bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strokes In Young Adults And Children
Authors: Iranmanesh Farhad 
Published: February 2017

Stroke is in second place on a mortality list in the world. Also, stroke is a leading cause of disability. Approximately 20% of all strokes occur in Children and young adults. The etiology of stroke in Children and young adults is different from that in older patients, and has an influence on diagnostic evaluation and treatment, so knowledge about older patients cannot always be applied to these patients. The list of stroke etiologies among young adults and children is extensive. Ischemic stroke are more frequent than hemorrhagic strokes in both groups. Stroke in young adults had been thought to be associated with risk factors, including arterial (such as dissection, reversible cerebral vasoconstriction syndrome, inflammatory arteritis ,moyamoya ,migraine - induced stroke, genetic or inherted arteriopathy, premature atherosclerosis ) cardiac (such as patent foramen ovale, cardiomyopathy , congenital heart disease) and hematologic (such as deficiencies of protein S,protein C,or antithrombin;factor V lieden mutation) . Common risk factors for stroke in children include: Sickle-cell disease, diseases of the arteries, abnormal blood clotting, head or neck trauma. There are no specific recommendations or guidelines for primary or secondary stroke prevention in young adults. Primary prevention focused on identifying and managing known vascular risk factors, such as hypertension, disorders of lipid metabolism, and diabetes, and non-drug strategies and lifestyle changes, including smoking, reducing body weight, increasing regular aerobic physical activity, and adopting a healthy diet with more fruit and vegetables and less salt. For secondary stroke prevention, identification of the etiologic mechanism of the initial stroke and the presence of any additional risk factors is most important. It consists of optimal treatment of vascular risk factors administering antiplatelet or anticoagulant therapy, and if indicated, invasive surgical or endovascular therapeutic procedures. An integral part of this is lifestyle changes, emphasizing regular physical activity, a diet low in salt and saturated fat and high in fruit and vegetables, reducing overweight and quitting smoking.
How To Manage Intracranial Arterial Stenosis? I'm Medical Or Interventional Treatment?
Authors: Rahim Kohansal 
Published: February 2017

Background and review: The risk of stroke per year is about 3.9-28.7% in patients with stenosis of the intracranial internal carotid artery and about 2.8-12% in patients with stenosis of middle cerebral artery. Intracranial stenoses are dynamic lesions. They can show progression, can remain stable or even undergo regression. The treatment of these patients is still controversial and several questions have to be answered.for example,whether only anti platelet/anticoagulantion therapy or angioplasty/stenting is the best first-line therapy?what is the best or maximal medical therapy?furthermore,what is the risk of stroke with medical or with interventional therapy or, what is the risk of complication from interventional therapy?is stenting necessary but or is angioplasty alone sufficient? Annual risk of stroke in patients with symptomatic intracranial stenosis where anti platelet/anticoagulantion therapy failed is about 4-12%(-45%). The intracranial complication rates of intracranial angioplasty or stenting are as high as 20%.during treatment,ischemic stroke has been reported in 0-20%,intracranial hemorrhage in 0-4%,vessel dissection in 0-10%,vessel rupture in 0-4%, vessel occlusion/thrombosis in 0-4% and death in 0-8%.Conclusion: In patients with intracranial areterial stenosis angioplasty or stenting placement should not be the first-line therapy. Instead,initial treatment should include the standard control of vascular risk factors and application of antiplatelet/anticoagulantion drugs,statins and angiotensin convert ing enzym ihibitor.
Anticoagulant Therapy In Ischemic Stroke Or TIA
Authors: Mehrvar Kaveh 
Published: February 2017

