Update in the Management of Acute Ischemic Stroke

Maldonado, Nelson; Kazmi, Syed Omar; Suárez, José I.

doi:10.1016/j.ccc.2014.06.002

Cited by 17 publications

(17 citation statements)

References 111 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[6] Early discovery and prevention of long-term sequelae is the primary task in treating patients with acute ischemic stroke. [7] Therefore, we aimed to test the effectiveness of an intravenous injection (5 ml/kg b.w.) of OGV shortly after onset of ischemic stroke or after reperfusion in a transient MCAO mouse model.…”

Section: Introductionmentioning

confidence: 99%

Intravenous Treatment with a Long-Chain Omega-3 Lipid Emulsion Provides Neuroprotection in a Murine Model of Ischemic Stroke – A Pilot Study

et al. 2016

View full text Add to dashboard Cite

Single long-chain omega-3 fatty acids (e.g. docosahexaenoic acid (DHA) or eicosapentaenoic acid (EPA)) are known for their neuroprotective properties associated with ischemic stroke. This pilot study aimed to test the effectiveness of an acute treatment with a long-chain omega-3 lipid emulsion (Omegaven 10%®, OGV) that contains fish oil (DHA 18 mg/ml; EPA 21 mg/ml) and α-tocopherol (0.2 mg/ml) in a transient middle cerebral artery occlusion (MCAO) model of ischemic stroke in mice. For this purpose, female CD-1 mice were anesthetized and subjected to 90 minutes of MCAO. To reflect a clinically relevant situation for an acute treatment, either after induction of stroke or after reperfusion, a single dose of OGV was injected intravenously into the tail vein (5 ml/kg b.w.). A neurological severity score was used to assess motor function and neurological outcome. Stroke-related parameters were determined 24 hours after MCAO. Microdialysis was used to collect samples from extracellular space of the striatum. Mitochondrial function was determined in isolated mitochondria or dissociated brain cells. Inflammation markers were measured in brain homogenate. According to control experiments, neuroprotective effects could be attributed to the long-chain omega-3 content of the emulsion. Intravenous injection of OGV reduced size and severity of stroke, restored mitochondrial function, and prevented excitotoxic glutamate release. Increases of pro-inflammatory markers (COX-2 and IL-6) were attenuated. Neurological severity scoring and neurochemical data demonstrated that acute OGV treatment shortly after induction of stroke was most efficient and able to improve short-term neurological outcome, reflecting the importance of an acute treatment to improve the outcome. Summarising, acute treatment of stroke with a single intravenous dose of OGV provided strong neuroprotective effects and was most effective when given immediately after onset of ischemia. As OGV is an approved fishoil emulsion for parenteral nutrition in humans, our results may provide first translational data for a possible early management of ischemic stroke with administration of OGV to prevent further brain damage.

show abstract

Section: Introductionmentioning

confidence: 99%

Intravenous Treatment with a Long-Chain Omega-3 Lipid Emulsion Provides Neuroprotection in a Murine Model of Ischemic Stroke – A Pilot Study

et al. 2016

View full text Add to dashboard Cite

show abstract

“…As the leading cause of disability in adults, cerebral ischemic stroke is frequently accompanied by long‐lasting neurological deficits that significantly impair the quality of life for stroke patients . The brain may undergo self‐repair events at late stage of stroke, which allows stroke patients to regain some part of their sensorimotor functions .…”

Section: Introductionmentioning

confidence: 99%

The evolving role of neuro‐immune interaction in brain repair after cerebral ischemic stroke

et al. 2018

View full text Add to dashboard Cite

Stroke is the world's leading cause of disability with limited brain repair treatments which effectively improve long-term neurological deficits. The neuroinflammatory responses persist into the late repair phase of stroke and participate in all brain repair elements, including neurogenesis, angiogenesis, synaptogenesis, remyelination and axonal sprouting, shedding new light on post-stroke brain recovery. Resident brain glial cells, such as astrocytes not only contribute to neuroinflammation after stroke, but also secrete a wide range of trophic factors that can promote post-stroke brain repair. Alternatively, activated microglia, monocytes, and neutrophils in the innate immune system, traditionally considered as major damaging factors after stroke, have been suggested to be extensively involved in brain repair after stroke. The adaptive immune system may also have its bright side during the late regenerative phase, affecting the immune suppressive regulatory T cells and B cells. This review summarizes the recent findings in the evolving role of neuroinflammation in multiple post-stroke brain repair mechanisms and poses unanswered questions that may generate new directions for future research and give rise to novel therapeutic targets to improve stroke recovery.

show abstract

“…Stroke is a devastating disease, currently ranked the fifth leading cause of death in this country and the leading cause of disability [1,2]. However, stroke outcomes dramatically improved with the introduction of alteplase (tPA) as a treatment for acute ischemic stroke in the 1990s [3].…”

Section: Introductionmentioning

confidence: 99%

Intra-Arterial Thrombectomy: Does Invasive Treatment Lead to Better Outcomes than Intravenous Thrombolysis Alone?

2015

View full text Add to dashboard Cite

Intravenous thrombolysis is considered to be standard of care for acute ischemic stroke patients arriving within 3-4.5 h of stroke symptom onset. Recently, endovascular therapies have been proposed to extend and enhance stroke outcomes by targeting large vessel occlusions. Different radiologic methods, time windows, and treatment tools have delineated differences between trials. Overall, intravenous thrombolysis remains the treatment of choice for all acute ischemic stroke patients, with a small subset benefiting from additional endovascular therapy. Endovascular therapy remains a viable singular option for patients with large vessel occlusion unable to receive thrombolysis.

show abstract

Update in the Management of Acute Ischemic Stroke

Cited by 17 publications

References 111 publications

Intravenous Treatment with a Long-Chain Omega-3 Lipid Emulsion Provides Neuroprotection in a Murine Model of Ischemic Stroke – A Pilot Study

Intravenous Treatment with a Long-Chain Omega-3 Lipid Emulsion Provides Neuroprotection in a Murine Model of Ischemic Stroke – A Pilot Study

The evolving role of neuro‐immune interaction in brain repair after cerebral ischemic stroke

Intra-Arterial Thrombectomy: Does Invasive Treatment Lead to Better Outcomes than Intravenous Thrombolysis Alone?

Contact Info

Product

Resources

About