Abstract:
BACKGROUND AND PURPOSE:The best management of patients with unruptured brain arteriovenous malformations (BAVM) is controversial. In this study, we analyzed the stroke rate and functional outcomes of patients having stereotactic radiosurgery (SRS) for unruptured BAVM using the same eligibility criteria and primary end points as the ARUBA trial. METHODS:Retrospective observational study of 174 ARUBA-eligible patients having SRS from 1990 to 2005. RESULTS:The median follow-up after SRS was 64 months. Fifteen patients (8.7%) had a hemorrhagic stroke at a median of 21 months after SRS. Six patients (3.5%) had a focal neurological deficit and 4 patients died (2.3%). The risk of stroke or death was 10.3% at 5 years and 11.5% at 10 years. Twelve additional patients (6.9%) had a focal neurological deficit from either radiation-related complications (n=7) or subsequent resection (n=5). The risk of patients' having clinical impairment (modified Rankin Score ≥ 2) was 8.4% at 5 years and 12.0% at 10 years. Increasing BAVM volume was associated with both stroke or death (hazard ratio=1.06; 95% confidence interval, 1.0-1.11; P=0.04) and clinical impairment (hazard ratio=1.06; 95% confidence interval, 1.01-1.09; P=0.01). The 10-year risk of stroke or death and clinical impairment for patients with BAVM ≤ 5.6 cm(3) was 5% and 4%, respectively. CONCLUSIONS:The observed risk of stroke or death after SRS was approximately 2% per year for the first 5 years after SRS, declining to 0.2% annually for years 6 to 10. Patients with small volume BAVM may benefit from SRS compared with the natural history of unruptured BAVM over the planned follow-up interval of the ARUBA trial (5-10 years).
journal_name
Strokejournal_title
Strokeauthors
Pollock BE,Link MJ,Brown RDdoi
10.1161/STROKEAHA.112.670232subject
Has Abstractpub_date
2013-02-01 00:00:00pages
437-41issue
2eissn
0039-2499issn
1524-4628pii
STROKEAHA.112.670232journal_volume
44pub_type
杂志文章相关文献
STROKE文献大全abstract::Background and Purpose- The use of oral anticoagulants (OAC) is considered a contra-indication for intravenous thrombolytics as acute treatment of ischemic stroke. However, little is known about the risks and benefits of endovascular treatment in patients on prior OAC. We aim to compare outcomes after endovascular tre...
journal_title:Stroke
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1161/STROKEAHA.119.028675
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The benefits of chronic disease self-management programs for stroke survivors are uncertain because individuals with severe impairments have been excluded from previous research. We undertook a phase II randomized controlled trial to determine whether a self-management program designed for surviv...
journal_title:Stroke
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1161/STROKEAHA.110.601997
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Stroke has global importance and it causes an increasing amount of human suffering and economic burden, but its management is far from optimal. The unsuccessful outcome of several research programs highlights the need for reliable data on which to plan future clinical trials. The Virtual Internat...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.106.473579
更新日期:2007-06-01 00:00:00
abstract::The hydrogen clearance method was used to measure local and total cerebral blood flow (CBF) in the rhesus monkey before and for five hours after a simulated subarachnoid hemorrhage (SAH). CBF remained stable after SAH unless SAH was associated with a fall in cerebral perfusion pressure. In addition, cerebrovascular re...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.6.6.664
更新日期:1975-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Intake of fruits and vegetables has been related to lower risk of ischemic stroke, but nutrients responsible for this apparent benefit remain ill-defined. Tocopherols (vitamin E) have also been proposed to be protective. METHODS:We conducted a prospective, nested case-control analysis among male...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000132197.67350.bd
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Progression of asymptomatic carotid artery stenosis (ACAS) in patients with >50% luminal narrowing is considered a potential risk factor for ischemic stroke; however, subclinical molecular biomarkers of ACAS progression are lacking. Recent studies suggest a regulatory function for several microRN...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.116.013650
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Although modern multisequence stroke MRI protocols are an emerging imaging routine for the diagnostic assessment of acute ischemic stroke, their sensitivity for intracerebral hemorrhage (ICH), the most important differential diagnosis, is still a matter of debate. We hypothesized that stroke MRI ...
