Clonic Perseveration after Acute Ischemic Stroke: An Insight into the Pathophysiological Mechanisms

2016 ◽  
Vol 25 (8) ◽  
pp. e109-e110 ◽  
Author(s):  
José Luiz Pedroso ◽  
Thiago Cardoso Vale ◽  
Marcos Knobel ◽  
Rodrigo Meirelles Massaud ◽  
Elias Knobel
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Pathophysiological Mechanisms ◽  
Insight Into

Abstract TP32: Endovascular Therapy for Acute Ischemic Stroke Beyond the 6 Hour Window

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Yi Mao ◽  
Sameer Sharma ◽  
Hesham Masoud ◽  
Julius G Latorre
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Endovascular Therapy ◽  
Current Data ◽  
Posterior Circulation ◽  
Published Data ◽  
Advanced Imaging ◽  
Poor Outcomes ◽  
Mr Clean ◽  
Insight Into

Background: Recent randomized trials demonstrated the efficacy of endovascular therapy (EVT) in managing acute ischemic stroke (AIS), though EVT was initiated <6 hours from time last seen well in nearly all patients, and posterior circulation strokes were excluded. Current data is limited for patients receiving EVT >6 hours, and more so for those with posterior circulation strokes. We aim to assess safety and clinical outcome of EVT in patients presenting >6 hours, with anterior or posterior circulation strokes. Methods: We conducted a retrospective review of patients with AIS receiving EVT >6 hours between 2012-2015, including those with unknown time of onset and wake-up strokes. Outcomes observed include mRS at ≥90 days, rates of recanalization (TICI 2b-3), sICH and mortality. Results: A total of 34 patients were identified presenting with AIS and receiving EVT >6 hours, including 25 anterior and 9 posterior circulation strokes. See Table 1 for comparison with published data from recent EVT trials. Conclusion: Our results are not significantly different from some of the recent trials. MR CLEAN, the only trial that did not employ advanced imaging in patient selection, had similar outcomes. The IV-tPA only groups of recent trials (where data is available) also produced comparable results. It should be noted that the patients in our study all have large vessel occlusions and high NIHSS, are mostly ineligible for tPA, and thus would be expected to have very poor outcomes without treatment. Our data supports the possibility of expanding the EVT window to >6 hours, and with advanced imaging screening, better rates of functional outcome/mortality may still be achieved. DAWN and DEFUSE3 trials currently underway should provide further insight into this subject.

Stroke in young cannabis users (18–49 years): National trends in hospitalizations and outcomes

2019 ◽  
Vol 15 (5) ◽  
pp. 535-539
Author(s):  
Rupak Desai ◽  
Sandeep Singh ◽  
Krupa Patel ◽  
Hemant Goyal ◽  
Manan Shah ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Relative Increase ◽  
Cannabis Use ◽  
Young Onset ◽  
The Mean ◽  
National Trends ◽  
Increasing Trends ◽  
Insight Into ◽  
Stroke In Young

Background Recent legalization of therapeutic and recreational cannabis use makes it imperative to have an insight into odds and trends in young-onset stroke-related hospitalizations among cannabis users (18–49 years). Methods The National Inpatient Sample dataset (2007–2014) was utilized to assess national trends, odds of young-onset stroke-related hospitalizations, and outcomes among cannabis users vs. nonusers using provided discharge weights, strata, and cluster design. The rates are described per 100,000 hospitalizations among cannabis users and non-users. Results A total of 3,307,310 hospitalizations were identified among young adults with current or previous cannabis use. Of these, 34,857 (1.1%) were related to young-onset stroke. A relative increase of 13.92% (553 in 2007 to 630 in 2014; ptrend < 0.001) in young-onset stroke admissions was reported among cannabis users. The odds of any stroke (OR 1.16, 95% CI 1.14–1.19, p < 0.001) and acute ischemic stroke (OR 1.41, 95% CI 1.31–1.51, p < 0.001) hospitalizations were considerably higher among cannabis users as compared to nonusers. In-hospital mortality rates were increasing (3.7% to 4.3%) among cannabis users whereas decreasing (7.7% to 5.9%) in nonusers from 2007 to 2014 ( ptrend < 0.001). The mean length of stay and the hospitalization charges showed increasing trends in cannabis-related young-onset stroke admissions. There was an increasing trend in young-onset stroke admissions among male cannabis users (578 to 701; ptrend < 0.001) but not among females (516 to 457; ptrend = 0.14). The maximum rise in the young-onset stroke-related admissions was seen in African Americans (743 to 996; ptrend < 0.001). Conclusions We identified rising trends and higher risk (16% higher of overall young-onset stroke, 41% higher of acute ischemic stroke) of stroke-related hospitalizations and worse outcomes among cannabis users aged 18–49 years from 2007 to 2014.

