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Stroke TIA scale

Mark I Boulos, Sara Elias, Anthony Wan, James Im, Fadi Frankul, Mina Atalla, Sandra E Black, Vincenzo S Basile, Arun Sundaram, Julia J Hopyan, Karl Boyle, David J Gladstone, Richard H Swartz, Brian J Murray
BACKGROUND: Home sleep apnea testing (HSAT) is an alternative to polysomnography for the detection of obstructive sleep apnea (OSA). We assessed the feasibility of HSAT as an unattended screening tool for patients with a stroke or transient ischemic attack (TIA). AIMS: The primary outcome was the feasibility of unattended HSAT, as defined by analyzability of the data. Secondary outcomes included determining (1) predictors of obtaining nonanalyzable sleep data and (2) time to OSA detection and continuous positive airway pressure (CPAP) initiation...
October 4, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Lixia Zong, Ming Yao, Jun Ni, Lixin Zhou, Jing Yuan, Bin Peng, Yi-Cheng Zhu, Liying Cui
BACKGROUND: Previous studies suggested the potential interactions between cerebrovascular diseases and impaired renal function. However, the relationship between renal function and white matter hyperintensity (WMH), marker of cerebral small vessel disease, in patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA) remains unknown. METHODS: We consecutively enrolled 1632 subjects with AIS or TIA who underwent brain MRI for this analysis. The severity of WMH in both of periventricular (PVH) and deep subcortical white matter (SDWMH) was evaluated using Fazekas scale...
October 6, 2016: BMC Neurology
O S Mattila, H Harve, S Pihlasviita, J Ritvonen, G Sibolt, M Pystynen, D Strbian, S Curtze, M Kuisma, T Tatlisumak, P J Lindsberg
OBJECTIVES: Blood-based biomarkers could enable early and cost-effective diagnostics for acute stroke patients in the prehospital setting to support early initiation of treatments. To facilitate development of ultra-acute biomarkers, we set out to implement large-scale prehospital blood sampling and determine feasibility and diagnostic timesavings of this approach. MATERIALS AND METHODS: Emergency medical services (EMS) personnel of the Helsinki metropolitan area were trained to collect prehospital blood samples from thrombolysis candidates using a cannula adapter technique...
September 18, 2016: Acta Neurologica Scandinavica
C H Nolte, H Erdur, U Grittner, A Schneider, S K Piper, J F Scheitz, I Wellwood, P M W Bath, H-C Diener, K R Lees, M Endres
BACKGROUND AND PURPOSE: Elevated heart rate (HR) is associated with worse outcomes in patients with cardiovascular disease. Its predictive value in acute stroke patients is less well established. We investigated the effects of HR on admission in acute ischaemic stroke patients. METHODS: Using the Virtual International Stroke Trials Archive (VISTA) database, the association between HR in acute stroke patients without atrial fibrillation and the pre-defined composite end-point of (recurrent) ischaemic stroke, transient ischaemic attack (TIA), myocardial infarction (MI) and vascular death within 90 days was analysed...
August 12, 2016: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Charlotte Zerna, Jayesh Modi, Lisa Bilston, Ashkan Shoamanesh, Shelagh B Coutts, Eric E Smith
BACKGROUND AND PURPOSE: Transient focal neurological episodes occur in cerebral amyloid angiopathy (CAA) and can mimic transient ischemic attack (TIA). Risk factors and outcomes of minor ischemic stroke or TIA might differ in patients with and without cerebral microbleeds (CMBs), including CAA-consistent lobar CMB. METHODS: Baseline magnetic resonance imaging (MRI) was analyzed for CMBs and cortical superficial siderosis in 416 patients in the prospective computed tomography and MRI in the CATCH study (Triage of TIA and Minor Cerebrovascular Events to Identify High Risk Patients)...
September 2016: Stroke; a Journal of Cerebral Circulation
Jian-Hua Cheng, Qiang Ye, Zu-Sen Ye, Ze-Qun Li, An-Ding Xu
This retrospective study included 101 adult moyamoya disease (MMD) patients of whom 58 were females and 43 were males in Wenzhou, China. Clinical and diagnostic features, surgical treatment, follow-up information and outcomes constitute this review. The modified Rankin Scale (mRS) was used to determine the neurological functional outcome. The Kaplan-Meier method was used to estimate recurrent stroke and mortality risk based on drug treatment alone or in combination with revascularization. The mean age at symptom onset was 43...
October 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Michael Knoflach, Wilfried Lang, Leonhard Seyfang, Elisabeth Fertl, Stefan Oberndorfer, Gerhard Daniel, Thomas Seifert-Held, Michael Brainin, Stefan Krebs, Benjamin Matosevic, Thomas Töll, Stefan Kiechl, Johann Willeit, Julia Ferrari
OBJECTIVE: It is not clear whether risk scores for early stroke recurrence after TIA that have been mainly established in outpatient and emergency department settings are valid on the background of highly specialized stroke unit care. METHODS: ABCD2 and ABCD3-I scores have been prospectively documented in a cohort of patients admitted to Austrian stroke units within 24 hours of symptom onset with TIA or minor stroke (NIH Stroke Scale score <4). RESULTS: A total of 5,237 TIA and minor stroke patients met inclusion criteria, with 3-month follow-up data available on 2,457...
