78,461 results match your criteria Stroke Hemorrhagic


Protective Effects of Antioxidant Polyphenols Against Hyperglycemia-Mediated Alterations in Cerebral Endothelial Cells and a Mouse Stroke Model.

Mol Nutr Food Res 2020 May 24:e1900779. Epub 2020 May 24.

Université de La Réunion, INSERM, UMR 1188 Diabète athérothrombose Thérapies Réunion Océan Indien (DéTROI), Saint-Denis, La Réunion, France.

Scope: Hyperglycemia alters cerebral endothelial cell and blood-brain barrier functions, aggravating cerebrovascular complications such as stroke during diabetes. Redox and inflammatory changes play a causal role. This study evaluated polyphenol protective effects on cerebral endothelial cells and in a mouse stroke model during hyperglycemia. Read More

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http://dx.doi.org/10.1002/mnfr.201900779DOI Listing

COVID-19 related neuroimaging findings: A signal of thromboembolic complications and a strong prognostic marker of poor patient outcome.

J Neurol Sci 2020 May 19;414:116923. Epub 2020 May 19.

Department of Medicine, New York University Langone Health, New York, NY, United States of America.

Objective: To investigate the incidence and spectrum of neuroimaging findings and their prognostic role in hospitalized COVID-19 patients in New York City.

Methods: This is a retrospective cohort study of 3218 COVID-19 confirmed patients admitted to a major healthcare system (three hospitals) in New York City between March 1, 2020 and April 13, 2020. Clinical data were extracted from electronic medical records, and particularly data of all neurological symptoms were extracted from the imaging reports. Read More

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http://dx.doi.org/10.1016/j.jns.2020.116923DOI Listing

Evidence-based practice guideline on integrative medicine for stroke 2019.

J Evid Based Med 2020 May 22. Epub 2020 May 22.

Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, The Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, P.R. China.

Objective: Stroke is the leading cause of death and disability in China. Chinese medicine integrated with conventional medicine is now widely used in the prevention and treatment of stroke. A clinical practice guideline for the application of integrative medicine in stroke is urgently needed. Read More

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http://dx.doi.org/10.1111/jebm.12386DOI Listing

Health Care Costs Associated With Macrovascular, Microvascular, and Metabolic Complications of Type 2 Diabetes Across Time: Estimates From a Population-Based Cohort of More Than 0.8 Million Individuals With Up to 15 Years of Follow-up.

Diabetes Care 2020 May 22. Epub 2020 May 22.

Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan

Objective: Developing country-specific unit-cost catalogs is a key area for advancing economic research to improve medical and policy decisions. However, little is known about how health care costs vary by type 2 diabetes (T2D) complications across time in Asian countries. We sought to quantify the economic burden of various T2D complications in Taiwan. Read More

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http://dx.doi.org/10.2337/dc20-0072DOI Listing

Apixaban versus No Anticoagulation in Patients Undergoing Long-Term Dialysis with Incident Atrial Fibrillation.

Clin J Am Soc Nephrol 2020 May 22. Epub 2020 May 22.

Nephrology Division, New York University Langone Medical Center and Grossman School of Medicine, New York, New York.

Background And Objectives: The relative efficacy and safety of apixaban compared with no anticoagulation have not been studied in patients on maintenance dialysis with atrial fibrillation. We aimed to determine whether apixaban is associated with better clinical outcomes compared with no anticoagulation in this population.

Design, Setting, Participants, & Measurements: This retrospective cohort study used 2012-2015 US Renal Data System data. Read More

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http://dx.doi.org/10.2215/CJN.11650919DOI Listing

Neuroimaging of Pediatric Intracerebral Hemorrhage.

J Clin Med 2020 May 18;9(5). Epub 2020 May 18.

Pediatric Radiology Department, Necker Enfants Malades & GHU Paris, Sainte-Anne Hospital, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR S1266, INSERM, Université de Paris, 75015 Paris, France.

Hemorrhagic strokes account for half of all strokes seen in children, and the etiologies of these hemorrhagic strokes differ greatly from those seen in adult patients. This review gives an overview about incidence and etiologies as well as presentation of children with intracerebral hemorrhage and with differential diagnoses in the emergency department. Most importantly it describes how neuroimaging of children with intracerebral hemorrhage should be tailored to specific situations and clinical contexts and recommends specific imaging protocols for acute and repeat imaging. Read More

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http://dx.doi.org/10.3390/jcm9051518DOI Listing

Effect of intraventricularly administered low-dose recombinant tissue plasminogen activator on interleukin 1-beta and transforming growth factor beta concentrations in cerebrospinal fluid of patients with primary intracerebral hemorrhage associated with intraventricular hemorrhage: A retrospective study.

Medicine (Baltimore) 2020 May;99(20):e19966

Department of Anesthesiology, Reanimatology, Intensive Care and Emergency Medicine, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.

