57,367 results match your criteria Medical Treatment of Stroke


Meta-analysis of the prognosis of Different treatments of symptomatic moyamoya disease.

World Neurosurg 2019 Apr 14. Epub 2019 Apr 14.

Department of Neurosurgery, Tianjin Medical University General Hospital, 154 Anshan Road, Tianjin 300052, China; Key Laboratory of Post-Neurotrauma Neurorepair and Regeneration in Central Nervous System, Ministry of Education in China and Tianjin, Tianjin Neurological Institute, Tianjin, 30052China. Electronic address:

Objective: The purpose of this study was to evaluate the efficacy of surgical revascularization versus conservative treatment and different surgical modalities, in order to provide evidence for the patient with MMD to choose the appropriate treatment.

Methods: We comprehensively searched PubMed, Embase, Web of Science and the Cochrane Library for the articles published regarding MMD treatment. If the I value, which evaluated the heterogeneity, was less than 50%, a fixed effect model was used; if not, a random effect model was applied. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.04.062DOI Listing

Effect of a Quality of Care Improvement Initiative in Patients With Acute Coronary Syndrome in Resource-Constrained Hospitals in China: A Randomized Clinical Trial.

JAMA Cardiol 2019 Apr 17. Epub 2019 Apr 17.

Department of Cardiology, Cardiovascular Institute and Fuwai Hospital, Beijing, China.

Importance: Prior observational studies suggest that quality of care improvement (QCI) initiatives can improve the clinical outcomes of acute coronary syndrome (ACS). To our knowledge, this has never been demonstrated in a well-powered randomized clinical trial.

Objective: To determine whether a clinical pathway-based, multifaceted QCI intervention could improve clinical outcomes among patients with ACS in resource-constrained hospitals in China. Read More

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http://dx.doi.org/10.1001/jamacardio.2019.0897DOI Listing
April 2019
1 Read

Current Opinion on Endovascular Therapy for Emergent Large Vessel Occlusion Due to Underlying Intracranial Atherosclerotic Stenosis.

Korean J Radiol 2019 May;20(5):739-748

Department of Radiology, Chonnam National University Medical School, Gwangju, Korea.

For recanalization of emergent large vessel occlusions (ELVOs), endovascular therapy (EVT) using newer devices, such as a stent retriever and large-bore catheter, has shown better patient outcomes compared with intravenous recombinant tissue plasminogen activator only. Intracranial atherosclerotic stenosis (ICAS) is a major cause of acute ischemic stroke, the incidence of which is rising worldwide. Thus, it is not rare to encounter underlying ICAS during EVT procedures, particularly in Asian countries. Read More

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https://synapse.koreamed.org/DOIx.php?id=10.3348/kjr.2018.08
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http://dx.doi.org/10.3348/kjr.2018.0809DOI Listing
May 2019
1 Read

Update in Neurocritical Care: a summary of the 2018 Paris international conference of the French Society of Intensive Care.

Ann Intensive Care 2019 Apr 16;9(1):47. Epub 2019 Apr 16.

Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles (ULB), Route de Lennik, 808, 1070, Brussels, Belgium.

The 2018 Paris Intensive Care symposium entitled "Update in Neurocritical Care" was organized in Paris, June 21-22, 2018, under the auspices of the French Intensive Care Society. This 2-day post-graduate educational symposium comprised several chapters, aiming first to provide all-board intensivists with current standards for the clinical assessment of altered consciousness states (including coma and delirium) and peripheral nervous system in critically ill patients, monitoring of brain function (specifically, electro-encephalography) and best practices for sedation-analgesia-delirium management. An update on the treatment of specific severe brain pathologies-including ischaemic/haemorrhagic stroke, cerebral venous thrombosis, hypoxic-ischaemic brain injury, immune-mediated and infectious encephalitis and refractory status epilepticus-was also provided. Read More

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http://dx.doi.org/10.1186/s13613-019-0523-xDOI Listing

Heparin for prophylaxis of venous thromboembolism in intracerebral haemorrhage.

J Neurol Neurosurg Psychiatry 2019 Apr 16. Epub 2019 Apr 16.

Neurology, University of Erlangen-Nürnberg, Erlangen, Germany

Objective: To determine the occurrence of intracranial haemorrhagic complications (IHC) on heparin prophylaxis (low-dose subcutaneous heparin, LDSH) in primary spontaneous intracerebral haemorrhage (ICH) (not oral anticoagulation-associated ICH, non-OAC-ICH), vitamin K antagonist (VKA)-associated ICH and non-vitamin K antagonist oral anticoagulant (NOAC)-associated ICH.

Methods: Retrospective cohort study (RETRACE) of 22 participating centres and prospective single-centre study with 1702 patients with VKA-associated or NOAC-associated ICH and 1022 patients with non-OAC-ICH with heparin prophylaxis between 2006 and 2015. Outcomes were defined as rates of IHC during hospital stay among patients with non-OAC-ICH, VKA-ICH and NOAC-ICH, mortality and functional outcome at 3 months between patients with ICH with and without IHC. Read More

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http://dx.doi.org/10.1136/jnnp-2018-319786DOI Listing

2019 Update of the Korean Clinical Practice Guidelines of Stroke for Endovascular Recanalization Therapy in Patients with Acute Ischemic Stroke.

