Intracerebral Hemorrhage and Ischemic Stroke of Different Etiologies Have Distinct Alternatively Spliced mRNA Profiles in the Blood: a Pilot RNA-seq Study

Understanding cell-specific transcriptome responses following intracerebral hemorrhage (ICH) and ischemic stroke (IS) will improve knowledge of the immune response to brain injury. Transcriptomic profiles of 141 samples from 48 subjects with ICH, different IS etiologies, and vascular risk factor controls were characterized using RNA-seq in isolated neutrophils, monocytes and whole blood. In both IS and ICH, monocyte genes were down-regulated, whereas neutrophil gene expression changes were generally up-regulated. The monocyte down-regulated response to ICH included innate, adaptive immune, dendritic, NK cell and atherosclerosis signaling. Neutrophil responses to ICH included tRNA charging, mitochondrial dysfunction, and ER stress pathways. Common monocyte and neutrophil responses to ICH included interferon signaling, neuroinflammation, death receptor signaling, and NFAT pathways. Suppressed monocyte responses to IS included interferon and dendritic cell maturation signaling, phagosome formation, and IL-15 signaling. Activated neutrophil responses to IS included oxidative phosphorylation, mTOR, BMP, growth factor signaling, and calpain proteases-mediated blood–brain barrier (BBB) dysfunction. Common monocyte and neutrophil responses to IS included JAK1, JAK3, STAT3, and thrombopoietin signaling. Cell-type and cause-specific approaches will assist the search for future IS and ICH biomarkers and treatments.

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Symptomatic Intracerebral Hemorrhage Among Eligible Warfarin-Treated Patients Receiving Intravenous Tissue Plasminogen Activator for Acute Ischemic Stroke

Yearbook of Neurology and Neurosurgery ◽

10.1016/j.yneu.2011.03.014 ◽

2011 ◽

Vol 2011 ◽

pp. 10-11

Author(s):

A.A. Rabinstein

Keyword(s):

Ischemic Stroke ◽

Intracerebral Hemorrhage ◽

Acute Ischemic Stroke ◽

Plasminogen Activator ◽

Tissue Plasminogen Activator ◽

Intravenous Tissue Plasminogen Activator ◽

Symptomatic Intracerebral Hemorrhage ◽

Tissue Plasminogen

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SERUM GLIAL FIBRILLARY ACIDIC PROTEIN IN THE DIFFERENTIAL DIAGNOSIS OF INTRACEREBRAL HEMORRHAGE AND ACUTE ISCHEMIC STROKE: A SYSTEMATIC REVIEW AND DIAGNOSTIC TEST ACCURACY META-ANALYSIS

10.26226/morressier.58e389add462b802923855f8 ◽

2017 ◽

Author(s):

Aristeidis Katsanos

Keyword(s):

Systematic Review ◽

Differential Diagnosis ◽

Ischemic Stroke ◽

Glial Fibrillary Acidic Protein ◽

Intracerebral Hemorrhage ◽

Acute Ischemic Stroke ◽

Diagnostic Test ◽

Meta Analysis ◽

Diagnostic Test Accuracy ◽

Test Accuracy

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Risk Factors for Early Death in Acute Ischemic Stroke and Intracerebral Hemorrhage

Stroke ◽

10.1161/01.str.30.11.2326 ◽

1999 ◽

Vol 30 (11) ◽

pp. 2326-2330 ◽

Cited By ~ 49

Author(s):

K. S. Wong

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Intracerebral Hemorrhage ◽

Acute Ischemic Stroke ◽

Early Death

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Factor V Leiden Mutation in Cerebrovascular Disease

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/107602960501100314 ◽

2005 ◽

Vol 11 (3) ◽

pp. 339-342 ◽

Cited By ~ 4

Author(s):

Nur Buyru ◽

Julide Altinisik ◽

Goksel Somay ◽

Turgut Ulutin

Keyword(s):

Ischemic Stroke ◽

Intracerebral Hemorrhage ◽

Cerebrovascular Disease ◽

Smoking Status ◽

Factor V Leiden ◽

Restriction Enzyme Digestion ◽

Factor V ◽

Mutation Site ◽

Factor V Leiden Mutation ◽

High Prevalence

Several studies indicate a high prevalence of factor V Leiden mutation as the most frequent coagulation defect found in patients with venous thrombosis. The relationship between this mutation and cerebrovascular disease has not been established in adults. In this investigation, we studied 29 patients with ischemic stroke and 20 with intracerebral hemorrhage, all of whom were compared with 20 controls. A region of the factor V gene containing the Leiden mutation site was amplified with polymerase chain reaction and the presence of mutation was determined with restriction enzyme digestion. We found no evidence of an association between factor V Leiden mutation and ischemic stroke or intracerebral hemorrhage. There was no evidence of association in subgroup the analysis by age, smoking status, myocardial infarction, hypertension, diabetes mellitus, or coronary disease. Factor V Leiden mutation doesn’t seem to be associated with a risk of cerebrovascular disease.