It is increasingly recognized that modulation of brain inflammation may uncover new potential therapeutic strategies for stroke. Recent studies have shifted focus from immunological implications in ischemic stroke to a more devastating form; the hemorrhagic stroke.The aim of this study was to investigate the neuroinflammatory response in cerebrospinal fluid in patients with primary intracerebral hemorrhage (ICH) associated with intraventricular hemorrhage (IVH) in the presence of low-dose recombinant tissue plasminogen activator (rt-PA). Read More

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http://dx.doi.org/10.1097/MD.0000000000019966DOI Listing

An atorvastatin calcium and poly(L-lactide-co-caprolactone) core-shell nanofiber-covered stent to treat aneurysms and promote reendothelialization.

Acta Biomater 2020 May 19. Epub 2020 May 19.

State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai 201620, P. R. China. Electronic address:

Aneurysmal subarachnoid hemorrhage is a common complication caused by an intracranial aneurysm that can lead to hemorrhagic stroke, brain damage, and death. Knowing this clinical situation, the purpose of this study was to develop a controlled-release stent covered with a core-shell nanofiber mesh, fabricated by emulsion electrospinning, for the treatment of aneurysms. By encapsulating atorvastatin calcium (AtvCa) in the inner of poly (L-lactide-co-caprolactone) (PLCL) nanofibers, the release period of AtvCa was effectively extended. Read More

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http://dx.doi.org/10.1016/j.actbio.2020.04.044DOI Listing

Postoperative Functional Outcomes and Prognostic Factors in Two Types of Adult Moyamoya Diseases.

J Stroke Cerebrovasc Dis 2020 May 18:104846. Epub 2020 May 18.

Department of Neurology, North Huashan hospital, Fudan University, No.108 Lu Xiang Road, Shanghai 201900, China; Department of Neurology, Huashan Hospital, Fudan University, No.12 Wulumuqi Zhong Road, Jing an District, Shanghai 200040, China. Electronic address:

Background: To determine the functional outcomes in each period for adult ischemic and hemorrhagic Moyamoya disease (MMD) patients and identify prognostic factors.

Methods: The current retrospective study reviewed consecutive adult MMD patients surgically treated from January 2012 to June 2017. Perioperative clinical data were collected and follow-up was conducted via telephone interviews. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.104846DOI Listing

Hemorrhagic onset intracranial artery dissection of middle cerebral artery followed by progressive arterial stenosis with genetic variant RNF213 p.Arg4810Lys (rs112735431).

World Neurosurg 2020 May 10. Epub 2020 May 10.

Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.

Background: Intracranial arterial dissection (IAD) is known to exhibit various patterns of arterial imaging features such as stenosis and dilation; however, the genetic background of IAD has not been elucidated so far. RNF213 was recently identified as a susceptibility gene for moyamoya disease (MMD) and intracranial artery stenosis (ICAS). More recently, RNF213 p. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.04.241DOI Listing

Asymmetrical cortical vessel sign predicts prognosis after acute ischemic stroke.

Brain Behav 2020 May 20:e01657. Epub 2020 May 20.

Department of Neurology, Dongguan People's Hospital (Affiliated Dongguan Hospital, South Medical University), Dongguan, China.

Introduction: To assess whether the asymmetrical cortical vessel sign (ACVS) on susceptibility-weighted imaging (SWI) could predict 90-day poor outcomes in anterior circulation acute ischemic stroke (AIS) patients treated with recombinant tissue plasminogen activator (r-tPA).

Methods: Clinical data of consecutive patients with anterior circulation AIS treated with r-tPA were retrospectively analyzed. Clinical variables included age, sex, vascular risk factors, NIHSS score, onset to treatment time, and initial hematologic and neuroimaging findings. Read More

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http://dx.doi.org/10.1002/brb3.1657DOI Listing

Stroke in patients with SARS-CoV-2 infection: case series.

J Neurol 2020 May 20. Epub 2020 May 20.

Clinical Neurology Unit, Azienda Sanitaria Universitaria Friuli Centrale, Presidio Ospedaliero Santa Maria della Misericordia, Udine, Italy.

Background: Italy is one of the most affected countries by the coronavirus disease 2019 (COVID-19). The responsible pathogen is named severe acute respiratory syndrome coronavirus (SARS-CoV-2). The clinical spectrum ranges from asymptomatic infection to severe pneumonia, leading to intensive care unit admission. Read More

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http://dx.doi.org/10.1007/s00415-020-09885-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238403PMC

Rapidly Resolving and Recurrent Contralateral Subdural Hematoma From Disseminated Intravascular Coagulation.

J Stroke Cerebrovasc Dis 2020 May 18:104872. Epub 2020 May 18.