Stroke is the leading cause of disability and the third leading cause of death . Anticoagulants have been used to treat patients with acute ischemic stroke for many years. Despite their widespread use, the usefulness of emergency anticoagulation is a subject of debate. Disagreements exist about the best agent to administer, the route of administration, the use of a bolus dose to start treatment, the level of anticoagulation required, and the duration of treatment. There are 2 types of anticoagulants: Parenteral and oral. Heparin is an anticoagulant that used parenteral. Oral anticoagulants are including Warfarin and new anticoagulants such as Dabigatrn,Rivaroxaban ,Apixaban and other newer drugs.In patients with noncardioembolic ischemic stroke or TIA antiplatelet agents are treatment of choice and preferred to anticoagulants.In cardioembolic ischemic stroke or TIA with high risk of reembolization anticoagulants are considered as preferred treatment. Warfarin, apixaban10mg/d ,Rivaroxaban20mg/d, and dabigatran 150 mg/d are all indicated for the prevention of recurrent stroke in patients with nonvalvular AF, whether paroxysmal or permanent.Also anticoagulant therapy is recommended for ischemic stroke or TIA patients in the setting of acute MI, atrial or ventricular thrombosis or dilated and restricted cardiomyopathy. Some valvular heart diseases are other indication for anticoagulant therapy in ischemic stroke or TIA patients.Ischemic Stroke or TIA in patients with Cerebral vein thrombosis and known hypercoagulable state specially anti phospholipid antibody syndrome are other indications for anticoagulant treatment.
An Overview Of Specialist Nurse Role In Patients With Stroke Caring And Their Care-Givers Support
Authors: Navab Elham , Shali Mehraneh 
Published: February 2017

Background: The practical difficulties for patients with stroke include lack of information about their condition, poor knowledge of the services and benefits available. Specialist Stroke nurses provide education and support services for people with Stroke in many health care systems. A key goal is helping and empowering unable people to self-manage their stroke and supporting caregivers of these valnurable population, too.Objective: The objective of this review was to assess the role of specialist nurse in care for patients following a stroke and their caregivers support.Search methods: The databases CINAHL, PubMed, Science Direct and Synergy were searched from 1988 to 2017 using the keywords Stroke, Specialist Nurse, Care, Caregivers and support. Bibliographies of relevant papers were searched, and hand searching of relevant publications was undertaken to identify additional Studies.Selection criteria: All studies of the effects of a specialist nurse practitioner on short and long term stroke outcomes were included in the review.Data collection and analysis: Three investigators performed data extraction and quality scoring independently; any discrepancies were resolved by consensus.Findings: Stroke, Specialist Nurse, Care, Caregivers concepts and labels are defined and measured in different and often contradictory ways by using 31 founded study.Conclusions: The findings indicate a dissonance in the views of different stakeholders within the care system. The division of labour associated with nursing care and specialist nurse requires further exploration. The contrasting paradigms of health care professionals and people with stroke regarding models of disability were highlighted. Stroke, like other chronic illnesses, requires substantial nursing care. There is a growing number of specialist nurses in the workforce, however, little is known how their role interfaces with other nurses.
Cryptogenic Stroke
Authors: Saadatnia Mohammad 
Published: February 2017

Cryptogenic stroke is defined as brain infarction that is not attributable to a source of definite embolism, large artery atherosclerosis, or small artery disease despite a thorough vascular, cardiac, and serologic evaluation. Despite many advances in our understanding of ischemic stroke, cryptogenic strokes remain a diagnostic and therapeutic challenge.The pathophysiology of cryptogenic stroke is likely various. Probable mechanisms include cardiac embolism secondary to occult paroxysmal atrial fibrillation, aortic atheromatous disease or other cardiac sources, paradoxical embolism from atrial septal abnormalities such as patent foramen ovale, hypercoagulable states, and preclinical or subclinical cerebrovascular disease. Cryptogenic stroke is one-fourth among cerebral infarction, but most of them could be ascribed to embolic stroke. A significant proportion of cryptogenic strokes adhere to embolic infarct topography on brain imaging and improvement in our ability to detect paroxysmal atrial fibrillation in patients with cryptogenic stroke has strengthened the idea that these strokes are embolic in nature. a significant proportion of cryptogenic strokes adhere to embolic infarct topography on brain imaging.embolic stroke of undetermined sources(ESUS) was planned for unifying embolic stroke of undetermined source. The etiologies underlying ESUS included minor-risk potential cardioembolic sources, covert paroxysmal atrial fibrillation, cancer-associated coagulopathy and embolism, arteriogenic emboli, and paroxysmal embolism. Extensive evaluation including transesophageal echocardiography and cardiac monitoring for long time could identify the etiology of these patients. Therefore cryptogenic stroke is a diagnosis of exclusion. Compared with other stroke subtypes, cryptogenic stroke tends to have a better prognosis and lower long-term risk of recurrence.
Carotid Angioplasty In Octogenarians: A Mono-Arm Trial With Clinical And Angiographic Follow Up
Authors: Sharifipour Ehsan , Mohammadian Reza 
Published: February 2017

