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National institutes of health stroke scale

Caroline A McHutchison, Vera Cvoro, Stephen Makin, Francesca M Chappell, Kirsten Shuler, Joanna M Wardlaw
OBJECTIVE: Many studies examining stroke outcomes focus on more severe strokes or have short follow-up periods, so the long-term outcomes post-minor ischaemic stroke are unclear. METHODS: We recruited participants from inpatient and outpatient services with a lacunar or minor cortical ischaemic stroke (National Institutes of Health Stroke Scale score <8) and assessed current and premorbid cognitive functioning (Addenbrooke's Cognitive Examination-Revised (ACE-R), National Adult Reading Test (NART)), physical functioning (Timed Get Up and Go (TUG), 9-Hole Peg Test (9HPT)), dependency (modified Rankin Scale (mRS)), depression (Beck's Depression Inventory) in-person and remotely (Stroke Impact Scale)...
December 15, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
Pedro Aguilar-Salinas, Guilherme Jose Agnoletto, Leonardo B C Brasiliense, Roberta Santos, Manuel F Granja, Douglas Gonsales, Amin Aghaebrahim, Eric Sauvageau, Ricardo A Hanel
BACKGROUND: Treatment of acute cerebrovascular pathology, such as acute ischemic stroke or intracranial aneurysms, presents a challenge if an extracranial or intracranial stent is required; immediate platelet inhibition is vital. To date, there is no standardized approach for antiplatelet inhibition in an acute setting. OBJECTIVE: To report our preliminary experience and lessons learnt using cangrelor in acute neurointervention. METHODS: A single-arm pilot study was performed to assess the safety and efficacy of cangrelor plus aspirin for platelet inhibition in patients who require acute stenting in the setting of neuroendovascular treatment...
December 14, 2018: Journal of Neurointerventional Surgery
Gonul Vural, Sadiye Gumusyayla, Orhan Deniz, Salim Neselioglu, Ozcan Erel
BACKGROUND: The objective of this study is to examine thiol-disulfide homeostasis in patients with cerebral venous sinus thrombosis. METHODS: Fifty-three patients diagnosed with cerebral venous sinus thrombosis and 80 healthy volunteers were included in the study. The native thiol and total thiol concentrations were measured with the newly developed automated method. In addition, their amount of disulfide bonds was calculated. RESULTS: The total thiol and native thiol levels of the patients with cerebral venous sinus thrombosis were significantly lower than the healthy volunteers (p = 0...
October 31, 2018: Clinical Laboratory
Shi-Ying Liu, Wen-Feng Cao, Ling-Feng Wu, Zheng-Bing Xiang, Shi-Min Liu, Hai-Yan Liu, Yang Pan, Feng Nie, Xiao-Mu Wu, Xu-Fang Xie
To determine whether glycated hemoglobin and mean arterial pressure (MAP) during thrombolysis are prognostic factors of intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) for acute ischemic stroke (AIS).A total of 125 AIS patients, who received rt-PA intravenous thrombolysis in our hospital, were included into the present study, and divided into good prognosis group and poor prognosis group. Univariate and multivariate logistic regression analyses were used to determine the prognostic factors of AIS treated by rt-PA thrombolysis, Spearman correlation analysis was used to analyze the correlation of the accumulated cigarette consumption in the smoking subgroup and glycated hemoglobin in the diabetic subgroup with the prognosis after intravenous thrombolysis and the symptomatic intracranial hemorrhage (sICH)...
December 2018: Medicine (Baltimore)
Yang Liu, ShiYu Jia, Xue Liang, MeiXue Dong, XiaoMin Xu, ChangQi Lu, YouDong Wei
BACKGROUND: The blood-brain barrier is impaired in patients with stroke. The release of protein markers such as Sirtuin1 (SIRTl) into circulation may be useful to assess the prognosis of patients with cerebrovascular disease. In this study, we investigated the predictive value of SIRT1 levels in acute ischemic stroke (AIS) patients. METHODS: In all, 101 AIS patients and 38 healthy controls were enrolled, and blood samples were collected within 72 hours of stroke onset...
