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Dao P Zhang, Hong T Zhang, Suo Yin, Fu L Yan
This series case report aimed to elucidate the underlying pathology and outcomes of lateral medullary infarction (LMI) using perfusion weighted imaging (PWI). Four patients were diagnosed with LMI based on high-field diffusion-weighted magnetic resonance imaging (MRI-DWI) and PWI. The national institutes of health stroke scale (NIHSS) scores were recorded on days 1, 7, and 30, and the Barthel index was assessed on days 7 and 30. Three patients exhibited relative regional hypoperfusion of medullary lesion in the perfusion maps...
October 2016: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
Torunn Askim, Julie Bernhardt, Leonid Churilov, Bent Indredavik
BACKGROUND: The National Institutes of Health Stroke Scale (NIHSS) is the first choice among stroke scales. The Scandinavian Stroke Scale (SSS) is an alternative scale that is easy to apply in the clinic. AIM: To compare the ability of the SSS with that of the NIHSS in identifying patients who are dead or dependent at 3-month follow-up. METHODS: A prospective study including patients with acute stroke. NIHSS and SSS measurements were obtained during index hospital stay...
October 13, 2016: Journal of Rehabilitation Medicine
N M Giannantoni, M Minisci, V Brunetti, E Scarano, E Testani, C Vollono, E De Corso, G Bastanza, L D'Alatri, G Della Marca
Oro-pharyngeal dysphagia is frequently present during the acute phase of stroke. The aim of the present study was to evaluate whether the recording of surface EMG using a nasopharyngeal (NP) electrode could be applied to evaluation of pharyngeal muscle activity in acute stroke patients and if this neurophysiological measure is related with clinical assessment of swallowing. Patients were examined and clinical severity was assessed with the National Institute of Health Stroke Scale (NIHSS) score; dysphagia was evaluated through bedside screening test using the Gugging Swallowing Scale (GUSS)...
August 2016: Acta Otorhinolaryngologica Italica
Meret Branscheidt, Juliane Schneider, Patrik Michel, Elissavet Eskioglou, Georg Kaegi, Robert Stark, Urs Fischer, Simon Jung, Marcel Arnold, Maria Wertli, Ulrike Held, Susanne Wegener, Andreas Luft, Hakan Sarikaya
BACKGROUND AND PURPOSE: The impact of excess body weight on prognosis after stroke is controversial. Many studies report higher survival rates in obese patients ("obesity paradox"). Recently, obesity has been linked to worse outcomes after intravenous (IV) thrombolysis, but the number and sample size of these studies were small. Here, we aimed to assess the relationship between body weight and stroke outcome after IV thrombolysis in a large cohort study. METHODS: In a prospective observational multicenter study, we analyzed baseline and outcome data of 896 ischemic stroke patients who underwent IV thrombolysis...
2016: PloS One
Naoyuki Uchiyama, Kouichi Misaki, Masanao Mohri, Tomoya Kamide, Yuichi Hirota, Ryo Higashi, Hisato Minamide, Yukihiko Kohda, Takashi Asahi, Katsuo Shoin, Masayuki Iwato, Daisuke Kita, Yoshitaka Hamada, Yuya Yoshida, Mitsutoshi Nakada
Five recent multicenter randomized controlled trials (RCTs) have clearly shown the superiority of mechanical thrombectomy in large vessel occlusion acute ischemic stroke compared to systemic thrombolysis. Although 14 hospitals in Ishikawa prefecture have uninterrupted availability of systemic thrombolysis, mechanical thrombectomy is not available at all of these hospitals. Therefore, we established a Kanazawa mobile embolectomy team (KMET), which could travel to these hospitals and perform the acute reperfusion therapy...
October 11, 2016: Neurologia Medico-chirurgica
Marcin Wiącek, Rafał Kaczorowski, Jarosław Homa, Edward Filip, Janusz Darocha, Daniel Dudek, Wiesław Guz, Halina Bartosik-Psujek
BACKGROUND AND PURPOSE: Recently, positive data from several randomized controlled trials (RCTs) of endovascular therapy for acute ischemic stroke (AIS) has emerged. The aim of this retrospective study is to present our clinical experience in cerebral vessel occlusion treatment using retrievable intracranial stents. METHODS: Forty-three consecutive patients with ischemic stroke (median age 75, range 22-87) treated by stent retriever thrombectomy (Solitaire™ FR) between January 2013 and December 2015 were identified...
September 23, 2016: Neurologia i Neurochirurgia Polska
Gustavo José Luvizutto, Marcelo Fernando Zeugner Bertotti, Thiago Dias Fernandes, Hélio Rubens de Carvalho Nunes, Gabriel Pereira Braga, Rodrigo Bazan, Luiz Antônio de Lima Resende
Objective: To relate F-waves with clinical and laboratory exams in the acute phase of stroke. Methods: Inclusion criteria for this cross-sectional study were: hemiplegia, absence of previous cranial trauma, myopathy, diabetes, alcoholism or other known causes of peripheral neuropathy, and normal sensory and motor conduction. The National Institutes of Health Stroke Scale (NIHSS) score, glycemia, glucosilate hemoglobin, and CPK were obtained at admission by routine blood exams...
