Publications by authors named "Leonidas Panos"

The global deployment of SARS-CoV-2 vaccines has been pivotal in curbing the COVID-19 pandemic, reducing morbidity and mortality associated with the virus. While most of these vaccines have demonstrated high efficacy and overall safety, emerging reports have highlighted potential neurovascular adverse effects, albeit uncommon, associated with these vaccinations. This review aims to assess and summarize the current knowledge on the neurovascular complications arising post-SARS-CoV-2 vaccination.

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Stem cells, renowned for their unique regenerative capabilities, present significant hope in treating stroke, a major cause of disability globally. This review offers a detailed analysis of stem cell applications in stroke (ischemic and hemorrhagic) recovery. It examines therapies based on autologous (patient-derived), allogeneic (donor-derived), and Granulocyte-Colony Stimulating Factor (G-CSF) based stem cells, focusing on cell types such as Mesenchymal Stem/Stromal Cells (MSCs), Bone Marrow Mononuclear Stem Cells (BMMSCs), and Neural Stem/Progenitor Cells (NSCs).

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  • Visible perivascular spaces (BGPVS) are linked to cerebral small vessel disease and may signal higher future stroke risk based on a large analysis of patient data.
  • The study analyzed 7,778 participants with recent ischemic stroke or transient ischemic attack (TIA), examining the relationship between BGPVS, CSOPVS, and various health factors.
  • Results indicated that a greater burden of BGPVS correlates with higher risks of ischemic stroke but not intracranial hemorrhage, while CSOPVS showed weaker associations overall.
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  • This study looks at how interpretable deep learning models can help predict functional recovery in stroke patients with large vessel occlusion using clinical and MRI data.* -
  • Researchers analyzed data from 222 patients who underwent mechanical thrombectomy and evaluated different models for their prediction accuracy based on clinical and imaging variables.* -
  • The findings showed that models utilizing clinical data combined with diffusion-weighted imaging performed best, and they surpassed the accuracy of experienced neurologists when imaging data was included.*
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  • Cerebral microbleeds increase the risk of both ischemic stroke and intracranial hemorrhage, complicating treatment choices for patients with atrial fibrillation on various antithrombotic therapies.
  • A study analyzed 7,839 patients, finding that microbleeds significantly raised the relative risk of intracranial hemorrhage (2.74 times) and ischemic stroke (1.29 times), particularly with combination therapies of anticoagulants and antiplatelets.
  • For patients on combination therapy, those with multiple microbleeds faced a higher absolute risk of intracranial hemorrhage compared to ischemic stroke, indicating a need for more research to develop effective preventive strategies.
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  • Researchers studied patients with certain types of strokes (IS or TIA) to find out how a brain condition called cortical superficial siderosis (cSS) affects their risk of having more strokes in the future.
  • They looked at data from a large group of patients and found that those with cSS had a higher chance of having more strokes than those without it.
  • Patients with cSS who took both types of blood-thinning medicines had an even higher risk of severe strokes and intracranial hemorrhage (bleeding in the brain).
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Background: An incomplete circle of Willis (CoW) has been associated with a higher risk of stroke and might affect collateral flow in large vessel occlusion (LVO) stroke. We aimed to investigate the distribution of CoW variants in a LVO stroke and transient ischemic attack (TIA) cohort and analyze their impact on 3-month functional outcome.

Methods: CoW anatomy was assessed with time-of-flight magnetic resonance angiography (TOF-MRA) in 193 stroke patients with acute middle cerebral artery (MCA)-M1-occlusion receiving endovascular treatment (EVT) and 73 TIA patients without LVO.

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Background And Purpose: Clinical outcomes vary substantially among individuals with large vessel occlusion (LVO) stroke. A small infarct core and large imaging mismatch were found to be associated with good recovery. The aim of this study was to investigate whether those imaging variables would improve individual prediction of functional outcome after early (<6 h) endovascular treatment (EVT) in LVO stroke.

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Background: Optimal management of patients with large vessel occlusion (LVO) and low NIHSS score is unknown, which was the aim to investigate in this study.

Methods: This is a retrospective analysis of a prospective single tertiary care centre 14-year cohort of patients with LVO in the anterior circulation and NIHSS score ≤ 5 on admission. Outcome was analysed according to primary intended therapy.

