81,618 results match your criteria Stroke Ischemic


Sleep architectural dysfunction and undiagnosed obstructive sleep apnea after chronic ischemic stroke.

Sleep Med 2021 Apr 15;83:45-53. Epub 2021 Apr 15.

The Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia; University of Melbourne, Melbourne, VIC, Australia.

Objective/background: Sleep-wake dysfunction is bidirectionally associated with the incidence and evolution of acute stroke. It remains unclear whether sleep disturbances are transient post-stroke or are potentially enduring sequelae in chronic stroke. Here, we characterize sleep architectural dysfunction, sleep-respiratory parameters, and hemispheric sleep in ischemic stroke patients in the chronic recovery phase compared to healthy controls. Read More

View Article and Full-Text PDF

Neuroprotective Effects of Scallop-Derived Plasmalogen in a Mouse Model of Ischemic Stroke.

Brain Res 2021 May 12:147516. Epub 2021 May 12.

Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kitaku, Okayama 700-8558, Japan. Electronic address:

Scallop-derived plasmalogen (sPlas) has both anti-oxidative and anti-inflammation activities, but its efficacy has not been investigated in ischemic stroke models where oxidative stress, inflammation, and neurovascular unit (NVU) damage accelerates pathophysiological progression. Therefore, in the present study, we aimed to assess the neuroprotective effects of sPlas in ischemic stroke by using a transient middle cerebral artery occlusion (tMCAO) mouse model. After the pretreatment of vehicle or sPlas (10 mg/kg/day) for 14 days, adult male mice were subjected to tMCAO for 60 minutes, then continuously treated with vehicle or sPlas during reperfusion and for an additional 5 days. Read More

View Article and Full-Text PDF

Sex Differences Among Patients With High Risk Receiving Ticagrelor With or Without Aspirin After Percutaneous Coronary Intervention: A Subgroup Analysis of the TWILIGHT Randomized Clinical Trial.

JAMA Cardiol 2021 May 15. Epub 2021 May 15.

The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.

Importance: Shortened dual antiplatelet therapy followed by potent P2Y12 receptor inhibitor monotherapy reduces bleeding without increasing ischemic events after percutaneous coronary intervention (PCI).

Objective: To explore sex differences and evaluate the association of sex with outcomes among patients treated with ticagrelor monotherapy vs ticagrelor plus aspirin.

Design, Setting, And Participants: This was a prespecified secondary analysis of TWILIGHT, an investigator-initiated, placebo-controlled randomized clinical trial conducted at 187 sites across 11 countries. Read More

View Article and Full-Text PDF

Microglia-Leukocyte Axis in Cerebral Ischemia and Inflammation in the Developing Brain.

Acta Physiol (Oxf) 2021 May 15:e13674. Epub 2021 May 15.

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

Development of the CNS is reliant on the proper function of numerous intricately orchestrated mechanisms that mature independently, including constant communication between the CNS and the peripheral immune system. This review summarizes experimental knowledge of how cerebral ischemia in infants and children alters physiological communication between leukocytes, brain immune cells, microglia, and the neurovascular unit (NVU)-the "microglia-leukocyte axis"-and contributes to acute and long-term brain injury. We outline physiologic development of CNS barriers in relation to microglial and leukocyte maturation and the plethora of mechanisms by which microglia and peripheral leukocytes communicate during postnatal period, including receptor-mediated and intracellular inflammatory signaling, lipids, soluble factors and extracellular vesicles. Read More

View Article and Full-Text PDF

The core/penumbra model: implications for acute stroke treatment and patient selection in 2021.

Eur J Neurol 2021 May 15. Epub 2021 May 15.

Université de Paris, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris, France.