December 2018: Medicine (Baltimore)
Lilin Chen, Qihua Yang, Rui Ding, Dan Liu, Zhijun Chen
Correlations of carotid intima-media thickness (IMT), atherosclerotic plaque stability, serum inflammatory factors and serum matrix metalloproteinase (MMP)-2 and MMP-9 levels with the condition of disease in patients with acute cerebral infarction were analyzed to explore the predictive value of these risk factors. A total of 56 patients diagnosed with acute cerebral infarction in Jingmen First People's Hospital from February 2016 to January 2017 were selected and divided into the plaque stability group (n=25) and plaque instability group (n=31)...
December 2018: Experimental and Therapeutic Medicine
Hongyin Ma, Zhen-Ni Guo, Hang Jin, Xiuli Yan, Jia Liu, Shan Lv, Peng Zhang, Xin Sun, Yi Yang
Background and Purpose: Dynamic cerebral autoregulation (dCA) is probably impaired in the acute and even subacute phases after acute ischemic stroke (AIS); however, the relationship between relevant clinical factors and dCA after AIS has not been investigated. The identification of possible determinants may therefore provide potential therapeutic targets to improve dCA in AIS. Methods: This study enrolled 67 consecutive patients diagnosed with AIS within 3 days from symptom onset. Serial measurements were performed 1-3 days (measurement 1) and 7-10 days (measurement 2) after the onset...
2018: Frontiers in Neurology
Jian Sun, Fa Liang, Youxuan Wu, Yan Zhao, Zhongrong Miao, Li Zhang, Adrian W Gelb, Matthew T V Chan, Yuming Peng, Ruquan Han
BACKGROUND: The effect of choice of anesthesia on clinical outcome for endovascular treatment (EVT) in patients with acute ischemic stroke (AIS) remains unclear. METHODS: We conducted a pilot trial of 43 patients with acute anterior circulation ischemic stroke having EVT. Patients were randomly allocated to receive general anesthesia or conscious sedation. We documented the rate of recruitment and rate of conversion from conscious sedation to general anesthesia...
December 7, 2018: Journal of Neurosurgical Anesthesiology
Syed Ali Raza, Clara M Barreira, Gabriel M Rodrigues, Michael R Frankel, Diogo C Haussen, Raul G Nogueira, Srikant Rangaraju
BACKGROUND: Age, neurologic deficits, core volume (CV), and clinical core or radiographic mismatch are considered in selection for endovascular therapy (ET) in anterior circulation emergent large vessel occlusion (aELVO). Semiquantitative CV estimation by Alberta Stroke Programme Early CT Score (CT ASPECTS) and quantitative CV estimation by CT perfusion (CTP) are both used in selection paradigms. OBJECTIVE: To compare the prognostic value of CTP CV with CT ASPECTS in aELVO...
December 7, 2018: Journal of Neurointerventional Surgery
Junya Tsurukiri, Takahiro Ota, Hiroyuki Jimbo, Eitaro Okumura, Keigo Shigeta, Tatsuo Amano, Masayuki Ueda, Yuji Matsumaru, Yoshiaki Shiokawa, Teruyuki Hirano
BACKGROUND: Although, thrombectomy for stroke more than 6 hours after onset supported by automated perfusion computed tomography (CT) software (RAPID, iSchemaView) is effective, this software is not available in Japan. This study aimed to elucidate the efficacy of thrombectomy 6-24 hours after onset in our patient cohort using conventional imaging mismatch. METHODS: Of 586 ischemic stroke patients who underwent thrombectomy registered from January 2015 to December 2017, patients with occlusion of the intracranial internal carotid artery or middle cerebral artery, who had last been known to be well 6-24 hours earlier and who had a prestroke modified Rankin scale (mRS) score 0 or 1 were enrolled...
