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Stroke; a Journal of Cerebral Circulation

Esther M C van Leijsen, H Bea Kuiperij, Iris Kersten, Mayra I Bergkamp, Ingeborg W M van Uden, Hugo Vanderstichele, Erik Stoops, Jurgen A H R Claassen, Ewoud J van Dijk, Frank-Erik de Leeuw, Marcel M Verbeek
BACKGROUND AND PURPOSE: Cerebral small vessel disease (SVD) is a frequent pathology in aging and contributor to the development of dementia. Plasma Aβ (amyloid β) levels may be useful as early biomarker, but the role of plasma Aβ in SVD remains to be elucidated. We investigated the association of plasma Aβ levels with severity and progression of SVD markers. METHODS: We studied 487 participants from the RUN DMC study (Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Imaging Cohort) of whom 258 participants underwent 3 MRI assessments during 9 years...
March 14, 2018: Stroke; a Journal of Cerebral Circulation
Charlotte Zerna, Amy Y X Yu, Jayesh Modi, Shiel K Patel, Jonathan I Coulter, Eric E Smith, Shelagh B Coutts
BACKGROUND AND PURPOSE: White matter lesions (WML) are associated with cognitive decline, increased stroke risk, and disability in old age. We hypothesized that superimposed acute cerebrovascular occlusion on chronic preexisting injury (leukoaraiosis) leads to worse outcome after minor cerebrovascular event, both using quantitative (volumetric) and qualitative (Fazekas scale) assessment, as well as relative total brain volume. METHODS: WML volume assessment was performed in 425 patients with high-risk transient ischemic attack (TIA; motor/speech deficits >5 minutes) or minor strokes from the CATCH study (CT and MRI in the Triage of TIA and Minor Cerebrovascular Events to Identify High Risk Patients)...
March 14, 2018: Stroke; a Journal of Cerebral Circulation
Henry Zhao, Lauren Pesavento, Skye Coote, Edrich Rodrigues, Patrick Salvaris, Karen Smith, Stephen Bernard, Michael Stephenson, Leonid Churilov, Nawaf Yassi, Stephen M Davis, Bruce C V Campbell
BACKGROUND AND PURPOSE: Clinical triage scales for prehospital recognition of large vessel occlusion (LVO) are limited by low specificity when applied by paramedics. We created the 3-step ambulance clinical triage for acute stroke treatment (ACT-FAST) as the first algorithmic LVO identification tool, designed to improve specificity by recognizing only severe clinical syndromes and optimizing paramedic usability and reliability. METHODS: The ACT-FAST algorithm consists of (1) unilateral arm drift to stretcher <10 seconds, (2) severe language deficit (if right arm is weak) or gaze deviation/hemineglect assessed by simple shoulder tap test (if left arm is weak), and (3) eligibility and stroke mimic screen...
March 14, 2018: Stroke; a Journal of Cerebral Circulation
Stephen van Gaal, Andrew Demchuk
No abstract text is available yet for this article.
March 14, 2018: Stroke; a Journal of Cerebral Circulation
Erin R Kulick, Gregory A Wellenius, Amelia K Boehme, Ralph L Sacco, Mitchell S Elkind
BACKGROUND AND PURPOSE: The evidence supporting the deleterious cardiovascular health effects of living near a major roadway is growing, although this association is not universal. In primary analyses, we hypothesized that residential proximity to a major roadway would be associated with incident ischemic stroke and that cardiovascular risk factors would modify that association. METHODS: NOMAS (The Northern Manhattan Study) is an ongoing, population-based cohort study designed to measure cardiovascular risk factors, stroke incidence, and other outcomes in a multiethnic urban population...
March 14, 2018: Stroke; a Journal of Cerebral Circulation
Michelle Livne, Jens K Boldsen, Irene K Mikkelsen, Jochen B Fiebach, Jan Sobesky, Kim Mouridsen
BACKGROUND AND PURPOSE: Stroke imaging is pivotal for diagnosis and stratification of patients with acute ischemic stroke to treatment. The potential of combining multimodal information into reliable estimates of outcome learning calls for robust machine learning techniques with high flexibility and accuracy. We applied the novel extreme gradient boosting algorithm for multimodal magnetic resonance imaging-based infarct prediction. METHODS: In a retrospective analysis of 195 patients with acute ischemic stroke, fluid-attenuated inversion recovery, diffusion-weighted imaging, and 10 perfusion parameters were derived from acute magnetic resonance imaging scans...
March 14, 2018: Stroke; a Journal of Cerebral Circulation
Arthur Stacey, Claire Toolis, Vijeya Ganesan
BACKGROUND AND PURPOSE: Recurrent ischemic events are common in children with arterial ischemic stroke (AIS) and put patients at risk for further neurological impairment. This study sought to identify rates and risk factors for recurrent AIS or transient ischemic attack in a cohort of children seen after index AIS and uniformly investigated and managed using contemporary clinical guidelines. METHODS: Case note and radiology review of children >28 days and <18 years of age who presented to Great Ormond Street Hospital from 2005 to 2015 with index AIS...
