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Neurology stroke

Wookjin Yang, Dong Wan Kang, Hyung Seok Gook, Sueyoung Ha, Seung Hoon Lee
BACKGROUND AND PURPOSE: The recent successes of the DAWN and DEFUSE 3 trials have extended the therapeutic time window for endovascular treatment (EVT). Accordingly, an increased care burden and clinical benefit for patients with acute stroke in the emergency room are expected. It is necessary to evaluate and respond to these changes in order to provide the best care to patients. METHODS: Data of patients with acute stroke or transient ischemic attack treated at Seoul National University Hospital between October 2010 and September 2016 were reviewed...
March 11, 2019: Journal of Clinical Neurology
Jeffrey R Hebert, Prem S Subramanian
PURPOSE OF REVIEW: Disorders of posture and balance cause significant patient morbidity, with reduction of quality of life as patients refrain from critical activities of daily living such as walking outside the home and driving. This review describes recent efforts to characterize visual disorders that interact with the neural integrators of positional maintenance and emerging therapies for these disorders. RECENT FINDINGS: Abnormalities of gait and body position sense may be unrecognized by patients but are correlated with focal neurological injury (stroke)...
March 16, 2019: Current Neurology and Neuroscience Reports
Kelly N Messingham, Adam D Miller, Nandakumar S Narayanan, Samuel J Connell, Janet A Fairley
Bullous pemphigoid (BP) is an autoantibody-mediated blistering disease that is often associated with neurologic disease. BP antibodies target two epidermal adhesion molecules, known as BP180 and BP230. Homologues to these proteins are found in the brain, and it is hypothesized that neurologic disease leads to the production of autoantibodies that can cross react with their cutaneous forms. To better understand the link between BP and neurologic disease, we evaluated primary demographic features (age, sex, race, ethnicity and elapsed time between onset of skin symptoms and BP diagnosis), severity of BP, and IgG and IgE autoantibody levels in BP controls and BP patients with preceding Parkinson's disease (PD), dementia (DEM), and stroke (STR)...
March 12, 2019: Journal of Investigative Dermatology
J F Alingh, V Weerdesteyn, B Nienhuis, E H F van Asseldonk, A C H Geurts, B E Groen
BACKGROUND: Recovery of walking is a primary rehabilitation goal of most stroke survivors. Control of pelvic movements is one of the essential determinants of gait, yet surprisingly, conventional robot-assisted gait trainers constrain pelvic movements. Novel robot-assisted gait trainers, such as LOPES II, are able to support pelvic movements during gait. The aim of this cross-over study was to investigate the immediate after-effects of pelvic support (PS) or pelvic constraint (PC) gait training with LOPES II on overground walking in healthy subjects...
March 15, 2019: Journal of Neuroengineering and Rehabilitation
Zhizhi Zuo, Xiang Ji
BACKGROUND: Recently, copeptin has been identified as a plasma prognosis marker in acute ischemic stroke and intracerebral hemorrhage (ICH). This study investigated the prognostic value of copeptin in the patients with aneurysmal subarachnoid hemorrhage(aSAH). METHODS: In this retrospective study, 243 consecutive patients were included. Upon admission, plasma copeptin levels were measured by enzyme-linked immunosorbent assay. The end points were mortality and poor functional outcome (Glasgow Outcome Scale score of 1-3) after 3 months...
March 8, 2019: Journal of Neuroimmunology
B Winter, M Wendt, C Waldschmidt, M Rozanski, A Kunz, F Geisler, U Grittner, S Kaczmarek, M Ebinger, H J Audebert
BACKGROUND: Time to reperfusion treatment is closely related to outcome in ischemic stroke. Prehospital stroke work-up in CT-equipped mobile stroke units is effective in reducing time to thrombolytic treatment. Current evidence predominantly comes from mobile stroke units staffed with neurologists but telemedicine-guided management may be acceptable for providing neurological expertise in ambulances. With unsatisfactory experiences in third-generation (3G)-based approaches, fourth-generation (4G) networks may provide adequate audio-visual quality but systematic comparisons of technological parameters and decision-making are lacking...
March 15, 2019: International Journal of Stroke: Official Journal of the International Stroke Society
Hoang-Anh Tran, Jessica B O'Connell, Urie K Lee, John C Polanco, Tina I Chang, Arthur H Friedlander
OBJECTIVE: Males with peripheral arterial disease (PAD) are at high risk of ischaemic stroke given that atherogenic risk factors for both diseases are similar. We hypothesized that neurologically asymptomatic males diagnosed with PAD would demonstrate calcified carotid artery plaques (CCAP) on panoramic images (PI) significantly more often than similarly aged males not having PAD. METHODS: Investigators implemented a retrospective cross-sectional study. Subjects were male patients over age 50 diagnosed with PAD by ankle-brachial systolic pressure index results of <mml:math xmlns:mml="http://www...