December 5, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Janja Pretnar Oblak, Miso Sabovic, Senta Frol
BACKGROUND: Rapid inactivation of dabigatran by its specific inhibitor idarucizamab allows intravenous thrombolysis (IVT) in patients suffering ischemic stroke while being treated with dabigatran. Only limited data of this approach is available and numerous questions regarding efficacy/safety remain to be answered. Herein, we present the findings from the Slovenian national cohort study. METHODS: Retrospective analysis of all stroke patients treated with idarucizumab and IVT (n = 11) in the period from July 2016 to February 2018 from Slovenian region were analyzed...
December 6, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
R B Goldhoorn, Maxim J H L Mulder, Ivo G H Jansen, Wim H van Zwam, Julie Staals, Aad van der Lugt, Diederik W J Dippel, Hester F Lingsma, Jan Albert Vos, Jelis Boiten, Ido R van den Wijngaard, Charles B L M Majoie, Yvo B W E M Roos, Robert J van Oostenbrugge
GOAL: Insufficient data is available about safety and efficacy of endovascular treatment (EVT) in patients with minor stroke symptoms because these patients were excluded from most randomized trials. We aimed to compare characteristics, functional outcome, and complications in patients with minor ischemic stroke National Institutes of Health Stroke Scale score ≤5 (NIHSS score ≤5) and moderate to severe ischemic stroke (NIHSS score ≥6) due to intracranial proximal artery occlusion of the anterior circulation who underwent EVT...
December 6, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
L X Zhou, M Yao, J Ni, Y C Zhu, B Peng, L Y Cui
Objective: To investigate a diffusion weighted imaging (DWI)-based morphological classification for acute isolated pontine infarcts (AIPI) and to assess differences in clinical characteristics, risk factors and functional outcomes among the different morphologies. Methods: All participants from SMART cohort with DWI-proven AIPI were included and categorized into 3 groups: basilar artery branch disease (BABD) group, small artery disease (SAD) group and large-artery-occlusive disease (LAOD) group, according to lesion extent of the transverse axial plane and basilar artery atherosclerosis severity...
December 4, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Aline Mansueto Mourão, Laélia Cristina Caseiro Vicente, Mery Natali Silva Abreu, Romeu Vale Sant'Anna, Erica Leandro Marciano Vieira, Leonardo Cruz de Souza, Aline Silva de Miranda, Milene Alvarenga Rachid, Antônio Lucio Teixeira
CONTEXT: Brain-derived neurotrophic factor (BDNF) is a neurotrophin involved in neuronal survival, differentiation, and maturation. PURPOSE: To evaluate the levels of BDNF in the acute phase of stroke and their potential association with neurological impairment. METHODS: Patients in the acute phase of ischemic stroke were evaluated with the following clinical tools: National Institutes of Health Stroke Scale, modified Rankin scale, Gugging Swallowing Screen and Alberta Stroke Program Early CT Score...
December 3, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Jingxia Zhou, Lin Chen, Bocan Chen, Shaozhu Huang, Chaosheng Zeng, Hairong Wu, Cong Chen, Faqing Long
BACKGROUND: The exosomal miRNAs have been emerged as biomarkers and therapeutic targets for various diseases, however, the function of exosomal miRNAs in stroke remains largely unknown. METHODS: The blood samples from acute ischemic stroke (AIS) patients and normal controls were collected. The exosomes were isolated from the blood samples, which were confirmed by electron microscopy and western blot with the specific exosomes biomarker CD9, CD63 and Tsg101. RESULTS: RT-qPCR analysis showed that exosomal miR-134 was significantly increased in AIS patients within 24 h after stroke onset compared with that of control group...
