Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Mar 2017
Neutrophil-to-Lymphocyte Ratio Is a Prognostic Marker in Acute Ischemic Stroke.
Neutrophil-to-lymphocyte ratio is an independent predictor of mortality in patients with acute ischemic stroke. However, it is uncertain whether neutrophil-to-lymphocyte ratio is related with functional outcome and recurrent ischemic stroke. In this study, we aimed to investigate the relationship of neutrophil-to-lymphocyte ratio with stroke severity, functional outcome, and recurrent ischemic stroke after acute ischemic stroke. ⋯ Our study suggests that neutrophil-to-lymphocyte ratio is associated with stroke severity on admission, primary unfavorable functional outcome, and recurrent ischemic stroke in patients with acute ischemic stroke.
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J Stroke Cerebrovasc Dis · Mar 2017
Demographic and Systemic Hemodynamic Influences in Mechanisms of Cerebrovascular Regulation in Healthy Adults.
A competent cerebrovascular regulation maintains an adequate cerebral blood flow by 3 major mechanisms: cerebral autoregulation (CA), vasomotor reactivity (VMR), namely to CO2, and neurovascular coupling (NVC). However, most studies generalize their results based on a response to a single parameter. Using a full battery of neurovascular stress tests, our study aims to evaluate the relationships among grades of CA, VMR, and NVC, and how their interplay is influenced by demographic and systemic hemodynamic factors. ⋯ Age and gender do not have major influence on the 3 major cerebrovascular regulation mechanisms. Our results also pinpoint the fact that neurovascular stress tests measure different aspects of cerebrovascular control, and that their outputs are uncorrelated and cannot be used interchangeability. Being independent of age and cognitive status, neurovascular stress tests seem adequate for studying several cerebrovascular conditions affecting the aging brain.
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J Stroke Cerebrovasc Dis · Mar 2017
Experience on Mechanical Thrombectomy for Acute Stroke Treatment in a Brazilian University Hospital.
Brazil is a developing country struggling to reduce its extreme social inequality, which is reflected on shortage of health-care infrastructure, mainly to the low-income class, which depends exclusively on the public health system. In Brazil, less than 1% of stroke patients have access to intravenous thrombolysis in a stroke unit, and constraints to the development of mechanical thrombectomy in the public health system increase the social burden of stroke. ⋯ Our study, the first ever large series of mechanical thrombectomy in Brazil, demonstrates acceptable efficacy and safety results, even under restricted conditions outside the ideal scenario of trial studies.