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https://www.readbyqxmd.com/read/28087804/clinical-selection-strategies-to-identify-ischemic-stroke-patients-with-large-anterior-vessel-occlusion-results-from-sits-istr-safe-implementation-of-thrombolysis-in-stroke-international-stroke-thrombolysis-registry
#1
Jan F Scheitz, Azmil H Abdul-Rahim, Rachael L MacIsaac, Charith Cooray, Heidi Sucharew, Dawn Kleindorfer, Pooja Khatri, Joseph P Broderick, Heinrich J Audebert, Niaz Ahmed, Nils Wahlgren, Matthias Endres, Christian H Nolte, Kennedy R Lees
BACKGROUND AND PURPOSE: The National Institutes of Health Stroke Scale (NIHSS) correlates with presence of large anterior vessel occlusion (LAVO). However, the application of the full NIHSS in the prehospital setting to select patients eligible for treatment with thrombectomy is limited. Therefore, we aimed to evaluate the prognostic value of simple clinical selection strategies. METHODS: Data from the Safe Implementation of Thrombolysis in Stroke International Stroke Thrombolysis Registry (January 2012-May 2014) were analyzed retrospectively...
January 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28074998/-prognostic-factors-of-functional-recovery-from-a-stroke-at-one-year
#2
J A Moreno-Palacios, I Moreno-Martinez, A Bartolome-Nogues, E Lopez-Blanco, R Juarez-Fernandez, I Garcia-Delgado
INTRODUCTION: Recovery of the ability to walk and independence is fundamental for any patient who suffers a stroke, and it can be influenced by a number of factors. AIM: To determine what variables are more important to achieve a good functional recovery at one year after the stroke. PATIENTS AND METHODS: An observational, longitudinal prospective study was conducted with 231 patients diagnosed with a stroke in the year 2013. An analysis was performed of the clinical characteristics, socio-demographic data, neurological situation at the time of hospitalisation -National Institute of Health Stroke Scale (NIHSS)-, functional situation (Rankin Scale and Barthel Index) and ability to walk, both on hospitalisation and on discharge from rehabilitation and at one year...
January 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28066971/the-association-between-diffusion-mri-defined-infarct-volume-and-nihss-score-in-patients-with-minor-acute-stroke
#3
Shadi Yaghi, Charlotte Herber, Amelia K Boehme, Howard Andrews, Joshua Z Willey, Sara K Rostanski, Matthew Siket, Mahesh V Jayaraman, Ryan A McTaggart, Karen L Furie, Randolph S Marshall, Ronald M Lazar, Bernadette Boden-Albala
BACKGROUND: Prior studies have shown a correlation between the National Institutes of Health Stroke Scale (NIHSS) and stroke volume on diffusion weighted imaging (DWI); data are more limited in patients with minor stroke. We sought to determine the association between DWI lesion(s) volume and the (1) total NIHSS score and (2) NIHSS component scores in patients with minor stroke. METHODS: We included all patients with minor stroke (NIHSS 0-5) enrolled in the Stroke Warning Information and Faster Treatment study...
January 9, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28065791/the-neuroprotective-strategic-analysis-for-patients-with-acute-myocardial-infarction-combined-with-hypoxic-ischemic-encephalopathy-in-icu
#4
Yali Chao, Weiwei Hu, Xiaojuan Geng
BACKGROUND: We conducted this study to investigate the neuroprotective treatment strategies for patients with acute myocardial infarction (AMI) complicated with hypoxic ischemic encephalopathy (HIE) in the ICU. METHODS: A total of 83 cases that were diagnosed with secondary AMI for the first time were selected and divided into observation group (n=43) and the control group (n=40). All of patients underwent emergency or elective PCI. Patients in the control group were treated with mannitol to reduce intracranial pressure, cinepazide maleate to improve microcirculation in the brain and also given comprehensive treatments of oxygen inhalation, fluid infusion, acid-base imbalance correction, electrolyte disturbance, etc...
January 5, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28065404/cerebral-microbleeds-and-risk-of-intracerebral-hemorrhage-post-intravenous-thrombolysis
#5
Ramin Zand, Georgios Tsivgoulis, Mantinderpreet Singh, Michael McCormack, Nitin Goyal, Muhammad Fawad Ishfaq, Reza Bavarsad Shahripour, Katherine Nearing, Lucas Elijovich, Anne W Alexandrov, David S Liebeskind, Andrei V Alexandrov
BACKGROUND: Stroke patients who have cerebral micro bleeds (CMBs) could be potentially at a greater risk for symptomatic intracerebral hemorrhage (sICH) than those patients without CMBs. The aim of our study was to investigate whether the presence and burden of CMBs are associated with post IVT sICH. METHODS: In this multicenter study, consecutive patients treated with intravenous tissue plasminogen activator were prospectively identified and analyzed. Patients without magnetic resonance imaging (MRI) within 24 hours of treatment were excluded...
