Benefits of MRI for Patients With Low-risk Transient or Persistent Minor Neurologic Deficits

More than 1 million patients receive a diagnosis of stroke or transient ischemic attack (TIA) in the United States each year. These patients are at increased risk of stroke during the first few weeks after the initial event, with the greatest risk during the first 2 days. Evidence-based secondary preventive measures are available to lower the risk of recurrent ischemic events, but for these measures to be effectively implemented, patients with stroke or TIA must be rapidly and correctly identified. Accurate diagnosis is important because some secondary preventive strategies carry risks of their own and are usually not appropriate for patients who did not have a TIA or stroke. Patients presenting with motor weakness, aphasia, or prolonged symptoms are at highest risk for recurrent stroke and are typically more comprehensively evaluated. Therefore, these patients are more likely to receive a more conclusive diagnosis and are likely to receive secondary prevention strategies promptly.
Source: JAMA Neurology - Category: Neurology Source Type: research

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Conclusions Organizing the various hypothesized brain-behavior relationships according to this framework and considering the mechanisms that drive these relationships may help investigators develop specific experimental designs and more complete statistical models to explain language and cognitive abilities after stroke. Eight main recommendations for future research are provided. Presentation Video PMID: 31756155 [PubMed - in process]
Source: Journal of speech, language, and hearing research : JSLHR - Category: Speech-Language Pathology Authors: Tags: J Speech Lang Hear Res Source Type: research
Abstract Background: Stroke-specific protocols for the 10-meter and 6-minute walk tests that include instructions for people with aphasia, accessible walkway lengths, and allow provision of assistance to walk are needed to facilitate uptake in hospital settings.Objectives: To estimate the test-retest reliability, measurement error, and construct validity of stroke-specific protocols for the 10-meter walk test (10mWT), and 6-minute walk test conducted using a 15-meter walkway (6MWT15m) and 30-meter walkway (6MWT30m), in people post-stroke.Methods: A quantitative, cross-sectional study involving ambulatory people po...
Source: Topics in Stroke Rehabilitation - Category: Neurology Authors: Tags: Top Stroke Rehabil Source Type: research
Abstract Background: Aphasia negatively impacts quality of life. This is the first Brazilian study that investigates the prevalence of aphasia and its related factors, the results of which may underpin hospital and health service planning for this vulnerable population.Objective: To establish the prevalence of aphasia in patients after first-ever ischemic stroke (FEIS) and associated factors.Methods: This is a retrospective cohort study, based on a database held in Joinville, Brazil. All cases of FEIS admitted to one public hospital in Joinville in 2015 were selected. The diagnosis of aphasia was verified by neuro...
Source: Topics in Stroke Rehabilitation - Category: Neurology Authors: Tags: Top Stroke Rehabil Source Type: research
In conclusion, FAS is a rare motor speech disorder, often related to cerebrovascular accidents involving critical regions in the dominant hemisphere. In addition, the present case adds further evidence to the role of the left primary motor cortex in modulation of prosody. In rare cases FAS can be the only sign of stroke or can appear after recovery from post-stroke aphasia.
Source: Neurological Sciences - Category: Neurology Source Type: research
Conclusions: EMS notification is influenced by AF, stroke severity, psychiatric disease, aphasia, and residence type. Early disability depends on age, the type and severity of the stroke, and pre-stroke mRS. Predictors of disability at 1 year after stroke are age, stoke severity, mRS at discharge, and recurrent ischemic stroke. Higher NIHSS and older age are associated with higher case fatality. In patients ineligible for recanalization, EMS notification had no significant effect on outcome, regarding both disability and survival.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
CONCLUSION: The entire field of acute stroke care has been revolutionized in the last 60 years. Big data management, telemedicine, software, new brain and vascular imaging techniques, biomarkers, robotics etc., are currently in development and again should lead to new and surprising changes during the next decades. PMID: 31521397 [PubMed - as supplied by publisher]
Source: Revue Neurologique - Category: Neurology Tags: Rev Neurol (Paris) Source Type: research
ConclusionIn-hospital strokes are frequently missed due to the complexities of the patients involved.  Education programs targeted at enhancing stroke pickup among hospital staff could potentially decrease delays and improve patient outcomes.
Source: Age and Ageing - Category: Geriatrics Source Type: research
AbstractBackgroundThe Aphasia Rapid Test (ART) is a screening questionnaire used for examining language in acute stroke patients. The ART was initially developed and validated in French. The purpose of this study was to assess the inter-rater reliability of Italian ART.MethodsThe original version of the ART was translated into Italian. The inter-rater reliability was assessed by two independent neurologists who were blind to each other ’s ratings in 52 acute post-stroke patients.ResultsThe 52 patients (28 men, 24 women; mean age 73.73  ± 28.99 years) were included within 1 week of strok...
Source: Neurological Sciences - Category: Neurology Source Type: research
We performed a retrospective, case-control study in consecutive ischemic stroke patients admitted to our stroke rehabilitation unit. Patients were matched for severity of neurological impairment (evaluated with the Canadian Neurological Scale, CNS), age (difference within 1 year) and onset admission interval (difference within 3 days). Participants were divided into two subgroups according to the presence or absence of PSD. Aim was to assess the specific influence of post-stroke depression (PSD) and antidepressant treatment on both basal functional status and rehabilitation outcomes. All PSD patients were treated primarily...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
ConclusionThe percentage of resolved aphasia was significantly higher in the treated patients compared to the non-treated, with the latter showing a higher percentage of global aphasia. Identifying classic aphasia subtypes after thrombolysis is still possible since reperfused areas do not necessary change the classification or lead to completely different aphasic syndromes. Reperfusion treatment, baseline NIHSS, and lacunar stroke were the main predictors of aphasia recovery.
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
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