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1
Kern, Ralph Z. "Progress in Clinical Neurosciences: Migraine-Stroke: A Causal Relationship, but Which Direction?" Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 31, n. 4 (novembre 2004): 451–59. http://dx.doi.org/10.1017/s0317167100003620.
Testo completoAbstract (sommario):
A significant association between migraine and ischemic stroke has been demonstrated in population and case-control studies. The risk of ischemic stroke appears to be higher in migraine with aura (MWA) than migraine without aura (MwoA). Migraine-stroke comprises a number of distinct entities, including migrainous infarction, in which ischemic stroke occurs during an attack of MWA and migraine-related stroke, in which the causal link is less clear. Migrainous infarction accounts for only one-third of migraine-stroke, strokes may occur during attacks of MwoA, and a number of cerebrovascular disorders may present as MWA or MwoA. Migraine may occur as a consequence of conditions that are known to cause stroke; therefore it remains to be determined whether migraine predisposes to stroke in the absence of any known disease associations, if it is an epiphenomenon of an underlying stroke diathesis, or if it requires the presence of another stroke risk factor to produce cerebral ischemia. Furthermore, it is unclear if ischemia results in migraine more often than migraine results in ischemia. Careful clinical studies that evaluate this bidirectional relationship are needed to determine why migraine patients are subject to a higher risk of ischemic stroke.
2
Pan, Jingrui, Xiangpen Li e Ying Peng. "Remote ischemic conditioning for acute ischemic stroke: dawn in the darkness". Reviews in the Neurosciences 27, n. 5 (1 luglio 2016): 501–10. http://dx.doi.org/10.1515/revneuro-2015-0043.
Testo completoAbstract (sommario):
AbstractStroke is a leading cause of disability with high morbidity and mortality worldwide. Of all strokes, 87% are ischemic. The only approved treatments for acute ischemic stroke are intravenous thrombolysis with alteplase within 4.5 h and thrombectomy within 8 h after symptom onset, which can be applied to just a few patients. During the past decades, ischemic preconditioning has been widely studied to confirm its neuroprotection against subsequent ischemia/reperfusion injury in the brain, including preconditioning in situ or in a remote organ (such as a limb) before onset of brain ischemia, the latter of which is termed as remote ischemic preconditioning. Because acute stroke is unpredicted, ischemic preconditioning is actually not suitable for clinical application. So remote ischemic conditioning performed during or after the ischemic duration of the brain was then designed to study its neuroprotection alone or in combination with alteplase in animals and patients, which is named as remote ischemic perconditioning or remote ischemic postconditioning. As expected, animal experiments and clinical trials both showed exciting results, indicating that an evolution in the treatment for acute ischemic stroke may not be far away. However, some problems or disputes still exist. This review summarizes the research progress and unresolved issues of remote ischemic conditioning (pre-, per-, and post-conditioning) in treating acute ischemic stroke, with the hope of advancing our understanding of this promising neuroprotective strategy for ischemic stroke in the near future.
3
Boling, Bryan, e Katie Keinath. "Acute Ischemic Stroke". AACN Advanced Critical Care 29, n. 2 (15 giugno 2018): 152–62. http://dx.doi.org/10.4037/aacnacc2018483.
Testo completoAbstract (sommario):
Acute ischemic stroke is a major cause of mortality and morbidity in the United States and worldwide. Despite the development of specialized stroke centers, mortality and morbidity as a result of acute ischemic strokes can and do happen anywhere. These strokes are emergency situations requiring immediate intervention. This article covers the fundamentals of care involved in treating patients with acute ischemic stroke, including essentials for the initial evaluation, basic neuroimaging, reperfusion therapies, critical care management, and palliative care, as well as current controversies. National guidelines and current research are presented, along with recommendations for implementation.
4
Brinjikji, Waleed, Jonathan M. Morris, Robert D. Brown, Kent R. Thielen, John T. Wald, Caterina Giannini, Harry J. Cloft e Christopher P. Wood. "Neuroimaging Findings in Cardiac Myxoma Patients: A Single-Center Case Series of 47 Patients". Cerebrovascular Diseases 40, n. 1-2 (2015): 35–44. http://dx.doi.org/10.1159/000381833.
Testo completoAbstract (sommario):
Background and Purpose: Cardiac myxomas can present with a myriad of neurological complications including stroke, cerebral aneurysm formation and metastatic disease. Our study had two objectives: (1) to describe the neuroimaging findings of patients with cardiac myxomas and (2) to examine the relationship between a history of embolic complications secondary to myxoma and intracranial aneurysm formation, hemorrhage and metastatic disease. We hypothesized that patients who present with embolic complications related to myxoma would be more likely to have such complications. Materials and Methods: We searched our institutional database for all patients with pathologically proven cardiac myxomas from 1995 to 2014 who received neuroimaging. Neuroimaging findings were categorized as acute ischemic stroke, intracerebral hemorrhage, oncotic aneurysm, and cerebral metastasis. Cardiac myxoma patients were divided into those presenting with embolic complications (i.e. lower extremity emboli or cerebral emboli) and those presenting with non-embolic complications prior to surgical resection of the myxoma. The prevalence of intracranial hemorrhage, myxomatous aneurysm formation, and cerebral metastases was compared in myxoma patients presenting with and without embolic complications using a Chi-squared test. Results: Forty-seven consecutive patients were included in this study. Sixteen patients (34.0%) had imaging evidence of acute ischemic stroke. Of these, 13 had acute ischemic strokes directly attributed to the cardiac myxoma (27.7%) and 3 had acute ischemic strokes secondary to causes other than myxoma (6.4%). Seven patients (14.9%) had aneurysms. Two patients (4.3%) had parenchymal metastatic disease on long-term imaging. Fourteen patients (29.8%) presented with ischemic symptoms that were attributed to cardiac myxoma (1 with lower extremity ischemia, 1 with lower extremity ischemia and ischemic stroke, and 12 with ischemic stroke). Patients presenting with embolic complications related to the myxoma (ischemic stroke or lower extremity ischemia) were more likely to have imaging evidence of intracranial hemorrhage (21.4 vs. 3.0%, p = 0.09), oncotic aneurysm (35.7 vs. 6.1%, p = 0.03), and cerebral metastasis (14.3 vs. 0.0%, p = 0.07) on follow-up imaging. Conclusions: Ischemic stroke and intracranial oncotic aneurysm were found in a substantial proportion of cardiac myxoma patients undergoing neuroimaging. Patients presenting with embolic complications of cardiac myxoma are more likely to have intracranial hemorrhage, intracranial oncotic aneurysms, and cerebral metastatic disease.
5
Khodjaeva, N. A. "PREVALENCE OF ISCHEMIC STROKE IN BUKHARA REGION". Oriental Journal of Medicine and Pharmacology 02, n. 01 (1 marzo 2022): 168–75. http://dx.doi.org/10.37547/supsci-ojmp-02-01-13.
Testo completoAbstract (sommario):
We analyzed the frequency of occurrence of various types of strokes and studied data on the epidemiology of ischemic stroke subtypes using the example of one neurological department. The most common was the atherothrombotic type of ischemic stroke, the least common was the hemodynamic type. The highest risk of ischemic stroke of various types are people with hypertension, tobacco users and overweight, the likelihood of ischemic stroke is higher in autumn and spring.
6
Simats, Alba, Laura Ramiro, Teresa García-Berrocoso, Ferran Briansó, Ricardo Gonzalo, Luna Martín, Anna Sabé et al. "A Mouse Brain-based Multi-omics Integrative Approach Reveals Potential Blood Biomarkers for Ischemic Stroke". Molecular & Cellular Proteomics 19, n. 12 (31 agosto 2020): 1921–35. http://dx.doi.org/10.1074/mcp.ra120.002283.
Testo completoAbstract (sommario):
Stroke remains a leading cause of death and disability worldwide. Despite continuous advances, the identification of key molecular signatures in the hyper-acute phase of ischemic stroke is still a primary interest for translational research on stroke diagnosis, prognosis, and treatment. Data integration from high-throughput -omics techniques has become crucial to unraveling key interactions among different molecular elements in complex biological contexts, such as ischemic stroke. Thus, we used advanced data integration methods for a multi-level joint analysis of transcriptomics and proteomics data sets obtained from mouse brains at 2 h after cerebral ischemia. By modeling net-like correlation structures, we identified an integrated network of genes and proteins that are differentially expressed at a very early stage after stroke. We validated 10 of these deregulated elements in acute stroke, and changes in their expression pattern over time after cerebral ischemia were described. Of these, CLDN20, GADD45G, RGS2, BAG5, and CTNND2 were next evaluated as blood biomarkers of cerebral ischemia in mice and human blood samples, which were obtained from stroke patients and patients presenting stroke-mimicking conditions. Our findings indicate that CTNND2 levels in blood might potentially be useful for distinguishing ischemic strokes from stroke-mimicking conditions in the hyper-acute phase of the disease. Furthermore, circulating GADD45G content within the first 6 h after stroke could also play a key role in predicting poor outcomes in stroke patients. For the first time, we have used an integrative biostatistical approach to elucidate key molecules in the initial stages of stroke pathophysiology and highlight new notable molecules that might be further considered as blood biomarkers of ischemic stroke.
7
Nawab, Kalsoom, Anwar Ul Haq, Mehmood Akhtar Khattak, Hina Gul, Naheed Khan e Irsa Shoaib. "A Systematic Review of Magnetic Resonance Imaging for the Diagnosis of Stroke". Pakistan Journal of Medical and Health Sciences 17, n. 3 (8 giugno 2023): 764–65. http://dx.doi.org/10.53350/pjmhs2023173764.