journal_title:Stroke
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1161/01.STR.0000114203.75678.88
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Enlarged perivascular spaces (EPVS) have been associated with aging, increased stroke risk, decreased cognitive function, and vascular dementia. However, the relationship of EPVS with age-related neuropathologies is not well understood. Therefore, the purpose of this study was to assess the neuro...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.120.029388
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Stroke risk increases with age in patients who have nonvalvular atrial fibrillation. It is uncertain whether the efficacy of stroke prevention therapies in atrial fibrillation changes as patients age. The objective of this study was to determine the effect of age on the relative efficacy of oral ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.108.526988
更新日期:2009-04-01 00:00:00
abstract::Background and Purpose- Ischemic stroke is one of the leading causes of morbidity and mortality worldwide and a major cause of long-term disability. Recently, long noncoding RNAs have been revealed, which are tightly associated with several human diseases. However, the functions of long noncoding RNAs in ischemic stro...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.118.023376
更新日期:2019-07-01 00:00:00
abstract::We report two patients with mixed transcortical aphasia following left frontal lobe infarctions. Although there was no evidence of anatomic isolation of the speech area on computed tomograms or magnetic resonance imaging scans, single-photon emission computed tomography in one case demonstrated diminished blood flow o...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.21.6.953
更新日期:1990-06-01 00:00:00
abstract::We studied 1,273 patients with ischemic cerebral infarction who were entered into the Stroke Data Bank, a prospective, observational study involving four university hospitals and the Biometry and Field Studies Branch of the National Institute of Neurological Disorders and Stroke. Forty patients had noniatrogenic recur...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.20.8.983
更新日期:1989-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Genetic enzyme variation and vitamin intake are important determinants of blood homocyst(e)ine levels. The prevalence of common genetic polymorphisms influencing homocyst(e)ine levels varies by race, and vitamin intake varies by socioeconomic status. Therefore, we examined the effect of vitamin i...
journal_title:Stroke
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1161/01.str.30.8.1554
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We have developed a minimally invasive model of photothrombotic occlusion of the distal middle cerebral artery in rats and have evaluated the patterns and features of the resulting histopathologic injury in two normotensive strains. METHODS:Food-deprived male Sprague-Dawley (n = 14) and Wistar (...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.24.2.286
更新日期:1993-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:One of the reasons for the failure of trials of neuroprotection in stroke may be the lack of white matter (WM) protection. However, whether patients entered into typical neuroprotection trials have WM involved in the ischemic process is unknown. We studied patients who were enrolled in neuroprote...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000189748.52500.a7
更新日期:2005-12-01 00:00:00
abstract::In experiments carried out on adult rabbit "chest-head" preparations the volume changes of the exposed brain (BrV) were determined in repeated tests during a controlled increase of the systemic venous pressure (SVP) of about 13 mm Hg. The changes of both SVP and BrV were usually parallel at the onset of the experiment...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.10.1.52
更新日期:1979-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Although a lower serum homocysteine concentration is associated with a reduced risk of stroke in epidemiologic studies, randomized, controlled trials have yielded mixed findings regarding the effect of therapeutic homocysteine lowering on stroke prevention. We performed a meta-analysis of randomi...
