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The incidence of medium vessel occlusions: a population-based study
ConclusionAs the only stroke center in Olmsted County, we have been able to estimate the incidence of ischemic stroke due to MeVO. While the incidence of MeVOs is less than both large and small vessel occlusions, they still represent a significant proportion of strokes with significant morbidity and mortality that would benefit from further studies in both acute intervention and prevention.
Source: Frontiers in Neurology - July 27, 2023 Category: Neurology Source Type: research

Lifelong cerebrovascular disease burden among CADASIL patients: analysis from a global health research network
DiscussionEarly screening and targeted treatment strategies are warranted to help CADASIL patients with symptom management and risk mitigation.
Source: Frontiers in Neurology - July 14, 2023 Category: Neurology Source Type: research

Seasonal variation in the incidence of primary intracerebral hemorrhage: a 16-year nationwide analysis
ConclusionUnlike AIS, ICH incidence is consistently higher in colder quarters, underscoring the need for evaluation and prevention of factors driving seasonal variations in ICH incidence.
Source: Frontiers in Neurology - June 29, 2023 Category: Neurology Source Type: research

EMAGINE –Study protocol of a randomized controlled trial for determining the efficacy of a frequency tuned electromagnetic field treatment in facilitating recovery within the subacute phase following ischemic stroke
Stroke is a leading cause of disability with limited effective interventions that improve recovery in the subacute phase. This protocol aims to evaluate the safety and efficacy of a non-invasive, extremely low-frequency, low-intensity, frequency-tuned electromagnetic field treatment [Electromagnetic Network Targeting Field (ENTF) therapy] in reducing disability and promoting recovery in people with subacute ischemic stroke (IS) with moderate-severe disability and upper extremity (UE) motor impairment. Following a sample-size adaptive design with a single interim analysis, at least 150 and up to 344 participants will be rec...
Source: Frontiers in Neurology - May 5, 2023 Category: Neurology Source Type: research

Lessons Learned From the Historical Trends on Thrombolysis Use for Acute Ischemic Stroke Among Medicare Beneficiaries in the United States
ConclusionsBetween 2007 and 2014, the frequency of IVT for patients with acute ischemic stroke increased substantially, though differences persisted in the form of less frequent treatment associated with certain characteristics. These findings can inform ongoing efforts to optimize the delivery of IVT to all AIS patients nationwide.
Source: Frontiers in Neurology - March 4, 2022 Category: Neurology Source Type: research

Cerebrovascular Risk Profiles in a Saudi Arabian Cohort of Young Stroke Patients
Conclusion: Cerebrovascular risk profiles and stroke etiologies in our cohort of young stroke patients differ from those of previous cohorts, suggesting the need for tailored prevention strategies that take into account local epidemiological data on cerebrovascular health.
Source: Frontiers in Neurology - November 12, 2021 Category: Neurology Source Type: research

End-of-Life Care Decision-Making in Stroke
Stroke is one of the leading causes of death and long-term disability in the United States. Though advances in interventions have improved patient survival after stroke, prognostication of long-term functional outcomes remains challenging, thereby complicating discussions of treatment goals. Stroke patients who require intensive care unit care often do not have the capacity themselves to participate in decision making processes, a fact that further complicates potential end-of-life care discussions after the immediate post-stroke period. Establishing clear, consistent communication with surrogates through shared decision-m...
Source: Frontiers in Neurology - September 28, 2021 Category: Neurology Source Type: research

Network Mapping of Time to Antithrombotic Therapy Among Patients With Ischemic Stroke and Transient Ischemic Attack (TIA)
Conclusion: The proportion of patients receiving antithrombotics within 48 h was higher than previously reported in Australia but remained lower than the standard achieved in North American hospitals. Our process map and network analysis show avenues to shorten the time to antithrombotic.
Source: Frontiers in Neurology - June 7, 2021 Category: Neurology Source Type: research

Stroke Treatment With PAR-1 Agents to Decrease Hemorrhagic Transformation
Ischemic stroke is the most widespread cause of disability and a leading cause of death in developed countries. To date, the most potent approved treatment for acute stroke is recanalization therapy with thrombolytic drugs such as tissue plasminogen activator (rt-PA or tPA) or endovascular mechanical thrombectomy. Although tPA and thrombectomy are widely available in the United States, it is currently estimated that only 10–20% of stroke patients get tPA treatment, in part due to restrictive selection criteria. Recently, however, tPA and thrombectomy selection criteria have loosened, potentially allowing more patients to...
Source: Frontiers in Neurology - March 15, 2021 Category: Neurology Source Type: research