J Stroke 2019 Apr 17. Epub 2019 Apr 17.

Department of Neurology, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.

Endovascular recanalization therapy (ERT) has been a standard of care for patients with acute ischemic stroke due to large artery occlusion (LAO) within 6 hours after onset, since five landmark ERT trials conducted by 2015 demonstrated its clinical benefit. Recently, two randomized clinical trials demonstrated that ERT, even in the late time window of up to 16 hours or 24 hours after last known normal time, improved the outcome of patients who had a target mismatch, defined as either clinical-core mismatch or perfusion-core mismatch, which prompted the update of national guidelines in several countries. Accordingly, to provide evidence-based and up-to-date recommendations for ERT in patients with acute LAO in Korea, the Clinical Practice Guidelines Committee of the Korean Stroke Society decided to revise the previous Korean Clinical Practice Guidelines of Stroke for ERT. Read More

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http://dx.doi.org/10.5853/jos.2019.00024DOI Listing

Chrysin prevents cognitive and hippocampal long-term potentiation deficits and inflammation in rat with cerebral hypoperfusion and reperfusion injury.

Life Sci 2019 Apr 13. Epub 2019 Apr 13.

Department of Physiology, Faculty of Medicine, Physiology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Electronic address:

Introduction: Ischemic stroke is one of the leading causes of death worldwide, and extensive efforts have focused on the neuroprotective strategies to minimize complications due to ischemia. This study aimed to examine neuroprotective potential of chrysin, as a natural potent antioxidative and anti-inflammatory agent in an animal model of bilateral common carotid artery occlusion and reperfusion (BCCAO/R).

Methods: Adult male Wistar rats (250-300 g) were randomly divided into 6 groups and submitted to either sham surgery or BCCAO/R after pretreatment with chrysin (10, 30 and 100 mg/kg, once daily, for 21 consecutive days) or saline containing %5 DMSO. Read More

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http://dx.doi.org/10.1016/j.lfs.2019.04.027DOI Listing

BK channel is a molecular target of vitamin C to protect against ischemic brain stroke.

Mol Membr Biol 2019 Apr 16:1-25. Epub 2019 Apr 16.

a Department of Basic Medical Sciences , Medical College of Xiamen University , Xiang'an Nan Lu , Xiamen 361102 , China.

Epidemiological studies have demonstrated that vitamin C decreases the risk of stroke, which has generally been ascribed to its function as antioxidant and free radical scavenger. However, whether there is a defined molecular target for vitamin C on stroke is unknown. Utilizing middle cerebral artery occlusion (MCAO) in rats as a model for ischemic stroke, we demonstrated that long-term, low-dose administration of vitamin C prior to MCAO could exert significant neuroprotective effect on the brain damage. Read More

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https://www.tandfonline.com/doi/full/10.1080/09687688.2019.1
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http://dx.doi.org/10.1080/09687688.2019.1608378DOI Listing
April 2019
1 Read

Heat-Related Illnesses.

Am Fam Physician 2019 Apr;99(8):482-489

82nd Airborne Division, Fort Bragg, NC, USA.

Heat-related illnesses comprise a spectrum of syndromes resulting from disruption of thermoregulation in people exposed to high environmental heat. Symptoms range from heat edema and exercise-associated muscle cramps to exercise-associated collapse, heat exhaustion, and life-threatening heat stroke. Athletes, outdoor laborers, and military personnel are at greatest risk. Read More

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April 2019
2 Reads

A Bayesian approach for individual-level drug benefit-risk assessment.

Stat Med 2019 Apr 15. Epub 2019 Apr 15.

Biostatistics and Research Decision Sciences, MSD, London, UK.

In existing benefit-risk assessment (BRA) methods, benefit and risk criteria are usually identified and defined separately based on aggregated clinical data and therefore ignore the individual-level differences as well as the association among the criteria. We proposed a Bayesian multicriteria decision-making method for BRA of drugs using individual-level data. We used a multidimensional latent trait model to account for the heterogeneity of treatment effects with latent variables introducing the dependencies among outcomes. Read More

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https://onlinelibrary.wiley.com/doi/abs/10.1002/sim.8166
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http://dx.doi.org/10.1002/sim.8166DOI Listing
April 2019
1 Read

Dental treatment procedures for periodontal disease and the subsequent risk of ischemic stroke: a retrospective population-based cohort study.

J Clin Periodontol 2019 Apr 16. Epub 2019 Apr 16.

Dental Technology Centre, Changhua Christian Hospital, Changhua, Taiwan.

Aim: To investigate the association between specific dental therapy for periodontal disease and the risk of ischemic stroke.