Testo completoAbstract (sommario):
Background: With the advancement of magnetic resonance imaging (MRI), a non-invasive imaging technique, ischemic and hemorrhagic stroke diagnostic accuracy has increased significantly. The intricate resolution of MRI enables better visualisation of the structure of the brain and vulnerable regions to ischemia. As a result, the detection of hypoperfused areas is now more accurate. Additionally, MRI makes it possible to see hematomas in the brain, revealing hemorrhagic strokes brought on by burst arteries. MRI has become an essential tool in the fight against strokes because to its crucial role in evaluating damage caused by strokes. Purpose: The purpose of this article is to examine the advantages and disadvantages of utilising MRI scans to identify strokes. The use of MRI technology to identify brain injury and differentiate between strokes caused by blood flow and haemorrhage will be highlighted. When it comes to stroke therapy and prognosis, MRI might potentially affect the advice given by doctors. Methods: The Department of Radiology at KTH Hospital Peshawar thoroughly investigated the possibility of MRI for stroke diagnosis between March 2016 and March 2017. We searched the PubMed and EMBASE archives for papers about the use of MRI in stroke patient investigations in order to assemble the most information possible. We only chose studies that have a main concentration on MRI imaging and stroke patients. Results: Twenty-nine research publications examined the efficiency of MRI with an emphasis on stroke diagnosis. Twenty-four of them examined ischemic stroke diagnosis, while the remaining five concentrated on hemorrhagic stroke diagnosis. Findings showed that MRI was very accurate, with a sensitivity and specificity of up to 97% for ischemic stroke detection. MRI shown success in the diagnosis of hemorrhagic stroke, with a sensitivity and specificity of up to [100%]. Conclusions: MRI is a crucial tool for the diagnosis and treatment of stroke. Because of the great accuracy and sensitivity of this imaging method, both ischemic and hemorrhagic strokes may be identified. It also carefully evaluates the effects of a stroke on the brain. The early and successful diagnosis and treatment of stroke depend heavily on the use of MRI. Keywords: diagnosis, ischemic stroke, hemorrhagic stroke, and magnetic resonance imaging
8
Babirad, A. M. "ATTITUDES TOWARDS DISEASE IN PATIENTS WITH CHRONIC PHASE OF ISCHEMIC STROKE BY THE RESULTS OF THE PERSONAL QUESTIONNAIRE OF THE BEKHTEREV INSTITUTE". East European Journal of Parkinson`s Disease and Movement Disorders 6, n. 3-4 (30 dicembre 2020): 19–26. http://dx.doi.org/10.33444/2414-0007.6.3-4.19-26.
Testo completoAbstract (sommario):
Every year, strokes are diagnosed in about 16 million people, of whom 5.7 million die and about the same number become disabled (Feigin V.L., Forouzanfar M.H., Krishnamurthi R., et al., 2014; Virani S.S., Alonso A., Benjamin E.J., et al., 2020; Kim J., Thayabaranathan T., Donnan G.A., et al. 2020). The objective of our research was to study the attitudes towards disease in patients with chronic phase of ischemic stroke. Material and methods. 100 consecutive patients with chronic phase of ischemic stroke and 17 patients with chronic cerebral ischemia were questioned in neurology in-patient department. The types of attitude towards disease were identified with the help of the Personal Questionnaire of the Bekhterev Institute. Results. We found that pathological types of attitude towards disease begin to form before the development of a stroke as a result of chronic cerebral ischemia. Among patients with chronic phase of ischemic stroke, pathological types of attitude towards disease prevailed significantly, and the harmonious type was rare (84.0% vs 16.0%, p < 0.001). The most frequently observed were neurasthenic (36.0%), harmonious (16.0%), anxious (16.0%), ergopathic (10.0%) and sensitive (8.0%) types of attitude towards disease. Our study has shown that any ischemic stroke, even in the case of complete recovery of the lost functions, can be associated with pathological types of attitude towards disease. Keywords: ischemic stroke, the Personal Questionnaire of the Bekhterev Institute, attitudes towards disease.
9
Al-Mufti, Fawaz, Krishna Amuluru, William Roth, Rolla Nuoman, Mohammad El-Ghanem e Philip M. Meyers. "Cerebral Ischemic Reperfusion Injury Following Recanalization of Large Vessel Occlusions". Neurosurgery 82, n. 6 (11 luglio 2017): 781–89. http://dx.doi.org/10.1093/neuros/nyx341.
Testo completoAbstract (sommario):
Abstract Although stroke has recently dropped to become the nation's fifth leading cause of mortality, it remains the top leading cause of morbidity and disability in the US. Recent advances in stroke treatment, including intravenous fibrinolysis and mechanical thromboembolectomy, allow treatment of a greater proportion of stroke patients than ever before. While intra-arterial fibrinolysis with recombinant tissue plasminogen is an effective for treatment of a broad range of acute ischemic strokes, endovascular mechanical thromboembolectomy procedures treat severe strokes due to large artery occlusions, often resistant to intravenous drug. Together, these procedures result in a greater proportion of revascularized stroke patients than ever before, up to 88% in 1 recent trial (EXTEND-IA). Subsequently, there is a growing need for neurointensivists to develop more effective strategies to manage stroke patients following successful reperfusion. Cerebral ischemic reperfusion injury (CIRI) is defined as deterioration of brain tissue suffered from ischemia that concomitantly reverses the benefits of re-establishing cerebral blood flow following mechanical or chemical therapies for acute ischemic stroke. Herein, we examine the pathophysiology of CIRI, imaging modalities, and potential neuroprotective strategies. Additionally, we sought to lay down a potential treatment approach for patients with CIRI following emergent endovascular recanalization for acute ischemic stroke.
10
Berthet, Carole, Lijing Xin, Lara Buscemi, Corinne Benakis, Rolf Gruetter, Lorenz Hirt e Hongxia Lei. "Non-Invasive Diagnostic Biomarkers for Estimating the Onset Time of Permanent Cerebral Ischemia". Journal of Cerebral Blood Flow & Metabolism 34, n. 11 (3 settembre 2014): 1848–55. http://dx.doi.org/10.1038/jcbfm.2014.155.
Testo completoAbstract (sommario):
The treatments for ischemic stroke can only be administered in a narrow time-window. However, the ischemia onset time is unknown in ∼ 30% of stroke patients (wake-up strokes). The objective of this study was to determine whether MR spectra of ischemic brains might allow the precise estimation of cerebral ischemia onset time. We modeled ischemic stroke in male ICR-CD1 mice using a permanent middle cerebral artery filament occlusion model with laser Doppler control of the regional cerebral blood flow. Mice were then subjected to repeated MRS measurements of ipsilateral striatum at 14.1 T. A striking initial increase in γ-aminobutyric acid (GABA) and no increase in glutamine were observed. A steady decline was observed for taurine (Tau), N-acetylaspartate (NAA) and similarly for the sum of NAA+Tau+glutamate that mimicked an exponential function. The estimation of the time of onset of permanent ischemia within 6 hours in a blinded experiment with mice showed an accuracy of 33 ± 10 minutes. A plot of GABA, Tau, and neuronal marker concentrations against the ratio of acetate/NAA allowed precise separation of mice whose ischemia onset lay within arbitrarily chosen time-windows. We conclude that 1H-MRS has the potential to detect the clinically relevant time of onset of ischemic stroke.
11
Wang, Qianwen, Xu Liu e Ruixia Zhu. "Long Noncoding RNAs as Diagnostic and Therapeutic Targets for Ischemic Stroke". Current Pharmaceutical Design 25, n. 10 (5 agosto 2019): 1115–21. http://dx.doi.org/10.2174/1381612825666190328112844.
Testo completoAbstract (sommario):
LncRNAs (long non-coding RNAs) are endogenous molecules lacking protein-encoding capacity, which have been identified as key regulators of ischemic stroke. Increasing evidence suggests that lncRNAs play critical roles in several aspects of ischemic stroke, including atherosclerosis, dyslipidemia, hypertension, and diabetes mellitus. Hence, lncRNAs may further broaden our understanding of stroke pathogenesis. Altered lncRNA expression has been found in rodent focal cerebral ischemia models and oxygen–glucose deprived mouse brain microvascular endothelial cells as well as stroke patients. LncRNAs are considered to be promising biomarkers for the diagnosis and prognosis of cerebral ischemia. Here, we have reviewed the latest advances in lncRNA-based therapeutic approaches for ischemic disease. Accordingly, we summarize the current understanding of lncRNAs and ischemic stroke, focusing on the regulatory role of lncRNAs in ischemic stroke, as well as their potential as biomarkers and therapeutic targets in cerebral ischemia.
12
Hasibuan, Hijriyah Putri Tarmizi, e Isra Thristy. "Comparison of Tryglicerides Levels and Total Cholesterol in Ischemic Stroke and Haemorrhagic Stroke Patients". Muhammadiyah Medical Journal 1, n. 2 (16 novembre 2020): 49. http://dx.doi.org/10.24853/mmj.1.2.49-56.
Testo completoAbstract (sommario):
Background: Stroke is the second largest cause of death in the world. Stroke is classified based on its etiology as ischemic stroke and hemorrhagic stroke. Most large-scale studies on the risk of total cholesterol and triglyceride levels in stroke are not distinguished between ischemic and hemorrhagic strokes. Purposes: The purpose of this study was to determine the comparison of triglyceride and total cholesterol levels in ischemic stroke patients with hemorrhagic stroke. Method: Descriptive analytic study using medical records of patients at Medan Haji General Hospital in 2018-2019. The number of ischemic stroke patients is 28 patients and hemorrhagic stroke 28 patients with a total sample of 56 patients. Results: In ischemic stroke patients, the average value of triglyceride levels was 144.75 mg/dL and the average value of total cholesterol was 250.93 mg/dL. In hemorrhagic stroke patients, the average value of triglyceride levels is 126.93 mg/dL and the average total cholesterol level is 174.25 mg/dL. Conclusion: From this study we found a significant difference in total cholesterol between ischemic and hemorrhagic strokes. No significant difference was found in triglycerides between ischemic and hemorrhagic strokes.
