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Acute stroke aphasia therapy

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https://www.readbyqxmd.com/read/29279254/factors-related-to-immediate-response-to-symptoms-in-patients-with-stroke-or-transient-ischaemic-attack
#1
R García Ruiz, J Silva Fernández, R M García Ruiz, M Recio Bermejo, Á Arias Arias, A Santos Pinto, A Lomas Meneses, E Botía Paniagua, J Abellán Alemán
INTRODUCTION: Despite recent advances in the management of acute stroke, fewer than 10% of patients receive reperfusion therapy. One of the main reasons for such a low rate of administration is the delay on the part of patients and their families in seeking medical attention. This study aimed to analyse this delay. METHODS: A prospective observational study was conducted on consecutive stroke or transient ischaemic attack. Data on sociodemographic and clinical parameters, decision delay, pre-hospital delay, and first medical contact were collected...
December 23, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29196200/incidental-thrombotic-thrombocytopenic-purpura-during-acute-ischemic-stroke-and-thrombolytic-treatment
#2
İbrahim Acır, Hacı Ali Erdoğan, Vildan Yayla, Nilay Taşdemir, Murat Çabalar
BACKGROUND: Intravenous tissue plasminogen activator (IV tPA) was shown to be an effective treatment for acute ischemic stroke (AIS). According to stroke guidelines, there is no need to wait for the complete blood count (CBC) and coagulation test results before application of IV alteplase if there is no suspected coagulation disorder. In this study, a patient with AIS and thrombotic thrombocytopenic purpura (TTP) symptoms during thrombolytic treatment was presented. CASE: A 33-year-old male patient was admitted at the 2...
November 28, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29175498/neuroimaging-of-stroke-recovery-from-aphasia-insights-into-plasticity-of-the-human-language-network
#3
REVIEW
Gesa Hartwigsen, Dorothee Saur
The role of left and right hemisphere brain regions in language recovery after stroke-induced aphasia remains controversial. Here, we summarize how neuroimaging studies increase the current understanding of functional interactions, reorganization and plasticity in the language network. We first discuss the temporal dynamics across the time course of language recovery, with a main focus on longitudinal studies from the acute to the chronic phase after stroke. These studies show that the functional contribution of perilesional and spared left hemisphere as well as contralesional right hemisphere regions to language recovery changes over time...
November 23, 2017: NeuroImage
https://www.readbyqxmd.com/read/29116473/early-rehabilitation-after-stroke-a-narrative-review
#4
REVIEW
Elisheva R Coleman, Rohitha Moudgal, Kathryn Lang, Hyacinth I Hyacinth, Oluwole O Awosika, Brett M Kissela, Wuwei Feng
PURPOSE OF REVIEW: Despite current rehabilitative strategies, stroke remains a leading cause of disability in the USA. There is a window of enhanced neuroplasticity early after stroke, during which the brain's dynamic response to injury is heightened and rehabilitation might be particularly effective. This review summarizes the evidence of the existence of this plastic window, and the evidence regarding safety and efficacy of early rehabilitative strategies for several stroke domain-specific deficits...
November 7, 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28950785/fidelity-to-a-motivational-interviewing-intervention-for-those-with-post-stroke-aphasia-a-small-scale-feasibility-study
#5
Emma-Joy Holland, Caroline L Watkins, Elizabeth Boaden, Catherine E Lightbody
OBJECTIVE: Depression after stroke is common, and talk-based psychological therapies can be a useful intervention. While a third of stroke survivors will experience communication difficulties impeding participation in talk-based therapies, little guidance exists to guide delivery for those with aphasia. We need to understand how to adapt talk-based therapies in the presence of aphasia. This study aimed to explore the feasibility of motivational interviewing (MI) in people with post-stroke aphasia...