Materials And Methods: We conducted a population-based cohort study that used data from the Taiwan National Health Insurance Research Database 2005 for the period of 2000-2013. Our observations focused on patients with the diagnoses of gingivitis or periodontitis with and without specific treatment and subsequent incidence of ischemic stroke. Read More

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http://dx.doi.org/10.1111/jcpe.13113DOI Listing

Mental imagery training for treatment of central neuropathic pain: a narrative review.

Acta Neurol Belg 2019 Apr 15. Epub 2019 Apr 15.

Amity Institute of Neuropsychology and Neurosciences (AINN), Amity University UP, Room No. 222A, J1 Block, Sector 125, Noida, 201303, India.

Mental imagery is a quasi-perceptual experience in the absence of external stimuli. This concept has intrigued psychologists, sportspersons, neurologists and other scientists for over a decade now. Imagery has been used in rehabilitation and the results have been promising. Read More

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http://link.springer.com/10.1007/s13760-019-01139-x
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http://dx.doi.org/10.1007/s13760-019-01139-xDOI Listing
April 2019
1 Read

DL-3-n-butylphthalide therapy for Parkinson's disease: A randomized controlled trial.

Exp Ther Med 2019 May 14;17(5):3800-3806. Epub 2019 Mar 14.

Department of Neurology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, Anhui 230001, P.R. China.

Currently available treatments for Parkinson's disease (PD) do not delay or prevent disease development and progression. DL-3-n-butylphthalide (NBP), isolated from seeds, alleviates oxidative damage and mitochondrial dysfunction. It has been revealed to reduce the loss of dopamine neurons in pre-clinical PD models, and has been approved for the treatment of ischemic stroke patients. Read More

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http://dx.doi.org/10.3892/etm.2019.7397DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6447885PMC
May 2019
4 Reads

Selenium nanoparticles for targeted stroke therapy through modulation of inflammatory and metabolic signaling.

Sci Rep 2019 Apr 15;9(1):6044. Epub 2019 Apr 15.

Physiology Research Center and Department of Physiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Ischemic cerebral stroke is a major cause of death and morbidity. Currently, no neuroprotective agents have been shown to impact the clinical outcomes in cerebral stroke cases. Here, we report therapeutic effects of Se nanoparticles on ischemic stroke in a murine model. Read More

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http://dx.doi.org/10.1038/s41598-019-42633-9DOI Listing

Cerebellar fastigial nucleus electrical stimulatin protects against cerebral ischemic damage by upregulating telomerase activity.

Restor Neurol Neurosci 2019 Apr 5. Epub 2019 Apr 5.

Department of Neurology, The First Affiliated Hospital of Guangxi Medical University in Nanning, China.

Background: Cerebellar fastigial nucleus electrical stimulation (FNS) in rats has been shown to protect against brain ischemia/reperfusion (I/R) damage. Activation of telomerase has been reported to provide neuroprotection in animal models of stroke.

Objective: The aim of this study was to explore whether precondition FNS increases the expression of telomerase reverse transcriptase (TERT) and telomerase activity in rats after cerebral I/R injury. Read More

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http://dx.doi.org/10.3233/RNN-180876DOI Listing

Preclinical Development of a vWF Aptamer to Limit Thrombosis and Engender Arterial Recanalization of Occluded Vessels.

Mol Ther 2019 Mar 30. Epub 2019 Mar 30.

Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA. Electronic address:

Endothelial surface and circulating glycoprotein von Willebrand factor (vWF) regulates platelet adhesion and is associated with thrombotic diseases, including ischemic stroke, myocardial infarction, and peripheral vascular disease. Thrombosis, as manifested in these diseases, is the leading cause of disability and death in the western world. Current parenteral antithrombotic and thrombolytic agents used to treat these conditions are limited by a short therapeutic window, irreversibility, and major risk of hemorrhage. Read More

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http://dx.doi.org/10.1016/j.ymthe.2019.03.016DOI Listing

Long-Term Outcome of Symptomatic Patients Undergoing Hybrid Revascularisation for Extracranial Carotid Artery Tandem Stenosis.

Eur J Vasc Endovasc Surg 2019 Apr 12. Epub 2019 Apr 12.

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

Objectives: Carotid tandem lesions are a multilevel significant (>50%) atherosclerotic disease involving both the internal carotid artery (ICA) and either the ipsilateral common carotid artery (CCA) or the innominate artery (IA). These lesions may be challenging to treat. Current guidelines offer no definitive recommendation on the optimal treatment algorithm. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10785884183086
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http://dx.doi.org/10.1016/j.ejvs.2018.11.016DOI Listing
April 2019
1 Read

Cardiovascular determinants of resuscitation from sepsis and septic shock.

Crit Care 2019 Apr 15;23(1):118. Epub 2019 Apr 15.

Department of Critical Care Medicine, University of Pittsburgh, 1215.4 Kaufmann Medical Building, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA.

Background: We hypothesized that the cardiovascular responses to Surviving Sepsis Guidelines (SSG)-defined resuscitation are predictable based on the cardiovascular state.