September 2016: Arquivos de Neuro-psiquiatria
Li Qian, Lin Yuanshao, Huang Wensi, Zhou Yulei, Chen Xiaoli, Wang Brian, Zhang Wanli, Cai Zhengyi, Xue Jie, Zhang Wenhui, Yu Tieer, Wang Hong, He Jincai, Jin Kunlin, Shao Bei
Interleukin-33 (IL-33), a newly recognized IL-1 family member, is expressed in various tissues and cells, and involved in pathogenesis of many human diseases. For example, IL-33 plays a protective role in cardiovascular diseases. However, the role of IL-33 in acute ischemic stroke (AIS) remains unclear. This study aims to investigate whether IL-33 level in AIS patient serum can be used as a potential diagnostic and prognostic marker. The study included two hundred and six patients with first-ever ischemic stroke, who were admitted within 72 hours after stroke onset...
October 2016: Aging and Disease
Silvia Olivato, Silvia Nizzoli, Milena Cavazzuti, Federica Casoni, Paolo Frigio Nichelli, Andrea Zini
BACKGROUND: The National Institutes of Health Stroke Scale (NIHSS) is the most widespread clinical scale used in patients presenting with acute stroke. The merits of the NIHSS include simplicity, quickness, and agreement between clinicians. The clinical evaluation on posterior circulation stroke remains still a limit of NIHSS. METHODS: We assessed the application of a new version of NIHSS, the e-NIHSS (expanded NIHSS), adding specific elements in existing items to explore signs/symptoms of a posterior circulation stroke...
September 28, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
S J Li, H Q Hu, X L Wang, B Z Cao
Objective: To investigate the correlation between post-stroke pneumonia and outcome in patients with acute brain infarction. Methods: Consecutive acute cerebral infarction patients who were hospitalized in Department of Neurology, Jinan Military General Hospital were prospectively recruited from August 2010 to August 2014. The baseline data including age, sex, the National Institute of Health Stroke Scale (NIHSS) scores, type of Oxfordshire Community Stroke Project (OCSP: total anterior circulation infarct, partial anterior circulation infarct, posterior circulation infarct and lacunar infarct), fasting blood glucose etc...
September 20, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Chao Jiang, Weixia Kong, Yuejuan Wang, Wendy Ziai, Qingwu Yang, Fangfang Zuo, Fangfang Li, Yali Wang, Hongwei Xu, Qian Li, Jie Yang, Hong Lu, Jiewen Zhang, Jian Wang
This study was designed to investigate dynamic changes in the cellular immune system and circulating inflammatory markers after ischemic stroke. Blood was collected from 96 patients and 99 age-matched control subjects for detection of lymphocyte subpopulations and inflammatory markers. We observed decreases in B cells, Th cells, cytotoxic T cells, and NK cells and an increase in regulatory T (Treg) cells in stroke patients on days 1, 3, and 7. Serum levels of TNF-α, C-reactive protein (CRP), IL-4, IL-6, IL-10, IL-17, IL-23, and TGF-β increased, whereas serum level of IFN-γ decreased at all time points after stroke...
September 22, 2016: Oncotarget
Chieh Grace Lau, Wai Kwong Tang, Xiang Xin Liu, Hua Jun Liang, Yan Liang, Vincent Mok, Adrian Wong, Gabor S Ungvari, Mansur A Kutlubaev, Ka Sing Wong
OBJECTIVE: To examine the relationship between neuroticism and fatigue in Chinese stroke patients. DESIGN: Cross-sectional. SETTING: PARTICIPANTS: One hundred and ninety-one ischemic stroke survivors recruited from the above-mentioned acute stroke unit between May 2010 and September 2011. INTERVENTIONS: None. MAIN OUTCOME MEASURES: The personality trait of neuroticism was measured with the neuroticism subscale of the Chinese version of the NEO-five-factor Inventory (NEO-FFI)...
September 24, 2016: Archives of Physical Medicine and Rehabilitation
Simon Butet, Clément Provost, Marylène Jousse, Leila Tlili, Victorine Quintaine, Isabelle Bonan, Alain Yelnik
OBJECTIVE: The positive effects on motor cortical excitability of stimulating proprioception with tendon vibration therapy have previously been reported in healthy individuals and in chronic stroke patient (Marconi et al., 2008 and 2011). The aim of this study is to evaluate the feasibility of a protocol of tendon vibration therapy in a neurorehabilitation service, with a view to proceeding to an efficacy study. MATERIAL/PATIENTS AND METHODS: We performed a prospective, single-centre study, including 11 patients, 8 men, mean age 61,7±10,6, with upper limb motor deficit secondary to a first stroke (5 ischaemic)...
