Dominik Wróbel, Paweł Wrona, Tomasz Homa, Klaudia Jakobschy, Gabriela Wrona, Katarzyna Sawczyńska, Mateusz Giełczyński, Tadeusz Popiela, Agnieszka Słowik, Wojciech Turaj
INTRODUCTION: The discourse surrounding differences in cerebral hemodynamics and clinical outcomes among male and female patients treated with mechanical thrombectomy (MT) for acute ischemic stroke (AIS) remains unresolved. We aimed to elucidate these differences by employing computed tomography perfusion (CTP) imaging before MT and examining the influence of perfusion deficits on the 90-day functional outcome. METHODS: This single-center retrospective analysis involved patients with anterior circulation AIS treated with MT at the Comprehensive Stroke Center, University Hospital, Krakow from January 2019 to July 2023...
April 17, 2024: Cerebrovascular Diseases
(no author information available yet)
No abstract text is available yet for this article.
April 11, 2024: Cerebrovascular Diseases
Sarvenaz Mehrabi, Lindsay Cameron, Andrew Bowman, Jamie L Fleet, Janice Eng, Mark Theodore Bayley, Robert Teasell
INTRODUCTION: Female participation is lower than males in both acute stroke and stroke rehabilitation trials. However, less is known about how female participation differs across countries and regions. OBJECTIVE: To systematically assess the percentage of female participants in RCTs of post stroke rehabilitation of upper extremity (UE) motor disorders in low-middle-income (LMICs) and high-income countries (HICs) as well as different HIC world regions. MATERIALS & METHODS: CINAHL, Embase, PubMed, Scopus and Web of Science were searched from 1960 to April 1, 2021...
April 6, 2024: Cerebrovascular Diseases
Vasileios-Arsenios Lioutas, Aristeidis H Katsanos, Ashkan Shoamanesh, Farhaan Vahidy, Elizabeth C Heistand, Lydia D Foster, Sharon D Yeatts, Magdy Selim
Introduction The impact of intracerebral hemorrhage (ICH) on cognition and the determinants of cognitive recovery early after ICH remain elusive. In this post-hoc analysis of the Intracerebral Hemorrhage Deferoxamine (iDEF) trial, we examined the trajectories of cognitive impairment and the determinants of early cognitive recovery after ICH. Methods We examined baseline factors associated with 90-day cognitive outcome and constructed generalized linear mixed models to examine the trajectory of cognitive function over time among iDEF participants...
April 5, 2024: Cerebrovascular Diseases
Tae Jung Kim, Ji Sung Lee, Jae Sun Yoon, Mi Sun Oh, Ji-Woo Kim, Soo-Hyun Park, Kyung-Ho Yu, Byung-Chul Lee, Sang-Bae Ko, Byung-Woo Yoon
INTRODUCTION: Although statin therapy reduces cardiovascular events, statin use is associated with the risk of new-onset diabetes mellitus (NODM). Using a linked dataset, we evaluated the effect of statin treatment on vascular outcomes and NODM development in patients with ischemic stroke. METHODS: From the dataset, we identified 20,250 patients with acute ischemic stroke who had neither a prior history of DM nor a previous history of statin use before the index stroke...
March 25, 2024: Cerebrovascular Diseases
Permesh Singh Dhillon, Nishita Singh, Johanna Maria Ospel, Bob Roozenbeek, Mayank Goyal, Michael D Hill
No abstract text is available yet for this article.
March 25, 2024: Cerebrovascular Diseases
Anthony Pereira, Vafa Alakbarzade, Deborah Lowe, David Hargroves
BACKGROUND: Traditionally, non-contrast computed tomography (CT) alone was used in the initial assessment of acute ischaemic stroke patients mainly to exclude haemorrhage or alternative pathology. SUMMARY: Late-window (beyond 6 hours) and recent large-volume endovascular mechanical thrombectomy (MT) trials integrated CT Perfusion (CTP) imaging to guide MT and/or intravenous thrombolysis (IVT) decision-making in stroke patients. KEY MESSAGES: In current clinical practice, many patients are being excluded from reperfusion therapy due to a lack of data from urgent investigations to assess cerebral vasculature and perfusion...
March 20, 2024: Cerebrovascular Diseases
Sarah Marchina, Sharon D Yeatts, Lydia D Foster, Scott Janis, Ashkan Shoamanesh, Pooja Khatri, Kimberlee Bernstein, Aaron Perlmutter, Catherine Stever, Elizabeth C Heistand, Joseph P Broderick, Steven M Greenberg, Enrique C Leira, Jonathan Rosand, Vasileios-Arsenios Lioutas, Rustam Al Shahi Salman, David Tirschwell, Joan Marti-Fabregas, Magdy Selim
INTRODUCTION: The benefits and risks of HMG-CoA reductase inhibitor (statin) drugs in survivors of intracerebral hemorrhage (ICH) are unclear. Observational studies suggest an association between statin use and increased risk of lobar ICH, particularly in patients with apolipoprotein-E (APOE) ε2 and ε4 genotypes. There are no randomized controlled trials (RCTs) addressing the effects of statins after ICH leading to uncertainty as to whether statins should be used in patients with lobar ICH who are at high risk for ICH recurrence...