September 27, 2017: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/28929424/aphasia-as-a-predictor-of-stroke-outcome
#6
REVIEW
Ronald M Lazar, Amelia K Boehme
PURPOSE OF REVIEW: Aphasia is a common feature of stroke, affecting 21-38% of acute stroke patients and an estimated 1 million stroke survivors. Although stroke, as a syndrome, is the leading cause of disability in the USA, less is known about the independent impact of aphasia on stroke outcomes. RECENT FINDINGS: During the acute stroke period, aphasia has been found to increase length of stay, inpatient complications, overall neurological disability, mortality, and to alter discharge disposition...
September 19, 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28895453/extracranial-internal-carotid-artery-vasospasm-during-thrombectomy
#7
Isamu Miura, Akitsugu Kawashima, Masataka Hayashi, Akane Tanda, Tomomi Ishikawa, Takakazu Kawamata
The use of a stent retriever increases the risk of intracranial vasospasm. Here, we report the case of a man who developed severe vasospasm in a long segment of the extracranial internal carotid artery after mechanical irritation by a stent retriever inserted for the treatment of acute cerebral ischemia. A 47-year-old right-handed man presented with sudden-onset right-sided weakness and difficulty speaking. The patient's National Institutes of Health Stroke Scale score was 6 and he had an Alberta Stroke Program Early Computed Tomography Score of 9...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28870554/effectiveness-of-speech-language-therapy-either-alone-or-with-add-on-computer-based-language-therapy-software-malayalam-version-for-early-post-stroke-aphasia-a-feasibility-study
#8
Praveen Kesav, S L Vrinda, Sajith Sukumaran, P S Sarma, P N Sylaja
CONTEXT AND AIMS: This study aimed to assess the feasibility of professional based conventional speech language therapy (SLT) either alone (Group A/less intensive) or assisted by novel computer based local language software (Group B/more intensive) for rehabilitation in early post stroke aphasia. SETTINGS AND DESIGN: Comprehensive Stroke Care Center of a tertiary health care institute situated in South India, with the study design being prospective open randomised controlled trial with blinded endpoint evaluation...
September 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28851714/takayasu-arteritis-presenting-as-embolic-stroke
#9
Kristina Field, Laila Gharzai, Kaye Bardeloza, Bruce Houghton
A 52-year-old Caucasian woman presented to the emergency department with symptoms of acute ischaemic stroke (right-side weakness, confusion and aphasia) that resolved completely after administration of tissue plasminogen activator. During stroke work-up, she was found to have an enhancing infiltrate of the aorta at the level of the take-off of the great vessels, most consistent with early Takayasu arteritis. After being discharged home on steroids and dual antiplatelet therapy, she returned 2 days later with re-presentation of weakness and aphasia...
August 28, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28806993/successful-intravenous-thrombolysis-for-ischemic-stroke-after-reversal-of-dabigatran-anticoagulation-with-idarucizumab-a-case-report
#10
Sergio Agosti, Laura Casalino, Enrico Rocci, Gabriele Zaccone, Eugenia Rota
BACKGROUND: Non-vitamin K antagonist oral anticoagulants, including dabigatran, are currently widely used for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation. Recently, idarucizumab, a monoclonal antibody fragment for immediate reversal of dabigatran-induced anticoagulation, has been introduced into the market to be used in life-threatening bleeding or urgent surgery, allowing for rapid normalization of clotting parameters. The use of idarucizumab is not yet well established in patients presenting with acute ischemic stroke on dabigatran who are candidates for thrombolytic therapy...
