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Stroke TIA scale

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https://www.readbyqxmd.com/read/29459397/predictors-of-thrombolysis-administration-in-mild-stroke-florida-puerto-rico-collaboration-to-reduce-stroke-disparities
#1
Negar Asdaghi, Kefeng Wang, Maria A Ciliberti-Vargas, Carolina Marinovic Gutierrez, Sebastian Koch, Hannah Gardener, Chuanhui Dong, David Z Rose, Enid J Garcia, W Scott Burgin, Juan Carlos Zevallos, Tatjana Rundek, Ralph L Sacco, Jose G Romano
BACKGROUND AND PURPOSE: Mild stroke is the most common cause for thrombolysis exclusion in patients acutely presenting to the hospital. Thrombolysis administration in this subgroup is highly variable among different clinicians and institutions. We aim to study the predictors of thrombolysis in patients with mild ischemic stroke in the FL-PR CReSD registry (Florida-Puerto Rico Collaboration to Reduce Stroke Disparities). METHODS: Among 73 712 prospectively enrolled patients with a final diagnosis of ischemic stroke or TIA from January 2010 to April 2015, we identified 7746 cases with persistent neurological symptoms and National Institutes of Health Stroke Scale ≤5 who arrived within 4 hours of symptom onset...
February 19, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29438515/diabetes-and-long-term-outcomes-of-ischaemic-stroke-findings-from-get-with-the-guidelines-stroke
#2
Justin B Echouffo-Tcheugui, Haolin Xu, Roland A Matsouaka, Ying Xian, Lee H Schwamm, Eric E Smith, Deepak L Bhatt, Adrian F Hernandez, Paul A Heidenreich, Gregg C Fonarow
Aims: There is a paucity of data on the influence of diabetes on long-term outcomes after ischaemic stroke (IS). We assessed whether outcomes after IS differ between patients with and without diabetes. Methods and results: Patients aged ≥65 years (n = 409 060) in Get With The Guidelines-Stroke (nationwide registry of stroke patients from 1690 sites in the USA) were followed for 3 years post-discharge. The outcomes of interest were mortality, cardiovascular and non-cardiovascular hospitalizations, heart failure (HF), and recurrence of IS/transient ischaemic attack (TIA)...
February 9, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29428326/a-modified-definition-for-obstructive-sleep-apnea-in-home-sleep-apnea-testing-after-stroke-or-transient-ischemic-attack
#3
Namita Patel, Afsaneh Raissi, Sara Elias, Maneesha Kamra, Tetyana Kendzerska, Brian J Murray, Mark I Boulos
BACKGROUND: Home sleep apnea testing (HSAT) underestimates obstructive sleep apnea (OSA) severity. Overnight oxygen desaturation has been shown to be a strong predictor of incident stroke, and may be helpful in determining which patients with lower apnea-hypopnea indices (AHIs) should be offered treatment. OBJECTIVES: To examine whether a modified definition for OSA that uses oxygen desaturation (i.e., AHI 5-14.9 per hour and lowest O2 desaturation ≤88%), as compared to an AHI ≥ 15 per hour, would impact: (1) changes in Epworth Sleepiness Scale scores post-continuous positive airway pressure (CPAP) initiation; (2) CPAP compliance rates; and (3) the accuracy of automated versus manual scoring of HSAT...
February 7, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29385837/verification-of-a-proteomic-biomarker-panel-to-diagnose-minor-stroke-and-transient-ischaemic-attack-phase-1-of-spectra-a-large-scale-translational-study
#4
Andrew M Penn, Maximilian B Bibok, Viera K Saly, Shelagh B Coutts, Mary L Lesperance, Robert F Balshaw, Kristine Votova, Nicole S Croteau, Anurag Trivedi, Angela M Jackson, Janka Hegedus, Evgenia Klourfeld, Amy Y X Yu, Charlotte Zerna, Christoph H Borchers
OBJECTIVE: To derive a plasma biomarker protein panel from a list of 141 candidate proteins which can differentiate transient ischaemic attack (TIA)/minor stroke from non-cerebrovascular ('mimic') conditions in emergency department (ED) settings. DESIGN: Prospective clinical study (#NCT03050099) with up to three timed blood draws no more than 36 hours following symptom onset. Plasma samples analysed by multiple reaction monitoring-mass spectrometry (MRM-MS). PARTICIPANTS: 545 participants suspected of TIA enrolled in the EDs of two urban medical centres...
