A5029421463- Acute Ischemic Stroke Management
- Intracranial Aneurysms: Treatment and Complications
- Cerebrovascular and Carotid Artery Diseases
- Traumatic Brain Injury and Neurovascular Disturbances
- Stroke Rehabilitation and Recovery
- Intracerebral and Subarachnoid Hemorrhage Research
- Neurosurgical Procedures and Complications
- Glioma Diagnosis and Treatment
- Vascular Malformations Diagnosis and Treatment
- Venous Thromboembolism Diagnosis and Management
- Atrial Fibrillation Management and Outcomes
- Rheumatoid Arthritis Research and Therapies
- Cerebrospinal fluid and hydrocephalus
- CNS Lymphoma Diagnosis and Treatment
- Moyamoya disease diagnosis and treatment
- Systemic Sclerosis and Related Diseases
- Meningioma and schwannoma management
- Systemic Lupus Erythematosus Research
- Brain Metastases and Treatment
- Head and Neck Surgical Oncology
- Congenital Heart Disease Studies
- Lymphoma Diagnosis and Treatment
- Spinal Fractures and Fixation Techniques
- Streptococcal Infections and Treatments
- Neurological Disorders and Treatments
Kyorin University
2016-2025
Allen Institute for Brain Science
1995-2024
Kyorin University Hospital
2011-2023
Creative Commons
2021
Nakamura Memorial Hospital
2009-2020
National Cerebral and Cardiovascular Center
2009-2020
St. Marianna University School of Medicine
2009-2020
Medical University of South Carolina
2020
Seoul National University Hospital
2020
Beijing Tian Tan Hospital
2020
The revised Japan Stroke Society Guidelines for the Treatment of were published in Japanese July 2021. In this article, extracted recommendation statements are published. revision keeps pace with great progress stroke control based on recently enacted Basic Act and Cardiovascular Disease Japan. guideline covers following areas: primary prevention, general acute management stroke, ischemic transient attack, intracerebral hemorrhage, subarachnoid asymptomatic cerebrovascular disease, other...
Intracranial fusiform aneurysms can be divided into 2 clinically different subtypes: acute dissecting and chronic or dolichoectatic aneurysms. Of these 2, the natural history growth mechanism of remains unknown.A consecutive series 16 patients with was studied retrospectively to clarify patient clinical neuroradiological features. Aneurysm tissues were obtained from 8 cases examined identify histological features that could correspond radiological findings.Four found: (1) fragmentation...
The clinical outcome of 40 cases with middle cerebral artery (MCA) occlusion was examined in relation to the site and findings on computed tomography (CT). Patients were treated conservatively without surgery. A few had decompressive craniotomy when necessary. Outcome 7 (18%) good, 6 (15%) moderate, 15 (38%) severe; 12 (30%) died by follow-up at 3 months. In origin MCA, hypodensity CT scan usually localized basal ganglia, presumably because collateral circulation through anterior arteries;...
A retrospective, multicenter, observational study was conducted to document clinical outcomes and identify outcome predictors in patients treated with low-dose intravenous recombinant tissue plasminogen activator (0.6 mg/kg alteplase), which approved Japan 2005, within 3 hours of stroke onset.Consecutive 10 Japanese centers were included.A total 600 (377 men, 72+/-12 years old) studied. Median National Institutes Health Stroke Scale scores decreased from 13 before 8 at 24 later. Symptomatic...
Background and Purpose— Blood pressure (BP) lowering is often conducted as part of general acute management in patients with intracerebral hemorrhage. However, the relationship between BP after antihypertensive therapy clinical outcomes not fully known. Methods— Hyperacute (<3 hours from onset) hemorrhage initial systolic (SBP) >180 mm Hg were included. All received intravenous treatment, based on predefined protocol to lower maintain SBP 120 160 Hg. BPs measured every 15 minutes...
To build a prediction model that estimates the 3-year rupture risk of unruptured saccular cerebral aneurysms.Survival analysis was done using each aneurysm as unit for analysis. Derivation data were from Unruptured Cerebral Aneurysm Study (UCAS) in Japan. It consists patients with aneurysms enrolled between 2000 and 2004 at neurosurgical departments tertiary care hospitals The presented scoring system, classified into 4 grades by predicted risk: I, < 1%; II, 1 to 3%; III, 3 9%, IV, >9%....
Large clinical trials are lack of data on non-vitamin K antagonist oral anticoagulants for acute stroke patients.To evaluate the choice at hospital discharge in patients with nonvalvular atrial fibrillation and clarify underlying characteristics potentially affecting that using multicenter Stroke Acute Management Urgent Risk-factor Assessment Improvement-NVAF registry (ClinicalTrials.gov NCT01581502).The study included 1192 ischemic stroke/transient attack (527 women, 77·7 ± 9·9 years old)...
Background and Purpose- We assessed whether lower-dose alteplase at 0.6 mg/kg is efficacious safe for acute fluid-attenuated inversion recovery-negative stroke with unknown time of onset. Methods- This was an investigator-initiated, multicenter, randomized, open-label, blinded-end point trial. Patients met the standard indication criteria intravenous thrombolysis other than a last-known-well >4.5 hours (eg, wake-up stroke). were randomly assigned (1:1) to receive or medical treatment if...
Unruptured intracranial aneurysms not undergoing preventive endovascular or neurosurgical treatment are often monitored radiologically to detect aneurysm growth, which is associated with an increase in risk of rupture. However, the absolute rupture after detection growth remains unclear. To determine during follow-up and develop a prediction model for Individual patient data were obtained from 15 international cohorts. Patients 18 years older who had imaging at least 1 untreated unruptured...
