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Stroke and predictive outcomes

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https://www.readbyqxmd.com/read/28342654/the-role-of-the-signal-intensity-ratio-on-fluid-attenuated-inversion-recovery-in-stroke-patients-achieving-successful-recanalization-with-endovascular-treatment
#1
Taehoon Kim, Jong-Won Chung, Myung Suk Jang, Mi Hwa Yang, Sang-Hwa Lee, Beom Joon Kim, Moon-Ku Han, Jae Hyoung Kim, Cheolkyu Jung, Jae-Sung Lim, Hee-Joon Bae
BACKGROUND: This study aimed to investigate whether fluid-attenuated inversion recovery (FLAIR) imaging hyperintensity can be used as a surrogate marker for the severity of ischemic insult and predict lesion growth. METHODS: Based on a prospective stroke registry database, we identified patients with ischemic stroke who were treated with endovascular treatment (EVT) within 8 hours of onset and achieved successful recanalization (modified thrombolysis in cerebral infarction ≥2B)...
March 22, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28340049/cardiac-troponin-i-as-a-predictor-of-mortality-in-patients-with-first-episode-acute-atrial-fibrillation
#2
Mohammad E Naffaa, Roni Nasser, Elias Manassa, Maha Younis, Zaher S Azzam, Doron Aronson
Background: Recent-onset atrial fibrillation (AF) is a frequent cause for presentation to the emergency department. Recent studies proposed that the addition of biomarker information might improve the prediction of clinical outcomes by enabling identification of patients at high risk. Aim: We aimed to examine the role of cardiac troponin I as a predictor of clinical outcome in patients with first episode acute atrial fibrillation. Design: : Patients, 18 years or older, presenting to our hospital with a primary diagnosis of first episode acute atrial fibrillation were included in this retrospective study...
March 11, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28339992/rheumatoid-arthritis-specific-cardiovascular-risk-scores-are-not-superior-to-general-risk-scores-a-validation-analysis-of-patients-from-seven-countries
#3
Cynthia S Crowson, Sherine E Gabriel, Anne Grete Semb, Piet L C M van Riel, George Karpouzas, Patrick H Dessein, Carol Hitchon, Virginia Pascual-Ramos, George D Kitas
Objectives.: Cardiovascular disease (CVD) risk calculators developed for the general population do not accurately predict CVD events in patients with RA. We sought to externally validate risk calculators recommended for use in patients with RA including the EULAR 1.5 multiplier, the Expanded Cardiovascular Risk Prediction Score for RA (ERS-RA) and QRISK2. Methods.: Seven RA cohorts from UK, Norway, Netherlands, USA, South Africa, Canada and Mexico were combined...
March 8, 2017: Rheumatology
https://www.readbyqxmd.com/read/28336740/towards-personalised-intra-arterial-treatment-of-patients-with-acute-ischaemic-stroke-a-study-protocol-for-development-and-validation-of-a-clinical-decision-aid
#4
Maxim J H L Mulder, Esmee Venema, Bob Roozenbeek, Joseph P Broderick, Sharon D Yeatts, Pooja Khatri, Olvert A Berkhemer, Yvo B W E M Roos, Charles B L M Majoie, Robert J van Oostenbrugge, Wim H van Zwam, Aad van der Lugt, Ewout W Steyerberg, Diederik W J Dippel, Hester F Lingsma
INTRODUCTION: Overall, intra-arterial treatment (IAT) proved to be beneficial in patients with acute ischaemic stroke due to a proximal occlusion in the anterior circulation. However, heterogeneity in treatment benefit may be relevant for personalised clinical decision-making. Our aim is to improve selection of patients for IAT by predicting individual treatment benefit or harm. METHODS AND ANALYSIS: We will use data collected in the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) trial to analyse the effect of baseline characteristics on outcome and treatment effect...
March 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28334882/decreased-integration-and-information-capacity-in-stroke-measured-by-whole-brain-models-of-resting-state-activity
#5
Mohit H Adhikari, Carl D Hacker, Josh S Siegel, Alessandra Griffa, Patric Hagmann, Gustavo Deco, Maurizio Corbetta
While several studies have shown that focal lesions affect the communication between structurally normal regions of the brain, and that these changes may correlate with behavioural deficits, their impact on brain's information processing capacity is currently unknown. Here we test the hypothesis that focal lesions decrease the brain's information processing capacity, of which changes in functional connectivity may be a measurable correlate. To measure processing capacity, we turned to whole brain computational modelling to estimate the integration and segregation of information in brain networks...