February 1, 2018: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/29363651/rationale-and-study-design-for-a-single-arm-phase-iia-study-investigating-feasibility-of-preventing-ischemic-cerebrovascular-events-in-high-risk-patients-with-acute-non-disabling-ischemic-cerebrovascular-events-using-remote-ischemic-conditioning
#5
Shi-Meng Liu, Wen-Le Zhao, Hai-Qing Song, Ran Meng, Si-Jie Li, Chang-Hong Ren, Bruce Ovbiagele, Xun-Ming Ji, Wu-Wei Feng
BACKGROUND: Acute minor ischemic stroke (AMIS) or transient ischemic attack (TIA) is a common cerebrovascular event with a considerable high recurrence. Prior research demonstrated the effectiveness of regular long-term remote ischemic conditioning (RIC) in secondary stroke prevention in patients with intracranial stenosis. We hypothesized that RIC can serve as an effective adjunctive therapy to pharmacotherapy in preventing ischemic events in patients with AMIS/TIA. This study aimed to investigate the feasibility, safety, and preliminary efficacy of daily RIC in inhibiting cerebrovascular/cardiovascular events after AMIS/TIA...
February 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29336708/emergency-dispatcher-stroke-recognition-associations-with-downstream-care
#6
J Adam Oostema, Todd Chassee, Mathew Reeves
OBJECTIVE: As the first point of contact for patients activating emergency medical services (EMS), emergency dispatchers have the earliest opportunity to recognize stroke. We sought to quantify dispatcher stroke recognition and its relationships with EMS stroke recognition and response speed. METHODS: We assembled a cohort of consecutive EMS-transported patients with a dispatcher suspected stroke or a hospital discharge diagnosis of stroke or transient ischemic attack (TIA)...
January 16, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29330312/high-sensitive-c-reactive-protein-and-dual-antiplatelet-in-intracranial-arterial-stenosis
#7
Jiejie Li, Anxin Wang, Xingquan Zhao, Liping Liu, Xia Meng, Jinxi Lin, Jing Jing, Xinying Zou, Yilong Wang, Yongjun Wang
OBJECTIVE: To determine the relationship of high-sensitive C-reactive protein (hsCRP) and the efficacy and safety of dual antiplatelet therapy in patients with and without intracranial arterial stenosis (ICAS) in the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial. METHODS: A subgroup of 807 patients with both magnetic resonance angiography images and hsCRP measurement was analyzed. Cox proportional hazards models were used to assess the interaction of hsCRP levels with the effects of dual and single antiplatelet therapy...
February 6, 2018: Neurology
https://www.readbyqxmd.com/read/29306602/alpha-2-antiplasmin-arg407lys-polymorphism-and-cryptogenic-ischemic-cerebrovascular-events-association-with-neurological-deficit
#8
Joanna Wzorek, Marek Karpiński, Ewa Wypasek, Michał Michalski, Andrzej Szczudlik, Krzysztof Piotr Malinowski, Anetta Undas
OBJECTIVE: Genetic background of cryptogenic ischemic stroke (IS) and transient ischemic attack (TIA) remains uncertain. Alpha-2-antiplasmin (α2AP) Arg407Lys polymorphism has been shown to be less common in patients with abdominal aortic aneurysm (AAA) compared with healthy controls. We investigated associations of α2AP Arg407Lys polymorphism with cryptogenic IS and TIA. METHODS: We studied 165 consecutive Caucasian patients who experienced cryptogenic IS (n=123) or TIA (n=42)...
December 26, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/29306185/pre-stroke-employment-results-in-better-patient-reported-outcomes-after-minor-stroke-short-title-functional-outcomes-after-minor-stroke
#9
Elisabeth B Marsh, Erin Lawrence, Argye E Hillis, Karen Chen, Rebecca F Gottesman, Rafael H Llinas
OBJECTIVE: Individuals with "minor stroke" lack a dense hemiparesis or aphasia; however, commonly endorse persistent cognitive and motor problems despite low NIHSS scores. They also report problems with mood, energy, and the ability to think clearly that are less well characterized. Socioeconomic factors and stroke severity can influence patient-reported outcomes. In this study we explore patient-reported outcomes and the influence of these factors after minor stroke. PATIENTS AND METHODS: Patients returning to clinic post-stroke with an NIHSS of ≤ 4 were administered a scale to quantify problems with daily activities and resulting functional burden, along with measures of fatigue and depression...
