• He primarily used positron emission tomography (PET) in the study of cerebrovascular diseases, using it in conjunction with other techniques such as CT, MR, and SPECT to investigate the pathophysiology of transient ischemic attacks (TIAs) and acute ischemic stroke, as well as the mechanisms underlying post-stroke recovery, in both patients and animal models. (wikipedia.org)
  • His main findings include the discovery of the ischemic penumbra in humans and the crucial role of hemodynamic impairment in carotid-territory TIAs, as well as crossed cerebellar diaschisis and thalamo-cortical diaschisis. (wikipedia.org)
  • Transient ischemic attacks (TIAs) are associated with a high risk of subsequent stroke and often pose a diagnostic and treatment challenge. (touchneurology.com)
  • It is important to separate TIAs from stroke as well as from TIA mimics to estimate individual stroke risk early and properly. (touchneurology.com)
  • The classic definition of transient ischemic attacks (TIAs) based on focal neurological deficits most likely due to cerebrovascular diseases with full recovery within 24 hours dates back to the 1960s. (touchneurology.com)
  • With this in mind and considering the fact that TIAs are well recognized risk factors for stroke (mean annual stroke risk after TIAs has been found to be up to 15%), 3 TIAs stopped to be considered harmless long ago. (touchneurology.com)
  • In patients with transient ischemic attacks (TIAs), failure to recognize the potential for near- term stroke, failure to perform a timely assessment for stroke risk factors, and failure to initiate primary and secondary stroke prevention exposes the patient to undue risk of stroke and exposes clinicians to potential litigation. (medscape.com)
  • TIAs confer a 10% risk of stroke within 30 days, and one half of the strokes occurring after a TIA, occurred within 48 hours. (medscape.com)
  • for example, in a patient with a territorial infarct, finding atrial fibrillation suggests a cardioembolic cause, or finding a ipsilateral carotid stenosis suggests a large artery stroke. (bmj.com)
  • Atrial fibrillation and stroke: chicken or egg? (mcmaster.ca)
  • The specific objectives were to review the current evidence supporting management of ten major modifiable risk factors for prevention of stroke: hypertension, current smoking, diabetes, obesity, poor diet, physical inactivity, atrial fibrillation, excessive alcohol consumption, abnormal lipid profile and psychosocial stress/ depression. (cdc.gov)
  • Effects of thalamic stroke on energy metabolism of the cerebral cortex. (wikipedia.org)
  • The original TIA definition as "a cerebral dysfunction of ischemic nature lasting no longer than 24 hours with a tendency to recur" was based on pure clinical findings and was formulated in a time period in which neuroimaging was rudimental and acute stroke treatment missing. (touchneurology.com)
  • Background and purpose Retinal pathologies are an independent risk factor for ischaemic stroke, but research on the predictive value of retinal abnormalities for recurrent vascular events in patients with prior stroke is inconclusive. (bmj.com)
  • Conclusions Retinal changes did not predict major subsequent vascular events in patients with recent TIA or minor stroke. (bmj.com)
  • Microvascular pathologies are an independent risk factor for incidental ischaemic strokes, but data regarding subsequent vascular events are sparse. (bmj.com)
  • In patients with recent transient ischaemic attacks (TIA) or minor stroke, the burden of retinal abnormalities was not associated with recurrent vascular events. (bmj.com)
  • Although we did not show a general association between fundus changes and subsequent vascular events, retinal imaging might be useful in a subset of patients with diabetes and hypertension for identifiying those at risk for recurrent ischaemic stroke. (bmj.com)
  • This requires application of a pathophysiological subtyping algorithm such as the Trial of Org 10 172 in Acute Stroke Treatment algorithm. (bmj.com)
  • those with a previous stroke (to reduce chance of patients having previous disability/dependency), those with a non-stroke diagnosis and patients with serious adverse events (SAEs) reported after 76 days (in an attempt to prevent SAEs directly affecting outcome at 90 days). (springer.com)
  • Effective prevention depends on both an accurate diagnosis of the stroke subtype, and an appreciation that different stroke subtypes may respond differently to secondary preventative treatments. (bmj.com)