March 15, 2019: Dento Maxillo Facial Radiology
Chikashi Aoki, Ikuo Fukuda, Ken-Ichi Watanabe, Yoshiaki Saito, Anan Nomura, Satoshi Taniguchi
The patient was a 64-year-old man who had aortic regurgitation, ischemic heart disease, a transverse aortic aneurysm, and an abdominal-common iliac aneurysm. Concomitant operations including aortic valve replacement, coronary artery bypass grafting, and total aortic arch replacement with elephant trunk technique were performed successfully. The patient developed postoperative cardiac tamponade on the 5th postoperative day, resulting in bulbar palsy due to occlusion of the dominant left vertebral artery. Thrombectomy of the vertebral artery with reconstruction by a saphenous vein was performed...
March 14, 2019: General Thoracic and Cardiovascular Surgery
Heather Y F Yong, Khalil S Rawji, Samira Ghorbani, Mengzhou Xue, V Wee Yong
Inflammation of the nervous system (neuroinflammation) is now recognized as a hallmark of virtually all neurological disorders. In neuroinflammatory conditions such as multiple sclerosis, there is prominent infiltration and a long-lasting representation of various leukocyte subsets in the central nervous system (CNS) parenchyma. Even in classic neurodegenerative disorders, where such immense inflammatory infiltrates are absent, there is still evidence of activated CNS-intrinsic microglia. The consequences of excessive and uncontrolled neuroinflammation are injury and death to neural elements, which manifest as a heterogeneous set of neurological symptoms...
March 15, 2019: Cellular & Molecular Immunology
Domenico Chirchiglia, Pasquale Chirchiglia, Rosa Marotta
This retrospective review focuses on some illustrious personalities of history, who have suffered from neurological illnesses. Neurological diseases represent about 10% of all illnesses, and therefore do not spare anyone, much less, famous people. In this review, we discuss the neurological disorders that have struck some celebrities throughout history. We briefly examine the lives of emperors, writers, poets, and musicians that have suffered from neurological diseases such as epilepsy, stroke, tumors, and other illnesses, and which caused death or disability...
March 15, 2019: Neuroscientist: a Review Journal Bringing Neurobiology, Neurology and Psychiatry
Marta Wallocha, René Chapot, Hannes Nordmeyer, Jens Fiehler, Ralph Weber, Christian Paul Stracke
Background and Purpose: A tandem occlusion of the intracranial circulation and the extracranial carotid artery (ICA) occurs in 10-20% of all strokes based on large vessel occlusion (LVO). The optimal treatment strategy for those patients is unknown. We report our management strategy and the outcome in these patients in a large single-center cohort. Materials and Methods: We retrospectively identified and analyzed all patients treated by Mechanical Thrombectomy (MT) for an intracranial LVO associated with an occlusion of the extracranial ICA between April 2009 and May 2016 (163/1,645, 9...
2019: Frontiers in Neurology
Kelly Q Zhou, Colin R Green, Laura Bennet, Alistair J Gunn, Joanne O Davidson
Perinatal brain injury remains a major cause of death and life-long disability. Perinatal brain injury is typically associated with hypoxia-ischemia and/or infection/inflammation. Both hypoxia-ischemia and infection trigger an inflammatory response in the brain. The inflammatory response can contribute to brain cell loss and chronic neuroinflammation leading to neurological impairments. It is now well-established that brain injury evolves over time, and shows a striking spread from injured to previously uninjured regions of the brain...
2019: Frontiers in Physiology
Kuven K Moodley, Valerie Jones, Mahinda Yogarajah, Bhavini Patel, Umesh Vivekananda, Pablo Garcia-Reitboeck, Kiran Samra, Gillian Cluckie, Oliver Foster, Anthony C Pereira, Niranjanan Nirmalananthan
St George's Hospital hyperacute neurology service (HANS) is a comprehensive, consultant-delivered service set in a teaching hospital regional neuroscience centre. The service addresses deficiencies in acute neurological care previously highlighted by the Royal College of Physicians and the Association of British Neurologists. HANS adopts a disease-agnostic approach to acute neurology, prioritising the emergency department (ED) management of both stroke and stroke mimics alike alongside proactive daily support to the acute medical unit and acute medical take...
March 2019: Clinical Medicine: Journal of the Royal College of Physicians of London
Kelly M DeMars, Changjun Yang, Eduardo Candelario-Jalil
Neuroinflammation after stroke significantly contributes to neuronal cell death. Bromodomain and Extra Terminal Domain (BET) proteins are essential to inflammatory gene transcription. BET proteins (BRD2, BRD3, BRD4, and BRDT) have varied effects including chromatin remodeling, histone acetyltransferase activity, and as scaffolds to recruit transcription factors; they couple chromatin remodeling with transcription. BRD2/4 are of particularly interest to stroke-induced neuroinflammation that contributes to delayed cell death as they are required for NF-κB-dependent gene transcription...
