Association between Common Genetic Variants in ESR1 and Stroke Risk: A Systematic Review and Meta-Analysis
Objectives: The associations between estrogen receptor alpha (ESR1) polymorphisms and stroke risk have been investigated in various studies, but remain controversial. The aim of this meta-analysis was to determine the relationships between ESR1 rs2234693 and rs9340799 polymorphisms and the risk of stroke. Methods: Electronic databases of PubMed, Embase, Cochrane Library, CNKI, VIP database, and WanFang database were searched for eligible studies up to March 2019. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the strength of associations under different genetic models. (Source: J...
Source: Journal of Stroke and Cerebrovascular Diseases - September 16, 2019 Category: Neurology Authors: Rong Fu, Yin Shen, Jin Zheng Source Type: research

Mechanical Recanalization after Transfer from a Distant Primary Stroke Center: Effectiveness and Future Directions
Introduction: Little is known about the effectiveness of endovascular treatment (EVT) in patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO) admitted to a primary stroke center (PSC). The aim of this study was to assess EVT effectiveness after transfer from a PSC to a distant (156 km apart; 1.5 hour by car) comprehensive stroke center (CSC), and to discuss perspectives to improve access to EVT, if indicated. Patients and Method: Analysis of the data collected in a 6-year prospective registry of patients admitted to a PSC for AIS due to LVO and selected for transfer to a distant CSC for EVT. (Sourc...
Source: Journal of Stroke and Cerebrovascular Diseases - September 16, 2019 Category: Neurology Authors: Geoffroy Farouil, Denis Sablot, Franck Leibinger, Laur ène Van Damme, Francis Coll, Nicolas Gaillard, Majo Ibanez, Philippe Smadja, Laurent Benayoun, Anais Dutray, Maxime Tardieu, Ludovic Nguyen Them, Jean-Marie Bonnec, Snejana Jurici, Zoubir Mourad Bens Source Type: research

The First 10 Thrombolysis for Acute Ischemic Stroke in Lao People's Democratic Republic under Teleconsultation from Thailand
This study aimed to evaluate the feasibility and safety of thrombolytic therapy administration at Mittaphab Hospital, Lao PDR under the international telestroke consultation system from King Chulalongkorn Memorial Hospital, Thailand. Methods: Acute ischemic stroke patients who presented at Mittaphab Hospital within 4.5 hours after the onset and received thrombolytic therapy between December 2016 and June 2017 were studied. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 14, 2019 Category: Neurology Authors: Aurauma Chutinet, Saysavath Keosodsay, Pongpat Vorasayan, Jitlada Samajarn, Wasan Akarathanawat, Naruchorn Kijpaisalratana, Naly Norsakpeseuth, Ketmany Phetsiriseng, Snong Thongsna, Pakkawan Vongvasinkul, Nijasri C. Suwanwela Source Type: research

Clinical and Radiological Difficulties to Detect Isolated MCA Dissection before Intravenous tPA Therapy
A 64-year-old woman was admitted to our hospital 48 minutes after sudden onset of dysphasia and right hemiplegia. Head computed tomography revealed small infarcts in the left putamen and 4-dimensional computed tomography angiography depicted high-degree stenosis in the left middle cerebral artery and delayed filling of the contrast media in the left middle cerebral artery territory. The patient underwent intravenous tissue plasminogen activator treatment. On day 5 of hospitalization, the patient underwent conventional cerebral angiography, revealing internal carotid artery to middle cerebral artery dissection. (Source: Jou...
Source: Journal of Stroke and Cerebrovascular Diseases - September 14, 2019 Category: Neurology Authors: Kazuhiro Yoshioka, Takahisa Mori Tags: Case Report Source Type: research

“Clip Anchor-Assisted Coil Embolization” for Endovascular Parent Artery Occlusion of Intracranial Traumatic Aneurysm
Traumatic cerebral aneurysms are histologically dissecting aneurysms or pseudoaneurysms, thus requiring parent artery occlusion for cure. Combination of endovascular parent artery occlusion and extracranial-intracranial bypass is considered optimal to obtain complete obliteration of the aneurysm and to avoid hemodynamic hypoperfusion. However, endovascular parent artery occlusion of the supraclinoid internal carotid artery (ICA) is at risk of ischemic complications due to distal coil protrusion to adjacent perforating arteries or distal embolism of the thrombi generated in the coil mass. (Source: Journal of Stroke and Cere...
Source: Journal of Stroke and Cerebrovascular Diseases - September 14, 2019 Category: Neurology Authors: Hitoshi Fukuda, Toshio Yanagawa, Fumihiko Horikawa, Norio Nakajima, Masashi Kitagawa, Benjamin Lo, Keisuke Yamada Tags: Case Report Source Type: research