August 15, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28611828/heads-up-a-novel-provocative-maneuver-to-guide-acute-ischemic-stroke-management
#11
Latisha K Ali, Julius K Weng, Sidney Starkman, Jeffrey L Saver, Doojin Kim, Bruce Ovbiagele, Brian H Buck, Nerses Sanossian, Paul Vespa, Oh Young Bang, Reza Jahan, Gary R Duckwiler, Fernando Viñuela, David S Liebeskind
BACKGROUND: A common dilemma in acute ischemic stroke management is whether to pursue recanalization therapy in patients with large vessel occlusions but minimal neurologic deficits. We describe and report preliminary experience with a provocative maneuver, i.e. 90-degree elevation of the head of bed for 30 min, which stresses collaterals and facilitates decision-making. METHODS: A prospective cohort study of <7.5 h of acute anterior circulation territory ischemia patients with minimal deficits despite middle cerebral artery (MCA) or internal carotid artery (ICA) occlusive disease...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28348771/angioinvasive-mucormycosis-and-paradoxical-stroke-a-case-report
#12
Roxana Mititelu, Samuel Bourassa-Blanchette, Karan Sharma, Virginia Roth
INTRODUCTION: Rhizopus typically results in acute, aggressive and angioinvasive infection, particularly in immunosuppressed individuals. Risk factors include immunosuppression in haematologic malignancy, uncontrolled hyperglycemia, iron overload states, and older chelator agents such as deferoxamine. CASE PRESENTATION: We describe a case of a 33-year-old female with transfusion-dependent beta thalassemia who was started on intravenous deferiprone therapy and subsequently presented with a retropharyngeal abscess...
August 2016: JMM Case Reports
https://www.readbyqxmd.com/read/28322130/motor-recovery-in-post-stroke-patients-with-aphasia-the-role-of-specific-linguistic-abilities
#13
Valeria Ginex, Laura Veronelli, Nicola Vanacore, Eleonora Lacorte, Alessia Monti, Massimo Corbo
BACKGROUND: Aphasia is a serious consequence of stroke but aphasics patients have been routinely excluded from participation in some areas of stroke research. OBJECTIVE: To assess the role of specific linguistic and non-verbal cognitive abilities on the short-term motor recovery of patients with aphasia due to first-ever stroke to the left hemisphere after an intensive rehabilitation treatment. METHODS: 48 post-acute aphasic patients, who underwent physiotherapy and speech language therapy, were enrolled for this retrospective cohort-study...
March 21, 2017: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/28002479/recovernow-feasibility-of-a-mobile-tablet-based-rehabilitation-intervention-to-treat-post-stroke-communication-deficits-in-the-acute-care-setting
#14
Karen H Mallet, Rany M Shamloul, Dale Corbett, Hillel M Finestone, Simon Hatcher, Jim Lumsden, Franco Momoli, Michel C F Shamy, Grant Stotts, Richard H Swartz, Christine Yang, Dar Dowlatshahi
BACKGROUND: Approximately 40% of patients diagnosed with stroke experience some degree of aphasia. With limited health care resources, patients' access to speech and language therapies is often delayed. We propose using mobile-platform technology to initiate early speech-language therapy in the acute care setting. For this pilot, our objective was to assess the feasibility of a tablet-based speech-language therapy for patients with communication deficits following acute stroke. METHODS: We enrolled consecutive patients admitted with a stroke and communication deficits with NIHSS score ≥1 on the best language and/or dysarthria parameters...
2016: PloS One
https://www.readbyqxmd.com/read/27845945/early-rehabilitation-after-stroke
#15
Julie Bernhardt, Erin Godecke, Liam Johnson, Peter Langhorne
PURPOSE OF REVIEW: Early rehabilitation is recommended in many guidelines, with limited evidence to guide practice. Brain neurobiology suggests that early training, at the right dose, will aid recovery. In this review, we highlight recent trials of early mobilization, aphasia, dysphagia and upper limb treatment in which intervention is commenced within 7 days of stroke and discuss future research directions. RECENT FINDINGS: Trials in this early time window are few...
February 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/27684629/factors-influencing-quality-of-life-six-months-after-a-first-ever-ischemic-stroke-focus-on-thrombolyzed-patients
#16
Sari Numminen, Anna-Maija Korpijaakko-Huuhka, Anna-Kaisa Parkkila, Teija Kulkas, Heikki Numminen, Prasun Dastidar, Mervi Jehkonen
OBJECTIVE: This prospective follow-up study aimed to identify sociodemographic and clinical factors that may affect the quality of life (QoL) of patients with acute ischemic stroke during a 6-month follow-up. PATIENTS AND METHODS: In the acute phase, sociodemographic and clinical data were collected using the National Institute of Health Stroke Scale, Barthel Index, and modified Rankin Scale. QoL was assessed with the Stroke and Aphasia Quality of Life Scale-39 6 months after stroke...
