Stroke Journal

FEBRUARY 1, 2024

Introduction:Delayed cerebral ischemia (DCI) is a leading cause of morbidity and mortality in aneurysmal subarachnoid hemorrhage (aSAH). The proportion of patients with functional independence was significantly higher in the LD group compared to the EVD group 1-month post-hemorrhage (BI p = 0.04; GOS p = 0.04)Conclusions:In

Aneurysm 40

Aneurysm Hemorrhage ICU Ischemia 40

Stroke Journal

FEBRUARY 1, 2024

Introduction:Elevated levels of Interleukin-6 (IL-6) levels in cerebrospinal fluid (CSF) have been correlated with delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH). Stroke, Volume 55, Issue Suppl_1 , Page AWP152-AWP152, February 1, 2024.

Aneurysm 40

Aneurysm Hemorrhage Ischemia Strokes 40

Stroke Journal

FEBRUARY 1, 2024

Background:We have previously identified that hemoglobin decrements and new-onset anemia during an intracerebral hemorrhage (ICH) hospitalization is frequent, rapid, and associates with poor outcome. Though this association may be related to impaired cerebral oxygen delivery, it is unclear whether these changes relate to cerebral ischemia.

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Hemorrhage Blood Pressure Ischemia Hospital 40

Stroke Journal

FEBRUARY 1, 2024

Background:We identified that major ABO incompatible platelet transfusions are associated with poor intracerebral hemorrhage (ICH) outcomes, yet the driver for this relationship is unknown and does not appear to be related to impaired hemostasis. Stroke, Volume 55, Issue Suppl_1 , Page AWP173-AWP173, February 1, 2024. 217.94, p = 0.03).Conclusions:Major

Hemorrhage 40

Hemorrhage Ischemia Risk Factors Outcomes 40

Stroke: Vascular and Interventional Neurology

FEBRUARY 19, 2024

We summarized the current clinical evidence on the use of dual‐energy computed tomography for identifying early cerebral ischemia, detecting and predicting hemorrhagic transformations, and characterizing clots and stenotic plaques.

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Strokes Stroke Ischemia Hemorrhage 40

Stroke Journal

FEBRUARY 1, 2024

Introduction:Tenecteplase (TNK) is becoming the preferred thrombolytic for acute brain ischemia. Median door-to-needle (DTN), door-to-puncture (DTP), thrombolytic utilization and symptomatic hemorrhage rates were recorded at five primary (P) and a comprehensive stroke center (C).Results:During Symptomatic hemorrhage occurred in 0.0%(P),

Hemorrhage 40

Hemorrhage Education Nursing Strokes 40

Stroke Journal

FEBRUARY 1, 2024

In this study, we tested the hypothesis that small extracellular vesicles (sEVs) derived from healthy human VSMCs (VSMC-sEVs) reduce diabetes- and ischemia-neurovascular damage.Methods and Results:VSMC-sEVs were characterized.

Diabetes 40

Diabetes Strokes Stroke Ischemia 40

Journal of the American Heart Association

JANUARY 31, 2024

The secondary outcomes included intracranial hemorrhage, major bleeding, systemic thromboembolism, and all‐cause death. A nonsignificantly higher incidence rate of intracranial hemorrhage was observed in the DOAC‐change group compared with the DOAC‐retain group (0.75 versus 0.53 per 100‐person‐years; HR, 1.49 [95% CI, 0.78–2.83]).

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Atrial Fibrillation Strokes Stroke Hemorrhage 40

All About Cardiovascular System and Disorders

MARCH 26, 2024

This highlights one of the most important complications of Eisenmenger syndrome, that is airway hemorrhage. Airway hemorrhage can occur in those who ascend to high altitude and during air travel. But if you go by the statistics, majority of the hemorrhages occur at sea level or ordinary level of height.

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VSD Pulmonary Hemorrhage Hypertension 52

Dr. Smith's ECG Blog

JULY 3, 2020

She had multiple rib fractures as well as serious hemorrhage and underwent massive transfusion. Either could be a result of myocardial contusion There is some minimal ST depression -- this could represent ischemia What else is there that could use therapy immediately? ng/mL, and an ECG was recorded: There are no P-waves visible.