journal_title:Stroke
pub_type: 杂志文章,meta分析
doi:10.1161/STROKEAHA.109.573410
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The most powerful predictors of functional recovery and eventual home discharge among stroke survivors are the initial severity of the stroke and the patient's age. We analyzed a large population of stroke rehabilitation admissions by stratifying subgroups with coherent outcomes in an attempt to ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.25.1.128
更新日期:1994-01-01 00:00:00
abstract::The coronavirus disease 2019 (COVID-19) pandemic has broad implications on stroke patient triage. Emergency medical services providers have to ensure timely transfer of patients while minimizing the risk of infectious exposure for themselves, their co-workers, and other patients. This statement paper provides a concep...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.120.030340
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:It is unclear whether intracerebral hemorrhage (ICH) is associated with dynamic or static exercise. Our aim was to assess whether such an association exists. METHODS:A case-control study was undertaken involving 331 consecutive cases of primary ICH and 331 age- and sex-matched community-based ne...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/hs0202.102878
更新日期:2002-02-01 00:00:00
abstract::Moyamoya is an intriguing and controversial syndrome. This patient study serves to align the pathophysiology of intracranial hemorrhage in moyamoya with the cerebral vascular disease seen with hypertension, or aging. The historical evidence linking lipohyalinosis and microaneurysms to cerebral hemorrhage is reviewed, ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.11.4.405
更新日期:1980-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:In Asian populations, few studies investigated the association between stroke and common carotid artery intima-media thickness (IMT). Our previous case-control studies showed that low end-diastolic velocity (EDV) in common carotid artery, a potential hemodynamic marker of intracranial resistance,...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.110.605477
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Apoptotic-like pathways may contribute to brain cell death after intracerebral hemorrhage. In this study, we used a simplified in vitro model of hemoglobin neurotoxicity to map the caspase cascades involved and to document the role of oxidative stress. METHODS:Primary neuronal cultures were obta...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.0000020121.41527.5d
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Arteriopathy is common in childhood arterial ischemic stroke (AIS) and predicts stroke recurrence. Currently available vascular imaging techniques mainly image the arterial lumen rather than the vessel wall and have a limited ability to differentiate among common arteriopathies. We aimed to inves...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.117.019827
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Sonothrombolysis is a new treatment approach in acute ischemic stroke. The results of a monocenter, randomized clinical study are presented. METHODS:Subjects with acute middle cerebral artery main stem occlusion were randomized into a target group receiving 1-hour transcranial continuous insonat...
journal_title:Stroke
pub_type: 杂志文章,随机对照试验
doi:10.1161/STROKEAHA.107.503870
更新日期:2008-05-01 00:00:00
abstract::Non-invasive ultrasonic imaging of the carotid bifurcation by duplex scanning and ultrasonic arteriography combined with pulsed Doppler spectrum analysis demonstrated patency of the external and internal carotid arteries distal to a common carotid occlusion in 3 patients. Common carotid occlusion is not invariably ass...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.11.3.249
更新日期:1980-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Patients with unilateral significant carotid artery stenosis present with a variable intracranial hemodynamic status. In the majority of patients, hemodynamics are normal because of sufficient collateral flow. One subgroup shows poor ipsilateral hemodynamics because of a severely reduced blood su...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.25.10.1952
更新日期:1994-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The impact of anesthesia technique on the outcomes of mechanical thrombectomy for acute ischemic stroke remains an issue of debate. We investigated the association of general anesthesia with outcomes in patients undergoing mechanical thrombectomy for ischemic stroke. METHODS:We performed a cohor...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.116.015343
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Brain injury caused by stroke is a frequent cause of perinatal morbidity and mortality with limited therapeutic options. Mesenchymal stem cells (MSC) have been shown to improve outcome after neonatal hypoxic-ischemic brain injury mainly by secretion of growth factors stimulating repair processes....
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.111.000326
更新日期:2013-05-01 00:00:00
abstract::Background and Purpose- Cerebral small vessel disease (cSVD) is the major vascular cause of cognitive decline and dementia. The pathogenesis of cSVD remains largely unknown, although several studies suggest a role for systemic inflammation. In certain pathophysiological situations, monocytes can reprogram toward a lon...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.118.023192
更新日期:2018-12-01 00:00:00