Department of Neurology, Mayo Clinic, Jacksonville, Florida, United States; Department of Critical Care Medicine, Mayo Clinic, Jacksonville, Florida, United States; Department of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida, United States. Electronic address:

Background: Acute, recurrent subdural hematoma (SDH) is a rare entity in the absence of trauma. Atraumatic SDH may be due to vascular disorders, coagulopathies, or intracranial hypotension. It is a rare complication of disseminated intravascular coagulation (DIC), with no prior reports in patients with intracranial metastatic colon cancer (MCC). Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.104872DOI Listing

Reconstruction of Complex Cranial and Orbit Fractures with Associated Hemorrhages: Case Report and Review of the Literature.

Cureus 2020 Apr 16;12(4):e7694. Epub 2020 Apr 16.

Neurological Surgery, The University of Toledo Medical Center, Toledo, USA.

We present our experience following a unique case of coincident intracranial hemorrhage and comminuted fractures of both the squamous temporal bone and zygomaticofrontal orbit. Surgical techniques and outcome for this presentation have yet to be sufficiently described. A 55-year-old male presented following trauma with Glasgow Coma Scale score of 7. Read More

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http://dx.doi.org/10.7759/cureus.7694DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233501PMC

Too Much of a Good Thing? Cerebral Sinovenous Thrombosis Due to Excessive Milk Intake Associated Anemia.

J Child Neurol 2020 May 19:883073820923807. Epub 2020 May 19.

Division of Child Neurology, Department of Neurology, Medical College of Wisconsin, Children's Wisconsin, Milwaukee, WI, USA.

Introduction: In young children, excessive cow's milk intake causes iron-deficiency anemia, which is associated with hypercoagulable states. We present a case series of 4 toddlers with excessive milk intake iron-deficiency anemia and cerebral sinovenous thrombosis.

Methods: Retrospective chart review of 4 patients was performed for patients with cerebral sinovenous thrombosis and iron-deficiency anemia secondary to excessive milk intake. Read More

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http://dx.doi.org/10.1177/0883073820923807DOI Listing

Alcohol and risk of non-traumatic bleeding events requiring hospital care in the general population: A prospective cohort study.

Alcohol 2020 May 16. Epub 2020 May 16.

National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen K, Denmark. Electronic address:

Alcohol has a direct effect on blood coagulation and fibrinolysis. We studied how alcohol is related to common (e.g. Read More

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http://dx.doi.org/10.1016/j.alcohol.2020.04.009DOI Listing

A Successful Quality Improvement Project for Detection and Management of Acute Stroke in Hospitalized Patients.

J Neurosci Nurs 2020 May 14. Epub 2020 May 14.

Questions or comments about this article may be directed to Carol J. Droegemueller, MS APRN CNS OCNS CNRN, at C.J.D. is Stroke Program Coordinator, Regions Hospital Comprehensive Stroke Center, St Paul, MN. Bhavani Kashyap, PhD MBBS, is Research Associate, HealthPartners Neuroscience Center, HealthPartners Institute, Bloomington, MN. Roberta L. Huna Wagner, DNP APRN CNS AGCNS-BC PCCN, is Clinical Nurse Specialist, Regions Hospital Comprehensive Stroke Center, St Paul, MN. Hannah Shibeshi, BAN RN CNRN CCRN, is Registered Nurse, Regions Hospital Comprehensive Stroke Center, St Paul, MN. Mitchell W. Clayton, BS, is Student Intern, HealthPartners Neuroscience Center, St Paul, MN. Mary W. Fennig, BA, is Student Intern, HealthPartners Neuroscience Center, St Paul, MN. Haitham M. Hussein, MD MSc FAHA FAAN, is Medical Director, Regions Hospital Comprehensive Stroke Center, HealthPartners Neuroscience Center, HealthPartners Institute, Bloomington, MN.

Background: The incidence rate of stroke in hospitalized patients ranges between 2% and 17% of all strokes-a higher rate than in the community. Delays in recognition and management of stroke in hospitalized patients lead to worse outcomes. At our hospital, the existing in-hospital stroke (IHS) code showed low usage and effectiveness. Read More

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http://dx.doi.org/10.1097/JNN.0000000000000517DOI Listing

Intracranial Hemorrhage Due to Secondary Hypertension from Intracranial Large Vessel Occlusion.

Clin Pract Cases Emerg Med 2020 May 2;4(2):167-170. Epub 2020 Mar 2.

North Florida Regional Medical Center, Department of Vascular and Interventional Neurology, Gainesville, Florida.

