Causes of Acute Stroke

Knight‐Greenfield, Ashley; Nario, Joel Jose Quitlong; Gupta, Ajay

doi:10.1016/j.rcl.2019.07.007

Cited by 53 publications

(31 citation statements)

References 41 publications

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“…CS is caused by the inability of blood and oxygen to be normally delivered to the brain due to the obstruction or rupture of cerebral vessels and arteries, resulting in brain tissue damage or infarction, so that there is brain nerve function damage. Furthermore, CS has extremely high morbidity and mortality in cerebral blood diseases [9]. Clinically, MRI is commonly applied to examine ischemic stroke, and multimode MRI techniques include DWI, perfusion weighted imaging (PWI), magnetic resonance angiography (MRA), and other technical methods [10].…”

Section: Discussionmentioning

confidence: 99%

Segmentation Algorithm for Intracranial Magnetic Resonance Images for Cerebral Stroke Identification and Nursing Evaluation

Shi

Kong

Tian

et al. 2021

Scientific Programming

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This study aimed to investigate the therapeutic effect and nursing evaluation of patients with cerebral stroke (CS) through intracranial magnetic resonance imaging (MRI) images under the condition of segmentation algorithm. 199 CS patients were selected and divided randomly into a control group (group A) and an experimental group (group B) based on different treatment methods. Patients of group A were given routine antithrombotic therapy, and patients of group B were treated with intravenous thrombolytic therapy under evaluation of segmentation algorithm-based MRI images. Then, there were comparisons on clinical therapeutic effect, neurological damage score, and daily living ability index score of all patients. After treatment, the total effective rate (92.12%) and daily life index (41.45 ± 11.24) of patients in group B were higher than those of group A ( P < 0.05). However, neurological damage scores (3.36 ± 1.13 points) of patients in group B after treatment were lower than those of group A (5.85 ± 2.31 points) ( P < 0.05). The routine clinical nursing satisfaction rate (79.8%) was lower than the overall satisfaction rate (97%) of the combination of clinical and imaging nursing ( P < 0.05). Therefore, there were greatly clinical therapeutic effects of intravenous thrombolysis evaluated by intracranial MRI images under segmentation algorithm for CS patients, and routine nursing could improve patients’ satisfaction, which were worthy of clinical promotion.

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Section: Discussionmentioning

confidence: 99%

Segmentation Algorithm for Intracranial Magnetic Resonance Images for Cerebral Stroke Identification and Nursing Evaluation

Shi

Kong

Tian

et al. 2021

Scientific Programming

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“…The greater part of the stroke is due to embolisms from heart- cervical arteries or to the atherosclerotic plaque in the aortic arch. The most important mechanism of stroke occurs through intracranial atherosclerosis ( 2 , 9 ). Based on this mechanism the etiology is subdivided into five major subtypes of (1) large-artery atherosclerosis (embolus or thromboembolism in cervical carotid arteries), (2) cardio embolism (secondary to clot formation in the heart), (3) small-vessel occlusion (lacunar infarct), (4) unusual cause or stroke of other determined causes, and (5) stroke of undetermined causes this classification is based on the Trial of Org 10172 in Acute Stroke Treatment (TOAST), which was developed to categorize the causes of AIS ( 2 , 9 ).…”

Section: Acute Ischemic Stroke (Ais)mentioning

confidence: 99%

“…The age of incidence is around 39–49 years and it is higher in men than in women according to the estimate ( 10 ). Factors include the following: the presence of hypertension, an increased apolipoprotein B (Apo B) to Apo-A1 ratio, diet, psychological stress, smoking, high alcohol consumption, diabetes, chronic kidney disease, and cardiac conditions like atrial fibrillation ( 2 , 9 – 13 ).…”

