Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Sep 2017
Case ReportsTemporal and Spatial Changes in Cerebral Blood Flow during Management for Preventing Delayed Cerebral Ischemia after Aneurysmal Subarachnoid Hemorrhage: Serial Semiquantitative Analysis.
Delayed cerebral ischemia is a major cause of morbidity after aneurysmal subarachnoid hemorrhage. The management for preventing the delayed cerebral ischemia is clinically difficult because of its multifactorial nature. We tested the hypothesis that spatial and temporal changes of regional cerebral blood flow after subarachnoid hemorrhage might relate to the incidence of the delayed cerebral ischemia and the clinical outcome. ⋯ Cerebral perfusion may change temporally and spatially during the management for preventing the delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage. Regional hypoperfusion refractory to the management might exist, which could impact on the clinical outcome. An additional therapeutic approach targeting on such regions may be required.
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J Stroke Cerebrovasc Dis · Sep 2017
Observational StudyReal-World Outcomes of Acute Ischemic Stroke Treatment with Intravenous Recombinant Tissue Plasminogen Activator.
In clinical trials, intravenous (IV) recombinant tissue-type plasminogen activator (rt-PA) reduces the likelihood of disability if given within 3 hours of acute ischemic stroke. This study compared real-world outcomes between patients treated and patients not treated with IV rt-PA. ⋯ This real-world study indicated that acute ischemic stroke patients treated with IV rt-PA experience long-term clinical benefits in survival and functional status.
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J Stroke Cerebrovasc Dis · Aug 2017
Observational StudyEfficacy of New Measures Saving Time in Acute Stroke Management: A Quantified Analysis.
Time to treatment remains the most important factor in acute ischemic stroke prognosis. We quantified the effect of new interventions reducing in-hospital delays in acute stroke management and assessed its repercussion on door-to-imaging (DTI), imaging-to-needle (ITN), and door-to-needle (DTN) times. ⋯ Every measure is an important part of a chain focused on saving time in acute stroke: the lowest DTI and ITN times were obtained when all steps were completed. Measures shortening ITN time produced a greater impact on DTN time reduction; therefore, ITN interventions should be considered a critical part of new protocols and guidelines.
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J Stroke Cerebrovasc Dis · Aug 2017
RNF213 p.R4810K Variant and Intracranial Arterial Stenosis or Occlusion in Relatives of Patients with Moyamoya Disease.
This study aimed to determine the effectiveness of genetic testing for the p.R4810K variant (rs112735431) of the Mysterin/RNF213 gene, which is associated with moyamoya disease and other intracranial vascular diseases, in the family members of patients with moyamoya disease. ⋯ Genotyping of the p.R4810K missense variant is useful for identifying individuals with an elevated risk for steno-occlusive intracranial arterial diseases in the family members of patients with moyamoya disease.
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J Stroke Cerebrovasc Dis · Aug 2017
Risk Prediction for Ischemic Stroke and Transient Ischemic Attack in Patients Without Atrial Fibrillation: A Retrospective Cohort Study.
Stroke mainly occurs in patients without atrial fibrillation (AF). This study explored risk prediction models for ischemic stroke and transient ischemic attack (TIA) in patients without AF. ⋯ Although the existing schemes for predicting ischemic stroke and TIA in patients with AF can be applied to patients without AF with comparable predictive accuracy, the evidence suggests that there is room for improvement in these models' performance.