Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · May 2017
Case ReportsComputed Tomography Perfusion-Based Decision Making for Acute Ischemic Stroke-Missing the Mismatch.
The emerging use of mechanical thrombectomy for acute ischemic stroke treatment focuses on the importance of patient selection. Computed tomography perfusion (CTP) is one of widely used techniques. However, the accuracy and reliability of this modality is in debate among vascular neurologists. ⋯ In our opinion, this case emphasizes why CTP should not be used for patient exclusion among patients in the early time frame for intervention. Such patients should be evaluated by MRI or by clinical-radiological mismatch only. CTP may have a role in selecting patients for endovascular intervention in borderline circumstances such as prolonged time window, wake-up stroke, etc.
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J Stroke Cerebrovasc Dis · May 2017
Review Meta AnalysisAssociation between the Matrix Metalloproteinase-9 rs3918242 Polymorphism and Ischemic Stroke Susceptibility: A Meta-Analysis.
In recent years, dozens of case-control studies showed that matrix metalloproteinase (MMP)-9 rs3918242 variants were associated with ischemic stroke (IS) susceptibility. However, the conclusions of case-control studies that evaluated the relationship between MMP-9 rs3918242 variants and the risk of IS were still equivocal. Herein, we conducted a comprehensive meta-analysis to investigate the association between MMP-9 rs3918242 variants and the risk of IS. ⋯ Therefore, our meta-analysis suggested that MMP-9 rs3918242 variants (T allele, TT and CT genotypes) contributed to significantly increase the risk of IS in the Chinese population.
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J Stroke Cerebrovasc Dis · May 2017
Cerebral Salt Wasting Is the Most Common Cause of Hyponatremia in Stroke.
The study aimed to evaluate the frequency, severity, and causes of hyponatremia in stroke and its influence on outcome. ⋯ Hyponatremia occurred in 43% of stroke patients. CSW was the most common cause of hyponatremia. Hyponatremia, however, was not related to death or disability.
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J Stroke Cerebrovasc Dis · May 2017
Case ReportsTacrolimus-Induced Reversible Cerebral Vasoconstriction Syndrome with Delayed Multi-Segmental Vasoconstriction.
Reversible cerebral vasoconstriction syndrome (RCVS) is a cerebrovascular syndrome characterized by multi-segmental constrictions of the cerebral arteries that resolves spontaneously within 3 months. Although RCVS is considered to be due to transient dysregulation of vascular tone, the exact pathomechanism remains unclear. ⋯ Although her neurological conditions rapidly improved after discontinuing tacrolimus, a repeat magnetic resonance angiogram demonstrated delayed progression of the multi-segmental vasoconstrictions followed by subsequent resolution. Our case demonstrates that cautious observation of the cerebral arteries using magnetic resonance angiography and careful management of vasoconstrictions with vasodilators are necessary for delayed vasoconstrictions even when the clinical symptoms improve.