Stroke
Warfarin seen as treatment of choice to cut stroke risk
|
|
Warfarin, an anti-clotting drug, is the best treatment to prevent stroke in patients with an abnormal heart rhythm despite side effects such as risk of bleeding, researchers said on Friday.
A trial of patients with the disorder known as atrial fibrillation uncovered evidence that warfarin was superior to the combined treatment of the blood-thinner Plavix plus aspirin in reducing strokes.
Plavix, or clopidogrel, is sold by Sanofi-Aventis and Bristol-Myers Squibb Corp in the United States.
Family Care Givers of Stroke Patients Get Little Information, Support
|
|
Stroke and brain injury patients living at home receive the bulk of their care from family members, but these volunteer care givers get little preparation, information or support from health care professionals and home health agencies, according to a new study.
Home services are often terminated with little warning, leaving families on their own to care for patients with limited mobility, speech problems or both, the study in the latest issue of the Milbank Quarterly also revealed.
Researchers interviewed 99 family care givers of stroke and brain injury patients in New York City while they received care from a certified home health agency and after these services were stopped. Even during the time when formal care was being given, patients received three-quarters of their care from family members.
Slovak doctor says solar flares could raise strokes
|
|
Human beings may be at higher risk of strokes in years when the explosions on the sun peak, according to a neurologist who studied the records of 6,100 patients in Slovakia.
Dr. Michal Kovac said he found a spike in strokes and brain hemorrhages in the town of Nove Zamky in southern Slovakia in years when solar flares—bursts of energy stronger than a million nuclear bombs combined—are most abundant.
Kovac says his work, recently published in the Bratislava Medical Journal, builds on studies that show parts of the human body respond to fluctuations in the earth’s geomagnetic field caused by sun storms.
Closure of holes in heart important treatment for young stroke patients
|
|
Placement of devices to close holes in the heart is a successful treatment for young stroke patients, finds a study involving three medical centers.
No major complications were reported from the 45 patients included in the study, leading physicians to determine that closure of patent foramen ovales (PFOs) and atrial septal defects (ASDs) with transcatheter devices is a safe surgical alternative for children and young adults who have had a stroke. Most patients who underwent device closure procedures for PFOs or ASDs remained symptom-free months afterward.
Published in the May issue of Mayo Clinic Proceedings, the retrospective medical record study involved patients from Mayo Clinic Rochester, the University of Parma in Italy, and Loyola University Medical Center in Illinois, who had been treated between January 1999 and August 2005. Included were patients younger than 35 who had undergone percutaneous closure (through the skin) of PFO or ASD and who had at least one presumed stroke.
Acidity in the brain could hold the key to stroke treatment
|
|
Development of a new technique for detecting brain damage caused by stroke has been boosted up by a ?1m grant to scientists at The University of Manchester.
Professor Gareth Morris of the School of Chemistry and Professor Risto Kauppinen of the University of Birmingham are to lead the development of a new non-invasive technique which measures acidity (pH) in the brain.
A stroke is caused when part of the blood supply to the brain is cut off. This causes acidity in the brain to build up, leading to damage.
Sleep apnea raises mortality risk after stroke
|
|
Sleep apnea, a common problem involving short periods when breathing stops during sleep, is often seen in stroke patients and appears to be associated with an increased risk of death, Swiss researchers report in the medical journal Stroke.
However, upon further analysis, the only single factor that increased the risk of death after stroke was older age.
Dr. Claudio L. Bassetti of Poliklinik, Zurich and colleagues note that despite being widespread, risk factors and other characteristics of sleep apnea in stroke patients are not widely known.
Aspirin + Cholesterol Drugs + Blood Pressure Drugs = Less Severe Strokes
|
|
Taking the “triple therapy” of aspirin, cholesterol drugs, and blood pressure drugs to prevent stroke also reduces stroke severity if one occurs, according to a new study published in the April 25, 2006, issue of Neurology, the scientific journal of the American Academy of Neurology.