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Hemorrhage Critical Care Blood Pressure Laboratory 52

Circulation

NOVEMBER 11, 2024

The anti-angiogenic impact of neutrophil elastase clouded the understanding of the role of neutrophils in promoting neovascularization (NV) and fibrinolysis in patients with chronic limb-threatening ischemia (CLTI). No hemorrhage occurred over the 30 day course. Segmental arterial recanalization indicated fibrinolysis.

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Document Ischemia Hemorrhage Circulation 40

Stroke Journal

JANUARY 4, 2024

Secondary outcomes were favorable functional outcome (modified Rankin Scale scores, 0–3), occurrence of symptomatic intracranial hemorrhages, successful reperfusion (extended Thrombolysis in Cerebral Ischemia ≥2B), first-attempt successful reperfusion, and mortality at 90 days.

Thrombolysis 40

Thrombolysis Circulation Hemorrhage Outcomes 40

Stroke: Vascular and Interventional Neurology

FEBRUARY 15, 2024

Secondary outcomes included a composite of periprocedural hemorrhagic/ischemia‐related complications and favorable functional outcome.RESULTSThe study included 104 patients treated with WEB and 107 patients treated with BAC. P= 0.180) and hemorrhagic events (WEB: 3.8% Of the patients, 60.5% versus BAC: 2.8%;P= versus BAC: 7.5%;P=

Aneurysm 40

Aneurysm Outcomes Hemorrhage Stent 40

Stroke Journal

FEBRUARY 1, 2024

Peripheral blood gene expression profiles can distinguish ischemic stroke from intracerebral hemorrhage and controls. Stroke, Volume 55, Issue Suppl_1 , Page AWP313-AWP313, February 1, 2024. However, it can be difficult to clinically distinguish “mimics” of transient ischemic attacks (TIA) and minor strokes from true TIAs and minor strokes.

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Atherosclerosis Ischemia Risk Factors Hemorrhage 40

Stroke Journal

FEBRUARY 1, 2024

Successful recanalization was defined as modified Thrombolysis in Cerebral Ischemia Score≥ 2b. Secondary outcomes were symptomatic intracranial hemorrhage and intracranial hemorrhage within 24 hours and mortality at 90 days. The primary outcome was a 90-day modified Rankin Scale (mRS) of 0-3.

Outcomes 40

Outcomes Strokes Stroke Hemorrhage 40

Dr. Smith's ECG Blog

DECEMBER 26, 2020

Side note: The differential of sudden persistent loss of consciousness with adequate hemodynamics is relatively short: seizure, intracranial hemorrhage, basilar artery occlusion. We have also shown several cases in which atrial flutter hides true, active ischemia. There was again no intracranial hemorrhage.

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Atrial Flutter Ischemia STEMI Tachycardia 52

Stroke: Vascular and Interventional Neurology

JANUARY 26, 2024

BACKGROUNDSteroids have pleiotropic neuroprotective actions including the regulation of inflammation and apoptosis which may influence the effects of ischemia on neurons, glial cells, and blood vessels. Stroke: Vascular and Interventional Neurology, Ahead of Print.

Strokes 40

Strokes Stroke Ischemia Hemorrhage 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Secondary outcomes included favorable functional outcome and periprocedural hemorrhagic/ischemia‐related complications. vs. BAC: 2.8%, p = 0.180) and hemorrhagic events (WEB: 3.8% The primary effectiveness outcome was complete aneurysm occlusion at the final imaging follow‐up using the Raymond‐Roy (RR) occlusion classification.

Aneurysm 40

Aneurysm Outcomes Hemorrhage Stent 40

Stroke Journal

FEBRUARY 1, 2024

The primary outcome measure was successful recanalization defined as modified Thrombolysis in Cerebral Ischemia (mTICI) score of 2b or higher. 90-day modified Rankin score (mRS) 0-2, mortality and symptomatic hemorrhage were used as secondary outcomes.

