Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
-
J Stroke Cerebrovasc Dis · Nov 2014
A geographic information system analysis of the impact of a statewide acute stroke emergency medical services routing protocol on community hospital bypass.
Our goal was to determine if a statewide Emergency Medical Services (EMSs) Stroke Triage and Destination Plan (STDP), specifying bypass of hospitals unable to routinely treat stroke patients with thrombolytics (community hospitals), changed bypass frequency of those hospitals. ⋯ Missing symptom duration time and data records in our state's EMS data system, along with conflicting hospital classifications between EMS agencies limit the ability to study statewide stroke routing protocols. Bypass policies may apply to a minority of patients because a community hospital is not the closest hospital to most stroke events. Given these limitations, we found no difference in community hospital bypass rates after implementation of the STDP.
-
J Stroke Cerebrovasc Dis · Oct 2014
Case Reports"Contrast-less" stent-assisted coiling of an A1 aneurysm.
Iodine-based contrast medium used in diagnostic and therapeutic cerebrovascular imaging may cause renal toxicity, especially in patients with underlying renal impairment. Contrast dilution may impede efforts of the neurointerventionalist to treat intracranial vascular pathology. ⋯ Further development of and experience with this technique is needed to improve its safety and efficacy.
-
J Stroke Cerebrovasc Dis · Oct 2014
Carotid plaque characteristics on magnetic resonance plaque imaging following long-term cilostazol therapy.
Cilostazol is an antiplatelet agent that can induce the regression of atherosclerosis. However, its long-term effects on plaque involution of the cervical carotid arteries remain unknown. Thus, we aimed to evaluate the effect of long-term cilostazol administration on carotid plaques using quantitative magnetic resonance (MR) plaque imaging. ⋯ Signal alterations on MR plaque imaging indicated the increase of fibrous components and the decrease of lipid/necrotic components in the carotid plaque during the cilostazol therapy.
-
J Stroke Cerebrovasc Dis · Oct 2014
Association of the ASCO classification with the executive function subscores of the Montreal cognitive assessment in patients with postischemic stroke.
The ASCO classification can evaluate the etiology and mechanisms of ischemic stroke more comprehensively and systematically than conventional stroke classification systems such as Trial of Org 10172 in Acute Stroke Treatment (TOAST). Simultaneously, risk factors for cognitive impairment such as arterial sclerosis, leukoaraiosis, and atrial fibrillation can also be gathered and graded using the ASCO classification. ⋯ These results suggest that the ASCO phenotypic classification of stroke is useful not only for assessing the etiology of ischemic stroke but also for predicting cognitive decline after ischemic stroke.
-
J Stroke Cerebrovasc Dis · Oct 2014
Association of variants in KCNK17 gene with ischemic stroke and cerebral hemorrhage in a Chinese population.
KCNK17 (potassium channel, subfamily K, member17) has a role in the pathogenesis of stroke. We reported previously that rs10947803 single-nucleotide polymorphism (SNP) in KCNK17 is associated with cerebral hemorrhage in a Chinese population. The aim of the present study was to examine other SNPs in the KCNK17 gene that are associated with cerebral hemorrhage and other subtypes of stroke in the Chinese population. ⋯ The T carrier of an SNP (rs12214600) is associated with reduced risk of cerebral hemorrhage in the Chinese population, together with previous findings that SNPs rs10947803 and rs12214600 in the KCNK17 gene are associated with hemorrhagic stroke, but none of the SNPs tested had an association with ischemic stroke. KCNK17 may be important in the pathogenesis of cerebral hemorrhage.