Acute Treatment of Stroke (Except Thrombectomy)

Venturelli, Paula Muñoz; Appleton, Jason P.; Anderson, Craig S.; Bath, Philip M.

doi:10.1007/s11910-018-0883-x

Cited by 3 publications

(2 citation statements)

References 89 publications

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“…Treatments such as use of antiplatelet agents that improve the circulation result in changes in the brain microcirculation. Changes caused by reperfusion and increased blood volume in the local circulation increase the possibility of bleeding or aggravate damage to infarcted brain tissue (Campbell et al., 2015; Lansberg et al., 2012; Venturelli et al., 2018).…”

Section: Discussionmentioning

confidence: 99%

Hyperdense middle cerebral artery sign in large cerebral infarction

et al. 2021

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Objectives To evaluate if the hyperdense middle cerebral artery sign (HMCAS) is an imaging biomarker for hemorrhagic transformation (HT) and the functional outcome of patients with large cerebral infarctions without thrombolytic therapy. Materials and Methods The clinical and imaging data of 312 patients with large cerebral infarction without thrombolytic therapy were retrospectively analyzed. They were divided into patients who presented with HMCAS (n = 121) and those who did not (non‐HMCAS[n = 168] patients), and the clinical data of the 2 groups were compared. This was a retrospective study. Results Of the 289 patients, 83(28.7%) developed HT. The incidence of atrial fibrillation, high homocysteine and admission NIHSS score at the time of admission was significantly higher in the HMCAS patients than in non‐HMCAS patients (p < .05). The ASPECTS was significantly lower in HMCAS patients (t = −5.835, p < .001). The incidence of PH‐2 and 3‐month mRS score was also statistically significant higher in HMCAS patients (χ2 = 3.971, p = .046; χ2 = 5.653, p < .001, respectively). A sub‐analysis showed HMCAS patients with HT were significantly older than non‐HMCAS patients with HT (t = 2.473, p = .015). The incidence of atrial fibrillation and the 3‐month mortality rate were higher in HMCAS patients with HT than in non‐HMCAS patients with HT (χ2 = 3.944, p = .047; χ2 = 6.043, p = .014, respectively). Multiple logistic regression analysis showed HT was independently associated with HMCAS (adjusted OR/95% CI/p = 2.762/1.571–4.854/p < .001) and admission NIHSS score (adjusted OR/95% CI/p = 1.081/1.026–1.139/0.003). And HMCAS with HT was independently associated with length of HMCAS (adjusted OR/95% CI/p = 1.216/1.076–1.374/0.002). Conclusions HMCAS in patients with a large cerebral infarction without thrombolytic therapy is an independent biomarker of HT. Length of HMCAS is also a marker of HT with lower ASPECTS in HMCAS patients.

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Section: Discussionmentioning

confidence: 99%

Hyperdense middle cerebral artery sign in large cerebral infarction

et al. 2021

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“…This is due to a better understanding of the disease and new potential therapies. Nevertheless, there is still a need for analyses of pathophysiological mechanisms depending on the type of stroke in order to personalize treatment [2]. Embolic stroke occurs when a blood clot that forms elsewhere is released from there and finally becomes stuck in a smaller brain vessel, causing an ischemic event.…”

Section: Introductionmentioning

confidence: 99%

The Importance of Platelets Response during Antiplatelet Treatment after Ischemic Stroke—Between Benefit and Risk: A Systematic Review

Sikora

Karczmarska-Wódzka

Bugieda

et al. 2022

IJMS

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Ischemic stroke is a disease related to abnormal blood flow that leads to brain dysfunction. The early and late phases of the disease are distinguished. A distinction is made between the early and late stages of the disease, and the best effect in treating an ischemic stroke is usually achieved within the first hours after the onset of symptoms. This review looked at studies platelet activity monitoring studies to determine the risks and benefits of various approaches including antiplatelet therapy. A study was conducted on recently published literature based on PRISMA. This review includes 32 research articles directly addressing the importance of monitoring platelet function during antiplatelet therapy (dual or monotherapy) after ischemic stroke. In patients with transient ischemic attack or ischemic stroke, antiplatelet therapy can reduce the risk of stroke by 11–15%, assuming that patients respond well. Secondary prevention results are dependent on platelet reactivity, meaning that patients do not respond equally to antiplatelet therapy. It is very important that aspirin-resistant patients can benefit from the use of dual antiplatelet therapy. The individualized approach to secondary stroke prevention is to administer the most appropriate drug at the correct dose and apply the optimal therapeutic procedure to the individual patient.

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Protocolo de tratamiento del ictus isquémico en fase aguda

Culleré¹

2019

Medicine - Programa de Formación Médica Continuada Acreditado

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Acute Treatment of Stroke (Except Thrombectomy)

Cited by 3 publications

References 89 publications

Hyperdense middle cerebral artery sign in large cerebral infarction

Hyperdense middle cerebral artery sign in large cerebral infarction

The Importance of Platelets Response during Antiplatelet Treatment after Ischemic Stroke—Between Benefit and Risk: A Systematic Review

Protocolo de tratamiento del ictus isquémico en fase aguda

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