Age- and Sex-Associated Impacts of Body Mass Index on Stroke Type Risk: A 27-Year Prospective Cohort Study in a Low-Income Population in China
Conclusions Being overweight increased the risk of both ischemic and hemorrhagic strokes; obesity was only associated with an increased risk of IS. Additionally, the positive association between BMI and stroke risk was only observed in participants aged <65 years and the associations differed between men and women. Being overweight increased the risk of both ischemic and hemorrhagic strokes in men and being underweight increased their risk of hemorrhagic stroke. In women, being overweight increased the hemorrhagic stroke risk, whereas obesity increased their IS risks. The high prevalence of hypertension and elevat...
Source: Frontiers in Neurology - April 30, 2019 Category: Neurology Source Type: research

Clinical Improvement Following Stroke Promptly Reverses Post-stroke Cellular Immune Alterations
Conclusions: SIIA are detectable on admission of acute stroke patients. While it was assumed that post-stroke immunosuppression is rapidly reversed with improvement this is the first data set that shows that improvement actually is associated with a rapid reversal of SIIA demonstrating that SIIA require a constant signal to persist. The observation that HMGB-1 serum concentrations were similar in improved and non-improved cohorts argues against a role for this pro-inflammatory mediator in the maintenance of SIIA. Serum miRNA observed to be regulated in stroke in other publications was counter regulated with improvement in ...
Source: Frontiers in Neurology - April 30, 2019 Category: Neurology Source Type: research

Reduction of Leukocyte Microvascular Adherence and Preservation of Blood-Brain Barrier Function by Superoxide-Lowering Therapies in a Piglet Model of Neonatal Asphyxia
Conclusion: Using three different strategies to either prevent formation or enhance elimination of O2⋅_ during the post-asphyxial period, we saw both reduced leukocyte adherence and preserved BBB function with treatment. These findings suggest that agents which lower O2⋅_ in brain may be attractive new therapeutic interventions for the protection of the neonatal brain following asphyxia. Introduction Asphyxia is a relatively common source of neonatal brain damage (1), affecting ~2 in every 1,000 births (2). The hypoxic ischemia resulting from this oxygen deprivation can produ...
Source: Frontiers in Neurology - April 30, 2019 Category: Neurology Source Type: research

Decreased CSF Levels of ß-Amyloid in Patients With Cortical Superficial Siderosis
Conclusions: Our results demonstrate that the presence and extent of cSS are associated with reduced CSF ß-amyloid 42 levels. Further studies are needed to investigate the underlying mechanisms of this association. Introduction Cerebral amyloid angiopathy (CAA)—characterized by the deposition of ß-amyloid in the walls of leptomeningeal vessels—is a common cerebral small vessel disease and a major cause of intracerebral hemorrhage in the elderly (1–3). Furthermore, it has become evident that CAA is associated with cognitive impairment (4). Specifically, it has been shown that ...
Source: Frontiers in Neurology - April 25, 2019 Category: Neurology Source Type: research

Robot-Assisted Therapy in Upper Extremity Hemiparesis: Overview of an Evidence-Based Approach
Conclusion Robotic therapy has matured and represents an embodiment of a paradigm shift in neurorehabilitation following a stroke: instead of focusing on compensation, it affords focus in ameliorating the impaired limb in line with concepts of neuroplasticity. This technology-based treatment provides intensity, interactivity, flexibility, and adaptiveness to patient's performance and needs. Furthermore, it increases the productivity of rehabilitation care. Of course, efficiency must be discussed within a local perspective. For example, following the cost containment shown in the VA ROBOTICS study (46), the UK Nati...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

World-Wide Efficacy of Bone Marrow Derived Mesenchymal Stromal Cells in Preclinical Ischemic Stroke Models: Systematic Review and Meta-Analysis
Conclusions: Our results show worldwide efficacy of BM-MSCs in improving functional outcomes in pre-clinical animal models of stroke and support testing these cells in clinical trials in various ranges of time windows using different delivery routes. The continued growing number of publications showing functional benefit of BM-MSCs are now adding limited value to an oversaturated literature spanning 18 years. Researchers should focus on identifying definitive mechanisms on how BM-MSCs lead to benefit in stroke models. Introduction Ischemic stroke is the 5th leading cause of death and the leading cause of long term di...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

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