13
Hasibuan, Hijriyah Putri Tarmizi, e Isra Thristy. "Comparison of Tryglicerides Levels and Total Cholesterol in Ischemic Stroke and Haemorrhagic Stroke Patients". Muhammadiyah Medical Journal 1, n. 2 (16 novembre 2020): 7. http://dx.doi.org/10.24853/mmj.1.2.7-14.
Testo completoAbstract (sommario):
Background: Stroke is the second largest cause of death in the world. Stroke is classified based on its etiology as ischemic stroke and hemorrhagic stroke. Most large-scale studies on the risk of total cholesterol and triglyceride levels in stroke are not distinguished between ischemic and hemorrhagic strokes. Purposes: The purpose of this study was to determine the comparison of triglyceride and total cholesterol levels in ischemic stroke patients with hemorrhagic stroke. Method: Descriptive analytic study using medical records of patients at Medan Haji General Hospital in 2018-2019. The number of ischemic stroke patients is 28 patients and hemorrhagic stroke 28 patients with a total sample of 56 patients. Results: In ischemic stroke patients, the average value of triglyceride levels was 144.75 mg/dL and the average value of total cholesterol was 250.93 mg/dL. In hemorrhagic stroke patients, the average value of triglyceride levels is 126.93 mg/dL and the average total cholesterol level is 174.25 mg/dL. Conclusion: From this study we found a significant difference in total cholesterol between ischemic and hemorrhagic strokes. No significant difference was found in triglycerides between ischemic and hemorrhagic strokes.
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Shakil, Saate S., Sophia Emmons-Bell, Christine Rutan, Jason Walchok, Babak Navi, Richa Sharma, Kevin Sheth, Gregory A. Roth e Mitchell S. V. Elkind. "Stroke Among Patients Hospitalized With COVID-19: Results From the American Heart Association COVID-19 Cardiovascular Disease Registry". Stroke 53, n. 3 (marzo 2022): 800–807. http://dx.doi.org/10.1161/strokeaha.121.035270.
Testo completoAbstract (sommario):
Background and Purpose: Coronavirus disease 2019 (COVID-19) may be associated with increased risk for ischemic stroke. We present prevalence and characteristics of strokes in patients with laboratory-confirmed severe acute respiratory syndrome coronavirus-2 infection enrolled in the American Heart Association COVID-19 Cardiovascular Disease Registry. Methods: In this quality improvement registry study, we examined demographic, baseline clinical characteristics, and in-hospital outcomes among hospitalized COVID-19 patients. The primary outcomes were ischemic stroke or transient ischemic attack (TIA) and in-hospital death. Results: Among 21 073 patients with COVID-19 admitted at 107 hospitals between January 29, 2020, and November 23, 2020, 160 (0.75%) experienced acute ischemic stroke/TIA (55.3% of all acute strokes) and 129 (0.61%) had other types of stroke. Among nonischemic strokes, there were 44 (15.2%) intracerebral hemorrhages, 33 (11.4%) subarachnoid hemorrhages, 21 (7.3%) epidural/subdural hemorrhages, 2 (0.7%) cerebral venous sinus thromboses, and 24 (8.3%) strokes not otherwise classified. Asians and non-Hispanic Blacks were overrepresented among ischemic stroke/TIA patients compared with their overall representation in the registry, but adjusted odds of stroke did not vary by race. Median time from COVID-19 symptom onset to ischemic stroke was 11.5 days (interquartile range, 17.8); median National Institutes of Health Stroke Scale score was 11 (interquartile range, 17). COVID-19 patients with acute ischemic stroke/TIA had higher prevalence of hypertension, diabetes, and atrial fibrillation compared with those without stroke. Intensive care unit admission and mechanical ventilation were associated with higher odds of acute ischemic stroke/TIA, but older age was not a predictor. In adjusted models, acute ischemic stroke/TIA was not associated with in-hospital mortality. Conclusions: Ischemic stroke risk did not vary by race. In contrast to the association between older age and death from COVID-19, ischemic stroke risk was the highest among middle-aged adults after adjusting for comorbidities and illness severity, suggesting a potential mechanism for ischemic stroke in COVID-19 independent of age-related atherosclerotic pathways.
15
Amalia Amin, Assyifa. "POST ISCHEMIC STROKE IMAGING AND ITS CLINICAL RELEVANCE: A SYSTEMATIC REVIEW". Journal of Advance Research in Medical & Health Science (ISSN: 2208-2425) 9, n. 5 (19 maggio 2023): 45–50. http://dx.doi.org/10.53555/nnmhs.v9i5.1682.
Testo completoAbstract (sommario):
Stroke is a focal or global functional brain disorder that starts suddenly and lasts longer than 24 hours and is caused by changes in cerebral blood flow. It is not caused by transient cerebral circulatory abnormalities, brain tumors, or secondary strokes as a result of trauma or infection. Strokes can develop in any part of the brain. Ischemia or brain hemorrhage are also potential causes of a stroke that occurs suddenly and leads in neurologic impairments. Strokes are classified into two types: bleeding and non-bleeding. Both are potentially fatal. Several studies have found that imaging is required before treating an acute ischemic stroke. The importance of imaging after stroke treatment, on the other hand, is less obvious. Bleeding, particularly cerebral haemorrhage, is the most feared complication in people who have had acute ischemic stroke treatment. As a result, the AHA/ASA IV-tPA guidelines recommend that a non-contrast computed tomography (NCCT) brain scan be performed at least 24 hours after therapy. Non-contrast CT (NCCT) is still the cheapest, quickest, most generally available, and simplest method for diagnosing intracerebral bleeding after an ischemic stroke. However, MRI with the right sequences may be able to detect the same thing. The NCCT may frequently detect hyperdense regions following treatment for acute ischemic stroke. Magnetic resonance imaging (MRI) is one of the most commonly used imaging methods both before and after stroke treatment due to the wealth of information it gives. Finally, post-ischemic stroke imaging is becoming increasingly essential because it can provide both specific clinical guidance and a better knowledge of the processes that occur after such a severe impact on the brain. It may aid in the prediction of long-term outcomes and, in the future, may assist clinicians in tailoring and optimizing rehabilitation efforts for specific patients.
16
Lobzin, V. Yu, e L. G. Nikiforova. "Dopplerographic features of venous cerebral blood flow disorders in acute period of ischemic stroke". Medical alphabet, n. 1 (2 marzo 2022): 22–28. http://dx.doi.org/10.33667/2078-5631-2022-1-22-28.
Testo completoAbstract (sommario):
The article analyzes results of a Doppler study of brachiocephalic vessels in the acute period of ischemic stroke. The role of the venous link of blood flow in maintaining the intracerebral constant in the acute period of ischemic stroke was revealed. The features of the reactivity of cerebral venous hemodynamics in patients with different volumes of brain damage during the formation of ischemic foci of various localization are shown. Attention is paid to the importance of a comprehensive assessment of cerebral venous circulation in the acute period of ischemic stroke. It was shown that in patients with ischemic stroke involving one or two lobes of one hemisphere of the brain, there was a significant increase in the size of the areas and a significant decrease in the speed indicators in the internal jugular and vertebral veins, respectively, the localization of the ischemic focus. It was found that in hemispheric ischemic strokes with signs of cerebral edema, cerebral blood flow disturbances were maximal and were accompanied by a paradoxical reaction of hemodynamic compensatory mechanisms, but no lateralization of dysgemia was observed according to the focus of ischemia.
17
Lee, Kathy B. "Can the Use of Oral Minocycline Improve Ischemic Stroke Outcomes?" Journal of Pharmacy Practice 21, n. 2 (aprile 2008): 159–64. http://dx.doi.org/10.1177/0897190007312310.
Testo completoAbstract (sommario):
Cerebrovascular accident (CVA), also known as ischemic stroke, is the sudden onset of neurologic deficit attributable to a focal vascular cause.1 It is the third leading cause of death, with the death rate being reported as 50.0 (per 100,000 population) in the United States in 2004.2 It is also a leading cause for serious, long-term disability in the United States. While there are various causes, the large majority of strokes result from either global or focal ischemia of the brain. Ischemic stroke accounts for 87% of all strokes, while intracerebral and subarachnoid hemorrhage makes up the remainder. 2 Currently, the primary pharmacological agents used in stroke treatment are thrombolytics, not without limitations, however, and antiplatelet therapy. 3 Minocycline, a semisynthetic tetracycline antibiotic, has recently gained attention as a neuroprotective agent. A recent study evaluated the use of minocycline in the treatment of acute stroke and demonstrated promising results.4 A review of the mechanisms of action and data presented in past studies will be examined to evaluate the efficacy and clinical impact of minocycline in the treatment of acute ischemic stroke.
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Ramazanov, G. R., A. N. Trofimova, E. A. Kovaleva e E. V. Shevchenko. "Аortic arch atheroma as a source of arterio-arterial embolism and ischemic stroke". Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH) 13, n. 2 (24 febbraio 2023): 31–39. http://dx.doi.org/10.20340/vmi-rvz.2023.2.clin.1.