August 30, 2016: Neurology
Mathias Wolfrum, Adrian Attinger-Toller, Samera Shakir, Steffen Gloekler, Burkhardt Seifert, Aris Moschovitis, Ahmed Khattab, Francesco Maisano, Bernhard Meier, Fabian Nietlispach
OBJECTIVE: The study in patients with percutaneous left atrial appendage (LAA) occlusion investigates clinical outcomes according to the position of the Amplatzer Cardiac Plug (ACP) disc. BACKGROUND: The ACP consists of a disc and an anchoring lobe. The disc is meant to cover the ostium of the LAA, but frequently retracts partially or completely into the neck of the LAA. It is not known whether a retracted disc affects outcome. METHODS: Outcomes of 169 consecutive patients (age 73...
July 28, 2016: Catheterization and Cardiovascular Interventions
Alexandra M Lesenskyj, Christina R Maxwell, Erol Veznedaroglu, Kenneth Liebman, Zakaria Hakma, Mandy J Binning
INTRODUCTION: Immediate treatment has been shown to decrease the recurrence of cerebrovascular accidents following transient ischemic attacks (TIA), prompting the use of a specialized neurologic emergency department (Neuro ED) to triage patients. Despite these findings, there is little evidence supporting the notion that hospital admission improves post-TIA outcomes. Through the lens of a Neuro ED, this retrospective chart review of TIA patients examines whether hospital admission improves 90-day outcomes...
September 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Koji Tanaka, Toshiyuki Uehara, Kazumi Kimura, Yasushi Okada, Yasuhiro Hasegawa, Norio Tanahashi, Akifumi Suzuki, Shigeharu Takagi, Jyoji Nakagawara, Kazumasa Arii, Shinji Nagahiro, Kuniaki Ogasawara, Takehiko Nagao, Shinichiro Uchiyama, Masayasu Matsumoto, Koji Iihara, Kazunori Toyoda, Kazuo Minematsu
BACKGROUND: Symptoms of transient ischemic attack (TIA) persist on arrival and subsequently resolve in some patients admitted to hospitals early after onset. Differences in clinical characteristics between patients with acute TIA whose symptoms do and do not persist on arrival remain unclear. METHODS: We retrospectively extracted data of consecutive TIA patients with an onset-to-door time (ODT) of 24 hours or less and without a history of stroke from a multicenter TIA database...
September 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Michael E Abboud, Roger Band, Judy Jia, William Pajerowski, Guy David, Michelle Guo, C Crawford Mechem, Steven R Messé, Brendan G Carr, Michael T Mullen
OBJECTIVE: Hospital arrival via Emergency Medical Services (EMS) and EMS prenotification are associated with faster evaluation and treatment of stroke. We sought to determine the impact of diagnostic accuracy by prehospital providers on emergency department quality measures. METHODS: A retrospective study was performed of patients presenting via EMS between September 2009 and December 2012 with a discharge diagnosis of transient ischemic attack (TIA), ischemic stroke (IS), or intracerebral hemorrhage (ICH)...
May 31, 2016: Prehospital Emergency Care
Peter M Rothwell, Ale Algra, Zhengming Chen, Hans-Christoph Diener, Bo Norrving, Ziyah Mehta
BACKGROUND: Aspirin is recommended for secondary prevention after transient ischaemic attack (TIA) or ischaemic stroke on the basis of trials showing a 13% reduction in long-term risk of recurrent stroke. However, the risk of major stroke is very high for only the first few days after TIA and minor ischaemic stroke, and observational studies show substantially greater benefits of early medical treatment in the acute phase than do longer-term trials. We hypothesised that the short-term benefits of early aspirin have been underestimated...
July 23, 2016: Lancet
Lumeng Yang, Wenjie Cao, Fei Wu, Yifeng Ling, Xin Cheng, Qiang Dong
BACKGROUND AND PURPOSE: We aimed to determine the predictive factors for super-acute perforating artery infarctions (PAI) involving lenticulostriate arteries infarctions (LSAI), anterior pontine arteries infarctions (APAI) and thalamic arteries infarctions (TAI). Whether intravenous thrombolysis (iv-tPA) therapy would influence the clinical outcome was also studied. METHODS: We analyzed 84 consecutive patients within 12h of stroke symptom onset from January 2008 to June 2015...
June 15, 2016: Journal of the Neurological Sciences
Mark T Mackay, Leonid Churilov, Geoffrey A Donnan, Franz E Babl, Paul Monagle
OBJECTIVE: To assess the utility of the Cincinnati Prehospital Stroke Scale (CPSS) and Recognition of Stroke in the Emergency Room (ROSIER) tools in children presenting to the emergency department (ED) with brain attack symptoms. METHODS: The ROSIER and CPSS tools were retrospectively applied to 101 children with stroke, presenting from 2003 to 2010, and prospectively to 279 children with mimics, presenting from 2009 to 2010. Positive CPSS was defined as ≥1 positive sign (face/asymmetrical arm weakness, speech disturbance)...