January 3, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28064431/the-prevalence-and-clinical-significance-of-sleep-disorders-in-acute-ischemic-stroke-patients-a-questionnaire-study
#6
Keun Tae Kim, Hye-Jin Moon, Jun-Gyu Yang, Sung-Ii Sohn, Jeong-Ho Hong, Yong Won Cho
PURPOSE: Sleep disturbances are frequently reported in stroke patients and associated with the outcome of strokes. Using sleep questionnaires, we investigated the prevalence of classified sleep disturbance and the influence of sleep disorders upon a stroke prognosis. METHODS: Patients with acute ischemic strokes or transient ischemic attacks (TIA) were included. We investigated the prevalence of sleep disturbance and the association of outcomes resulting from strokes...
January 7, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28059705/emergent-endovascular-management-of-long-segment-and-flow-limiting-carotid-artery-dissections-in-acute-ischemic-stroke-intervention-with-multiple-tandem-stents
#7
S A Ansari, A L Kühn, A R Honarmand, M Khan, M C Hurley, M B Potts, B S Jahromi, A Shaibani, M J Gounis, A K Wakhloo, A S Puri
BACKGROUND AND PURPOSE: Although most cervical dissections are managed medically, emergent endovascular treatment may become necessary in the presence of intracranial large-vessel occlusions, flow-limiting and long-segment dissections with impending occlusion, and/or hypoperfusion-related ischemia at risk of infarction. We investigated the role of emergent endovascular stenting of long-segment carotid dissections in the acute ischemic stroke setting. MATERIALS AND METHODS: We retrospectively studied long-segment carotid dissections requiring stent reconstruction with multiple tandem stents (≥3 stents) and presenting with acute (<12 hours) ischemic stroke symptoms (NIHSS score, ≥4)...
November 10, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28052272/ischemic-stroke-in-young-adults-of-northern-china-characteristics-and-risk-factors-for-recurrence
#8
Fang Li, Li Yang, Rui Yang, Wei Xu, Fu-Ping Chen, Nan Li, Jin-Biao Zhang
BACKGROUND: Young adults accounted for 10-14% of ischemic stroke patients. The risk factors may differ in this population from elder patients. In addition, the factors associated with stroke recurrence in this population have not been well investigated. OBJECTIVE: The study aimed to investigate the characteristics and risk factors associated with recurrence of ischemic stroke in young adults. METHODS: Clinical data of 1,395 patients of age 18-45 years who were treated between 2008 and 2014 in 3 centers located in northern China was reviewed...
January 5, 2017: European Neurology
https://www.readbyqxmd.com/read/28028726/predictors-of-in-hospital-mortality-and-dependence-at-discharge-in-patients-with-mca-stroke-with-intravenous-thrombolysis
#9
Renata Dal-Prá Ducci, Marcos Christiano Lange, Viviane de Hiroki Flumignan Zétola
Early risk stratification of mortality and dependence is important for guiding medical decision-making in stroke care. The study aim is to evaluate whether there are any differences between risk factors for in-hospital mortality and dependence at discharge in patients with first-episode ischemic stroke in the middle cerebral artery (MCA) receiving intravenous thrombolysis (IVT) treatment. The study comprised a single-center cohort of patients admitted consecutively for first-episode MCA ischemic stroke. A logistic regression analysis was performed to determine the variables associated with in-hospital mortality and dependence at discharge...
December 27, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28025821/identifying-patients-at-risk-of-acute-symptomatic-seizure-after-ischemic-stroke
#10
K N Alme, B A Engelsen, M Naik, H Naess
BACKGROUND: Contributors to post-stroke seizure research have advocated the need for prospective studies of acute symptomatic seizures after stroke. Identification of the patient at risk of seizure and the impact of the event on outcome is a prerequisite for this kind of research. The aim of this study was to identify risk factors, make an outline for a risk score, and look at consequences of seizure on short-time clinical outcomes. METHODS: This registry-based study included patients with ischemic stroke admitted between 2007 and 2013...