  • Tailored secondary prevention approaches require accurate diagnosis of the stroke subtype. (bmj.com)
  • The contribution of DWI MRI to the diagnosis of the stroke mechanism a 43-year-old man with hypertension, diabetes and raised serum cholesterol developed sudden-onset left hemiparesis with face, arm and leg weakness, consistent with a pure motor lacunar syndrome. (bmj.com)
  • Many potential biomarkers have been described to contribute to the diagnosis, prognosis of outcomes, and risk stratification after stroke. (viamedica.pl)
  • 7 Good TIA management requires a practical definition and confident diagnosis, based on good and reliable diagnostic tools, separation from TIA mimics, a valid prognosis and stroke risk assessment to identify potential sources of stroke and risk factors and a strategy for treatment and prevention. (touchneurology.com)
  • Methods In a substudy of the Intensified secondary prevention intending a reduction of recurrent events in TIA and minor stroke patients (INSPiRE-TMS) trial, we enrolled patients with recent transient ischaemic attack (TIA) or minor stroke with at least one modifiable risk factor. (bmj.com)
  • 1. Cucchiara BL, Messé SR. Antiplatelet therapy for secondary prevention of stroke. (bvs.br)
  • The primary end point was time to the occurrence of stroke or death within 30 days.Results:Of 11 016 randomized patients, 2351 (21.3%) patients had an ipsilateral atherosclerotic stenosis. (kb.se)
  • Arterial Tortuosity: An Imaging Biomarker of Childhood Stroke Pathogenesis? (mcmaster.ca)
  • Post hoc data on infections were obtained from serious adverse events reports between 1 and 76 days following stroke in this large cohort of patients. (springer.com)
  • The ENOS was an international multicentre trial of transdermal glyceryl trinitrate (GTN) or no GTN [ 16 ] in patients with acute ischaemic stroke and high blood pressure. (springer.com)
  • Patients were randomised within 48 h of stroke onset and treated for 7 days. (springer.com)
  • The trial included 11 016 patients with a noncardioembolic, nonsevere ischemic stroke or high-risk TIA, including 10 803 with modified Rankin Scale score (mRS) recorded at 30 days.Interventions: Ticagrelor (180-mg loading dose on day 1 followed by 90 mg twice daily for days 2-30) or placebo within 24 hours of symptom onset. (kb.se)
  • All patients received aspirin, 300 to 325 mg on day 1 followed by 75 to 100 mg daily for days 2 to 30.Main Outcomes and Measures: Time to the occurrence of disabling stroke (progression of index event or new stroke) or death within 30 days, as measured by mRS at day 30. (kb.se)
  • In a selective post hoc analysis in patients with diabetes mellitus and hypertension, patients with vascular retinopathy with vessel rarefaction had a higher risk for recurrent stroke (HR 24.14 (95% CI 2.74 to 212.50), p=0.004). (bmj.com)
  • Further studies are needed to examine the utility of fundus photography in assessing the risk of stroke recurrence in patients with diabetes mellitus and hypertension. (bmj.com)
  • Determining the copeptin level may help individualize the management of ischemic stroke patients, keep stroke risk lower, reduce post-stroke complications, including patient death, and minimize healthcare costs. (viamedica.pl)
  • Diabetes mellitus causes lipid profile abnormalities, resulting in dyslipidemia in diabetic patients leading to ischemic stroke. (upnvj.ac.id)
  • This research aims to contrast lipid profiles in ischemic stroke patients with type 2 diabetes mellitus (T2DM) and non-type 2 diabetes mellitus (non-T2DM) to prevent stroke recurrence, treat dyslipidemia in diabetes mellitus, and evaluate for treatment of T2DM and non-T2DM ischemic stroke patients. (upnvj.ac.id)
  • Multifaceted analysis in age, gender, hypertension, and coronary heart disease was incorporated to observe its influence on T2DM and non-T2DM ischemic stroke patients. (upnvj.ac.id)
  • Is There an Optimal Management Regimen for Transient Ischemic Attack Patients to Best Prevent Stroke? (touchneurology.com)
  • Management should take place in a stroke-specialized center and consist of rapid assessment and identification of those patients at highest risk for subsequent strokes, including extensive brain and vascular imaging as well as cardiological assessement. (touchneurology.com)
  • While many prefer admitting these patients to a stroke unit for full work-up within 72 hours, others propose 24-hour open 'TIA clinics' or even a quick work-up in a specialized outpatient department. (touchneurology.com)
