymerase Inhibitors For The Therapy of Sepsis.

Shock 2021 Jun 10. Epub 2021 Jun 10.

Division of Infectious Diseases, Escola Paulista de Medicina, Universidade Federal de Sao Paulo - Sao Paulo - Brazil Laboratory of Medical Research - Faculty of Medicine of the University of São Paulo-USP, São Paulo, Brazil Chair of Pharmacology, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland.

Abstract: Sepsis' pathogenesis involves multiple mechanisms that lead to a dysregulation of the host's response. Significant efforts have been made in search of interventions that can reverse this situation and increase patient survival. Poly (ADP-polymerase) (PARP) is a constitutive nuclear and mitochondrial enzyme, which functions as a co-activator and co-repressor of gene transcription, thus regulating the production of inflammatory mediators. Read More

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Prophylactic dialysis improves short-term clinical outcome in patients with non-dialysis-dependent chronic kidney disease undergoing cardiac surgery: a meta-analysis of randomized controlled trials.

Coron Artery Dis 2021 Jun 10. Epub 2021 Jun 10.

Division of Nephrology, Beijing Anzhen Hospital, Capital Medical University, Beijing, P.R.China.

Background: Several studies have reported that prophylactic dialysis can reduce the mortality of non-dialysis-dependent chronic kidney disease (CKD) patients after cardiac surgery. However, the results of complications in these randomized controlled trials (RCTs) were not consistent. We aimed to perform a meta-analysis to systematically evaluate the effect of prophylactic dialysis in these non-dialysis-dependent CKD patients. Read More

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Use of artificial intelligence as an instrument of evaluation after stroke: a scoping review based on international classification of functioning, disability and health concept.

Top Stroke Rehabil 2021 Jun 11:1-16. Epub 2021 Jun 11.

Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Brazil.

: To understand the current practices in stroke evaluation, the main clinical decision support system and artificial intelligence (AI) technologies need to be understood to assist the therapist in obtaining better insights about impairments and level of activity and participation in persons with stroke during rehabilitation. : This scoping review maps the use of AI for the functional evaluation of persons with stroke; the context involves any setting of rehabilitation. Data were extracted from CENTRAL, MEDLINE, EMBASE, LILACS, CINAHL, PEDRO Web of Science, IEEE Xplore, AAAI Publications, ACM Digital Library, MathSciNet, and arXiv up to January 2021. Read More

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Moving Toward a New Standard of Care for Acute Pediatric Stroke.

Authors:
Henry David

Pediatr Ann 2021 Jun 1;50(6):e242-e244. Epub 2021 Jun 1.

Acute pediatric stroke is growing in incidence with the longer survivorship of children with medical complexities, yet detection and treatment of this disease continues to be met with limitations. It is essential for the frontline provider to appropriately identify various presentations of acute pediatric stroke for timely management to occur. Although studies in thrombolytic and endovascular recanalization therapies are limited, the safety and efficacy of these treatments continues to be explored. Read More

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Cost-Effectiveness of Ticagrelor Compared with Clopidogrel in Patients with Acute Coronary Syndrome from Vietnamese Healthcare Payers' Perspective.

Adv Ther 2021 Jun 11. Epub 2021 Jun 11.

AstraZeneca Medical Affairs, Ho Chi Minh City, Vietnam.

Introduction: The PLATelet inhibition and patient Outcomes (PLATO) trial (NCT00391872) demonstrated that ticagrelor compared to clopidogrel significantly reduced the rate of death from cardiovascular causes, myocardial infarction or stroke in patients with acute coronary syndrome (ACS). The aim of this study is to analyze the long-term cost-effectiveness of ticagrelor compared to clopidogrel in ACS patients from a Vietnamese healthcare payers' perspective.

Methods: A two-part cost-effectiveness model was developed to estimate long-term costs and quality-adjusted life-years (QALY). Read More

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Off-label reduced-dose apixaban does not reduce hemorrhagic risk in Taiwanese patients with nonvalvular atrial fibrillation: A retrospective, observational study.

Medicine (Baltimore) 2021 Jun;100(23):e26272

Department of Internal Medicine, Division of Cardiology, National Cheng Kung University Hospital.

Abstract: East Asians are reportedly at high risk of anticoagulant-related bleeding; therefore, some physicians prefer to prescribe low-dose direct oral anticoagulants (DOACs). Little is known about the therapeutic effectiveness and safety of off-label reduced-dose apixaban in East Asians with nonvalvular atrial fibrillation (AF). We aimed to investigate the effectiveness and safety of off-label reduced-dose apixaban in Taiwanese patients with nonvalvular AF. Read More

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The active feedback program: bringing medical students out of the shadows.

