No abstract available.
Ischemic Attack, Transient* ; Stroke*

Background: Among the multiple scoring systems for hemorrhagic transformation, only few of these address spontaneous hemorrhagic transformation after an ischemic stroke, with most done with Western population data. Objectives: This study aims to identify the predictors for hemorrhagic transformation among patients with ischemic stroke admitted in a tertiary hospital in Cebu City, Philippines. Methods: This is a retrospective cohort study of patients with ischemic stroke admitted in a tertiary hospital in Cebu City. Patients’ baseline characteristics, clinical, and radiologic data were collected. Chi square test and t-test were used to determine which variables were significantly different between patients with and without hemorrhagic transformation. Odds ratio (OR) and 95% confidence interval (CI) were determined to measure the association between the different variables and hemorrhagic transformation. Results: A total of 500 ischemic stroke patients were included in the study. There were 28 (6%) ischemic stroke patients with Hemorrhagic Transformation. The mean age of these patients is 66.93 ± 12.42 years, 48.8% male, 10.8% had atrial fibrillation, and 2.4% had myocardial infarction. Controlling for the effect of confounders, white blood cell count (OR 1.11; 95% CI 1.03-1.19), myocardial infarction (OR 5.25; 95% CI 1.13-24.34), and presence of brain edema (OR 2.86; 95% CI 1.05-7.80) were significant predictors of hemorrhagic transformation. Conclusion White blood cell count, presence of brain edema, and myocardial infarction were significantly associated with hemorrhagic transformation among ischemic stroke patients.
Ischemic Stroke ; Philippines

Background: In Vascular Dementia (VaD) patients, the causes of blood vessels were common, and preventable and treatable, so that it is very important to detect and diagnose in the early stages of the disease. Diagnosis of dementia is based on clinical symptoms, and neuropsychological tests are useful tools. Objectives: (1) To evaluate the severity of VaD and Vascular Cognitive Impairment (VCI) after the 1st ischemic stroke in patients over 60 years old. (2) To make observations on the clinical features of post stroke dementia in these patient groups using neuropsychological battery. Subjects: 94 patients with 1st acute ischemic stroke, who were over 60 years old, conscious and literate, and cooperated well with physicians. A standard evaluation protocol was conducted at one month after an ischemic stroke for all the patients. Method: Prospective study. Data was analyzed by using SPSS software version 13.0. Results and conclusions: The rates of VCI and VaD after the first ischemic stroke were 21.3% and 25.5%, respectively. Clinical determinants of dementia were: visuoconstruction (65% patients), visual motor speed (50%), memory disorders (more than 40%, in which visual memory 45.8% and verbal memory 41.6%), executive function (37.5%), and language skill (37.5%). The attention and language functions were less affected (only 25% of the patients). Mini mental state examination score can be used to evaluate and classify clearly 3 groups: VaD, VCI patients and normal people.
Ischemic stroke ; Dementia ; Neuropsychological test

Background: Hyperglycemia is commonly seen in cerebral vascular accidents in general and in acute phase in particular. It is difficult for doctors to treat. Objectives: To evaluate the effect of stress hyperglycemia on mortality risk and disability risk in patient with acute ischemic stroke. Subjects and method: 105 patients with acute ischemic stroke with admission blood glucose level >/= 8.0mmol/l without history of diabetes mellitus from 2004 to 2007. These patients were divided into two groups: group 1 with admission blood glucose level of 8.0-11.0mmol/l; group 2 with that level of >l1.0mmol/l. Results: There was a significant reverse correlation between blood glucose level and the Glasgow score scale on admission and after 24 hours. The mortality risk in hospital of group 2 was higher than that of group 1 and the disability level of group 2 was more severe than that of group 1. Conclusion: Stress hyperglycemia increased the risk of in-hospital mortality in acute ischemic stroke patients and risk of severe disability after leaving hospital. \r\n', u'\r\n', u'
Stress hyperglycemia ; acute ischemic stroke

Humans ; Child ; Consensus ; Ischemic Stroke

Introduction: Acute Ischemic Stroke (AIS) is a medical emergency that affects people globally. In the Philippines, it remains as the third leading cause of mortality. This study aims to determine the use of platelet-lymphocyte ratio (PLR) - a simple, economical, and safe tool - as a predictor of in-hospital outcomes in patients with acute ischemic stroke. Methods: A retrospective cross-sectional study was conducted among AIS patients at the Remedios Trinidad Romualdez Hospital (RTRH) Tacloban City, Leyte, Philippines from January 2020 to December 2022. Clinical demographics, laboratory profile, and hospital outcomes were described. Descriptive statistics, Mann-Whitney test, and T-test were utilized to determine the association between PLR and in-hospital outcomes. Results and Conclusions There were 76 patients enrolled in the study, majority were females (57.9%), and hypertensive (84.2%). Risk factors that are pivotal to the development of AIS were also identified. To note, half of the population presented with unilateral body weakness. Moreover, only 7.9% died due to the disease. Higher PLR levels resulted from an increased platelet count and a decreased lymphocyte count. However, no significant association between PLR levels and AIS outcomes was noted, hence the need for further investigation of these parameters.
Ischemic Stroke ; Tertiary Care Centers