scholarly journals Myocardial injury in acute ischemic stroke

2021 ◽  
Vol 5 (1) ◽  
pp. 2514183X2110185
Author(s):  
Christian H Nolte ◽  
Matthias Endres ◽  
Jan F Scheitz
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Myocardial Injury ◽  
Current Knowledge ◽  
Narrative Review ◽  
Pathophysiological Mechanisms ◽  
The Brain

Since antiquity, the interaction of brain and heart has inspired physicians and philosophers. Today, our knowledge has vastly improved, but the exact way of their interaction still holds many secrets to reveal. The interaction between brain and heart merits particular attention in the aftermath of a sudden injury to the brain-like acute ischemic stroke (AIS). This narrative review gives an overview of current knowledge on frequency, prognosis, and potential pathophysiological mechanisms of myocardial injury following AIS.

scholarly journals Changes of Metabolites in Acute Ischemic Stroke and Its Subtypes

2021 ◽  
Vol 14 ◽  
Author(s):  
Xin Wang ◽  
Luyang Zhang ◽  
Wenxian Sun ◽  
Lu-lu Pei ◽  
Mengke Tian ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Acid Metabolism ◽  
Artery Occlusion ◽  
Large Artery ◽  
Serum Samples ◽  
Multivariate Statistical ◽  
Pathophysiological Mechanisms ◽  
Small Artery Occlusion ◽  
Potential Biomarkers

Existing techniques have many limitations in the diagnosis and classification of ischemic stroke (IS). Considering this, we used metabolomics to screen for potential biomarkers of IS and its subtypes and to explore the underlying related pathophysiological mechanisms. Serum samples from 99 patients with acute ischemic stroke (AIS) [the AIS subtypes included 49 patients with large artery atherosclerosis (LAA) and 50 patients with small artery occlusion (SAO)] and 50 matched healthy controls (HCs) were analyzed by non-targeted metabolomics based on liquid chromatography–mass spectrometry. A multivariate statistical analysis was performed to identify potential biomarkers. There were 18 significantly different metabolites, such as oleic acid, linoleic acid, arachidonic acid, L-glutamine, L-arginine, and L-proline, between patients with AIS and HCs. These different metabolites are closely related to many metabolic pathways, such as fatty acid metabolism and amino acid metabolism. There were also differences in metabolic profiling between the LAA and SAO groups. There were eight different metabolites, including L-pipecolic acid, 1-Methylhistidine, PE, LysoPE, and LysoPC, which affected glycerophospholipid metabolism, glycosylphosphatidylinositol-anchor biosynthesis, histidine metabolism, and lysine degradation. Our study effectively identified the metabolic profiles of IS and its subtypes. The different metabolites between LAA and SAO may be potential biomarkers in the context of clinical diagnosis. These results highlight the potential of metabolomics to reveal new pathways for IS subtypes and provide a new avenue to explore the pathophysiological mechanisms underlying IS and its subtypes.