December 26, 2016: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28025467/mechanical-thrombectomy-using-the-trevo-provue-in-50-consecutive-patients-with-anterior-circulation-stroke-a-single-center-experience-after-approval-of-the-stent-retriever-in-japan
#11
Taichiro Imahori, Kazuhiro Tanaka, Junji Koyama, Atsushi Arai, Ryoji Shiomi, Hirofumi Iwahashi, Akiyoshi Yokote, Kazushi Matsushima, Daisaku Matsui, Makoto Kobayashi, Atsushi Fujita, Kohkichi Hosoda, Eiji Kohmura
Mechanical thrombectomy using the stent retriever has been proven to be effective for select patients with acute ischemic stroke. We evaluated our early experience using the device after its approval in 2014 in Japan, with a special emphasis on the occlusion site. Fifty consecutive endovascular revascularization procedures for treating anterior acute large vessel occlusion were performed using the Trevo ProVue as the first-line device at our institute between April 2015 and March 2016. Focusing on the involvement of the M1-M2 bifurcation with deployment or retrieval of the stent retriever, we regarded the middle cerebral artery M1 mid-portion as the boundary and divided the cases into proximal (n = 26) and distal (n = 24) groups...
December 27, 2016: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28024976/neurological-functional-outcomes-of-decompressive-hemicraniectomy-versus-conventional-treatment-for-malignant-middle-cerebral-artery-infarction-a-systematic-review-and-mata-analysis
#12
Yu-Ping Li, Meng-Zhuo Hou, Guang-Yu Lu, Natalia Ciccone, Xing-Dong Wang, Lun Dong, Chen Cheng, Heng-Zhu Zhang
BACKGROUND: This study aims to evaluate the effect of decompressive hemicraniectomy (DHC) versus conventional treatments (CT) for patients with malignant middle cerebral artery infarction (MMI), and to investigate the impact of age and surgical timing on neurological function and mortality. METHODS: We searched English and Chinese databases for randomized controlled trials (RCTs) or observational studies (OSs) published before August 2016. The outcomes included good functional outcome (GFO), mortality, National Institutes of Health Stroke Scale (NIHSS) score, and Barthel Index (BI) score...
December 23, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28019142/the-association-between-hyperglycemia-and-the-prognosis-of-acute-spontaneous-intracerebral-hemorrhage
#13
Yanxia Zhao, Jie Yang, Hongdong Zhao, Yunlong Ding, Junshan Zhou, Yingdong Zhang
OBJECTIVE: To evaluate the potential association between the plasma glucose levels and the 90-day prognosis in patients with spontaneous intracerebral hemorrhage (sICH). METHODS: Patients with a well-defined diagnosis of sICH admitted within 24 h of onset were included. Random plasma glucose at admission and fasting plasma glucose on the following day were measured. Hyperglycemia was defined as a random plasma glucose ≥10 mmol/L or a fasting plasma glucose ≥7 mmol/L...
December 26, 2016: Neurological Research
https://www.readbyqxmd.com/read/28017749/general-anesthesia-during-endovascular-stroke-therapy-does-not-negatively-impact-outcome
#14
Arthur Wang, Madison Stellfox, Fred Moy, Apolonia E Abramowicz, Rachel Lehrer, Rivkah Epstein, Nicole Eiden, Amy Aquilina, Noorie Pednekar, Glenn Brady, Matthew Wecksell, John Cooley, Justin Santarelli, Michael F Stiefel
OBJECTIVE: Recent randomized trials, have demonstrated that endovascular therapy improves outcomes in patients with an acute ischemic stroke from a large vessel occlusion (LVO). Sub-group analysis of the MR CLEAN study found that patients undergoing general anesthesia (GA) for the procedure did worse than those with non-general anesthesia (non-GA). Current guidelines now suggest that we consider non-GA over GA, without large, randomized trials specifically designed to address this issue...
December 22, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28017746/outcome-evaluation-of-acute-ischemic-stroke-patients-treated-with-endovascular-thrombectomy-a-single-institution-experience-in-the-era-of-randomized-controlled-trials
#15
Francesca Sarzetto, Shaurya Gupta, Naif M Alotaibi, Peter Howard, Leodante da Costa, Chris Heyn, Pejman Jabehdar Maralani, Daipayan Guha, Rick Swartz, Karl Boyle, Victor X D Yang
BACKGROUND: Endovascular thrombectomy is an effective procedure to treat selected ischemic strokes as shown in recent randomized controlled trials (RCTs). However, the generalizability of these trial data to real-world setting is unknown. The aim of this study was to examine our single center experience with endovascular thrombectomy for acute ischemic strokes and perform a comparative outcome analysis to the most recent RCTs. METHODS: We performed a 5-year retrospective analysis, from April 2011 to March 2016, on 66 consecutive patients with acute ischemic stroke who received endovascular thrombectomy at our institution...