Background: Octogenarians account for a third of ischemic stroke (IS) patients and they have higher morbidity and mortality rate among IS patients. The aim of this study was to evaluate the pri-procedural and long term clinical and angiographic statement of carotid artery angioplasty (CAA) in octogenarians.Methods: In a mono-arm trial 102 patients>80 years old with symptomatic internal carotid artery (ICA) stenosis presented by non-disabling IS or TIA underwent the CAA and were evaluated prospectively from January 2010 to July 2014. All patients had standard stroke care during the study follow up. The peri-procedural complications, cerebrovascular accidents, restenosis in target vessel and mortality rate were recorded to evaluate safety and durability of this secondary stroke prevention method in octogenarians.Results: 48 (47.06%) males and 54 (52.9%) females in a mean period of 24.5±14.1 (6-50 months) were followed. For all patients mean age was 83.39 ±2.53 (range, 80-88) years. The success rate of CAA was 100%, whereas the peri-procedural complication rate was 5.8% (access-site local hematoma and bradycardia during CAA both in 2.94%).There was only one patient who had acute ischemic stroke during the procedure. Restenosis occurred in 3.9% after a mean of 21.5 months. The proportion of recurrent cerebrovascular accident was 9.8% while TIAs occurred in 3.9% and stroke in 1% of patients. Also 4.9% of patients experienced coronary artery disease and the proportion of fatal recurrent cerebrovascular accident was 2.9%. The median patient event-free survival was 20 months.Conclusion: CAA seems to be a safe and durable IS secondary prevention method in octogenarians with symptomatic carotid artery stenosis.
Diagnosis Of The Risk For Carotid Artery Stenos Based On Thermal Model In Infrared Images
Authors: Valipoori Goodarzi Fatemeh , Habashi Zadeh Tahereh 
Published: February 2017

Background and purpose: Ischemic stroke is the third leading cause of death and a common cause of hospitalization in the United States of America and is also an important factor for Inability of patients and carotid stenos is one of the most important factors in creating it. Now, Imaging studies include: Angiography, MRI, CT scan and Doppler ultrasonography , are used to detect carotid artery stenos that is one of the most important causes of ischemic stroke. However, each method has unique advantages and disadvantages, that many of them will have a compromise between performance and accuracy versus easy usage and cost considerations. In contrast, in this paper, thermography is used as a non-invasive and cost effective to detect carotid artery Stenos and thus the risk of stroke.Materials and methods: This study is done on a series of thermal images obtained from the Clinical Center in California. In this imaging, the automatic detection of carotid artery stenos and thus Risk for stroke was done, based on: (1) the difference of average temperature between the right and left carotid arteries in the neck (2) The presence or absence of internal and external carotid arteries.Results: In this study, with the survey conducted by a specialist brain of patients had been previously, the accuracy of this work is confirmed. the techniques and points that are Experimental and scientifically based and obtained in this study, can help to doctors for Early detection of Artery disease, based on analysis of thermal images .Conclusion: The method presented in this paper is considered as a non-invasive and cost-effective method that automatically operates to detect the carotid arteries and prevent the Risk for stroke.
Increased Expression Of Toll-Like Receptor 2 Mrna Following Permanent Middle Cerebral Artery Occlusion In Rat: Role Of TRPV1 Receptors
Authors: Moghadam Ahmadi Amir , Allahtavakoli Mohammad , Shamsizadeh Ali , Roohbakhsh Ali , Vakilian Alireza , Hakimizadeh Elham , Rahmani Mohammadreza , Bazmandegan Gholamreza 
Published: February 2017