Despite major advances in prevention, ischemic stroke remains one of the leading causes of death and disability worldwide. After centuries of nihilism and decades of failed neuroprotection trials, the discovery initially in non-human primates and subsequently in man, that ischemic brain tissue termed the ischemic penumbra can be salvaged from infarction up to and perhaps beyond 24hrs after stroke onset has underpinned the development of highly efficient reperfusion therapies, namely intravenous thrombolysis and endovascular thrombectomy, which have revolutionized the management of the acute stroke patient. Animal experiments have documented that how long the penumbra can survive depends not only on time elapsed since arterial occlusion ('Time is brain'), but also on how severely perfusion is reduced. Read More

View Article and Full-Text PDF

Low LDL-C levels are associated with risk of mortality in a Chinese cohort study.

Endocrine 2021 May 14. Epub 2021 May 14.

Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Zhejiang, 310058, Hangzhou, China.

Background And Aims: Although low-density lipoprotein cholesterol (LDL-C) has been considered as a risk factor of atherosclerotic cardiovascular disease, limited studies can be available to evaluate the association of LDL-C with risk of mortality in the general population. This study aimed to examine the association of LDL-C level with risk of mortality using a propensity-score weighting method in a Chinese population, based on the health examination data.

Methods: We performed a retrospective cohort study with 65,517 participants aged 40 years or older in Ningbo city, Zhejiang. Read More

View Article and Full-Text PDF

Mechanical thrombectomy versus medical care alone in large ischemic core: An up-to-date meta-analysis.

Interv Neuroradiol 2021 May 14:15910199211016258. Epub 2021 May 14.

Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.

Objective: We compared outcomes and adverse events of thrombectomy versus medical management in acute ischemic stroke (AIS) patients with baseline large infarct core.

Methods: We searched Ovid MEDLINE(R) ALL, Cochrane Library Clinical Controlled Trials and EMBASE from inception to January 2021 for studies comparing thrombectomy and medical management alone in AIS patients who had ASPECTS <=7 or ischemic core volume >=50 ml. Imaging modalities to valuate ASPECTS and core volume were without restriction. Read More

View Article and Full-Text PDF

Ischemic stroke associated with aneurysmal lenticulostriate vasculopathy and symmetric reversible basal ganglia lesions in COVID-19.

J Neurol Sci 2021 May 8;426:117484. Epub 2021 May 8.

Department of Neurology, University of Pennsylvania, 3 West Gates, 3400 Spruce Street, Philadelphia, PA 19104, United States of America. Electronic address:

View Article and Full-Text PDF

Comparison of automated infarct core volume measures between non-contrast computed tomography and perfusion imaging in acute stroke code patients evaluated for potential endovascular treatment.

J Neurol Sci 2021 May 8;426:117483. Epub 2021 May 8.

Department of Neurology, University of Helsinki and Helsinki University Hospital, Finland. Electronic address:

Introduction: Patients with small core infarction and salvageable penumbra are likely to benefit from endovascular treatment (EVT). As computed tomography perfusion imaging (CTP) is not always available 24/7 for patient selection, many patients are transferred to stroke centers for CTP. We compared automatically measured infarct core volume (NCCT) from the non-contrast computed tomography (NCCT) with ischemic core volume (CTP) from CTP and the outcome of EVT to clarify if NCCT measurement alone is sufficient to identify patients that benefit from transfer to stroke centers for EVT. Read More

View Article and Full-Text PDF

Kidney Transplant List Status and Outcomes in the ISCHEMIA-CKD Trial.

J Am Coll Cardiol 2021 May 4. Epub 2021 May 4.

NYU Grossman School of Medicine, New York, NY, USA.

Background: Patients with chronic kidney disease (CKD) and coronary artery disease frequently undergo preemptive revascularization before kidney transplant listing.

Objectives: In this post-hoc analysis from ISCHEMIA-CKD, we compared outcomes of patients not listed versus those listed according to management strategy.

Methods: In ISCHEMIA-CKD (n=777), 194 patients (25%) with chronic coronary syndromes and at least moderate ischemia were listed for transplant. Read More

View Article and Full-Text PDF

Functional hemispherectomy: can preoperative imaging predict outcome?

J Neurosurg Pediatr 2020 Jun 21;25(6). Epub 2020 Feb 21.

Division of Pediatric Neurosurgery, Department of Neurosurgery, Brain Institute, Miami Children's Hospital, Miami, Florida.