Simultaneous hemorrhagic and ischemic strokes have been previously reported in the literature. Typically, these occur in patients secondary to dialysis, cerebral amyloid angiopathy, or thrombotic thrombocytopenic purpura.1,2,3 However, this is the unique case of a 62-year-old Asian female who presented with a hemorrhagic stroke suspected to be secondary to refractory hypertension from intracranial large vessel atherosclerotic flow limiting stenosis, with rapid subsequent large vessel occlusion and ischemic stroke. Read More

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http://dx.doi.org/10.5811/cpcem.2020.1.44908DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220007PMC

Follow-Up in Aphasia Caused by Acute Stroke in a Prospective, Randomized, Clinical, and Experimental Controlled Noninvasive Study With an iPad-Based App (Neolexon®): Study Protocol of the Lexi Study.

Front Neurol 2020 30;11:294. Epub 2020 Apr 30.

Department of Neurology, Ludwig Maximilians University (LMU), Munich, Germany.

Treatment of aphasia is still challenging for clinicians and patients. So far, there is proven evidence for "face-to-face" speech therapy. However, the digital age potentially offers new and complementary strategies that may add to treatment outcome in a cost-effective way. Read More

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http://dx.doi.org/10.3389/fneur.2020.00294DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7212356PMC

Natural History of Infratentorial Intracerebral Hemorrhages: Two Subgroups with Distinct Presentations and Outcomes.

J Stroke Cerebrovasc Dis 2020 May 15:104920. Epub 2020 May 15.

Department of Neurology, Northwestern University, 710 N. Lake Shore Drive, Suite 1105, Chicago, IL 60611, USA. Electronic address:

Background/objective: Infratentorial intracerebral hemorrhage (ICH) is associated with worse prognosis than supratentorial ICH; however, infratentorial ICH is often excluded or underrepresented in clinical trials of ICH. We sought to evaluate the natural history of infratentorial ICH stratified by brainstem or cerebellar location using a prospective observational study inclusive of all spontaneous ICH.

Methods: Using a prospective, single center cohort of patients with spontaneous ICH between 2008-2019, we conducted a descriptive analysis of baseline demographics, severity of injury scores, and long-term functional outcomes of infratentorial ICH stratified by cerebellar or brainstem location. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.104920DOI Listing

Prognosis and futility in neurosurgical emergencies: A review.

Clin Neurol Neurosurg 2020 May 7;195:105851. Epub 2020 May 7.

Department of Neurosurgery, Tufts Medical Center, Boston, MA, USA. Electronic address:

A patient with a life-threatening intracranial insult presents a difficult situation to the neurosurgeon. In a few short minutes the neurosurgeon must assess the patient's neurologic status, imaging, and medical condition then confer with the patient's proxy regarding treatment. This assessment ideally includes recognition of situations where aggressive care is futile and therefore such treatments should not be offered. Read More

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http://dx.doi.org/10.1016/j.clineuro.2020.105851DOI Listing

Continuous positive pressure therapy usage and incident stroke in patients with obstructive sleep apnea: A nationwide population- based cohort study.

Clin Respir J 2020 May 18. Epub 2020 May 18.

Department of Psychiatry, Tzu Chi General Hospital, and School of Medicine, Tzu Chi University, Hualien, Taiwan.

Introduction: Continuous positive airway pressure (CPAP) is the main treatment for obstructive sleep apnea (OSA). To date, the link between CPAP usage and incident stroke has been inconsistent.

Objective: This nationwide population study is designed to examine the effect of CPAP on stroke incidence in OSA patients. Read More

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http://dx.doi.org/10.1111/crj.13214DOI Listing

Short and long-term outcomes of continuous-flow left ventricular assist device therapy in 79 patients with end-stage heart failure.

Pol Arch Intern Med 2020 May 18. Epub 2020 May 18.

Introduction: Increasing numbers of patients (pts) with end-stage heart failure (ESHF) and shortage of heart donors impose use of mechanical circulatory support.

Objectives: The aim of this single-center retrospective study was to evaluate short and long-term outcomes of continuous-flow left ventricular assist device (CF-LVAD) therapy in ESHF pts.

Patients And Methods: Data of 79 pts (77 male, 2 female, mean age - 50. Read More

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http://dx.doi.org/10.20452/pamw.15362DOI Listing

Decompressive Craniectomy: the Right Call at the Right Moment.

Maedica (Buchar) 2020 Mar;15(1):129-133

University and Emergency Hospital of Bucharest, Interventional Radiology Department,Bucharest, Romania.

Massive intracerebral hemorrhages and large internal carotid artery infarcts may cause early death due to severe cerebral edema with elevated intracranial pressure, despite maximal medical therapy. Decompressive craniectomy may be of benefit to these patients in terms of survival and even functional outcome. The aim of our paper is to present two cases that illustrate the use of decompressive craniectomy both in ischemic and hemorrhagic stroke, followed by a discussion on the indication and right timing of the intervention, but also on the outcome of these patients. Read More

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http://dx.doi.org/10.26574/maedica.2020.15.1.129DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7221286PMC

The Challenge of Managing Parkinson's Disease Patients during the COVID-19 Pandemic.