Comparison of Fractional Anisotropy from Tract-Based Spatial Statistics with and without Lesion Masking in Patients with Intracerebral Hemorrhage: A Technical Note
Background: Diffusion-tensor fractional anisotropy (FA) is an index of neural-fiber damage in patients following stroke. To better characterize FA, tract-based spatial statistics (TBSS) is frequently used, which involves spatial transformation into the standard brain space. Despite its utility, this technique is susceptible to space-occupying hematoma in patients with intracerebral hemorrhage. To correct this, “lesion making” has been proposed. Here, FA values from TBSS without lesion masking and TBSS with lesion masking were compared, and the clinical utility was evaluated. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 14, 2019 Category: Neurology Authors: Tetsuo Koyama, Yuki Uchiyama, Kazuhisa Domen Source Type: research

Use of 3-Dimensional, Black-Blood, Contrast-Enhanced, T1-Weighted Magnetic Resonance Imaging to Identify Vascular Occlusion in the Posterior Circulation After Acute Ischemic Stroke
Background: Three-dimensional, black-blood, contrast-enhanced, T1-weighted magnetic resonance imaging (3D-BB-ceT1-MRI) could play a role in detection of thrombi and symptomatic intracranial atherosclerotic stenosis. We investigated the role of 3D-BB-ceT1-MRI in patients with acute ischemic stroke in the posterior circulation, and compared our findings with those from susceptibility-weighted imaging (SWI). Materials and Methods: We retrospectively reviewed 3D-BB-ceT1-MRI for patients between January 2017 and August 2018 with acute ischemic symptoms in the posterior circulation. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 13, 2019 Category: Neurology Authors: Gyung Ho Chung, Seung Bae Hwang, Hyo Sung Kwak Source Type: research

Corrigendum to ‘External Validation of the PREMISE Score in the Athens Stroke Registry’ [Journal of Stroke and Cerebrovascular disease 28 (2019) 1806–1809/10.1016/j.jstrokecerebrovasdis.2019.04.023]
The authors regret the following mistake in the reference list: the reference No 1 is wrong and should be substituted with the following one: (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 13, 2019 Category: Neurology Authors: George Ntaios, George Georgiopoulos, Eleni Korompoki, Konstantinos Vemmos Tags: Corrigendum Source Type: research

Repeated Use of 6-min Walk Test with Immediate Knowledge of Results for Walking Capacity in Chronic Stroke: Clinical Trial of Fast versus Slow Walkers
This study aimed to determine the effects of repeated use of the 6-minute walk test (6MWT) with immediate knowledge of results (KR) on the walking capacity by comparing fast and slow walkers in patients with chronic hemiparesis. Methods: Twenty-five subjects were allocated to 2 groups depending on their walking speed1: Group 1 (fast walkers, n1  = 11): greater than equal to .8 m/s and2 Group 2 (slow walkers, n2 = 14): less than .8 m/s. All subjects underwent the 6MWT once a day, 5 days a week, for 4 weeks (a total of 20 sessions). (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 12, 2019 Category: Neurology Authors: Dong-Kyu Kim, Duck-Won Oh Source Type: research

Subclinical Peripheral Arterial Disease in Patients with Acute Ischemic Stroke: A Study with Ultrasonography
Background: Peripheral arterial disease (PAD) is an advanced form of atherosclerosis defined by an abnormal ankle-brachial index (ABI). However, the ABI provides no information about the location of atherosclerosis. We investigated the clinical implication of PAD confirmed using lower-extremity ultrasonography (LEUS), with consideration of the atherosclerosis location. Methods: Patients with acute ischemic stroke who underwent LEUS were enrolled. Patients with PAD were further divided into those with PAD at the proximal (above-popliteal artery, PADP) and distal (below-tibialis artery, PADD) segments. (Source: Journal of St...
Source: Journal of Stroke and Cerebrovascular Diseases - September 12, 2019 Category: Neurology Authors: Yu Yong Shin, Sang Hee Ha, Ho Geol Woo, Sung Hyuk Heo, Dae-il Chang, Bum Joon Kim Source Type: research

Long-Term Follow-Up of Cerebral Amyloid Angiopathy-Associated Intracranial Hemorrhage Reveals a High Prevalence of Atrial Fibrillation
Goal: Cerebral amyloid angiopathy (CAA) is the second-most common cause of nontraumatic intracerebral hemorrhages (ICH), surpassed only by uncontrolled hypertension. We characterized the percentage, risk factors, and comorbidities of patients suffering from CAA-related ICH in relation to long-term outcomes. Material and Methods: We performed retrospective analyses and clinical follow-ups of individuals suffering from ICH who were directly admitted to neurosurgery between 2002 and 2016. Findings: Seventy-four of 174 (42%) spontaneous nontraumatic lobar ICH cases leastwise satisfied the modified Boston criteria definition fo...
Source: Journal of Stroke and Cerebrovascular Diseases - September 11, 2019 Category: Neurology Authors: Johanna Kaiser, Karl-Michael Schebesch, Alexander Brawanski, Ralf A. Linker, Felix Schlachetzki, Andrea Wagner Source Type: research