March 14, 2018: Stroke; a Journal of Cerebral Circulation
Fang Wu, Haiqing Song, Qingfeng Ma, Jiayu Xiao, Tao Jiang, Xiaoqin Huang, Xiaoming Bi, Xiuhai Guo, Debiao Li, Qi Yang, Xunming Ji, Zhaoyang Fan
BACKGROUND AND PURPOSE: The aim of the present study was to investigate atherosclerotic plaque characteristics in patients with artery-to-artery (A-to-A) embolic infarction by whole-brain high-resolution magnetic resonance imaging. METHODS: Seventy-four patients (mean age, 54.7±12.1 years; 59 men) with recent stroke in the territory of middle cerebral artery because of intracranial atherosclerotic disease were prospectively enrolled. Whole-brain high-resolution magnetic resonance imaging was performed in all the patients both precontrast and postcontrast administration by using a 3-dimensional T1-weighted vessel wall magnetic resonance imaging technique known as inversion-recovery prepared sampling perfection with application-optimized contrast using different flip angle evolutions...
March 14, 2018: Stroke; a Journal of Cerebral Circulation
Gabriel DeVela, J Michael Taylor, Bin Zhang, Luke L Linscott, Alan M Chen, Kunal B Karani, Andrew Furthmiller, James L Leach, Sudhakar Vadivelu, Todd Abruzzo
BACKGROUND AND PURPOSE: Quantitative arterial tortuosity (QAT) is a ratio of vessel length between 2 points to the shortest linear distance between same points. QAT has been reported as an imaging biomarker of arteriopathy in pediatric arterial ischemic stroke (AIS) because of dissection and transient cerebral arteriopathy. We sought to determine whether QAT abnormalities are present in other subtypes of pediatric AIS. METHODS: Children with AIS-absent conventional biomarkers of arteriopathy and case-controls who underwent magnetic resonance angiography were classified by stroke mechanism...
March 14, 2018: Stroke; a Journal of Cerebral Circulation
George Hindy, Gunnar Engström, Susanna C Larsson, Matthew Traylor, Hugh S Markus, Olle Melander, Marju Orho-Melander
BACKGROUND AND PURPOSE: Statin therapy is associated with a lower risk of ischemic stroke supporting a causal role of low-density lipoprotein (LDL) cholesterol. However, more evidence is needed to answer the question whether LDL cholesterol plays a causal role in ischemic stroke subtypes. In addition, it is unknown whether high-density lipoprotein cholesterol and triglycerides have a causal relationship to ischemic stroke and its subtypes. Our aim was to investigate the causal role of LDL cholesterol, high-density lipoprotein cholesterol, and triglycerides in ischemic stroke and its subtypes through Mendelian randomization (MR)...
March 13, 2018: Stroke; a Journal of Cerebral Circulation
Christopher J Stapleton, Fred G Barker
No abstract text is available yet for this article.
March 13, 2018: Stroke; a Journal of Cerebral Circulation
Raffaele Ornello, Diana Degan, Cindy Tiseo, Caterina Di Carmine, Laura Perciballi, Francesca Pistoia, Antonio Carolei, Simona Sacco
BACKGROUND AND PURPOSE: Preventive strategies, together with demographic and socioeconomic changes, might have modified the worldwide distribution of ischemic stroke (IS) subtypes. We investigated those changes by means of a systematic review and meta-analysis. METHODS: We evaluated all population- and hospital-based studies reporting the distribution of IS etiologic subtypes according to the TOAST criteria (Trial of ORG 10172 in Acute Stroke Treatment). Studies were identified by searching articles indexed on PubMed and Scopus from January 1, 1993, to June 30, 2017...
March 13, 2018: Stroke; a Journal of Cerebral Circulation
Simone A Dijkland, Daphne C Voormolen, Esmee Venema, Bob Roozenbeek, Suzanne Polinder, Juanita A Haagsma, Daan Nieboer, Vicky Chalos, Albert J Yoo, Jennifer Schreuders, Aad van der Lugt, Charles B L M Majoie, Yvo B W E M Roos, Wim H van Zwam, Robert J van Oostenbrugge, Ewout W Steyerberg, Diederik W J Dippel, Hester F Lingsma
BACKGROUND AND PURPOSE: The utility-weighted modified Rankin Scale (UW-mRS) has been proposed as a new patient-centered primary outcome in stroke trials. We aimed to describe utility weights for the mRS health states and to evaluate the statistical efficiency of the UW-mRS to detect treatment effects in stroke intervention trials. METHODS: We used data of the 500 patients enrolled in the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands)...
