Abstract:
BACKGROUND AND PURPOSE:The role of early and delayed recanalization after thrombolysis in the development of hemorrhagic transformation (HT) subtypes remains uncertain. We sought to explore the association between the timing of recanalization and HT risk in patients with proximal middle cerebral artery (MCA) occlusion treated with intravenous recombinant tissue plasminogen activator (rtPA) <3 hours of stroke onset and to investigate the relationship between HT subtypes, infarct volume, and outcome. METHODS:Thirty-two patients with acute stroke caused by proximal MCA occlusion treated with rtPA <3 hours of symptom onset were prospectively studied. Serial transcranial Doppler examinations were performed on admission and at 6, 12, 24, and 48 hours. Presence and type of HT were assessed on CT at 36 to 48 hours. Modified Rankin scale was used to assess outcome at 3 months. RESULTS:Early and delayed recanalization was identified in 17 patients (53.1%) and 8 patients (25%), respectively. HT was detected in 14 patients (43.7%): 4 (12.5%) with hemorrhagic infarction (HI1), 5 (15.6%) with HI2, 3 (9.3%) with parenchymal hematoma (PH1), and 2 (6.8%) with PH2. Distribution of HT subtypes differed significantly (P=0.025), depending on the time to artery reopening. Eight of 9 (89%), 1 of 5 (20%), and 8 of 18 (44.4%) with HI1-HI2, with PH1-PH2, and without HT, respectively, recanalized in <6 hours. Delayed recanalization was observed in 1 patient with HI1-HI2 (11%), 4 with PH1-PH2 (80%), and 3 without HT (16.6%). Neurological improvement was significantly (P<0.001) more frequent in patients with HI1-HI2 (88%) than in those without HT (39%). Infarct volume was significantly (P<0.031) lower in patients with HI1-HI2 (51.4+/-42 cm3) than in patients with PH1-PH2 (83.8+/-48 cm3) and those without HT (98.4+/-84 cm3, P=0.021). The modified Rankin scale score was significantly lower in HI1-HI2 compared with PH1-PH2 patients (1.9+/-1.1 versus 4.6+/-1.2, P<0.001) and with those without HT (1.9+/-1.1 versus 3.5+/-2.0, P=0.009.). CONCLUSIONS:Thrombolysis-related HI (HI1-HI2) represents a marker of early successful recanalization, which leads to a reduced infarct size and improved clinical outcome.
journal_name
Strokejournal_title
Strokeauthors
Molina CA,Alvarez-Sabín J,Montaner J,Abilleira S,Arenillas JF,Coscojuela P,Romero F,Codina Adoi
10.1161/01.str.0000016323.13456.e5subject
Has Abstractpub_date
2002-06-01 00:00:00pages
1551-6issue
6eissn
0039-2499issn
1524-4628journal_volume
33pub_type
临床试验,杂志文章相关文献
STROKE文献大全abstract:BACKGROUND AND PURPOSE:Some clinical models, like California ABCD and unified ABCD2 scores, are now available to predict the early risk of stroke after a TIA. Despite the transitivity of symptoms, DWI identified an area of acute brain ischemia in almost half of patients. It would be interesting to know how the presence...
journal_title:Stroke
pub_type: 信件
doi:10.1161/STROKEAHA.108.537969
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Angiotensin II produces oxidative stress and endothelial dysfunction in cerebral arteries, and angiotensin II type I receptors may play a role in longevity and vascular aging. Angiotensin-converting enzyme type 2 (ACE2) converts angiotensin II to angiotensin (1-7) and thus, may protect against ef...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.112.667063
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Thromboxane prostaglandin receptors have been implicated to be involved in the atherosclerotic process. We assessed whether Terutroban, a thromboxane prostaglandin receptor antagonist, affects the progression of atherosclerosis, as measured by common carotid intima-media thickness and carotid pla...
journal_title:Stroke
pub_type: 杂志文章,随机对照试验
doi:10.1161/STROKEAHA.114.004775
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We sought to assess outcomes after endovascular treatment/therapy of acute ischemic stroke, overall and by subgroups, and looked for predictors of outcome. METHODS:We used data from a mandatory, population-based registry that includes external monitoring of completeness, which assesses reperfusi...
