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wake-up stroke

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https://www.readbyqxmd.com/read/29920688/modified-constraint-induced-movement-therapy-is-a-feasible-and-potentially-useful-addition-to-the-community-rehabilitation-tool-kit-after-stroke-a-pilot-randomised-control-trial
#1
Cathryn R Baldwin, Amy J Harry, Lynda J Power, Katherine L Pope, Katherine E Harding
BACKGROUND/AIM: The National Stroke Foundation recommends that Occupational Therapists use Constraint-Induced Movement Therapy (CIMT) with stroke survivors that experience an upper limb deficit. CIMT involves constraining the unaffected upper limb coupled with intensive therapy. The aim of this study was to evaluate the feasibility and effectiveness of a modified, low intensity version of CIMT (mCIMT) provided within usual resources of an Australian community rehabilitation setting. METHODS: A pilot randomised control trial (n = 19) was conducted with stroke survivors referred for community rehabilitation...
June 19, 2018: Australian Occupational Therapy Journal
https://www.readbyqxmd.com/read/29909667/haematomas-after-carotid-endarterectomy-can-be-reduced-by-direct-pressure-to-the-neck-postoperatively
#2
R Saghir, G Humm, T Rix
Introduction A recognised complication of carotid endarterectomy (CEA) is postoperative haematoma, which can threaten the airway. Previous studies have looked at medical methods of preventing this complication. This study aims to evaluate the impact of simple direct pressure postoperatively on the development of haematoma. Materials and methods From 2011 to 2016, 161 consecutive CEA were performed by a single surgeon or trainee under supervision. After 80 operations, the postoperative technique was altered, with additional pressure being applied by the surgeon to the skin incision from completion of suturing until each patient was awake in the recovery room...
June 18, 2018: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29857856/homogeneous-application-of-imaging-criteria-in-a-multicenter-trial-supported-by-investigator-training-a-report-from-the-wake-up-study
#3
Ivana Galinovic, Volker Dicken, Johannes Heitz, Jan Klein, Josep Puig, Jorge Guibernau, Andre Kemmling, Susanne Gellissen, Kersten Villringer, Lars Neeb, Johannes Gregori, Florian Weiler, Salvador Pedraza, Götz Thomalla, Jens Fiehler, Christian Gerloff, Jochen B Fiebach
BACKGROUND AND PURPOSE: WAKE-UP is a randomized, placebo-controlled trial of thrombolysis in stroke with unknown time of symptom onset using magnetic resonance imaging criteria to determine patients' eligibility. As it is a multicenter trial, homogeneous interpretation of criteria is an important contributor to the trial's success. We describe the investigator image training as well as results of the quality control done by the central image reading board (CIRB). METHODS: Investigators at local centers were given an imaging manual and passed a software-based image training prior to being allowed to judge images in the trial...
July 2018: European Journal of Radiology
https://www.readbyqxmd.com/read/29808241/dawn-and-defuse-3-trials-is-time-still-important
#4
REVIEW
A Ragoschke-Schumm, S Walter
BACKGROUND: Endovascular thrombectomy has been proven effective in the first 6 h after onset of stroke and large-vessel occlusion in the anterior cerebral circulation. To date, it was not clear whether thrombectomy beyond 6 h is also beneficial. METHODS: A summary of the prospective DAWN (DWI or CTP Assessment with Clinical Mismatch in the Triage of Wake-Up and Late Presenting Strokes Undergoing Neurointervention with Trevo) and DEFUSE-3 (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke) trials is presented...