Ann Indian Acad Neurol 2020 Apr 20;23(Suppl 1):S24-S27. Epub 2020 Apr 20.

Department of Neurology, Lady Hardinge Medical College, New Delhi, India.

The 2019 novel coronavirus (nCoV) pandemic is rapidly developing across the globe and new information is emerging expeditiously and constantly, particularly in relation to neurological illnesses. Both central and peripheral nervous system involvement has been reported including headache, dizziness, hyposmia/anosmia, taste disturbances, seizures, stroke, alteration of the sensorium, and even acute hemorrhagic necrotizing leukoencephalopathy. Varying degrees of olfactory disturbances may pre-empt the diagnosis of COVID-19. Read More

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http://dx.doi.org/10.4103/aian.AIAN_295_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213030PMC

The role of hemorrhagic transformation in acute ischemic stroke upon clinical complications and outcomes.

J Stroke Cerebrovasc Dis 2020 May 13:104898. Epub 2020 May 13.

Department of Neurology, Universidade Federal de Sao Paulo, Rua Napoleao de Barros, 715, Sao Paulo, SP 04039-001, Brazil. Electronic address:

Background And Purpose: Hemorrhagic transformation (HT) is a common neurological complication after ischemic stroke. The influence of symptomatic HT upon clinical outcomes post-stroke is well established, however, the role of asymptomatic HT upon prognosis is still unclear. We aimed to analyze the relationship between HT, clinical complications and outcomes in patients not submitted to reperfusion therapies (RT). Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.104898DOI Listing

Serum netrin-1 concentrations are associated with clinical outcome in acute intracerebral hemorrhage.

Clin Chim Acta 2020 May 14;508:154-160. Epub 2020 May 14.

Department of Pain Medicine, Ruian People's Hospital, The Third Affiliated Hospital of Wenzhou Medical University, 108 Wansong Road, Ruian 325200, Zhejiang Province, China. Electronic address:

Background: Netrin-1 is an axon guidance protein, which can inhibit inflammatory reaction and stabilize the blood-brain barrier to protect against experimental brain injury. We evaluated the concentration of netrin-1 in acute intracerebral hemorrhage (ICH) patients and explored whether netrin-1 is a potential prognostic biomarker for ICH.

Methods: This study recruited a total of 126 ICH patients and 126 healthy controls. Read More

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http://dx.doi.org/10.1016/j.cca.2020.05.032DOI Listing

Association of High-sensitivity C-reactive Protein with Patient Prognosis Following Mechanical Thrombectomy for Acute Ischemic Stroke.

Curr Neurovasc Res 2020 May 17. Epub 2020 May 17.

Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul. Korea.

Objective: The aim of this investigation was to examine the association of hsCRP (high-sensitivity C-reactive protein) with outcomes and prognosis of patients who underwent mechanical thrombectomy (MT) for large vessel occlusion (LVO) after acute ischemic stroke (AIS).

Methods: A total of 404 patients were enrolled, and outcomes included unfavorable clinical outcome at three months (modified Rankin Scale, mRS scores 3-6), occurrence of symptomatic intracerebral hemorrhage (sICH) and hemorrhagic transformation (HT) of infarct. Receiver operating characteristic (ROC) curve analysis was performed to identify the cutoff value of hsCRP to discriminate between favorable and unfavorable outcomes. Read More

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http://dx.doi.org/10.2174/1567202617666200517110949DOI Listing

Platelet-to-neutrophil ratio after Intravenous Thrombolysis Predicts Unfavorable Outcomes in Acute Ischemic Stroke.

Curr Neurovasc Res 2020 May 17. Epub 2020 May 17.

Stroke Center, Neuroscience Center, Department of Neurology, the First Hospital of Jilin University, Chang Chun, Jilin. China.

Background And Purpose: Platelet-to-neutrophil ratio (PNR) was suggested to be an independent protective predictor for 90-days outcome in acute ischemic stroke (AIS) patients in previous studies. This study aims to investigate the association between PNR and outcomes of AIS in intravenous thrombolysis (IVT) group.

Methods: Data of acute ischemic stroke patients who received intravenous thrombolysis from April 2015 to March 2019 were collected. Read More

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http://dx.doi.org/10.2174/1567202617666200517111802DOI Listing

Prediction of early neurological deterioration in acute minor ischemic stroke by machine learning algorithms.

Clin Neurol Neurosurg 2020 May 5;195:105892. Epub 2020 May 5.

Finance Fishery Manufacture Industrial Mathematics Center on Big Data, Pusan National University, Busan, Republic of Korea.

Objectives: A significant proportion of patients with acute minor stroke have unfavorable functional outcome due to early neurological deterioration (END). The purpose of this study was to evaluate the applicability of machine learning algorithms to predict END in patients with acute minor stroke.

