The Role of Carotid Plaque Vulnerability and Inflammation in the Pathogenesis of Acute Ischemic Stroke

2008 ◽  
Vol 336 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Shifang Ding ◽  
Mei Zhang ◽  
Yuxia Zhao ◽  
Wenqiang Chen ◽  
Guihua Yao ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Carotid Plaque ◽  
Plaque Vulnerability

scholarly journals Emerging Role of Carotid MRI for Personalized Ischemic Stroke Risk Prediction in Patients With Carotid Artery Stenosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Kelly P. H. Nies ◽  
Luc J. M. Smits ◽  
Mohamed Kassem ◽  
Paul J. Nederkoorn ◽  
Robert J. van Oostenbrugge ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Stenosis ◽  
Risk Prediction ◽  
Carotid Plaque ◽  
Prediction Models ◽  
Risk Of Bias ◽  
Plaque Vulnerability ◽  
Carotid Mri ◽  
Pet Ct

Rupture of a vulnerable carotid plaque is an important cause of ischemic stroke. Prediction models can support medical decision-making by estimating individual probabilities of future events, while magnetic resonance imaging (MRI) can provide detailed information on plaque vulnerability. In this review, prediction models for medium to long-term (>90 days) prediction of recurrent ischemic stroke among patients on best medical treatment for carotid stenosis are evaluated, and the emerging role of MRI of the carotid plaque for personalized ischemic stroke prediction is discussed. A systematic search identified two models; the European Carotid Surgery Trial (ECST) medical model, and the Symptomatic Carotid Atheroma Inflammation Lumen stenosis (SCAIL) score. We critically appraised these models by means of criteria derived from the CHARMS (CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modeling Studies) and PROBAST (Prediction model Risk Of Bias ASsessment Tool). We found both models to be at high risk of bias. The ECST model, the most widely used model, was derived from data of large but relatively old trials (1980s and 1990s), not reflecting lower risks of ischemic stroke resulting from improvements in drug treatment (e.g., statins and anti-platelet therapy). The SCAIL model, based on the degree of stenosis and positron emission tomography/computed tomography (PET/CT)-based plaque inflammation, was derived and externally validated in limited samples. Clinical implementation of the SCAIL model can be challenging due to high costs and low accessibility of PET/CT. MRI is a more readily available, lower-cost modality that has been extensively validated to visualize all the hallmarks of plaque vulnerability. The MRI methods to identify the different plaque features are described. Intraplaque hemorrhage (IPH), a lipid-rich necrotic core (LRNC), and a thin or ruptured fibrous cap (TRFC) on MRI have shown to strongly predict stroke in meta-analyses. To improve personalized risk prediction, carotid plaque features should be included in prediction models. Prediction of stroke in patients with carotid stenosis needs modernization, and carotid MRI has potential in providing strong predictors for that goal.

Role of S100β Glial Protein as a Serological Marker for Analysis of Acute Ischemic Stroke

2021 ◽  
pp. 251660852110112
Author(s):  
Kiran Buddharaju ◽  
Mahendra Javali ◽  
Anish Mehta ◽  
R Srinivasa ◽  
Purushottam Acharya
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Recovery ◽  
Protein Level ◽  
Serological Marker ◽  
Protein Levels ◽  
S100β Protein ◽  
Asymptomatic Volunteers ◽  
Scale Scores

