Cerebrovascular diseases
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Cerebrovascular diseases · Jan 2011
Randomized Controlled TrialFrequent early cardiac complications contribute to worse stroke outcome in atrial fibrillation.
Atrial fibrillation (AF) is associated with worse outcomes following ischemic stroke and more frequent cardiac complications in the general population. We aimed to establish whether early cardiac complications contribute to the poorer ischemic stroke outcomes in patients with AF, independent of baseline differences in age, stroke severity and cardiovascular risk factors. This might have important implications for acute stroke management in patients with AF. ⋯ Early SCAE are common after stroke and are independently associated with the presence of AF. Given that many cardiac complications are potentially remediable, these results highlight the need for more rigorous surveillance for cardiac complications in acute ischemic stroke patients with AF.
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Cerebrovascular diseases · Jan 2011
Comparative StudyChanges in cerebral perfusion around the time of delayed cerebral ischemia in subarachnoid hemorrhage patients.
Because the pathogenesis of delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) is unclear, we studied cerebral perfusion at different time points around the occurrence of DCI. ⋯ Our findings suggest that DCI patients already have diffusely worse perfusion (absolute values) than no-DCI patients before focal worsening (increased asymmetry) occurs and becomes symptomatic. The partial recovery in the measured areas suggests that DCI can be partly reversible.
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Cerebrovascular diseases · Jan 2011
Randomized Controlled TrialCilostazol improves outcome after subarachnoid hemorrhage: a preliminary report.
Cerebral vasospasm (VS) is the most common cause of morbidity and mortality after aneurysmal subarachnoid hemorrhage (SAH). Reversal of VS by intra-arterial infusion of cyclic adenosine monophosphate (cAMP)-elevating agents has been reported; however, the preventive role in the development of VS is not fully understood. This study is designed to evaluate the possible efficacy of using cilostazol, a selective inhibitor of phosphodiesterase type 3 and a cAMP-elevating agent, in patients with SAH. ⋯ Cilostazol may improve outcomes after SAH, but further double-blind, placebo-controlled studies are required for a definitive conclusion.
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Cerebrovascular diseases · Jan 2011
Comparative StudyConventional enhancement CT: a valuable tool for evaluating pial collateral flow in acute ischemic stroke.
To establish an easy and rapid method for evaluating pial collateral flow, we compared the Alberta Stroke Program Early CT Score (ASPECTS) on nonenhanced CT (NECT), conventional contrast-enhanced CT (CECT), and CT angiography source images (CTA-SI) in patients with acute ischemic stroke. ⋯ ASPECTS on CECT is a feasible method for predicting pial collateral flow and overall outcomes in acute ischemic stroke.
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Cerebrovascular diseases · Jan 2011
Management of patients with transient ischemic attack is safe in an outpatient clinic based on rapid diagnosis and risk stratification.
Transient ischemic attack (TIA) patients are at high risk of short-term stroke, myocardial infarction and vascular death. Stroke risk is reduced by immediate treatment initialization. Stroke unit treatment is recommended for TIA patients. We established an outpatient TIA clinic to address the question whether outpatient evaluation of suspected TIA is safe. ⋯ Based on risk stratification, outpatient evaluation of TIA is safe. TIA mimics are frequent.