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Predicting the Risk of Symptomatic Intracerebral Hemorrhage in Ischemic Stroke Treated With Intravenous Alteplase

Stroke ◽

10.1161/strokeaha.111.644815 ◽

2012 ◽

Vol 43 (6) ◽

pp. 1524-1531 ◽

Cited By ~ 172

Author(s):

Michael Mazya ◽

José A. Egido ◽

Gary A. Ford ◽

Kennedy R. Lees ◽

Robert Mikulik ◽

...

Keyword(s):

Ischemic Stroke ◽

Intracerebral Hemorrhage ◽

Symptomatic Intracerebral Hemorrhage ◽

Intravenous Alteplase

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Three-dimensional cultured mesenchymal stem cells enhance repair of ischemic stroke through inhibition of microglia

Stem Cell Research & Therapy ◽

10.1186/s13287-021-02416-4 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Yuejiao Li ◽

Yankai Dong ◽

Ye Ran ◽

Yanan Zhang ◽

Boyao Wu ◽

...

Keyword(s):

Stem Cells ◽

Mesenchymal Stem Cells ◽

Ischemic Stroke ◽

Proinflammatory Cytokines ◽

Infarct Volume ◽

Brain Lesion ◽

Three Dimensional ◽

Artery Occlusion ◽

Rna Seq ◽

The Brain

Abstract Background We show previously that three-dimensional (3D) spheroid cultured mesenchymal stem cells (MSCs) exhibit reduced cell size thus devoid of lung entrapment following intravenous (IV) infusion. In this study, we determined the therapeutic effect of 3D-cultured MSCs on ischemic stroke and investigated the mechanisms involved. Methods Rats underwent middle cerebral artery occlusion (MCAO) and reperfusion. 1 × 106 of 3D- or 2D-cultured MSCs, which were pre-labeled with GFP, were injected through the tail vain three and seven days after MCAO. Two days after infusion, MSC engraftment into the ischemic brain tissues was assessed by histological analysis for GFP-expressing cells, and infarct volume was determined by MRI. Microglia in the lesion were sorted and subjected to gene expressional analysis by RNA-seq. Results We found that infusion of 3D-cultured MSCs significantly reduced the infarct volume of the brain with increased engraftment of the cells into the ischemic tissue, compared to 2D-cultured MSCs. Accordingly, in the brain lesion of 3D MSC-treated animals, there were significantly reduced numbers of amoeboid microglia and decreased levels of proinflammatory cytokines, indicating attenuated activation of the microglia. RNA-seq of microglia derived from the lesions suggested that 3D-cultured MSCs decreased the response of microglia to the ischemic insult. Interestingly, we observed a decreased expression of mincle, a damage-associated molecular patterns (DAMPs) receptor, which induces the production of proinflammatory cytokines, suggestive of a potential mechanism in 3D MSC-mediated enhanced repair to ischemic stroke. Conclusions Our data indicate that 3D-cultured MSCs exhibit enhanced repair to ischemic stroke, probably through a suppression to ischemia-induced microglial activation.

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Acute intracranial stenting with mechanical thrombectomy is safe and efficacious in patients diagnosed with underlying intracranial atherosclerotic disease

Interventional Neuroradiology ◽

10.1177/15910199211039403 ◽

2021 ◽

pp. 159101992110394

Author(s):

Ameer E Hassan ◽

Victor M Ringheanu ◽

Laurie Preston ◽

Wondwossen G Tekle ◽

Adnan I Qureshi

Keyword(s):