February 20, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28331857/thrombosis-neuroinflammation-and-poststroke-infection-the-multifaceted-role-of-neutrophils-in-stroke
#6
REVIEW
Johanna Ruhnau, Juliane Schulze, Alexander Dressel, Antje Vogelgesang
Immune cells can significantly predict and affect the clinical outcome of stroke. In particular, the neutrophil-to-lymphocyte ratio was shown to predict hemorrhagic transformation and the clinical outcome of stroke; however, the immunological mechanisms underlying these effects are poorly understood. Neutrophils are the first cells to invade injured tissue following focal brain ischemia. In these conditions, their proinflammatory properties enhance tissue damage and may promote ischemic incidences by inducing thrombus formation...
2017: Journal of Immunology Research
https://www.readbyqxmd.com/read/28330876/electrocorticographic-dynamics-as-a-novel-biomarker-in-five-models-of-epileptogenesis
#7
Dan Z Milikovsky, Itai Weissberg, Lyna Solomon-Kamintsky, Kristina Lippmann, Osnat Schefenbauer, Federica Frigerio, Massimo Rizzi, Liron Sheintuch, Daniel Zelig, Jonathan Ofer, Annamaria Vezzani, Alon Friedman
Post injury epilepsy (PIE) is a devastating sequela of various brain insults. While recent studies offer novel insights into the mechanisms underlying epileptogenesis and discover potential preventive treatments, the lack of PIE biomarkers hinders the clinical implementation of such treatments. Here we explored the biomarker potential of different electrographic features in five models of PIE. Electrocorticographic or intrahippocampal recordings of epileptogenesis (from the insult to the first spontaneous seizure) from two laboratories were analyzed in 3 mouse and 2 rat PIE models...
March 22, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28328821/is-carotid-sonography-a-useful-tool-for-predicting-functional-capabilities-in-ischemic-stroke-patients-following-carotid-artery-stenting
#8
Chih-Ming Lin, Jian-Chi Su, Yu-Jun Chang, Chi-Kuang Liu, Henry Horng-Shing Lu, Yuh-Jyh Jong
Carotid stenosis is a major cause of stroke and timely intervention with stenting manipulation can significantly reduce the risk of secondary stroke. The impact of stenting procedures on patient functional capabilities has not yet been explored. The primary aim of this study was to examine associations between periprocedural carotid sonography parameters and post-treatment functional capabilities in stroke patients.Sixty-seven patients who received carotid stenting at 1 angiography laboratory were included...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328002/endovascular-treatment-of-middle-cerebral-artery-m2-occlusion-strokes-clinical-and-procedural-predictors-of-outcomes
#9
Maxim Mokin, Christopher T Primiani, Zeguang Ren, Peter Kan, Edward Duckworth, Raymond D Turner, Aquilla S Turk, Kyle M Fargen, Guilherme Dabus, Italo Linfante, Travis M Dumont, Leonardo B C Brasiliense, Hussain Shallwani, Kenneth V Snyder, Adnan H Siddiqui, Elad I Levy
BACKGROUND: Patients with strokes from M2 segment middle cerebral artery (MCA) occlusion have been underrepresented in recent randomized trials of endovascular therapy. OBJECTIVE: To better understand the clinical, imaging, and procedural predictors of successful recanalization and clinical outcomes in this population of patients. METHODS: We performed a multicenter retrospective analysis of consecutive patients with acute MCA M2 segment occlusion who underwent thrombectomy with stent retrievers or primary aspiration thrombectomy (including A Direct Aspiration First Pass Technique approach)...
March 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327981/long-term-outcome-after-multiple-burr-hole-surgery-in-children-with-moyamoya-angiopathy-a-single-center-experience-in-108-hemispheres
#10
Thomas Blauwblomme, Bertrand Mathon, Olivier Naggara, Manoelle Kossorotoff, Marie Bourgeois, Stéphanie Puget, Philippe Meyer, Valentine Brousse, Marianne de Montalembert, Francis Brunelle, Michel Zerah, Christian Sainte-Rose
BACKGROUND: Multiple burr hole (MBH) surgery is a simple, safe, and effective indirect technique of revascularization in moyamoya angiopathy (MM). However, it is not yet recognized as a first-line treatment. OBJECTIVE: To assess the long-term outcome and perioperative complications in a large single-center cohort of children with MM who underwent burr hole surgery. METHODS: This study is a retrospective analysis of children who underwent surgery for MM in a national reference center for pediatric stroke between 1999 and 2015...
