scholarly journals Сonstitucional features of ischemic stroke patients with concomitant cardiac pathology

2010 ◽  
Vol 9 (4) ◽  
pp. 148-151
Author(s):  
N. V. Oleksyuk ◽  
Yu. T. Kuryachenko
Keyword(s):  
Ischemic Stroke ◽  
Adverse Outcome ◽  
Neurological Status ◽  
Stroke Patients ◽  
Cardiac Pathology ◽  
Acute Period ◽  
Positive Correlation ◽  
Different Types

Identification of influence of cardiac pathology on the course of ischemic stroke in patients with different types of constitution, can play an important role in the tactics of treatment and prognosis. The assessment of neurological status in the acute period of stroke depending of the type of cardiac pathology and constitutional features, evaluation of hemostasis was performed. A positive correlation between the existed cardiac pathology with some anthropometric somatotype parameters and their influence on adverse outcome of stroke was revealed.

scholarly journals Gut Microbiotic Features Aiding the Diagnosis of Acute Ischemic Stroke

2020 ◽  
Vol 10 ◽  
Author(s):  
Lei Xiang ◽  
Yanfeng Lou ◽  
Lingyu Liu ◽  
Yuanling Liu ◽  
Weizheng Zhang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Gut Microbiota ◽  
Bacterial Species ◽  
Lacunar Infarction ◽  
Stroke Patients ◽  
Receiver Operating Characteristic Curves ◽  
Ischemic Infarction ◽  
Operational Taxonomic Units ◽  
Different Types ◽  
Pathway Analyses

Increasing evidence suggests that features of the gut microbiota correlate with ischemic stroke. However, the specific characteristics of the gut microbiota in patients suffering different types of ischemic stroke, or recovering from such strokes, have rarely been studied, and potential microbiotic predictors of different types of stroke have seldom been analyzed. We subjected fecal specimens from patients with lacunar or non-lacunar acute ischemic infarctions, and those recovering from such strokes, to bacterial 16S rRNA sequencing and compared the results to those of healthy volunteers. We identified microbial markers of different types of ischemic stroke and verified that these were of diagnostic utility. Patients with two types of ischemic stroke, and those recovering from ischemic stroke, exhibited significant shifts in microbiotic diversities compared to healthy subjects. Cluster of Orthologous Groups of Proteins (COG) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses revealed reduced metabolic and transport-related pathway activities in ischemic stroke patients. We performed fivefold cross-validation using a Random Forest model to identify two optimal bacterial species (operational taxonomic units; OTUs) serving as markers of lacunar infarction; these were Lachnospiraceae (OTU_45) and Bacteroides (OTU_4), and the areas under the receiver operating characteristic curves (AUCs under the ROCs) were 0.881 and 0.872 respectively. In terms of non-lacunar acute ischemic infarction detection, the two optimal species were Bilophila (OTU_330) and Lachnospiraceae (OTU_338); the AUCs under the ROCs were 0.985 and 0.929 respectively. In post-ischemic stroke patients, the three optimal species were Pseudomonas (OTU_35), Sphingomonadaceae (OTU_303), and Akkermansia (OTU_9); the AUCs under the ROCs were 1, 0.897, and 0.846 respectively. Notably, the gut microbial markers were of considerable value for utility when diagnosing lacunar infarction, non-lacunar acute ischemic infarction, and post-ischemic stroke. This study is the first to characterize the gut microbiotic profiles of patients with lacunar or non-lacunar, acute ischemic strokes, and those recovering from stroke, and to identify microbiotic predictors of such strokes.

scholarly journals Ischemic Stroke in Young Adults: Study of the Subtypes, Risk factors and Predictors of Poor Outcomes

2019 ◽  
Vol 16 (1) ◽  
pp. 29-34
Author(s):  
Reema Rajbhandari ◽  
Parmatma Prajuli ◽  
K K Oli
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Ischemic Stroke ◽  
Small Scale ◽  
Sudden Increase ◽  
Large Artery ◽  
Stroke Patients ◽  
Aggressive Approach ◽  
Positive Correlation ◽  
Poor Outcomes