Testo completoAbstract (sommario):
Introduction. Currently, despite the introduction of modern diagnostic algorithms in 20-40 % of patients with ischemic stroke, it is not possible to establish its cause. Potential causes of acute cerebral ischemia in patients with cryptogenic ischemic stroke include paroxysmal atrial fibrillation, patent foramen ovale, atrial cardiomyopathy, carotid network, aortic arch atheroma, and cancer-associated thrombophilia.Target: to systematize data on methods for diagnosing and preventing aortic arch atheroma.Material and methods. The literature search was carried out in electronic search systems Scopus, eLibrary, PubMed using the key words: ischemic stroke, cryptogenic stroke, aortic arch atheroma, pathogenesis of ischemic stroke.Results. At present, despite such a detailed study of therapeutic strategies for the prevention of recurrent thrombotic events in patients with aortic arch atheroma, none of the drugs has proven its advantage. Although the NAVIGATE ESUS and RESPECT ESUS trials did not show the superiority of oral anticoagulants over antiplatelet agents in preventing recurrent ischemic strokes in patients with cryptogenic stroke, it was found that cryptogenic ischemic stroke is heterogeneous, which requires a differentiated approach to secondary prevention.Conclusion. Аortic atheroma can be the cause of embolic syndrome and cryptogenic stroke. The main methods for diagnosing aortic atheroma are transesophageal echocardiography and computed tomographic angiography. The therapeutic strategy for the treatment of aortic atheroma is lipid-lowering, antithrombotic therapy in combination with blockers of the renin-angiotensin-aldosterone system.
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Somasundaran, Abhilash, Hashik Mohammed, Jayaraj Kezhukatt, Alvin Treasa George e S. Narayanan Potty. "Accuracy of Siriraj stroke scale in the diagnosis of stroke subtypes among stroke patients". International Journal of Research in Medical Sciences 5, n. 3 (20 febbraio 2017): 1084. http://dx.doi.org/10.18203/2320-6012.ijrms20170666.
Testo completoAbstract (sommario):
Background: Early detection of intracranial blood is essential for the rational use of anti hemostatic drugs in stroke patients. CT scan is quite expensive as well as it is not easily available especially in the rural areas. Clinical stroke scores were developed to overcome these limitations. Aim of present study is to identify the stroke subtype using Siriraj stroke scoring and thus asses its accuracy by comparing with CT scan reports.Methods: A cross sectional study was conducted in a tertiary centre that evaluated 464 patients admitted with a diagnosis of stroke. Siriraj Stroke score was calculated for each patient and a CT scan of brain was also taken. The results of diagnosis made by Siriraj stroke scoring were compiled and compared with the diagnosis obtained by CT Scan.Results: Of the total 464 patients, the incidence of hemorrhagic stroke was 27.8% and ischemic stroke was 72.2%, as per the CT scan reports, while the Siriraj stroke score diagnosed 16.8% patients to have hemorrhagic stroke and 74.6% to have ischemic stroke and no definite diagnosis was made in rest of the patients (8.6%). The sensitivity of the scoring was found to be 59.2% in diagnosing hemorrhagic stroke and 95.5% in ischemic stroke.Conclusions: Our study has shown that siriraj stroke scoring has a high degree of accuracy in detecting both types of strokes, with roughly 80% of both hemorrhagic and ischemic strokes being correctly identified. However there is a low sensitivity in diagnosing hemorrhagic strokes and higher sensitivity in diagnosing ischemic strokes.
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Kvistad, Christopher Elnan, Vojtech Novotny, Halvor Næss, Guri Hagberg, Hege Ihle-Hansen, Ulrike Waje-Andreassen, Lars Thomassen e Nicola Logallo. "Safety and predictors of stroke mimics in The Norwegian Tenecteplase Stroke Trial (NOR-TEST)". International Journal of Stroke 14, n. 5 (18 luglio 2018): 508–16. http://dx.doi.org/10.1177/1747493018790015.
Testo completoAbstract (sommario):
Background Stroke mimics are frequently treated with thrombolysis in clinical practice and thrombolytic trials. Although alteplase in stroke mimics has proven to be safe, safety of tenecteplase in stroke mimics has not been assessed in an ischemic stroke study setting. We aimed to assess clinical characteristics and safety of stroke mimics treated with thrombolysis in the Norwegian Tenecteplase Stroke Trial. We also aimed to identify possible predictors of stroke mimics as compared to patients with acute cerebral ischemia. Methods Norwegian Tenecteplase Stroke Trial was a phase-3 trial investigating safety and efficacy of tenecteplase vs. alteplase in patients with suspected acute cerebral ischemia. Two groups were defined based on diagnose at discharge: patients with a different diagnose than ischemic stroke or transient ischemic attack (stroke mimics group) and patients diagnosed with ischemic stroke or transient ischemic attack (acute cerebral ischemia group). Logistic regression analyses were performed with stroke mimics vs. acute cerebral ischemia as dependent variable to identify predictors of stroke mimics. Results Of 1091 randomized patients, 181 (16.6%) were stroke mimics. Migraine (22.2%) and peripheral vertigo (11.4%) were the two most frequent stroke mimic-diagnoses. There was no symptomatic intracerebral hemorrhage in the stroke mimics group. Stroke mimics were independently associated with age ≤60 years (OR 2.75, p < 0.001), female sex (OR 1.48, p = 0.026), no history of myocardial infarction (OR 2.03, p = 0.045), systolic BP ≤ 150 mmHg (OR 2.33, p < 0.001), NIHSS ≤ 6 points (OR 1.83, p = 0.011), sensory loss (OR 1.55, p = 0.015), and no facial paresis (OR 2.41, p < 0.001) on admission. Conclusion Thrombolysis with tenecteplase seems to be as safe as with alteplase in stroke mimics. Predictors were identified for stroke mimics which may contribute to differentiate stroke mimics from acute cerebral ischemia in future stroke trials.
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fitria candradewi, susan, e Shinta Dewi Nur Rahmah. "ANALISIS HUBUNGAN TERAPI ANTIHIPERTENSI SEBAGAI PENCEGAHAN SEKUNDER TERHADAP KEJADIAN SERANGAN ULANG STROKE ISKEMIK PADA PASIEN STROKE ISKEMIK". Jurnal Insan Farmasi Indonesia 5, n. 1 (29 maggio 2022): 1–8. http://dx.doi.org/10.36387/jifi.v5i1.923.
Testo completoAbstract (sommario):
Individuals who survive a first ischemic stroke are at high risk for recurrent stroke. This study aims to analyze the relationship between antihypertensives on the incidence of ischemic stroke recurrence in ischemic stroke patients. Type of research is analytic observational with a retrospective cohort approach. The research sample was taken using purposive sampling technique. The research sample was patients who had an ischemic stroke at PKU Muhammadiyah Hospital Yogyakarta in 2018. There were 201 samples that met the inclusion criteria. Consisting of 135 treatment groups and 66 patients as the control group. In the treatment group, 110 patients did not have recurrent strokes and 25 patients had recurrent strokes. In the control group there were 58 patients who did not have recurrent strokes and 8 patients had recurrent strokes. Statistical analysis showed an RR value of 0.927 (95% CI: 0.822-1.046) and p-value of 0.344. The conclusion from the results of this study is that there is no relationship between the administration of antihypertensive therapy with the incidence of ischemic stroke recurrence in ischemic stroke patients at PKU Muhammadiyah Hospital Yogyakarta.
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Halil, Eray. "CT perfusion – an up-to-date element of the contemporary multimodal diagnostic approach to acute ischemic stroke". Folia Medica 65, n. 4 (31 agosto 2023): 531–38. http://dx.doi.org/10.3897/folmed.65.e96954.
Testo completoAbstract (sommario):
Acute ischemic stroke is of great clinical and societal importance due to its high incidence and mortality rates, as well as the fact that those who are affected suffer from permanent acquired disability. Modern trends explicitly state that the disease’s diagnostic plan should use a multidisciplinary approach. The therapeutic steps that ultimately determine the clinical outcome are defined by an accurate diagnosis of acute ischemic stroke. Highly specialized facilities for the diagnosis and treatment of acute ischemic stroke (Stroke Units) are in operation in countries that make significant investments in healthcare. Imaging the brain parenchyma at risk, or the so-called ischemic penumbra, in acute ischemic stroke is one of the main tasks of the multimodal computed tomography approach. The most rapid method for imaging the ischemic penumbra is computed tomography perfusion (CTP). This modality provides information about the anatomy and the physiologic state of the brain parenchyma. The current literature review offers a comprehensive overview of the various aspects of computed tomography perfusion in acute ischemic stroke and, more specifically, about the differential diagnosis of acute ischemic strokes and diseases that mimic strokes, predicting the risk of hemorrhagic transformation, the computed tomography perfusion used in intravenous thrombolysis (IVT) beyond the therapeutic window, wake-up strokes (WUS) and strokes of unknown onset (SUKO), and the reported predictive parameters of CTP in correlation with the clinical outcome in acute ischemic stroke.
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Wu, Cheng-Tien, Ting-Hua Yang, Man-Chih Chen, Siao-Syun Guan, Chang-Mu Chen e Shing-Hwa Liu. "Therapeutic Effect of Icaritin on Cerebral Ischemia-Reperfusion-Induced Senescence and Apoptosis in an Acute Ischemic Stroke Mouse Model". Molecules 27, n. 18 (7 settembre 2022): 5783. http://dx.doi.org/10.3390/molecules27185783.
Testo completoAbstract (sommario):
An ischemic stroke is brain damage caused by interruption of blood supply to the brain that can cause death and long-term disability. New medical strategies or therapies are urgently needed for ischemic stroke. Icaritin (ICT) is a metabolite of icariin (ICA), which are two active flavonoid components extracted from Herba epimedii and considered neuroprotective agents in animal models of Alzheimer’s disease and ischemic stroke. The therapeutic effect of ICT on ischemic still remains to be clarified. The aim of this study was to investigate the therapeutic effect of ICT on cerebral ischemia-reperfusion-associated senescence and apoptosis in a middle cerebral artery occlusion (MCAO) mouse model (ischemia for 50 min and reperfusion for 24 h). Administration of ICT after ischemia significantly reduced MCAO-induced neurological damage, infarct volume, and histopathological changes in the brain of acute ischemic stroke mice. ICT treatment could also reduce neuronal apoptosis and senescence and reversed the expression of apoptosis- and senescence-related signaling proteins. These findings suggest that ICT may have therapeutic potential to ameliorate acute ischemic stroke.