February 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28322914/computer-aided-prediction-of-extent-of-motor-recovery-following-constraint-induced-movement-therapy-in-chronic-stroke
#11
Sarah Hulbert George, Mohammad Hossein Rafiei, Lynne Gauthier, Alexandra Borstad, John A Buford, Hojjat Adeli
Constraint-induced movement therapy (CI therapy) is a well-researched intervention for treatment of upper limb function. Overall, CI therapy yields clinically meaningful improvements in speed of task completion and greatly increases use of the more affected upper extremity for daily activities. However, individual improvements vary widely. It has been suggested that intrinsic feedback from somatosensation may influence motor recovery from CI therapy. To test this hypothesis, an enhanced probabilistic neural network (EPNN) prognostic computational model was developed to identify which baseline characteristics predict extent of motor recovery, as measured by the Wolf Motor Function Test (WMFT)...
March 17, 2017: Behavioural Brain Research
https://www.readbyqxmd.com/read/28320188/clinical-significance-of-changes-in-serum-neuroglobin-and-hif-1%C3%AE-concentrations-during-the-early-phase-of-acute-ischemic-stroke
#12
Lixia Xue, Hao Chen, Kaili Lu, Jiankang Huang, Hao Duan, Yuwu Zhao
BACKGROUND: Neuroglobin (NGB) has been described as a neuroprotective agent in cerebral ischemia, hypoxia inducible factor (HIF) has shown an important role in modulating hypoxic and ischemic injury, and therefore they have the potential to impact outcomes after acute ischemic stroke (AIS). Thus, we investigated early changes in the concentrations of serum NGB and HIF-1α after AIS and evaluated the relations of both NGB and HIF-1α to stroke severity and prognosis. METHODS: We prospectively measured the serum concentrations of NGB and HIF-1α in 40 patients with AIS at 24, 48, 72, and 96h after stroke...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28320171/stroke-severity-predicts-poststroke-delirium-and-its-association-with-dementia-longitudinal-observation-from-a-low-income-setting
#13
Akin Ojagbemi, Mayowa Owolabi, Toyin Bello, Olusegun Baiyewu
OBJECTIVE: The effect of delirium on stroke outcome has not been quantified in sub-Saharan Africa. We investigated the prevalence of delirium occurring within one week of stroke in Nigerian survivors and its association with dementia and mortality at 3months. METHODS: Delirium was ascertained after repeated assessments within one week of stroke using the Confusion Assessment Method. Demographic and clinical characteristics, stroke severity, current and pre-morbid cognitive functioning were also assessed...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28318959/utility-of-items-of-baseline-national-institutes-of-health-stroke-scale-as-predictors-of-functional-outcomes-at-three-months-after-mild-ischemic-stroke
#14
Jay Chol Choi, Beom Joon Kim, Moon-Ku Han, Soo Joo Lee, Kyusik Kang, Jong-Moo Park, Sang-Soon Park, Tai Hwan Park, Yong-Jin Cho, Keun-Sik Hong, Kyung Bok Lee, Jun Lee, Wi-Sun Ryu, Dong-Eog Kim, Hyun-Wook Nah, Dae-Hyun Kim, Jae-Kwan Cha, Joon-Tae Kim, Kang-Ho Choi, Mi Sun Oh, Kyung-Ho Yu, Byung-Chul Lee, Myung Suk Jang, Ji Sung Lee, Juneyoung Lee, Hee-Joon Bae
BACKGROUND: Predicting outcomes of acute stroke patients initially presenting with mild neurologic deficits is crucial in decision making regarding thrombolytic therapy. We examined the utility of individual National Institutes of Health Stroke Scale (NIHSS) score items or clusters of items as predictors of functional outcomes at 3 months after mild stroke. METHODS: Using a multicenter stroke registry database, we identified patients with acute ischemic stroke who presented within 4...
March 15, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28317947/parietal-operculum-and-motor-cortex-activities-predict-motor-recovery-in-moderate-to-severe-stroke
#15
Firdaus Fabrice Hannanu, Thomas A Zeffiro, Laurent Lamalle, Olivier Heck, Félix Renard, Antoine Thuriot, Alexandre Krainik, Marc Hommel, Olivier Detante, Assia Jaillard
While motor recovery following mild stroke has been extensively studied with neuroimaging, mechanisms of recovery after moderate to severe strokes of the types that are often the focus for novel restorative therapies remain obscure. We used fMRI to: 1) characterize reorganization occurring after moderate to severe subacute stroke, 2) identify brain regions associated with motor recovery and 3) to test whether brain activity associated with passive movement measured in the subacute period could predict motor outcome six months later...