  • In patients with primary APS, the presence of the 3 aCL isotypes plus LAC has been associated with a higher number of recurrent spontaneous abortions, compared with other possible combinations of aCL isotypes. (medscape.com)
  • The HLA-DR3 phenotypes seem to predispose to the formation of aCL antibodies and antinuclear antibodies (ANAs), but this has not been confirmed in patients, and particular HLA alleles associated with recurrent miscarriage have not been reported. (medscape.com)
  • The goal for the acute management of patients with stroke is to stabilize the patient and to complete initial evaluation and assessment, including imaging and laboratory studies, within 60 minutes of patient arrival. (medscape.com)
  • Administration of glucose in hypoglycemia produces profound and prompt improvement, while insulin should be started for patients with stroke and hyperglycemia. (medscape.com)
  • In the small proportion of patients with stroke who are relatively hypotensive, pharmacologically increasing blood pressure may improve flow through critical stenoses. (medscape.com)
  • [ 5 ] . A 2015 update of the American Heart Association/American Stroke Association guidelines for the early management of patients with acute ischemic stroke recommends that patients eligible for intravenous t-PA should receive intravenous t-PA even if endovascular treatments are being considered and that patients should receive endovascular therapy with a stent retriever if they meet criteria. (medscape.com)
  • Newer stroke trials have explored the benefit of using neuroimaging to select patients who are most likely to benefit from thrombolytic therapy and the potential benefits of extending the window for thrombolytic therapy beyond the guideline of 3 hours with t-PA and newer agents. (medscape.com)
  • The above systematic review and meta-analysis suggests that monitoring the copeptin levels may help predict the long-term prognosis of ischemic stroke efficiently. (viamedica.pl)
  • 1 With the advent of advanced neuroimaging techniques (computed tomography [CT] and magnetic resonance imaging [MRI]), new insights into pathobiology and prognosis of cerebrovascular events, as well as the approval of recombinant tissue plasminogen activator (rtPA) treatment and the increasing emergency management in stroke units, this definition has become outdated and suggestions for its change have been frequently made. (touchneurology.com)
  • 4. Rothwell PM, Algra A, Chen Z, Diener HC, Norrving B, Mehta Z. Effects of aspirin on risk and severity of early recurrent stroke after transient ischaemic attack and ischaemic stroke: time-course analysis of randomised trials. (bvs.br)
  • Stroke due to large artery stenosis-from atherosclerosis in the carotid, vertebral or intracranial vessels-is probably primarily thromboembolic secondary to thrombosis at the site of stenosis, rather than haemodynamic. (bmj.com)
  • We aimed to determine whether delayed infections (up to 76 days post-stroke) are associated with poor outcome at 90 days. (springer.com)
  • In conclusion, severe post-stroke infections, whether occurring early or late after stroke, are associated with an increased risk of death and poorer functional outcome, independent of differences in baseline characteristics or treatment. (springer.com)
  • However, only a few studies have examined the effect of infections beyond the first 14 days after a stroke, and these showed that infections in the period from 14 up to 30 days post-stroke were associated with increased dependence on hospital discharge and increased mortality [ 14 , 15 ]. (springer.com)
  • Using the data collected in this trial, we aimed to perform a post hoc examination of the effect of infection up to 76 days post-stroke on survival and functional outcome and quality of life at 90 days post-randomisation. (springer.com)
  • This article provides practical tips to diagnose the underlying subtype of stroke, and in particular discusses non-lacunar pathologies that can present with a clinical lacunar syndrome. (bmj.com)
  • 3 Classification systems that record clinical syndromes rather than underlying pathophysiological mechanisms, such as in the Oxfordshire Community Stroke Project, are less useful. (bmj.com)
  • 4 Predictors such as the ABCD2 score 5 or fluctuations of symptoms 6 characterizing the individual risk for stroke are clinical or imaging-related (CT, MRI). (touchneurology.com)