journal_title:Stroke
pub_type: 杂志文章,多中心研究
doi:10.1161/STROKEAHA.113.003489
更新日期:2014-04-01 00:00:00
abstract::Using clinical presentation, angiography, computed tomography, and nuclear magnetic resonance imaging, 7 patients were identified who had strictly unilateral hemispheric infarction and unilateral cerebrovascular disease. In 6, cerebral blood flow measured by fluorine-18-fluoromethane inhalation and positron emission t...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.18.5.882
更新日期:1987-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Hyperglycemia may worsen brain injury during acute cerebral infarction. We tested the feasibility and tolerability of aggressive hyperglycemia correction with intravenous insulin compared with usual care during acute cerebral infarction. METHODS:We conducted a randomized, multicenter, blinded pi...
journal_title:Stroke
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1161/STROKEAHA.107.493544
更新日期:2008-02-01 00:00:00
abstract::Background and Purpose- Intraluminal thrombus (ILT) is an uncommon finding among patients with ischemic stroke. We report clinical-imaging manifestations, treatment offered, and outcome among patients with ischemic stroke/transient ischemic attack and ILT in their cervico-cephalic arteries. Methods- Sixty-one of 3750 ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.118.023015
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Historically, the use of tissue plasminogen activator (tPA) thrombolysis in pregnancy has been regarded as relatively contraindicated. Underlying this stance has been the concern over the risk of bleeding complications in both mother and child. SUMMARY OF CASE:We report the successful use of int...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000230286.95513.c2
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Preclinical data suggest that cell-based therapies have the potential to improve stroke outcomes. METHODS:Eighteen patients with stable, chronic stroke were enrolled in a 2-year, open-label, single-arm study to evaluate the safety and clinical outcomes of surgical transplantation of modified bon...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.116.012995
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Antiplatelet therapy is currently one of the methods for preventing transient ischemic attacks and cerebral thrombosis. Because antiplatelet agents are generally administered on a long-term basis, patient compliance is an important factor. The purpose of this study was to determine the compliance...
journal_title:Stroke
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.str.25.12.2337
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Chronic kidney disease may increase the risk for ischemic stroke or systemic embolism in patients with nonvalular atrial fibrillation (AF). We conducted a meta-analysis to summarize all published studies to investigate the link between chronic kidney disease and risk of thromboembolic events in A...
journal_title:Stroke
pub_type: 杂志文章,meta分析
doi:10.1161/STROKEAHA.114.006881
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Transtemporal insonation in transcranial Doppler sonography is often impaired by an insufficient signal-to-noise ratio, especially in elderly patients. A transpulmonary stable air microbubble suspension was injected intravenously in humans as an intracranial ultrasonic contrast agent. METHODS:In...
journal_title:Stroke
pub_type: 临床试验,杂志文章
doi:10.1161/01.str.24.12.1903
更新日期:1993-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:In primary intracerebral hemorrhage, the presence of contrast extravasation after computed tomographic angiography (CTA), termed the spot sign, predicts hematoma expansion and mortality. Because the biological underpinnings of the spot sign are not fully understood, we investigated whether the ra...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.115.009659
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Fibrinogen is an independent risk factor for coronary events in population-based studies and in patients with coronary heart disease, but there is uncertainty about prediction of stroke, particularly in secondary prevention. METHODS:We studied unpublished data from 3 prospective studies of patie...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000141701.36371.d1
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Arterial stiffness is associated with an increased risk of myocardial infarction and stroke, independent of classical vascular risk factors. Vascular factors and stroke are associated with cognitive function and dementia. We examined whether arterial stiffness was independently associated with co...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000257998.33768.87
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Cerebral white matter hyperintensities (WMHs) are believed to be the consequence of small vessel disease, and it is uncertain whether their extent predicts the risk of dementia in patients with vascular disease history. Method- Brain MRI was performed in 226 participants of the PROGRESS study. WM...
journal_title:Stroke
pub_type: 信件,随机对照试验
doi:10.1161/STROKEAHA.108.540633
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We sought to identify the most powerful binary measures of the treatment effect of tissue plasminogen activator (tPA) in the National Institute of Neurological Disorders and Stroke (NINDS) rTPA Stroke Trial. METHODS:Using the Classification and Regression Tree (CART) algorithm, we evaluated bina...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.31.10.2335
更新日期:2000-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Current US guideline statements regarding primary and secondary cardiovascular risk prediction and prevention use absolute risk estimates to identify patients who are at high risk for vascular disease events and who may benefit from specific preventive interventions. These guidelines do not expli...