Methods: Fifty-five septic patients treated by SSG were studied before and after volume expansion (VE), and if needed norepinephrine (NE) and dobutamine. We measured mean arterial pressure (MAP), cardiac index (CI), and right atrial pressure (Pra) and calculated pulse pressure and stroke volume variation (PPV and SVV), dynamic arterial elastance (Ea), arterial elastance (Ea) and left ventricular (LV) end-systolic elastance (Ees), Ees/Ea (VAC), LV ejection efficiency (LVeff), mean systemic pressure analogue (Pmsa), venous return pressure gradient (Pvr), and cardiac performance (Eh), using standard formulae. Read More

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https://ccforum.biomedcentral.com/articles/10.1186/s13054-01
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http://dx.doi.org/10.1186/s13054-019-2414-9DOI Listing
April 2019
5 Reads

Stent-retriever assisted vacuum-locked extraction (SAVE) versus a direct aspiration first pass technique (ADAPT) for acute stroke: data from the real-world.

BMC Neurol 2019 Apr 15;19(1):65. Epub 2019 Apr 15.

Department of Neuroradiology, University Medical Center Goettingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.

Background: Embolectomy is the standard of care in acute ischemic stroke (AIS) caused by large vessel occlusion (LVO). Aim of this study was to compare two techniques: A Direct Aspiration First Pass Technique (ADAPT) and Stent-retriever Assisted Vacuum-locked Extraction (SAVE) stratified by the occluded vessel.

Methods: One hundred seventy-one patients (71 male) treated between January 2014 and September 2017 with AIS due to LVO of the anterior circulation (55 carotid T, 94 M1, 22 M2) were included. Read More

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https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-
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http://dx.doi.org/10.1186/s12883-019-1291-9DOI Listing
April 2019
3 Reads

Arterial Stiffness, Cognitive Dysfunction, and Adherence to Antihypertensive Agents. Is there a Link to Hypertensive Patients?

Curr Vasc Pharmacol 2019 Apr 15. Epub 2019 Apr 15.

Department of Internal Medicine, Medical School, University of Ioannina, 451 10, Ioannina. Greece.

The incidence of hypertension (HTN) and its cardiovascular (CV) complications are increasing throughout the world. Blood pressure (BP) control remains unsatisfactory worldwide. Medical inertia and poor adherence to treatment are among the factors that can partially explain, why BP control rate remains low. Read More

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http://dx.doi.org/10.2174/1570161117666190415112953DOI Listing

Endovascular treatment of acute ischaemic stroke in octogenarians and nonagenarians compared with younger patients.

Neuroradiol J 2019 Apr 16:1971400919840847. Epub 2019 Apr 16.

2 Department of Neurosurgery, National Hospital Organization Kyoto Medical Center, Japan.

Purpose: Endovascular therapy for emergent large vessel occlusion has been established as the standard approach for acute ischaemic stroke. However, the effectiveness and safety of endovascular therapy in the very elderly population has not been proved.

Objective: To determine the safety and effectiveness of endovascular therapy in octogenarians and nonagenarians. Read More

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http://dx.doi.org/10.1177/1971400919840847DOI Listing

IMM-H004 Protects against Cerebral Ischemia Injury and Cardiopulmonary Complications via CKLF1 Mediated Inflammation Pathway in Adult and Aged Rats.

Int J Mol Sci 2019 Apr 3;20(7). Epub 2019 Apr 3.

Hunan Engineering Technology Center of Standardization and Function of Chinese Herbal Decoction Pieces & College of Pharmacy, Hunan University of Chinese Medicine, Changsha 410208, China.

(1) Background: Chemokine-like factor 1 (CKLF1) is a chemokine with potential to be a target for stroke therapy. Compound IMM-H004 is a novel coumarin derivative screened from a CKLF1/C-C chemokine receptor type 4 (CCR4) system and has been reported to improve cerebral ischemia/reperfusion injury. This study aims to investigate the protective effects of IMM-H004 on cerebral ischemia injury and its infectious cardiopulmonary complications in adult and aged rats from the CKLF1 perspective. Read More

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http://dx.doi.org/10.3390/ijms20071661DOI Listing

Disability-Adjusted Life-Years Due to Stroke in Kenya.

Neuroepidemiology 2019 Apr 15:1-7. Epub 2019 Apr 15.

Maine Medical Center Research Institute, Portland, Oregon, USA.

Background: There is little information on stroke morbidity in Kenya to inform health care planning. The disability-adjusted life-years (DALYs) are a time-based measure of health status that incorporates both disability and mortality.

Methods: This was a multicenter prospective study in Kenya's public tertiary hospitals conducted in 2015-2017. Read More

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http://dx.doi.org/10.1159/000498970DOI Listing

Association between perioperative stroke and 30-day mortality in carotid endarterectomy: A meta-analysis.

Clin Neurol Neurosurg 2019 Apr 1;181:44-51. Epub 2019 Apr 1.

Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. Electronic address:

Objectives: Perioperative stroke is a known complication of carotid endarterectomy (CEA) for patients with symptomatic and asymptomatic carotid stenosis. The Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST) has shown that stroke following CEA is associated with nearly a 3-fold increase in the 4-year mortality compared to patients without such an event. However, no studies to date can establish whether the stroke was the cause of the short term mortality. Read More

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http://dx.doi.org/10.1016/j.clineuro.2019.03.028DOI Listing

Can we stop the stuttering in stroke? Interventions in 40 patients with acute lacunes.

J Neurol Sci 2019 Apr 6;401:1-4. Epub 2019 Apr 6.

Department of Neurology, Division of Critical Care Neurology, Mayo Clinic, Rochester, MN, United States of America.

Background: Whether any treatment can stop fluctuations of stuttering lacunar syndromes (SLS) is unclear. Case reports have variably suggested effectiveness of intravenous thrombolysis, dual antiplatelet treatment, blood pressure augmentation and anticoagulation. We aim to describe our experience with different treatments used in in patients presenting with SLS and their effect on clinical fluctuations and functional outcome. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S0022510X193016
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http://dx.doi.org/10.1016/j.jns.2019.04.009DOI Listing
April 2019
1 Read

Dl-3-n-butylphthalide promotes remyelination process in cerebral white matter in rats subjected to ischemic stroke.

Brain Res 2019 Apr 12. Epub 2019 Apr 12.

Department of Neurology, The first affiliated hospital, China Medical University, Shenyang, Liaoning, PR China.

Remyelination has been widely noticed as an important repair mechanism triggered after a stroke-induced white matter injury, but it often fails due to the lack of recruitment of the oligodendrocyte progenitor cells (OPCs) to the demyelinated area and the inadequate differentiation of OPCs. Racemic dl-3-n-butylphthalide (dl-NBP) has been reported to improve the functional recovery in animal models of vascular dementia, Alzheimer's disease (AD) and ischemic stroke. Dl-NBP (70 mg/kg) by oral gavage for two weeks from day 7 after a stroke was administered in the study, the treatment promoted differentiation and maturation of OPCs in perilesional white matter and enhanced the length of crossing corticospinal tract (CST) fibers into the denervated hemispheres. Read More

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http://dx.doi.org/10.1016/j.brainres.2019.03.017DOI Listing

An assay to measure levels of factor Xa inhibitors in blood and plasma.

J Thromb Haemost 2019 Apr 15. Epub 2019 Apr 15.

Thrombosis and Atherosclerosis Research Institute, Hamilton, OntarioCanada.

Background: Rivaroxaban and apixaban are the most commonly used anti-factor (F) Xa direct oral anticoagulants (DOAC), with indications for prevention of stroke in non-valvular atrial fibrillation as well as treatment and prevention of venous thromboembolism. However, lacking is accessibility to a detection method that is able to quantify low levels of anti-FXa DOACs.

Objective: We report a new assay that measures anti-FXa DOACs levels in plasma and whole blood. Read More

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https://onlinelibrary.wiley.com/doi/abs/10.1111/jth.14451
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http://dx.doi.org/10.1111/jth.14451DOI Listing
April 2019
1 Read

Widespread Striatal Delivery of GDNF from Encapsulated Cells Prevents the Anatomical and Functional Consequences of Excitotoxicity.

Neural Plast 2019 11;2019:6286197. Epub 2019 Mar 11.

Gloriana Therapeutics, Providence, Rhode Island, USA.

Methods: Human ARPE-19 cells engineered to secrete high levels of the glial cell line-derived neurotrophic factor (GDNF) were encapsulated into hollow fiber membranes. The devices were implanted into the rat striatum 1 week prior to striatal quinolinic acid injections. Animals were evaluated using a battery of validated motor tests, and histology was performed to determine the extent of GDNF diffusion and associated prevention of neuronal cell loss and behavioral deficits. Read More

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http://dx.doi.org/10.1155/2019/6286197DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6432730PMC

Targeted Vagus Nerve Stimulation for Rehabilitation After Stroke.

Front Neurosci 2019 29;13:280. Epub 2019 Mar 29.

Texas Biomedical Device Center, The University of Texas at Dallas, Richardson, TX, United States.

Stroke is a leading cause of disability worldwide, and in approximately 60% of individuals, upper limb deficits persist 6 months after stroke. These deficits adversely affect the functional use of the upper limb and restrict participation in day to day activities. An important goal of stroke rehabilitation is to improve the quality of life by enhancing functional independence and participation in activities. Read More

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https://www.frontiersin.org/article/10.3389/fnins.2019.00280
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http://dx.doi.org/10.3389/fnins.2019.00280DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6449801PMC
March 2019
1 Read

Kidney function stratified outcomes of percutaneous left atrial appendage occlusion in patients with atrial fibrillation and high bleeding risk.

Acta Cardiol 2019 Apr 14:1-9. Epub 2019 Apr 14.

a Medical Faculty, Department of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine , Heinrich-Heine-University , Düsseldorf , Germany.

Background: Patients with chronic kidney disease (CKD) and atrial fibrillation have increased risks for stroke and bleeding under oral anticoagulation (OAC). We investigated an alternative therapy of percutaneous left atrial appendage occlusion (LAAO) in CKD patients in this study.