March 16, 2024: Cerebrovascular Diseases
Jing Xue, Mingming Shi, Qin Xu, Anxin Wang, Xue Jiang, Jinxi Lin, Xia Meng, Hao Li, Lemin Zheng, Yongjun Wang, Jie Xu
Introduction The angiotensin-converting enzyme-2 (ACE-2) and its shedding product [soluble ACE-2 (sACE-2)] are implicated in adverse cardiovascular outcomes. However, the relationship between sACE-2 and stroke recurrence is unknown. Herein, we examined the relationship of sACE-2 with stroke recurrence in patients with ischemic stroke or transient ischemic attack (TIA). Methods Data were obtained from the Third China National Stroke Registry (CNSR-Ⅲ). Eligible cases consisted of 494 patients who developed recurrent stroke within 1-year follow-up, 494 controls were selected using age- and sex- matched with a 1:1 case-control ratio...
March 12, 2024: Cerebrovascular Diseases
Roshini Kalagara, Susmita Chennareddy, Emma Reford, Abhiraj D Bhimani, Daniel D Cummins, Margaret H Downes, Jenna M Tosto, Joshua B Bederson, J Mocco, David Putrino, Christopher P Kellner, Fedor Panov
INTRODUCTION: Vagus Nerve Stimulation (VNS) has emerged as a promising tool in ischemic stroke rehabilitation. However, there has been no systematic review summarizing its adverse effects, critical information for patients and providers when obtaining informed consent for this novel treatment. This systematic review and meta-analysis reports the adverse effects of VNS. METHODS: A systematic review was performed in accordance with PRISMA guidelines to identify common complications after VNS therapy...
March 12, 2024: Cerebrovascular Diseases
Laura Catherine Gioia, George Nunes Mendes, Alexandre Yves Poppe, Christian Stapf
BACKGROUND: Spontaneous acute intracerebral hemorrhage (ICH) is associated with greater stroke-related disability and mortality. Hematoma expansion (HME), an important treatment target in acute ICH, is time-dependent, with a greater probability of hematoma growth occurring <3 hours from ICH onset. SUMMARY: Promising treatment options to reduce HME include early intensive blood pressure (BP) reduction and the administration of hemostatic or anticoagulant reversal agents, yet large phase III clinical trials have so far failed to show overwhelming benefit for these interventions in acute ICH...
March 7, 2024: Cerebrovascular Diseases
Menglu Ouyang, Francisca González, Michelle Montalbano, April Pruski, Stephen Jan, Xia Wang, Brenda Johnson, Debbie V Summers, Pooja Khatri, Alejandra Malavera, Michael Iacobelli, Roland Faigle, Paula Munoz-Venturelli, Francisca Urrutia Goldsack, Diana Day, Thompson G Robinson, Alice C Durham, Ahtasam Ebraimo, Lili Song, Yi Sui, Wan Asyraf Wan Zaidi, Richard I Lindley, Candice Delcourt, Victor Cruz Urrutia, Craig S Anderson, Hueiming Liu
INTRODUCTION: The ongoing OPTIMISTmain study, an international, multicenter, stepped-wedge cluster randomized trial, aims to determine effectiveness and safety of low-intensity versus standard monitoring in thrombolysis-treated patients with mild-to-moderate acute ischemic stroke (AIS). An embedded process evaluation explored integration and impact of the intervention on care processes at participating US sites. METHODS: A mixed-methods approach with quantitative and qualitative data were collected between September 2021 and November 2022...
March 5, 2024: Cerebrovascular Diseases
Mihir Khunte, Huanwen Chen, Marco Colasurdo, Seemant Chaturvedi, Ajay Malhotra, Dheeraj Gandhi
INTRODUCTION: Atrial fibrillation or flutter (AF) is a well-known risk factor for ischemic stroke. While female sex has been associated with higher stroke risk among AF patients, overall sex-specific real-world burdens of AF-related strokes and hemorrhages are unknown. METHODS: The 2016-2020 National Inpatient Sample was queried for hospitalizations, morbidity, and mortality due to AF-related ischemic strokes and bleeds. Patient demographic information, vascular risk factors, comorbidities, and stroke characteristics were extracted using ICD-10 codes...
March 2, 2024: Cerebrovascular Diseases
Marie Luby, Amie W Hsia, Carolyn A Lomahan, Victoria Uche, Rachel Davis, Yongwoo Kim, Sana Somani, Shannon Burton, Rainier Cabatbat, Veronica Craft, Jill B De Vis, Malik M Adil, Mariam M Afzal, Leila C Thomas, William Gandler, Evan S McCreedy, John K Lynch, Lawrence L Latour
Introduction Stroke lesion volume on MRI or CT provides objective evidence of tissue injury as a consequence of ischemic stroke. Measurement of "final" lesion volume at 24hr following endovascular therapy (post-EVT) has been used in multiple studies as a surrogate for clinical outcome. However, despite successful recanalization, a significant proportion of patients do not experience favorable clinical outcome. The goals of this study were to quantify lesion growth during the first week after treatment, identify early predictors, and explore the association with clinical outcome...
