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https://www.readbyqxmd.com/read/29791600/unilateral-spatial-neglect-in-the-acute-phase-of-ischemic-stroke-can-predict-long-term-disability-and-functional-capacity
#1
Gustavo José Luvizutto, Augusta Fabiana Moliga, Gabriela Rizzo Soares Rizzatti, Marcelo Ortolani Fogaroli, Eduardo de Moura Neto, Hélio Rubens de Carvalho Nunes, Luiz Antônio de Lima Resende, Rodrigo Bazan
OBJECTIVE: The aim of this study was to assess the relationship between the degree of unilateral spatial neglect during the acute phase of stroke and long-term functional independence. METHODS: This was a prospective study of right ischemic stroke patients in which the independent variable was the degree of spatial neglect and the outcome that was measured was functional independence. The potential confounding factors included sex, age, stroke severity, topography of the lesion, risk factors, glycemia and the treatment received...
May 21, 2018: Clinics
https://www.readbyqxmd.com/read/29789395/blood-pressure-attained-analysis-of-atach-2-trial
#2
Adnan I Qureshi, Yuko Y Palesch, Lydia D Foster, William G Barsan, Joshua N Goldstein, Daniel F Hanley, Chung Y Hsu, Claudia S Moy, Mushtaq H Qureshi, Robert Silbergleit, Jose I Suarez, Kazunori Toyoda, Haruko Yamamoto
BACKGROUND AND PURPOSE: We compared the rates of death or disability, defined by modified Rankin Scale score of 4 to 6, at 3 months in patients with intracerebral hemorrhage according to post-treatment systolic blood pressure (SBP)-attained status. METHODS: We divided 1000 subjects with SBP ≥180 mm Hg who were randomized within 4.5 hours of symptom onset as follows: SBP <140 mm Hg achieved or not achieved within 2 hours; subjects in whom SBP <140 mm Hg was achieved within 2 hours were further divided: SBP <140 mm Hg for 21 to 22 hours (reduced and maintained) or SBP was ≥140 mm Hg for at least 2 hours during the period between 2 and 24 hours (reduced but not maintained)...
May 22, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29789393/long-term-outcomes-in-patients-aged-%C3%A2-70-years-with-intravenous-glyburide-from-the-phase-ii-games-rp-study-of-large-hemispheric-infarction-an-exploratory-analysis
#3
Kevin N Sheth, Nils H Petersen, Ken Cheung, Jordan J Elm, Holly E Hinson, Bradley J Molyneaux, Lauren A Beslow, Gordon K Sze, J Marc Simard, W Taylor Kimberly
BACKGROUND AND PURPOSE: We aimed to determine whether subjects aged ≤70 years who were treated with intravenous glyburide (RP-1127; BIIB093; glibenclamide) would have better long-term outcomes than those who received placebo. METHODS: GAMES-RP (Glyburide Advantage in Malignant Edema and Stroke-Remedy Pharmaceuticals) was a prospective, double-blind, randomized, placebo-controlled phase 2 clinical trial. Eighty-six participants, aged 18 to 80 years, who presented to 18 centers with large hemispheric infarction (baseline diffusion-weighted imaging volumes, 82-300 cm3 ) randomized within 10 hours of symptom onset were enrolled...
May 22, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29788198/venous-thromboembolism-after-intraventricular-hemorrhage-results-from-the-clear-iii-trial
#4
(no author information available yet)
BACKGROUND: Venous thromboembolism (VTE) after intracerebral hemorrhage is well studied, but data on patients with spontaneous intraventricular hemorrhage (IVH) are limited. OBJECTIVE: To study the factors associated with VTE, association between VTE and clinical outcomes in IVH, and safety of VTE chemoprophylaxis in IVH treated with intraventricular catheters and thrombolysis. METHODS: Retrospective cohort study of patients enrolled in the CLEAR III trial, a multicenter, randomized trial comparing external ventricular drainage, with administration of intraventricular alteplase vs placebo, for obstructive IVH...
May 21, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29787575/safety-of-intravenous-alteplase-within-4-5-hours-for-patients-awakening-with-stroke-symptoms
#5
Victor C Urrutia, Roland Faigle, Steven R Zeiler, Elisabeth B Marsh, Mona Bahouth, Mario Cerdan Trevino, Jennifer Dearborn, Richard Leigh, Susan Rice, Karen Lane, Mustapha Saheed, Peter Hill, Rafael H Llinas
BACKGROUND: Up to 25% of acute stroke patients first note symptoms upon awakening. We hypothesized that patients awaking with stroke symptoms may be safely treated with intravenous alteplase (IV tPA) using non-contrast head CT (NCHCT), if they meet all other standard criteria. METHODS: The SAfety of Intravenous thromboLytics in stroke ON awakening (SAIL ON) was a prospective, open-label, single treatment arm, pilot safety trial of standard dose IV tPA in patients who presented with stroke symptoms within 0-4...