Methods: Consecutive patients undergoing LAAO were included in a retrospective analysis and stratified for kidney function into CKD/Non-CKD groups (cutoff eGFR 60 ml/min). Read More

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http://dx.doi.org/10.1080/00015385.2019.1585643DOI Listing

Trial of atorvastatin for the primary prevention of cardiovascular events in patients with rheumatoid arthritis (TRACE RA): A multicenter, randomized, placebo controlled trial.

Arthritis Rheumatol 2019 Apr 15. Epub 2019 Apr 15.

Arthritis Research UK Centre for Epidemiology, University of Manchester, Manchester.

Objective: Rheumatoid arthritis (RA) is associated with increased cardiovascular event (CVE) risk. The impact of statins in RA is not established. We assessed whether atorvastatin is superior to placebo for the primary prevention of CVE in RA patients. Read More

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http://dx.doi.org/10.1002/art.40892DOI Listing

Pretreatment Blood Pressure is a Simple Predictor of Hemorrhagic Infarction after Intravenous Recombinant Tissue Plasminogen Activator (rt-PA) Therapy.

J Stroke Cerebrovasc Dis 2019 Apr 11. Epub 2019 Apr 11.

Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Fukakusa, Kyoto, Japan.

Background: Hemorrhagic infarction (HI) is among the most severe complications that can occur following the administration of intravenous recombinant tissue plasminogen activator (rt-PA). In the present study, we aimed to determine the optimal cut-off points of blood pressure (BP) for HI after rt-PA treatment, and to compare our findings with those for other prediction models.

Methods: We analyzed data from 109 consecutive patients with stroke treated at our hospital between 2009 and 2016. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2019.03.035DOI Listing

Recent Trends in Electively Treated Unruptured Intracranial Aneurysms.

J Stroke Cerebrovasc Dis 2019 Apr 11. Epub 2019 Apr 11.

Department of Neurology, University of Toledo, Toledo, Ohio. Electronic address:

Background And Purpose: To determine recent treatment and outcome trends in patients undergoing elective surgical clipping (SC) or endovascular therapy (EVT) for unruptured intracranial aneurysms (UIAs) in the United States.

Methods: Data were extracted and analyzed from the National Inpatient Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality for all patients admitted for elective EVT or SC of UIAs between 2011 and 2014. Treatment trends, in-hospital mortality, complication rates, length of stay (LOS) and total hospital costs were evaluated and analyzed. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2019.03.010DOI Listing

Meta-Analysis of Direct-Acting Oral Anticoagulants Compared With Warfarin in Patients >75 Years of Age.

Am J Cardiol 2019 Mar 18. Epub 2019 Mar 18.

Division of Cardiology, Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, New York.

Older patients with atrial fibrillation (AF) are at higher risk of thromboembolic events and oral anticoagulant (OAC)-related bleeding complications. This meta-analysis evaluates the efficacy and safety of direct-acting OACs (DOACs) compared with warfarin in older patients with nonvalvular AF. PubMed, Embase, and Cochrane Central databases were searched for randomized controlled trials assessing the efficacy and safety of DOACs compared with warfarin in AF patients who were >75 years old. Read More

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http://dx.doi.org/10.1016/j.amjcard.2019.02.060DOI Listing
March 2019
1 Read

Differences in muscle activity and fatigue of the upper limb between Task-Specific training and robot assisted training among individuals post stroke.

J Biomech 2019 Apr 10. Epub 2019 Apr 10.

Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address:

Objective: To compare the activity and fatigue of upper extremity muscles, pain levels, subject satisfaction levels, perceived exertion, and number of repetitions in Task-Specific Training (TST) compared with Robot-Assisted Training (RAT) in individuals post-stroke.

Methods: Twenty sub-acute post stroke subjects (16 men; median (interquartile range) age 64.0 (71. Read More

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http://dx.doi.org/10.1016/j.jbiomech.2019.04.005DOI Listing

Intracranial arterial wall imaging: Techniques, clinical applicability, and future perspectives.

Int J Stroke 2019 Apr 13:1747493019840942. Epub 2019 Apr 13.

4 Department of Radiology and Nuclear Medicine, Erasmus MC - University Medical Center Rotterdam, the Netherlands.

Purpose: To review the current state of the art and future development of intracranial vessel wall imaging.

Methods: Recent literature review and expert opinion about intracranial arterial wall imaging.

Results: Intracranial large artery diseases represent an important cause of stroke and vascular cognitive impairment worldwide. Read More

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http://dx.doi.org/10.1177/1747493019840942DOI Listing
April 2019
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Occurrence of cerebral small vessel disease at diagnosis of MPO-ANCA-associated vasculitis.

J Neurol 2019 Apr 13. Epub 2019 Apr 13.

Division of Neurology, Department of Internal Medicine IV, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan.

