Cerebrovascular Accident
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Cureus ◽  
2021 ◽  
Author(s):  
Kyle Wiseman ◽  
Dhairya Gor ◽  
Gautham Upadrasta ◽  
Ndausung Udongwo ◽  
Kara Lanpher ◽  
...  

Pharmacia ◽  
2021 ◽  
Vol 68 (3) ◽  
pp. 665-670
Author(s):  
Bogdan S. Burlaka ◽  
Igor F. Belenichev ◽  
Olga I. Ryzhenko ◽  
Victor P. Ryzhenko ◽  
Olena G. Aliyeva ◽  
...  

Introduction: This study was designed to evaluate the effect activity of RAIL-gel in comparison with Citicoline on nitroxydergic system during acute cerebrovascular accident. Methods: In this study, 80 white nonlinear rats were randomly assigned to 4 groups (20 rats in each): 1) intact; 2) control - untreated with acute cerebrovascular accident (ACVA), examined on the 4th day; 3) animals with ACVA, receiving RAIL, examined on the 18th day; 4) animals with ACVA, treated with Citicoline, examined on the 4th day. The expression of inducible NOS was determined by Western blotting. The nitrosative stress marker, nitrotyrosine, was determined using the ELISE kit NITROTYROSINE (kit no. HK501-02, series 12825k1212-k). To assess the state of iNOS mRNA expression, we used the method of polymerase chain reaction with reverse transcription in real time (RT-PCR). Results: Our research demonstrated that course administration of the RAIL and Citicoline to animals with ACVA for 4 days leads to the stabilization of the parameters of the brain nitroxydergic system. However, Citicoline does not provide a full effect on the shifts of the NO system in the brain. It does not have the proper effect on such an important link in the pathogenesis of ischemic brain damage as nitrosative stress. RAIL leads to a significant decrease in NOS activity due to its inducible form (decrease in the expression of iNOS and iNOS mRNA) and a decrease in NO metabolits, and inhibition of nitrosative stress (decrease in nitrotyrosine). Conclusion: IL-1b antagonist RAIL (Intranal Gel) significantly exceeds Citicoline in terms of the severity of the effect on the nitroxydergic system indicators.


Circulation ◽  
2021 ◽  
Vol 144 (10) ◽  
pp. 763-772
Author(s):  
Sung-Min Cho ◽  
J. Hunter Mehaffey ◽  
Susan L. Meyers ◽  
Ryan S. Cantor ◽  
Randall C. Starling ◽  
...  

Background: Ischemic and hemorrhagic cerebrovascular accidents remain common among patients with centrifugal-flow left ventricular assist devices, despite improvements in survival and device longevity. We compared the incidence of neurologic adverse events (NAEs) associated with 2 contemporary centrifugal-flow left ventricular assist devices: the Abbott HeartMate3 (HM3) and the Medtronic HeartWare HVAD (HVAD). Methods: Using the Society of Thoracic Surgeons Interagency Registry for Mechanically Assisted Circulatory Support (Intermacs), we collected data on adult patients who received a centrifugal-flow left ventricular assist device as a primary isolated implant between January 1, 2017, and September 30, 2019. Major NAEs were defined as transient ischemic attack, ischemic cerebrovascular accident, or hemorrhagic cerebrovascular accident. The association of HVAD with risk of NAE in the first year after implant was evaluated using propensity score matching to balance for preimplant risk factors. After matching, freedom from first major NAE in the HM3 and HVAD cohorts was compared with Kaplan-Meier curves. A secondary analysis using multivariable multiphase hazard models was used to identify predictors of NAE, which uses a data-driven parametric fit of the early declining and constant phase hazards and the associations of risk factor with either phase. Results: Of 6205 included patients, 3129 (50.4%) received the HM3 and 3076 (49.6%) received the HVAD. Median follow-up was 9 and 12 months (HM3 and HVAD, respectively). Patients receiving HVAD had more major NAEs (16.4% versus 6.4%, P <0.001) as well as each subtype (transient ischemic attack: 3.3% versus 1.0%, P <0.001; ischemic cerebrovascular accident: 7.7% versus 3.4%, P <0.001; hemorrhagic cerebrovascular accident: 7.2% versus 2.0%, P <0.001) than did patients receiving HM3. A propensity-matched cohort balanced for preimplant risk factors showed that HVAD was associated with higher probabilities of major NAEs (% freedom from NAE 82% versus 92%, P <0.001). Device type was not significantly associated with NAEs in the early hazard phase, but HVAD was associated with higher incidence of major NAEs during the constant hazard phase (hazard ratio, 5.71 [CI, 3.90–8.36]). Conclusions: HM3 is associated with lower hazard of major NAEs than is HVAD beyond the early postimplantation period and during the constant hazard phase. Defining the explanation for this observation will inform device selection for individual patients.


Kontakt ◽  
2021 ◽  
Author(s):  
Miroslav Paulíček ◽  
Lenka Krhutová ◽  
Iva Kuzníková ◽  
Kamila Vondroušová ◽  
Iva Tichá ◽  
...  

2021 ◽  
pp. 1-8
Author(s):  
Amira Athanasios ◽  
Ivy Daley ◽  
Anjali Patel ◽  
Olu Oyesanmi ◽  
Parth Desai ◽  
...  