May 28, 2018: Der Radiologe
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/29774008/repeated-endovascular-treatment-of-early-recurrent-proximal-middle-cerebral-artery-occlusion-case-report-and-brief-review-of-the-literature
#6
Simon Fandler, Hannes Deutschmann, Franz Fazekas, Thomas Gattringer
Mechanical thrombectomy (MT) is the gold standard treatment for large vessel occlusion (LVO) stroke of the anterior circulation. Whether MT can also be effectively and safely performed in early recurrent LVO is largely unclear. We present the case of a middle-aged patient who was successfully treated by MT for right proximal middle cerebral artery (MCA) occlusion with excellent outcome. One day after discharge (9 days after the first MT), the patient was readmitted with wake-up stroke. MRI again revealed right proximal MCA occlusion with severe diffusion-perfusion mismatch...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29772576/wake-up-stroke-versus-stroke-with-known-onset-time-clinical-and-multimodality-ct-imaging-characteristics
#7
Jan W Dankbaar, Henri P Bienfait, Coen van den Berg, Edwin Bennink, Alexander D Horsch, Tom van Seeters, Irene C van der Schaaf, L Jaap Kappelle, Birgitta K Velthuis
BACKGROUND: Current guidelines for the treatment of acute ischemic stroke are mainly based on the time between symptom onset and initiation of treatment. This time is unknown in patients with wake-up stroke (WUS). We investigated clinical and multimodality CT imaging characteristics on admission in patients with WUS and in patients with a stroke with a known onset time. METHODS: All patients were selected from a large prospective cohort study (Dutch acute stroke study)...
May 17, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29766770/mri-guided-thrombolysis-for-stroke-with-unknown-time-of-onset
#8
Götz Thomalla, Claus Z Simonsen, Florent Boutitie, Grethe Andersen, Yves Berthezene, Bastian Cheng, Bharath Cheripelli, Tae-Hee Cho, Franz Fazekas, Jens Fiehler, Ian Ford, Ivana Galinovic, Susanne Gellissen, Amir Golsari, Johannes Gregori, Matthias Günther, Jorge Guibernau, Karl Georg Häusler, Michael Hennerici, André Kemmling, Jacob Marstrand, Boris Modrau, Lars Neeb, Natalia Perez de la Ossa, Josep Puig, Peter Ringleb, Pascal Roy, Enno Scheel, Wouter Schonewille, Joaquin Serena, Stefan Sunaert, Kersten Villringer, Anke Wouters, Vincent Thijs, Martin Ebinger, Matthias Endres, Jochen B Fiebach, Robin Lemmens, Keith W Muir, Norbert Nighoghossian, Salvador Pedraza, Christian Gerloff
Background Under current guidelines, intravenous thrombolysis is used to treat acute stroke only if it can be ascertained that the time since the onset of symptoms was less than 4.5 hours. We sought to determine whether patients with stroke with an unknown time of onset and features suggesting recent cerebral infarction on magnetic resonance imaging (MRI) would benefit from thrombolysis with the use of intravenous alteplase. Methods In a multicenter trial, we randomly assigned patients who had an unknown time of onset of stroke to receive either intravenous alteplase or placebo...
May 16, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29730541/stroke-causes-a-transient-imbalance-of-interhemispheric-information-flow-in-eeg-during-non-rem-sleep
#9
Frederic Zubler, Andrea Seiler, Thomas Horvath, Corinne Roth, Silvia Miano, Christian Rummel, Heidemarie Gast, Lino Nobili, Kaspar A Schindler, Claudio L Bassetti
OBJECTIVE: Large-scale connectivity, especially interhemispheric connections, plays a crucial role for recovery after stroke. Here we used methods from information theory to characterize interhemispheric information flow in wake- and sleep-EEG after cerebral ischemia. METHODS: 34 patients with unilateral ischemic stroke were included. Symbolic Transfer Entropy (STE) was applied between bipolar EEG signals on the left and the right cerebral hemisphere during polysomnographic recordings in the acute phase and 3 months after stroke...
July 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/29729542/safety-and-cost-effectiveness-thrombolysis-by-diffusion-weighted-imaging-and-fluid-attenuated-inversion-recovery-mismatch-for-wake-up-stroke
#10
REVIEW
Tong Sun, Zhuan Xu, Shan-Shan Diao, Lu-Lu Zhang, Qi Fang, Xiu-Ying Cai, Yan Kong
Wake-up stroke, defined as patients who wake up with stroke symptoms which were not present prior to falling asleep, accounted for 14%-25% of acute ischemic stroke. Due to the unknown time of symptom onset, wake-up stoke was not in including criteria of intravenous thrombolysis. Several large randomized stroke trials using diffusion-weighted imaging(DWI)and fluid attenuated inversion recovery(FLAIR)mismatch patient selection may identify a subset of patients with wake-up stroke that can safely and effectively benefit from intravenous thrombolysis...
