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  1. Article ; Online: Thrombolysis in Stroke-Heart Syndrome: a useful tool for neurocardiac wellness?

    Scali, Ilario / Naccarato, Marcello / Prandin, Gabriele / Palacino, Federica / Lugnan, Carlo / Mancinelli, Laura / Vincis, Emanuele / Furlanis, Giovanni / Caruso, Paola / Manganotti, Paolo

    Journal of neurology

    2024  Volume 271, Issue 5, Page(s) 2405–2411

    Abstract: Introduction: Stroke-heart syndrome is a physiopathological condition of cardiac suffering due to cerebral injury secondary to major vessel occlusion in anterior circulation. It can be detected by increase in cardiac blood biomarkers. Our aim was to ... ...

    Abstract Introduction: Stroke-heart syndrome is a physiopathological condition of cardiac suffering due to cerebral injury secondary to major vessel occlusion in anterior circulation. It can be detected by increase in cardiac blood biomarkers. Our aim was to investigate a possible ancillary effect of thrombolysis in mitigating Stroke-Heart Syndrome after acute ischaemic stroke.
    Patients and methods: We retrospectively collected ischaemic stroke patients admitted to our Stroke Unit between August 1, 2017 and December 31, 2020 and acutely treated for an intracranial anterior circulation occlusion, without anamnestic ischaemic cardiopathy. We divided patients into Group B ("Bridge") including patients treated with both thrombolysis and thrombectomy and Group D ("Direct") including primary thrombectomies.
    Results: 120 patients were included in the study. Group B consisted of 92 patients, Group D of 28 patients, without significant differences in age, baseline and discharge NIHSS, cardiovascular risk factors or TOAST aetiology. Whilst admission, troponin levels were similar in both groups, significant differences in troponin peak (median 16 ng/L in Group B vs 45 ng/L in Group D, p = 0.022) and BNP values (median 455 pg/mL in Group B vs 784 pg/mL in Group D, p = 0.031) were found in the first 72 h since admission. Functional independence at discharge was significantly higher in Group B than Group D (mRS 0-2 36% vs 10%, p = 0.011).
    Discussion and conclusion: Significant differences in troponin peak and BNP values suggest a reduced stroke-related heart impairment in patients treated with bridge therapeutic approach: thrombolysis prior to thrombectomy could have a complementary effect on reducing Stroke-Heart Syndrome, improving overall neurological outcome.
    MeSH term(s) Humans ; Male ; Female ; Aged ; Thrombolytic Therapy/methods ; Retrospective Studies ; Ischemic Stroke/complications ; Ischemic Stroke/blood ; Middle Aged ; Thrombectomy/methods ; Aged, 80 and over ; Heart Diseases/etiology ; Heart Diseases/complications ; Fibrinolytic Agents/administration & dosage ; Syndrome
    Chemical Substances Fibrinolytic Agents
    Language English
    Publishing date 2024-01-11
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 187050-6
    ISSN 1432-1459 ; 0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
    ISSN (online) 1432-1459
    ISSN 0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
    DOI 10.1007/s00415-023-12167-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Ui II Zs.40: Show issues Location:
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  2. Article ; Online: Improving acute stroke assessment in non-enhanced computed tomography: automated tool for early ischemic lesion volume detection.

    Bernardi, Mara Sabina / Rodriguez, Alex / Caruso, Paola / Furlanis, Giovanni / Ridolfi, Mariana / Prandin, Gabriele / Naccarato, Marcello / Laio, Alessandro / Amati, Daniele / Manganotti, Paolo

    Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

    2024  

    Abstract: Background and objectives: ASPECTs is a widely used marker to identify early stroke signs on non-enhanced computed tomography (NECT), yet it presents interindividual variability and it may be hard to use for non-experts. We introduce an algorithm ... ...

