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National institutes of health stroke scale

Angela Sm Salinet, Nathália Cc Silva, Juliana Caldas, Daniel S de Azevedo, Marcelo de-Lima-Oliveira, Ricardo C Nogueira, Adriana B Conforto, Manoel J Texeira, Thompson G Robinson, Ronney B Panerai, Edson Bor-Seng-Shu
We aimed to assess cerebral autoregulation (CA) and neurovascular coupling (NVC) in stroke patients of differing severity comparing responses to healthy controls and explore the association between CA and NVC with functional outcome. Patients admitted with middle cerebral artery (MCA) stroke and healthy controls were recruited. Stroke severity was defined by the National Institutes of Health Stroke Scale (NIHSS) scores: ≤4 mild, 5-15 moderate and ≥16 severe. Transcranial Doppler ultrasound and Finometer recorded MCA cerebral blood flow velocity (CBFv) and blood pressure, respectively, over 5 min baseline and 1 min passive movement of the elbow to calculate the autoregulation index (ARI) and CBFv amplitude responses to movement...
August 17, 2018: Journal of Cerebral Blood Flow and Metabolism
Pia Löwhagen Hendén, Alexandros Rentzos, Jan-Erik Karlsson, Lars Rosengren, Jonatan Oras, Sven-Erik Ricksten
BACKGROUND AND PURPOSE: In the new era of endovascular treatment for acute ischemic stroke, one of the main predictors of good neurological outcome is a short time interval from stroke onset to recanalization of the occluded vessel. In this study, we examined the effect of on-hour vs off-hour admittance on the time intervals from stroke onset to recanalization in patients with acute ischemic stroke (AIS) undergoing endovascular treatment (EVT). METHODS: One-hundred-ninety-eight patients receiving EVT for anterior AIS between 2007 and 2016 were included...
August 16, 2018: Acta Anaesthesiologica Scandinavica
Antti Lindgren, Mervyn DI Vergouwen, Irene van der Schaaf, Ale Algra, Marieke Wermer, Mike J Clarke, Gabriel Je Rinkel
BACKGROUND: Around 30% of people who are admitted to hospital with aneurysmal subarachnoid haemorrhage (SAH) will rebleed in the initial month after the haemorrhage if the aneurysm is not treated. The two most commonly used methods to occlude the aneurysm for prevention of rebleeding are microsurgical clipping of the neck of the aneurysm and occlusion of the lumen of the aneurysm by means of endovascular coiling. This is an update of a systematic review that was previously published in 2005...
August 15, 2018: Cochrane Database of Systematic Reviews
Longling Li, Changqing Li
Objective This study was performed to evaluate the potential predictors of poor outcomes associated with diabetes-specific microvascular pathologies and to analyze their influence on clinical outcomes by adjusting for other well-known prognostic factors in patients with acute ischemic stroke. Methods We analyzed 1389 consecutive adult patients with acute ischemic stroke and explored the relationship among clinical characteristics, laboratory measurements, imaging findings, and 6-month functional outcomes. Results The final study population comprised 216 patients with both acute ischemic stroke and diabetes mellitus who were followed up for 6 months...
August 2018: Journal of International Medical Research
Sridhara Sastry Yaddanapudi, Maria Carissa Pineda, David W Boorman, Richard E Bryne, Krista Lim Hing, Sunil Sharma
INTRODUCTION: Obstructive sleep apnea (OSA) is a well-known risk factor for stroke. This is attributed to multiple mechanisms such as endothelial dysfunction, atrial fibrillation, hypertension, and comorbid obesity. STOP questionnaire alone is unreliable to diagnose OSA and in-hospital sleep study is costly and can be technically challenging. We used high-resolution pulse oximetry (HRPO) to test the feasibility of screening for OSA and predicting outcome. METHODS: Data from 115 stroke patients who underwent HRPO was collected including Oxygen desaturation index (ODI) <4%, pulse rate, arterial oxygen saturation (SaO2 ), and time spent at SaO2 saturation <88%...
August 7, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Leila Simani, Fari Ryan, Shadab Hashemifard, Etrat Hooshmandi, Maryam Madahi, Zahra Sahraei, Omidvar Rezaei, Kamran Heydari, Mahtab Ramezani
Disruption of prooxidant-antioxidant balance may lead to oxidative stress which is known as a mechanism contributing to ischemic stroke. Coenzyme Q10 (CoQ10) is an endogenous antioxidant that could be effective in preventing oxidative stress. However, the contribution of serum levels of CoQ10 in clinical neurological outcomes following ischemic stroke has not been clearly established. This study aims at measuring serum concentration of CoQ10 along with major indicators of antioxidant and oxidant among patients within 24 h after onset of the stroke symptoms, and investigating their relation with the clinical status of patients...
