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  • 1
    Online Resource
    Online Resource
    Large but Nonstenotic Carotid Artery Plaque in Patients With a History of Embolic Stroke of Undetermined Source
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Stroke Vol. 49, No. 12 ( 2018-12), p. 3054-3056
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 49, No. 12 ( 2018-12), p. 3054-3056
    Abstract: This study’s objective is to determine if nonstenotic carotid plaque of 〈 50% luminal narrowing predominantly develops ipsilateral rather than contralateral to the stroke site. Methods— This was a cross-sectional observational study. We identified consecutive patients with anterior circulation embolic stroke of undetermined source (ESUS), excluding stroke in multiple vascular territories. Using ultrasonography, we measured the internal carotid plaque size and stenosis for each patient. We dichotomized the plaque size at several predefined thresholds and calculated the frequency of the plaque size and morphology above each threshold ipsilateral versus contralateral to the stroke site. Results— We included 53 patients with unilateral anterior circulation ESUS. Initially, we found that plaque with a thickness ≥1.5 mm was present ipsilateral to the stroke site in 59% of the patients, and present contralateral to the stroke site in 42% of the patients (31/53 versus 22/53 patients; P =0.049). Plaque with low echo likewise had a similar prevalence when present ipsilateral (9%) and contralateral (4%) to the stroke site (5/53 versus 2/53; P =0.25). Conclusions— Internal carotid artery plaque with a thickness ≥1.5 mm but that is nonstenotic ( 〈 50%) is considerably more common when ipsilateral to the ESUS site than when contralateral to the ESUS site, especially in plaque with a thickness ≥2.6 mm. Large but nonstenotic carotid artery plaque is associated with anterior circulation ESUS.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.118.022986
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 1467823-8
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  • 2
    Online Resource
    Online Resource
    Middle Cerebral Artery Pulsatility Index Correlates with Prognosis and Diastolic Dysfunctions in Acute Ischemic Stroke
    Elsevier BV ; 2022
    In:  Journal of Stroke and Cerebrovascular Diseases Vol. 31, No. 3 ( 2022-03), p. 106296-
    Details
    In: Journal of Stroke and Cerebrovascular Diseases, Elsevier BV, Vol. 31, No. 3 ( 2022-03), p. 106296-
    Type of Medium: Online Resource
    ISSN: 1052-3057
    URL: Article
    DOI: 10.1016/j.jstrokecerebrovasdis.2021.106296
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2052957-0
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  • 3
    Online Resource
    Online Resource
    In-stent thrombosis evaluated by carotid ultrasound
    Japan Academy of Neurosonology ; 2017
    In:  Neurosonology Vol. 30, No. 3 ( 2017), p. 117-
    Details
    In: Neurosonology, Japan Academy of Neurosonology, Vol. 30, No. 3 ( 2017), p. 117-
    Type of Medium: Online Resource
    ISSN: 0917-074X , 1884-3336
    Uniform Title: 頸動脈超音波で評価しえたステント内血栓症
    URL: Article
    DOI: 10.2301/neurosonology.30.117
    Language: English , Japanese
    Publisher: Japan Academy of Neurosonology
    Publication Date: 2017
    detail.hit.zdb_id: 2416064-7
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  • 4
    Online Resource
    Online Resource
    Abstract TP71: One-twentieth of Acute Ischemic Stroke With Anticoagulation Therapy for Venous Thromboembolism Have Hemorrhagic Complications
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Stroke Vol. 49, No. Suppl_1 ( 2018-01-22)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 49, No. Suppl_1 ( 2018-01-22)