    Abstract Background and objectives: ASPECTs is a widely used marker to identify early stroke signs on non-enhanced computed tomography (NECT), yet it presents interindividual variability and it may be hard to use for non-experts. We introduce an algorithm capable of automatically estimating the NECT volumetric extension of early acute ischemic changes in the 3D space. We compared the power of this marker with ASPECTs evaluated by experienced practitioner in predicting the clinical outcome.
    Methods: We analyzed and processed neuroimaging data of 153 patients admitted with acute ischemic stroke. All patients underwent a NECT at admission and on follow-up. The developed algorithm identifies the early ischemic hypodense region based on an automatic comparison of the gray level in the images of the two hemispheres, assumed to be an approximate mirror image of each other in healthy patients.
    Results: In the two standard axial slices used to estimate the ASPECTs, the regions identified by the algorithm overlap significantly with those identified by experienced practitioners. However, in many patients, the regions identified automatically extend significantly to other slices. In these cases, the volume marker provides supplementary and independent information. Indeed, the clinical outcome of patients with volume marker = 0 can be distinguished with higher statistical confidence than the outcome of patients with ASPECTs = 10.
    Conclusion: The volumetric extension and the location of acute ischemic region in the 3D-space, automatically identified by our algorithm, provide data that are mostly in agreement with the ASPECTs value estimated by expert practitioners, and in some cases complementary and independent.
    Language English
    Publishing date 2024-01-29
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2016546-8
    ISSN 1590-3478 ; 1590-1874
    ISSN (online) 1590-3478
    ISSN 1590-1874
    DOI 10.1007/s10072-024-07339-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1877: Show issues Location:
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  3. Article ; Online: Epidemiology and management of transient ischemic attack in Trieste district, how day hospital assessment improves outcomes: a five-year retrospective study.

    Caruso, Paola / Prandin, Gabriele / Rossi, Lucrezia / Cegalin, Matteo / Lugnan, Carlo / Pasquin, Fulvio / Sisto, Ugo Giulio / Furlanis, Giovanni / Naccarato, Marcello / Cominotto, Franco / Manganotti, Paolo

    Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

    2024  

    Abstract: Background: Transient ischemic attack (TIA) is defined as a transient episode of neurologic dysfunction, without acute infarction or tissue injury lasting less than 24 h. Previous data suggest TIA precedes 15% of ischemic strokes, with a higher risk in ... ...

    Abstract Background: Transient ischemic attack (TIA) is defined as a transient episode of neurologic dysfunction, without acute infarction or tissue injury lasting less than 24 h. Previous data suggest TIA precedes 15% of ischemic strokes, with a higher risk in the first week. Current practice guidelines advise evaluation through rapid neurological visit or admission to hospital. We provide data on TIA incidence in Trieste, and we compare three different types of assessment: day hospital (DH), stroke unit (SU), and emergency department/outpatients (ED).
    Methods: This is a 5-year retrospective study of transient cerebrovascular events admitted in the University Hospital of Trieste (230.623 inhabitants), between 2016 and 2020. We calculated TIA prevalence in Trieste district's general population. Our primary endpoint is ischemic recurrences within 90 days, and we evaluate the possible association between different types of management.
    Results: TIA incidence rate was 0.54/1000 inhabitants. In the multivariate analysis remained significantly associated with primary endpoint: ABCD2 (OR 1.625, CI 95% 1.114-2.369, p = 0.012) and DH evaluation (OR 0.260, CI 95% 0.082-0.819, p = 0.021).
    Conclusions: Incidence of TIA in Trieste district is in line with previous data. We demonstrate the crucial role of DH evaluation over the outpatient/ED in reducing overall mortality and recurrence rate. Prompt recognition of patients at high risk for cerebrovascular events and specialist follow-up may reduce the incidence of major vascular events and death.
    Language English
    Publishing date 2024-03-11
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2016546-8
    ISSN 1590-3478 ; 1590-1874
    ISSN (online) 1590-3478
    ISSN 1590-1874
    DOI 10.1007/s10072-024-07443-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1877: Show issues Location:
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  4. Article ; Online: Correction to: Epidemiology and management of transient ischemic attack in Trieste district, how day hospital assessment improves outcomes: a five‑year retrospective study.