December 4, 2018: BMC Neurology
Cory J Rice, Sung-Min Cho, Lucy Q Zhang, Catherine Hassett, Randall C Starling, Ken Uchino
BACKGROUND: Ischemic and hemorrhagic strokes are frequent complications among those with left ventricular assist device (LVAD). Scarce data exist regarding the prevalence of acute large vessel occlusion (LVO) and treatment of acute ischemic stroke (AIS) in this setting. METHODS: We reviewed prospectively collected data of LVAD patient registry from a single, tertiary center from October 2004 to November 2016. Among those with AIS complications, patients were divided into early stroke (during implantation hospitalization) and late stroke (post-discharge) groups, and neuroimaging was reviewed and data on acute stroke therapy were collected...
December 4, 2018: Cerebrovascular Diseases
Shahram Majidi, Alexis N Simpkins, Richard Leigh
BACKGROUND AND PURPOSE: Timely restoration of tissue-level cerebral blood flow is the goal of thrombolytic therapy in patients presenting with an acute ischemic stroke. We aimed to identify the incidence and predictors of reperfusion immediately following treatment with intravenous recombinant tissue plasminogen activator (IV rt-PA). METHODS: This study included patients with acute ischemic stroke triaged using magnetic resonance imaging (MRI) with perfusion-weighted imaging (PWI) and treated with IV rt-PA who were subsequently enrolled in our natural history study and underwent repeat MRI with PWI approximately 2 hours posttreatment...
December 3, 2018: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
Laura Vandelli, Marco Marietta, Tommaso Trenti, Manuela Varani, Guido Bigliardi, Francesca Rosafio, Maria Luisa Dell'acqua, Livio Picchetto, Paolo Nichelli, Andrea Zini
BACKGROUND: Post-thrombotic intracerebral hemorrhage (ICH) is experienced by 6-8% of stroke patients and is associated with multiple factors, including acquired coagulopathy induced by the thrombolytic drug. OBJECTIVES: The objective of this study was to assess the outcome of the intravenous (IV) administration of fibrinogen concentrate in a series of acute stroke patients who developed iatrogenic fibrinogen critical depletion after IV thrombolysis. MATERIAL AND METHODS: Of the 39 ischemic stroke patients treated with IV thrombolysis with a severe hypofibrinogenemia requiring infusion with IV fibrinogen concentrate, 30 patients were treated with 2 g of IV recombinant tissue plasminogen activator (rt-PA), followed by further doses until the fibrinogen level reached 200 mg/dL in hemorrhagic patients or 100 mg/dL in non-hemorrhagic patients, and 9 were treated with IV rt-PA followed by endovascular thrombectomy...
December 3, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Jingwen Jiang, Xiaojun Huang, Yu Zhang, Weiping Deng, Fanxia Shen, Jianrong Liu
BACKGROUND: The patients of single small subcortical strokes (SS) commonly have neurological worsening with risk factors, and mechanisms remain unclear. Asymptomatic lacunes, white matter lesions, cerebral microbleeds, and enlarged perivascular spaces are MRI markers of cerebral small vessel disease (cSVD). Previous studies mostly explored the association between the neurological deterioration and presence of above markers separately. The relationship between progressive single small SS and the simultaneous presence of multiple markers of cSVD has not been fully identified...
December 3, 2018: Brain and Behavior
Ting-Chun Lin, Yen-Kuang Lin, Chin-I Chen, Lung Chan, Nai-Fang Chi, Rey-Yue Yuan, Jau-Jiuan Sheu, Chun-Ren Wei, Jui-Ping Tsai, Tu-Hsueh Yeh
Background: This study assessed whether serum lipid levels are associated with the risk of symptomatic intracerebral hemorrhage (sICH) and functional outcomes in patients with acute ischemic stroke after receiving intravenous thrombolysis. Methods: We retrospectively analyzed consecutive ischemic stroke patients who were treated with intravenous tissue plasminogen activator between January 2007 and January 2017. Lipid levels on admission, including total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride levels, as well as potential predictors of sICH were tested using univariate and multivariate analyses...
2018: PeerJ
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