Objective: Although hemispherectomy is an effective treatment for children with intractable hemispheric epilepsy syndromes, as many as 40% of patients eventually develop seizure recurrence. The causes of seizure recurrence in these patients are incompletely understood. The authors sought to evaluate the efficacy of hemispherectomy at their center and determine whether contralateral MRI abnormalities can predict seizure recurrence. Read More

View Article and Full-Text PDF

Cross-sectional study on patients' understanding and views on the informed consent procedure of a secondary stroke prevention trial.

Eur J Neurol 2021 May 14. Epub 2021 May 14.

Institute for Clinical Epidemiology and Biometry, University of Würzburg, Germany.

Background: Improving understanding of study contents and procedures might enhance recruitment into studies and retention during follow-up. However, data in stroke patients on understanding of the informed consent (IC) procedure are sparse.

Methods: We conducted a cross-sectional study among ischemic stroke patients taking part in the IC procedure of an ongoing cluster-randomized secondary prevention trial. Read More

View Article and Full-Text PDF

Dose-Response Association Between High-Density Lipoprotein Cholesterol and Stroke: A Systematic Review and Meta-Analysis of Prospective Cohort Studies.

Prev Chronic Dis 2021 May 13;18:E45. Epub 2021 May 13.

Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100, Kexue Avenue, Gaoxin District, Zhengzhou, Henan 450001, People's Republic of China. Email:

Introduction: Studies investigating the effect of high-density lipoprotein cholesterol (HDL-C) on stroke and stroke subtypes have reached inconsistent conclusions. The purpose of our study was to clarify the dose-response association between HDL-C level and risk of total stroke and stroke subtypes by a systematic review and meta-analysis.

Methods: We performed a systematic search of PubMed, Embase, and Web of Science databases through July 30, 2020, for prospective cohort studies that reported the HDL-C-stroke association and extracted the estimate that was adjusted for the greatest number of confounding factors. Read More

View Article and Full-Text PDF

EXPRESS: Stent Retriever Alone vs. Aspiration and Stent-Retriever Combination in Large Vessel Occlusion Stroke: A Matched Analysis.

Int J Stroke 2021 May 14:17474930211019204. Epub 2021 May 14.

Emory University School of Medicine, Atlanta, Georgia, United States.

Background Three randomized clinical trials have reported similar safety and efficacy for contact aspiration (CA) and Stent-retriever (SR) thrombectomy. AimWe aimed to determine whether the Combined Technique (SR+CA) was superior to SR alone as first-line thrombectomy strategy in a patient cohort where balloon-guide catheter was universally used. MethodsA prospectively maintained mechanical thrombectomy database from January 2018-December 2019 was reviewed. Read More

View Article and Full-Text PDF

The clinical and cognitive spectrum of locked-in syndrome: 1-year follow-up of 100 patients.

Acta Neurol Belg 2021 May 13. Epub 2021 May 13.

Neurology Department, Acibadem Hospital, Bursa, Türkiye.

In patients with locked-in syndrome (LIS), it is not known exactly to what extent cognitive functions are preserved and it is not known exactly how much it has improved. We aimed to examine the clinical and cognitive features of LIS 1 year after stroke. One hundred patients with locked-in syndrome (LIS) were recruited between January 2008 and May 2019 among 8200 patients with ischemic stroke. Read More

View Article and Full-Text PDF

In-hospital prognosis of first-ever noncardiogenic ischemic stroke in patients with and without indication for prestroke antiplatelet therapy: Chinese Stroke Center Alliance.

Ann Transl Med 2021 Apr;9(8):626

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

Background: It is unknown about the influence of prestroke antiplatelet use on early outcomes in patients with and without the indication. We aimed to evaluate the in-hospital prognosis of first-ever noncardiogenic ischemic stroke patients with and without indications of antiplatelet use for primary prevention.

