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Cerebrovascular Diseases

Ajay Malhotra, Kimberly Seifert, Xiao Wu, Charles Matouk, John A Elefteriades
INTRODUCTION: A higher prevalence of intracranial aneurysms (IAs) has been previously reported by retrospective studies in patients with thoracic aortic aneurysms (TAAs). The goal of this study was to evaluate the prevalence of IAs in a large cohort of prospectively screened patients with TAAs and identify potential risk factors. METHODS: Patients above 18 years with TAAs who were prospectively screened for IAs using computed tomographic angiogram/magnetic resonance angiogram over a 9-year period were included in the study...
August 14, 2019: Cerebrovascular Diseases
Claudia Altamura, Matteo Paolucci, Carmelina Maria Costa, Nicoletta Brunelli, Angelo Cascio Rizzo, Gianluca Cecchi, Fabrizio Vernieri
BACKGROUND: The causal relationship between patent foramen ovale (PFO) and migraine with aura (MA) is controversial. We aimed at exploring whether attack clinical features relate to the presence of right-to-left shunt (RLS) in MA patients. METHODS: We retrospectively examined a cohort of consecutive patients diagnosed with MA in our headache center and undergoing transcranial doppler (TCD) for RLS detection. We collected from our clinical electronic dossiers, clinical features of MA attacks (type, frequency, duration of aura phenomenon, trigger factors, onset age), family history for MA, thrombophilia genotypes, and the response to preventive treatments...
July 29, 2019: Cerebrovascular Diseases
Michael Ertl, Christoph Beck, Benjamin Kühlbach, Jasmin Hartmann, Gertrud Hammel, Annette Straub, Esther Giemsa, Stefanie Seubert, Andreas Philipp, Claudia Traidl-Hoffmann, Jens Soentgen, Jucundus Jacobeit, Markus Naumann
BACKGROUND/OBJECTIVES: Meteorological factors seem to influence stroke incidence, however, the complex association between weather and stroke remains unclear. Possible explanations from the literature do not categorize into subdivisions of ischemic strokes, only have small patient numbers, or refer to a selection of isolated weather elements without investigating weather changes and more. METHOD: In this exploratory trial, almost 18,000 stroke cases from a single stroke center in Southern Germany were analyzed from 2006 to 2015 and classified into the main subgroups of strokes and subdivisions of ischemic stroke etiologies applying the Trial of Org 10172 in Acute Stroke Treatment classification...
July 25, 2019: Cerebrovascular Diseases
Clare Flach, Maria Elstad, Walter Muruet, Charles D A Wolfe, Anthony G Rudd, Abdel Douiri
BACKGROUND: The benefit of statins on stroke incidence is well known. However, data on the relationship between pre- and post-stroke statin use, recurrence, and survival outcomes are limited. We aim to investigate the short- and long-term relationships between statin prescription, stroke recurrence, and survival in patients with first-ever ischemic stroke. METHODS: Data were collected from the population-based South London Stroke Register for the years 1995-2015...
July 16, 2019: Cerebrovascular Diseases
Iris Q Grunwald, Johann Kulikovski, Wolfgang Reith, Stephen Gerry, Rafael Namias, Maria Politi, Panagiotis Papanagiotou, Marco Essig, Shrey Mathur, Olivier Joly, Khawar Hussain, Viola Wagner, Sweni Shah, George Harston, Julija Vlahovic, Silke Walter, Anna Podlasek, Klaus Fassbender
Computed tomography angiography (CTA) collateral scoring can identify patients most likely to benefit from mechanical thrombectomy and those more likely to have good outcomes and ranges from 0 (no collaterals) to 3 (complete collaterals). In this study, we used a machine learning approach to categorise the degree of collateral flow in 98 patients who were eligible for mechanical thrombectomy and generate an e-CTA collateral score (CTA-CS) for each patient (e-STROKE SUITE, Brainomix Ltd., Oxford, UK). Three experienced neuroradiologists (NRs) independently estimated the CTA-CS, first without and then with knowledge of the e-CTA output, before finally agreeing on a consensus score...