March 11, 2019: Neurochemistry International
Liying Xing, Shuang Liu, Yuanmeng Tian, Han Yan, Li Jing, Kangjing Chen, Fei Yan, Yingqiu Li, Jianfeng Lv, Yingxian Sun
BACKGROUND: Limited data are available on the impact of fasting plasma glucose (FPG) on outcomes in nondiabetic acute ischemic stroke patients. METHODS: The prospective, multi-center, and observational study was performed at 8 hospitals in the Liaoning Province between 2015-2016, sought to elucidate the relationship between FPG and the 6-month functional outcomes in nondiabetic acute ischemic stroke patients. The primary effect measure was the adjusted odds ratio for a shift in the direction of unfavorable outcome on the modified Rankin Scale (mRS) score at 6 months, estimated with an ordinal logistic regression, and adjusted for common prognostic factors...
March 11, 2019: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Shu Yang, Hong Jin, Zhi-Gang Zhao
Tight junctions (TJs) serve an important role in maintaining the integrity of the blood-brain barrier (BBB), while neurological disorders, including ischemic stroke, induce TJ disruption and increase BBB permeability; results include edema formation and hemorrhage transformation. Cerebral endothelium protection presents a promising approach in ischemic stroke therapy. In the current study, protective effects of the epidermal growth factor (EGF) on ischemia-induced disruption of BBB integrity were examined using an oxygen-glucose deprivation (OGD) model in bEnd3 cells...
March 2019: Experimental and Therapeutic Medicine
Martin Roesner, Joachim Beyer, Christoph Peter Dohm, Matthias Elsner, Martin Groß, Alfons Meyer, Thomas Mokrusch, Hans-Peter Neunzig, Randall Thomas, Christian Winkler, Jens D Rollnik
INTRODUCTION: We analyzed the delivery of healthcare services among patients in neurological and neurosurgical early rehabilitation programmes in the German states of Lower Saxony and Bremen. METHODS: Patients´applications and admissions for neurological and neurosurgical early rehabilitation in Lower Saxony and Bremen were recorded during a period of two weeks both in November 2015 as well as 2016. The proportion of patients admitted to early rehabilitation within a six-week-period after disease onset was calculated...
March 13, 2019: Fortschritte der Neurologie-Psychiatrie
Ali Shamsara, Vahid Sheibani, Majid Asadi-Shekaari, Seyed Noureddin Nematollahi-Mahani
Introduction Transient cerebral ischemia is a pandemic neurological disorder and the main aim of medical intervention is to reduce complications. Human umbilical cord mesenchymal cells (hUCMs) are capable of differentiating into neural-like cells (NLC) in vitro, therefore we investigated the neuroprotective potential of these cells in comparison to aspirin and in combination (NLC-Aspirin) on spatial memory and neural morphologic changes in male rats submitted to transient cerebral ischemia. Methods Ten days after the intervention, the improvement in learning and memory were assessed in the animals by Morris Water Maze...
December 26, 2018: Biomolecular Concepts
Zi-Xian Chen, Qing-Qing Xu, Chun-Shuo Shan, Yi-Hua Shi, Yong Wang, Raymond Chuen-Chung Chang, Guo-Qing Zheng
Borneol, a natural product in the Asteraceae family, is widely used as an upper ushering drug for various brain diseases in many Chinese herbal formulae. The blood-brain barrier (BBB) plays an essential role in maintaining a stable homeostatic environment, while BBB destruction and the increasing BBB permeability are common pathological processes in many serious central nervous system (CNS) diseases, which is especially an essential pathological basis of cerebral ischemic injury. Here, we aimed to conduct a systematic review to assess preclinical evidence of borneol for experimental ischemic stroke as well as investigate in the possible neuroprotective mechanisms, which mainly focused on regulating the permeability of BBB...
2019: Oxidative Medicine and Cellular Longevity
Yanan Wang, Xuming Mao, Di Wang, Christoph M Hammers, Aimee S Payne, Yiman Wang, Hongzhong Jin, Bin Peng, Li Li
Objective: Current evidence has revealed a significant association between bullous pemphigoid (BP) and neurological diseases (ND), including stroke, but the incidence of BP autoantibodies in patients with stroke has not previously been investigated. Our study aimed to assess BP antigen-specific antibodies in stroke patients. Design: One hundred patients with stroke and 100 matched healthy controls were randomly selected for measurement of anti-BP180/BP230 IgG autoantibodies by enzyme-linked immunosorbent assay (ELISA), salt-split indirect immunofluorescence (IIF), and immunoblotting against human cutaneous BP180 and BP180-NC16A...
2019: Frontiers in Immunology
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