A Case of Cerebral Venous Thrombosis and Deep Venous Thrombosis Due to Hyperthyroidism with Increased Factor VIII Activity
A 48-year-old woman was admitted to our hospital because of headache and fever. She was diagnosed with aseptic meningitis. Five days later, she had a seizure and developed left hemiparesis. Magnetic resonance imaging showed hyperintensity in the right parietal area on fluid attenuated inversion recovery imaging. She was diagnosed as having cerebral venous thrombosis (CVT) because the suprasagittal sinus was invisible on the venographic studies. Moreover, deep venous thrombosis (DVT) was detected in her left lower extremity. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 11, 2019 Category: Neurology Authors: Mutsumi Yokoyama, Ryotaro Yamashita, Masayuki Furuya, Maiko Yamazaki, Kazuo Koyama, Fumiaki Tanaka Tags: Case Report Source Type: research

Contribution of Onset-to-Alarm Time to Prehospital Delay in Patients with Ischemic Stroke
Background: Stroke is a leading cause of death and disability. Tissue plasminogen activator (tPA) improves the clinical outcome when administered properly; however, the most important factor to receive tPA is time. The main reason for late hospital arrival is a considerable delay in onset-to-alarm time (OAT), comprising more than 50% of the onset-to-door time. Aims: To identify the factors associated with a delay in OAT and evaluate its contribution to onset-to-door time in ischemic stroke patients. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 10, 2019 Category: Neurology Authors: Alejandro Gonzalez-Aquines, Adolfo C. Cordero-P érez, Mario Cristobal-Niño, Gil Pérez-Vázquez, Fernando Góngora-Rivera, GECEN Investigators Source Type: research

The Prevalence of Multiple Comorbidities in Stroke Survivors in Rural Appalachia and the Clinical Care Implications
Background: The majority of studies on multimorbidity have been in aging populations and there is a paucity of data on individuals following stroke. Objective: In order to better understand the overall complexity of the stroke population in rural Kentucky, we examined the prevalence of multimorbidity that impact the overall long-term health and health care for these individuals. Methods: A secondary analysis examined whether there are gender or age differences in this stroke population related to the prevalence of multimorbidity. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 10, 2019 Category: Neurology Authors: Patrick H. Kitzman, Kathleen M. Sutton, Marc Wolfe, Lisa Bellamy, Michael R. Dobbs Source Type: research

Prediction of Gait without Physical Assistance after Inpatient Rehabilitation in Severe Subacute Stroke Subjects
This study is aimed at describing the frequency of achievement of gait without physical assistance in poststroke subacute patients by the time of discharge from a rehabilitation hospitalized program. Secondarily, our goal is to identify gait without physical assistance predictors in this same population based on the admission's clinical and demographic conditions. Methods: Data from 185 first unilateral hemispheric stroke patients that need physical assistance to walk at admission were analyzed. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 10, 2019 Category: Neurology Authors: M.G. Gianella, C.F. Gath, L. Bonamico, L.E. Olmos, M.J. Russo Source Type: research

Hemicraniectomy for Supratentorial Primary Intracerebral Hemorrhage: A Retrospective, Propensity Score Matched Study
Background and Purpose: Spontaneous supratentorial intracerebral hemorrhage (ICH) contributes disproportionately to stroke mortality, and randomized trials of surgical treatments for ICH have not shown benefit. Decompressive hemicraniectomy (DHC) improves functional outcome in patients with malignant middle cerebral artery ischemic stroke, but data in ICH patients is limited. We hypothesized that DHC would reduce in-hospital mortality and poor functional status (defined as modified Rankin scale ≥5) among survivors at 3 months, without increased complications. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 9, 2019 Category: Neurology Authors: Kasey L. Gildersleeve, Mohammad I. Hirzallah, Yoshua Esquenazi, Charles J. Moomaw, Padmini Sekar, Chunyan Cai, Nitin Tandon, Daniel Woo, Nicole R. Gonzales Source Type: research

“Basilar Web” Causing Basilar Branch Infarction
We present a young patient with no vascular risk factors with a basilar branch infarction secondary to a shelf-like filling defect of the basilar artery. This defect was present and unchanged on repeat imaging and determined to be most consistent with a basilar web. Similar to carotid webs, a basilar web is believed to be an area of focal intimal fibroplasia that increases the risk of brainstem infarction. Focal fibroplasia of the posterior circulation should be considered when evaluating young adults with posterior circulation strokes of otherwise undetermined cause. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 9, 2019 Category: Neurology Authors: Charles Esenwa, Daniel Labovitz, Louis R. Caplan Tags: Case Report Source Type: research

Serum Retinoic Acid Level and The Risk of Poststroke Cognitive Impairment in Ischemic Stroke Patients
This study aimed to detect the association between RA level and PSCI among patients with first-ever acute ischemic stroke. Methods: Two hundred and 61 consecutive patients were prospectively recruited during March 2018 and March 2019. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 6, 2019 Category: Neurology Authors: Le Hou, Caixia Ding, Zhao Chen, Yuanyue Liu, Haishan Shi, Cong Zou, Hui Zhang, Zhiwei Lu, Dong Zheng Source Type: research