Strokes 40

Strokes Stroke Circulation Thrombolysis 40

Stroke Journal

FEBRUARY 1, 2024

The primary efficacy end point was achievement of modified Thrombolysis in Cerebral Ischemia (mTICI) reperfusion scores of ≥2b on first pass. There were no differences in distal emboli, or symptomatic intracranial hemorrhage. The total cohort was trichotomized into 3 groups (A, B, C) based on M1 tortuosity tertiles. and 26.5%, p=0.003.

Atrial Fibrillation 40

Atrial Fibrillation Thrombolysis Strokes Stroke 40

Stroke Journal

FEBRUARY 1, 2024

intraluminal floating thrombus, intracardiac thrombus, acute coronary syndrome, acute limb ischemia, DVT and PE) within 3 days of symptom onset. The primary outcome was the incidence of intracranial hemorrhage (ICH) between both groups.

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Atrial Fibrillation Strokes Stroke Ischemia 40

Stroke Journal

FEBRUARY 1, 2024

The protective effect of NO donors has been shown to prevent ischemia-reperfusion injury through reduction of reactive oxygen species formation in cardiovascular studies. Eligible patients were randomized to receive 800μg GTN or same volume of normal saline through the catheter after recanalization.

Strokes 40

Strokes Stroke Ischemia Hemorrhage 40

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

His response: “subendocardial ischemia. Smith : It should be noted that, in subendocardial ischemia, in contrast to OMI, absence of wall motion abnormality is common. With the history of Afib, CTA abdomen was ordered to r/o mesenteric ischemia vs ischemic colitis vs small bowel obstruction. Anything more on history?

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Stroke Journal

FEBRUARY 1, 2024

Background:Ischemia on diffusion weighted imaging (DWI) after intracerebral hemorrhage (ICH) increases the risk of future ischemic stroke. Though cortical superficial siderosis (cSS) is also a hemorrhagic small vessel disease subtype, it is unclear if cSS similarly relates to DWI lesions.

Hemorrhage 40

Hemorrhage Ischemia Blood Pressure Strokes 40

Dr. Smith's ECG Blog

OCTOBER 12, 2024

CTA head and neck were obtained and showed no evidence of intracranial hemorrhage, large vessel occlusion stroke (what a helpful and apt name for an acute arterial occlusion paradigm, by the way.), or basilar ischemia. Blood glucose was not low at 162 mg/dL. EKG on arrival to the ED is shown below: What do you think?

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STEMI Document Blog Ischemia 97

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Additionally, patients undergoing stenting were less likely to have symptomatic intracranial hemorrhage (sICH) (OR 0.34, 95% CI [0.17 ‐ 0.67]; p = 0.002). ConclusionPTAS appears to be an effective and safe treatment for ICAD after MT in the posterior circulation both improving likelihood of good outcomes and overall survival.

Stent 40

Stent Stents Circulation Strokes 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

The primary outcome was successful reperfusion defined as a Modified Treatment in Cerebral Ischemia (mTICI) score of 2b or greater at the end of the procedure. Safety measures included rates of symptomatic intracranial hemorrhage (sICH) and mortality at 90 days.ResultsAmong 9 patients who met our criteria, the median age was 63 (51‐69.5)

Angioplasty 40

Angioplasty Stent Stents Strokes 40

Dr. Smith's ECG Blog

FEBRUARY 2, 2024

Osborn waves have been reported with hypercalcemia, brain injury, subarachnoid hemorrhage, Brugada syndrome, cardiac arrest from VFib — and — severe, acute ischemia resulting in acute MI ( See My Comment in the November 22, 2019 post on Dr. Smith’s Blog ). Rituparna et al — as well as Chauhan and Brahma ( Int.

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Cardiac Arrest Blog Atrial Fibrillation Bradycardia 132

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

IntroductionPituitary apoplexy is a serious, emergent, and potentially dangerous condition of the pituitary in which the gland is affected by hemorrhage and/or ischemia typically in the setting of an underlying adenoma. Stroke: Vascular and Interventional Neurology, Volume 3, Issue S2 , November 1, 2023.