2018: PloS One
https://www.readbyqxmd.com/read/29784608/acute-stroke-patients-with-newly-diagnosed-diabetes-mellitus-have-poorer-outcomes-than-those-with-previously-diagnosed-diabetes-mellitus
#6
Yacouba Njankouo Mapoure, Hamadou Ba, Chia Mark Ayeah, Caroline Kenmegne, Henry Namme Luma, Alfred Kongnyu Njamnshi
BACKGROUND: Diabetes mellitus (DM) is associated with poor outcomes in acute stroke patients (ASPs). This study aims to determine the prevalence of NDDM in the ASPs and to compare the outcome in NDDM and previously diagnosed DM (PDDM) in Cameroon. METHODS AND MATERIALS: This was a hospital-based prospective cohort study that included ASPs with NDDM and PDDM. Outcome data were collected within 3 months of stroke onset. Chi-square and t tests were used for comparisons, whereas survival analysis was performed using Cox regression and Kaplan-Meier analysis...
May 18, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29780232/cerebral-arteriovenous-malformations-in-the-era-of-embolization-for-angiographic-cure-a-single-center-experience-in-egypt
#7
Mohamed K Elewa
Background: Embolization for cerebral arteriovenous malformations (AVMs) has evolved in the last decade with evolution in both equipment and material. Embolization targets have expanded to include angiographic cure. Methods: To discuss the technical and management outcomes of our first cerebral AVM case series treated with embolization. The clinical, angiographic, treatment, and outcome variables of consecutive cerebral arteriovenous malformation cases, treated with curative embolization, between January 2011 and June 2017 in one regional center, were retrospectively analyzed...
2018: The Egyptian journal of neurology, psychiatry and neurosurgery
https://www.readbyqxmd.com/read/29780228/risk-factors-of-acute-ischemic-stroke-in-patients-presented-to-beni-suef-university-hospital-prevalence-and-relation-to-stroke-severity-at-presentation
#8
Rasha H Soliman, Mohammed I Oraby, Mohammed Fathy, Alaa M Essam
Background: Acute ischemic stroke is one of the major causes of disability and death worldwide. Effective prevention remains the best approach for reducing the burden of stroke. The aim of this work was to study the prevalence of stroke risk factors and the possible relation between such risk factors and the disease severity at presentation in a sample of stroke patients presented to Beni-Suef University Hospital, north Upper Egypt. Methods: A sample of 167 patients of acute ischemic stroke recruited from Beni-Suef University Hospital was included in this cross-sectional descriptive study...
2018: The Egyptian journal of neurology, psychiatry and neurosurgery
https://www.readbyqxmd.com/read/29779883/gender-gap-and-risk-factors-for-poor-stroke-outcomes-a-single-hospital-based-prospective-cohort-study
#9
Kuo-Hua Hung, Jerry Cheng-Yen Lai, Kuang-Nan Hsu, Chihmin Hu, Hung-Chang Chang, Cheng-Neng Chen, He-Shu Ku, Ming-Shiang Yang, Pei-Hao Chen
BACKGROUND: This study intended to investigate whether etiological stroke subtypes and their corresponding major risk factors have differential effects on outcomes between genders. PATIENTS AND METHODS: We enrolled 403 consecutive patients with first-ever acute ischemic stroke (170 women, 233 men), from a referral hospital in Taiwan over a 2-year period. Gender differences in demographics, vascular risk factors, access to health care, etiological stroke subtypes, stroke severity, and outcomes were examined...
May 17, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29778996/stent-and-flow-diverter-assisted-treatment-of-acutely-ruptured-brain-aneurysms
#10
José E Cohen, J Moshe Gomori, Ronen R Leker, Sergey Spektor, Hosni Abu El Hassan, Eyal Itshayek
OBJECTIVE: We present our experience with stent techniques in the management of acutely ruptured aneurysms, focusing on aneurysm occlusion rates, intraprocedural complications, and late outcomes. METHODS: We retrospectively reviewed the clinical records of patients treated by stent techniques during the early acute phase of aneurysmal rupture, from June 2011 to June 2016. Patients who underwent stenting for the management of unruptured aneurysms, or in a delayed fashion for a ruptured lesion, were excluded...
May 19, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29778943/prognostic-significance-of-serum-cystatin-c-in-acute-ischemic-stroke-patients-according-to-lipid-component-levels
#11
Zhengbao Zhu, Chongke Zhong, Tian Xu, Aili Wang, Yanbo Peng, Tan Xu, Hao Peng, Chung-Shiuan Chen, Jinchao Wang, Qunwei Li, Deqin Geng, Yingxian Sun, Yongqiu Li, Yonghong Zhang, Jiang He
BACKGROUND AND AIMS: Serum cystatin C (CysC) is associated with the risk of ischemic stroke and may predict cardiovascular events and death after ischemic stroke onset. However, the association between serum CysC and functional outcome in ischemic stroke patients remains unclear, and whether lipid component level influences the relationship between them has not been studied. METHODS: A total of 3348 ischemic patients from China Antihypertensive Trial in Acute Ischemic Stroke were included in the study...