Symptomatic Intracerebral Hemorrhage after Intravenous Thrombolysis: Predictive Factors and Validation of Prediction Models
Objective: Thrombolytic therapy with intravenous alteplase (IV-rtPA) has a known risk of symptomatic intracerebral hemorrhage (sICH). We aim to identify factors with a significant association with the development of sICH post-IV-rtPA. We also aim to perform an external validation of sICH predicting scores in our patient population. Material and Methods: We performed a retrospective chart review of patients who received IV-rtPA at our tertiary care hospital. We excluded patients who underwent mechanical thrombectomy. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 6, 2019 Category: Neurology Authors: Taha Nisar, Rajanigandhi Hanumanthu, Priyank Khandelwal Source Type: research

Renal Dysfunction Associated with Symptomatic Intracranial Hemorrhage after Intravenous Thrombolysis
Background and Aim: Renal dysfunction (RD) is prevalent in patients with acute ischemic stroke requiring intravenous thrombolysis. The relationship between renal function and thrombolysis related intracranial hemorrhagic (ICH) complications is contradictory according to previous studies. The current study is to clarify whether RD could increase the risk of symptomatic intracranial hemorrhage (SICH) after recombinant tissue plasminogen activator (IV rtPA) in acute ischemic stroke patients. Methods: In this observational study, acute ischemic stroke patients who received IV rtPA within 4.5 hours of symptom onset were retrosp...
Source: Journal of Stroke and Cerebrovascular Diseases - September 6, 2019 Category: Neurology Authors: Juehua Zhu, Xiahong Shen, Chunyan Han, Chunhao Mei, Yun Zhou, Hui Wang, Yan Kong, Yongjun Jiang, Qi Fang, Xiuying Cai Source Type: research

A Preliminary Study of Dual-Task Training Using Virtual Reality: Influence on Walking and Balance in Chronic Poststroke Survivors
Stroke is a leading cause of death and disability in the Western world, and leads to impaired balance and mobility. Objective: To investigate the feasibility of using a Virtual Reality-based dual task of an upper extremity while treadmill walking, to improve gait and functional balance performance of chronic poststroke survivors. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 5, 2019 Category: Neurology Authors: Pavel Fishbein, Yeshayahu Hutzler, Motti Ratmansky, Iuly Treger, Ayelet Dunsky Source Type: research

Comorbid Atrial Fibrillation in Cerebral Amyloid Angiopathy-related Intracerebral Hemorrhage: Between a Rock and a Hard Place
Atrial fibrillation (AF) and intracerebral hemorrhage (ICH), including cerebral amyloid angiopathy (CAA)-related ICH, are age-related conditions that additionally share hypertension as a common risk factor. A Spanish population-based study reported a 50% increase in the prevalence of AF in ICH patients between 2003 (10.5%) and 2012 (15.5%).1 The prevalence of AF and ICH, and their ensuing comorbidity, are expected to continue increasing with global aging demographics. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 5, 2019 Category: Neurology Authors: Ashkan Shoamanesh, Andreas Charidimou, Kevin N. Sheth Source Type: research

Computer-Based Cognitive Rehabilitation in Patients with Visuospatial Neglect or Homonymous Hemianopia after Stroke
Objectives: The purpose of this pilot study was to investigate the feasibility and effects of computer-based cognitive rehabilitation (CBCR) in patients with symptoms of visuospatial neglect or homonymous hemianopia in the subacute phase following stroke. Method: A randomized, controlled, unblinded cross-over design was completed with early versus late CBCR including 7 patients in the early intervention group (EI) and 7 patients in the late intervention group (LI). EI received CBCR training immediately after inclusion (m  = 19 days after stroke onset) for 3 weeks and LI waited for 3 weeks after inclusion before receivi...
Source: Journal of Stroke and Cerebrovascular Diseases - September 5, 2019 Category: Neurology Authors: Katrine Wordenskjold Svaerke, Kenneth Viktor Omkvist, Inger Birgitte Havsteen, Hanne Krarup Christensen Source Type: research

Intracranial Hemorrhage Diagnosed with Transcranial Ultrasound in a Comatose, Postliver Transplant Patient
We report a case of an intracranial hemorrhage first suspected during a trans-cranial Doppler assessment of a postorthotopic liver transplant patient. The patient was at considerable risk of bleeding, due to a primary graft nonfunction, but he had also elevated ammonium levels, justifying the comatose state, and no focal neurological deficits. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 5, 2019 Category: Neurology Authors: Amedeo Bianchini, Rocco D'Andrea, Berin Lepic, Lorenzo Querci, Cristiana Laici, Antonio Siniscalchi Tags: Case Report Source Type: research