Med Educ Online 2021 Dec;26(1):1939842

Department of Neurology, Georgetown University, Washington, DC, USA.

Despite many advances in medical education, medical students continue to mostly shadow on inpatient rotations like Neurology. They seldom receive face-to-face feedback or mentorship from attending physicians. This results from not training attending physicians how to integrate medical students into clinical activities in a way that does not detract from patient rounds. Read More

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December 2021

Anti-inflammatory effects of paeoniflorin caused by regulation of the hif1a/miR-210/caspase1/GSDMD signaling pathway in astrocytes: a novel strategy for hypoxia-induced brain injury in rats.

Immunopharmacol Immunotoxicol 2021 Jun 11:1-9. Epub 2021 Jun 11.

The First Clinical Medical College, Lanzhou University, Lanzhou, China.

Hypoxia-induced injury is a classic symptom of obstructive sleep apnea hypopnea syndrome (OSAHS), which is a risk factor of various diseases, such as hypertension, heart failure and stroke. However, there is no effective therapy for hypoxia-induced injury or OSAHS due to the elusive mechanism involved. This study aimed to assess the effects of paeoniflorin on hypoxia-induced injury and explore the underlying mechanism. Read More

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Giant axonal neuropathy: cross sectional analysis of a large natural history cohort.

Brain 2021 Jun 11. Epub 2021 Jun 11.

National Institutes of Health, Neuromuscular and Neurogenetic Disorders of Childhood Section, Bethesda, MD 20892, USA.

Giant axonal neuropathy (GAN) is an ultra-rare autosomal recessive, progressive neurodegenerative disease with early childhood onset that presents as a prominent sensorimotor neuropathy and commonly progresses to affect both the peripheral nervous system and central nervous system. The disease is caused by biallelic mutations in the GAN gene located on 16q23.2, leading to loss of functional gigaxonin, a substrate specific ubiquitin ligase adapter protein necessary for the regulation of intermediate filament turnover. Read More

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Effects of detraining on preconditioning exercise-induced neuroprotective potential after ischemic stroke in rats.

Brain Struct Funct 2021 Jun 10. Epub 2021 Jun 10.

Department of Systems Biology in Thromboregulation, Kagoshima University Graduate School of Medical and Dental Science, Kagoshima, Japan.

Preconditioning exercise prior to stroke exerts neuroprotection, which is an endogenous strategy that leads the brain cells to express several intrinsic factors and inhibits their apoptosis. However, it is unclear how long these benefits last after exercise cessation. The aim of this study was to investigate the effects of detraining on preconditioning exercise-induced neuroprotective potential after stroke. Read More

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Thirty-Day and One-Year Outcomes of Endovascular Treatments for Severe Atherosclerotic Stenosis of Intracranial ICA: Results From a Single Center.

Front Neurol 2021 25;12:668868. Epub 2021 May 25.

Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Endovascular treatment for intracranial atherosclerotic stenosis (ICAS) has been developed. However, the intracranial internal carotid artery (ICA) presents a particular challenge due to the location and tortuous route, and the outcomes of endovascular treatment in patients with stenosis of the intracranial ICA still have not been reported. This article retrospectively investigated the 30-day and 1-year outcomes of tailored endovascular treatment for patients with severe intracranial ICA stenosis from a single center. Read More

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Subarachnoid Hemorrhage in Mechanical Thrombectomy for Acute Ischemic Stroke: Analysis of the STRATIS Registry, Systematic Review, and Meta-Analysis.

Front Neurol 2021 25;12:663058. Epub 2021 May 25.

Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital, Toronto, ON, Canada.

The indications for mechanical thrombectomy in acute ischemic stroke continue to broaden, leading neurointerventionalists to treat vessel occlusions at increasingly distal locations farther in time from stroke onset. Accessing these smaller vessels raises the concern of iatrogenic subarachnoid hemorrhage (SAH) owing to increasing complexity in device navigation and retrieval. This study aims to determine the prevalence of SAH following mechanical thrombectomy, associated predictors, and resulting functional outcomes using a multicenter registry and compare this with a systematic review and meta-analysis of the literature. Read More

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The Effectiveness of Music Therapy on Hand Function in Patients With Stroke: A Systematic Review of Randomized Controlled Trials.