June 19, 2019: Cerebrovascular Diseases
Damien Viglino, Sébastien Baillieul, Ingrid Jullian-Desayes, Marie Joyeux-Faure, Renaud Tamisier, Jean-Louis Pépin
No abstract text is available yet for this article.
June 19, 2019: Cerebrovascular Diseases
Young Seo Kim, Bum Joon Kim, Kyung Chul Noh, Kyung Mi Lee, Sung Hyuk Heo, Hye-Yeon Choi, Hyun Young Kim, Seong-Ho Koh, Dae-Il Chang
BACKGROUND: Clinical and radiological characteristics of middle cerebral artery (MCA) infarction may differ according to the location of occlusion. OBJECTIVES: We investigated the difference between proximal and distal symptomatic MCA occlusion (MCAO) in patients with ischemic stroke. The factors associated with the imaging characteristics were also analyzed. METHODS: Patients with ischemic stroke due to MCAO were consecutively enrolled. The location of MCAO was determined by the ratio of the length of the ipsilesional MCA to that of the contralateral MCA and dichotomized to proximal and distal MCAO...
June 18, 2019: Cerebrovascular Diseases
Karen M Adams, Paul A Burns, Annemarie Hunter, Ian Rennie, Peter A Flynn, Graham Smyth, Patricia L Gordon, Cathy E Patterson, Patricia Fearon, Enda L F Kerr, M Ivan Wiggam
BACKGROUND: Mechanical thrombectomy has revolutionised the treatment of acute ischaemic stroke due to large vessel occlusion. It is well recognised that patients are more likely to benefit when reperfusion happens quickly, however, there is uncertainty as to how best to deliver this service. OBJECTIVES: To compare outcomes of patients in Northern -Ireland who underwent thrombectomy via direct admission to the single endovascular centre (mothership [MS]) with those transferred from primary stroke centres (drip-and-ship [DS])...
June 18, 2019: Cerebrovascular Diseases
Sebastian S Roeder, Maximilian I Sprügel, Jochen A Sembill, Antje Giede-Jeppe, Kosmas Macha, Dominik Madžar, Hannes Lücking, Philip Hoelter, Stefan T Gerner, Joji B Kuramatsu, Hagen B Huttner
BACKGROUND AND OBJECTIVE: Intraventricular hemorrhage (IVH) is a verified independent prognostic parameter in patients with intracerebral hemorrhage (ICH). However, the impact of the extent of IVH on clinical outcomes is unestablished. METHODS: We analyzed 1,112 consecutive primary ICH patients of the UKER-ICH cohort (NCT03183167) and hypothesized that there is no difference in outcome between patients without IVH and patients with minor IVH not leading to obstructive hydrocephalus...
June 18, 2019: Cerebrovascular Diseases
Ki-Woong Nam, Won-Sang Cho, Hyung-Min Kwon, Jeong Eun Kim, Yong-Seok Lee, Sun-Won Park, Jung Hyo Rhim, Young-Je Son
BACKGROUND: Although there is a standard guideline for performing revascularization surgery in patients with Moyamoya diseases (MMD), more objective and easily obtainable predictors are still needed. OBJECTIVES: In this study, we aimed to evaluate the relationship between an ipsilateral ivy sign and ischemic stroke recurrence in adult MMD patients without revascularization surgery. METHODS: We included consecutive MMD patients without revascularization surgery between 2006 and 2014...
June 18, 2019: Cerebrovascular Diseases
Sergio Amaro, Arturo Renú, Carlos Laredo, Mar Castellanos, Juan F Arenillas, Laura Llull, Salvatore Rudilloso, Xabier Urra, Victor Obach, Ángel Chamorro
BACKGROUND: Collateral circulation may modify the effect of neuroprotective therapies. We report a post hoc analysis of the URICO-ICTUS trial (NCT00860366) assessing the modifying treatment effect of pretreatment collaterals on clinical and radiological outcomes in patients with large-vessel acute ischemic stroke receiving uric acid therapy or placebo. METHODS: URICO-ICTUS was a randomized clinical trial where 411 alteplase-treated patients also received uric acid 1,000 mg (n = 211) or placebo (n = 200) before the end of alteplase infusion...
