Cerebrovascular diseases
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Cerebrovascular diseases · Jan 2006
Serial measurements of N-terminal pro-brain natriuretic peptide after acute ischemic stroke.
The exact time-course of N-terminal pro-brain natriuretic peptide (NT-proBNP) and the prognostic importance in the immediate phase of ischemic stroke have not been established. ⋯ NT-proBNP peaks the day after onset of symptoms in patients with acute ischemic stroke. A single measurement of NT-proBNP appears to be an indicator of 6-month mortality.
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Cerebrovascular diseases · Jan 2006
Comparative StudyPredictors of cerebral microbleeds in acute ischemic stroke and TIA patients.
Cerebral microbleeds (CMB) detected on gradient-echo T2*-weighted MRI have been associated with cognitive impairment and the potential for increased risk of intracranial hemorrhage. We evaluated risk factors for these microangiopathic lesions in a cohort of stroke and transient ischemic attack patients. ⋯ CMB are more frequently noted in hospitalized stroke and transient ischemic attack patients with small vessel ischemia, as well as those with important modifiable vascular risk factors like atrial fibrillation and smoking.
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Cerebrovascular diseases · Jan 2006
Comparative StudyHigh blood pressure in acute ischemic stroke and underlying disorders.
The Acute Candesartan Cilexetil Therapy in Stroke Survivors (ACCESS) study indicated that early treatment with an angiotensin type 1 receptor blocker in acute stroke patients who had relatively high blood pressure improved cardiovascular morbidity and mortality in the chronic stage. To better interpret the findings of this study, we determined whether stroke patients with high acute blood pressure had specific underlying conditions. ⋯ Poorly controlled diabetes mellitus and advanced renal damage appeared to correlate with acute hypertension after stroke. Since intracranial arterial stenosis also seemed to contribute to high acute blood pressure, one should be careful not to induce cerebral hypoperfusion by the early use of antihypertensives.
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Cerebrovascular diseases · Jan 2006
Comparative StudyDirect costs of surgical clipping and endovascular coiling of unruptured intracranial aneurysms.
Unruptured intracranial aneurysms can be preventively treated by surgical clipping or endovascular coiling. We determined in detail the costs of these treatments. ⋯ For unruptured intracranial aneurysms, direct in-hospital costs of coiling are on average higher than those of clipping, mostly because of the more expensive coils.
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Cerebrovascular diseases · Jan 2006
Antiplatelet cilostazol is effective in the prevention of pneumonia in ischemic stroke patients in the chronic stage.
We have previously reported that the phosphodiesterase inhibitor cilostazol, an antiplatelet agent, is effective and safe for secondary prevention of recurrent cerebral infarction (Cilostazol Stroke Prevention Study; CSPS). We now report the efficacy of this drug in the prevention of pneumonia in the chronic stage of cerebral infarction as a part of our CSPS subgroup analysis. ⋯ The rates of complications and pneumonia risk factors showed no difference between the two groups. We conclude that the administration of cilostazol to patients with cerebral infarction in the chronic stage does not only reduce the recurrence of infarction but also the incidence of pneumonia at least in Japanese patients.