02 septiembre 2014

STROKE. Clinical Sciences. Coated-Platelets Improve Prediction of Stroke and Transient Ischemic Attack in Asymptomatic Internal Carotid Artery Stenosis

Angelia C. Kirkpatrick, MD, MPH; Alfonso J. Tafur, MD, MS; Andrea S. Vincent, PhD; George L. Dale, PhD; Calin I. Prodan, MD

Background and Purpose: Coated-platelets, a subset of procoagulant platelets observed on dual agonist stimulation with collagen and thrombin, support a robust prothrombinase activity and provide a unique measure of platelet thrombotic potential. Coated-platelet levels are increased in large artery stroke, and higher levels are associated with early stroke recurrence, suggesting a potential role for risk stratification in asymptomatic patients with carotid artery stenosis.

28 agosto 2014

STROKE. Clinical Sciences. Morphological, Hemodynamic, and Clinical Independent Risk Factors for Anterior Communicating Artery Aneurysms

Wojciech Kaspera, MD; Piotr Ładziński, MD, PhD; Patrycja Larysz, MD; Anna Hebda, MS; Krzysztof Ptaszkiewicz, MD; Marek Kopera, MD; Dawid Larysz, MD, PhD

Background and Purpose: The pathogenesis of cerebral aneurysms still raises some controversies. The aim of this study was to identify morphological, hemodynamic, and clinical independent risk factors for anterior communicating artery (ACoA) aneurysm development.

25 septiembre 2014

STROKE. Clinical Sciences. Complication Rates and Center Enrollment Volume in the Carotid Revascularization Endarterectomy Versus Stenting Trial

Nicole R. Gonzales, MD; Bart M. Demaerschalk, MD; Jenifer H. Voeks, PhD; MeeLee Tom, MS; George Howard, DrPH; Alice J. Sheffet, PhD; Lawrence Garcia, MD; Daniel G. Clair, MD; John Barr, MD; Steven Orlow, MD; Thomas G. Brott, MD; on behalf of the CREST Investigators

Background and Purpose: Evidence indicates that center volume of cases affects outcomes for both carotid endarterectomy and stenting. We evaluated the effect of enrollment volume by site on complication rates in the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST).

09 octubre 2014

STROKE. Clinical Sciences. Comparative Effectiveness of Carotid Revascularization Therapies

Robert J. McDonald, MD, PhD; Jennifer S. McDonald, PhD; Terry M. Therneau, PhD; Giuseppe Lanzino, MD; David F. Kallmes, MD; Harry J. Cloft, MD, PhD

Background and Purpose: Clinical equipoise of carotid revascularization therapies remains controversial. We sought to determine whether adverse outcomes after carotid endarterectomy (CEA) or carotid angioplasty and stenting (CAS) were similar using propensity score–matched analysis of retrospective data from a large hospital discharge database.

09 octubre 2014

STROKE. Clinical Sciences. Incidence and Risk Factors for Diffusion-Weighted Imaging (+) Lesions After Intracranial Stenting and Its Relationship With Symptomatic Ischemic Complications

Keun Young Park, MD; Byung Moon Kim, MD; Dong Joon Kim, MD; Dong Ik Kim, MD; Ji Hoe Heo, MD; Hyo Suk Nam, MD; Young Dae Kim, MD; Dongbeom Song, MD

Background and Purpose: Little is known about high-signal lesions in magnetic resonance diffusion-weighted imaging (DWI [+]) after stenting for intracranial atherosclerotic stenosis. This study aimed to evaluate the incidence, distribution, risk factors, and clinical implications of DWI (+) after intracranial stenting.

12 agosto 2014

STROKE. Clinical Sciences. Number of Cerebral Microbleeds and Risk of Intracerebral Hemorrhage After Intravenous Thrombolysis

Steffen Dannenberg*; Jan F. Scheitz, MD*; Michal Rozanski, MD; Hebun Erdur, MD; Peter Brunecker, Dr rer medic; David J. Werring, PhD; Jochen B. Fiebach, MD; Christian H. Nolte, MD

Background and Purpose: Cerebral microbleeds (CMBs) are found in a substantial proportion of patients with ischemic stroke eligible for treatment with intravenous thrombolysis. Until now, there is limited data on the impact of multiple CMBs on occurrence of intracerebral hemorrhage (ICH) after intravenous thrombolysis.

09 septiembre 2014

STROKE. Clinical Sciences. Natural History and Outcome After Treatment of Unruptured Intradural Fusiform Aneurysms

Raphael H. Sacho, MD, FRCS(Eng); Guillaume Saliou, MD, PhD; Alex Kostynskyy, MBBS; Ravi Menezes, PhD; Michael Tymianski, MD, PhD; Timo Krings, MD, PhD; Ivan Radovanovic, MD, PhD; Karel Terbrugge, MD; Gabriel J.E. Rinkel, MD; Robert Willinsky, MD

Background and Purpose: Management of unruptured fusiform intracranial aneurysms is controversial because of the paucity of natural history data. We studied their natural history and outcome after treatment.

18 septiembre 2014

STROKE. Clinical Sciences. Prevalence of Brain Arteriovenous Malformations in First-Degree Relatives of Patients With a Brain Arteriovenous Malformation

Janneke van Beijnum, MD, PhD; H. Bart van der Worp, MD, PhD; Ale Algra, MD, PhD; W. Peter Vandertop, MD, PhD; René van den Berg, MD, PhD; Patrick A. Brouwer, MD; Jan Willem Berkelbach van der Sprenkel, MD, PhD; L. Jaap Kappelle, MD, PhD; Gabriël J.E. Rinkel, MD, FRCPE; Catharina J.M. Klijn, MD, PhD

Background and Purpose: It is uncertain whether familial occurrence of brain arteriovenous malformations (BAVMs) represents coincidental aggregation or a shared familial risk factor. We aimed to compare the prevalence of BAVMs in first-degree relatives (FDRs) of patients with BAVM and the prevalence in the general population.