Stroke-Related Knowledge and Lifestyle Behavior among Stroke Survivors
Aims: Awareness of stroke symptoms and risk factors, and actions taken in order to reduce the risk of new stroke events, should be of great importance among stroke survivors. The aims of this study were to assess changes in stroke-related knowledge and lifestyle behavior among patients experiencing a cerebrovascular event, and to assess the agreement between the patients ’ self-reported diagnosis, and the discharge diagnosis. Methods: All patients discharged with a diagnosis of stroke or transient ischemic attack during a 1-year period, received postal survey questionnaires at 3 and 12 months after discharge. (Source...
Source: Journal of Stroke and Cerebrovascular Diseases - September 5, 2019 Category: Neurology Authors: Kashif Waqar Faiz, Angela Susan Labberton, Bente Thommessen, Ole Morten R ønning, Mathias Barra Source Type: research

Is There Equipoise Regarding the Optimal Medical Treatment of Patients with Asymptomatic White Matter Hyperintensities?
Background: White matter hyperintensity (WMH) is a common manifestation of chronic ischemic microvascular disease that heralds greater risk of functional disability, stroke, and dementia. SPRINT MIND recently reported that intensive blood pressure reduction resulted in lower rates of mild cognitive impairment and WMH progression, suggesting that medical interventions could have a measurable impact on WMH. We conducted an anonymous survey of providers in the NINDS StrokeNet to better understand neurologist attitudes about asymptomatic WMH. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 5, 2019 Category: Neurology Authors: Adam de Havenon, Shyam Prabhakaran, Tanya Turan, Rebecca Gottesman, Sharon Yeatts, Natalia Rost Source Type: research

The Yield of Multimodal Computed Tomography among Emergency Department Patients with Suspected Large Vessel Occlusion Stroke
Objectives: Endovascular therapy (EVT) improves outcomes for appropriately selected acute ischemic stroke patients. Guidelines suggest rapid acquisition of noninvasive vascular imaging to screen suspected ischemic stroke patients for large vessel occlusion (LVO) and candidacy for EVT. We sought to quantify the yield of an LVO stroke screening process in an undifferentiated emergency department (ED) suspected stroke population as well as identify predictors of successful EVT. Methods: We identified a cohort of consecutive ED patients who received CT angiography and brain perfusion (CTA/P) imaging to determine candidacy for ...
Source: Journal of Stroke and Cerebrovascular Diseases - September 4, 2019 Category: Neurology Authors: Yalda Serena Dastmalchi, J. Adam Oostema Source Type: research

A Case of Leukoencephalopathy and Small Vessels Disease Caused by a Novel HTRA1 Homozygous Mutation
Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) is a heritable, rare small vessel disease, which is caused by HTRA1 mutations and mostly reported Japanese and Chinese population. CARASIL is an orphan disease, which presents with progressive motor and cognitive impairment, alopecia, and spondylosis. The disease typically starts with lumbago at early twenties. Ischemic strokes start at mid-twenties. Patients have no cardiovascular or any other risk factors. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 4, 2019 Category: Neurology Authors: Tuncay G ündüz, Yasemin Demirkol, Özlem Doğan, Serkan Demir, Nihan Hande Akçakaya Source Type: research

Unstable Carotid Plaque is Associated With Coagulation Function and Platelet Activity Evaluated by Thrombelastography
Background: Rupture of unstable carotid plaque and consequently occlusive thrombus formation for the most part cause ischemic cerebral vascular event. Many researchers have been studying on the risk predictors of carotid plaque formation. But the risk factors for unstable carotid plaque have not been researched for so much. In the current study, we aimed to evaluate the association of coagulation function and carotid plaque especially unstable plaque by thrombelastography (TEG). Methods: This was a cross-sectional study. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 3, 2019 Category: Neurology Authors: Jiaqi Li, Hengqu Wu, Yong Hao, Xiaoying Yao Source Type: research

Letter to the Editor Regarding “Relationship of Malnutrition during Hospitalization with Functional Recovery and Postdischarge Destination in Elderly Stroke Patients”
We read with great interest the article by Sato et al on the relationship of malnutrition with acute stroke in 205 patients hospitalized at the Shinshu University hospital, Japan.1 We would like to provide an additional nationwide United States (US) perspective on outcomes of hospitalized stroke patients with protein energy malnutrition (PEM). (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 3, 2019 Category: Neurology Authors: Rupak Desai, Alok R. Amraotkar Tags: Letter to the Editor Source Type: research

Poor Sleep Quality I Related to Impaired Functional Status Following Stroke
Introduction: Sleep disorders are more prevalent in patients with previous stroke compared to healthy individuals. The main objective of the present study was to investigate the impact of sleep quality on the functional status of patients with a history of stroke, upon admission to inpatient rehabilitation. Methods: Fifty patients (mean age: 69 ± 11 years) with previous stroke were consecutively included in this single center cross-sectional observational study upon admission to inpatient rehabilitation. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 3, 2019 Category: Neurology Authors: Ipek Sonmez, Seide Karasel Source Type: research