June 4, 2019: Cerebrovascular Diseases
Laurie Fraticelli, Julie Freyssenge, Clément Claustre, Marielle Buisson, Magali Bischoff, Norbert Nighoghossian, Laurent Derex, Carlos El Khoury
BACKGROUND: Literature has highlighted sex-based differences in the natural course of stroke and in response to treatment with intravenous tissue plasminogen activator (tPA). OBJECTIVES: We aimed to compare the management and outcome of acute ischemic stroke (AIS) among women and men on a French registry based on a federated network of emergency physicians and neurologists. METHOD: We included 2,790 patients received tPA between 2010 and 2016 from the stroke centers in the RESUVal area...
May 23, 2019: Cerebrovascular Diseases
Ryosuke Tashiro, Miki Fujimura, Masayuki Kameyama, Shunji Mugikura, Hidenori Endo, Yohei Takeuchi, Yasutake Tomata, Kuniyasu Niizuma, Teiji Tominaga
OBJECTIVE: Superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis is the standard surgical management for adult moyamoya disease (MMD) patients, but local cerebral hyperperfusion (CHP) and cerebral ischemia are potential complications of this procedure. Recent hemodynamic analysis of the acute stage after revascularization surgery for MMD revealed a more complex and unique pathophysiological condition, the so-called "watershed shift (WS) phenomenon," which is defined as a paradoxical decrease in the cerebral blood flow (CBF) at the adjacent cortex near the site of local CHP...
May 23, 2019: Cerebrovascular Diseases
Nazife Dinc, Sae-Yeon Won, Michael Eibach, Johanna Quick-Weller, Jürgen Konczalla, Joachim Berkefeld, Volker Seifert, Gerhard Marquardt
OBJECTIVE: Cerebral vasospasm (CVS) after a ruptured arteriovenous malformation (AVM) is rarely reported. This study is aimed at evaluating the predictive variables in AVM hemorrhage for CVS. METHODS: A total of 160 patients with ruptured AVMs were admitted to our neurosurgical department from 2002 to 2018. The frequency of cerebral vasospasm after AVM hemorrhage and the impact of AVM-associated aneurysms were evaluated. We compared different bleeding patterns, such as intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH) or a combination of both (ICH + SAH) and evaluated predictive variables for outcome in last follow-up...
May 8, 2019: Cerebrovascular Diseases
David Weisenburger-Lile, Raphaël Blanc, Maeva Kyheng, Jean-Philippe Desilles, Julien Labreuche, Michel Piotin, Mikael Mazighi, Arturo Consoli, Bertrand Lapergue, Benjamin Gory
BACKGROUND: To date, thrombectomy for large vessel occlusion (LVO) strokes can be performed only in comprehensive stroke centers with thrombectomy capacity. We compared the clinical outcome of patients first referred to a primary stroke center to those admitted directly to a comprehensive stroke center and treated on site in the multicentric observational Endovascular Treatment in Ischemic Stroke (ETIS) registry. METHODS: From our perspective, multicenter, observational ETIS registry, we analyzed anterior circulation stroke patients, treated within 8 h, who underwent thrombectomy after thrombolysis and were admitted to a comprehensive stroke center either with drip and ship or mothership...
May 7, 2019: Cerebrovascular Diseases
Tomofumi Nishikawa, Naomi Miyamatsu, Aya Higashiyama, Masato Hojo, Yoko Nishida, Shunichi Fukuda, Takumi Hirata, Kayoko Ichiura, Yoshimi Kubota, Sachimi Kubo, Tetsuya Ueba, Aya Kadota, Daisuke Sugiyama, Tomonori Okamura
BACKGROUND: While water intake is frequently recommended to prevent cerebral infarction (CI), only few studies have been published on this topic. OBJECTIVES: This study retrospectively estimated the daily non-alcohol drink (NAD) intake in CI patients before CI onset and compared it with NAD in healthy subjects. METHODS: We performed a cross-sectional study on CI patients in 3 hospitals and healthy subjects in the Kobe Orthopedic and Biomedical Epidemiologic (KOBE) study...
