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Stroke and Vascular Neurology

Xiaowen Hou, Xiaoqiu Li, Xinhong Wang, Huisheng Chen
Background: A recent study shows that dual antiplatelet therapy with clopidogrel plus aspirin is superior to aspirin monotherapy for minor stroke, which is defined as a National Institutes of Health Stroke Scale (NIHSS)score of ≤3. However, acute mild-moderate ischaemic stroke (4≤NIHSS≤10) still needs aggressive antiplatelet intervention to prevent deterioration and recurrence of stroke. The efficacy and safety of dual antiplatelet therapy versus aspirin monotherapy in the population are not clear...
December 2018: Stroke and Vascular Neurology
Yongjun Wang, Zixiao Li, Yilong Wang, Xingquan Zhao, Liping Liu, Xin Yang, Caiyun Wang, Hongqiu Gu, Fuying Zhang, Chunjuan Wang, Ying Xian, David Z Wang, Qiang Dong, Anding Xu, Jizong Zhao
Background: In June 2015, the Chinese Stroke Association (CSA) initiated the Chinese Stroke Center Alliance (CSCA) to establish the national hospital-based stroke care quality assessment and improvement platform. This article outlines its objectives, operational structure, patient population, quality improvement (QI) intervention tools, data elements, data collection methodology and current patient and hospital data. Methods: The CSCA is a national, hospital-based, multicentre, voluntary, multifaceted intervention and continuous QI initiative...
December 2018: Stroke and Vascular Neurology
Xiaodi Li, Yuzhou Wang, Zhanhang Wang, Peiming Wang, Chuanxing Shao, Jinlong Ye
No abstract text is available yet for this article.
December 2018: Stroke and Vascular Neurology
Pervinder Bhogal, Victoria Hellstern, Muhammad AlMatter, Oliver Ganslandt, Hansjörg Bäzner, Marta Aguilar Pérez, Hans Henkes
Background: Paediatric arterial ischaemic stroke is an important cause of morbidity and mortality among children. Currently, there are no recommendations regarding mechanical thrombectomy in children despite overwhelming evidence of improved outcomes in adults. Therefore, the need for individual case reports and case series is important to highlight potential advantages and disadvantages in this approach. Case descriptions: We retrospectively searched our prospectively maintained database of patients undergoing mechanical thrombectomy for ischaemic stroke...
December 2018: Stroke and Vascular Neurology
Ting Ye, Shengyan Huang, Yi Dong, Qiang Dong
Background: Dysphagia is a common complication after stroke. Water swallowing test (WST) is a recognised but limited tool in providing details about dysphagia, including severity and how to adjust the diet based on the test results. Methods: We performed a prospective observational study of comparing WST and volume-viscosity swallow test (V-VST) in patients with acute stroke within 14 days. All patients had WST and if failed would have a V-VST. The primary outcome was to compare the dysphagia levels assessed by these two test tools...
December 2018: Stroke and Vascular Neurology
Vafa Alakbarzade, Alice Taylor, Marie Scully, Robert Simister, Arvind Chandratheva
Introduction: Approximately 40% of strokes in young adults are cryptogenic. The diagnostic yield of thrombophilia screening remains controversial. We aimed to determine utility of current thrombophilia testing for young patients with stroke and transient ischaemic attack (TIA). Methods: We present a retrospective review of all patients with stroke and TIA ≤60 years presenting to University College London Hospital stroke unit and daily TIA clinic from 1 January 2015 to 1 August 2016...
December 2018: Stroke and Vascular Neurology
Ji Liu, Guanen Zhou, Bradley J Kolls, Yanli Tan, Chuan Fang, Haichen Wang, Daniel T Laskowitz
Objective: Subarachnoid haemorrhage (SAH) accounts for 3% of all strokes, and is associated with significant morbidity and mortality. There is growing evidence implicating apolipoprotein E (apoE) in mediating adaptive anti-inflammatory and neuroprotective responses following ischaemic and traumatic brain injury. In the current study, we test the efficacy of a small apoE mimetic peptide, CN-105 in a murine model of SAH. Methods: Mice subjected to SAH received repeated intravenous injections of CN-105 every 12 hours for 3 days, with the first dose given 2 hours after injury...