    Abstract: Background and Purpose: The availability of direct-acting oral anticoagulants (DOACs) for nonvalvular atrial fibrillation (NVAF) and venous thromboembolism (VTE) has changed the therapeutic landscape of anticoagulation therapy, but the guideline-based recommendation of anticoagulation therapy for the acute stroke patients with VTE is unclear. Our aim of this study is to survey clinical characteristics of acute stroke patients with VTE in new treatment paradigms including DOACs. Methods: Subjects were acute stroke patients within 7 days from onset with VTE detected by enhanced CT and/or ultrasound of leg veins. VTE evaluation was performed for the patients as follows; presence of right-to-left shunts by transcranial Doppler, elevation of D-dimer, and suspected embolic stroke of undetermined source. We analyzed the following information: 1) the prevalence of VTE among acute stroke patients, 2) clinical information of VTE (i.e. subtype and symptom of VTE), 3) treatment details for stroke and VTE, 4) hemorrhagic complication after VTE treatment. Results: From October 2012 to June 2017, we registered 1077 acute stroke patients. We underwent the VTE evaluation for 226 patients (21%). Of them, 65 patients (39 female, mean age of 76 years, 6% of all patients, and 29% of patients with examination) had VTE (deep vein thrombosis (DVT); 52, pulmonary embolisms (PE); 2, DVT+PE; 11). In 65 patients with VTE, ischemic stroke was 60 cases. Antiplatelet agents were given for 35 of these 60 cases before starting therapy for VTE. Medications for VTE were as follows; 29 cases with DOACs, 14 with warfarin, 7 with warfarin following heparin, and 9 with heparin alone. Hemorrhagic complication occurred in 3 of 60 case of ischemic stroke with VTE (5%). One case had intraventricular hemorrhage after starting DOAC following 200mg aspirin, and muscle hematoma was found in the other two cases using warfarin following heparin. Conclusions: Prevalence of VTE was 6% of acute stroke patients in our preliminary survey. After medication for acute ischemic stroke with VTE, 5% of them had hemorrhagic complication. We should choose anticoagulation therapy for acute stroke patients with VTE focused on former use of antiplatelet drug and hemorrhagic complication.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.49.suppl_1.TP71
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
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  • 5
    Online Resource
    Online Resource
    Abstract WP531: Nontraumatic Convexal Subarachnoid Hemorrhage Concomitants with Hyperacute Ischemic Stroke
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Stroke Vol. 50, No. Suppl_1 ( 2019-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 50, No. Suppl_1 ( 2019-02)
    Abstract: Background and Purpose: Nontraumatic convexal subarachnoid hemorrhage (cSAH) rarely occurs concomitant with acute ischemic stroke. The purpose of this study was to investigate the incidence, imaging findings, clinical backgrounds, and outcomes of hyperacute ischemic stroke with cSAH. Methods: Patients were selected from a comprehensive stroke center with ≤4.5 h from onset to door with symptomatic ischemic stroke between October 2012 and May 2018. All patients underwent CT and/or MRI on admission and we reviewed them to identify cSAH. Follow-up CT and/or MRI were also reviewed. cSAH caused by trauma, detected after thrombolysis or endovascular treatment, and accompanied with intracerebral hemorrhage was excluded. Retrospective review of cSAH incidence, imaging findings, clinical backgrounds, and outcomes was performed. Results: We screened 1249 consecutive symptomatic ischemic stroke patients, including 466 patients with ≤4.5 h from onset to door (342 (73%) male, median age 68 years). Of 466 hyperacute ischemic stroke patients, cSAH was observed in 5 (1.1%) patients (5 male, median age 49 years): 3 were detected on admission and the other was detected at follow-up. None had any meningeal irritation signs, and all were detected incidentally. Four patients (case 1-4) were diagnosed as arterial infarction, and 1 as venous infarction. Of the 4 arterial infarction patients, arterial stenosis or occlusion was observed ipsilaterally to the cSAH (Figure). In addition, of the 4 arterial infarction patients, hyperintense vessel signs were observed on FLAIR imaging on admission suggesting retrograde flow via collateral vessels, or slow flow (Figure). In all, cSAH disappeared gradually, and outcomes were favorable (modified Rankin Scale 0-1 at 3 months from the onset). Conclusions: cSAH was accompanied with approximately 1% of hyperacute ischemic stroke. Patients with arterial infarction and cSAH had arterial stenosis or occlusion ipsilaterally to cSAH.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.50.suppl_1.WP531