Background: Stroke is a major cause of neurological disability, which can be often predicted with serological markers. Glial-derived S100β protein is a potential biomarker for cerebral ischemia and may be helpful in predicting the severity, outcome, and recovery of stroke. Aim: This study aimed to study the role of S100β glial protein as a serological marker in predicting the severity of acute ischemic stroke (AIS), outcome, and functional recovery after 1 month. Methods: A hospital-based prospective case control study included 43 consecutive patients, >18 years old, who were admitted with acute middle cerebral artery (MCA) territory infarcts within 72 h of onset of neurological deficits. Control group comprised of 43 age-matched asymptomatic volunteers. Independent t-test and chi square test were used to compare the means and evaluate the association between protein level and various parameters. P ≤ .05 was statistically significant. Results: S100β protein level in AIS patients was significantly higher compared to controls ( P < .05). Elevated serum S100β protein level was found to be associated with larger infarct volumes, higher National Institute Health Stroke Scale scores, and higher modified Rankin Scale scores at admission ( P < .05). Patients with higher S100β protein levels at admission had poor recovery at 1 month compared to patients having normal S100β protein levels. Conclusion: S100β protein levels at admission after an acute MCA territory infarct may be used as a reliable serological tool in predicting the severity, outcome, and functional recovery in stroke.

scholarly journals Role of some inflammatory biomarkers in prediction of short-term outcome in acute ischemic stroke

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Yosria Abd Al Hameed AlTaweel ◽  
Rania Sanad Nageeb ◽  
Pakinam Mahmoud Metwally ◽  
Ahmed Elsayed Badawy
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Stroke Severity ◽  
Short Term ◽  
Laboratory Assessment ◽  
Term Outcome ◽  
Neutrophil Lymphocyte Ratio ◽  
Short Term Outcome ◽  
Wbc Count

Abstract Background Several factors affect acute ischemic stroke (AIS) outcomes. Objective This study aimed to assess the role of the leukocyte count, neutrophil/lymphocyte ratio (NLR), and c reactive protein (CRP) as early predictors of outcome in AIS patients. Methods This study was conducted on 60 AIS patients. They were subjected to detailed history taking, clinical examination, brain imaging, and laboratory assessment including the CRP, white blood cell (WBC) count, absolute neutrophil count (ANC), absolute lymphocyte count (ALC), and NLR which is calculated by dividing ANC by ALC. Neurological scales were used to assess the level of consciousness by the Glasgow Coma Scale (GCS) and stroke severity by the National Institute of Health Stroke Scale (NIHSS) at the first 48 h of stroke onset as well as 1 week and 2 weeks later for the assessment of short-term functional neurological outcome. Results Sixty percent of the patients had unfavorable outcomes assessed by the Modified Rankin Scale (mRS). Patients with unfavorable outcomes had higher NIHSS scores. NLR was positively correlated with WBC count, ANC, and CRP. The higher WBC, NLR, and NIHSS, the unfavorable the outcome was. Conclusion The higher WBC, the NLR, and the level of CRP at the onset of AIS, the more severe stroke and the poorer the short-term outcome are expected.

scholarly journals Role of Monitoring in Management of Acute Ischemic Stroke Patients

Stroke ◽  
2003 ◽  
Vol 34 (11) ◽  
pp. 2599-2603 ◽  
Author(s):  
Anna Cavallini ◽  
Giuseppe Micieli ◽  
Simona Marcheselli ◽  
Silvana Quaglini
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Stroke Patients

scholarly journals Therapeutically Targeting Neuroinflammation and Microglia after Acute Ischemic Stroke

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Youngjeon Lee ◽  
Sang-Rae Lee ◽  
Sung S. Choi ◽  
Hyeon-Gu Yeo ◽  
Kyu-Tae Chang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Inflammatory Responses ◽  
Secondary Injury ◽  
Initial Event ◽  
Stroke Models ◽  
Anti Inflammatory ◽  
Preclinical And Clinical Studies ◽  
Multiple Receptor

Inflammation has a pivotal role in the pathogenesis of ischemic stroke, and recent studies posit that inflammation acts as a double-edged sword, not only detrimentally augmenting secondary injury, but also potentially promoting recovery. An initial event of inflammation in ischemic stroke is the activation of microglia, leading to production of both pro- and anti-inflammatory mediators acting through multiple receptor signaling pathways. In this review, we discuss the role of microglial mediators in acute ischemic stroke and elaborate on preclinical and clinical studies focused on microglia in stroke models. Understanding how microglia can lead to both pro- and anti-inflammatory responses may be essential to implement therapeutic strategies using immunomodulatory interventions in ischemic stroke.

