A Simple Geometric Assessment of Perfusion Lesion Volume at Hyperacute Stage of Ischemic Stroke in Patients with Symptomatic Steno-Occlusion of Major Cerebral Arteries and Risk of Subsequent Cerebral Ischemic Events

2015 ◽  
Vol 24 (12) ◽  
pp. 2669-2675
Author(s):  
Jihoon Kang ◽  
Cheolkyu Jung ◽  
Nayoung Kim ◽  
Yoo Ri Son ◽  
Byungse Choi ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cerebral Arteries ◽  
Lesion Volume ◽  
Cerebral Ischemic ◽  
Ischemic Events

Symptomatic Steno-occlusion of Cerebral Arteries and Subsequent Ischemic Events in Patients with Acute Ischemic Stroke

2014 ◽  
Vol 23 (5) ◽  
pp. e347-e353 ◽  
Author(s):  
Jihoon Kang ◽  
Nayoung Kim ◽  
Chang W. Oh ◽  
O-Ki Kwon ◽  
Chol K. Jung ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Cerebral Arteries ◽  
Ischemic Events

Abstract T P64: Cerebral Ischemic Events Associated with Intravenous Thrombolytic Administration in International Joint Efficacy Comparison of Thrombolytics (INJECT) Trial.

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Nudrat Tasneem ◽  
Malik M Adil ◽  
M Fareed K Suri ◽  
Adnan I Qureshi
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Ischemic Stroke ◽  
Double Blind ◽  
Intravenous Heparin ◽  
Acute Mi ◽  
Cardiac Shock ◽  
Cerebral Ischemic ◽  
Post Hoc ◽  
Ischemic Events

Background: Platelet activation can be seen subsequent to thrombolytic administration leading to re-occlusion within coronary arteries. However, the occurrence of cerebral ischemic events secondary to thrombolytic administration is not well studied. Objective: To study the rate and outcome of patients with acute myocardial infarction [MI] who develop cerebral ischemic events within 48 hours of thrombolytic administration. Methods: A post-hoc analysis of the INJECT trial data was performed. Patients from 208 centers in nine countries (n = 6010) with acute myocardial infarction (<12 hr after symptom onset) were randomized to receive double-blind either streptokinase 1.5 MU intravenously over 60 min or reteplase two boluses of 10 MU given 30 min apart. All patients received intravenous heparin for at least 24 h. Ascertainment of ischemic stroke during hospitalization was performed throughout the study. Results: A total of 81 in-hospital strokes were observed in 6010 acute MI patients of which 47 were classified as ischemic events. A total of 29 (62%) suffered ischemic events within 48 hours of thrombolytic administration; 23 were ischemic stroke and 06 were transient ischemic attacks. The mean age (±SD) of the 29 patients was 70± (10) ; 20 were men. None of the patients had pre-existing or new onset atrial fibrillation. Underlying cardiac shock and heart failure was seen in 2 and 5 patients, respectively. IV heparin was continued for 24-72 hours in 11 patients. Survival was 66% (n=19) at 35 days and 55% (n=16) at 6 months. Conclusions: Most cerebral ischemic events occur in the immediate post-thrombolytic period and result in disproportionately low survival over 6 months.

scholarly journals Analysis of Clinical and Demographic Variables in the Treatment of Carotid Stenosis by Endarterectomy and Stent Angioplasty

2018 ◽  
Vol 26 (4) ◽  
pp. 269-273
Author(s):  
André Stavitski Costa De Oliveira ◽  
André Giacomelli Leal ◽  
Murilo Sousa De Meneses ◽  
Emanuel Cassou Dos Santos ◽  
Guilherme Santos Piedade
Keyword(s):  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Carotid Stenosis ◽  
Medical Records ◽  
Demographic Variables ◽  
Stent Angioplasty ◽  
Significant Difference ◽  
Cerebral Ischemic ◽  
Ischemic Events ◽  
Clinical Worsening

Introduction: Carotid stenosis plays a major role in the etiology of cerebral ischemic events. We evaluated the variables that impact the evolution of these patients. Methods: Data were retrospectively checked from the medical records of patients treated in the period between 2008 and 2015. Different variables were evaluated to determine the factors that influence the patients clinically. Results: The analysis was conducted based on a sample of 63 patients with carotid stenosis who underwent surgery. Regarding the factors that influenced the outcome, there was significant association with age ≥70 years, smoking and previous ischemic stroke. Although hypertension was the most prevalent comorbidity, no significant association as clinical worsening factor was found, as well as the isolated analysis of each surgery showed no significant difference. Conclusions: The clinical profile and lifestyle habits associated with certain comorbidities are variables that influence the clinical outcome of patients with carotid stenosis.

scholarly journals Preconditioning by Preceding Ischemic Cerebrovascular Events

2021 ◽  
Author(s):  
Pamela N. Correia ◽  
Ivo A. Meyer ◽  
Ashraf Eskandari ◽  
Michael Amiguet ◽  
Lorenz Hirt ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
University Hospital ◽  
Stroke Severity ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Stroke Registry ◽  
Cerebral Ischemic ◽  
The Impact ◽  
Ischemic Events