2017: NeuroImage: Clinical
https://www.readbyqxmd.com/read/28315960/intravenous-thrombolysis-for-ischemic-stroke-in-the-golden-hour-propensity-matched-analysis-from-the-sits-east-registry
#16
Georgios Tsivgoulis, Aristeidis H Katsanos, Pavla Kadlecová, Anna Czlonkowska, Adam Kobayashi, Miroslav Brozman, Viktor Švigelj, Laszlo Csiba, Klara Fekete, Janika Kõrv, Vida Demarin, Aleksandras Vilionskis, Dalius Jatuzis, Yakup Krespi, Chrissoula Liantinioti, Sotirios Giannopoulos, Robert Mikulik
As there are scarce data regarding the outcomes of acute ischemic stroke (AIS) patients treated with intravenous thrombolysis (IVT) within 60 min from symptom onset ("golden hour"), we sought to compare outcomes between AIS patients treated within [GH(+)] and outside [GH(-)] the "golden hour" by analyzing propensity score matched data from the SITS-EAST registry. Clinical recovery (CR) at 2 and 24 h was defined as a reduction of ≥10 points on NIHSS-score or a total NIHSS-score of ≤3 at 2 and 24 h, respectively...
March 18, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28314625/transthyretin-concentrations-in-acute-stroke-patients-predict-convalescent-rehabilitation
#17
Naofumi Isono, Yuki Imamura, Keiko Ohmura, Norihide Ueda, Shinji Kawabata, Motomasa Furuse, Toshihiko Kuroiwa
OBJECTIVE: For stroke patients, intensive nutritional management is an important and effective component of inpatient rehabilitation. Accordingly, acute care hospitals must detect and prevent malnutrition at an early stage. Blood transthyretin levels are widely used as a nutritional monitoring index in critically ill patients. Here, we had analyzed the relationship between the transthyretin levels during the acute phase and Functional Independence Measure in stroke patients undergoing convalescent rehabilitation...
March 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28314519/after-effects-of-peripheral-neurostimulation-on-brain-plasticity-and-ankle-function-in-chronic-stroke-the-role-of-afferents-recruited
#18
Louis-David Beaulieu, Hugo Massé-Alarie, Samuel Camiré-Bernier, Édith Ribot-Ciscar, Cyril Schneider
AIMS OF THE STUDY: This study tested the after-effects of neuromuscular electrical stimulation (NMES), repetitive peripheral magnetic stimulation (rPMS) and muscle tendon vibration (VIB) on brain plasticity and sensorimotor impairments in chronic stroke to investigate whether different results could depend on the nature of afferents recruited by each technique. MATERIALS AND METHODS: Fifteen people with chronic stroke participated in five sessions (one per week)...
March 14, 2017: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/28304219/surgical-or-transcatheter-aortic-valve-replacement-in-intermediate-risk-patients
#19
Michael J Reardon, Nicolas M Van Mieghem, Jeffrey J Popma, Neal S Kleiman, Lars Søndergaard, Mubashir Mumtaz, David H Adams, G Michael Deeb, Brijeshwar Maini, Hemal Gada, Stanley Chetcuti, Thomas Gleason, John Heiser, Rüdiger Lange, William Merhi, Jae K Oh, Peter S Olsen, Nicolo Piazza, Mathew Williams, Stephan Windecker, Steven J Yakubov, Eberhard Grube, Raj Makkar, Joon S Lee, John Conte, Eric Vang, Hang Nguyen, Yanping Chang, Andrew S Mugglin, Patrick W J C Serruys, Arie P Kappetein
Background Although transcatheter aortic-valve replacement (TAVR) is an accepted alternative to surgery in patients with severe aortic stenosis who are at high surgical risk, less is known about comparative outcomes among patients with aortic stenosis who are at intermediate surgical risk. Methods We evaluated the clinical outcomes in intermediate-risk patients with severe, symptomatic aortic stenosis in a randomized trial comparing TAVR (performed with the use of a self-expanding prosthesis) with surgical aortic-valve replacement...
March 17, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28302608/ipsilateral-prominent-thalamostriate-vein-on-susceptibility-weighted-imaging-predicts-poor-outcome-after-intravenous-thrombolysis-in-acute-ischemic-stroke
#20
X Zhang, S Zhang, Q Chen, W Ding, B C V Campbell, M Lou
BACKGROUND AND PURPOSE: The impact of deep cerebral veins on neurologic outcome after intravenous thrombolysis in patients with acute ischemic stroke is unclear. We investigated the relationship between the appearance of deep cerebral veins on susceptibility-weighted imaging and neurologic outcome in patients who underwent thrombolysis. MATERIALS AND METHODS: We retrospectively analyzed 109 consecutive patients with acute ischemic stroke who had pretreatment SWI and received intravenous thrombolysis within 6 hours...
March 16, 2017: AJNR. American Journal of Neuroradiology
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