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Baule, Antonio. "About ESUS…". AboutOpen 4, n. 1 (26 ottobre 2018): 179–84. http://dx.doi.org/10.19156/abtpn.2018.0070.
Testo completoAbstract (sommario):
Five subtypes of Ischemic stroke are classified based on therir causes. ESUS (Embolic Stroke of Undetermined Source) stands for a non-lacunar cerebral infarct, in the absence of stenosis of large arteries or causes of cardioembolic stroke. It is estimated that ESUS accounts for about 25% of all ischemic strokes. A multidisciplinary, multistep diagnostic investigation is needed for a correct diagnosis, in order to exclude other possible causes of stroke. At present there are limited indications on how to plan secondary prevention of ischemic stroke in patients with ESUS. In the patient described, cortical ischemia, probably arising following an arterial embolization, represents an index event that could be classified as ESUS: in this case dabigatran was administered off-label, althoughin this type of patient this could be soon supported by the results of the RESPECT-ESUS study, a randomized trial comparing dabigatran and ASA in patients with recent ESUS, to test whether anticoagulant therapy can improve the outcome of patients in this clinical condition (Cardiology).
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Basu, Elora, Setareh Salehi Omran, Hooman Kamel e Neal S. Parikh. "Sex differences in the risk of recurrent ischemic stroke after ischemic stroke and transient ischemic attack". European Stroke Journal 6, n. 4 (9 novembre 2021): 367–73. http://dx.doi.org/10.1177/23969873211058568.
Testo completoAbstract (sommario):
Background Sex differences in stroke outcomes have been noted, but whether this extends to stroke recurrence is unclear. We examined sex differences in recurrent stroke using data from the Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) trial. Patients and methods We assessed the risk of recurrent stroke in women compared to men using data from the POINT trial. Adults >18 years old were randomized within 12 hours of onset of minor ischemic stroke or transient ischemic attack (TIA), and followed for up to 90 days for ischemic stroke, our primary outcome. We used Cox proportional hazards model adjusted for demographics and stroke risk factors to evaluate the association between sex and stroke recurrence. We used interaction term testing and prespecified subgroup analyses to determine if the association between sex and recurrent stroke differed by age (<60 versus >60 years old), locale (US versus non-US), and index event type (stroke versus TIA). Last, we evaluated whether sex modified the effect of common stroke risk factors on stroke recurrence. Results Of 4,881 POINT trial participants with minor stroke or high-risk TIA, 2,195 (45%) were women. During the 90-day follow-up period, 267 ischemic strokes occurred; 121 were in women and 146 in men. The cumulative risk of recurrent ischemic stroke was not significantly different among women (5.76%; 95% CI, 4.84%–6.85%) compared to men (5.67%; 95% CI, 4.83%–6.63%). Women were not at a different risk of recurrent ischemic stroke compared to men (hazard ratio [HR], 1.02; 95% CI, 0.80–1.30) in unadjusted models or after adjusting for covariates. However, there was a significant interaction of age with sex (P=0.04). Among patients <60 years old, there was a non-significantly lower risk of recurrent stroke in women compared to men (HR 0.66; 95% CI 0.42–1.05). Last, sex did not modify the association between common stroke risk factors and recurrent stroke risk. Discussion and Conclusion Among patients with minor stroke or TIA, the risk of recurrent ischemic stroke and the impact of common stroke risk factors did not differ between men and women.
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Kauw, Frans, Richard A. P. Takx, Hugo W. A. M. de Jong, Birgitta K. Velthuis, L. Jaap Kappelle e Jan W. Dankbaar. "Clinical and Imaging Predictors of Recurrent Ischemic Stroke: A Systematic Review and Meta-Analysis". Cerebrovascular Diseases 45, n. 5-6 (2018): 279–87. http://dx.doi.org/10.1159/000490422.
Testo completoAbstract (sommario):
Background: Predictors of recurrent ischemic stroke are less well known in patients with a recent ischemic stroke than in patients with transient ischemic attack (TIA). We identified clinical and radiological factors for predicting recurrent ischemic stroke in patients with recent ischemic stroke. Methods: A systematic search in PubMed, Embase, Cochrane Library, and CINAHL was performed with the terms “ischemic stroke,” “predictors/determinants,” and “recurrence.” Quality assessment of the articles was performed and the level of evidence was graded for the articles included for the meta-analysis. Pooled risk ratios (RR) and heterogeneity (I2) were calculated using inverse variance random effects models. Results: Ten articles with high-quality results were identified for meta-analysis. Past medical history of stroke or TIA was a predictor of recurrent ischemic stroke (pooled RR 2.5, 95% CI 2.1–3.1). Small vessel strokes were associated with a lower risk of recurrence than large vessel strokes (pooled RR 0.3, 95% CI 0.1–0.7). Patients with stroke of an undetermined cause had a lower risk of recurrence than patients with large artery atherosclerosis (pooled RR 0.5, 95% CI 0.2–1.1). We found no studies using CT or ultrasound for the prediction of recurrent ischemic stroke. The following MRI findings were predictors of recurrent ischemic stroke: multiple lesions (pooled RR 1.7, 95% CI 1.5–2.0), multiple stage lesions (pooled RR 4.1, 95% CI 3.1–5.5), multiple territory lesions (pooled RR 2.9, 95% CI 2.0–4.2), chronic infarcts (pooled RR 1.5, 95% CI 1.2–1.9), and isolated cortical lesions (pooled RR 2.2, 95% CI 1.5–3.2). Conclusions: In patients with a recent ischemic stroke, a history of stroke or TIA and the subtype large artery atherosclerosis are associated with an increased risk of recurrent ischemic stroke. Predictors evaluated with MRI include multiple ischemic changes and isolated cortical lesions. Predictors of recurrent ischemic stroke concerning CT or ultrasound have not been published.
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Sun, Xiaohui, Tian Wang, Lin Zhou, Yawen Yu, Zhaofeng Liu, Runchen Ma e Fenghua Fu. "How antidepressants affect the cerebral ischemic injury and ischemic stroke". Journal of Pharmaceutical and Biopharmaceutical Research 4, n. 2 (17 febbraio 2023): 318–25. http://dx.doi.org/10.25082/jpbr.2022.02.003.
Testo completoAbstract (sommario):
Ischemic stroke is the main cause of long-term disability and death worldwide. Studies have pointed out that antidepressants not only can be used to treat depression, but also promote nerve regeneration, nerve plasticity, and recovery of nerve function after stroke. Some evidences indicated that antidepressants have beneficial effects on ischemic stroke. At the same time, there are also risks in treatment process. The mechanisms of the effects of antidepressants on ischemic stroke are complicated and rarely reported. This review summarizes the roles of antidepressants in patients and animal models of stroke, the possible mechanisms of antidepressants against brain injury induced by stroke, and the risks and challenges of antidepressants treatment in patients with ischemia.
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Cao, Cathy, Ashley Martinelli, Brian Spoelhof, Rafael H. Llinas e Elisabeth B. Marsh. "In Potential Stroke Patients on Warfarin, the International Normalized Ratio Predicts Ischemia". Cerebrovascular Diseases Extra 7, n. 2 (11 agosto 2017): 111–19. http://dx.doi.org/10.1159/000478793.
Testo completoAbstract (sommario):
Background: Stroke can occur in patients on warfarin despite anticoagulation. Patients with a low international normalized ratio (INR) should theoretically be at greater risk for ischemia than those who are therapeutic. Therefore, INR may be able to indicate whether new neurological deficits are more likely strokes or stroke mimics in patients on warfarin. This study evaluates the association and predictive value of INR in determining the likelihood of ischemia. Methods: Patients were identified using the acute stroke registry at a Primary Stroke Center from January 2013 through December 2014. All adult patients undergoing evaluation for acute stroke with prior documented use of warfarin and an INR level at presentation were included. Data were collected regarding patient demographics, medical comorbidities, stroke severity, reason for anticoagulation, and laboratory studies including INR. Student t tests and χ2 analysis were used to evaluate factors associated with increased likelihood of ischemia (stroke or transient ischemic attack) versus mimic. Significant results were entered into a multivariable regression analysis. Sensitivity and specificity analyses were conducted to determine the predictive value of INR for ischemic risk. Results: 116 patients were included; 46 were diagnosed with ischemia, 70 were diagnosed as mimics. 75% of patients were on warfarin for atrial fibrillation versus 25% for venous thrombosis. A statistically significant difference in mean INR for patients with ischemia (n = 46) versus mimics (n = 70) was observed (1.7 vs. 2.8; p < 0.001). In multivariable analysis, both sub-therapeutic INR (p < 0.001) and atrial fibrillation (p = 0.014) were predictors of ischemia. In patients with an INR ≥2, the predictive value of having a non-ischemic etiology was 79%. No patient with an INR of ≥3.6 was found to have ischemia. Conclusions: Sub-therapeutic INR and atrial fibrillation are strongly associated with ischemia in patients on warfarin presenting with acute neurologic symptoms. Ischemia is far less likely in patients with an INR of ≥2 and rare in those with an INR ≥3.6. This study shows that the INR value of a patient on warfarin can help stratify patients’ risk for acute ischemic stroke and guide further neurologic imaging and workup.
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Mandal, SK, M. Majumder, MS Hossain e M. Sarker. "Serum Ferritin and Plasma Fibrinogen Level in Acute Ischemic Stroke". Bangladesh Journal of Medical Biochemistry 10, n. 1 (17 maggio 2018): 16–20. http://dx.doi.org/10.3329/bjmb.v10i1.36694.