August 9, 2018: Journal of Molecular Neuroscience: MN
Andrea Wagner, Karl-Michael Schebesch, Florian Zeman, Stefan Isenmann, Andreas Steinbrecher, Thomas Kapapa, Dobri Baldaranov, Roland Backhaus, Felix Schlachetzki
Background and Purpose: Intracerebral hemorrhage (ICH) requires rapid decision making to decrease morbidity and mortality although time frame and optimal therapy are still ill defined. Ideally, specialized neurologists, neurosurgeons, and (neuro-) radiologists who know the patient's clinical status and their cerebral computed tomography imaging (cCT) make a joint decision on the clinical management. However, in telestroke networks, a shift toward cCT imaging criteria used for decision making can be observed for practical reasons...
2018: Frontiers in Neurology
Monica S Badve, Zien Zhou, Craig S Anderson, Maree L Hackett
BACKGROUND: Pneumonia is a common complication after stroke which increases morbidity and mortality. This systematic review was conducted to evaluate the efficacy and safety of antibiotics for the prevention of pneumonia after acute stroke. METHODS: Medline, EMBASE, and Cochrane databases were searched for randomized controlled trials comparing preventive antibiotics to placebo or no antibiotics after acute stroke. The primary outcome was poststroke pneumonia. Secondary outcomes were all infections, urinary tract infections, death, dependency, length of hospital stay, and adverse events...
August 6, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Joji Hagii, Norifumi Metoki, Shin Saito, Ayaka Fujita, Hiroshi Shiroto, Satoko Sasaki, Koki Takahashi, Hiroyasu Hitomi, Yoshiko Baba, Satoshi Seino, Takaatu Kamada, Takamitsu Uchizawa, Manabu Iwata, Shigeo Matsumoto, Minoru Yasujima, Hirofumi Tomita
BACKGROUND: The relationship between body mass index (BMI) and the severity of cardioembolic stroke (CES) remains poorly understood. METHOD: A total of 419 consecutive CES patients with nonvalvular atrial fibrillation (NVAF), and with a modified Rankin Scale (mRS) score of 0 or 1 before onset admitted within 48 hours after onset to the Hirosaki Stroke and Rehabilitation Center were studied. The patients were divided into three groups, low BMI (L-BMI; n = 36, BMI < 18...
August 6, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Ramin Zand, Shima Shahjouei, Georgios Tsivgoulis, Mantinderpreet Singh, Michael McCormack, Nariman Noorbakhsh-Sabet, Nitin Goyal, Andrei V Alexandrov
BACKGROUND: Several studies have shown that cerebral microbleeds (CMBs) increase the risk of long-term stroke-related mortality. The purpose of this study was to determine if the existence and burden of CMBs are a predictor of in-hospital death among patients with acute ischemic stroke (AIS). METHODS: We studied consecutive ischemic stroke patients who admitted to our tertiary center over a 2-year period (2013-2014). Patients who underwent thrombolysis were excluded...
August 6, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Thomas Raphael Meinel, Frauke Pult, Jan Gralla, Marcel Arnold, Claudio Bassetti, Simon Jung
A 76-year-old man with a history of arterial hypertension, obstructive sleep apnea, dyslipidemia, family history of cardiovascular events, prestroke and overweight presented 90 minutes after acute onset of right-sided sensorimotor hemiparesis, hemiataxia and dysarthria (National Institutes of Health Stroke Scale (NIHSS) 9/42). Magnetic resonance imaging (MRI) revealed a pontine ischemia and MR angiography showed a thrombus in the middle to distal portion of the basilar artery. Owing to the location, an occlusion of one lumen of a fenestrated basilar artery was suspected...
August 9, 2018: Interventional Neuroradiology
Joonsang Yoo, Sung-Il Sohn, Jinkwon Kim, Seong Hwan Ahn, Kijeong Lee, Jang-Hyun Baek, Kyoungsub Kim, Jeong-Ho Hong, Jaseong Koo, Young Dae Kim, Jaehyuk Kwak, Hyo Suk Nam, Ji Hoe Heo
BACKGROUND: The actions and responses of the hospital personnel during acute stroke care in the emergency department (ED) may differ according to the severity of a patient's stroke symptoms. We investigated whether the time from arrival at ED to various care steps differed between patients with minor and non-minor stroke who were treated with intravenous tissue plasminogen activator (IV tPA). METHODS: We included consecutive patients who received IV tPA during a 1...
August 9, 2018: Cerebrovascular Diseases
Volker Maus, Jan Borggrefe, Daniel Behme, Christoph Kabbasch, Nuran Abdullayev, Utako Birgit Barnikol, Leonard Leong Litt Yeo, Patrick A Brouwer, Michael Söderman, Markus Möhlenbruch, Thomas Liebig, Gereon Rudolf Fink, Anastasios Mpotsaris
BACKGROUND: One endovascular treatment option of acute ischemic stroke due to tandem occlusion (TO) comprises intracranial thrombectomy and acute extracranial carotid artery stenting (CAS). In this setting, the order of treatment may impact the clinical outcome in this stroke subtype. METHODS: Retrospective analysis was performed on data prospectively collected in 4 international stroke centers between 2013 and 2017. One hundred sixty-five patients with anterior TO were treated by endovascular therapy...