Background: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) often causes peripheral nervous system impairments. However, little is known about subclinical involvements of the central nervous system in AAV. We investigated the frequency and progression of cerebral small vessel disease (SVD) in patients with AAV. Read More

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http://dx.doi.org/10.1007/s00415-019-09318-9DOI Listing

CKLF1 Aggravates Focal Cerebral Ischemia Injury at Early Stage Partly by Modulating Microglia/Macrophage Toward M1 Polarization Through CCR4.

Cell Mol Neurobiol 2019 Apr 13. Epub 2019 Apr 13.

State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medica & Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100050, China.

CKLF1 is a chemokine with increased expression in ischemic brain, and targeting CKLF1 has shown therapeutic effects in cerebral ischemia model. Microglia/macrophage polarization is a mechanism involved in poststroke injury expansion. Considering the quick and obvious response of CKLF1 and expeditious evolution of stroke lesions, we focused on the effects of CKLF1 on microglial/macrophage polarization at early stage of ischemic stroke (IS). Read More

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http://dx.doi.org/10.1007/s10571-019-00669-5DOI Listing

Focus on the pedunculopontine nucleus. Consensus review from the May 2018 brainstem society meeting in Washington, DC, USA.

Clin Neurophysiol 2019 Mar 28;130(6):925-940. Epub 2019 Mar 28.

Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.

The pedunculopontine nucleus (PPN) is located in the mesopontine tegmentum and is best delimited by a group of large cholinergic neurons adjacent to the decussation of the superior cerebellar peduncle. This part of the brain, populated by many other neuronal groups, is a crossroads for many important functions. Good evidence relates the PPN to control of reflex reactions, sleep-wake cycles, posture and gait. Read More

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http://dx.doi.org/10.1016/j.clinph.2019.03.008DOI Listing

OCT4B-190 protects against ischemic stroke by modulating GSK-3β/HDAC6.

Exp Neurol 2019 Apr 11. Epub 2019 Apr 11.

Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing 210008, China; Institute of Brain Science, Nanjing University, Nanjing 210008, China. Electronic address:

OCT4 is a key regulator in maintaining the pluripotency and self-renewal of embryonic stem cells (ESCs). Human OCT4 gene has three mRNA isoforms, termed OCT4A, OCT4B and OCT4B1. The 190-amino-acid protein isoform (OCT4B-190) is one of the major products of OCT4B mRNA, the biological function of which is still not well defined. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00144886193006
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http://dx.doi.org/10.1016/j.expneurol.2019.04.005DOI Listing
April 2019
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Intravenous Stem cell Therapy for High Grade Aneurysmal Subarachnoid Haemorrhage: Case Report and Literature Review.

World Neurosurg 2019 Apr 11. Epub 2019 Apr 11.

Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA. Electronic address:

Background: and Importance: Aneurysmal subarachnoid haemorrhage is associated with high mortality (30-40%) and morbidity with long-term physical, neurologic and/or psychologic impairments; most of which are patients presenting with high initial Hunt & Hess grade. In view of the great need for efficacious therapies for high grade SAH, recent animal studies have demonstrated improved outcomes with administration of mesenchymal stem cells (MSCs) as a potential neuroregenerative strategy. We present the first case of human intravenous administration of MSCs after aneurysmal subarachnoid haemorrhage. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.04.055DOI Listing

Anti-apoptotic impact of granulocyte-colony stimulating factor after peripheral nerve trauma.

World Neurosurg 2019 Apr 11. Epub 2019 Apr 11.

Department of Neurosurgery, Saarland University Medical Center, Homburg-Saar, Germany. Electronic address:

Background: Granulocyte-colony stimulating factor (G-CSF) has been observed to have direct protective effects on neurons after stroke in experimental models and in humans.

Objective: In the present study, anti-apoptotic effects of G-CSF on spinal α-motoneurons after peripheral sciatic nerve lesion were evaluated in a rat model.

Methods: Twenty-four animals were treated with G-CSF and 24 animals were treated with glucose 5%-solution serving as control group. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18788750193105
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http://dx.doi.org/10.1016/j.wneu.2019.04.059DOI Listing
April 2019
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Predictors for Functional Outcome in Patients with Aneurysmal Subarachnoid Hemorrhage Who Completed In-Hospital Rehabilitation in a Single Institution.

J Stroke Cerebrovasc Dis 2019 Apr 10. Epub 2019 Apr 10.

Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto City, Kumamoto, Japan.

Background: Although many studies evaluated independent prognosis factors of functional outcome in patients with subarachnoid hemorrhage (SAH) at a suitable time point, some patients take a long time to get functional improvement. The purpose of this study is to evaluate predictors for functional outcome in SAH patients who underwent surgical clipping and in-hospital rehabilitation in our single institution using Modified Rankin Scale (MRS) and Barthel Index (BI).

Methods: Two-hundred fifty-one SAH patients were admitted to our hospital from January 2008 to December 2017. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2019.03.042DOI Listing

Improving Prognostic Evaluation by 4D CTA for Endovascular Treatment in Acute Ischemic Stroke Patients: A Preliminary Study.