March 13, 2018: Stroke; a Journal of Cerebral Circulation
Han-Gil Jeong, Beom Joon Kim, Jay Chol Choi, Keun-Sik Hong, Mi Hwa Yang, Cheolkyu Jung, Moon-Ku Han, Hee-Joon Bae
BACKGROUND AND PURPOSE: The majority of ischemic stroke patients receiving endovascular recanalization therapy (EVT) experience variable changes of neurological severities during the hyperacute period. We hypothesized that the National Institutes of Health Stroke Scale (NIHSS) score after EVT is a better prognostic factor compared with the initial NIHSS score or revascularization status. METHODS: We identified 566 stroke patients who received EVT at Seoul National University Bundang Hospital between April 2008 and December 2015...
March 13, 2018: Stroke; a Journal of Cerebral Circulation
Virginia Prendergast, Janice L Hinkle
No abstract text is available yet for this article.
March 13, 2018: Stroke; a Journal of Cerebral Circulation
Hooman Kamel, Traci M Bartz, Mitchell S V Elkind, Peter M Okin, Evan L Thacker, Kristen K Patton, Phyllis K Stein, Christopher R deFilippi, Rebecca F Gottesman, Susan R Heckbert, Richard A Kronmal, Elsayed Z Soliman, W T Longstreth
BACKGROUND AND PURPOSE: Emerging evidence suggests that an underlying atrial cardiopathy may result in thromboembolism before atrial fibrillation (AF) develops. We examined the association between various markers of atrial cardiopathy and the risk of ischemic stroke. METHODS: The CHS (Cardiovascular Health Study) prospectively enrolled community-dwelling adults ≥65 years of age. For this study, we excluded participants diagnosed with stroke or AF before baseline...
March 13, 2018: Stroke; a Journal of Cerebral Circulation
Nicole Varble, Vincent M Tutino, Jihnhee Yu, Ashish Sonig, Adnan H Siddiqui, Jason M Davies, Hui Meng
BACKGROUND AND PURPOSE: Many ruptured intracranial aneurysms (IAs) are small. Clinical presentations suggest that small and large IAs could have different phenotypes. It is unknown if small and large IAs have different characteristics that discriminate rupture. METHODS: We analyzed morphological, hemodynamic, and clinical parameters of 413 retrospectively collected IAs (training cohort; 102 ruptured IAs). Hierarchal cluster analysis was performed to determine a size cutoff to dichotomize the IA population into small and large IAs...
March 13, 2018: Stroke; a Journal of Cerebral Circulation
Bian Liu, Kui Kai Lau, Linxin Li, Caroline Lovelock, Ming Liu, Wilhelm Kuker, Peter M Rothwell
BACKGROUND AND PURPOSE: It has been hypothesized that cerebral small vessel disease (SVD) and chronic renal impairment may be part of a multisystem small-vessel disorder, but their association may simply be as a result of shared risk factors (eg, hypertension) rather than to a systemic susceptibility to premature SVD. However, most previous studies were hospital based, most had inadequate adjustment for hypertension, many were confined to patients with lacunar stroke, and none stratified by age...
March 9, 2018: Stroke; a Journal of Cerebral Circulation
Kerstin Spielmann, W Mieke E van de Sandt-Koenderman, Majanka H Heijenbrok-Kal, Gerard M Ribbers
BACKGROUND AND PURPOSE: The aim of the present study is to investigate the effect of transcranial direct current stimulation on word-finding treatment outcome in subacute poststroke aphasia. METHODS: In this multi-center, double-blind, randomized controlled trial with 6-month follow-up, we included 58 patients with subacute aphasia (<3 months poststroke), who were enrolled in a stroke rehabilitation program. Patients participated in 2 separate intervention weeks...
March 9, 2018: Stroke; a Journal of Cerebral Circulation
Paul Reidler, Kolja M Thierfelder, Matthias P Fabritius, Wieland H Sommer, Felix G Meinel, Franziska Dorn, Frank A Wollenweber, Marco Duering, Wolfgang G Kunz
BACKGROUND AND PURPOSE: Ipsilateral thalamic diaschisis (ITD) describes the reduction of thalamic function, metabolism, and perfusion resulting from a distant lesion of the ipsilateral hemisphere. Our aim was to evaluate the perfusion characteristics and clinical impact of ITD in acute middle cerebral artery stroke, which does not directly affect the thalamus. METHODS: One hundred twenty-four patients with middle cerebral artery infarction were selected from a prospectively acquired cohort of 1644 patients who underwent multiparametric computed tomography (CT), including CT perfusion for suspected stroke...
March 9, 2018: Stroke; a Journal of Cerebral Circulation
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