July 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29667266/application-of-the-dawn-clinical-imaging-mismatch-and-defuse-3-selection-criteria-benefit-seems-similar-but-restrictive-volume-cut-offs-might-omit-potential-responders
#11
C Ducroux, N Khoury, A Lecler, R Blanc, A Chetrit, H Redjem, G Ciccio, S Smajda, S Escalard, J-P Desilles, M Mazighi, M Ben Maacha, M Piotin, R Fahed
BACKGROUND AND PURPOSE: An external validation of the selection criteria of diffusion-weighted imaging or computerized tomography perfusion assessment with clinical mismatch in the triage of wake-up and late-presenting strokes undergoing the Neurointervention with Trevo (DAWN) and the Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke (DEFUSE3) trials was conducted in a cohort of unknown onset stroke (UOS) patients treated with thrombectomy. METHODS: A validation cohort of UOS patients was selected from a prospectively collected thrombectomy database to match the inclusion criteria of DAWN and DEFUSE 3...
April 18, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29581344/eligibility-for-endovascular-trial-enrollment-in-the-6-to-24-hour-time-window-analysis-of-a-single-comprehensive-stroke-center
#12
Ashutosh P Jadhav, Shashvat M Desai, Cynthia L Kenmuir, Marcelo Rocha, Matthew T Starr, Bradley J Molyneaux, Bradley A Gross, Brian T Jankowitz, Tudor G Jovin
BACKGROUND AND PURPOSE: The results of the DAWN trial (Diffusion-Weighted Imaging or Computerized Tomography Perfusion Assessment With Clinical Mismatch in the Triage of Wake Up and Late Presenting Strokes Undergoing Neurointervention With Trevo) support the benefit of endovascular therapy in patients presenting beyond the 6-hour time window with anterior circulation large vessel occlusions. The impact of these results with respect to additional number of eligible patients in clinical practice remains unknown...
April 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29564601/wake-up-stroke-and-sleep-disordered-breathing-a-meta-analysis-of-current-studies
#13
Zijian Xiao, Ming Xie, Yong You, Heng Wu, Guijuan Zhou, Mingyong Li
Sleep-disordered breathing (SDB) is a frequent comorbidity in patients with wake-up stroke (WUS). It affects the occurrence of this disease through its interference of breathing changes and sleep quality. We aim to assess the performances of sleep-disordered breathing in WUS. A systematical search for the studies that investigated sleep-disordered breathing in WUS was done in PubMed, Web of Science, and Cochrane Library. Data were extracted by two independent investigators, and then analyzed using the Revman 5...
March 21, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29557745/positron-emission-tomography-and-autoradiography-imaging-of-p-selectin-activation-using-68ga-fucoidan-in-photothrombotic-stroke-in-rats
#14
Ina Israel, Felix Fluri, Fabian Schadt, Adreas Buck, Samuel Samnick
BACKGROUND: P-selectin is activated early after stroke, followed by a rapid decline. This time course can be used to generate important information on stroke onset. The latter is crucial for therapeutic decision-making of wake-up strokes (i.e. thrombolysis or not). Here we evaluated the specific p-selectin inhibitor 68Ga-Fucoidan for assessing p-selectin activation after ischemic stroke using PET. METHODS: 68Ga-Fucoidan was investigated in rats brain at 2-5 h (n=16), and additionally at 24-26 h (n=9) and 48 h (n=3) after induction of photothrombic stroke or in sham operated animals (n=6)...