    Caruso, Paola / Prandin, Gabriele / Rossi, Lucrezia / Cegalin, Matteo / Lugnan, Carlo / Pasquin, Fulvio / Sisto, Ugo Giulio / Furlanis, Giovanni / Naccarato, Marcello / Cominotto, Franco / Manganotti, Paolo

    Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

    2024  

    Language English
    Publishing date 2024-03-23
    Publishing country Italy
    Document type Published Erratum
    ZDB-ID 2016546-8
    ISSN 1590-3478 ; 1590-1874
    ISSN (online) 1590-3478
    ISSN 1590-1874
    DOI 10.1007/s10072-024-07482-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1877: Show issues Location:
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  5. Article ; Online: Status Epilepticus after mechanical thrombectomy: The role of early EEG assessment in Stroke Unit, clinical and radiological prognostication.

    Prandin, Gabriele / Furlanis, Giovanni / Scali, Ilario / Palacino, Federica / Mancinelli, Laura / Vincis, Emanuele / Caruso, Paola / Mazzon, Giulia / Tomaselli, Marinella / Naccarato, Marcello / Manganotti, Paolo

    Epilepsy research

    2024  Volume 202, Page(s) 107343

    Abstract: Background: Convulsive (CSE) and non-convulsive (NCSE) Status Epilepticus are a complication in 0.2-0.3% ischemic strokes. Large stroke and cortical involvement are the main risk factors for developing SE. This study evaluates the prevalence of SE in ... ...

    Abstract Background: Convulsive (CSE) and non-convulsive (NCSE) Status Epilepticus are a complication in 0.2-0.3% ischemic strokes. Large stroke and cortical involvement are the main risk factors for developing SE. This study evaluates the prevalence of SE in patients treated with endovascular thrombectomy (EVT) through EEG recording within 72- h from admission. Moreover, we compared clinical, radiological, and outcome measures in SE and no-SE patients.
    Materials and methods: We collected retrospectively demographical and clinical characteristics of acute ischemic stroke patients who underwent EVT, admitted in the Stroke Unit (SU) of the University Hospital of Trieste between January 2018 and March 2020 who underwent EEG recording within 72- h from the symptoms' onset.
    Results: Out of 247 EVT patients, 138 met the inclusion criteria, of whom 9 (6.5%) showed SE with median onset time of 1 day (IQR 1-2). No difference was found between the two groups as for age, sex, risk factors, grade of recanalization, etiology of stroke, and closed vessel. The no-SE group presented higher NIHSS improvement rate (p=0.025) compared to the SE group. The sum of the lobes involved in the ischemic lesion was significantly higher in SE group (p=0.048).
    Conclusion: SE after EVT in large strokes is a non-rare complication, with most being NCSE. Performing a rapid EEG assessment in a Stroke Unit setting may allow for a prompt recognition and treatment of SE in the acute/hyper-acute phase. SE may be correlated with worse clinical outcomes in patients with large vessel occlusion.
    MeSH term(s) Humans ; Status Epilepticus/physiopathology ; Status Epilepticus/diagnostic imaging ; Electroencephalography/methods ; Male ; Female ; Aged ; Thrombectomy/methods ; Retrospective Studies ; Middle Aged ; Prognosis ; Ischemic Stroke/surgery ; Ischemic Stroke/physiopathology ; Ischemic Stroke/diagnostic imaging ; Stroke/surgery ; Stroke/physiopathology ; Aged, 80 and over ; Risk Factors ; Brain Ischemia/physiopathology ; Brain Ischemia/surgery
    Language English
    Publishing date 2024-03-12
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 632939-1
    ISSN 1872-6844 ; 0920-1211
    ISSN (online) 1872-6844
    ISSN 0920-1211
    DOI 10.1016/j.eplepsyres.2024.107343
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2193: Show issues Location:
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