People who were taking all three drugs had less severe strokes, had shorter hospital stays, and were better able to function when leaving the hospital than those who were taking one, two, or none of the three drugs.
The study examined 179 people who came to the hospital within 24 hours after having a stroke. Researchers looked at how severe the strokes were, how much brain cell damage was caused by the stroke, and other factors. The participants were divided into five groups: 69 people were taking none of the three drugs; 47 people were taking aspirin only; 29 were taking aspirin and ACE inhibitors, or blood pressure drugs; 14 were taking aspirin and statins, or cholesterol-lowering drugs; and 20 people were taking all three drugs.
Research Compares Two Diagnostic Methods for Subarachnoid Hemorrhage
|
|
Cerebrovascular disease is a leading cause of serious long-term disability, affecting as many as 700,000 people every year. The interruption of blood flow to the brain can be caused by a blockage, leading to the far more common ischemic stroke, or by bleeding in the brain, leading to the more deadly subarachnoid hemorrhage (SAH). The latter condition affects approximately 30,000 Americans every year. Of those, about one half will not survive beyond 30 days, and an additional 25 percent will have some form of neurological deficit.
About 90 percent of all cases of SAH are caused by cerebral aneurysms. A cerebral aneurysm is a weakened part of an artery in the brain that results in a bulging or ballooning out of part of the vessel wall. Identifying the exact location, size and configuration of the aneurysm is critical to prevent rehemorrhage, which occurs in about 20 percent of cases within the first 14 days after the initial rupture. The current “gold standard” for identification is the diagnostic cerebral angiogram, which involves temporarily inserting a tube (catheter) into the artery of the leg (the femoral artery) and navigating it to the vessels of the brain (the two carotid arteries and the two vertebral arteries). Though very sensitive and very specific in identifying these potentially lethal aneurysms, the procedure is invasive and carries a small risk of causing ischemic stroke.
Neurosurgeons recently studied a relatively new method of testing, called computed tomographic angiography (CTA). This is performed by injecting a volume of contrast agent, similar to that used in the conventional angiogram, through a vein in the patient’s arm. The results of this study, Three-Dimensional Computed Tomographic Angiography (3D CTA) vs. Digital Subtraction Angiography (DSA) in the Detection of Intracranial Aneurysms in Spontaneous Subarachnoid Hemorrhage, will be presented by Charles J. Prestigiacomo, MD, senior author of the study, 2:45 to 3:00 p.m. on Monday, April 24, 2006, during the 74th Annual Meeting of the American Association of Neurological Surgeons in San Francisco. Co-authors are Aria Sabit, MD, Pinakin Jethwa, BS, and Jonathan Russin, BS.
Preeclampsia a risk factor for future stroke
|
|
Pregnant women who develop preeclampsia—a condition that includes abnormally high blood pressure—are known to run the risk of having a stroke during pregnancy, but researchers at the US Centers for Disease Control and Prevention now report that preeclampsia is also a risk factor for stroke in the future.
Dr. David W. Brown and colleagues in Atlanta used data from the Stroke Prevention in Young Women Study to assess the association of preclampsia with stroke in women between the ages of 15 and 44. The team identified 261 cases of stroke among nonpregnant women in the study group and compared them with 416 randomly chosen “controls” who had not had a stroke.
There was a history of preeclampsia in 15 percent of the women with stroke and in 10 percent of controls, the investigators report in the medical journal Stroke.
Moderate drinking may boost cognition in women
|
|
In a multi-ethnic sample of older adults living in upper Manhattan, women who reported a moderate alcohol intake achieved higher cognition scores than those who said they did not drink, New York-based researchers report in the journal Stroke.
“We found,” lead researcher Dr. Clinton B. Wright told Reuters Health, “that women who reported drinking between one drink weekly and two daily, had better performance on a global cognitive measure given at the same time as those that reported being never drinkers.”
Wright and colleagues at Columbia University conducted the study in more than 2200 men and women, ranging in age from 62 to 76. Slightly more than half were black, about a quarter were Hispanic and a similar proportion was white.