The aim of this study is to show the subtype, risk factors and predictors of poor outcomes in young ischemic stroke patients. Materials and Methods: It is a prospective study where only young onset ischemic stroke patients are analyzed. 8% of total ischemic stroke sufferers were young adults; more prevalent in female (57.1%), with risk factors of smoking (47.6%) subtype cardio embolic (42.9%) was common. High NIHSS score was related to new event and correlation to mortality. Three month follow up showed MRS 2.86 ± 1.02. 57.1% of cases had significant disability (defined as MRS ≥ 3). There was a positive correlation of the cardio embolic subtype and the unclassified subtype to all three forms of poor outcomes, along with a positive correlation of the large artery atherothrombotic subtype to new events Recurrence of events (new stroke, sudden increase in symptoms and new TIAs) was observed in 14.3 %. Death was reported in 9.5% of cases.   Etiological diagnosis can be reached in majority of cases if an aggressive approach is maintained. This small scale study has provided an overview of the distribution of subtypes, risk factors and poor outcomes and their predictors. Cardiac diseases (esp. valvular disease) need to be taken more seriously to prevent cardio embolic strokes, while addressing other traditional risk factors to prevent the atherothrombotic subtypes.

scholarly journals Plasma D-Dimer Level in Different Types of Acute Ischaemic Stroke Patients: Experience at a Tertiary Hospital in Dhaka City

2019 ◽  
Vol 5 (1) ◽  
pp. 13-17
Author(s):  
Paritosh Kumar Sarkar ◽  
Anwar Israil ◽  
Mohammad Sayeed Hassan ◽  
Abu Nayeem ◽  
Md Azharul Hoque ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Ischemic Stroke ◽  
Ischaemic Stroke ◽  
Clinical Diagnosis ◽  
Acute Ischaemic Stroke ◽  
Stroke Patients ◽  
College Hospital ◽  
Medical College ◽  
Different Types ◽  
D Dimer

Background: Plasma D-Dimer is a biomarker of thrombo-embolism. Objective: The purpose of the present study was to see the plasma D-dimer level in different types of acute ischaemic stroke patients. Methodology: This cross-sectional study was conducted in the Department of Neurology & Department of Internal Medicine at Dhaka Medical College Hospital, Dhaka, Bangladesh from July 2010 to June 2012 for a period of two (02) years. Patients with ischemic stroke with history within 7 days attending in the stroke clinic of Department of Neurology or admitted in the Department of Neurology and Internal Medicine through the outpatient and emergency Department of Dhaka Medical College Hospital (DMCH) were selected as study population for this study. Analysis of plasma D-Dimer was done in the Department of Hematology of DMCH.b Result: A total of 50 cases were recruited for this study. There were 24.0% lacunar infarcts, 40.0% atherothrombotic and 36.0% embolic infarcts in the study group. Highest level of plasma D-Dimer was observed in embolic (1700±964 ηg/ml) followed by atherothrombotic group (536±234 ηg/ml). The plasma D-Dimer was lowest (100±0 ηg/ml) in lacunar group. Concentration of Plasma D-Dimer showed significant correlation with clinical diagnosis in different subtypes of ischemic stroke (r=0.902; p=0.001) and also with risk factors, example, diabetes (r=0.319; p=0.012) and valvular heart disease (r=0.281; p=0.024), but no significant correlation with age, hypertension, hyperlipidaemia and smoking. Conclusion: In conclusion plasma D-Dimer is an important bio-marker in the clinical diagnosis and subtypes of ischemic stroke patients. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 13-17