Testo completoAbstract (sommario):
Acute ischemic stroke is the primary pathology of brain vascular system that temporarily or permanently affects brain functions as a result of ischemia. In ischemic stroke events, many biochemical and immunological reactions occur secondarily in response to the reduced cerebral blood flow. Brain tissue damage after acute ischemic stroke is mediated partly by inflammation induced by ischemia-reperfusion injury. It is thought that acute ischemic stroke due to cerebral ischemia triggers acute phase reaction and the blood concentration of ferritin and fibrinogen could rise during brain infarction. This study was carried out in the Department of Biochemistry, Sylhet MAG Osmani Medical College during the period of July 2015 to June 2016 to evaluate the status of ferritin and fibrinogen in acute ischemic stroke patients. For this study serum ferritin and plasma fibrinogen level were assessed in 50 acute ischemic stroke patients and 50 normal individuals. Data were analyzed with the help of SPSS version 19.0. Unpaired Student's 't' test and Mann-Whitney U test were done to see the level of significance. Findings of the study revealed that serum ferritin and plasma fibrinogen levels were 83.1 ng/ml and 190.6 mg/dl in subjects with acute ischemic stroke, while in control subjects these were 41.3 ng/ml and 177.0 mg/dl respectively. Study showed that serum ferritin and plasma fibrinogen levels were significantly higher in patients with ischemic acute stroke compared to that of normal controls (p<0.001). It may be concluded that serum ferritin and plasma fibrinogen levels are significantly increased in acute ischemic stroke.Bangladesh J Med Biochem 2017; 10(1): 16-20
30
Rogozhina, A. A. "Sphingolipids in ischemic stroke". Ateroscleroz 17, n. 4 (13 gennaio 2022): 93–100. http://dx.doi.org/10.52727/2078-256x-2021-17-4-93-100.
Testo completoAbstract (sommario):
Determination of new biomarkers involved in the pathogenesis of ischemic stroke is an extremely important task from the point of view of identifying possible mechanisms for preventing the occurrence of an acute event, better diagnosis, and influencing the stages of pathogenesis to reduce the inflammatory focus. Sphingolipids belong to new biomarkers of atherosclerosis, which are involved in inflammation, apoptosis, and ischemia. The widespread introduction of mass spectrometry has made it possible to study sphingolipids in more detail. This review aims to summarize the available data on the role of sphingolipids in ischemic stroke.
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Liu, Shimin, Honglian Shi, Wenlan Liu, Takamitsu Furuichi, Graham S. Timmins e Ke Jian Liu. "Interstitial pO2 in Ischemic Penumbra and Core are Differentially Affected following Transient Focal Cerebral Ischemia in Rats". Journal of Cerebral Blood Flow & Metabolism 24, n. 3 (marzo 2004): 343–49. http://dx.doi.org/10.1097/01.wcb.0000110047.43905.01.
Testo completoAbstract (sommario):
Stroke causes heterogeneous changes in tissue oxygenation, with a region of decreased blood flow, the penumbra, surrounding a severely damaged ischemic core. Treatment of acute ischemic stroke aims to save this penumbra before its irreversible damage by continued ischemia. However, effective treatment remains elusive due to incomplete understanding of processes leading to penumbral death. While oxygenation is central in ischemic neuronal death, it is unclear exactly what actual changes occur in interstitial oxygen tension (pO2) in ischemic regions during stroke, particularly the penumbra. Using the unique capability of in vivo electron paramagnetic resonance (EPR) oximetry to measure localized interstitial pO2, we measured both absolute values, and temporal changes of pO2 in ischemic penumbra and core during ischemia and reperfusion in a rat model. Ischemia rapidly decreased interstitial pO2 to 32% ± 7.6% and 4% ± 0.6% of pre-ischemic values in penumbra and core, respectively 1 hour after ischemia. Importantly, whilst reperfusion restored core pO2 close to its pre-ischemic value, penumbral pO2 only partially recovered. Hyperoxic treatment significantly increased penumbral pO2 during ischemia, but not in the core, and also increased penumbral pO2 during reperfusion. These divergent, important changes in pO2 in penumbra and core were explained by combined differences in cellular oxygen consumption rates and microcirculation conditions. We therefore demonstrate that interstitial pO2 in penumbra and core is differentially affected during ischemia and reperfusion, providing new insights to the pathophysiology of stroke. The results support normobaric hyperoxia as a potential early intervention to save penumbral tissue in acute ischemic stroke.
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Zhan, Xinhua, Bradley P. Ander, Glen Jickling, Renée Turner, Boryana Stamova, Huichun Xu, Dazhi Liu, Ryan R. Davis e Frank R. Sharp. "Brief Focal Cerebral Ischemia That Simulates Transient Ischemic Attacks in Humans Regulates Gene Expression in Rat Peripheral Blood". Journal of Cerebral Blood Flow & Metabolism 30, n. 1 (9 settembre 2009): 110–18. http://dx.doi.org/10.1038/jcbfm.2009.189.
Testo completoAbstract (sommario):
Blood gene expression profiles of very brief (5 and 10 mins) focal ischemia that simulates transient ischemic attacks in humans were compared with ischemic stroke (120 mins focal ischemia), sham, and naïve controls. The number of significantly regulated genes after 5 and 10 mins of cerebral ischemia was 39 and 160, respectively (fold change ⩾∣1.5∣ and P<0.05). There were 103 genes common to brief focal ischemia and ischemic stroke. Ingenuity pathway analysis showed that genes regulated in the 5 mins group were mainly involved in small molecule biochemistry. Genes regulated in the 10 mins group were involved in cell death, development, growth, and proliferation. Such genes were also regulated in the ischemic stroke group. Genes common to ischemia were involved in the inflammatory response, immune response, and cell death—indicating that these pathways are a feature of focal ischemia, regardless of the duration. These results provide evidence that brief focal ischemia differentially regulates gene expression in the peripheral blood in a manner that could distinguish brief focal ischemia from ischemic stroke and controls in rats. We postulate that this will also occur in humans.
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Shahar, Eyal, Lloyd E. Chambless, Wayne D. Rosamond, Lori L. Boland, Christie M. Ballantyne, Paul G. McGovern e A. Richey Sharrett. "Plasma Lipids, Lipoproteins, and Apolipoproteins and Incident Ischemic Stroke:". Circulation 103, suppl_1 (marzo 2001): 1363. http://dx.doi.org/10.1161/circ.103.suppl_1.9998-63.
Testo completoAbstract (sommario):
P63 The role of plasma lipids, lipoproteins, and apolipoproteins in the pathogenesis of ischemic stroke is unclear. We examined the association of incident hospitalized ischemic stroke with baseline plasma measurements of LDL-cholesterol, apoB, HDL-cholesterol, apoA-1, and triglycerides in a population-derived sample of 14,175 middle-aged men and women. Over an average follow up of 8.2 years, we documented 233 incident ischemic strokes (120 in men; 113 in women). After multivariable adjustment for stroke risk factors, categorical analysis revealed weak, inconsistent, and statistically non-significant associations between ischemic stroke and the five analytes. For example, the adjusted hazard ratios (95% CI) of ischemic stroke for the top fourth versus the bottom fourth were 1.17 (0.81-1.68) for LDL-cholesterol; 1.29 (0.90-1.87) for apoB; 0.90 (0.57-1.41) for HDL-cholesterol; 0.83 (0.55-1.26) for apoA-1; and 1.25 (0.82-1.92) for triglycerides. Sex-specific analysis (supported by evidence of statistical interaction) indicated lack of any association in men. In women, however, we observed moderate associations of ischemic stroke with LDL-cholesterol, apoB, and triglycerides, primarily restricted to the right tail of their distributions. Hazard ratios of ischemic stroke in women are shown in the table below. These findings are compatible with the following hypotheses: 1) The effect of LDL-cholesterol, apoB, and triglycerides on ischemic stroke might differ qualitatively between men and women; 2) The pathogenesis of a substantial proportion of ischemic strokes (e.g., lacunar strokes) does not involve classical atherosclerotic mechanisms. Table 1.
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Wang, Lei, Xu Zhang, Xiaoxing Xiong, Hua Zhu, Ran Chen, Shudi Zhang, Gang Chen e Zhihong Jian. "Nrf2 Regulates Oxidative Stress and Its Role in Cerebral Ischemic Stroke". Antioxidants 11, n. 12 (30 novembre 2022): 2377. http://dx.doi.org/10.3390/antiox11122377.
Testo completoAbstract (sommario):
Cerebral ischemic stroke is characterized by acute ischemia in a certain part of the brain, which leads to brain cells necrosis, apoptosis, ferroptosis, pyroptosis, etc. At present, there are limited effective clinical treatments for cerebral ischemic stroke, and the recovery of cerebral blood circulation will lead to cerebral ischemia-reperfusion injury (CIRI). Cerebral ischemic stroke involves many pathological processes such as oxidative stress, inflammation, and mitochondrial dysfunction. Nuclear factor erythroid 2-related factor 2 (Nrf2), as one of the most critical antioxidant transcription factors in cells, can coordinate various cytoprotective factors to inhibit oxidative stress. Targeting Nrf2 is considered as a potential strategy to prevent and treat cerebral ischemia injury. During cerebral ischemia, Nrf2 participates in signaling pathways such as Keap1, PI3K/AKT, MAPK, NF-κB, and HO-1, and then alleviates cerebral ischemia injury or CIRI by inhibiting oxidative stress, anti-inflammation, maintaining mitochondrial homeostasis, protecting the blood–brain barrier, and inhibiting ferroptosis. In this review, we have discussed the structure of Nrf2, the mechanisms of Nrf2 in cerebral ischemic stroke, the related research on the treatment of cerebral ischemia through the Nrf2 signaling pathway in recent years, and expounded the important role and future potential of the Nrf2 pathway in cerebral ischemic stroke.
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Eide, Sarah, e Zhong-Ping Feng. "Implications of age-related changes in the blood-brain barrier for ischemic stroke and new treatment strategies". Advanced Neurology 1, n. 2 (12 agosto 2022): 1. http://dx.doi.org/10.36922/an.v1i2.1.