August 9, 2018: Cerebrovascular Diseases
Daniel Václavík, Michal Bar, Lukáš Klečka, David Holeš, Martin Čábal, Robert Mikulík
BACKGROUND AND PURPOSE: Mechanical thrombectomy (MT) is indicated for the treatment of large vessel occlusion (LVO) stroke. MT should be provided as quickly as possible; therefore, a test identifying suspected LVO in the prehospitalization stage is needed to ensure direct transport to a comprehensive stroke center (CSC). We assume that patients with clinically severe hemiparesis have a high probability of LVO stroke. We modified the FAST test into the FAST PLUS test: The first part is the FAST test and the second part evaluates the presence of severe arm or leg motor deficit...
August 7, 2018: Brain and Behavior
Xinwei He, Yuyan Bao, Yuguang Shen, En Wang, Weijun Hong, Shaofa Ke, Xiaoping Jin
Increasing evidence supports the involvement of periostin in the pathophysiological processes of stroke and atherosclerosis. The aim of this study was to assess circulating periostin levels at different times after large-artery atherosclerotic (LAA) stroke and their association with stroke. Serum periostin levels were measured using enzyme-linked immunosorbent assay on day 1 in 162 patients with LAA stroke and in 108 age- and sex-matched controls, on day 6 after stroke in 134 patients, and during the 4th week after stroke in 46 of the 162 patients...
August 6, 2018: Scientific Reports
Adrian Gheorghe, Ulla Griffiths, Adrianna Murphy, Helena Legido-Quigley, Peter Lamptey, Pablo Perel
BACKGROUND: The evidence on the economic burden of cardiovascular disease (CVD) in low- and middle- income countries (LMICs) remains scarce. We conducted a comprehensive systematic review to establish the magnitude and knowledge gaps in relation to the economic burden of CVD and hypertension on households, health systems and the society. METHODS: We included studies using primary or secondary data to produce original economic estimates of the impact of CVD. We searched sixteen electronic databases from 1990 onwards without language restrictions...
August 6, 2018: BMC Public Health
N David Åberg, Daniel Åberg, Katarina Jood, Michael Nilsson, Christian Blomstrand, H Georg Kuhn, Johan Svensson, Christina Jern, Jörgen Isgaard
BACKGROUND: Insulin-like growth factor I (IGF-I) has neuroprotective effects in experimental ischemic stroke (IS). However, in patients who have suffered IS, various associations between the levels of serum IGF-I (s-IGF-I) and clinical outcome have been reported, probably reflecting differences in sampling time-points and follow-up periods. Since changes in the levels of post-stroke s-IGF-I have not been extensively explored, we investigated whether decreases in the levels of s-IGF-I between the acute time-point (median, 4 days) and 3 months (ΔIGF-I, further transformed into ΔIGF-I-quintiles, ΔIGF-I-q) are associated with IS severity and outcome...
August 6, 2018: BMC Neurology
Juexian Song, Yi Lyu, Pingping Wang, Yuting Nie, Huiqiang Lu, Li Gao, Xiaolin Tong
Aims: To evaluate the clinical efficacy of Naoxueshu oral liquid in the treatment of intracerebral hemorrhage (ICH) patients. Methods: In our study, December 2008 to August 2010, 88 patients with intracerebral hemorrhage were enrolled and 87 patients with complete information of whom 44 patients received Naoxueshu oral liquid plus regular treatment (Naoxueshu group), 43 patients received regular treatment (control group) only. Naoxueshu oral liquid 10 ml was taken in the Naoxueshu group, with 3 times a day for 21 consecutive days...
2018: Frontiers in Physiology
Shashvat M Desai, Marcelo Rocha, Matthew Starr, Bradley J Molyneaux, Cynthia L Kenmuir, Bradley A Gross, Brian T Jankowitz, Tudor G Jovin, Ashutosh P Jadhav
OBJECTIVE: Endovascular thrombectomy (ET) for acute ischemic stroke (AIS) due to large-vessel occlusion (LVO) is offered to select patients meeting strict criteria. One of the criteria is stroke severity as indicated by the National Institute of Health Stroke Scale (NIHSS). Inherently, NIHSS is biased towards left hemisphere strokes (LHS) with median NIHSS score 4 points higher than right hemisphere strokes (RHS). This may potentially affect clinical decision making and thrombectomy eligibility...
August 2, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Bin Chen, Jia Shen, Guan-Rong Zheng, Shen-Zhong Qiu, Huai-Ming Yin, Wei Mao, Hong-Xiang Wang, Jian-Bo Gao
BACKGROUND: Cyclophilin A is involved in brain injury. We investigated the relationship between serum cyclophilin A concentrations, hemorrhagic severity and clinical outcome in intracerebral hemorrhage (ICH). METHODS: We enrolled 105 ICH patients and 105 healthy individuals. Admission serum cyclophilin A concentrations were detected in ICH patients. Hemorrhagic severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) and hematoma volume...
August 2, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
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