June 7, 2016: Neurology
A Carnes-Vendrell, J Deus-Yela, J Molina-Seguin, J Pifarre-Paredero, F Purroy
INTRODUCTION: Stroke is a leading cause of disability in adults. The development of depressive symptoms is the most common emotional complication. To date, most studies of post-stroke depression have excluded patients who have suffered a minor stroke or transient ischaemic attack (TIA), although they are equally vulnerable subgroups of this sickness. AIM: We present a review of published studies of post-stroke depression to elucidate aspects that have already been widely demonstrated and those who need more evidence...
May 16, 2016: Revista de Neurologia
Joanna Wieczorek, Katarzyna Mizia-Stec, Anetta Lasek-Bal, Piotr Wieczorek, Andrzej Hoffmann, Seweryn Nowak, Jarosław Kolasa, Maciej Faryan, Iwona Woźniak-Skowerska, Anna Wnuk-Wojnar
BACKGROUND: The aim was to assess the occurrence, severity and risk factors for silent white matter hyperintensities (WMH) in brain magnetic resonance imaging (MRI) in patients with atrial fibrillation (AF) and to determine the potential relationship between WHM and cognitive decline. METHODS: Seventy-four patients with paroxysmal non-valvular AF were enrolled (age 59 (IQR 50-63)years, males 45/61%). All patients were on adequate warfarin treatment before inclusion and had no history of stroke or TIA...
July 15, 2016: International Journal of Cardiology
Digvijaya D Navalkele, Kristian Barlinn, Alireza Minagar, Oleg Y Chernyshev
BACKGROUND: Frequency of sleep-disordered breathing (SDB) among stroke and transient ischemic attack (TIA) patients ranges from 30-80% and is associated with poor neurological outcomes. Per current stroke prevention guidelines from American Heart Association/American Stroke Association (AHA/ASA), SDB is included in the list of modifiable risk factors for stroke and TIA prevention. Goal of our study is to determine screening practices for SDB in stroke medical community. METHODS: A web-based survey was sent to physicians taking care of stroke patients across North America and Europe...
June 2016: Pathophysiology: the Official Journal of the International Society for Pathophysiology
Zaitao Yu, Xiang'en Shi, Hai Qian, Fangjun Liu, Zhongqing Zhou, Yuming Sun, Yang Yang
OBJECTIVE: To evaluate the effectiveness of internal maxillary artery (IMA) - radial artery graft (RAG) - middle cerebral artery (MCA) bypass surgery for chronic arterial-sclerotic severe stenosis or occlusion of the internal carotid artery (ICA) or MCA. METHODS: A retrospective study was conducted in 31 patients with ischemic cerebrovascular disease who underwent bypass surgery of the IMA with a RAG of the MCA. Twenty-seven patients had complete occlusion of the ICA or MCA, and four patients had severe stenosis of the M1 segment of the MCA...
May 2016: Neurological Research
Naoto Kohno, Kazunori Okada, Shingo Yamagata, Hiroyuki Takayoshi, Shuhei Yamaguchi
BACKGROUND: Ischemic penumbra in acute ischemic stroke (AIS) can be evaluated using arterial spin-labeled (ASL) perfusion magnetic resonance imaging (MRI). We used three-dimensional ASL-MRI to examine patients with different stroke subtypes and the clinical utility of the method within 24 hours of AIS onset. SUBJECTS AND METHODS: The 55 male and 48 female patients (mean age, 79.0 years) underwent diffusion-weighted imaging (DWI), fluid-attenuated inversion recovery imaging, magnetic resonance angiography, and pulsed continuous ASL perfusion imaging to determine stroke subtype, hypoperfused ASL area, and neurological deficit severity (National Institutes of Health Stroke Scale)...
July 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Richard H Swartz, Mark Bayley, Krista L Lanctôt, Brian J Murray, Megan L Cayley, Karen Lien, Michelle N Sicard, Kevin E Thorpe, Dar Dowlatshahi, Jennifer L Mandzia, Leanne K Casaubon, Gustavo Saposnik, Yael Perez, Demetrios J Sahlas, Nathan Herrmann
Stroke can cause neurological impairment ranging from mild to severe, but the impact of stroke extends beyond the initial brain injury to include a complex interplay of devastating comorbidities including: post-stroke depression, obstructive sleep apnea, and cognitive impairment ("DOC"). We reviewed the frequency, impact, and treatment options for each DOC condition. We then used the Ottawa Model of Research Use to examine gaps in care, understand the barriers to knowledge translation, identification, and addressing these important post-stroke comorbidities...
July 2016: International Journal of Stroke: Official Journal of the International Stroke Society
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