February 27, 2024: Cerebrovascular Diseases
Megan Heffernan, Mark Woodward, Deidre Anne De Silva, Christopher Chen, Craig S Anderson, Christine Kremer, Katie Harris, Else Charlotte Sandset, Maria Teresa Ferretti, Valeria Caso, Cheryl Carcel
INTRODUCTION: Reporting of sex and gender analysis in medical research has been shown to improve quality of the science and ensures findings are applicable to women and men. There is conflicting evidence on whether efforts by funding agencies and medical journals to encourage reporting of sex and gender analysis has resulted in tangible improvements. This study mapped the inclusion of sex and gender analysis in stroke and dementia research conducted in the Asia-Pacific region. METHODS: A systematic search for Asia-Pacific stroke and dementia research was conducted in PubMed and papers included from the period 2012 to 2022...
February 24, 2024: Cerebrovascular Diseases
Samuel D Pettersson, Shunsuke Koga, Shan Ali, Alejandro Enriquez-Marulanda, Philipp Taussky, Christopher S Ogilvy
INTRODUCTION: This study aimed to elucidate mechanisms underlying moyamoya disease (MMD) pathogenesis and to identify potential novel biomarkers. We utilized gene coexpression networks to identify hub genes associated with the disease. METHODS: Twenty-one middle cerebral artery (MCA) samples from MMD patients and 11 MCA control samples were obtained from the Gene Expression Omnibus (GEO) dataset, GSE189993. To discover functional pathways and potential biomarkers, weighted gene coexpression network analysis (WGCNA) was employed...
February 24, 2024: Cerebrovascular Diseases
Yunke Li, Yang Zhao, Xiaoxi Zhang, Lingli Sun, Yingfeng Wan, Yongwei Zhang, Pengfei Yang, Lili Song, Jianmin Liu, Craig S Anderson
BACKGROUND: Although guidelines recommend a target blood pressure 185-180/105-110 mmHg after mechanical thrombectomy for acute ischemic stroke (AIS), there is limited randomized evidence to support this level. We surveyed candidate institutions about the approach to blood pressure management in this patient group in preparation for inviting them to participate in the Enhanced Blood Pressure Control after Endovascular Thrombectomy for the Acute Ischemic Stroke Trial (ENCHANTED2/MT). METHODS: Physicians from a professional network of institutions that met mechanical thrombectomy qualification requirements were invited to participate in an online questionnaire covering basic clinical information as well as questions on blood pressure management...
February 20, 2024: Cerebrovascular Diseases
Mohammed A Almanna, Ziad S Aloraini, Robert W Regenhardt, Adam A Dmytriw, Mohammed A Bayounis, Mohammed A Bin-Mahfooz, Yousef I Alghamdi, Ysmeen T Bucklain, Abdulrahman Y Alhoumaily, Naif M Alotaibi
BACKGROUND: The use of Alteplase (ALT) bridging to endovascular mechanical thrombectomy (MT) has become the standard approach in treating patients with large vessel stroke (LVO). Tenecteplase (TNK) has emerged as an equivalent fibrinolytic agent in treating ischemic stroke due to its remarkable pharmacological characteristics. This study aims to compare the use of intravenous TNK to ALT bridging to MT in patients with LVO. METHODS: We included observational and randomized controlled trials of patients with LVO who received bridging TNK vs ALT before undergoing MT...
February 15, 2024: Cerebrovascular Diseases
Kun An, Chun Chen, Meijuan Dong, Wei Chen, Yongjun Cao
INTRODUCTION: Post-thrombectomy intraparenchymal hyperdense (PTIH) in patients with acute ischaemic stroke (AIS) is a common CT sign, making it difficult for physicians to distinguish intracerebral hemorrhage in the early post-thrombectomy period. The aim of this study is to develop an effective model to differentiate intracerebral hemorrhage from contrast extravasation in patients with PTIH. METHODS: We retrospectively collected information on patients who underwent endovascular thrombectomy (EVT) at two stroke centers between August 2017 and January 2023...
February 10, 2024: Cerebrovascular Diseases
Laurien Onkenhout, Tine Arts, Doeschka Ferro, Sanne Kuipers, Eline Oudeman, Thijs van Harten, Matthias J P van Osch, Jaco Zwanenburg, Jeroen Hendrikse, Geert Jan Biessels, L Jaap Kappelle
INTRODUCTION: Cerebral perforating arteries provide blood supply to the deep regions of the brain. Recently, it became possible to measure blood flow velocity and pulsatility in these small arteries. It is unknown if vascular risk factors are related to these measures. METHODS: We measured perforating artery flow with 2D phase contrast 7 Tesla MRI at the level of the centrum semiovale (CSO) and the basal ganglia (BG) in seventy participants from the Heart Brain Connection study with carotid occlusive disease (COD), vascular cognitive impairment (VCI), or no actual cerebrovascular disease...
February 9, 2024: Cerebrovascular Diseases
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