  • Serial monitoring and interventions when necessary early in the clinical course and eventual stroke rehabilitation and physical and occupational therapy are the ideals of management. (medscape.com)
  • Current treatments for acute ischemic stroke include IV thrombolytic therapy with tissue-type plasminogen activator ( t-PA ) and endovascular therapies using stent retriever devices. (medscape.com)
  • Ischaemic stroke represents a syndrome caused by several diverse pathologies that all result in disruption of blood supply and secondary ischaemic damage. (bmj.com)
  • The specific objectives were to review the current evidence supporting management of ten major modifiable risk factors for stroke. (cdc.gov)
  • Not only can both produce symptoms that mimic ischemic stroke, but they can also aggravate ongoing neuronal ischemia. (medscape.com)
  • It also reviews the recent advances in recurrent stroke prevention, including using more intensive antiplatelet regimens in the acute phase, and the concept that undetected cardiac arrhythmias may be important in apparently cryptogenic stroke. (bmj.com)
  • Excessive alcohol consumption and psychosocial stress/depression were considered by the AHA/ASA as less well- documented risk factors for stroke [4] but we have included them in this review since they emerged as major risk factors for stroke in the INTERSTROKE study [3]. (cdc.gov)
  • Stroke is the second main cause of mortality and the third leading cause of mortality and permanent disability combined. (viamedica.pl)
  • Stroke is the second leading cause of preventable death worldwide and the fourth leading cause of lost productivity [2], as measured by disability-adjusted life years. (cdc.gov)
  • The international multicentre Efficacy of Nitric Oxide in Stroke (ENOS) trial [ 16 ] collected data on all serious adverse events until 90 days post-randomisation, including common infections such as pneumonia and urinary tract infections [ 17 ]. (springer.com)
  • Most of the problems associated with CVD are due to changes in the structural integrity of the blood vessel wall resulting in obstruction of blood flow that can lead to a heart attack or stroke. (hrb.ie)
  • Genetic data suggest that risk factors relating to altered coagulation are important for both cardioembolic and large artery stroke, but less so for small vessel stroke. (bmj.com)
  • Jean-Claude Baron is an Emeritus Professor of Stroke Medicine at the University of Cambridge. (wikipedia.org)
  • Stroke is a syndrome caused by many different disease mechanisms rather than being a single disease. (bmj.com)
  • The exact mechanisms underlying lacunar stroke are uncertain, and there is debate about the role of thrombosis as a final mediating mechanism causing ischaemia. (bmj.com)
  • American Stroke Association guidelines have reinforced the need for caution in lowering blood pressures acutely. (medscape.com)
  • Data came from the international Efficacy of Nitric Oxide Stroke (ENOS, ISRCTN99414122) trial. (springer.com)
  • The overall objectives of this article were to review how epidemiological studies during the last 5 years have advanced our knowledge in addressing the global stroke epidemic. (cdc.gov)
  • Stroke secondary to cardioembolism also has a thromboembolic basis, although from thrombosis occurring in the heart. (bmj.com)
  • Baron's principal research interests are in the pathophysiology of stroke and the processes of functional recovery after stroke, which he has mostly studied using imaging techniques. (wikipedia.org)
  • Disabling stroke was defined by mRS greater than 1.Results: Among participants with 30-day mRS greater than 1, mean age was 68.1 years, 1098 were female (42.6%), and 2670 had an ischemic stroke (95.8%) as a qualifying event. (kb.se)
  • This paper reviews how epidemiological studies during the last 5 years have advanced our knowledge in addressing the global stroke epidemic. (cdc.gov)
  • In addition, the timing of the infection after stroke did not alter its detrimental association with fatality ( p = 0.14) or functional outcome ( p = 0.47). (springer.com)
  • The present study isa systematic review and meta-analysis to assess plasma copeptin concentrations, diagnostic and prognostic values for risk stratification after acute ischemic stroke and transient ischemic attack. (viamedica.pl)
  • Evidence obtained from large epidemiological studies has revealed that the risk factors for stroke and their associations with stroke were similar in different parts of the world [3]. (cdc.gov)