Echocardiographic Findings And Ischemic Stroke

2011 ◽  
Vol 2 ◽  
Author(s):  
Natalya Gamletovna Dadamyants
Keyword(s):  
Ischemic Stroke ◽  
Heart Defects ◽  
Cerebrovascular Diseases ◽  
Left Ventricular ◽  
Control Group ◽  
Stroke Patients ◽  
Cardiac Pathology ◽  
Normal Limits ◽  
Hemodynamic Stroke ◽  
Echocardiographic Findings

In order to study cardiac pathology in different subtypes of ischemic stroke we examined 165 stroke patients. The 1st group included 90 (54.5%) patients with hemodynamic stroke, the 2nd one - 75 (45.5%) patients with cardioembolic stroke. Control group consisted of 45 individuals without cerebrovascular diseases. Cardiac pathologies with the prevalence of various types of ischemic heart disease were observed in all groups. The parameters of left ventricular stroke volume and ejection fraction were lower in patients with hemodynamic stroke than in other groups, but were within normal limits. Potential sources of cardiogenic embolism were found in all groups: in the 1st group at 74.4%, in the 2nd one at 100%. Thus, most patients with ischemic stroke have different heart defects related to the subtypes of ischemic stroke. 

scholarly journals Outcome of intravenous thrombolysis for acute ischemic stroke in patients with and without atrial fibrillation

2017 ◽  
Vol 70 (7-8) ◽  
pp. 203-208
Author(s):  
Zeljko Zivanovic ◽  
Dragan Adamovic ◽  
Aleksandra Lucic-Prokin ◽  
Timea Kokai-Zekic ◽  
Jelena Sekaric ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Intravenous Thrombolysis ◽  
Binary Logistic Regression ◽  
Neurological Status ◽  
Stroke Patients ◽  
Severe Stroke ◽  
Increased Risk ◽  
Favorable Clinical Outcome

Introduction. Atrial fibrillation is associated with an increased risk of ischemic stroke. The benefit of intravenous thrombolysis in patients with acute ischemic stroke and atrial fibrillation is still unclear. The aim of the study was to assess and compare the effects of intravenous thrombolysis in stroke patients with and without atrial fibrillation. Material and Methods. We analyzed stroke patients who were treated with intravenous thrombolysis. Patients were divided into two groups according to the presence of atrial fibrillation. Demographic, clinical and radiological characteristics of patients were compared between the two groups. The treatment efficacy was evaluated in relation to the improvement of neurological status after 24 hours, and functional recovery after three months. Binary logistic regression was used to evaluate predictors of outcome. Results. From a total of 188 patients, 39.4% presented with atrial fibrillation. Patients with atrial fibrillation were older (69.4 vs. 62.6 years; p <0.0001), with female predominance (43.2% vs. 28.9%, p = 0.04) and had clinically more severe stroke (National Institutes of Health Stroke Scale, score on admission 15.4 vs. 12.1; p = 0.0001). Significantly more patients without atrial fibrillation (61.4% vs. 43.2%, p = 0.01) had a favorable clinical outcome at three months after stroke. Nevertheless, atrial fibrillation was not an independent predictor of poor outcome at three months after stroke (p=0.66). Conclusion. Acute ischemic stroke patients, with atrial fibrillation, treated with intravenous thrombolysis, had worse outcomes than patients without atrial fibrillation did. However, it is mainly due to older age and a more severe stroke in patients with atrial fibrillation.

scholarly journals Neurovascular Unit as a Source of Ischemic Stroke Biomarkers—Limitations of Experimental Studies and Perspectives for Clinical Application

2019 ◽  
Vol 11 (4) ◽  
pp. 553-579 ◽  
Author(s):  
Aleksandra Steliga ◽  
Przemysław Kowiański ◽  
Ewelina Czuba ◽  
Monika Waśkow ◽  
Janusz Moryś ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Brain Damage ◽  
Neurovascular Unit ◽  
Experimental Studies ◽  
High Specificity ◽  
Neurological Status ◽  
Developed Countries ◽  
Cerebral Stroke ◽  
Specificity And Sensitivity ◽  
Different Types