December 27, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29279801/technical-factors-affecting-outcomes-following-endovascular-treatment-of-posterior-circulation-atherosclerotic-lesions
#10
Matthew D Alexander, Jeffrey M Rebhun, Steven W Hetts, Matthew R Amans, Fabio Settecase, Robert J Darflinger, Christopher F Dowd, Van V Halbach, Randall T Higashida, Daniel L Cooke
Background: Atherosclerotic disease of the vertebrobasilar system causes significant morbidity and mortality. All lesions require aggressive medical management, but the role of endovascular interventions remains unsettled. This study examines such endovascular interventions for vertebrobasilar atherosclerosis. Methods: Retrospective review was performed of prospectively maintained procedure logs at three hospitals with comprehensive neurointerventional services...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29274727/antiplatelet-therapy-with-aspirin-clopidogrel-and-dipyridamole-versus-clopidogrel-alone-or-aspirin-and-dipyridamole-in-patients-with-acute-cerebral-ischaemia-tardis-a-randomised-open-label-phase-3-superiority-trial
#11
Philip M Bath, Lisa J Woodhouse, Jason P Appleton, Maia Beridze, Hanne Christensen, Robert A Dineen, Lelia Duley, Timothy J England, Katie Flaherty, Diane Havard, Stan Heptinstall, Marilyn James, Kailash Krishnan, Hugh S Markus, Alan A Montgomery, Stuart J Pocock, Marc Randall, Annemarei Ranta, Thompson G Robinson, Polly Scutt, Graham S Venables, Nikola Sprigg
BACKGROUND: Intensive antiplatelet therapy with three agents might be more effective than guideline treatment for preventing recurrent events in patients with acute cerebral ischaemia. We aimed to compare the safety and efficacy of intensive antiplatelet therapy (combined aspirin, clopidogrel, and dipyridamole) with that of guideline-based antiplatelet therapy. METHODS: We did an international, prospective, randomised, open-label, blinded-endpoint trial in adult participants with ischaemic stroke or transient ischaemic attack (TIA) within 48 h of onset...
December 20, 2017: Lancet
https://www.readbyqxmd.com/read/29244081/atrial-fibrillation-type-matters-greater-infarct-volume-and-worse-neurological-defects-seen-in-acute-cardiogenic-cerebral-embolism-due-to-persistent-or-permanent-rather-than-paroxysmal-atrial-fibrillation
#12
Osamu Inaba, Yasuteru Yamauchi, Masahiro Sekigawa, Naoyuki Miwa, Junji Yamaguchi, Yasutoshi Nagata, Toru Obayashi, Takamichi Miyamoto, Tomoyuki Kamata, Mitsuaki Isobe, Masahiko Goya, Kenzo Hirao
Aims: Some studies have shown that the type of atrial fibrillation (AF), whether paroxysmal AF (PAF) or persistent or permanent AF (PeAF), affects the incidence of ischaemic stroke. This study sought to determine the relationship between the AF pattern and the severity and brain volume of infarction in an AF population including transient ischaemic attack (TIA) patients. Methods and results: This was a retrospective observational study. We studied 161 consecutive patients who were admitted to our stroke care unit with cardiogenic embolism or TIA related to non-valvular AF (age 79 ± 9...
December 12, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29212745/factors-associated-with-focal-computed-tomographic-perfusion-abnormalities-in-supratentorial-transient-ischemic-attacks
#13
Ivo A Meyer, Carlo W Cereda, Pamela N Correia, Jean-Baptiste Zerlauth, Francesco Puccinelli, David C Rotzinger, Michael Amiguet, Philippe Maeder, Reto A Meuli, Patrik Michel
BACKGROUND AND PURPOSE: Computed tomographic perfusion (CTP) is useful in diagnosis of patients with transient focal neurological symptoms. In acute imaging of patients with a suspected transient ischemic attack (TIA), it remains unclear which patients develop focal perfusion abnormalities (FPA), that is, hypoperfusion or hyperperfusion. We aimed at determining independent factors associated with FPA in patients with supratentorial TIAs. METHODS: We prospectively collected consecutive patients with supratentorial TIAs defined by the traditional time-based definition who underwent CTP within 24 hours of symptom onset...
December 6, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29103861/public-and-private-hospital-care-disparities-of-ischemic-stroke-in-mexico-results-from-the-primer-registro-mexicano-de-isquemia-cerebral-premier-study
#14
José Luis Ruiz-Sandoval, María Eugenia Briseño-Godínez, Erwin Chiquete-Anaya, Antonio Arauz-Góngora, Rogelio Troyo-Sanromán, Juan Didier Parada-Garza, Alma Ramos-Moreno, Fernando Barinagarrementería, Luis Manuel Murillo-Bonilla, Carlos Cantú-Brito
BACKGROUND AND AIMS: Mortality and bad outcome by stroke are higher in developing countries than in industrialized countries. Health-care system efficiency could explain these disparities. Our objective was to identify the impact on short- and middle-term outcomes of patients with acute ischemic stroke (AIS) among public and private Mexican medical care. METHODS: We analyzed data from patients with AIS included in the Primer Registro Mexicano de Isquemia Cerebral (PREMIER) study...