Section: Acute Ischemic Stroke (Ais)mentioning

confidence: 99%

Biomarkers for Antiplatelet Therapies in Acute Ischemic Stroke: A Clinical Review

et al. 2021

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Stroke is one of the world's leading causes of disability and death. Antiplatelet agents are administered to acute ischemic stroke patients as secondary prevention. Clopidogrel involves biotransformation by cytochrome P450 (CYP) enzymes into an active metabolite, and single nucleotide polymorphisms (SNPs) can influence the efficacy of this biotransformation. Despite the therapeutic advantages of aspirin, there is significant inter-individual heterogeneity in response to this antiplatelet drug. In this clinical review, the recent advances in the biomarkers of antiplatelet agents in acute ischemic stroke are discussed. The studies reviewed herein highlight the clinical relevance of antiplatelet resistance, pharmacotherapy of antiplatelet agents predicting drug response, strategies for identifying aspirin resistance, pharmacogenetic variants of antiplatelet agents, miRNAs, and extracellular vesicles (EVs) as biomarkers toward the personalized approach in the management of acute ischemic stroke. The precise pathways contributing to antiplatelet resistance are not very well known but are presumably multi-factorial. It is essential to understand the clinical relevance of clopidogrel and aspirin-related single nucleotide polymorphism (SNPs) as potential predictive and prognostic biomarkers. Prasugrel is a next-generation antiplatelet agent that prevents ADP-platelet activation by binding irreversibly to P2Y12 receptor. There are sporadic reports of prasugrel resistance and polymorphisms in the Platelet endothelial aggregation receptor-1 (PEAR1) that may contribute to a change in the pharmacodynamics response. Ticagrelor, a direct-acting P2Y12-receptor antagonist, is easily absorbed and partly metabolized to major AR-C124910XX metabolite (ARC). Ticagrelor's primary active metabolite, ARC124910XX (ARC), is formed via the most abundant hepatic cytochrome P450 (CYP) enzyme, CYP3A4, and CYP3A5. The integration of specific biomarkers, genotype as well as phenotype-related data in antiplatelet therapy stratification in patients with acute ischemic stroke will be of great clinical significance and could be used as a guiding tool for more effective, personalized therapy.

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“…Some additional unusual causes, such as vasculopathy or extracranial artery dissection, account for 2%‐11%. 4 , 5 Approximately 5%‐21% of strokes are hemorrhagic, and their common causes are hypertension and vascular malformations. 6 Strokes are heterogeneous diseases, and in vivo models are essential tools to mimic these processes for investigating pathophysiology and therapeutic approaches.…”

Section: Introductionmentioning

confidence: 99%

Animal models of stroke

Zhang

2021

Anim Models and Exp Med

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Stroke is a leading cause of morbidity and mortality worldwide and in China. In China, stroke was the leading cause of death and DALYs in 2017. 1 Age-standardized DALYs per 100 000 population decreased by 33.1% for stroke. Of all strokes, up to 80% to 85% are ischemic, 2 which can be subdivided based on the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification. 3 Large vessel atherosclerosis of cervical or proximal intracranial vessels comprises a major cause of acute stroke, ranging from 30% to 43%, while 20%-31% is caused by cardioembolism. Approximately 10%-23% of all strokes are lacunar in type, which are mainly caused by diabetes and hypertension. Some additional unusual causes, such as vasculopathy or extracranial artery dissection, account for 2%-11%. 4,5 Approximately 5%-21% of strokes are hemorrhagic, and their common causes are hypertension and vascular malformations. 6 Strokes are heterogeneous diseases, and in vivo models are essential tools to mimic these processes for investigating pathophysiology and therapeutic approaches. Each model has its unique strengths and weaknesses (Tables 1 and 2). Only when we realize their importance can we choose the best one for an investigation, with "best" referring to that which most closely approximates a certain aspect of the multiple facets of strokes.

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Causes of Acute Stroke

Cited by 53 publications

References 41 publications

Segmentation Algorithm for Intracranial Magnetic Resonance Images for Cerebral Stroke Identification and Nursing Evaluation

Segmentation Algorithm for Intracranial Magnetic Resonance Images for Cerebral Stroke Identification and Nursing Evaluation

Biomarkers for Antiplatelet Therapies in Acute Ischemic Stroke: A Clinical Review

Animal models of stroke

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