<b><i>Background:</i></b> While the most common neurologic symptoms reported in patients affected by SARS-CoV-2 are headache, dizziness, myalgia, mental fog, and anosmia, there is a growing basis of published peer-reviewed cases reporting stroke in the setting of SARS-CoV-2 infection. The peer-reviewed literature suggests an increased risk of cerebrovascular accident (CVA) in the setting of COVID-19 infection. <b><i>Methods:</i></b> We searched 3 databases (PubMed, MEDLINE, and CINAHL) with search terms COVID-19, novel coronavirus, stroke, and cerebrovascular accident. Case series and case studies presenting patients positive for both COVID-19 and CVA published from January 1 through September 1, 2020, were included. Data collection and analysis was completed and risk of bias assessed. <b><i>Results:</i></b> The search identified 28 studies across 7 counties comprising 73 patients. Amongst patients hospitalized for COVID-19 infection and CVA, the average age was 60; the most common preexisting conditions were hypertension and diabetes mellitus, and those without preexisting conditions were significantly younger with an average age of 47. Amongst hospitalized patients with COVID-19 and CVA, there was a bimodal association with COVID-19 infection severity with majority of patients classified with mild or critical COVID-19 infection. <b><i>Discussion:</i></b> The data suggest SARS-CoV-2 is a risk factor for developing stroke, particularly in patients with hypertension and diabetes. Furthermore, the younger average age of stroke in patients with SARS-CoV-2, particularly those patients with zero identifiable preexisting conditions, creates high suspicion that SARS-CoV-2 is an independent risk factor for development of stroke; however, this cannot yet be proven without comparable control population. The data suggest the risk of developing CVA in the setting of COVID-19 infection is not dependent upon severity of illness. Continued studies must be done to understand the epidemiologic factors of COVID-19 infection and stroke and the pathophysiology of the COVID-associated hypercoagulable state.


2021 ◽  
Vol 8 (8) ◽  
pp. 1171
Author(s):  
Gaurav Gupta ◽  
Saurabh Kishor ◽  
Aditya Kumar

Background: Stroke or cerebrovascular accident (CVA) is noted as the second cause of mortality, especially in the elderly population. Recent studies indicated that higher concentrations of uric acid are involved in various vascular diseases. The findings of previous investigations suggest that, elevated serum alkaline phosphatase (ALP) levels may have a pathophysiological character in the occurrence of atherosclerotic vascular disease (AVD) of the heart and brain. This study evaluated the association between serum uric acid (SUA) levels, serum lipid levels, serum alkaline phosphatase (ALP) levels, and changes in ischemic cerebrovascular accident patients.Methods: All patients with Ischemic cerebrovascular accident age >50 years were included based on their clinical, laboratory, and radiological findings (including computed tomography (CT)/magnetic resonance imaging (MRI)) those admitted in our hospital. As control group 200 healthy individuals matched for sex and age were recruited from the same demographic area.Result: Multiple logistic regression analysis findings proposed four components as significant predictors in ischemic cerebrovascular accident (serum uric acid, serum ALP, LDL and HDL. In this study, it was found, that patients with ischemic cerebrovascular accident had significant difference (p<0.001) in serum uric acid and serum ALP than normal patients (non-ischemic cerebrovascular accident patients).Conclusions: Patients with ischemic cerebrovascular accident had significant difference (p<0.001) in SUA and serum ALP than normal patients (non-ischemic cerebrovascular accident patients). High SUA levels were observed to be associated significantly with ischemic stroke. On the basis of our study design, we cannot clarify that the elevated levels are the risk of ischemic stroke and it requires further studies.


2021 ◽  
Vol 12 (2) ◽  
Author(s):  
Saeed Kazemi ◽  
Reza Mahdavinejad ◽  
Shahram Lenjani

: Cerebrovascular accident (CVA) refers to any kind of damage caused by direct or indirect damage to the brain and its related elements. It is estimated that about 60% of brain injury victims have a permanent disorder. The consequences of CVA include reduced movement speed, weakness, functional impairment, reduced power, and balance. The purpose of this study was to investigate the effect of a 12-week selected training protocol on motor function following brain injury. In a semi-experimental study, 30 male subjects with a mean and standard deviation of 52.2 ± 5.4 years, weight 173.2 ± 4.2 kg, and height of 78.8 ± 5.3 cm were selected purposefully and accessible with inclusion and exclusion criteria. The participants were randomly divided into experimental (n = 15) and control groups (n = 15). In order to evaluate the physical-motor performance, 10-meter walking tests, get up and go tests, and climbing stairs tests were used. The training program lasted for 12 weeks, three sessions per week, and each session for 30 - 60 minutes. Data were analyzed by independent t-test and dependent t-test using SPSS-21 software at P ≤ 0.05 level. Based on dependent t-test and covariance test, there were significant differences in all three components of motor function (10 m walk time tests, get up and go test, and stair climbing test), there was a significant increase after training in men with CVA (P = 0.00). From the findings of this study, it can be concluded that the special exercises of the present study have a positive effect on motor function parameters of male patients with CVA, so it can be recommended as one of the most important rehabilitation strategies for these patients.


Cureus ◽  
2021 ◽  
Author(s):  
Steven Hamilton ◽  
Rana A Tauseen ◽  
Sara L Wallach ◽  
Adam C Kaplan

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