May 3, 2019: Cerebrovascular Diseases
Francisco Purroy, Ana Vena, Carles Forné, Ana María de Arce, Antonio Dávalos, Blanca Fuentes, Juan Francisco Arenillas, Jerzy Krupinski, Manuel Gómez-Choco, Ernest Palomeras, Joan Martí-Fábregas, José Castillo, Xavier Ustrell, Javier Tejada, Jaime Masjuan, Moisés Garcés, Ikram Benabdelhak, Joaquin Serena
BACKGROUND: In-hospital stroke death rate is an important sanitary issue. Despite advances in the acute phase management of stroke patients, mortality and disability rates remain high. In aging populations and with different mortality between the sexes in general, the study of sex- and age-related differences becomes increasingly relevant for optimization of post-acute clinical care of stroke patients. METHODS: We designed a cohort follow-up study with 13,932 consecutive ischemic stroke (IS) patients from 19 Spanish hospitals...
May 3, 2019: Cerebrovascular Diseases
Kenichi Todo, Nobuyuki Sakai, Hirotoshi Imamura, Hiroshi Yamagami, Hidemitsu Adachi, Tomoyuki Kono, Junya Kobayashi, Shiro Yamamoto, Takeshi Morimoto, Shoichi Tani, Michi Kawamoto, Manabu Sakaguchi, Yasushi Ueno, Takeharu Kunieda, Osamu Narumi, Chiaki Sakai, Akira Ishii, Taku Hoshi, Masaomi Koyanagi, Yohei Mineharu, Tatsuya Ishikawa, Yoji Kuramoto, Shinsuke Sato, Nobuyuki Ohara, Koichi Arimura, Hajime Nakamura, Takeo Nishida, Yasufumi Gon, Toshiyuki Fujinaka, Kazuhisa Yoshiya, Haruhiko Kishima, Hideki Mochizuki, Nobuo Kohara
BACKGROUND AND PURPOSE: Recent studies have demonstrated that endovascular reperfusion therapy improves clinical outcomes at 90 days after ischemic stroke. However, the effects on long-term outcomes are not well known. We hypothesized that successful reperfusion might be associated with long-term improvement beyond 90 days after endovascular therapy. To assess the long-term effects beyond 90 days, we analyzed the association of successful reperfusion with a temporal change in modified Rankin Scale (mRS) score from 90 days to 1 year after endovascular therapy...
April 9, 2019: Cerebrovascular Diseases
Shunsuke Nomura, Koji Yamaguchi, Hiroyuki Akagawa, Akitsugu Kawashima, Yosuke Moteki, Tatsuya Ishikawa, Yasuo Aihara, Taiichi Saito, Yoshikazu Okada, Takakazu Kawamata
BACKGROUND: Homozygosity of this p.R4810K founder variant of RNF213 moyamoya disease (MMD) susceptibility gene is known to influence the severity of the clinical disease phenotype at disease onset. However, the association between this genotype and long-term clinical manifestations has remained unclear. OBJECTIVES: The principal goal of this study was to investigate whether and how the p.R4810K variant of RNF213 influences the long-term phenotype in Japanese patients with MMD...
April 4, 2019: Cerebrovascular Diseases
Xiao-Yu Xin, Lin Cheng, Zhao Yang, Yu Zhang, Li-Li Zeng, Jian-Rong Liu
BACKGROUND: Precise subtype classification based on underlying pathophysiology is important to prevent recurrent attack in minor stroke patients. A newly developed Atherosclerosis, Small vessel disease, Cardiac source, Others (ASCO) phenotypic classification system aims to characterize patients using different grades of evidence for stroke subtypes. However, this system has not been specifically applied to minor stroke population. In our study, the impact of using the newer ASCO criteria on minor stroke etiologies was investigated, and compared with that of Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification...
March 28, 2019: Cerebrovascular Diseases
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