Testo completoAbstract (sommario):
Ischemic strokes are prevalent across all age groups. Recent research has highlighted the importance of better understanding ischemia-induced damage of the blood-brain barrier (BBB) because it is related to both the severity of ischemic injury and neurological outcomes. The influence of advancing age on the structure and function of the BBB and the potential influence of these changes on ischemic stroke injury have received little consideration to date. Therefore, the present review outlines how ischemic injury influences the structure and function of the BBB at the anatomical, cellular, and molecular levels, and how these changes differ between adult and elderly populations with and without age-related comorbid diseases. This review further discusses how age-dependent changes and features of the BBB, and the corresponding alterations in response to ischemia, can affect the efficacy and delivery of current and future treatment options. Current research efforts are underway to develop prospective stroke treatment strategies that target the restoration of BBB functionality. This review also discusses the importance of considering the unique properties and characteristics of the BBB in elderly individuals for developing new stroke treatment strategies.
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Su, Zhongzhou, Yingze Ye, Chengen Shen, Sheng Qiu, Yao Sun, Siping Hu, Xiaoxing Xiong, Yuntao Li, Liqin Li e Hongfa Wang. "Pathophysiology of Ischemic Stroke: Noncoding RNA Role in Oxidative Stress". Oxidative Medicine and Cellular Longevity 2022 (12 settembre 2022): 1–12. http://dx.doi.org/10.1155/2022/5815843.
Testo completoAbstract (sommario):
Stroke is a neurological disease that causes significant disability and death worldwide. Ischemic stroke accounts for 75% of all strokes. The pathophysiological processes underlying ischemic stroke include oxidative stress, the toxicity of excitatory amino acids, ion disorder, enhanced apoptosis, and inflammation. Noncoding RNAs (ncRNAs) may have a vital role in regulating the pathophysiological processes of ischemic stroke, as confirmed by the altered expression of ncRNAs in blood samples from acute ischemic stroke patients, animal models, and oxygen-glucose-deprived (OGD) cell models. Due to specific changes in expression, ncRNAs can potentially be biomarkers for the diagnosis, treatment, and prognosis of ischemic stroke. As an important brain cell component, glial cells mediate the occurrence and progression of oxidative stress after ischemic stroke, and ncRNAs are an irreplaceable part of this mechanism. This review highlights the impact of ncRNAs in the oxidative stress process of ischemic stroke. It focuses on specific ncRNAs that underlie the pathophysiology of ischemic stroke and have potential as diagnostic biomarkers and therapeutic targets.
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Safari, Anahid, Rasool Safari e Afshin Borhani-Haghighi. "Immunology of stroke". Galen Medical Journal 5 (24 maggio 2016): 10–17. http://dx.doi.org/10.31661/gmj.v5is1.592.
Testo completoAbstract (sommario):
Stroke, a multifactorial disease, has distinct pathophysiologic mechanisms, among which inflammation plays a pivotal role. Various types of inflammatory cells, substances, and molecules emerge in the ischemic stroke. Neutrophils, Tcell subtypes, macrophages, microglial cells, dendritic cell, mast cells, asrocytes, as influential cell, tumor necrosis factor_α, interleukin-17, interleukin-10, as released substances, and vascular cell adhesion molecule-1 (VCAM-1), leukocyte very late antigen-4 (VLA-4), and glial fibrillary acidic protein (GFAP), as cellular adhesion molecules. Lymphocytes' invasion to the ischemic brain tissue occurs as the result of VLA-4 ̶ VCAM-1 interaction. Regarding Tcell subtypes, CD4+ cells have known detrimental effects in the ischemic area, while natural killer T cells (NKT cells) and γδ T cells have minor importance in the early stage of ischemia. While some studies proved the cerebroprotective impact of T regulatory cells, others refuted this by presenting a prominent harmful role of them. Bcells have important protective function by releasing IL-10. Neutrophils along with microglial cell, appearing as the first inflammatory cell in the ischemic tissue, and also macrophages deteriorate ischemia. Mast cells and dendritic cells are of great value in stroke progression. The resting astrocytes are neuroprotective, whereas the activated ones present detrimental function in the ischemic region by expression of GFAP. Hence, stroke consequences occur as the result of systemic inflammatory response. The more activation of this system, the poorer neurological outcomes would be observed. As expected, anti-inflammatory interventions in the experimental stroke in animals, have revealed successful results as less infarct size and attenuated neurological damages.
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Huang, Jyun-Bin, Nai-Ching Chen, Chien-Liang Chen, Mu-Hui Fu, Hsiu-Yung Pan, Chung-Yao Hsu, Shang-Der Chen e Yao-Chung Chuang. "Serum Levels of Soluble Triggering Receptor Expressed on Myeloid Cells-1 Associated with the Severity and Outcome of Acute Ischemic Stroke". Journal of Clinical Medicine 10, n. 1 (26 dicembre 2020): 61. http://dx.doi.org/10.3390/jcm10010061.
Testo completoAbstract (sommario):
Stroke is a neurological emergency, where the mechanism of the blood supply to the brain is impaired, resulting in brain cell ischemia and death. Neuroinflammation is a key component in the ischemic cascade that results in cell damage and death after cerebral ischemia. The triggering receptor expressed on myeloid cells-1 (TREM-1) modulates neuroinflammation after acute ischemic stroke. In the present study, 60 patients with acute ischemic stroke, who had been subjected to neurological examinations and National Institutes of Health Stroke Scale (NIHSS) and brain magnetic resonance imaging studies, were enrolled in the emergency room of Kaohsiung Chang Gung Memorial Hospital. Twenty-four healthy volunteers were recruited as controls. The serum levels of soluble TREM-1 (sTREM-1), human S100 calcium-binding protein B (S100B), and proinflammatory cytokines and chemokines, including tumor necrosis α (TNF-α), interleukin 1β, interleukin 6 (IL-6), interleukin 8, and interferon-γ were measured immediately after acute ischemic stroke. The serum levels of sTREM-1, TNFα, IL-6, and S100B were correlated with the stroke volume and NIHSS, after acute ischemic stroke. Additionally, the serum levels of sTREM-1 were significantly positively correlated with S100B. The functional outcomes were evaluated 6 months after ischemic stroke by the Barthel index, which was correlated with the age and levels of sTREM-1 and S100B. We suggest that acute ischemic stroke induces neuroinflammation by the activation of the TREM-1 signaling pathway and the downstream inflammatory machinery that modulates the inflammatory response and ischemic neuronal cell death. From a translational perspective, our results may allow for the development of a new therapeutic strategy for acute ischemic stroke by targeting the TREM-1 signaling pathway.
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Bernick, Charles B., Lewis H. Kuller, Will T. Longstreth, Corinne Dulberg, Teri A. Manolio, Norman J. Beauchamp e Thomas R. Price. "Silent Brain MRI Infarcts and Subsequent Stroke Type In the Cardiovascular health Study". Stroke 32, suppl_1 (gennaio 2001): 363. http://dx.doi.org/10.1161/str.32.suppl_1.363-d.
Testo completoAbstract (sommario):
P136 Objective: Silent infarcts seen on cranial MRI scans are a risk factor for subsequent clinical stroke in the elderly. This study examines the type of clinical strokes seen in those with silent infarcts. Methods: Cranial MRI examination was completed on 3324 Cardiovascular Health Study (CHS) participants aged 65+ who were without a prior history of clinical stroke. Incident strokes were identified over an average follow-up of 4 years and classified as hemorrhagic or ischemic. Ischemic strokes were further subdivided into lacunar, cardioembolic, atherosclerotic or other/unknown. Results: Silent MRI infarcts >3mm were found in approximately 28% (n=923). Of these, 7% (n=67) subsequently had a clinically evident stroke. The characteristics of the silent MRI infarcts in those who sustained an incident stroke were as folows: 56 had only subcortical infarcts, of which 55 were <20mm; 4 had only cortical infarcts; and 7 had both cortical and subcortical infarcts. Of those with only subcortical silent MRI infarcts, 16% (n=9) went on to a hemorrhagic stroke and 84% (n=47) sustained an ischemic stroke. The ischemic strokes were subtyped as 12 cardioembolic, 3 lacunar, 2 atherosclerotic and 30 unknown/other. Considering only those with cortical silent infarcts, either alone or in combination with subcortical infarcts, there was 1 hemorrhagic stroke and 10 ischemic strokes. Half of the ischemic strokes were cardioembolic and half were unknown type. Conclusion: Elderly individuals with silent subcortical infarcts who go onto subsequent stroke may be at risk not only for lacunar infarcts but also cardioembolic or hemorrhagic strokes.
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Yamashita, Toru, Kentaro Deguchi, Shoko Nagotani, Tatsushi Kamiya e Koji Abe. "Gene and Stem Cell Therapy in Ischemic Stroke". Cell Transplantation 18, n. 9 (settembre 2009): 999–1002. http://dx.doi.org/10.3727/096368909x471233.
Testo completoAbstract (sommario):
Possible strategies for treating ischemic stroke include neuroprotection (preventing injured neurons from undergoing apoptosis in the acute phase of cerebral ischemia) and stem cell therapy (the repair of disrupted neuronal networks with newly born neurons in the chronic phase of cerebral ischemia). First, we estimated the neuroprotective effect of glial cell line-derived neurotrophic factor (GDNF) by administration of GFNF protein. GDNF protein showed a direct protective effect against ischemic brain damage. Pretreatment of animals with adenoviral vector containing GDNF gene (Ad-GDNF) 24 h before the subsequent transient middle cerebral artery occlusion (MCAO) effectively reduced infarcted volume. Secondly, we studied the neuroprotective effect of a calcium channel blocker, azelnidipine, or a by-product of heme degradation, biliverdin. Both azelnidipine and biliverdin had a neuroprotective effect in the ischemic brain through their antioxidative property. Lastly, we developed a restorative stroke therapy with a bioaffinitive scaffold, which is able to provide an appropriate platform for newly born neurons. In the future, we will combine these strategies to develop more effective therapies for treatment of strokes.