journal_title:Stroke
pub_type: 杂志文章,实务指引
doi:10.1161/STR.0b013e31825bcdac
更新日期:2012-07-01 00:00:00
abstract:PURPOSE:The aim of the present study was to investigate the diagnostic potential of contrast-enhanced transcranial color-coded real-time sonography (CE-TCCS) in otherwise ultrasound-refractory acute stroke patients with an ischemia in the territory of the middle cerebral artery (MCA). Furthermore, correlations of CE-TC...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.30.9.1819
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Cerebral blood flow (CBF) is reduced after subarachnoid hemorrhage (SAH), and symptomatic vasospasm is a major cause of morbidity and mortality. Volume expansion has been reported to increase CBF after SAH, but CBF values in hypervolemic (HV) and normovolemic (NV) subjects have never been directl...
journal_title:Stroke
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.str.31.2.383
更新日期:2000-02-01 00:00:00
abstract::Background and Purpose- Identifying the etiology of acute ischemic stroke is essential for effective secondary prevention. However, in at least one third of ischemic strokes, existing investigative protocols fail to determine the underlying cause. Establishing etiology is complicated by variation in clinical practice,...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.119.027123
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Hetereothermic mammals tolerate hypoxia during euthermy and torpor, and evidence suggests this tolerance may extend beyond hypoxia to cerebral ischemia. During hibernation, CA1 hippocampal neurons endure extreme fluctuations in cerebral blood flow during transitions into and out of torpor as well...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000217409.60731.38
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:To evaluate the periprocedural outcome after carotid artery stenting with embolic brain protection (EBP+) versus without embolic brain protection (EBP-). METHODS:We retrospectively reviewed data from a prospective nonrandomized database of 357 patients who underwent carotid artery stenting in th...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.110.607820
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Poststroke cognitive decline and white matter lesions (WML) are related to poor poststroke survival. Whether cognitive reserve as reflected by educational history associates with cognitive decline, recurrent strokes, and poststroke mortality independent of WML is not known. METHODS:A total of 48...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.112.667618
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We sought to assess the long-term predictive usefulness of bone mineral density (BMD) for stroke incidence and stroke mortality. METHODS:The First National Health and Nutrition Examination Survey data were obtained from a nationally representative sample of noninstitutionalized civilians. A coho...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000065826.23815.A5
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Lacunar ischemic stroke accounts for 25% of all ischemic strokes, but the exact etiology is unknown. Numerous pathophysiologies have been proposed, including atheroma and endothelial dysfunction. Models of any of these pathological features would aid understanding of the etiology and help develop...
journal_title:Stroke
pub_type: 杂志文章,meta分析,评审
doi:10.1161/STROKEAHA.108.528430
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Diffusion-weighted imaging (DWI) is the most sensitive MR sequence in acute arterial ischemic stroke but has not yet been evaluated in venous cerebral ischemia. We describe a patient with DWI performed at the acute phase of a venous ischemic stroke. CASE DESCRIPTION:A rapid cerebral MRI including DWI and fa...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.29.12.2649
更新日期:1998-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Higher proportions of hemorrhagic stroke and lacunar infarction were reported in rural Japan compared with those in Western countries. We examined the relative proportions of stroke subtypes in an urban Japanese city where westernized lifestyles are more common than in rural areas. METHODS:Strok...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000221714.96986.5f
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Increased amount of therapy seems to be beneficial for motor recovery after stroke. The primary aim of the present study was to evaluate the effect of a 4-week community-based intensive motor training program combined with early supported discharge after initial treatment in a comprehensive strok...
journal_title:Stroke
pub_type: 杂志文章,随机对照试验
doi:10.1161/STROKEAHA.110.584284
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The objective is to compare the effects of high-intensity interval training (HIIT) with long versus short intervals on endurance and motor performance. Their influence on neuroplasticity markers is assessed in the ipsilesional and contralesional cortex and hippocampus since their remodeling could...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.120.031873
更新日期:2021-02-01 00:00:00