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Cardiac myxoma can embolize and cause early and delayed sequelae including stroke, growth into intracranial fusiform aneurysms and cerebral tumors with risk of hemorrhage and mass effect. Here, we report the rare coincidence of all these manifestations in a 63-year-old man who presented with cognitive and behavioral changes, and seizures 9 months after an embolic stroke from the heart tumor. C-reactive protein (CRP) was elevated at the time of stroke and cardiac myxoma diagnosis but was normal at late neurologic manifestation with isolated myxoma-related intracranial tumors and aneurysms.

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Background: Performing mechanical thrombectomy (MT) in patients with basilar artery occlusion (BAO) is currently not evidence-based.

Objective: To compare patients' outcome, relative merits of achieving recanalization, and predictors of futile recanalization (FR) between BAO and anterior circulation large vessel occlusion (ACLVO) MT.

Methods: In the multicenter BEYOND-SWIFT registry (NCT03496064), univariate and multivariate (displayed as adjusted Odds Ratios, aOR and 95% confidence intervals, 95%-CI) outcome comparisons between BAO (N=165) and ACLVO (N=1574) were performed.

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Article Synopsis
  • Cerebral microbleeds are small brain hemorrhages that may indicate heightened stroke risk, raising concerns about future intracranial hemorrhage versus recurrent ischemic stroke in patients receiving antithrombotic medications.
  • This study pooled data from various cohort studies, focusing on adult patients with recent ischemic strokes or transient ischemic attacks, to determine the relationship between the presence and patterns of cerebral microbleeds and the risks of future strokes or hemorrhages.
  • Analyzing data from 20,322 patients over multiple years, researchers found that patients with cerebral microbleeds had a 1.35 times higher risk of experiencing adverse outcomes compared to those without microbleeds, highlighting the significance of monitoring these markers in clinical
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Background and Purpose- The brush sign (BS) is an abnormally accentuated signal drop of the subependymal and deep medullary veins in paramagnetic-sensitive magnetic resonance sequences, previously described in acute ischemic stroke. We aimed to describe the BS in patients with thrombosis of the cerebral veins and sinuses and explore its association with clinical severity, thrombosis extent, parenchymal brain lesion, and clinical prognosis. Methods- We assessed consecutive adult patients admitted to 2 university hospitals with diagnosis of acute thrombosis of the cerebral veins and sinuses and imaging assessment with magnetic resonance imaging, including paramagnetic-sensitive sequences.

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Background and Purpose- If anterior circulation large vessel occlusion acute ischemic stroke patients presenting with ASPECTS 0-5 (Alberta Stroke Program Early CT Score) should be treated with mechanical thrombectomy remains unclear. Purpose of this study was to report on the outcome of patients with ASPECTS 0-5 treated with mechanical thrombectomy and to provide data regarding the effect of successful reperfusion on clinical outcomes and safety measures in these patients. Methods- Multicenter, pooled analysis of 7 institutional prospective registries: Bernese-European Registry for Ischemic Stroke Patients Treated Outside Current Guidelines With Neurothrombectomy Devices Using the SOLITAIRE FR With the Intention for Thrombectomy (Clinical Trial Registration-URL: https://www.

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Background And Purpose: If patients presenting with large vessel occlusions (LVO) and mild symptoms should be treated with endvoascular treatment (EVT) remains unclear. Aims of this study were (1) assessing the safety and technical efficacy of EVT in patients with NIHSS < 8 as opposed to a comparison group of patients presenting with NIHSS ≥ 8 and (2) evaluation of the clinical effect of reperfusion in patients with NIHSS < 8.

Methods: Patients included into the retrospective multicenter BEYOND-SWIFT registry (NCT03496064) were analyzed.

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Background and Purpose- Sustained successful reperfusion is an important prognostic factor for good clinical outcome in acute ischemic stroke. We aimed to identify the prevalence, clinical impact, and predictors of early reocclusion after initially successful thrombectomies within a prospective cohort. Methods- A total of 711 stroke patients with successful reperfusion (modified Thrombolysis in Cerebral Infarction, 2b/3) followed with magnetic resonance or computed tomographic angiography at 24 to 48 hours were included.

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