Patients And Methods: We collected clinical and neuroimaging information from patients with acute minor stroke with NIHSS score of ≤ 3. Read More

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http://dx.doi.org/10.1016/j.clineuro.2020.105892DOI Listing

Tirofiban Protocol Protects Against Delayed Cerebral Ischemia: A Case-Series Study.

Neurosurgery 2020 May 16. Epub 2020 May 16.

Department of Neurosurgery, University of Tokyo, Tokyo, Japan.

Background: There has not been any effective prophylaxis for delayed cerebral ischemia delayed cerebral ischemia (DCI) since the introduction of nimodipine. Platelet inhibition may reduce the risk by preventing the formation of microthrombi. Tirofiban has been used as a single monotherapy bridge given its safety profile and controlled platelet inhibition. Read More

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http://dx.doi.org/10.1093/neuros/nyaa170DOI Listing

Potential of stem cell therapy in intracerebral hemorrhage.

Mol Biol Rep 2020 May 15. Epub 2020 May 15.

Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.

Spontaneous intracerebral hemorrhage (ICH) is a common disease associated with high mortality and morbidity. The treatment of patients with ICH includes medical and surgical interventions. New areas of surgical intervention have been focused on the evacuation of hematoma through minimally invasive neurosurgery. Read More

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http://dx.doi.org/10.1007/s11033-020-05457-9DOI Listing

Dual antiplatelet therapy after carotid artery stenting: trends and outcomes in a large national database.

J Neurointerv Surg 2020 May 15. Epub 2020 May 15.

Radiology, Stanford University School of Medicine, Stanford, California, USA.

Background: While dual antiplatelet therapy (dAPT) is standard of care following carotid artery stenting (CAS), the optimal dAPT regimen and duration has not been established.

Methods: We canvassed a large national database (IBM MarketScan) to identify patients receiving carotid endarterectomy (CEA) or CAS for treatment of ischemic stroke or carotid artery stenosis from 2007 to 2016. We performed univariable and multivariable regression methods to evaluate the impact of covariates on post-CAS stroke-free survival, including post-discharge antiplatelet therapy. Read More

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http://dx.doi.org/10.1136/neurintsurg-2020-016008DOI Listing

Intravenous cangrelor and oral ticagrelor as an alternative to clopidogrel in acute intervention.

J Neurointerv Surg 2020 May 15. Epub 2020 May 15.

Miami Cardiac & Vascular Institute, Baptist Health South Florida, Miami, Florida, USA.

Background: Dual antiplatelet therapy (DAP) is necessary to prevent thromboembolic events during carotid stenting, stent-assisted coil embolization, and implant of flow diverters (FD). However, DAP in the acute phase may be challenging. An intravenous alternative, cangrelor, has rapid onset, short plasma half-life, and more reliable antiplatelet action for acute interventions. Read More

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http://dx.doi.org/10.1136/neurintsurg-2020-015841DOI Listing

Relationship of white matter lesion severity with early and late outcomes after mechanical thrombectomy for large vessel stroke.

J Neurointerv Surg 2020 May 15. Epub 2020 May 15.

Department of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts, USA

Background: White matter lesions (WML) are associated with poor outcome after mechanical thrombectomy (MT) for large vessel stroke; the reasons are uncertain. To elucidate this issue we sought to determine the association of WML with multiple early and late outcome measures after MT.

Methods: We retrospectively analyzed 181 MT patients prospectively included in our local stroke registry (January 2012 to November 2016). Read More

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http://dx.doi.org/10.1136/neurintsurg-2020-015940DOI Listing

[Locoregional anesthesia in endoscopic surgery of intracerebral hypertensive hemangiomas].

Zh Vopr Neirokhir Im N N Burdenko 2020 ;84(2):65-71

Omsk State Medical University, Omsk, Russia.

Introduction: Currently, minimally invasive methods of surgical treatment of hypertensive intracerebral hematomas (ICHs) are actively used. However, anesthetic management of these surgeries are unclear. Moreover, advisability of locoregional anesthesia (LRA) for endoscopic aspiration of hypertensive ICHs has not been studied. Read More

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http://dx.doi.org/10.17116/neiro20208402165DOI Listing
January 2020

[Arteriovenous malformations of the brain in children: treatment results for 376 patients].

Zh Vopr Neirokhir Im N N Burdenko 2020 ;84(2):22-34

I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.

Undefined: Cerebral arteriovenous malformations (AVM) are increasingly detected in children.

Objective: To estimate the risk of hemorrhage in children with AVM before and after treatment and evaluate the outcomes of various methods of AVM management in children.

Material And Methods: This study included 376 patients with various cerebral AVM under the age of 18 years. Read More

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http://dx.doi.org/10.17116/neiro20208402122DOI Listing
January 2020

Thrombotic Thrombocytopenic Purpura Masquerading as Acute Ischemic Stroke.

Cureus 2020 Apr 13;12(4):e7661. Epub 2020 Apr 13.