Background and Objective: Stroke has remained one of the primary causes of significant morbidity and mortality. Among the therapeutic options for acute stroke management, endovascular thrombectomy is intended to remove the thrombi within the intracerebral vasculature and restore adequate perfusion to the surrounding penumbra. It is recommended up to 24 hours from onset of neurologic symptom. In the Philippines, only a few tertiary healthcare institutions are able to offer and perform endovascular thrombectomies. The aim was to describe the profile and discharge outcomes of endovascular thrombectomy for acute ischemic stroke at a tertiary hospital in our country. Methods: We conducted a retrospective records review among 924 patients admitted for acute ischemic stroke from October 2018 to August 2021 who underwent mechanical thrombectomy. Clinical and functional outcomes were measured using the National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Score (mRS). Results: Among 31 patients included in the study, 29 subjects (93.5%) had moderate to severe disability (mRS 3–5), and 25 (80.6%) had moderate stroke (NIHSS 6–21) on admission. The identified site of the cerebrovascular thrombi was within the M1 segment of the middle cerebral artery (41.9%, n=13). The stent retriever approach was performed in 19 participants (61.2%). Upon discharge, only 7 (22.6%) had favorable functional outcomes (MRS 0–2), and 9 (29.0%) resulted in mortality. Successful reperfusion was achieved in 92.3% of the patients. Conclusion Overall, endovascular thrombectomy is a possible treatment option for large vessel acute ischemic stroke in developing countries.
thrombectomy ; endovascular procedures ; ischemic stroke ; treatment outcomes

Background: Antiplatelet resistance is one factor that contributes to stroke recurrence among patients with noncardioembolic ischemic strokes. Objectives: This paper aims to describe the prevalence of aspirin and clopidogrel resistance, along with frequency of statin, NSAID and proton pump inhibitor use among our cohort of stroke patients. Method. This is a single-center cross-sectional review that included all adult patients with recurrent noncardioembolic ischemic stroke admitted in a tertiary hospital between January 2019 and June 2023. Results: A total of 1,374 patients were admitted for ischemic stroke from January 2019 to June 2023. Among these, 155 (11.28%) were recurrent noncardioembolic ischemic strokes. Prevalence of aspirin and clopidogrel resistance were 25% and 32.7%, respectively. Clinical profiles of those in the resistant group were comparable with those in the nonresistant group. None of the patients taking aspirin had concomitant use of nonsteroidal antiinflammatory drugs. Only 2 of the patients who were resistant to clopidogrel were on proton pump inhibitors. More than half of the patients both in the resistant and the nonresistant groups were on statin. The study had a small sample size and hence it was not enough to establish causal relationship between factors and antiplatelet resistance. Conclusion More patients were resistant to clopidogrel than to aspirin. Further studies with a bigger sample size are recommended to explore factors that contribute to antiplatelet resistance in Filipino patients.
Aspirin ; Clopidogrel ; Ischemic Stroke ; Tertiary Care Centers

The therapeutic efficacy of Danshen and Jiangxiang in the treatment of ischemic stroke (IS) is relatively significant. Studying the mechanism of action of Danshen and Jiangxiang in the treatment of IS can effectively identify candidate traditional Chinese medicines (TCM) with efficacy. However, it is challenging to analyze the effector substances and explain the mechanism of action of Danshen-Jiangxiang from a systematic perspective using traditional pharmacological approaches. In this study, a systematic study was conducted based on the drug-target-symptom-disease association network using complex network theory. On the basis of the association information about Danshen, Jiangxiang and IS, the protein-protein interaction (PPI) network and the "drug pair-pharmacodynamic ingredient-target-IS" network were constructed. The different topological features of the networks were analyzed to identify the core pharmacodynamic ingredients including formononetin in Jiangxiang, cryptotanshinone and tanshinone IIA in Danshen as well as core target proteins such as prostaglandin G/H synthase 2, retinoic acid receptor RXR-alpha, sodium channel protein type 5 subunit alpha, prostaglandin G/H synthase 1 and beta-2 adrenergic receptor. Further, a method for screening IS candidates based on TCM symptoms was proposed to identify key TCM symptoms and syndromes using the "drug pair-TCM symptom-syndrome-IS" network. The results showed that three TCMs, namely Puhuang, Sanleng and Zelan, might be potential therapeutic candidates for IS, which provided a theoretical reference for the development of drugs for the treatment of IS.
Ischemic Stroke ; Salvia miltiorrhiza ; Stroke/drug therapy* ; Cyclooxygenase 2 ; Prostaglandins

With an increasing incidence rate, ischemic stroke has become a major public health problem. Early and effective secondary prevention is a key strategy for reducing its high morbidity, high recurrence and high mortality. Combined with the clinical phenotypes and imaging features, the application of potential blood biomarkers can provide the scientific basis for early screening and treatment monitoring to assess stroke recurrence risk stratification, then guide individualized secondary prevention. This article describes and analyzes the current clinical application, existing challenge, and the future development model of blood biomarkers in the field of secondary stroke prevention.
Biomarkers ; Humans ; Incidence ; Ischemic Stroke ; Secondary Prevention ; Stroke/prevention & control*