Outcomes 40

Outcomes Ischemia Hemorrhage Stroke 40

Dr. Smith's ECG Blog

OCTOBER 23, 2023

Alternation in ST segment appearance ( or in the amount of ST elevation or depression ) — is often linked to ischemia. Repolarization Alternans — entails beat-to-beat variation in the ST segment and/or T wave. Conduction and Refractoriness Alternans — entails variance of impulse propagation along some par t of the conduction system.

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Tachycardia Cardiac Arrest ICU Blog 120

Dr. Smith's ECG Blog

AUGUST 9, 2019

Post by Smith and Meyers Sam Ghali ( [link] ) just asked me (Smith): "Steve, do left main coronary artery *occlusions* (actual ones with transmural ischemia) have ST Depression or ST Elevation in aVR?" That said, complete LM occlusion would be expected to have subepicardial ischemia (STE) in these myocardial territories: STE vector 1.

Myocardial Infarction 52

Myocardial Infarction Ischemia STEMI Cardiogenic Shock 52

Stroke Journal

FEBRUARY 1, 2024

Background:Ischemic lesions on diffusion weighted imaging (DWI) occur in one-third of intracerebral hemorrhage (ICH). Patients with severe, chronic hypertension may be more vulnerable to the development of ischemia after ICH due to altered cerebral autoregulatory limits. and LVH was seen in 23.5%.

Hemorrhage 40

Hemorrhage Blood Pressure Hypertension Biomarkers 40

Dr. Smith's ECG Blog

FEBRUARY 8, 2022

Osborn waves have been reported with hypercalcemia, brain injury, subarachnoid hemorrhage, Brugada syndrome, cardiac arrest from VFib — and — severe, acute ischemia resulting in acute MI ( See My Comment in the November 22, 2019 post on Dr. Smith’s Blog ). Rituparna et al — as well as Chauhan and Brahma ( Int.

Cardiac Arrest 52

Cardiac Arrest Bradycardia Chest Pain Ischemia 52

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

The ECG shows sinus tachycardia with RBBB and LAFB, without clear additional superimposed signs of ischemia. Massive Transfusion for Motorcycle Collision with Hemorrhage, Troponin Elevated. Chest trauma was suspected on initial exam. Here is his initial ECG around 1330: What do you think?

Tachycardia 107

Tachycardia Dysrhythmia Atrial Fibrillation Bradycardia 107

Dr. Smith's ECG Blog

JANUARY 21, 2023

J waves can also be induced by Occlusion MI (5), STEMI mimics including takotsubo and myocarditis complicated by ventricular arrhythmias (6, 7), and subarachnoid hemorrhage with VF (8). Occurrence of “J Waves” in 12-Lead ECG as a Marker of Acute Ischemia and Their Cellular Basis. Pacing Clin Electrophysiol.

STEMI 52

STEMI Bradycardia Arrhythmia Cardiac Arrest 52

Stroke Journal

FEBRUARY 1, 2024

Introduction:Subarachnoid hemorrhage (SAH) following mechanical thrombectomy (MT) is not uncommon. Stroke, Volume 55, Issue Suppl_1 , Page ATMP90-ATMP90, February 1, 2024. There were no statistically significant differences for sex, thrombolytics administration, pre mRS score, baseline NIHSS score, and procedure access (p >0.1)

Hemorrhage 40

Hemorrhage Outcomes Stent Stents 40

Dr. Smith's ECG Blog

NOVEMBER 28, 2022

Less common etiologies include uremia, bacterial or tubercular pericarditis, chronic idiopathic pericarditis, hemorrhage, and other causes such as autoimmune diseases, radiation, myxedema, etc. Alternation in ST segment appearance ( or in the amount of ST elevation or depression ) — is often linked to ischemia.

Pericarditis 52

Pericarditis Tachycardia Ultrasound Blood Pressure 52