Prevention Strategies for Cardioembolic Stroke: Present and Future Perspectives~!2009-05-11~!2009-12-23~!2010-06-09~!

Giacalone, Giacomo; Abbas, Mohammed Abballa; Corea, Francesco

doi:10.2174/1874205x01004020056

Cited by 10 publications

(3 citation statements)

References 55 publications

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“…As is known, the co-existence of PFO and atrial septal aneurysm increases the risk of stroke [ 31 , 32 ]. In addition, the risk of stroke is also elevated in the presence of greater PFO diameter and spontaneous right-to-left shunt [ 33 , 34 ]. In our study, there was no correlation between the increase in PFO diameter and presence of spontaneous right-to-left shunt and atrial septal aneurysm with MPV.…”

Section: Discussionmentioning

confidence: 99%

Mean platelet volume is elevated in patients with patent foramen ovale

Demir

Caglar

Ünğan

et al. 2013

aoms

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IntroductionPlatelets play a major role in thromboembolic events. Increased mean platelet volume (MPV) indicates higher platelet reactivity and also a tendency to thrombosis. Patent foramen ovale (PFO), persistence of the fetal anatomic shunt between right and left atria, is strongly associated with cryptogenic stroke. The aim of this study is to determine the relationship between MPV and PFO and if such an association exists, whether higher MPV levels may require antiplatelet therapy before a thromboembolic event happens, together with a literature review.Material and methodsThirty patients (15 women, 15 men), free of any cerebrovascular events, were diagnosed with PFO by transesophageal echocardiography (TEE), enrolled as the study group. Thirty consecutive patients (16 women and 14 men), who were diagnosed as normal in TEE, were enrolled as the control group. These two groups were compared according to MPV and anatomical features of the right atrium.ResultsThere was no significant difference between study and control groups in clinical features and also no difference was observed in platelet counts; however, MPV in the PFO group was significantly higher than the control group (8.38 ±0.93 fl and 7.45 ±0.68 fl respectively).ConclusionsOur results indicate that elevated MPV may be detected in patients with PFO. This might be one of the explanations for the relationship between PFO and cryptogenic stroke; however, larger cohorts are warranted in order to define further mechanisms.

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Section: Discussionmentioning

confidence: 99%

Mean platelet volume is elevated in patients with patent foramen ovale

Demir

Caglar

Ünğan

et al. 2013

aoms

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“…Stroke subtypes were defined at discharge, according to the TOAST and OCSP criteria. 13 , 14 , 18 , 19 …”

Section: Methodsmentioning

confidence: 99%

Airborne pollutants and lacunar stroke: a case cross-over analysis on stroke unit admissions

et al. 2012

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Particulate air pollution is known to be associated with cardiovascular disease. The relation of particulate air pollution with cerebrovascular disease (CVD) has not been extensively studied, particularly in relation to different subtypes of stroke. A time-series study was conducted to evaluate the association between daily air pollution and acute stroke unit hospitalizations in Mantua, Italy. We analyzed 781 CVD consecutive patients living in Mantua county admitted between 2006–08. Data on stroke types, demographic variables, risk factors were available from the Lombardia Stroke Registry. Daily mean value of particulate matter with a diameter <10 µm (PM10), carbon monoxide, nitric oxide, nitrogen dioxide, sulphur dioxide, benzene and ozone were used in the analysis. The association between CVD, ischemic strokes subtypes and pollutants was investigated with a case-crossover design, using conditional logistic regression analysis, adjusting for temperature, humidity, barometric pressure and holidays. Among the 781 subjects admitted 75.7% had ischemic stroke, 11.7% haemorrhagic stroke 12.6% transient ischemic attack. In men admission for stroke was associated with PM10 [odds ratio (OR) 1.01, 95%; confidence interval (CI) 1.00–1.02; P<0.05]. According to the clinical classification, lacunar anterior circulation syndrome stroke type was related to PM10 level registered on the day of admission for both genders (OR: 1.01, 95%; CI: 1.00–1.02; P<0.05) while for total anterior circulation syndrome stroke only in men (OR: 1.04, 95%; CI 1.01–1.07; P<0.05).In conclusion, our study confirms that air pollution peaks may contribute to increase the risk of hospitalization for stroke and particulate matter seems to be a significant risk factor, especially for lacunar stroke.

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“…A recent meta-analysis summarized that PFO is significantly associated with stroke in patients younger than 60 years of age, in particular in the subgroup of young patients with cryptogenic stroke. Several factors have been suggested to increase the risk for stroke or recurrent stroke in patients with a PFO: these include a younger age, the association with atrial septal aneurysm, the presence of a right-to-left shunt at rest, the size of the PFO, and the association with thrombophilic conditions [ 1 ]. Our patient had 3 out of these 5 factors.…”

Section: Discussionmentioning

confidence: 99%

Churg-Strauss Syndrome as an Unusual Aetiology of Stroke with Haemorrhagic Transformation in a Patient with No Cardiovascular Risk Factors

Sairanen¹,

Kanerva

Valanne

et al. 2011

Case Rep Neurol

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Background: We present here a case of haemorrhagic brain infarction in a middle-aged and physically active male, who had never smoked. This case report aims to remind the internist and neurologist to bear in mind unusual aetiologies of brain infarcts in patients without classical cardiovascular risk factors. Case Description: A 49-year-old male with pulmonary asthma and a prior history of nasal polyps had a wake-up stroke with left-sided symptoms and speech disturbance. A head MRI and MR angiography revealed a recent haemorrhagic infarct in the right putamen and corona radiata. The left hemiparesis progressed to sensory-motor hemiplegia on the 4th day. In the head CT, it was shown that the haemorrhagic infarct had progressed to a large haematoma. A pansinusitis was also diagnosed. The aetiological investigations revealed a minor atrial septal defect (ASD) with shunting and a heterozygotic clotting factor V R506Q mutation. A remarkable blood eosinophilia of 9.80 E9/l (42%) together with fever, sinusitis, wide-spread bilateral nodular pulmonary infiltrates that did not respond to wide-spectrum antimicrobial treatment, positive anti-neutrophilic cytoplasmic antibodies, a high myeloperoxidase antibody level and slightly positive anti-proteinase 3 antibodies suggested the diagnosis of Churg-Strauss syndrome. These inflammatory symptoms and findings promptly responded to treatment with corticosteroids and cyclophosphamide. Conclusions: Even after the concomitant findings of the low risk factors, i.e. small ASD and heterozygotic clotting factor mutation, continued search for the final aetiology of stroke revealed Churg-Strauss syndrome, which was the key to the treatment.

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Prevention Strategies for Cardioembolic Stroke: Present and Future Perspectives~!2009-05-11~!2009-12-23~!2010-06-09~!

Cited by 10 publications

References 55 publications

Mean platelet volume is elevated in patients with patent foramen ovale

Mean platelet volume is elevated in patients with patent foramen ovale

Airborne pollutants and lacunar stroke: a case cross-over analysis on stroke unit admissions

Churg-Strauss Syndrome as an Unusual Aetiology of Stroke with Haemorrhagic Transformation in a Patient with No Cardiovascular Risk Factors

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