Background: Stroke is a major cause of mortality and long term disability in adults. TRPV1 has a pivotal role in neuroinflammation. Among TLRs, TLR2 significantly participate in induction of inflammation in brain. In this study, the effect of TRPV1 receptor agonist and antagonist on outcome and gene expression of TLR2 in a rat model of permanent middle cerebral artery occlusion (MCAO) was investigated.Methods: Forty male rats were assigned to the following groups: sham, vehicle )stroke), AMG9810 (selective TRPV1 antagonist, 0.5 mg/kg; 3 h after stroke), and capsaicin (1 mg/kg; 3 h after stroke). Stroke was induced by permanent middle cerebral artery occlusion and behavioral functions were assessed 1, 3, and 7 days after stroke. Infarct volume, brain edema and mRNA expression of TLR2 were also evaluated at the end of the study.Results: While stroke animals showed infarctions and behavioral functions, we did not observe any cerebral infarction and behavioral functions in sham-operated animals. AMG9810 decreased neurological deficits 7 days after cerebral ischemia (P<0.01). In the ledged beam-walking test, the slip ratio was increased following ischemia (*P < 0.05). AMG9810 improved this index in animals undergone stroke. However, capsaicin enhanced the slip ratio 3 and 7 days after cerebral ischemia (#P<0.05). TLR2) P<0.05(mRNA expression was elevated in ischemic rats. Conclusion: Our data indicate that pharmacological blockade of TRPV1 by AMG9810 attenuates behavioral function and mRNA expression of TLR2. Therefore, it might be useful as a potential target for the treatment of ischemic stroke.
Correlation Between Lower And Higher Order Sensory Functions And Fine And Gross Motor Function In Dominant And Non-Dominant Hand Of Patients With Choronic Stroke
Authors: Najafabadi Mahbubeh Mandehgary , Akram Azad , Ghorban Taghizadeh 
Published: February 2017

Introduction: To investigate the correlation between lower and higher order sensory functions and manual dexterity as well as Identify factors affecting upper extremity motor function(UEMF) in subjects with chronic stroke.Methods: In this correlational study, seventy chronic stroke subjects (48 male and 22 female) by mean age of 56.94 (±12.92) years and mean time after stroke of 3.01 (±2.64) years were selected by simple nonprobability method. Lower order sensory function (i.e., light touch threshold), higher order sensory functions (i.e., tactile acuity, weight and texture discrimination, haptic performance and wrist proprioception) were measured by Weinstein enhanced sensory test, two point discrimination, wrist position sense test, hand active sensation test and haptic object test, respectively. The gross and fine manual dexterity were measured by Wolf Motor Function Test (WMFT), Box and Block Test(BBT) and Purdue Pegboard (PPB) test. The step by step regression model was used to investigate the sensory determinants of motor function.Results: A weak to high significant correlation (r =0.25 to 0.80) was found between sensory predictors and motor outcomes. The regression models explained 19.8%, 30.3% and 52.3% of variancein motor function measures of the PPB, BBT and WMFT, respectively. The tactile threshold (p<0.001) was the most relevant predictor in all stepwise models for all motor outcomes in dominant or non-dominant hand , followed by tactile acuity, haptic performance and wrist proprioception (p< 0.05). The weight and texture discrimination was not included in any outcome models. Conclusion: The results of present study showed that tactile threshold as lowr order sensory function is the most relevant predictor for UEMF in stroke. The results reinforce that rehabilitation interventions focused on tactile threshold may be best able to impact UEMF in stroke subjects.
Diagnosis Of The Risk For Carotid Artery Stenos Based On Thermal Model In Infrared Images
Authors: Valipoori Goodarzi Fatemeh , Habashizadeh Tahereh 
Published: February 2017

Background and purpose: Ischemic stroke is the third leading cause of death and a common cause of hospitalization in the United States of America and is also an important factor for Inability of patients and carotid stenos is one of the most important factors in creating it. Now, Imaging studies include: Angiography, MRI, CT scan and Doppler ultrasonography , are used to detect carotid artery stenos that is one of the most important causes of ischemic stroke. However, each method has unique advantages and disadvantages, that many of them will have a compromise between performance and accuracy versus easy usage and cost considerations. In contrast, in this paper, thermography is used as a non-invasive and cost effective to detect carotid artery Stenos and thus the risk of stroke.Materials and methods: This study is done on a series of thermal images obtained from the Clinical Center in California. In this imaging, the automatic detection of carotid artery stenos and thus Risk for stroke was done, based on: (1) the difference of average temperature between the right and left carotid arteries in the neck (2) The presence or absence of internal and external carotid arteries.Results: In this study, with the survey conducted by a specialist brain of patients had been previously, the accuracy of this work is confirmed. the techniques and points that are Experimental and scientifically based and obtained in this study, can help to doctors for Early detection of Artery disease, based on analysis of thermal images .Conclusion: The method presented in this paper is considered as a non-invasive and cost-effective method that automatically operates to detect the carotid arteries and prevent the Risk for stroke.
Reversible Cerebral Vasoconstriction Syndromes
Authors: Karimi Narges 
Published: February 2017