Methods: This was a retrospective, observational study based on a prospective hospital-based registry (Chinese Stroke Center Alliance). Read More

View Article and Full-Text PDF

Long Term Outcome of Postoperative Atrial Fibrillation After Cardiac Surgery-A Propensity Score-Matched Cohort Analysis.

Front Cardiovasc Med 2021 27;8:650147. Epub 2021 Apr 27.

Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

Postoperative atrial fibrillation (POAF) results in a longer hospital stay and excess mortality. However, whether POAF would increase stroke rate has been debated for years. When and how long should anticoagulation be used to prevent stroke are unknown. Read More

View Article and Full-Text PDF

Editorial: Current Challenges in Cardioembolic Stroke.

Front Neurol 2021 27;12:688371. Epub 2021 Apr 27.

Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

View Article and Full-Text PDF

Shexiang Baoxin Pill, a Proprietary Multi-Constituent Chinese Medicine, Prevents Locomotor and Cognitive Impairment Caused by Brain Ischemia and Reperfusion Injury in Rats: A Potential Therapy for Neuropsychiatric Sequelae of Stroke.

Front Pharmacol 2021 27;12:665456. Epub 2021 Apr 27.

School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.

Ischemic stroke is a common type of cerebrovascular event and also the leading cause of disability. Post-stroke cognitive impairment occurs frequently in stroke survivors. Shexiang Baoxin Pill (SBP) is a proprietary Chinese medicine, initially used to treat cardiovascular diseases. Read More

View Article and Full-Text PDF

Noninvasive transcranial classification of stroke using a portable eddy current damping sensor.

Sci Rep 2021 May 13;11(1):10297. Epub 2021 May 13.

Department of Medical Engineering, California Institute of Technology, Pasadena, CA, USA.

Existing paradigms for stroke diagnosis typically involve computed tomography (CT) imaging to classify ischemic versus hemorrhagic stroke variants, as treatment for these subtypes varies widely. Delays in diagnosis and transport of unstable patients may worsen neurological status. To address these issues, we describe the development of a rapid, portable, and accurate eddy current damping (ECD) stroke sensor. Read More

View Article and Full-Text PDF

Author Correction: Blood substitution therapy rescues the brain of mice from ischemic damage.

Nat Commun 2021 May 13;12(1):2957. Epub 2021 May 13.

Department of Neuroscience, West Virginia University, Morgantown, WV, USA.

View Article and Full-Text PDF

Postoperative occlusion degree after flow-diverter placement with adjunctive coiling: analysis of complications.

J Neurointerv Surg 2021 May 13. Epub 2021 May 13.

Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

Background: Although coiling with a flow diverter may provide immediate dome protection, no studies have evaluated the effect on complications of postoperative occlusion degree immediately postoperatively. The purpose of this study was to determine whether postoperative occlusion degree immediately after flow-diverter placement with adjunctive coiling was associated with complications.

Methods: All patients' data were collected from the post-market multi-center cohort study of embolization of intracranial aneurysms with a pipeline embolization device (PED) in China (PLUS) registry. Read More

View Article and Full-Text PDF

Where in the Brain do Strokes Occur? A Pilot Study and Call for Data.

Clin Med Res 2021 May 13. Epub 2021 May 13.

Department of Pathology and Clinical Sciences Education, Mercer University School of Medicine, Macon, Georgia, USA

Every year, more than 795,000 people in the United States have a stroke and each year stroke kills about 140,000 Americans. Although there is abundant information on the epidemiology, risk factors, pathophysiology, and many clinical features of strokes, there is a glaring lack of specific numerical quantitation on the neuroanatomical distribution of strokes. This retrospective study utilized de-identified reports of radiologic imaging to determine the neurovascular anatomical location of acute ischemic cerebral infarcts in a 637-bed regional hospital in a rural area during the one year interval from October 1, 2018 through September 30, 2019. Read More

View Article and Full-Text PDF

β-Cell Function and Clinical Outcome in Nondiabetic Patients With Acute Ischemic Stroke.

Stroke 2021 May 14:STROKEAHA120031392. Epub 2021 May 14.

Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. (T. Kiyohara, R.M., J.H., K.N., Y.W., T. Kitazono, T.A.).