December 2018: Stroke and Vascular Neurology
Charith Cooray, Michael V Mazya, Matteo Bottai, Jan F Scheitz, Azmil H Abdul-Rahim, Tiago Prazeres Moreira, Robert Mikulik, Antonin Krajina, Miroslava Nevsimalova, Danilo Toni, Nils Wahlgren, Niaz Ahmed
Background and purpose: Triage tools to identify candidates for thrombectomy are of utmost importance in acute stroke. No prognostic tool has yet gained any widespread use. We compared the predictive value of various models based on National Institutes of Health Stroke Scale (NIHSS) subitems, ranging from simple to more complex models, for predicting large artery occlusion (LAO) in anterior circulation stroke. Methods: Patients registered in the SITS international Stroke Register with available NIHSS and radiological arterial occlusion data were analysed...
December 2018: Stroke and Vascular Neurology
Angela Liu, Mohsen Pirastehfar, Daohai Yu, Guillermo Linares
Background and purpose: Stroke in young individuals is a serious public health burden. This study aimed to characterise the various phenotypes of ischaemic stroke in a young urban population (≤50 years old) using the ASCOD classification system, which assigns a score to five stroke categories: atherosclerosis, small vessel disease (SVD), cardioembolism, other and dissection. Within each category, a numerical score represents the degree of causality attributed to the stroke. Methods: This retrospective study cohort was composed of patients from an urban tertiary care academic centre...
December 2018: Stroke and Vascular Neurology
Yijia Guo, Yaqiong Yang, Muke Zhou, Li He
Objective: To identify risk factors for haemorrhagic transformation in Chinese patients with acute ischaemic stroke treated with recombinant tissue plasminogen activator. Methods: We searched electronic databases including PubMed, EMBASE, CNKI and WanFang Data for studies reporting risk factors of haemorrhagic transformation after intravenous thrombolysis. Pooled OR, weighted mean difference (WMD) and 95% CI were estimated. Meta-analysis was performed by using Stata V...
December 2018: Stroke and Vascular Neurology
Li-Jun Li, Yang Yang, Bo-Yuan Guan, Qi Chen, An-Xin Wang, Yong-Jun Wang, Ning Zhang, Chun-Xue Wang
Objective: Insomnia is a highly prevalent disorder among patients suffering from stroke. The association between insomnia and stroke mortality is less studied, particularly using the latest diagnostic criteria. The current study examined the relationship between insomnia and mortality among patients with first-evonal hazard models were used to calculate HRs for stroke er stroke in China. Methods: Patients with acute cerebrovascular diseases (stroke) were recruited from 56 hospitals in mainland China...
December 2018: Stroke and Vascular Neurology
Jorge C Kattah
Following the initial description of HINTS to diagnose acute vestibular syndrome (AVS) in 2009, there has been significant interest in the systematic evaluation of HINTs to diagnose stroke and other less common central causes of AVS. This trend increased with availability of the video head impulse test (video-HIT). This article reviews the original papers and discusses the main publications from 2009 to 2017. Many authors use video-HIT in the diagnosis of patients with AVS; this paper focuses on the major publications on the topic featuring nystagmus, manual and video-HIT, and skew deviation...
December 2018: Stroke and Vascular Neurology
(no author information available yet)
[This corrects the article DOI: 10.1136/svn-2017-000104.].
September 2018: Stroke and Vascular Neurology
Guilherme J Agnoletto, Pedro Aguilar-Salinas, Roberta Santos, Eric Sauvageau, Ricardo A Hanel
No abstract text is available yet for this article.
September 2018: Stroke and Vascular Neurology
Ning Ma, Yong Zhang, Jie Shuai, Changchun Jiang, Qiyi Zhu, Kangning Chen, Li Liu, Baomin Li, Xiangqun Shi, Lianbo Gao, Yajie Liu, Feng Wang, Yongli Li, Tieyan Liu, Hongbo Zheng, Dapeng Mo, Feng Gao, Yilong Wang, Yongjun Wang, Lei Feng, Zhongrong Miao
Background and purpose: A multicentre prospective registry study of individually tailored stenting for a patient with symptomatic intracranial atherosclerotic stenosis (ICAS) combined with poor collaterals in China showed that the short-term safety and efficacy of stenting was acceptable. However, it remained uncertain whether the low event rate could be of a long term. We reported the 1-year outcome of this registry study to evaluate the long-term efficacy of individually tailored stenting for patients with severe symptomatic ICAS combined with poor collaterals...