The "1-3-6-12-day rule" for starting direct oral anticoagulants (DOACs) in patients with nonvalvular atrial fibrillation after acute ischemic stroke or transient attack recommends timings that may be later than used clinical practice. We investigated more practical optimal timing of DOAC initiation according to severity. combined data prospective registries Japan, Stroke Acute Management Urgent Risk-factor Assessment and Improvement-nonvalvular (September 2011 March 2014) RELAXED (February...
To study the expression and function of L-type amino acid transporter 1 (LAT1), a major catalytic subunit system L that is responsible for transport large neutral acids, including most essential in concert with covalently bound 4F2 heavy chain, implicated tumorigenesis.Human glioma cell lines tumor specimens were analyzed LAT1 using Western blotting reverse transcription polymerase chain reaction analysis. The rate uptake was measured L-[C]leucine. proliferation apoptosis rates by 3-(4,...
Background and Purpose— Alberta Stroke Programme Early CT Score (ASPECTS) is a quantitative topographical score to evaluate early ischemic change in the middle cerebral arterial territory on as well diffusion-weighted imaging (DWI). The aim of present study was elucidate relationship between CT-ASPECTS DWI-ASPECTS for patients with hyperacute stroke their associations outcomes after recombinant tissue-type plasminogen activator therapy based multicenter registry. Methods— ASPECTS assessed...
<i>Background:</i> The aim of this study was to determine whether renal dysfunction affects the outcome stroke patients treated with recombinant tissue plasminogen activator (rt-PA). <i>Methods:</i> A retrospective, multicenter, observational conducted identify effects underlying risk factors on intravenous rt-PA therapy using 0.6 mg/kg alteplase in 10 centers Japan. Consecutive a premorbid modified Rankin Scale (mRS) score ≤3 who received were studied. Renal defined...
<b>Objective:</b> To evaluate whether the pretreatment Alberta Stroke Programme Early CT Score (ASPECTS) assessed using diffusion-weighted imaging (DWI) predicts stroke outcomes at 3 months following IV recombinant tissue-type plasminogen activator (rt-PA) therapy. <b>Methods:</b> patients treated with rt-PA (0.6 mg/kg alteplase) in 10 centers Japan were retrospectively studied. ASPECTS was on DWI just prior to injection. The primary outcome a modified Rankin Scale (mRS) score of 0–2 months....
The present study determines associations between early blood pressure (BP) variability and stroke outcomes after intravenous thrombolysis.In 527 patients receiving alteplase (0.6 mg/kg), BP was measured 8 times within the first 25 hours. determined as ΔBP (maximum-minimum), standard deviation (SD), coefficient of variation, successive variation.The systolic course lower among with modified Rankin Scale (mRS) 0 to 1 than those without (P<0.001). Most profiles were significantly associated...
A high incidence of autoantibody against the neutral glycolipid "asialo GM1" was observed in sera from patients with systemic lupus erythematosus (SLE) neurological disorders, using an immunoflocculation test. The 14 out 17 cases SLE disorders showed antibody activity asialo GM1 but not following glycolipids: GM2 GM1, and galactocerebroside. In another 87 without any history seizures, as well 61 other autoimmune diseases (rheumatoid arthritis, progressive sclerosis, mixed connective tissue...
<b><i>Background:</i></b> The initial 24 h after thrombolysis are critical for patients’ conditions, and continuous neurological assessment blood pressure measurement required during this time. goal of study was to identify the clinical factors associated with early deterioration (END) within stroke patients receiving intravenous recombinant tissue plasminogen activator (rt-PA) therapy clarify effect END on 3-month outcomes....
Background and Purpose— The associations between early blood pressure (BP) variability clinical outcomes in patients with intracerebral hemorrhage after antihypertensive therapy, recently clarified by a post hoc analysis of Intensive Blood Pressure Reduction Acute Cerebral Hemorrhage Trial 2 (INTERACT2), were confirmed using the Stroke Management Urgent Risk-factor Assessment Improvement (SAMURAI)-intracerebral study cohort. Methods— Patients hyperacute (<3 hours from onset) initial...
Aims This study was performed to determine the short-term risk-benefit profiles of patients treated with oral anticoagulation for acute ischemic stroke or transient attack using a multicenter, prospective registry. Methods A total 1137 (645 men, 77 ± 10 years old) stroke/transient taking warfarin (662 patients) non-vitamin K antagonist anticoagulants (dabigatran in 205, rivaroxaban 245, apixaban 25 nonvalvular atrial fibrillation who completed three-month follow-up survey were studied....
Abstract BACKGROUND Wearable devices with heads-up displays or smart glasses can overlay images onto the sight of wearer. This technology has never been applied to surgical navigation. OBJECTIVE To assess applicability and accuracy for augmented reality (AR)-based neurosurgical METHODS Smart were AR-based Three-dimensional computer graphics created based on preoperative magnetic resonance visualized in see-through glasses. Optical markers attached patient's head accurate Two motion capture...
<h3>Objectives</h3> This cross-sectional survey explored the characteristics and outcomes of direct oral anticoagulant (DOAC)–associated nontraumatic intracerebral hemorrhages (ICHs) by analyzing a large nationwide Japanese discharge database. <h3>Methods</h3> We analyzed data from 2,245 patients who experienced ICHs while taking anticoagulants (DOAC: 227; warfarin: 2,018) were urgently hospitalized at 621 institutions in Japan between April 2010 March 2015. compared DOAC- warfarin-treated...