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
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  • 6
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    Online Resource
    Abstract TP235: Risk Factors for Infarct Expansion Are Different Between Lacunar and Giant Lacunar Infarction
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Stroke Vol. 50, No. Suppl_1 ( 2019-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 50, No. Suppl_1 ( 2019-02)
    Abstract: Background and Purpose: The purpose of this study was to determine risk factors for lacunar and giant lacunar infarction and to clarify differences in pathophysiological mechanisms for these two groups. Methods: Patients were selected from a comprehensive stroke center with ≤24 h from onset to initial magnetic resonance imaging (MRI) with lacunar and giant lacunar infarction. All patients underwent second MRI during hospitalization. Infarct expansion was defined as present when the area of the diffusion-weighted imaging (DWI)-positive region on second MRI exceeded that on the initial MRI. To calculate the area of the DWI-positive region, we manually traced each region of interest and calculated the DWI-positive region area in each slice. Infarct size was calculated and compared by the positive region on DWI. Factors related to infarct expansion were evaluated separately in the two groups. Results: We screened 950 consecutive ischemic stroke patients, including 106 patients with small vessel disease (lacunar infarction, 54 patients; giant lacunar infarction, 52 patients). High cardio-ankle vascular index (odds ratio, 6.255; 95% confidence interval, 1.791-21.846; p = 0.004) was independently associated with infarct expansion in lacunar infarction patients (Figure 1A). Concerning giant lacunar infarction, high concentration of low-density lipoprotein-cholesterol (odds ratio, 1.923; 95% confidence interval, 1.158-3.194; p = 0.012) and low/normal body mass index (odds ratio, 0.714; 95% confidence interval, 0.515-0.989; p = 0.042) were factors independently associated with infarct expansion (Figure 1B). Conclusions: Risk factors for infarct expansion differed between lacunar and giant lacunar infarction. The underlying pathophysiological mechanisms for infarct expansion in these two groups should be recognized individually.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.50.suppl_1.TP235
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
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  • 7
    Online Resource
    Online Resource
    Abstract TP198: The Impact of Regular Employments on Hyper-Acute Ischemic Stroke
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Stroke Vol. 51, No. Suppl_1 ( 2020-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 51, No. Suppl_1 ( 2020-02)
    Abstract: Background and Purpose: We aimed to investigate the differences in weekly variations of stroke occurrence between hyper-acute ischemic stroke patients with and without regular employments (RE), and the impact of RE on outcome. Methods: Consecutive symptomatic ischemic stroke patients with 〈 4.5 h from onset to door between October 2012 and May 2018 were enrolled. All the situations of employment on admission were obtained from interviews with the participant or substitute guardians. First, we divided the patients into with and without RE to evaluate the differences in weekly variations of stroke occurrence. Second, we divided the same patients into with and without favorable outcome (mRS score of 0 to 2 at 3 months from the onset) to evaluate the impact of RE on outcome. Results: We screened 1,249 consecutive symptomatic ischemic stroke patients, including 385 patients (292 (76%) male, median age 67 years) with hyper-acute ischemic stroke. Of all, 251 patients (65%) were included in RE group. In the multivariate analysis, patients with RE were more likely to develop strokes on Monday compared to that on Sunday and public holiday (OR 2.841, 95% CI 1.145-7,049, p = 0.024, Figure A). In the multivariate analysis, the factors associated with favorable outcome were low NIHSS score on admission (OR 0.909, 95% CI 0.857-0.964, p = 0.001), not receiving endovascular therapy (OR 0.175 95% CI 0.069-0.444, p 〈 0.001), and having RE (OR 2.506, 95% CI 1.049-5.986, p = 0.039, Figure B). Conclusions: There were dramatic differences in weekly variations of hyper-acute ischemic stroke occurrence between patients with and without RE. Monday seems to be “a black day” for ischemic stroke patients with RE. RE had a positive impact on outcome in hyper-acute ischemic stroke.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.51.suppl_1.TP198
