Stroke; a journal of cerebral circulation
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Randomized Controlled Trial Clinical Trial
Serum neuron-specific enolase and S-100B protein in cardiac arrest patients treated with hypothermia.
High serum levels of neuron-specific enolase (NSE) and S-100B protein are known to be associated with ischemic brain injury and poor outcome after cardiac arrest. Therapeutic hypothermia has been shown to improve neurological outcome after cardiac arrest. The aim of this study was to evaluate the effect of therapeutic hypothermia on levels of serum NSE and S-100B protein, their time course, and their prognostic value in predicting unfavorable outcome after out-of-hospital cardiac arrest. ⋯ Decreasing levels of serum NSE but not S-100B over time may indicate selective attenuation of delayed neuronal death by therapeutic hypothermia in victims of cardiac arrest.
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Assessing both stroke patients and their CT scans by using a conventional videoconference system offers an interesting opportunity to improve stroke care in rural areas. However, until now there have been no studies to suggest whether this method is feasible in routine stroke management. ⋯ Teleconsultation using a videoconference system seems to be a feasible and promising method to improve stroke care in rural areas where management in a stroke unit is hindered by long transportation distances.
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Several studies established smoking as a risk factor for ischemic stroke and subarachnoid hemorrhage (SAH) in men and women. A recent study added smoking as a risk factor for intracerebral hemorrhage (ICH) in men. In contrast, the impact of smoking on ICH in women is less clear. ⋯ This prospective study indicates an increased risk of total hemorrhagic stroke, ICH, and SAH in women who are current cigarette smokers. The risk increases with the amount of cigarettes smoked.
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Clinical Trial
Intracranial heme metabolism and cerebral vasospasm after aneurysmal subarachnoid hemorrhage.
The goal of this prospective study was to clarify the potential role of an inducible heme-metabolizing enzyme, heme oxygenase (HO)-1, and an inducible iron-detoxifying protein, ferritin, in cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH). ⋯ This is the first study to show that higher levels of bilirubin and ferritin in the cerebrospinal fluid after SAH were associated with no vasospasm in clinical settings. These findings support the concept that the induction of HO-1 and ferritin may be an intrinsic regulatory mechanism that acts against cerebral vasospasm.