November 2, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29056996/sex-related-differences-in-clinical-outcomes-and-quality-of-life-after-transcatheter-aortic-valve-implantation-for-severe-aortic-stenosis
#15
Maciej Bagienski, Tomasz Tokarek, Agata Wiktorowicz, Artur Dziewierz, Lukasz Rzeszutko, Danuta Sorysz, Pawel Kleczynski, Dariusz Dudek
INTRODUCTION: There are inconsistent data on the sex-related differences in clinical outcomes and quality of life (QoL) after transcatheter aortic valve implantation (TAVI). AIM: We sought to investigate sex-related differences in procedural, clinical and QoL outcomes of TAVI. MATERIAL AND METHODS: A total of 101 consecutive patients undergoing TAVI were enrolled. Patients were stratified by gender. Baseline characteristics, procedural and long-term clinical outcomes as well as frailty and QoL indices (EQ-5D-3L questionnaire) were compared between women and men...
2017: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/29021355/population-based-study-of-home-time-by-stroke-type-and-correlation-with-modified-rankin-score
#16
MULTICENTER STUDY
Amy Y X Yu, Edwin Rogers, Meng Wang, Tolulope T Sajobi, Shelagh B Coutts, Bijoy K Menon, Michael D Hill, Eric E Smith
OBJECTIVE: To describe home-time, stratified by stroke type, in a complete population and to determine its correlation with modified Rankin Scale (mRS) scores. METHODS: We used linked administrative data to derive home-time in all patients admitted for a cerebrovascular event in Alberta, Canada, between 2012 and 2016. Home-time is the number of days spent outside a health institution in the first 90 days after index hospitalization. We used negative binomial regression, adjusted for age, sex, Charlson comorbidity index, and hospital location, to determine the association between home-time and stroke type...
November 7, 2017: Neurology
https://www.readbyqxmd.com/read/29018133/carotid-web-intimal-fibromuscular-dysplasia-has-high-stroke-recurrence-risk-and-is-amenable-to-stenting
#17
Diogo C Haussen, Jonathan A Grossberg, Mehdi Bouslama, Gustavo Pradilla, Samir Belagaje, Nicolas Bianchi, Jason W Allen, Michael Frankel, Raul G Nogueira
BACKGROUND AND PURPOSE: Carotid webs have been increasingly recognized as a cause of recurrent stroke, but evidence remains scarce. We aim to report the clinical outcomes and first series of carotid stenting in a cohort of patients with strokes from symptomatic carotid webs. METHODS: Prospective and consecutive data of patients <65 years old with cryptogenic stroke admitted within September 2014 to May 2017. Carotid web was defined by a shelf-like/linear filling defect in the posterior internal carotid artery bulb by computed tomographic angiography...
November 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28965666/differences-in-carotid-artery-atherosclerosis-between-men-and-women-in-the-early-phase-after-ischemic-event
#18
Marta Skowronska, Anna Piorkowska, Anna Czlonkowska
OBJECTIVES: There is little data about sex differences in carotid atherosclerosis in the early phase after an ischemic event. The aim of this study was to examine the carotid artery atherosclerosis differences between men and women in early phase after TIA or stroke. METHODS: Consecutive patients with recent ischemic event, admitted during the first week after symptom onset were examined with ultrasound. Sex differences in degree of stenosis, number of plaques and plaque morphology were compared...
September 20, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28959230/accuracy-of-emergency-medical-services-dispatcher-and-crew-diagnosis-of-stroke-in-clinical-practice
#19
Judy Jia, Roger Band, Michael E Abboud, William Pajerowski, Michelle Guo, Guy David, C Crawford Mechem, Steven R Messé, Brendan G Carr, Michael T Mullen
BACKGROUND: Accurate recognition of stroke symptoms by Emergency Medical Services (EMS) is necessary for timely care of acute stroke patients. We assessed the accuracy of stroke diagnosis by EMS in clinical practice in a major US city. METHODS AND RESULTS: Philadelphia Fire Department data were merged with data from a single comprehensive stroke center to identify patients diagnosed with stroke or TIA from 9/2009 to 10/2012. Sensitivity and positive predictive value (PPV) were calculated...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28899866/subacute-endovascular-recanalization-of-symptomatic-cerebral-artery-occlusion-a-propensity-score-matched-analysis
#20
Sang Hun Lee, Dae Chul Suh, Su Hee Cho, Jae Jon Sheen, Deok Hee Lee, Jong S Kim
BACKGROUND: The interval between the onset of cerebral vessel occlusion and recanalization has been shown to be an independent predictor of poor outcomes. However, endovascular recanalization of symptomatic cerebral vessel occlusion in the subacute period has not been well documented. We investigated the safety and efficacy of subacute recanalization of occluded cerebral vessels in patients with ischemic stroke or transient ischemic attacks (TIAs). METHODS: Between 2014 and 2015, 98 patients were admitted to the emergency room for ischemic stroke or TIA with a small infarct core, which was defined as modest early ischemic change on non-contrast CT or overt diffusion-perfusion mismatch...
September 12, 2017: Journal of Neurointerventional Surgery
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