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1467823-8
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  • 8
    Online Resource
    Online Resource
    Outcomes of Coil Embolization for Pulmonary Arteriovenous Fistula as Evaluated Using a Novel Soft Ultrasound Probe Pasted to the Neck
    Japanese Society of Internal Medicine ; 2020
    In:  Internal Medicine Vol. 59, No. 15 ( 2020-8-1), p. 1883-1885
    Details
    In: Internal Medicine, Japanese Society of Internal Medicine, Vol. 59, No. 15 ( 2020-8-1), p. 1883-1885
    Type of Medium: Online Resource
    ISSN: 0918-2918 , 1349-7235
    URL: Article
    DOI: 10.2169/internalmedicine.3788-19
    RVK:
    XA 49642
    Language: English
    Publisher: Japanese Society of Internal Medicine
    Publication Date: 2020
    detail.hit.zdb_id: 2202453-0
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  • 9
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    Online Resource
    Venous Stasis and Cerebrovascular Complications in Cerebral Venous Sinus Thrombosis
    S. Karger AG ; 2017
    In:  European Neurology Vol. 78, No. 3-4 ( 2017), p. 154-160
    Details
    In: European Neurology, S. Karger AG, Vol. 78, No. 3-4 ( 2017), p. 154-160
    Abstract: 〈 b 〉 〈 i 〉 Background/Aims: 〈 /i 〉 〈 /b 〉 The factors related to cerebrovascular complications in cerebral venous sinus thrombosis (CVST) are controversial. We focused on venous stasis and investigated its relationship with cerebrovascular complications in CVST. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 CVST patients between June 2013 and October 2016 were enrolled. Relationships between cerebrovascular complications, defined as cerebral venous infarction, intracerebral hemorrhage, or subarachnoid hemorrhage, and cerebrum venous stasis and other clinical information were retrospectively analyzed. Venous stasis was evaluated by the prominence of the veins on susceptibility-weighted imaging (SWI). The cerebrum was divided into 10 regions according to the venous drainage territories, and venous stasis was quantified by adding one point for venous prominence on SWI for each region (CVST SWI score). 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 All 5 cases in the noncomplicated group had a CVST SWI score of 0. The 3 patients with CVST SWI scores higher than 0 had cerebrovascular complications. The CVST SWI scores were higher in the complicated group than in the noncomplicated group (3.0 vs. 0, 〈 i 〉 p 〈 /i 〉 = 0.010). Seizures were seen in all patients with complications and in none of the patients without complications (3 vs. 0, 〈 i 〉 p 〈 /i 〉 = 0.018). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Venous stasis evaluated by SWI can help predict cerebrovascular complications in CVST. A seizure is an important initial symptom that suggests cerebrovascular complications in CVST.
    Type of Medium: Online Resource
    ISSN: 0014-3022 , 1421-9913
    URL: Article
    DOI: 10.1159/000478980
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2017
    detail.hit.zdb_id: 1482237-4
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  • 10
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    Online Resource
    Dynamic ultrasound findings in drinking and mastication steal syndrome; Case report
    Elsevier BV ; 2022
    In:  Journal of Stroke and Cerebrovascular Diseases Vol. 31, No. 9 ( 2022-09), p. 106643-
    Details
    In: Journal of Stroke and Cerebrovascular Diseases, Elsevier BV, Vol. 31, No. 9 ( 2022-09), p. 106643-
    Type of Medium: Online Resource
    ISSN: 1052-3057
    URL: Article
    DOI: 10.1016/j.jstrokecerebrovasdis.2022.106643
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2052957-0
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