March 19, 2018: Current Neurovascular Research
https://www.readbyqxmd.com/read/29552091/mechanical-thrombectomy-in-a-young-stroke-patient-with-duchenne-muscular-dystrophy
#15
Charlotte Spicher, Ruth Schneider, Peter Mönnings, Christiane Schneider-Gold, Dennis Kallenberg, Bilal Cevik, Carsten Lukas, Ralf Gold, Christos Krogias
Background: Duchenne muscular dystrophy (DMD) is an X-linked recessive skeletal muscle myopathy which is caused by mutations in the dystrophin gene. Lack of dystrophin also results to cardiomyopathy, which raises significantly the stroke risk in DMD-patients. However, data about therapeutic opportunities in the acute setting are scarce in literature. So far, only two cases receiving IV thrombolysis are described, one of them with fatal outcome. Method: Case report of a case of successful mechanical thrombectomy (MTE) in an acute ischemic stroke (AIS) patient with DMD and associated dilatative cardiomyopathy...
2018: Therapeutic Advances in Neurological Disorders
https://www.readbyqxmd.com/read/29517077/wake-up-stroke-is-not-associated-with-sleep-disordered-breathing-in-women
#16
Devin L Brown, Chengwei Li, Ronald D Chervin, Erin Case, Nelda M Garcia, Susan D Tower, Lynda D Lisabeth
Background: We sought to investigate the frequency of wake-up stroke (WUS) and its association with sleep-disordered breathing (SDB) in women. Methods: Within a population-based study, women with acute ischemic stroke were asked about their stroke symptom onset time. SDB screening was performed with the well-validated ApneaLink Plus device; SDB was defined by a respiratory event index ≥10. Logistic regression was used to test the association between SDB presence and severity and WUS unadjusted and adjusted for potential confounders including prestroke depression and sleep duration...
February 2018: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/29504291/increased-risk-of-ischemic-stroke-during-sleep-in-apneic-patients
#17
Jin Soo Kim, Seongheon Kim, Seung Hwan Lee, Hee Young Lee, Seo Young Lee, Kyoung Bin Im
BACKGROUND AND PURPOSE: The literature indicates that obstructive sleep apnea (OSA) increases the risk of ischemic stroke. However, the causal relationship between OSA and ischemic stroke is not well established. This study examined whether preexisting OSA symptoms affect the onset of acute ischemic stroke. METHODS: We investigated consecutive patients who were admitted with acute ischemic stroke, using a standardized protocol including the Berlin Questionnaire on symptoms of OSA prior to stroke...
April 2018: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/29439123/endovascular-thrombectomy-in-wake-up-stroke-and-stroke-with-unknown-symptom-onset
#18
P Bücke, M Aguilar Pérez, V Hellstern, M AlMatter, H Bäzner, H Henkes
BACKGROUND AND PURPOSE: Mechanical thrombectomy in acute ischemic stroke within 6 hours of symptom onset is effective and safe. However, in many patients, information on the beginning of symptoms is not available. Patients can be divided into those with wake-up stroke and daytime-unwitnessed stroke. Evidence on outcome and complications after mechanical thrombectomy in wake-up stroke and daytime-unwitnessed stroke is rare. A potential beneficial effect of mechanical thrombectomy in selected patients with wake-up stroke or daytime-unwitnessed stroke is suspected...
February 8, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29358523/correction-to-enlightenment-and-challenges-offered-by-dawn-trial-dwi-or-ctp-assessment-with-clinical-mismatch-in-the-triage-of-wake-up-and-late-presenting-strokes-undergoing-neurointervention-with-trevo
#19
(no author information available yet)
No abstract text is available yet for this article.
February 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29356273/unknown-onset-strokes-with-anterior-circulation-occlusion-treated-by-thrombectomy-after-dwi-flair-mismatch-selection
#20
S Escalard, B Gory, M Kyheng, J-P Desilles, H Redjem, G Ciccio, S Smajda, J Labreuche, M Mazighi, M Piotin, R Blanc, B Lapergue, R Fahed
BACKGROUND AND PURPOSE: The DAWN trial recently showed compelling evidence in treating late window and wake-up stroke patients with thrombectomy using a clinical-imaging mismatch. The aim was to evaluate the results of thrombectomy for unknown-onset strokes (UOS) treated in our centres after a diffusion weighted imaging/fluid attenuated inversion recovery (DWI-FLAIR) mismatch based selection. METHODS: A multicentre, cohort study was performed of consecutive UOS treated by thrombectomy between 2012 and 2016...
May 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
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