Internal Medicine, Florida Atlantic University, Boca Raton, USA.

Thrombotic thrombocytopenic purpura (TTP) is a hematologic disorder that results in widespread clotting due to a deficiency of a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS13) protease. This leads to excessive von Willebrand factor (VWF) protein-platelet multimers. Due to platelet consumption, platelet levels fall, resulting in thrombocytopenia. Read More

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http://dx.doi.org/10.7759/cureus.7661DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7219015PMC

Coagulopathy reversal in intracerebral haemorrhage.

Stroke Vasc Neurol 2020 20;5(1):29-33. Epub 2020 Feb 20.

Neurology, University of California Irvine Medical Center, Orange, California, USA.

As intracerebral hemorrahge becomes more frequent as a result of an aging population with greater comorbidities, rapid identification and reversal of precipitators becomes increasingly paramount. The aformentioned population will ever more likely be on some form of anticoagulant therapy. Understanding the mechanisms of these agents and means by which to reverse them early on is critical in managing the acute intracerebral hemorrhage. Read More

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http://dx.doi.org/10.1136/svn-2019-000274DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213499PMC
February 2020

Therapeutic targets of oxidative/nitrosative stress and neuroinflammation in ischemic stroke: Applications for natural product efficacy with omics and systemic biology.

Pharmacol Res 2020 May 12;158:104877. Epub 2020 May 12.

School of Chinese Medicine, The University of Hong Kong, Hong Kong Special Administrative Region; The University of Hong Kong-Shenzhen Institute of Research and Innovation (HKU-SIRI), China; School of Medical Technology, Xuzhou Medical University, Xuzhou, 221002, China. Electronic address:

Oxidative/nitrosative stress and neuroinflammation are critical pathological processes in cerebral ischemia-reperfusion injury, and their intimate interactions mediate neuronal damage, blood-brain barrier (BBB) damage and hemorrhagic transformation (HT) during ischemic stroke. We review current progress towards understanding the interactions of oxidative/nitrosative stress and inflammatory responses in ischemic brain injury. The interactions between reactive oxygen species (ROS)/reactive nitrogen species (RNS) and innate immune receptors such as TLR2/4, NOD-like receptor, RAGE, and scavenger receptors are crucial pathological mechanisms that amplify brain damage during cerebral ischemic injury. Read More

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http://dx.doi.org/10.1016/j.phrs.2020.104877DOI Listing

Association between coagulation function and spontaneous hemorrhagic transformation in acute ischemic stroke.

Curr Neurovasc Res 2020 May 14. Epub 2020 May 14.

Center of Cerebrovascular Disease, Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan. China.

Background And Purpose: Hemorrhagic transformation (HT) has an adverse effect on the prognosis of patients with acute ischemic stroke, and it is currently known associated with coagulation system. But the conclusion is not consistent and remains to be identified. The aim of this study was to investigate the association between coagulation function and spontaneous hemorrhagic transformation. Read More

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http://dx.doi.org/10.2174/1567202617666200514114258DOI Listing

Flow-diverting stent and delayed intracranial bleeding: the case for discussing acquired von Willebrand disease.

Authors:
Ismail Oran

Platelets 2020 May 14:1-4. Epub 2020 May 14.

Section of Interventional Radiology, KENT Hospital, Izmir, Turkey.

A unique feature of the flow-diverting stent (FDS) has rendered it useful in the endovascular treatment of selected intracranial aneurysms for the last decade. Delayed aneurysmal rupture and intracranial parenchymal bleeding are two leading hemorrhagic complications after FDS. It has recently been shown for the first time that there is a relationship between FDS and reduced level of vWF activity in patients undergoing endovascular cerebral aneurysm treatment. Read More

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http://dx.doi.org/10.1080/09537104.2020.1754379DOI Listing

Anatomical distribution of lower-extremity deep venous thrombosis in patients with acute stroke.

J Stroke Cerebrovasc Dis 2020 May 10:104866. Epub 2020 May 10.

Department of Pediatric Neurology, the First Hospital of Jilin University, 71 Xinmin Street, Changchun, Jilin 130021, China. Electronic address:

Objective: Post-stroke paralysis is a common contributor to deep vein thrombosis (DVT) of the lower extremities, but little is known about its epidemiology and anatomy. This prospective study aimed to investigate the clinical incidence and anatomical distribution of lower-extremity DVT in acute stroke.

Patients And Methods: A total of 679 patients diagnosed with acute stroke (ischemic stroke, n = 507; hemorrhagic stroke, n = 172) were enrolled. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.104866DOI Listing

Protective Effect of ApoA1 (Apolipoprotein A1)-Milano in a Rat Model of Large Vessel Occlusion Stroke.

Stroke 2020 May 14:STROKEAHA119027898. Epub 2020 May 14.