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Alam, Muhammad Naveed, Tahir Habib Rizvi, Memoona Alam e Muhammad Tahir. "ISCHEMIC STROKE". Professional Medical Journal 25, n. 01 (8 gennaio 2018): 84–89. http://dx.doi.org/10.29309/tpmj/18.4234.
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Kumar, Ramesh, Muhammad Iqbal Shah, Manzoor Ali Lakhair e Zaheer Memon. "ISCHEMIC STROKE". Professional Medical Journal 23, n. 08 (10 agosto 2016): 925–31. http://dx.doi.org/10.29309/tpmj/2016.23.08.1664.
Testo completoAbstract (sommario):
Objectives: To determine the frequency of Dyslipidemia and other risk factorsin patients with ischemic stroke. Study design: Descriptive and case series. Setting: Thisresearch study was carried out in the Medicine department of Liaquat University HospitalJamshoro/Hyderabad. Duration of study: Six months. Sample size: Total 100 patients of bothmale and female sex were enrolled in this research study. Results: Total 100 cases of ischemicstroke were included. The mean age + SD (range) was 59.72 + 6.40 (45 – 70 years), 76(76.0%)were males and 24(24.0%) were females. Speech deficits was present in 28(28.0%, n = 100)patients. Eighty seven (87.0%, n = 100) patients had difficulty in walking, 17(17.0%, n = 100)patients had seizures, confusion was observed in 35(35.0%, n = 100) patients, 35(35.0%, n =100) had headache, Vertigo was seen in 11(11.0%n = 100) patients, Visual disturbances wasseen in 14(14.0%, n = 100) cases and 20(20.0%n = 100) patients had vomiting. High bloodpressure was in 51(51.0%, n = 100), diabetes mellitus and dyslipidemia in 30(30.0%, n = 100)respectively. Eighteen (18.0%, n = 100) patients were known cases of cardiovascular diseases,36(36.0%, n = 100) were smokers, 22(22.0%, n = 100) patients had family history of strokeand only 2(2.0%, n = 100) patients had the history of alcoholism. High cholesterol (mg/dL) wasseen in 21(21.0% n = 30) patients, High LDL (mg/dL) in 37(37.0%, n = 30), Low HDL (mg/dL) in90(90.0%, n = 30) and High Triglycerides (mg/dL) were seen in 40(40.0%, n = 30). Conclusion:High Blood pressure, Diabetes mellitus, Dyslipidemia and Smoking are chief risk elements ofischemic stroke. Prevalence of stroke is high in poor socioeconomic demographics with singleor multiple risk elements and this may be because of unawareness about these risk elements,unaffordability of treatment or proper follow up.
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Shahwani, Irfan Murtaza, Faisal Shahab, Shuaib Ansari e Syed Zulfiquar Ali Shah. "ISCHEMIC STROKE". Professional Medical Journal 22, n. 02 (10 febbraio 2015): 221–26. http://dx.doi.org/10.29309/tpmj/2015.22.02.1397.
Testo completoAbstract (sommario):
Stroke is characterized by the sudden loss of blood circulation to an areaof the brain, resulting in a corresponding loss of neurologic function. It is also called ascereberovascular accident (CVA) or stroke syndrome. Objectives: To determine frequencyof hypertension, diabetes mellitus and smoking in patients with ischemic stroke. Patientsand methods: This cross sectional study of six months was carried out in the department ofmedicine, Liaquat University of Medical and Health Sciences. Patients aged 20-70 years of agewith ischemic stroke on CT were enrolled in the study after taking consent from caretaker ofpatients. Detailed history focusing on hypertension, diabetes and smoking and their durationwas taken. Blood pressure was recorded and fundoscopy was done to find out diabetic orhypertensive retinopathy. Thorough neurological examination was done and blood sugar(fasting and random) was evaluated. Data was entered and analyzed using SPSS version 16.Results: A total of 100 patients were included in the study during study period. 64% of patientswere in ≥ 50 years of age group with mean age of 52±11 years. A total of 66 (66%) were male;with male to female ratio was 2:1. Hypertension was present in 61% of cases, Diabetes wasfound in 32% cases and 40 patients were cigarette smokers. Conclusions: It was concludedthat high blood pressure, diabetes mellitus and smoking are associated with ischemic stroke.
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Humaira, Mona, Atif Sitwat Hayat, Tariq Zaffar Shaikh, Hanif Ghani, Shoaib Ansari e Irum Sikandar. "ISCHEMIC STROKE". Professional Medical Journal 23, n. 04 (10 aprile 2016): 444–50. http://dx.doi.org/10.29309/tpmj/2016.23.04.1503.
Testo completoAbstract (sommario):
Objectives: Stroke is continued to rise in developing countries of the world.Early recognition and prompt treatment of poor prognostic factors would reduce mortality andmorbidity. The objective of our study was evaluation of factors affecting prognosis of ischemicstroke patients and to assess thirty days mortality and outcome. Study Design: Crosssectional,prospective study. Setting: Medical wards of Liaquat University Hospital Jamshoro/Hyderabad. Period: August 2009 to February 2011. Material and Methods: 150 patients wascarried out, patients having acute cerebral infarction of either gender, aged equal to or greaterthan 13 years were included while patients of stroke because of hemorrhage, space occupyinglesion and known diabetic were excluded from study. Results: 150 patients were selected,out of them 60% were male. Age of patients ranged from 13- 90 years with median age of51 years. At the end of one month mortality rate was 10% in our study. No improvement wasfound in 16% patients, partial improvement in 62% while only 12% recovered fully. Conclusion:Our study showed high mortality rate in ischemic stroke patients. Males at and after age of50 years develop ischemic stroke more commonly. Patients of ischemic stroke having fever,dysphagia, urinary incontinence, hyperglycemia and altered level of consciousness showedpoor prognosis.
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Alam, Muhammad Naveed, Tahir Habib Rizvi, Memoona Alam e Muhammad Tahir. "ISCHEMIC STROKE". Professional Medical Journal 25, n. 01 (10 gennaio 2018): 84–89. http://dx.doi.org/10.29309/tpmj/2018.25.01.543.
Testo completoAbstract (sommario):
Objectives: To determine the frequency and contributing factors of atrialfibrillation in patients with first ischemic stroke. Methodology: This study included 150 patientswith first acute ischemic stroke. All the patients had electrocardiography to detect the presenceof atrial fibrillation. The patients were also labeled for risk factors like hypertension, congestiveheart failure, smoking, and hyperthyroidism, etc. Setting: Mayo Hospital Lahore. Duration ofStudy: 1st January 2013 to 30th June 2013. Type: Descriptive Cross Sectional. Results: Atrialfibrillation was present among 22 (14.6%) patients. Among patients with atrial fibrillation,smoking, congestive heart failure and hypertension were the most frequent risk factors whichwere present in 11 (50%), 6 (27%), and 5 (22.7%) patients, respectively. Conclusion: Frequencyof atrial fibrillation among patients with first ischemic stroke was high. Smoking, congestiveheart failure and history of coronary artery bypass grafting are frequent risk factors.
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Rehman, Naveed ur, Muhammad Absar Alam e Kashif Rehman. "ISCHEMIC STROKE;". Professional Medical Journal 24, n. 11 (3 novembre 2017): 1761–69. http://dx.doi.org/10.29309/tpmj/2017.24.11.671.
Testo completoAbstract (sommario):
Background: Patients with acute ischemic stroke frequently test positive forhyperglycemia, which is associated with a poor clinical outcome. This association between poorglycemic control and an unfavorable prognosis is particularly evident in patients with persistenthyperglycemia, patients without a known history of diabetes mellitus (DM), and patients withcortical infarction. Objective: To determine the frequency of raised hemoglobin A1c in patientspresenting with ischemic stroke. Material & Methods: Study design: Retrospective study.Setting: Department of Medicine, Independent University Hospital, Faisalabad. Duration:6 months. Data collection procedure: Reports of 150 patients fulfilling selection criteriawere selected from medical record section of Independent University Hospital, Faisalabad.Demographic details were obtained. Then medical record of patients was assessed for presenceof HbA1c. If HbA1c of patients was reported ≥ 6.5%, then raised HbA1c was labeled. Results:In this study raised HbA1C level in patients presenting with ischemic stroke was 25%. Amongthese patients the most affected age group of patients was 41-60 years. Female patients weremore effected than male patients. Among these patients only 27% were diabetic while 73%were non-diabetic, 54% were smokers, 32% patients were hypertensive and in 14% patientshyperlipidemia was seen. All these factors were not significantly associated with raised HbA1clevel in patients presenting with ischemic stroke. Conclusion: Results of this study demonstratea high frequency of raised HbA1c level in patients presenting with ischemic stroke. i.e. 25%. Sokeeping in mind these findings it is recommended that stroke patients should also be screenedfor hyperglycemia or increased HbA1c so that patients can be prevented from development ofpermanent hyperglycemia or other complications associated with it.
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Bundlie, Scott R. "Ischemic stroke". Postgraduate Medicine 90, n. 8 (dicembre 1991): 56–63. http://dx.doi.org/10.1080/00325481.1991.11701139.
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Randolph, Susan A. "Ischemic Stroke". Workplace Health & Safety 64, n. 9 (settembre 2016): 444. http://dx.doi.org/10.1177/2165079916665400.
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WITYK, ROBERT J., e BARNEY J. STERN. "Ischemic stroke". Critical Care Medicine 22, n. 8 (agosto 1994): 1278–93. http://dx.doi.org/10.1097/00003246-199408000-00012.
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Smith, Wade S. "Ischemic stroke". Current Opinion in Critical Care 4, n. 2 (aprile 1998): 89–93. http://dx.doi.org/10.1097/00075198-199804000-00004.
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