Background Emerging yet contrasting evidence from animal and human studies associates ischemic preconditioning with improvement of subsequent stroke severity, although long‐term outcome remains unclear. The purpose of this study was to analyze how preceding cerebral ischemic events influence subsequent stroke severity and outcome. Methods and Results Data for this retrospective cohort study were extracted from ASTRAL (Acute Stroke Registry and Analysis of Lausanne). This registry includes a sample of all consecutive patients with acute ischemic strokes admitted to the stroke unit and/or intensive care unit of the Lausanne University Hospital, Switzerland. We investigated associations between preceding ischemic events (transient ischemic attacks or ischemic strokes) and the impact on subsequent stroke severity and clinical improvement within 24 hours, measured through National Institute of Health Stroke Scale, as well as 3‐month outcome, determined through a shift in the modified Rankin Scale. Of 3530 consecutive patients with ischemic stroke (43% women, median age 73 years), 1001 (28%) had ≥1 preceding cerebral ischemic events (45% transient ischemic attack, 55% ischemic stroke; 31% multiple events). After adjusting for multiple prehospital, clinical, and laboratory confounders, admission stroke severity was significantly lower in patients preconditioned through a preceding ischemic event, but 24‐hour improvement was not significant and 3‐month outcome was unfavorable. Conclusions Preceding ischemic events were independently associated with a significant reduction in subsequent stroke severity but worsened long‐term clinical outcome. These results, if confirmed by future randomized studies, may help design neuroprotective strategies. The unfavorable effect on stroke outcome is probably a consequence of the cumulative disability burden after multiple ischemic events.

Irisin Ameliorates Hypoxia/Reoxygenation-Induced Inflammation and Apoptosis in PC12 Cells by Inhibiting TLR4/MYD88 Signaling Pathway

2019 ◽  
Vol 17 (3) ◽  
pp. 329-336
Author(s):  
Wang Jinli ◽  
Xu Fenfen ◽  
Zheng Yuan ◽  
Cheng Xu ◽  
Zhang Piaopiao ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Signaling Pathway ◽  
Pc12 Cells ◽  
Major Complication ◽  
Lactic Dehydrogenase ◽  
Dependent Manner ◽  
Cerebral Ischemic Stroke ◽  
Cerebral Ischemic ◽  
Myd88 Signaling ◽  
Hypoxia Reoxygenation

Cardiovascular disease including cerebral ischemic stroke is the major complication that increases the morbidity and mortality in patients with diabetes mellitus as much as four times. It has been well established that irisin, with its ability to regulate glucose and lipid homeostasis as well as anti-inflammatory and anti-apoptotic properties, has been widely examined for its therapeutic potentials in managing metabolic disorders. However, the mechanism of irisin in the regulation of cerebral ischemic stroke remains unclear. Using PC12 cells as a model, we have shown that hypoxia/reoxygenation inhibits cell viability and increases lactic dehydrogenase. Irisin, in a dose-dependent manner, reversed these changes. The increase in inflammatory mediators (IL-1β, IL-6, and TNF-α) by hypoxia/reoxygenation was reversed by irisin. Furthermore, the cell apoptosis promoted by hypoxia/reoxygenation was also inhibited by irisin. Irisin suppressed TLR4/MyD88 signaling pathway leading to amelioration of inflammation and apoptosis in PC12 cells. Thus, inhibition of TLR4/MyD88 signaling pathway via irisin could be an important mechanism in the regulation of hypoxia/reoxygenation-induced inflammation and apoptosis in PC12 cells.

Risk Factors of Recurrent Ischemic Events after Acute Noncardiogenic Ischemic Stroke

2020 ◽  
Vol 25 (45) ◽  
pp. 4827-4834 ◽  
Author(s):  
Limin Zhang ◽  
Xingang Li ◽  
Dongzhi Wang ◽  
Hong Lv ◽  
Xuezhong Si ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Ischemic Stroke ◽  
Operating Characteristic ◽  
Control Group ◽  
Case Group ◽  
Stroke Patients ◽  
Clopidogrel Therapy ◽  
Ischemic Events

Background: A considerable proportion of acute noncardiogenic ischemic stroke patients continue to experience recurrent ischemic events after standard therapy. Aim: We aimed to identify risk factors for recurrent ischemic event prediction at an early stage. Methods : 286 non-cardioembolic ischemic stroke patients with the onset of symptoms within 24 hours were enrolled. Vascular risk factors, routine laboratory data on admission, thromboelastography test seven days after clopidogrel therapy and any recurrent events within one year were assessed. Patients were divided into case group (patients with clinical adverse events, including ischemic stokes, transient ischemic attack, myocardial infarction and vascular related mortality) and control group (events-free patients). The risk of the recurrent ischemic events was determined by the receiver operating characteristic curve and multivariable logistic regression analysis. Results: Clinical adverse events were observed in 43 patients (case group). The mean levels of Mean Platelet Volume (MPV), Platelet/Lymphocyte Ratio (PLR), Lymphocyte Count (LY) and Fibrinogen (Fib) on admission were significantly higher in the case group as compared to the control group (P<0.001). Seven days after clopidogrel therapy, the ADP-induced platelet inhibition rate (ADP%) level was lower in the case group, while the Maximum Amplitude (MA) level was higher in the case group as compared to the control group (P<0.01). The Area Under the Curve (AUC) of receiver operating characteristic(ROC) curve of LY, PLR, , Fib, MA, ADP% and MPV were 0.602, 0.614, 0.629, 0.770, 0.800 and 0.808, respectively. The logistic regression analysis showed that MPV, ADP% and MA were indeed predictive factors. Conclusion: MPV, ADP% and MA were risk factors of recurrent ischemic events after acute noncardiogenic ischemic stroke. Urgent assessment and individual drug therapy should be offered to these patients as soon as possible.

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