Abstract Cerebral stroke, which is one of the most frequent causes of mortality and leading cause of disability in developed countries, often leads to devastating and irreversible brain damage. Neurological and neuroradiological diagnosis of stroke, especially in its acute phase, is frequently uncertain or inconclusive. This results in difficulties in identification of patients with poor prognosis or being at high risk for complications. It also makes difficult identification of these stroke patients who could benefit from more aggressive therapies. In contrary to the cardiovascular disease, no single biomarker is available for the ischemic stroke, addressing the abovementioned issues. This justifies the need for identifying of effective diagnostic measures characterized by high specificity and sensitivity. One of the promising avenues in this area is studies on the panels of biomarkers characteristic for processes which occur in different types and phases of ischemic stroke and represent all morphological constituents of the brains’ neurovascular unit (NVU). In this review, we present the current state of knowledge concerning already-used or potentially applicable biomarkers of the ischemic stroke. We also discuss the perspectives for identification of biomarkers representative for different types and phases of the ischemic stroke, as well as for different constituents of NVU, which concentration levels correlate with extent of brain damage and patients’ neurological status. Finally, a critical analysis of perspectives on further improvement of the ischemic stroke diagnosis is presented.

scholarly journals On the Question of the Reflexotherapy Action Mechanisms in the Ischemic Stroke Acute Period (Literature Review)

2021 ◽  
Vol 20 (6) ◽  
pp. 67-75
Author(s):  
Elena E. Molchanova ◽  
Victoria V. Polunina ◽  
Boris A. Polyaev ◽  
Valery P. Plotnikov ◽  
Andrey N. Lobov ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cerebral Ischemia ◽  
Economic Losses ◽  
Stroke Patients ◽  
Cerebrovascular Reserve ◽  
Acute Period ◽  
Mediators Of Inflammation ◽  
Acute Cerebral Ischemia ◽  
Degree Of Disability ◽  
Underlying Mechanisms

A high degree of disability in stroke patients, along with severe social and economic losses, determine the enduring urgency of the problem of early rehabilitation for post-stroke patients. Despite the proven effectiveness of the various reflexotherapy techniques in rehabilitation of patients with ischemic stroke, the underlying mechanisms remain unclear. The aim of the review was to analyze the mechanisms of the acupuncture intervention effect on the main links of the ischemic stroke pathogenesis, on neurological deficit and the volume of cerebral infarction (based on publications in international databases). The use of acupuncture in the acute period of ischemic stroke can improve the ability to cerebrovascular reserve, reduce the severity of arterial stiffness and endothelial dysfunction, induce neuroprotection, inhibit cell apoptosis and stimulate neuroplasticity, alleviate the inflammatory response in acute cerebral ischemia, regulate mediators of inflammation and oxidative stress etc., thus improving cerebral blood flow. The analysis of literature data has shown that acupuncture induces multilevel regulation through complex mechanisms, and one factor may not be enough to explain the positive effect against cerebral ischemia.

scholarly journals THE ROLE OF EARLY REHABILITATION AFTER CAROTID ENDARTERECTOMY IN ACUTE PERIOD OF ISCHEMIC STROKE

2018 ◽  
Vol 17 (2) ◽  
pp. 98-101 ◽  
Author(s):  
Alexandra Viktorovna Polyakova ◽  
D. V Tokareva ◽  
S. Sh Zabirov ◽  
I. A Voznyuk
Keyword(s):  
Ischemic Stroke ◽  
Carotid Endarterectomy ◽  
Early Period ◽  
Early Rehabilitation ◽  
Long Term Results ◽  
Stroke Patients ◽  
Acute Period ◽  
Results Of Treatment ◽  
Neuropsychological Status

The aim of our study was to evaluate the role of early rehabilitation of patients with ischemic stroke after carotid endarterectomy. Material and methods. We examined a group of 28 patients with atherosclerotic carotid stenosis who had CEA in an acute period of stroke and who started rehabilitation in the early period of stroke. Patients of the 1st group were admitted to rehabilitation in the early stages (within 21 days after the stroke), patients of the 2nd group - in the delayed period (more than 60 days after the stroke).The results of treatment were assessed on the NIHSS scale, Rankin scale, Rivermead mobility scale, spasticity was assessed on the Ashworth scale. Results. An analysis of the long-term results of surgical treatment convincingly showed its positive effect on the neurological and neuropsychological status of patients with the most favorable outcomes in performing early rehabilitation.