December 22, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28017233/bridging-therapy-with-intravenous-recombinant-tissue-plasminogen-activator-improves-functional-outcome-in-patients-with-endovascular-treatment-in-acute-stroke
#16
Ilko L Maier, Daniel Behme, Marlena Schnieder, Ioannis Tsogkas, Katharina Schregel, Alexander Kleinknecht, Katrin Wasser, Mathias Bähr, Michael Knauth, Marios Psychogios, Jan Liman
BACKGROUND: Although endovascular treatment for proximal cerebral vessel occlusion is very effective, it remains controversial if intravenous thrombolysis (IVT) prior to endovascular treatment is superior compared to endovascular treatment alone. In this study we compared functional outcomes and recanalization rates of endovascularly treated stroke patients with and without bridging IVT. METHODS: Patients with acute large artery occlusion within the anterior and posterior cerebral circulation eligible for intraarterial revascularization with and without prior IVT were included in this monocentric, prospective observational study...
January 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28017193/does-stroke-etiology-play-a-role-in-predicting-outcome-of-acute-stroke-patients-who-underwent-endovascular-treatment-with-stent-retrievers
#17
Semih Giray, Ozcan Ozdemir, Demet F Baş, Yusuf İnanç, Zulfikar Arlıer, Ozcan Kocaturk
AIMS: The goal of the study was to identify whether the stroke etiology play a role in the recanalization and outcome of patients who underwent mechanical thrombectomy with stent retrievers. METHODS AND RESULTS: A retrospective analysis of a prospectively collected database included consecutive patients treated with stent retrievers. We included patients with cardioembolic stroke and large vessel atherosclerotic disease and compared risk factors for stroke, baseline NIHSS and Alberta Stroke Program Early CT scores (ASPECTS), stroke outcome, recanalization rate, onset-to-recanalization, onset-to-groin puncture time and the procedural time between two groups...
January 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28017191/the-role-of-very-high-high-sensitivity-c-reactive-protein-levels-on-mortality-after-stroke
#18
Ahmed Itrat, Sandra D Griffith, Shazia Alam, Nicolas Thompson, Irene L Katzan
: High-sensitivity C-reaction protein (hsCRP) levels are correlated with risk of vascular disease. The clinical implications of markedly elevated hsCRP levels in the setting of acute stroke are less understood. OBJECTIVE: To determine the association of very high admission hsCRP levels (≥10mg/L) on all-cause mortality in patients with acute stroke. METHODS: A retrospective cohort study of 1176 patients hospitalized with acute stroke between 2005 and 2012 who had a hsCRP assay drawn within seven days of admission...
January 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28011949/the-presence-of-tau-protein-in-blood-as-a-potential-prognostic-factor-in-stroke-patients
#19
A A Lasek-Bal, H Jedrzejowska-Szypulka, J Rozycka, W Bal, A Kowalczyk, M Holecki, J Dulawa, J Lewin-Kowalik
Tau protein is found in the blood of 40 - 50% of patients in the acute phase of a stroke, as a result of the degradation of neurons and damage to the blood-brain barrier. The aim of the study was to assess the incidence of tau protein in the blood of stroke patients, as well as to evaluate the potential impact of tau protein presence in the blood of patients on their neurological state during the first 24 hours, and their functional condition three months after the stroke. Eighty-seven patients aged 39 - 99 (42 females and 45 males) diagnosed with stroke were enrolled in the prospective study (August 2014 - April 2015)...
October 2016: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/28004340/lipoprotein-a-as-a-predictor-of-early-stroke-recurrence-in-acute-ischemic-stroke
#20
Xiao-Wu Hong, Dong-Mei Wu, Jun Lu, Yuan-Lin Zheng, Wen-Jun Tu, Jing Yan
Inflammation plays a crucial role in the pathogenesis of stroke. This study aims to determine lipoprotein (a) [Lp(a)] levels in serum and to investigate their associations with stroke recurrence events in a 3-month follow-up study in patients with acute ischemic stroke (AIS). Serum Lp(a) levels were determined in 203 ischemic stroke patients and 120 normal controls at admission. The severity and clinical outcome of ischemic stroke patients were evaluated by the National Institutes of Health Stroke Scale (NIHSS)...
December 21, 2016: Molecular Neurobiology
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