Ischemic Stroke ◽

Length Of Stay ◽

Intracerebral Hemorrhage ◽

Cerebral Infarction ◽

Acute Ischemic Stroke ◽

Mechanical Thrombectomy ◽

Modified Rankin Scale ◽

Stroke Patients ◽

Intracranial Stenting ◽

Intracranial Atherosclerotic Disease

Objective To investigate whether significant differences exist in recanalization rates and primary outcomes between patients who undergo mechanical thrombectomy alone versus those who undergo mechanical thrombectomy with acute intracranial stenting. Methods Through the utilization of a prospectively collected endovascular database at a comprehensive stroke center between 2012 and 2020, variables such as demographics, co-morbid conditions, symptomatic intracerebral hemorrhage, mortality rate at discharge, and good/poor outcomes in regard to modified thrombolysis in cerebral infarction score and modified Rankin Scale were examined. The outcomes between patients receiving acute intracranial stenting + mechanical thrombectomy and patients that underwent mechanical thrombectomy alone were compared. Results There were a total of 420 acute ischemic stroke patients who met criteria for the study (average age 70.6 ± 13.01 years; 46.9% were women). Analysis of 46 patients from the acute stenting + mechanical thrombectomy group (average age 70.34 ± 13.75 years; 37.0% were women), and 374 patients from the mechanical thrombectomy alone group (average age 70.64 ± 12.92 years; 48.1% were women). Four patients (8.7%) in the acute stenting + mechanical thrombectomy group experienced intracerebral hemorrhage versus 45 patients (12.0%) in the mechanical thrombectomy alone group ( p = 0.506); no significant increases were noted in the median length of stay (7 vs 8 days; p = 0.208), rates of modified thrombolysis in cerebral infarction 2B-3 recanalization ( p = 0.758), or good modified Rankin Scale scores ( p = 0.806). Conclusion Acute intracranial stenting in addition to mechanical thrombectomy was not associated with an increase in overall length of stay, intracerebral hemorrhage rates, or any change in discharge modified Rankin Scale. Further research is required to determine whether mechanical thrombectomy and acute intracranial stenting in acute ischemic stroke patients is unsafe.

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Dysphagia screening after intracerebral hemorrhage

International Journal of Stroke ◽

10.1177/1747493017729265 ◽

2017 ◽

Vol 13 (5) ◽

pp. 503-510 ◽

Cited By ~ 1

Author(s):

Raed A Joundi ◽

Rosemary Martino ◽

Gustavo Saposnik ◽

Vasily Giannakeas ◽

Jiming Fang ◽

...

Keyword(s):

Ischemic Stroke ◽

Intracerebral Hemorrhage ◽

Acute Stroke ◽

Clinical Severity ◽

Stroke Severity ◽

Stroke Registry ◽

Patients At Risk ◽

Poor Outcomes ◽

Risk Of Aspiration ◽

To Receive

Background Dysphagia screening is recommended after acute stroke to identify patients at risk of aspiration and implement appropriate care. However, little is known about the frequency and outcomes of patients undergoing dysphagia screening after intracerebral hemorrhage (ICH). Methods We used the Ontario Stroke Registry from 1 April 2010 to 31 March 2013 to identify patients hospitalized with acute stroke and to compare dysphagia screening rates in those with ICH and ischemic stroke. In patients with ICH we assessed predictors of receiving dysphagia screening, predictors of failing screening, and outcomes after failing screening. Results Among 1091 eligible patients with ICH, 354 (32.4%) patients did not have documented dysphagia screening. Patients with mild ICH were less likely to receive screening (40.4% of patients were omitted, adjusted odds ratio (aOR) 0.40, 95% confidence interval (CI) 0.26–0.63). Older age, greater stroke severity, speech deficits, lower initial level of consciousness, and admission to intensive care unit were predictive of failing the screening test. Failing screening was associated with poor outcomes, including pneumonia (aOR 5.3, 95% CI 2.36–11.88), severe disability (aOR 4.78, 95% CI 3.08–7.41), and 1-year mortality (adjusted hazard ratio 2.1, 95% CI 1.38–3.17). When compared to patients with ischemic stroke, patients with ICH were less likely to receive dysphagia screening (aOR 0.64, 95% CI 0.54–0.76) and more likely to fail screening (aOR 1.98, 95% 1.62–2.42). Conclusion One-third of patients with ICH did not have documented dysphagia screening, increasing to 40% in patients with mild clinical severity. Failing screening was associated with poor outcomes. Patients with ICH were less like to receive screening and twice as likely to fail compared to patients with ischemic stroke, and thus efforts should be made to include ICH patients in dysphagia screening protocols whenever possible.

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