Abstract TP202: Increased Pulse Pressure is Related to Higher Burden of Microvascular Brain Damage in Ischemic Stroke Patients

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Maria C Zurru ◽  
Claudia Alonzo ◽  
Laura Brescacín ◽  
Natalia Balián ◽  
Maria V Baroni ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
White Matter ◽  
Brain Damage ◽  
Pulse Pressure ◽  
White Matter Hyperintensities ◽  
Large Artery ◽  
Vascular Risk ◽  
Stroke Patients ◽  
Positive Correlation

Introduction: pulse pressure (PP), a marker of arterial stiffness, is a useful tool for measuring vascular aging. White matter hyperintensities (WMH), deep and periventricular, are the expression of subclinical ischemic brain damage. Hypotesis: our objective was to evaluate the relationship between pre-stroke blood pressure and the burden of WMH. Method: acute ischemic stroke patients, excluding TIA, were prospectively included in a multidisciplinary secondary stroke prevention program. Pre-stroke vascular risk factor profile and control were obtained from electronic medical records and the presence of WMH was evaluated on admission MRI. Periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWMH) were classified according to Fazekas scale (0-3). A correlation analysis between different components of blood pressure and WMH was performed. Results: 808 patients (59% females, mean age 77±11 years) were included between January 2009 and December 2014. Main vascular risk factors were: hypertension (83%), dyslipemia (64%), obesity (52%), smoking (37%), metabolic syndrome (37%), diabetes (14%), AF (19%), CKD (45%), CHD (14%), stroke (10%), peripheral artery disease (12%). There was a positive correlation between PP values and the severity of PVH (R 0.93) and DWMH (R 0.95), but not with SBP (R 0.48 and R 0.50) and DBP (R 0.52 and 0.47). (figure) Conclusion: different blood pressure components may have different deleterious effects on large and small vessels. Pulse pressure, a pulsatile component mainly reflecting large artery stiffness and wave reflections, was the only component of blood pressure with a positive correlation with the burden of WMH in our cohort. As the world is aging, is mandatory to identify predictors of subclinical brain damage, which is related to increased risk of dementia, depression, stroke and gait disorders.

scholarly journals Stenting of precerebral arteries in acute period of ischemic stroke

2017 ◽  
Vol 176 (6) ◽  
pp. 13-17
Author(s):  
T. V. Ermolaeva ◽  
O. S. Sedunova ◽  
O. I. Tkachenko ◽  
A. A. Matyukov ◽  
S. S. Roshchupkin ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Treatment Efficacy ◽  
Neurological Status ◽  
Motor Disorders ◽  
Surgical Risk ◽  
Acute Period ◽  
High Surgical Risk ◽  
Status Data

OBJECTIVE. The study aimed to raise an efficacy of motor functions after stenting of precerebral arteries in acute period of ischemic stroke in patients of elderly and senile age. MATERIAL AND METHODS. Treatment efficacy was assessed according to dynamics of neurological status, data of duplex scanning of brachiocephalic vessels, index of mobility «Rivermed», scale «Bartel» in 30 patients. RESULTS. Stenting of precerebral arteries in acute period of ischemic stroke facilitated to regress of motor disorders and normalized cerebral hemodynamics. CONCLUSIONS. Stenting is an alternative method to carotid endarterectomy. This approach should be applied in patients with expressed carotid stenosis in combination with accompanied diseases and high surgical risk.

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