September 30, 2016: Folia Phoniatrica et Logopaedica
https://www.readbyqxmd.com/read/27676976/predictors-of-motor-outcomes-in-severe-sub-acute-stroke-patients-after-upper-limb-intensive-combined-robot-mediated-usual-care-training
#17
Christophe Duret, Anne Gaelle Grosmaire, Ophélie Courtial
OBJECTIVE: In stroke patients, motor impairments evaluated during the first few weeks usually predict upper limb motor outcomes after rehabilitation. However, a recent growing literature suggests that severe patients might not follow this principle [1]. This study aimed at exploring predictors of motor recovery after intensive training in that sub population of stroke patients. MATERIAL/PATIENTS AND METHODS: Thirty-eight patients with sub-acute hemiparesis (19 females, age 56±17 [19-87] years; time from stroke, 55±22 days) carried out 16 sessions (33±12 days) of robot-assisted adaptive training using a shoulder/elbow device integrated into conventional care...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27562709/resolving-thrombus-in-the-left-atrial-appendage-by-edoxaban-treatment-after-acute-ischemic-stroke-report-of-2-cases
#18
Shin Saito, Seigo Shindo, Shun Tsudaka, Kazutaka Uchida, Manabu Shirakawa, Shinichi Yoshimura
Here we report first 2 cases of patients with nonvalvular atrial fibrillation with acute cardioembolic stroke in whom thrombi in the left atrial appendage (LAA) were resolved by edoxaban administration. Case 1 reports an 86-year-old woman who suddenly showed right hemiparesis and aphasia due to occlusion of the left middle cerebral artery. She received mechanical thrombectomy and recovered neurologically. Transesophageal echocardiography (TEE) performed on day 1 demonstrated thrombus in the LAA. The thrombus was resolved on day 13 after initiation of edoxaban (30 mg once daily) instead of warfarin, which was administered before stroke onset...
October 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27506677/constraint-induced-aphasia-therapy-in-the-acute-stage-what-is-the-key-factor-for-efficacy-a-randomized-controlled-study
#19
RANDOMIZED CONTROLLED TRIAL
Hartwig Woldag, Nancy Voigt, Maria Bley, Horst Hummelsheim
BACKGROUND: Constraint-induced aphasia therapy (CIAT) has proven effective in patients with subacute and chronic forms of aphasia. It has remained unclear, however, whether intensity of therapy or constraint is the relevant factor. Data about intensive speech and language therapy (SLT) are conflicting. OBJECTIVE: To identify the effective component of CIAT and assess the feasibility of SLT in the acute stage after stroke. METHOD: A total of 60 patients with aphasia (68...
January 2017: Neurorehabilitation and Neural Repair
https://www.readbyqxmd.com/read/27484456/transcranial-direct-current-stimulation-in-post-stroke-sub-acute-aphasia-study-protocol-for-a-randomized-controlled-trial
#20
Kerstin Spielmann, W Mieke E van de Sandt-Koenderman, Majanka H Heijenbrok-Kal, Gerard M Ribbers
BACKGROUND: Transcranial direct current stimulation (tDCS) is a promising new technique to optimize the effect of regular Speech and Language Therapy (SLT) in the context of aphasia rehabilitation. The present study focuses on the effect of tDCS provided during SLT in the sub-acute stage after stroke. The primary aim is to evaluate the potential effect of tDCS on language functioning, specifically on word-finding, as well as generalization effects to verbal communication. The secondary aim is to evaluate its effect on social participation and quality of life, and its cost-effectiveness...
2016: Trials
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