J Stroke Cerebrovasc Dis 2019 Apr 10. Epub 2019 Apr 10.

Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing, China. Electronic address:

Objective: We aim to use 4D CTA with a comprehensive and objective scoring system to assess collateral circulation, and explore the value of prognosis prediction in endovascular treated patients.

Methods: Thirty-four patients with unilateral anterior circulation large vessels occlusion were reviewed in this study retrospectively. Single-phase CTA (sCTA) and 4D CTA acquired by CT perfusion scanning were analyzed for collateral circulation assessment. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2019.03.038DOI Listing

Atractylenolide III ameliorates cerebral ischemic injury and neuroinflammation associated with inhibiting JAK2/STAT3/Drp1-dependent mitochondrial fission in microglia.

Phytomedicine 2019 Apr 6;59:152922. Epub 2019 Apr 6.

Department of Physical Medicine and Rehabilitation, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027 Zhejiang, China; Integrative & Optimized Medicine Research center, China-USA Institute for Acupuncture and Rehabilitation, Wenzhou Medical University, Wenzhou, Zhejiang, China. Electronic address:

Background: Inflammation is a major contributor to stroke pathology, making it a promising strategy for intervention. Microglia, the resident macrophages in the brain, play essential roles in both the generation and resolution of neuroinflammation. In particular, mitochondrial homeostasis is critical for microglial function and its dysregulation is involved in the pathogenesis of ischemic stroke. Read More

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http://dx.doi.org/10.1016/j.phymed.2019.152922DOI Listing

Comparative effectiveness, safety, and costs of rivaroxaban and warfarin among morbidly obese patients with atrial fibrillation.

Am Heart J 2019 Feb 20;212:113-119. Epub 2019 Feb 20.

Department of Medicine, Anticoagulation and Clinical Thrombosis Services, Northwell Health System, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY.

Background: There are limited data regarding clinical outcomes and healthcare resource utilization of direct oral anticoagulants (DOACs) in patients with atrial fibrillation (AF) who are morbidly obese (body mass index >40 kg/m or body weight >120 kg).

Methods: Using data from 2 US healthcare claims databases, we identified patients initiating rivaroxaban or warfarin who had ≥1 medical claim with an AF diagnosis, a diagnostic code for morbid obesity (ICD-9: 278.01, V85. Read More

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http://dx.doi.org/10.1016/j.ahj.2019.02.001DOI Listing
February 2019

Endovascular Thrombectomy, Platelet Count and Intracranial Hemorrhage.

World Neurosurg 2019 Apr 10. Epub 2019 Apr 10.

University of Pittsburgh Medical Center, Departments of Neurology, Pittsburgh PA; Neurosurgery, Pittsburgh PA. Electronic address:

Background: Intracranial hemorrhage (ICH) can be a devastating complication of endovascular thrombectomy (ET) following acute ischemic stroke increasing disability and mortality. Patients with low platelet count were excluded from major ET trials. This study explores the association between platelet count and ICH after ET. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.04.036DOI Listing

Endovascular mechanical thrombectomy for cerebral venous sinus thrombosis: a single center experience.

World Neurosurg 2019 Apr 10. Epub 2019 Apr 10.

Department of Diagnostic and Interventional Neuroradiology, University Medical Center Goettingen, Robert-Koch-Straße 40, 37075 Goettingen, Germany.

Background: Cerebral venous thrombosis (CVT) is a rare entity with a potentially fatal outcome. Especially patients who do not respond to standard medical therapy alone may benefit from endovascular treatment options. We evaluate the angiographic and clinical results of mechanical thrombectomy (MT) in patients with severe CVT. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18788750193104
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http://dx.doi.org/10.1016/j.wneu.2019.04.049DOI Listing
April 2019
3 Reads

Interrupted transport by the emergency medical service in stroke/transitory ischemic attack: A consequence of changed treatment routines in prehospital emergency care.

Brain Behav 2019 Apr 13:e01266. Epub 2019 Apr 13.

Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.

Background: The discovery that not all patients who call for the emergency medical service (EMS) require transport to hospital has changed the structure of prehospital emergency care. Today, the EMS clinician at the scene already distinguishes patients with a time-critical condition such as stroke/transitory ischemic attack (TIA) from patients without. This highlights the importance of the early identification of stroke/TIA. Read More

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http://dx.doi.org/10.1002/brb3.1266DOI Listing

Early post-Humanitarian Device Exemption experience with the Neuroform Atlas stent.

J Neurointerv Surg 2019 Apr 12. Epub 2019 Apr 12.

Cerebrovascular Center, Cleveland Clinic, Cleveland, Ohio, USA.

Introduction: The low-profile Neuroform Atlas stent received FDA Humanitarian Device Exemption status (HDE) in January 2018 for stent-assisted coil embolization of wide-necked saccular aneurysms. We review and report our results with the Atlas stent in our institution within the first year after its HDE approval.

Methods: Our retrospective chart review identified patients treated with the Atlas stent. Read More

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http://dx.doi.org/10.1136/neurintsurg-2019-014874DOI Listing