The role of elevated levels of microRNA-155-5p and microRNA-124-5p in hyperuricemia and acute ischemic stroke

2021 ◽  
Vol 11 (10) ◽  
pp. 1674-1680
Author(s):  
Yuan Yao ◽  
Jun Yuan ◽  
Yanju Ma ◽  
Runxiu Zhu ◽  
Yong Ma
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Clinical Application ◽  
Cerebral Vasospasm ◽  
Rat Model ◽  
Inner Mongolia ◽  
Neuronal Apoptosis ◽  
Projection Neuron ◽  
Neuron Differentiation

Hyperuricemia is closely related to acute ischemic stroke (AIS). In our study, we investigated the pattern of miRNA-155-5p and miRNA-124-5p expressions along with its clinical application in AIS and hyperuricemia patients and in a hyperuricemia rat model by RT-qPCR. The hyperuricemia rat model was established, and we found that the levels of miRNA-155-5p and miRNA-124-5p were increased in the serum, brain and kidney tissues compared with those in the normal rats. We proved that the levels of miRNA-155-5p and miRNA-124-5p were also elevated in AIS, hyperuricemia and AIS accompanied with hyperuricemia patients enrolled from the department of neurology in Inner Mongolia People’s Hospital (IMPH). The miRNA-155-5p and miRNA-124-5p were mainly associated with neuronal apoptosis, cerebral vasospasm, neuron projection, neuron projection morphogenesis, neuron differentiation and exocytosis. The above results might provide clues for the study the pathogenesis of AIS and hyperuricemia.

Potential role of neuroprotective agents in the treatment of patients with acute ischemic stroke

2003 ◽  
Vol 5 (6) ◽  
pp. 441-449 ◽  
Author(s):  
Bruce Ovbiagele ◽  
Chelsea S. Kidwell ◽  
Sidney Starkman ◽  
Jeffrey L. Saver
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Potential Role ◽  
Neuroprotective Agents

scholarly journals The Role of Personality Associated with In-Hospital Delay in Intravenous Thrombolysis for Acute Ischemic Stroke

2020 ◽  
Author(s):  
Zhenchan Lu ◽  
Caixia Qiu ◽  
Xiangyan Yang ◽  
Honggang Ma ◽  
Shuang Shen ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Personality Traits ◽  
Acute Ischemic Stroke ◽  
Big Five ◽  
Multivariable Analysis ◽  
Intravenous Thrombolysis ◽  
Big Five Personality ◽  
Effective Strategies

Abstract Background: Decreasing the in-hospital delay is one of the critical effective strategies for thrombolytic therapy for acute ischemic stroke. we examined whether physician personality traits are associated with in-hospital delay in conducting treatment of intravenous thrombolysis for acute ischemic stroke among neurologists.Methods: Overall 354 consecutive patients who received intravenous thrombolysis during a 2.5 year-period in emergency department were included. Self-reported questionnaires of the Big Five Inventory and demographic characteristics were distributed among 13 neurologists. Multivariable analysis was performed to explore the effects of the Big Five Personality Traits on in-hospital delay for acute ischemic stroke. Results: The traits of agreeableness in all physicians decreased the likelihood of in-hospital delay (OR: 0.831, 95% CI: 0.766-0.901, p<0.001). The traits of openness in female physicians (OR:0.646; 95% CI:0.469-0.890; p=0.008) and the traits of extraversion in male physicians (OR:0.613; 95% CI: 0.475-0.791; p<0.001) decreased the likelihood of in-hospital delay. The traits of conscientiousness in female (OR: 1.713, 95% CI: 1.209–2.427; p=0.002) and the traits of openness in male (OR: 1.431; 95% CI: 1.802-1.892; p=0.012) increased the likelihood of in-hospital delay. Conclusions: The study demonstrate that the personality traits of physician are associated with in-hospital delay for thrombolytic therapy in acute ischemic stroke.

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