16 septiembre 2014

STROKE. Clinical Sciences. Atherosclerotic Plaque in the Left Carotid Artery Is More Vulnerable Than in the Right

Mariana Selwaness, MD; Quirijn van den Bouwhuijsen, MD; Robbert S. van Onkelen, MD; Albert Hofman, MD, PhD; Oscar H. Franco, MD, PhD; Aad van der Lugt, MD, PhD; Jolanda J. Wentzel, PhD; Meike Vernooij, MD, PhD

Background and Purpose: Ischemic stroke is more often diagnosed in the left hemisphere than in the right. It is unknown whether this asymmetrical prevalence relates to differences in carotid atherosclerosis. We compared atherosclerotic plaque prevalence, severity, and composition between left and right carotid arteries.

02 octubre 2014

STROKE. Posttraumatic Stress Disorder After Cerebrovascular Events. Broadening the Landscape of Psychological Assessment in Stroke and Transient Ischemic Attack

Barbara G. Vickrey, MD, MPH; Linda S. Williams, MD

Posttraumatic stress disorder (PTSD) is defined based on exposure to actual or threatened death, injury, or violence and the presence for ≥30 days postevent of intrusive symptoms (eg, flashbacks), persistent avoidance of stimuli, negative alteration in mood and cognition, and marked alteration in arousal and reactivity (eg, hypervigilance).

07 octubre 2014

STROKE. Brief Report. Multimodal 3 Tesla MRI Confirms Intact Arterial Wall in Acute Stroke Patients After Stent-Retriever Thrombectomy

Kety Hsieh, MD; Rajeev K. Verma, MD; Gerhard Schroth, MD; Pascal P. Gratz, MD; Frauke Kellner-Weldon, MD; Jan Gralla, MD, MSc; Christoph Zubler, MD; Pasquale Mordasini, MD, MSc; Simon Jung, MD; Heinrich P. Mattle, MD; Marwan El-Koussy, MD

Background and Purpose: The aim of this prospective study was to assess vascular integrity after stent-retriever thrombectomy.

16 septiembre 2014

STROKE. Brief Report. Effects of Extracranial Carotid Stenosis on Intracranial Blood Flow

Sophia F. Shakur, MD; Tomas Hrbac, MD, PhD; Ali Alaraj, MD; Xinjian Du, MD; Victor A. Aletich, MD; Fady T. Charbel, MD; Sepideh Amin-Hanjani, MD

Background and Purpose: The hemodynamic effects of extracranial carotid stenosis on intracranial blood flow are not well characterized. We sought to determine the impact of degree of stenosis, stenosis length, and residual lumen on intracranial blood flow in patients with extracranial carotid stenosis.

28 agosto 2014

STROKE. Clinical Sciences. External Validation of the Boston Acute Stroke Imaging Scale and M1-BASIS in Thrombolyzed Patients

Leonard L.L. Yeo, MBBS; Prakash R. Paliwal, MBBS; Benjamin Wakerley, MBBS; Chin M. Khoo, MBBS; Hock L. Teoh, MBChB; Aftab Ahmad, MBBS; Eric Y. Ting, MBBS; Raymond C. Seet, MBBS; Venetia Ong, BN; Bernard P. Chan, MBBS; Kusama Yohanna, MBBS; Anil Gopinathan, MBBS; Rahul Rathakrishnan, BM; Vijay K. Sharma, MBBS

Background and Purpose: Radiological findings play an essential role in therapeutic decision making and prognostication in acute ischemic stroke (AIS). The Boston Acute Stroke Imaging Scale (BASIS) and Middle Cerebral Artery-BASIS (M1-BASIS) methodologies are rapid purely radiological instruments and easily applicable for patients with AIS. We validated these methods in patients with AIS treated with intravenous tissue-type plasminogen activator.

01 noviembre 2015

NEUROSURGERY. Randomized Controlled Trial of Minimally Invasive Sacroiliac Joint Fusion Using Triangular Titanium Implants vs Nonsurgical Management for Sacroiliac Joint Dysfunction: 12-Month Outcomes

Polly, David W. MD*; Cher, Daniel J. MD‡; Wine, Kathryn D. MPH‡; Whang, Peter G. MD§; Frank, Clay J. MD¶; Harvey, Charles F. MD‖; Lockstadt, Harry MD#; Glaser, John A. MD**; Limoni, Robert P. MD‡‡; Sembrano, Jonathan N. MD§§; for the INSITE Study Group

BACKGROUND: Sacroiliac joint (SIJ) dysfunction is a prevalent cause of chronic, unremitting lower back pain.

01 noviembre 2015

NEUROSURGERY. Elevated Baseline C-Reactive Protein as a Predictor of Outcome After Aneurysmal Subarachnoid Hemorrhage: Data From the Simvastatin in Aneurysmal Subarachnoid Hemorrhage (STASH) Trial

Turner, Carole L. MSc; Budohoski, Karol PhD; Smith, Christopher PhD; Hutchinson, Peter J. PhD; Kirkpatrick, Peter J. FMedSci; for the STASH collaborators

BACKGROUND: There remains a proportion of patients with unfavorable outcomes after aneurysmal subarachnoid hemorrhage, of particular relevance in those who present with a good clinical grade. A forewarning of those at risk provides an opportunity towards more intensive monitoring, investigation, and prophylactic treatment prior to the clinical manifestation of advancing cerebral injury.