May 17, 2018: Atherosclerosis
https://www.readbyqxmd.com/read/29778598/relevance-of-antiplatelet-therapy-duration-after-stent-assisted-coil-embolization-for-unruptured-intracranial-aneurysms
#12
Tackeun Kim, Chang Hyeun Kim, Si-Hyuck Kang, Seung Pil Ban, O-Ki Kwon
BACKGROUND: The optimal duration of dual antiplatelet therapy (DAPT) for preventing delayed thromboembolic events (DTEs) remains unclear. We aimed to determine whether longer DAPT provides improved protection against delayed DTEs. METHODS: This retrospective cohort study included 507 stent-assisted coil embolization procedures using a single stent for unruptured intracranial aneurysms. We performed coarsened exact matching according to the duration of maintenance DAPT...
May 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29778325/tranexamic-acid-for-hyperacute-primary-intracerebral-haemorrhage-tich-2-an-international-randomised-placebo-controlled-phase-3-superiority-trial
#13
Nikola Sprigg, Katie Flaherty, Jason P Appleton, Rustam Al-Shahi Salman, Daniel Bereczki, Maia Beridze, Hanne Christensen, Alfonso Ciccone, Ronan Collins, Anna Czlonkowska, Robert A Dineen, Lelia Duley, Juan Jose Egea-Guerrero, Timothy J England, Kailash Krishnan, Ann Charlotte Laska, Zhe Kang Law, Serefnur Ozturk, Stuart J Pocock, Ian Roberts, Thompson G Robinson, Christine Roffe, David Seiffge, Polly Scutt, Jegan Thanabalan, David Werring, David Whynes, Philip M Bath
BACKGROUND: Tranexamic acid can prevent death due to bleeding after trauma and post-partum haemorrhage. We aimed to assess whether tranexamic acid reduces haematoma expansion and improves outcome in adults with stroke due to intracerebral haemorrhage. METHODS: We did an international, randomised placebo-controlled trial in adults with intracerebral haemorrhage from acute stroke units at 124 hospital sites in 12 countries. Participants were randomly assigned (1:1) to receive 1 g intravenous tranexamic acid bolus followed by an 8 h infusion of 1 g tranexamic acid or a matching placebo, within 8 h of symptom onset...
May 15, 2018: Lancet
https://www.readbyqxmd.com/read/29777362/the-silver-effect-of-admission-glucose-level-on-excellent-outcome-in-thrombolysed-stroke-patients
#14
Charlotte Rosso, Flore Baronnet, Belen Diaz, Raphael Le Bouc, Giulia Frasca Polara, Eric Jr Moulton, Sandrine Deltour, Anne Leger, Sophie Crozier, Yves Samson
Higher admission glucose levels (AGL) are associated with less favorable outcome in thrombolysis. But, could AGL's impact on outcome vary by onset-to-treatment (OTT) time? Is hyperglycemia associated with a shorter therapeutic time window for excellent outcome for thrombolysed stroke patients? We assessed predictive values of AGL, baseline NIHSS, age, and OTT time quartiles on excellent outcome (3-month modified Rankin score of 0-1) in 773 patients treated by rt-Pa. We added the AGL × OTT time quartile interaction in the model and separately analyzed the predictive values of AGL, age, and NIHSS for each OTT time quartile if the interaction was significant...
May 18, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29777016/clinical-utility-of-electronic-alberta-stroke-program-early-computed-tomography-score-software-in-the-enchanted-trial-database
#15
Simon Nagel, Xia Wang, Cheryl Carcel, Thompson Robinson, Richard I Lindley, John Chalmers, Craig S Anderson
BACKGROUND AND PURPOSE: Clinical utility of electronic Alberta Stroke Program Early CT Score (e-ASPECTS), an automated system for quantifying signs of infarction, was evaluated in a large database of thrombolyzed patients with acute ischemic stroke. METHODS: All baseline noncontrast computed tomographic scans of patients with anterior circulation acute ischemic stroke who participated in the alteplase dose arm of the randomized controlled trial ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study) were reviewed; poor quality and large (>6 mm) slice thickness were excluded...