In-Hospital and Long-Term Prognosis after Spontaneous Intracerebral Hemorrhage among Young Adults Aged 18-65 Years
Background: Spontaneous intracerebral hemorrhage (ICH) accounts for 10%-15% of all strokes and has an estimated annual incidence of 5/100,000 in young adults. Limited data on prognosis after ICH in young adults are available. We aimed to identify prognostic predictors after ICH among adults aged 18-65 years. Methods: We retrospectively selected all patients with ICH from a prospective single-center registry of adults with first stroke before 65 years between 1997 and 2002. We recorded in-hospital mortality as well as mortality and recurrent stroke after discharge until December 1, 2018. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 3, 2019 Category: Neurology Authors: Francisco Bernardo, Leonor Rebord ão, Sara Machado, Vasco Salgado, Amélia Nogueira Pinto Source Type: research

Association of Prevalent Stroke with Hospitalization for Seizure: Patterns and Prognoses
Introduction: Despite the close relationship between stroke and seizures, little is known about stroke trends and inpatient mortality among patients with seizures. Materials and Methods: The National Inpatient Sample was used to analyze the prevalence and trends of stroke among patients discharged with a primary diagnosis of seizures between 2006 and 2014. International Classification of Diseases, Ninth Revision, Clinical Modification was used to identify patients discharged with a primary diagnosis of seizures and those with a secondary diagnosis of stroke. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 2, 2019 Category: Neurology Authors: Alain Lekoubou, Kinfe G. Bishu, Bruce Ovbiagele Source Type: research

Determination of Clinical Cut-Off Values for Serum Cystatin C Levels to Predict Ischemic Stroke Risk
Background: The association between cystatin C and risk of ischemic stroke is inconsistent and the cut-off values of cystatin C are diverse in different articles. We aimed to investigate the association between cystatin C levels and the development of ischemic stroke and to explore the clinical cut-off values of serum cystatin C levels for ischemic stroke. Methods: This prospective cohort study included 7658 participants from the China Health and Retirement Longitudinal Study who were free of cardiovascular diseases and cancer at baseline. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - September 2, 2019 Category: Neurology Authors: Youyi Wang, Ying Zhang, Qinghua Ma, Congju Wang, Yong Xu, Hongpeng Sun, Yana Ma Source Type: research

The Value of the CHADS2 and CHA2DS2-VASc Score for Predicting the Prognosis in Lacunar Stroke with or without Atrial Fibrillation Patients
Background: The CHADS2 and CHA2DS2-VASc scoring systems have been proved efficacy to stratify stroke and thromboembolism risk in patients with atrial fibrillation (AF). Whether CHADS2 and CHA2DS2-VASc score has predictive value for the prognosis in lacunar stroke (LS) patients remains unclear. Methods: A total of 763 consecutive patients with LS (mean age: 66 ± 12 years; 464 male) were enrolled in this study between January 2013 and December 2014. Patients were divided into LS without AF (LS; n = 679) and LS with AF (LS-AF; n = 84) groups. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - August 30, 2019 Category: Neurology Authors: Hong-Jie Yang, Guang-Ji Wang, Wei Shuai, Cai-Jie Shen, Bin Kong, He Huang Source Type: research

Development of Hemorrhage-prone Anastomoses in Asymptomatic Moyamoya Disease —A Comparative Study with Japan Adult Moyamoya Trial
This study used the data set of cerebral angiography in Asymptomatic Moyamoya Registry (AMORE) Study and Japan Adult Moyamoya (JAM) Trial at enrollment. The development of 3 subtypes of collateral vessels, including lenticulostriate, thalamic, and choroidal anastomosis, was evaluated on cerebral angiography. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - August 27, 2019 Category: Neurology Authors: Shusuke Yamamoto, Takeshi Funaki, Miki Fujimura, Jun C. Takahashi, Haruto Uchino, Kiyohiro Houkin, Teiji Tominaga, Susumu Miyamoto, Satoshi Kuroda, on behalf of the Asymptomatic Moyamoya Registry Investigators and the Japan Adult Moyamoya Trial Investigat Source Type: research

Baseline Neutrophil Counts and Neutrophil Ratio May Predict a Poor Clinical Outcome in Minor Stroke Patients with intravenous Thrombolysis
Background: Evidence about whether neutrophil counts, neutrophil ratio linked with clinical outcome in patients with minor stroke after thrombolysis is scarce. The purpose of this study is to explore the association of neutrophil counts, neutrophil ratio with the 90-day clinical outcome in patients with minor stroke treated with intravenous thrombolysis. Materials and methods: A total of 163 patients with minor stroke treated with thrombolysis within window time were recruited from 2013 to 2017. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - August 26, 2019 Category: Neurology Authors: Huihui Liu, Ruojun Wang, Jijun Shi, Yanlin Zhang, Zhichao Huang, Shoujiang You, Guodong Xiao, Dapeng Wang, Yongjun Cao Source Type: research

