Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Jul 2015
Case ReportsLocal Vasogenic Edema without Cerebral Hyperperfusion after Direct Revascularization Surgery for Moyamoya Disease.
Superficial temporal artery-middle cerebral artery anastomosis is generally used as the standard surgical treatment for moyamoya disease to prevent cerebral ischemic attacks. Although the main potential complications associated with this treatment are cerebral hyperperfusion and ischemia, the adverse impacts of revascularization surgery remain unclear. Of the 142 consecutive surgeries for moyamoya disease at our hospital from 2008, we herein presented 2 cases of adult-onset moyamoya disease that manifested local vasogenic edema at the site of anastomosis without cerebral hyperperfusion; 1 in a 31-year-old woman presented with transient ischemic attack and the other in a 22-year-old man manifested as minor completed stroke. ⋯ They did not have any further cerebrovascular events during the follow-up period. Regional vasogenic edema without cerebral hyperperfusion, possibly due to cerebral ischemia/reperfusion injury, may be another novel entity that needs to be considered as a potential complication after extracranial-intracranial bypass for moyamoya disease. Strict postoperative management should be used to avoid hemorrhagic transformation.
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J Stroke Cerebrovasc Dis · Jul 2015
Comparative StudyThe Safety and Efficacy of Triple Antiplatelet Therapy after Intracranial Stent-Assisted Coil Embolization.
Stent-assisted coil embolization is effective for intracranial aneurysms, especially for wide-necked aneurysms; however, the optimal antiplatelet regimens for postoperative ischemic events have not yet been established. We aimed at determining the efficacy and safety of a triple antiplatelet therapy regimen after intracranial stent-assisted coil embolization. ⋯ Triple antiplatelet therapy had a significantly lower incidence of postoperative ischemic events and a similar incidence of postoperative bleeding events 140 days postoperatively.
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J Stroke Cerebrovasc Dis · Jul 2015
Surgical Revascularization in North American Adults with Moyamoya Phenomenon: Long-Term Angiographic Follow-up.
North American and Asian forms of moyamoya have distinct clinical characteristics. Asian adults with moyamoya are known to respond better to direct versus indirect revascularization. It is unclear whether North American adults with moyamoya have a similar long-term angiographic response to direct versus indirect bypass. ⋯ Direct bypass provides a statistically significant, more consistent, and complete cerebral revascularization than indirect techniques in this patient population. This is similar to that reported in the Asian literature, which suggests that the manner of presentation (ischemia in North American adults versus hemorrhage in Asian adults) is likely not a contributor to the extent of revascularization achieved after surgical intervention.
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J Stroke Cerebrovasc Dis · Jul 2015
Blood Pressure Variability and Clinical Outcome in Patients with Acute Intracerebral Hemorrhage.
The aim of this study was to evaluate whether fluctuations of blood pressure (BP) levels occurring in the acute stage of spontaneous intracerebral hemorrhage (ICH) affect the 3-month clinical outcome. ⋯ In patients with acute ICH, BPV was a strong predictor of the 3-month clinical outcome and may represent a still neglected potential therapeutic target.
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J Stroke Cerebrovasc Dis · Jul 2015
Systemic Inflammatory Response Syndrome Predicts Severity of Stroke and Outcome.
This study was undertaken to evaluate the frequency of systemic inflammatory response syndrome (SIRS) at admission and its correlation with clinical and radiological severity of stroke and outcome. ⋯ SIRS at presentation is a useful marker for clinicoradiological severity of stroke but not an independent marker of death and disability.