From the Department of neurology and stroke center, Bichat hospital, Paris, France (C.D., P.A.).

Background and Purpose- Previous experimental studies found that the infusion of human purified nascent HDL (high-density lipoprotein) significantly reduced infarct volume and hemorrhagic transformation rate by decreasing neutrophil recruitment. ApoA1-M (apolipoprotein A1-Milano) is a natural variant of human ApoA1 that confers protection against atherosclerosis. Recombinant ApoA1-M has been formulated as a complex with phospholipids to mimic the properties of nascent HDL. Read More

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http://dx.doi.org/10.1161/STROKEAHA.119.027898DOI Listing

Safety of direct oral anticoagulant - and antiplatelet therapy in patients with atrial fibrillation treated by carotid artery stenting.

J Stroke Cerebrovasc Dis 2020 May 10:104899. Epub 2020 May 10.

Department of Neurosurgery, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino, Fukuoka 818-8502, Japan; Stroke Prevention and Community Healthcare, Fukuoka University Graduate School, Nanakuma, Jonan-ku, Fukuoka, Japan.

Background: The periprocedural administration of dual antiplatelet therapy has been recommended in patients treated by carotid artery stenting. However, some patients with concurrent disease have been prescribed anticoagulants. We compared the post-operative incidence of hemorrhagic and thromboembolic events in two patient groups treated by different regimens of multi-antithrombotic agents. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.104899DOI Listing

Risk analysis of post-procedural intracranial hemorrhage based on STAY ALIVE Acute Stroke Registry.

J Stroke Cerebrovasc Dis 2020 May 10:104851. Epub 2020 May 10.

Department of Anaesthesiology and Intensive Care, University of Pecs, Medical School, Pecs, Hungary.

Background: Intracranial hemorrhages (ICH) are classified as symptomatic or asymptomatic according to the presence of clinical deterioration. Here, we aimed to find predictive factors of symptomatic intracranial bleeding in a registry-based stroke research.

Methods: Data of consecutive patients with acute ischemic stroke (AIS) were extracted from the prospective STAY ALIVE stroke registry. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.104851DOI Listing

Predictors of hemorrhagic transformation after acute ischemic stroke based on the experts' opinion.

Arq Neuropsiquiatr 2020 May 11. Epub 2020 May 11.

Vascular Neurology Department, Universidade Federal de São Paulo, São Paulo, SP, Brazil.

Background: Hemorrhagic transformation (HT) is a common complication after ischemic stroke. It may be associated to poor outcomes. Some predictors of HT have been previously identified, but there remain controversies. Read More

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http://dx.doi.org/10.1590/0004-282x20200008DOI Listing

Aspirin Is Associated With Reduced Rates of Venous Thromboembolism in Older Patients With Cancer.

J Cardiovasc Pharmacol Ther 2020 May 13:1074248420925021. Epub 2020 May 13.

Wafic Said Molecular Cardiology Research Laboratory, Texas Heart Institute, Houston, TX, USA.

Background: Older patients with cancer are at high risk of developing venous thromboembolism (VTE) and bleeding. Aspirin may decrease VTE in the general population without significant bleeding. Here, we examined whether aspirin is associated with reduced rates of VTE in older patients with cancer. Read More

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http://dx.doi.org/10.1177/1074248420925021DOI Listing

The Methods of Reserving Integrity of Seriously Damaged Cavernous Carotid in the Management of Traumatic Carotid-Cavernous Fistula.

J Craniofac Surg 2020 May 8. Epub 2020 May 8.

Department of Neurosurgery, The First Affiliated Hospital of Shandong First Medical University.

Background: The A type of carotid-cavernous fistulas (CCF-A) is characterized by direct communication between the internal carotid artery (ICA) with a very low incidence. But it severely endangers the health and even the life of patients, not only causes insufferable symptoms but also can induce fatal epistaxis, intracranial hemorrhages or even death. So, this disease needs therapy as early as possible. Read More

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http://dx.doi.org/10.1097/SCS.0000000000006491DOI Listing

Outcome differences between carotid artery stenting (CAS) and carotid endarterectomy (CEA) in postoperative ventricular arrhythmia, neurological complications, and in-hospital mortality.

Postgrad Med 2020 May 20:1-8. Epub 2020 May 20.

Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University , Hangzhou, China.

Objective: We study whether the carotid artery stenting (CAS) and carotid endarterectomy (CEA) differ from each other in postoperative ventricular arrhythmia, along with neurological complications (perioperative stroke and transient ischemic attack), in-hospital mortality, and estimated medical cost.

Methods: This study used data of patients with carotid artery stenosis from the National Inpatient Sample (NIS) database (2011-2014) from the United States of America. Based on the procedure that patients received, individuals were categorized into groups of CAS and CEA. Read More

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http://dx.doi.org/10.1080/00325481.2020.1768765DOI Listing