May 18, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29776804/hemicraniectomy-for-malignant-middle-cerebral-artery-syndrome-a-review-of-functional-outcomes-in-two-high-volume-stroke-centers
#16
Abhi Pandhi, Georgios Tsivgoulis, Nitin Goyal, Muhammad F Ishfaq, Shailesh Male, Efstathios Boviatsis, Jason J Chang, Ramin Zand, Konstantinos Voumvourakis, Lucas Elijovich, Anne W Alexandrov, Marc D Malkoff, Daniel Hoit, Adam S Arthur, Andrei V Alexandrov
BACKGROUND AND PURPOSE: Despite recent landmark randomized controlled trials showing significant benefits for hemicraniectomy (HCT) compared with medical therapy (MT) in patients with malignant middle cerebral artery infarction (MMCAI), HCT rates have not substantially increased in the United States. We sought to evaluate early outcomes in patients with MMCAI who were treated with HCT (cases) in comparison to patients treated with MT due to the perception of procedural futility by families (controls)...
May 15, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29776732/posttraumatic-stress-and-depressive-symptoms-characterize-cardiac-arrest-survivors-perceived-recovery-at-hospital-discharge
#17
Alex Presciutti, Jayati Verma, Marykay Pavol, Deepti Anbarasan, Cristina Falo, Daniel Brodie, Leroy E Rabbani, David J Roh, Soojin Park, Jan Claassen, Sachin Agarwal
OBJECTIVE: To test the hypothesis that posttraumatic stress and depressive symptoms, not cognitive or functional impairment, are associated with cardiac arrest survivors' negative recovery perceptions at hospital discharge. METHODS: Prospective observational cohort of cardiac arrest patients admitted between 9/2015-5/2017. Survival to discharge with sufficient mental status to complete a psychosocial interview was the main inclusion criterion. Perceived recovery was assessed through the question, "Do you feel that you have made a complete recovery from your arrest?" The following measures were examined as potential correlates of perceived recovery: Repeatable Battery for Assessment of Neuropsychological Status, Modified Lawton Physical Self-Maintenance Scale, Barthel Index, Modified Rankin Scale, Cerebral Performance Category, Center for Epidemiological Studies-Depression (CES-D), and PTSD Checklist-Specific (PCL-S)...
May 10, 2018: General Hospital Psychiatry
https://www.readbyqxmd.com/read/29773716/thrombectomy-6-24-hours-after-stroke-in-trial-ineligible-patients
#18
Shashvat M Desai, Marcelo Rocha, Bradley J Molyneaux, Matthew Starr, Cynthia L Kenmuir, Bradley A Gross, Brian Thomas Jankowitz, Tudor G Jovin, Ashutosh P Jadhav
BACKGROUND AND PURPOSE: The DAWN and DEFUSE-3 trials demonstrated the benefit of endovascular thrombectomy (ET) in late-presenting acute ischemic strokes due to anterior circulation large vessel occlusion (ACLVO). Strict criteria were employed for patient selection. We sought to evaluate the characteristics and outcomes of patients treated outside these trials. METHODS: A retrospective review of acute ischemic stroke admissions to a single comprehensive stroke center was performed during the DAWN trial enrollment period (November 2014 to February 2017) to identify all patients presenting in the 6-24 hour time window...
May 17, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29773715/embolus-retriever-with-interlinked-cages-versus-other-stent-retrievers-in-acute-ischemic-stroke-an-observational-comparative-study
#19
Philipp Gruber, Salome Zeller, Carlos Garcia-Esperon, Jatta Berberat, Javier Anon, Michael Diepers, Krassen Nedeltchev, Fabian Flottmann, Jens Fiehler, Luca Remonda, Timo Kahles
BACKGROUND AND PURPOSE: Given the promising performance of the new Embolus Retriever with Interlinked Cages (ERIC) in smaller case series, we sought to assess the efficacy and safety of mechanical thrombectomy (MT) with ERIC compared with other stent retrievers (SRs) in acute ischemic stroke due to large vessel occlusion (LVO). METHODS: We reviewed the databases of two comprehensive stroke centers in in Germany and Switzerland for MT due to LVO in the anterior circulation with either ERIC or another SR as a first device...
May 17, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29772365/location-of-thalamic-hemorrhage-impacts-prognosis
#20
Brandon L Neisewander, Kimberly Hu, Zach Tan, Jack Zakrzewski, Pouyan Kheirkhah, Prateek Kumar, Miloni Shah, Douglas Cotanche, Kalpesh Shah, Darian R Esfahani, Ankit I Mehta
OBJECT: Approximately 12% of intracerebral hemorrhages (ICH) occur in the thalamus. Understanding the anatomical regions involved with thalamic hemorrhages is potentially useful, offering the physician a more accurate prognosis for patient outcomes. This study was performed to determine if thalamic hemorrhage location observed on a computed tomography scan (CT) is predictive of neurologic outcomes. METHODS: A sample of 168 thalamic hemorrhage patients admitted to a tertiary care center was analyzed...
May 14, 2018: World Neurosurgery
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