September 2016: Annals of Physical and Rehabilitation Medicine
Alain Yelnik, Cedric Andriantsifanetra, Peggy Reinert, Mathilde Evrard, Hélène Marneff, Marie Wanepain, Margaux Barbie, Johann Beaudreuil, Jean Pascal Devailly, Eric Vicaut
OBJECTIVE: Active and intensive physical therapy (PT) facilitates motor recovery when provided at a subacute stage after stroke. The efficiency of very early intensive PT (within the 2 first weeks) has been much less investigated. Early intensive rehabilitation might be beneficial for neural plasticity but also detrimental by worsening the cerebral ischemia. The AVERT study (Bernhardt 2015) showed negative effect of high dose of very early mobilisation. MATERIAL/PATIENTS AND METHODS: Patients have been recruited in this multicentre randomized controlled trial (9 stroke units with PRM teams) to compare "soft" (20 min/day apart from respiratory needs) versus "intensive" PT (idem+45 minutes of intensive exercises/day), initiated within the 72 first hours after a first hemispheric stroke...
September 2016: Annals of Physical and Rehabilitation Medicine
Ligen Shi, Feng Liang, Yunping Li, Anwen Shao, Keren Zhou, Jun Yu, Jianmin Zhang
Recent studies have shown inconsistent results regarding the value of desmoteplase for treating acute ischemic stroke (AIS) when administered within an extended time window. We performed a meta-analysis to explore the value of desmoteplase in AIS treatment. The MEDLINE, EMBASE, and Cochrane Library databases were searched for randomized controlled trials (RCTs) that had evaluated desmoteplase versus placebo for AIS. The primary outcomes were intracranial hemorrhage (ICH) within 72 hours and favorable outcome at Day 90...
September 27, 2016: Scientific Reports
Qiuhong Ji, Yuhua Ji, Jingwen Peng, Xin Zhou, Xinya Chen, Heng Zhao, Tian Xu, Ling Chen, Yun Xu
The aims of this study were to examine the alternation in serum exosome concentrations and the levels of serum exosomal miR-9 and miR-124, two brain-specific miRNAs, in acute ischemic stroke (AIS) patients and to explore the predictive values of these miRNAs for AIS diagnosis and damage evaluation. Sixty-five patients with AIS at the acute stage were enrolled and 66 non-stroke volunteers served as controls. Serum exosomes isolated by ExoQuick precipitations were characterized by transmission electron microscopy, nanoparticle-tracking analysis and western blotting...
2016: PloS One
Sheng-Feng Sung, Cheng-Yang Hsieh, Huey-Juan Lin, Yu-Wei Chen, Chih-Hung Chen, Yea-Huei Kao Yang, Ya-Han Hu
BACKGROUND: Ascertaining stroke severity in claims data-based studies is difficult because clinical information is unavailable. We assessed the predictive validity of a claims-based stroke severity index (SSI) and determined whether it improves case-mix adjustment. METHODS: We analyzed patients with acute ischemic stroke (AIS) from hospital-based stroke registries linked with a nationwide claims database. We estimated the SSI according to patient claims data. Actual stroke severity measured with the National Institutes of Health Stroke Scale (NIHSS) and functional outcomes measured with the modified Rankin Scale (mRS) were retrieved from stroke registries...
2016: BMC Health Services Research
X-L Chen, Q Li, W-S Huang, Y-S Lin, J Xue, B Wang, K-L Jin, B Shao
BACKGROUND AND PURPOSE: Inflammation comprises important aspects of large-artery atherosclerosis (LAA) stroke pathophysiology. YKL-40 is a new and emerging biomarker that is associated with both acute and chronic inflammations. Elevated serum concentrations of YKL-40 have been reported in patients with atherosclerosis and other cardiovascular diseases. This study investigates whether serum YKL-40 concentrations on admission can predict 3-month clinical outcomes after LAA stroke. METHODS: We recruited control patients (n=85) and those with LAA stroke (n=141) according to the TOAST classification system...
September 21, 2016: Acta Neurologica Scandinavica
Xiaodan Wei, Zhuang Liu, Min Li, Chunhua Yang, Wenming Wang, Xianglin Li, Shuping Zhang, Xuri Li, Geng Tian, Jonas Bergquist, Bin Wang, Jia Mi
BACKGROUND: The severity of ischemic stroke symptoms varies among patients and is a critical determinant of patient outcome. To date, the association between the number of stenotic intracranial arteries and stroke severity remains unclear. AIMS: We aimed to investigate the association between the number of stenotic major intracranial arteries (NSMIA) and ischemic stroke severity, as well as the degree of stenosis and common stroke risk factors. METHODS: We performed a retrospective analysis of patients with digital subtraction angiography (DSA)-confirmed ischemic stroke...
2016: PloS One
Aparna Pandey, Amit Shrivastava, Ashok Solanki
BACKGROUND: Stroke is one of the most frequent causes of death and disability worldwide and has significant clinical and socioeconomic impact. Hyperlipidemia and inflammation play major roles in atherothrombosis and in stroke. This study is conducted to compare the high sensitive C-reactive protein (hs-CRP) levels and the lipid profile parameters between stroke patients and control group and demonstrate correlation between markers, neurological deficit, and short-term outcome. METHODS: We have studied a total 162 patients according to inclusion criteria...
July 6, 2016: Iranian Journal of Neurology
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