Front Neurol 2021 25;12:641023. Epub 2021 May 25.

Department of Rehabilitation Medicine, Zhujiang Hospital of Southern Medical University, Guangzhou, China.

This study aims to evaluate the efficacy of music-supported therapy for stroke patients' hand function. The databases used included Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PubMed, Embase, Music Index, and Google Scholar. Studies published between January 2010 and August 2020 were included. Read More

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Non Vitamin K Antagonist Oral Anticoagulants in Atrial Fibrillation Patients Scheduled for Electrical Cardioversion: A Real-Life Propensity Score Matched Study.

J Blood Med 2021 4;12:413-420. Epub 2021 Jun 4.

Department of Cardiology, Monaldi Hospital, Naples, Italy.

Aim: The aim of the present study was to assess the safety and effectiveness of non-vitamin K antagonist oral anticoagulants (NOACs) versus vitamin K antagonists (VKAs) in atrial fibrillation (AF) patients undergoing electrical cardioversion (EC).

Methods: A propensity score-matched analysis was performed in order to identify two homogeneous groups including AF patients on NOACs and VKAs treatment scheduled for EC. The primary safety endpoint was major bleeding. Read More

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Updated Review on the Diagnosis and Primary Management of Psychogenic Nonepileptic Seizure Disorders.

Neuropsychiatr Dis Treat 2021 4;17:1825-1838. Epub 2021 Jun 4.

Buenos Aires University, Ramos Mejía Hospital, Epilepsy Center, Buenos Aires, Argentina.

Psychogenic nonepileptic seizures (PNES) are paroxystic and episodic events associated with motor, sensory, mental or autonomic manifestations, which resemble epileptic seizures (ES), but are not caused by epileptogenic activity. PNES affect between 20% and 30% of patients attending at epilepsy centers and constitute a serious mental health problem. PNES are often underdiagnosed, undertreated and mistaken with epilepsy. Read More

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Ameliorative Effect of Parishin C Against Cerebral Ischemia-Induced Brain Tissue Injury by Reducing Oxidative Stress and Inflammatory Responses in Rat Model.

Neuropsychiatr Dis Treat 2021 4;17:1811-1823. Epub 2021 Jun 4.

Department of Anesthesiology, the Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, 570311, People's Republic of China.

Background: Blume () is a widely used traditional Chinese herbal medicine in the clinical practice of China, to treat nervous headache, convulsions, dizziness, neurasthenia, and so on. Parishin C (Par C), one of the major bioactive components of Blume, is known to exert many different biological activities, including antipsychotic and neuroprotective effects. However, there is little research about its neuroprotective effect in an ischemic stroke model. Read More

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Thrombus or No Thrombus: Is That the Embolic Question?

J Am Coll Cardiol 2021 Jun;77(23):2887-2889

Department of Cardiology, University Heart & Vascular Center Hamburg, Hamburg, Germany; German Centre of Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Germany.

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[Clinical effects of intermittent oro-esophageal tube feeding combined with Xuanqiaoliyan decotion in stroke patients with dysphagia].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2021 May;33(5):552-556

Department of Neurology, Yidu Central Hospital Affiliated Hospital of Weifang Medical University, Qingzhou 262500, Shandong, China. Corresponding author: Sun Xibo, Email:

Objective: To investigate the clinical effects of intermittent oro-esophageal tube feeding (IOE) combined with Xuanqiaoliyan decotion in stroke patients with dysphagia.

Methods: A prospective study was conducted. Stroke patients with dysphagia admitted to Yidu Central Hospital Affiliated Hospital of Weifang Medical University from January 2018 to December 2019 were enrolled. Read More

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European registry of type A aortic dissection (ERTAAD) - rationale, design and definition criteria.

J Cardiothorac Surg 2021 Jun 10;16(1):171. Epub 2021 Jun 10.

Leipzig Heart center, Leipzig, Germany.

Background: Acute Stanford type A aortic dissection (TAAD) is a life-threatening condition. Surgery is usually performed as a salvage procedure and is associated with significant postoperative early mortality and morbidity. Understanding the patient's conditions and treatment strategies which are associated with these adverse events is essential for an appropriate management of acute TAAD. Read More

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Migraine and neuroinflammation: the inflammasome perspective.

J Headache Pain 2021 Jun 10;22(1):55. Epub 2021 Jun 10.

Institute of Neurological Sciences and Psychiatry, Hacettepe University, Ankara, Turkey.