Health Care Use and Its Associated Factors 5-8 Years after Stroke
Objectives: To describe health care use and its associated factors in the chronic phase after stroke. Methods: Patients completed a questionnaire on health care use, 5-8 years after hospital admission for stroke. It comprised the number of visits to physicians or other health care professionals over the past 6 months (Physician-visits; Low ≤1 or High ≥2) and other health care professionals (Low = 0 or High ≥ 1). In addition the Longer-term Unmet Needs after Stroke (LUNS), Frenchay Activity Index (FAI) and Physical and Mental Component Summary Scales of the Short Form 12 (PCS and MCS) were administered. (Source...
Source: Journal of Stroke and Cerebrovascular Diseases - August 24, 2019 Category: Neurology Authors: Henk J. Arwert, Iris F. Groeneveld, Thea P.M. Vliet Vlieland, Jorit J.L. Meesters Source Type: research

Computational Fluid Dynamics Analysis of Lateral Striate Arteries in Acute Ischemic Stroke Using 7T High-resolution Magnetic Resonance Angiography
Background: Infarcts in the lateral striate artery (LSA) territory can be caused by several pathological changes, including lipohyalinosis and microatheroma. However, fluid dynamic effects on these changes remain unknown. Thus, we investigated whether the fluid dynamic metrics of the LSAs were altered in patients with acute ischemic stroke using computational fluid dynamics (CFD) analysis. Methods: Fifty-one patients with acute ischemic stroke confined in the basal ganglia and/or corona radiata underwent high-resolution magnetic resonance angiography (HR-MRA) at 7T. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - August 24, 2019 Category: Neurology Authors: Futoshi Mori, Fujimaro Ishida, Tatsunori Natori, Haruna Miyazawa, Hiroyuki Kameda, Taisuke Harada, Kunihiro Yoshioka, Fumio Yamashita, Ikuko Uwano, Kenji Ito, Makoto Sasaki Source Type: research

Floating Aortic Thrombus: A Rare Cause of Acute Ischemic Stroke Necessitating Modification of Access Route for Thrombectomy
We report 2 patients with acute occlusion of middle cerebral artery successfully treated by mechanical thrombectomy performed via transbrachial access. Both patients had floating aortic arch thrombi precluding safe transfemoral access due to risk of further iatrogenic embolization. Moreover both patients were diagnosed with hypercoagulopathy secondary to lung malignancy (paraneoplastic etiology, Trousseau's syndrome) as the cause of both aortic thrombi and acute ischemic stroke. Mechanical thrombectomy in the setting of a floating aortic thrombus has been mentioned only once as part of general management of floating aortic...
Source: Journal of Stroke and Cerebrovascular Diseases - August 21, 2019 Category: Neurology Authors: Sinan Balci, Ethem Murat Arsava, Mehmet Akif Topcuoglu, Anil Arat Source Type: research

Cerebral Venous Thrombosis after Red Blood Cell Transfusion for the Treatment of Iron Deficiency Anemia
A 57-year-old male presented with generalized seizure who received red blood cell (RBC) transfusion for the treatment of iron deficiency anemia (IDA). Neuroradiological findings revealed cerebral venous thrombosis (CVT) on the left frontal vein. He received anticoagulants, anticonvulsants, and iron supplements. He discharged without any neurological deficit. It should be noted that RBC transfusion might increase the risk of CVT in patients with IDA. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - August 21, 2019 Category: Neurology Authors: Taku Inada, Nobutake Sadamasa, Ryota Motoie, Norikazu Yamana, Waro Taki Tags: Case Report Source Type: research

Comment on: External Validation of the PREMISE Score in the Athens Stroke Registry
This study externally validated our proposed predicting early mortality from ischemic stroke (PREMISE) score, derived from the nationwide Austrian Stroke Unit registry.2 While we feel obliged to point out that the original PREMISE score publication2 was incorrectly referenced3 by Ntaios et al, it is reassuring that the authors confirmed prognostic accuracy (with excellent calibration and good discrimination) of the PREMISE score as an instrument for predicting early (within one week after admission) death after ischemic stroke in 2608 patients from the Athens Stroke Unit registry. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - August 20, 2019 Category: Neurology Authors: Thomas Gattringer, Alexandra Posekany, Stefan Kiechl, Franz Fazekas, Christian Enzinger Tags: Letter to the Editor Source Type: research

Carotid-Cavernous Sinus Fistula caused by Persistent Primitive Trigeminal Artery Aneurysm rupture: A case report
Carotid-Cavernous sinus fistula (CCF) caused by a ruptured aneurysm of persistent primitive trigeminal artery (PPTA) is exceptionally rare. Herein, we reported the case of a 64-year-old female who presented with headache, pulsatile tinnitus, and diplopia. Angiography showed a PPTA and CCF. Three-dimensional digital subtraction angiograms revealed a direct shunt between the PPTA aneurysm and the left cavernous sinus. The trigeminal carotid fistula was successfully treated with detachable coils and Onyx, and the PPTA was preserved. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - August 19, 2019 Category: Neurology Authors: Yu Fan, Yuechun LI, Tianyou Zhang, Changchun Jiang, Peng Zhang Tags: Case Report Source Type: research