Stroke Patients May Be More Likely to Experience Memory Decline
|
|
A history of stroke may be associated with progressive memory difficulties in patients without dementia or cognitive impairment, according to a study in the April issue of Archives of Neurology, one of the JAMA/Archives journals.
Cerebrovascular disease, which includes stroke, is the second leading cause of death and the major cause of long-term disability in Western societies, according to background information in the article. Several studies have shown that risk factors for vascular disease, such as diabetes and hypertension, are associated with stroke, which in turn may increase the risk for dementia and Alzheimer’s disease. However, it remains unclear whether stroke is directly related to cognitive decline - increasing problems with thinking, learning and memory - in patients without dementia or cognitive impairment.
Better Stroke Outcome with High Blood Calcium
|
|
Higher levels of calcium in the blood are associated with less severe stroke and better outcome, according to research that will be presented at the American Academy of Neurology 58th Annual Meeting in San Diego, Calif., April 1 - 8, 2006.
Calcium and magnesium are intricately involved in the pathways of cell death in models of stroke, and high dietary intake of these minerals has been associated with a reduced risk of experiencing a stroke according to lead scientist Bruce Ovbiagele, MD, of the Stroke Center and Department of Neurology at the University of California, Los Angeles. This association led Ovbiagele to ask whether levels of serum calcium and magnesium might predict the severity and outcome in patients presenting with a stroke.
Ovbiagele’s group studied 240 consecutive patients who were seen at the UCLA Stroke Center within 24 hours of their stroke. Patients were classified into four groups, based on the level of calcium and magnesium in their blood. Researchers measured stroke severity at the time that patients were admitted into the hospital and how well they functioned upon being discharged.
Few get prompt care after mini-stroke
|
|
Most people don’t seek medical attention immediately after suffering a “mini-stroke,” a new UK study shows.
Symptoms of a mini-stroke, known medically as a transient ischemic attack (TIA), are exactly the same as those of a full-fledged stroke, but resolve within 24 hours. While TIAs in themselves cause no long-term problems, they substantially increase the likelihood of having a full-fledged stroke soon afterwards.
“Because they don’t cause any long-term problems themselves, people are inclined often to ignore them or instead put them down to ‘one of those things,’” Dr. Matthew F. Giles of Oxford University’s Stroke Prevention Research Unit in London, the study’s lead author, told Reuters Health. “That can be a dangerous action.”
Patient’s perceptions may delay stroke treatment
|
|
People who think they can control their dizziness, speech disturbance or other symptoms that suggest they have had a stroke are less likely to seek immediate medical care, a team of Israeli researchers reports.
Delays in seeking treatment for stroke may not be due to patients’ inability to identify stroke symptoms, as has been thought, but may also be influenced by patients’ perceptions of those symptoms, according to the findings of a study in the current issue of the medical journal Stroke.
“Delay in seeking medical help in response to the appearance of stroke symptoms is a complex issue, which we believe is affected by many different types of factors including demographic, clinical, perceptual, social and behavioral variables,” Dr. Lori Mandelzweig, of Sheba Medical Center in Tel Hashomer, told Reuters Health.
Tip Sheet: Stroke Awareness Month
|
|
Stroke experts are studying deadly snake venom and vampire bat saliva to dissolve blood clots in stroke victims. One of the trials involves Desmoteplase, a genetically engineered version of a clot-busting agent found in the saliva of a vampire bat that can be given to stroke patients up to nine hours after symptoms appear. The other trial involves Viprinex, an investigational drug derived from a compound found in Malaysian Pit Viper snake venom, called ancrod, which acts as an anti-coagulant in blood. This study may help determine if acute ischemic stroke patients treated with a one-time dose within six hours of the onset of stroke symptoms will have improved neurological function.
“The goal of both experimental drugs is to reduce a naturally occurring substance in the blood that is involved in blood clotting,” said Dr. David Chiu, medical director of the Eddy Scurlock Stroke Center at the Methodist Neurological Institute (NI).