Platelet apoptosis and phenotype in patients with acute ischemic stroke

2018 ◽  
pp. 75-83
Author(s):  
А.А. Соколовская ◽  
М.Ю. Максимова ◽  
Э.Д. Вирюс ◽  
А.А. Московцев ◽  
А.В. Иванов ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Healthy Subjects ◽  
Annexin V ◽  
Surface Antigens ◽  
Control Group ◽  
Platelet Apoptosis ◽  
Membrane Bound ◽  
Insight Into

Aim. To develop of knowledge of platelet apoptosis and phenotype in patients with acute ischemic stroke and to study the prognostic value of some membrane-bound proteins. Method. The study included 18 patients aged 59-78 with acute ischemic stroke. Platelet were isolated by immonomagnetic separation within the first 24 hours and at 7 days of ischemic stroke. The expression of surface antigens was measured using monoclonal antibodies. For detection of phosphatidylserine (PS) externalization platelets were incubated with Annexin V. The mitochondrial membrane potential (MMP) was measured using JC-1 during platelets apoptosis. Immediately after the incubation, platelets were analyzed by flow cytometry. Results. On day 1 of stroke, the expression of CD62p (P-selectin) was higher than in healthy subjects (18.3% vs . 4.1%, respectively, p<0.05). The PS externalization on platelets from patients with stroke was significantly higher than in healthy subjects (20.6% vs. 3.2%, respectively, p<0.01). A decrease in MMP to 70% was observed in platelets from patients with stroke compared to 94% in the control group (p<0.05). Conclusion. Therefore, acute ischemic stroke was associated with the following platelet abnormalities: increased PS expression and declined MMP in parallel with increased P-selectin expression, which reflects platelet activation. Further studies of platelet phenotype and apoptosis biomarkers will provide a deeper insight into the pathogenetic role of platelets in ischemic stroke and contribute to the development of methods for monitoring effects of antiplatelet therapy.

scholarly journals Relationship Between Cardiac Surgery and Acute Ischemic Stroke: An Examination in Terms of Clinical, Radiological, and Functional Outcomes and Possible Pathophysiological Mechanisms

2021 ◽  
Vol 24 (4) ◽  
pp. E713-E723
Author(s):  
Mehmet Işık ◽  
Hasan Hüseyin Kozak ◽  
Niyazi Görmüş
Keyword(s):  
Cardiac Surgery ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Surgical Procedures ◽  
Functional Outcomes ◽  
Anterior Circulation ◽  
Pathophysiological Mechanisms ◽  
Cerebrovascular Events ◽  
Stroke Group ◽  
History Of

Aim: The aim is to discuss the clinical characteristics, time, anatomical vascular distribution, radiological features, functional outcomes after stroke and possible pathophysiological mechanisms of acute ischemic stroke (AIS) that develop after cardiac surgery. Method: A total of 3,474 patients, who underwent cardiac surgery between 2015-2020, retrospectively were analyzed. Forty-nine patients, who developed AIS and had brain CT and diffusion MR images during hospitalization, were included in the study. Results: AIS distribution was at 53% CABG, 12.2% isolated mitral valve, 8.1% isolated aortic valve, and 26.5% combined surgical procedures. Patients with a ≤2 days (P = 0.03) preop preparation time and body surface area (BSA) of <1.85 m2 (P = 0.02) had a high discharge rate. While newly developing AF was low in the early stroke group, it was higher in the late stroke group (P = 0.02). A history of previous cerebrovascular events was found in 3.3% of the patients. Postoperative new AIS was detected in 7.8% of those with a history of cerebrovascular events. Total anterior circulation infarction (TACI) case rate was 8.1%, partial anterior circulation infarction (PACI) 12.2%, posterior circulation infarction (POCI) 24.4%, cortical border zone infarction (CBZI) 30.6%, combined POCI + CBZI 12.2%, multiple territorial infarcts (MTI) 10.2%, and lacunar circulation infarction (LACI) rate was 2%. The modified Rankin Scale means following AIS was 3.45. The worst Rankin score was 5.75 in CABG+MVR cases; it was found to be 5 in the valve + ascending aorta case and 5 in the five bypass cases. Conclusion: Calculation of cerebrovascular reserve with extra/intracranial vascular imaging is important in patients with multiple risk factors, whose association with stroke has been determined before cardiac surgery. We believe that cardiovascular surgery and neurology multidisciplinary prospective randomized studies should be conducted to obtain pre-, peri- and post-procedural risk calculation scales, according to cardiac surgery type and to reshape surgical procedures accordingly.

Sign in / Sign up

Export Citation Format

Share Document