Background And Purpose: Little is known about how β-cell dysfunction affects clinical outcome after ischemic stroke. We examined whether β-cell function is associated with clinical outcome after acute ischemic stroke and if so, whether insulin resistance influences this association in a prospective study of patients with acute stroke.

Methods: A total of 3590 nondiabetic patients with acute ischemic stroke (mean age, 71 years) were followed up for 3 months. Read More

View Article and Full-Text PDF

Antihypertensives and Statin Therapy for Primary Stroke Prevention: A Secondary Analysis of the HOPE-3 Trial.

Stroke 2021 May 14:STROKEAHA120030790. Epub 2021 May 14.

Population Health Research Institute, Hamilton Health Sciences, ON, Canada (J.B., E.M.L., P.G., R.G.H., S.Y.).

Background And Purpose: The HOPE-3 trial (Heart Outcomes Prevention Evaluation-3) found that antihypertensive therapy combined with a statin reduced first stroke among people at intermediate cardiovascular risk. We report secondary analyses of stroke outcomes by stroke subtype, predictors, treatment effects in key subgroups.

Methods: Using a 2-by-2 factorial design, 12 705 participants from 21 countries with vascular risk factors but without overt cardiovascular disease were randomized to candesartan 16 mg plus hydrochlorothiazide 12. Read More

View Article and Full-Text PDF

The Protective Effects of Statins Towards Vessel Wall Injury Caused by a Stent Retrieving Mechanical Thrombectomy Device : A Histological Analysis of the Rabbit Carotid Artery Model.

J Korean Neurosurg Soc 2021 May 14. Epub 2021 May 14.

Department of Neurosurgery, Veterans Health Service Medical Center, Seoul, Korea.

Objective: Endovascular mechanical thrombectomy (MT) has been regarded as one of the standard treatments for acute ischemic stroke caused by large vessel occlusion. Despite the wide use of stent retrievers for MT, arterial intimal damage caused when deployed stent is pulled has been a certain disadvantage. We hypothesized that statin could protect and stabilize vessel damage after endovascular MT using a stent retriever. Read More

View Article and Full-Text PDF

Using Objective Structured Clinical Exams (OSCE) to Teach Neurology Residents to Disclose Prognosis after Hypoxic Ischemic Brain Injury.

J Stroke Cerebrovasc Dis 2021 May 10;30(7):105846. Epub 2021 May 10.

Department of Neurology, NYU Langone Medical Center, New York, NY, United States; Department of Neurosurgery, NYU Langone Medical Center, New York, NY, United States. Electronic address:

Background: Neurologists need to be adept at disclosing prognosis and breaking bad news. Objective structured clinical examinations (OSCE) allow trainees to practice these skills.

Methods: In 2017, in conjunction with the NYU School of Medicine Simulation Center, neurology faculty designed an OSCE case in which a resident had to inform a standardized patient (SP) her father had severe global hypoxic ischemic injury. Read More

View Article and Full-Text PDF

Leveraging Artificial Intelligence in Ischemic Stroke Imaging.

J Neuroradiol 2021 May 10. Epub 2021 May 10.

Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address:

Artificial intelligence (AI) is having a disruptive and transformative effect on clinical medicine. Prompt clinical diagnosis and imaging are critical for minimizing the morbidity and mortality associated with ischemic strokes. Clinicians must understand the current strengths and limitations of AI to provide optimal patient care. Read More

View Article and Full-Text PDF

Safety in Dermatologic Procedures: Vascular Occlusion by Filling Materials.

Actas Dermosifiliogr 2021 May 10. Epub 2021 May 10.

Servicio de Radiología Intervencionista. Avda. de Córdoba s/n, 28041, Madrid, España.

Ischemic events are the most serious complications of facial antiaging treatment with dermal fillers. Ischemia can cause Nicolau syndrome, blindness, or even stroke. This article discusses how to prevent ischemic complications and what steps to take should a dermatologic emergency develop. Read More

View Article and Full-Text PDF