The Effect of Motor and Cognitive Tasks on Gait in People with Stroke
Objective: Gait of people with unilateral stroke is characterized by pronounced asymmetry. The aim of the study was to investigate the effect of cognitive and motor tasks on asymmetry of gait in people with stroke. Materials and Methods: Nine individuals with stroke walked over the GAITRite walkway while performing motor (holding a cup with water) or cognitive (reciting the alphabet) tasks or walked with no additional task. Gait velocity, cadence, and symmetry indexes for the stance phase, swing phase, and single support phase of a gait cycle were calculated. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - August 19, 2019 Category: Neurology Authors: Etem Curuk, Nikita Goyal, Alexander S. Aruin Source Type: research

Variability and Delay in Telestroke Physician Alert among Spokes in a Telestroke Network: A Need for Metric Benchmarks
We describe variation in time to alert a telestroke physician of suspected acute ischemic stroke patients potentially eligible for acute stroke therapies among community hospitals in our telestroke network, and explore demographic and spoke-related characteristics associated with delays. Methods: From our telestroke registry, we identified suspected acute ischemic stroke patients who arrived within 6 hours of symptom onset and underwent video consultation at 1 of 17 community hospitals in our hub-and-spoke network. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - August 19, 2019 Category: Neurology Authors: Amanda L Jagolino-Cole, Shima Bozorgui, Christy M Ankrom, Farhaan Vahidy, Arvind B Bambhroliya, Jaskaren Randhawa, Alyssa D Trevino, TC Cossey, Sean I Savitz, Tzu-Ching Wu Source Type: research

Nephrotic Syndrome is Associated with Increased Risk of Ischemic Stroke
Background: To determine if the nephrotic syndrome (NS) is an independent risk factor of ischemic stroke. Methods: This is a retrospective nationwide cohort study through an analysis of the National Health Insurance Research Database in Taiwan. To evaluate the risk of stroke, the corresponding controls were selected at a 4:1 ratio in the number of subjects, and they were matched with the study group in age, gender, Charlson comorbidity index (CCI), and index date. Results: From a total of 16,245 surveyed subjects, ischemic stroke occurred in 1235 (7.6%) and hemorrhagic stroke in 129 (.74%) of them. (Source: Journal of Stro...
Source: Journal of Stroke and Cerebrovascular Diseases - August 16, 2019 Category: Neurology Authors: Jin-An Huang, Ching-Heng Lin, Yao-Tien Chang, Cheng-Ting Lee, Ming-Ju Wu Source Type: research

Intracardiac Thrombus Following Rivaroxaban Treatment in a Patient with Atrial Fibrillation Associated with Rheumatic Heart Disease
We report a case of atrial fibrillation with rheumatic heart disease (RHD) who had intracardiac thrombus and cardiogenic cerebral embolism with rivaroxaban therapy. Intracardiac thrombus disappeared after switching from rivaroxaban to warfarin. Patients of RHD have the possibility of gradual progression of valvular disease even if they are old, so we need to distinguish nonvalvular atrial fibrillation from RHD before starting direct oral anticoagulants. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - August 16, 2019 Category: Neurology Authors: Hiroaki Ohara, Shiro Yamamoto, Keiko Nagano, Kazuo Hashikawa Tags: Case Report Source Type: research

Usefulness of Oral Xa Inhibitor for Management of Ischemic Stroke Associated with Thrombosis in the Pulmonary Vein Stump after Lung Resection
We describe serial 3 cases of brain infarctions associated with thrombosis in the PV stumps, which were successfully treated with the oral Xa inhibitor rivaroxaban. Methods and Results: We retrospectively reviewed medical records of 3 patients. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - August 15, 2019 Category: Neurology Authors: Takeo Amemiya, Tadahisa Shono, Keitaro Yamagami, Soh Takagishi, Hiroki Toma, Tomonari Kobarai, Toru Eguchi, Ichio Hirota Source Type: research

Cerebral Venous Sinus Thrombosis Score and its Correlation with Clinical and MRI Findings
Background: It is plausible that extent of cerebral venous sinus thrombosis (CVST) may determine clinical severity, magnetic resonance imaging (MRI) lesion, and outcome, therefore this study was undertaken. Methods: A total of 160 CVST patients were included and their clinical details, risk factors, Glasgow Coma Scale score, and parenchymal lesion on MRI were noted. The extent of venous sinus thrombosis on magnetic resonance venography was assessed by using CVST score which was computed giving 1 point for each thrombosed sinus and 3 points to superior sagittal sinus (SSS). (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - August 15, 2019 Category: Neurology Authors: Jayantee Kalita, Varun K. Singh, Neeraj Jain, Usha K. Misra, Sunil Kumar Source Type: research

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(Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - August 14, 2019 Category: Neurology Source Type: research