Reversible cerebral vasoconstriction syndromes (RCVS) show reversible multifocal narrowing of the cerebral arteries with clinical manifestations that characteristically include thunderclap headache and less commonly focal neurologic deficits related to brain edema, stroke, or seizure. RCVS predominantly affects women (female to male ratio 2:1 to 10:1, depending on the case series). The mean age across published studies is 42 to 44 years. RCVS has been associated with a multiplicity of conditions including pregnancy, migraine ,use of vasoconstrictive drugs and other medications, neurosurgical procedures, hypercalcemia, unruptured saccular aneurysms, cervical artery dissection, cerebral venous thrombosis, and others. Between 30 and 70 percent of patients with RCVS have no abnormality on initial brain scans, despite having widespread cerebral vasoconstriction. However, approximately 75 percent of admitted patients eventually develop parenchymal lesions. The most frequent lesions are ischemic stroke and cortical surface (nonaneurysmal or convexal) subarachnoid hemorrhage, followed by reversible vasogenic brain edema and parenchymal hemorrhage. Infarcts are often bilateral and symmetrical, located in arterial "watershed" regions of the cerebral hemispheres or in the cortical-subcortical junction. Larger infarcts are often wedge-shaped. Cerebral angiographic abnormalities are dynamic and progress proximally, resulting in a "sausage on a string" appearance of the circle of Willis arteries and their branches. There is no proven therapy for RCVS. Supportive care is directed towards managing blood pressure, severe headaches, and other complications such as seizures. Oral calcium channel blockers are often administered to treat vasoconstriction but the supporting evidence for this strategy is weak.
A Case Of Postprtum Rcvs Failed To Respond To Metylprednisolon
Authors: Mehrpour M , Haji Akhoundi F , Afrakhteh M , Raeesmohammadi L , Ashyeri R , Motamed M 
Published: February 2017

Introduction:Reversible cerebral vasoconstriction syndrome(RCVS) is a rare condition that occurs as the result of a sudden constriction(tightening) of the vessels that supply blood to the brain. the main symptom of RCVS is thunderclap headaches. stroke or bleeding in to the brain and seizure may or may not be present. the condition is more commonly diagnosed in women between the ages of 20 to 50 and may be associated with changes that happen in the body immediately after giving birth or changing birth control pills. other risk factors associated with RCVS include: use of drugs, alcohol, nicotin patches and certain tumors.Objective:For the first time in our center we diagnose and treat a postpartum RCVS.Case Description:A 37year old lady was referred to our center with GTCS and thunderclap headache. she had an uncomplicated cesarian section last week. she had no significant past medical history and her blood pressure was normal during pregnancy. drug history was negative. in physical exam blood pressure and neurologic exam were normal. in our assessment brain imaging showed cortical SAH, lab data including blood biochemistries and csf were normal, in Angiography vasospasm in left A1 and in carotid duplex MCA velocity was 220 cm/s. Therefore we started nimodipin and metylprednisolon but her symptom aggravated and she showed increased MCA velocity in TCD.SO BRAIN Angiography was done for the second time that show generalized vasospasm in anterior circulation, bilateral v4 and basilar arteries. nimodipin and milrinone were injected slowly and vasospasm become better.TCD monitoring showed decreased MCAs velocities and her symptom did not recur and in TCD MCAs PSVs were below 150 cm/s.Discussion:We presented a case of postpartum RCVS , that aggravated with intra venous metylprednisolon, and resolved with intra arterial milrinone. RCVS is a syndrome of cerebral arterial vasoconstriction, usually presenting with recurrent thunderclap headaches, seizures and focal neurologic deficits. our patient s symptoms consist of a thunderclap headache and a GTCS. our patient was not a case of eclampsia and other predisposing factors of RCVS were also absent. she was one of the rare reported cases of RCVS in the postpartum period. treatment of RCVS in usually conservative and symptomatic cases. few existing trapeutic option include: oral or intra arterial of CCBs. Recent studies reported that steroids lack beneficial in RCVS and may even worsen vasoconstriction. this is what happened in our patient. She finally improved with intra arterial milrinone injection.