September 2018: Stroke and Vascular Neurology
Bowen Jiang, Matthew T Bender, Erick M Westbroek, Jessica K Campos, Li-Mei Lin, Risheng Xu, Rafael J Tamargo, Judy Huang, Geoffrey P Colby, Alexander L Coon
Background: Acute in situ thrombosis is an ischaemic phenomenon during Pipeline embolisation device (PED) procedures with potentially high morbidity and mortality. There is controversy regarding the role of platelet function testing with P2Y12 assay as a predictor of intraprocedural thromboembolic events. There is limited knowledge on whether procedural complexity influences these events. Methods: Data were collected retrospectively on 742 consecutive PED cases at a single institution...
September 2018: Stroke and Vascular Neurology
Jason J Sico, Laura J Myers, Brenda J Fenton, John Concato, Linda S Williams, Dawn M Bravata
Objective: Anaemia is associated with higher mortality among patients with non-stroke cardiovascular conditions; less is known regarding the relationship between anaemia and mortality among patients with acute ischaemic stroke. Methods: Medical records were abstracted for n=3965 veterans from 131 Veterans Health Administration facilities who were admitted with ischaemic stroke in fiscal year 2007. Haematocrit values within 24 hours of admission were classified as ≤27%, 28%-32%, 33%-37%, 38%-42%, 43%-47% or ≥48%...
September 2018: Stroke and Vascular Neurology
Koteswara Rao Nalamolu, Bharath Chelluboina, Ian B Magruder, Diane N Fru, Adithya Mohandass, Ishwarya Venkatesh, Jeffrey D Klopfenstein, David M Pinson, Krishna M Boini, Krishna Kumar Veeravalli
Background and purpose: Recent reports from our laboratory demonstrated the post-ischaemic expression profile of various matrix metalloproteinases (MMPs) in rats and the detrimental role of MMP-12 in post-stroke brain damage. We hypothesise that the post-stroke dysregulation of MMPs is similar across species and that genetic deletion of MMP-12 would not affect the post-stroke expression of other MMPs. We tested our hypothesis by determining the pre-ischaemic and post-ischaemic expression profile of MMPs in wild-type and MMP-12 knockout mice...
September 2018: Stroke and Vascular Neurology
Mahmud Saedon, Athanasios Saratzis, Rachel W S Lee, Charles E Hutchinson, Christopher H E Imray, Donald R J Singer
Background: Cerebral microemboli may lead to ischaemic neurological complications after carotid endarterectomy (CEA). The association between classical cardiovascular risk factors and acute cerebral microemboli following carotid surgery has not been studied. The aim of this study was to explore whether an established cardiovascular risk score (Pocock score) predicts the presence of cerebral microemboli acutely after CEA. Subjects and methods: Pocock scores were assessed for the 670 patients from the Carotid Surgery Registry (age 71±1 (SEM) years, 474 (71%) male, 652 (97%) Caucasian) managed from January 2002 to December 2012 in the Regional Vascular Centre at University Hospitals Coventry and Warwickshire NHS Trust, which serves a population of 950 000...
September 2018: Stroke and Vascular Neurology
Wengui Yu, Wei-Jian Jiang
Intracranial stenosis is a common cause of ischaemic strokes, in particular, in the Asian, African and Hispanic populations. The randomised multicentre study Stenting and Aggressive Medical Management for the Prevention of Recurrent stroke in Intracranial Stenosis (SAMMPRIS) showed 14.7% risk of stroke or death in the stenting group versus 5.8% in the medical group at 30 days, and 23% in the stenting group versus 15% in the medical group at a median follow-up of 32.4 months. The results demonstrated superiority of medical management over stenting and have almost put the intracranial stenting to rest in recent years...
September 2018: Stroke and Vascular Neurology
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