Background: Neuroinflammation has an important role in the pathophysiology of migraine, which is a complex neuro-glio-vascular disorder. The main aim of this review is to highlight findings of cortical spreading depolarization (CSD)-induced neuroinflammatory signaling in brain parenchyma from the inflammasome perspective. In addition, we discuss the limited data of the contribution of inflammasomes to other aspects of migraine pathophysiology, foremost the activation of the trigeminovascular system and thereby the generation of migraine pain. Read More

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Risk of Cardiovascular Complications in Patients with Persistent Atrial Fibrillation after Dissolution of a Thrombus in the Left Atrial Appendage.

Kardiologiia 2021 May 31;61(5):17-22. Epub 2021 May 31.

Tver State Medical University, Tver.

Aim      To compare the incidence of cardiovascular complications (CVC) in patients with persistent atrial fibrillation (AF) following thrombus dissolution in the left atrial appendage (LAA) and in patients with persistent AF without preceding LAA thrombosis.Material and methods  The main group included 43 patients who had been diagnosed with LAA thrombosis on the first examination, transesophageal echocardiography, and who showed dissolution of the thrombus on a repeated study performed after 7.1+2. Read More

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Obesity in acute ischaemic stroke patients treated with intravenous thrombolysis therapy.

Neurol Res 2021 Jun 10:1-8. Epub 2021 Jun 10.

The Departments of Cerebrovascular Diseases, The Second Affiliated Hospital of Zhengzhou University.

: This article aimed to analyze the relationship between obesity and the efficacy of acute ischaemic stroke patients treated with IVT.: Stroke causes morbidity and mortality in large numbers of individuals annually. Intravenous thrombolysis (IVT)with recombinant tissue plasminogen activator (r-tPA) is currently the only approved by the FDA for treatment of acute ischaemic stroke. Read More

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Continuous-Flow Left Ventricular Assist Device Explantation After More Than 5 Years of Circulatory Support and Ventricular Reconditioning.

Tex Heart Inst J 2021 Jun;48(2)

Center for Cardiac Support, Texas Heart Institute, Houston, Texas.

Continuous-flow left ventricular assist devices have proved to be effective, durable, life-saving tools in patients with end-stage heart failure. However, because of the risks associated with mechanical circulatory support (including stroke, infection, gastrointestinal bleeding, and device malfunction), the optimal goal of device therapy is myocardial recovery and device removal. Ventricular reconditioning and pump explantation after continuous-flow support have been reported; however, little is known about variables that govern the pace and degree of myocardial response in patients who experience such recovery. Read More

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Contemporary Medical Management of Peripheral Artery Disease.

Circ Res 2021 Jun 10;128(12):1868-1884. Epub 2021 Jun 10.

Heart and Vascular Center, Dartmouth-Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (M.A.C.).

Peripheral artery disease (PAD) is a manifestation of systemic atherosclerosis. Modifiable risk factors including cigarette smoking, dyslipidemia, diabetes, poor diet quality, obesity, and physical inactivity, along with underlying genetic factors contribute to lower extremity atherosclerosis. Patients with PAD often have coexistent coronary or cerebrovascular disease, and increased likelihood of major adverse cardiovascular events, including myocardial infarction, stroke and cardiovascular death. Read More

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New Directions in Therapeutic Angiogenesis and Arteriogenesis in Peripheral Arterial Disease.

Circ Res 2021 Jun 10;128(12):1944-1957. Epub 2021 Jun 10.

Department of Cardiovascular Sciences, Houston Methodist Research Institute, TX (J.P.C.).

The prevalence of peripheral arterial disease (PAD) in the United States exceeds 10 million people, and PAD is a significant cause of morbidity and mortality across the globe. PAD is typically caused by atherosclerotic obstructions in the large arteries to the leg(s). The most common clinical consequences of PAD include pain on walking (claudication), impaired functional capacity, pain at rest, and loss of tissue integrity in the distal limbs that may lead to lower extremity amputation. Read More

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Economic burden associated with stroke in India: Insights from National Sample Survey 2017-18.

Expert Rev Pharmacoecon Outcomes Res 2021 Jun 10. Epub 2021 Jun 10.

Health Technology Assessment Resource Centre, Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry - 605 006, India.

To estimate the out-of-pocket (OOP) expenditure and catastrophic expenditure due to stroke -related hospitalisation and determine associated predictors. Secondary analysis of household-based survey conducted by National Sample Survey Organization during June 2017 to 2018. A total of 1152 and 407 individuals reported stroke-related hospitalization and outpatient care respectively in the survey. Read More

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