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Declining Rate and Severity of Hospitalized Stroke From 2004 to 2013 Clinical Sciences
Background and Purpose—Stroke is a leading cause of morbidity and disability. We assessed trends in rates of hospitalized stroke and stroke severity on admission in a prospective national registry of stroke from 2004 to 2013.Methods—All 6693 acute ischemic strokes and intracerebral hemorrhage in the National Acute Stroke Israeli participants ≥20 years old were included. Data were prospectively collected in 2004 (February–March), 2007 (March–April), 2010 (April–May), and 2013 (March–April). Rates of hospitalized stroke from 2004 to 2013 were studied using generalized linear models assuming a quasi-Poisson erro...
Source: Stroke - May 25, 2018 Category: Neurology Authors: Silvia Koton, Diklah Geva, Jonathan Y. Streifler, Sagi Harnof, Yoav Pougach, Olga Azrilin, Shoshana Hadar, Natan M. Bornstein, David Tanne Tags: Cardiovascular Disease, Epidemiology, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

Intravenous Thrombolysis for Stroke and Presumed Stroke in Human Immunodeficiency Virus-Infected Adults Brief Report
Background and Purpose—Human immunodeficiency virus (HIV) infection has been shown to increase both ischemic and hemorrhagic stroke risks, but there are limited data on the safety and outcomes of intravenous thrombolysis with tPA (tissue-type plasminogen activator) for acute ischemic stroke in HIV-infected patients.Methods—A retrospective chart review of intravenous tPA-treated HIV patients who presented with acute stroke symptoms was performed in 7 large inner-city US academic centers (various search years between 2000 and 2017). We collected data on HIV, National Institutes of Health Stroke Scale score, ischemic stro...
Source: Stroke - December 22, 2017 Category: Neurology Authors: Mahmoud A. AbdelRazek, Jose Gutierrez, David Mampre, Anna Cervantes–Arslanian, Cora Ormseth, Diogo Haussen, Kiran T. Thakur, Jennifer L. Lyons, Bryan R. Smith, Owen O’Connor, Joshua Z. Willey, Farrah J. Mateen Tags: Treatment, Complications, Mortality/Survival, Intracranial Hemorrhage, Ischemic Stroke Brief Reports Source Type: research

Clinical Utility of Electronic Alberta Stroke Program Early Computed Tomography Score Software in the ENCHANTED Trial Database Clinical Sciences
Background and Purpose—Clinical utility of electronic Alberta Stroke Program Early CT Score (e-ASPECTS), an automated system for quantifying signs of infarction, was evaluated in a large database of thrombolyzed patients with acute ischemic stroke.Methods—All baseline noncontrast computed tomographic scans of patients with anterior circulation acute ischemic stroke who participated in the alteplase dose arm of the randomized controlled trial ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study) were reviewed; poor quality and large (>6 mm) slice thickness were excluded. Included scans had e-ASPECTS...
Source: Stroke - May 25, 2018 Category: Neurology Authors: Simon Nagel, Xia Wang, Cheryl Carcel, Thompson Robinson, Richard I. Lindley, John Chalmers, Craig S. Anderson Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research

STARTING-SICH Nomogram to Predict Symptomatic Intracerebral Hemorrhage After Intravenous Thrombolysis for Stroke Clinical Sciences
Background and Purpose—Symptomatic intracerebral hemorrhage (sICH) is a rare but the most feared complication of intravenous thrombolysis for ischemic stroke. We aimed to develop and validate a nomogram for individualized prediction of sICH in intravenous thrombolysis–treated stroke patients included in the multicenter SITS-ISTR (Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register).Methods—All patients registered in the SITS-ISTR by 179 Italian centers between May 2001 and March 2016 were originally included. The main outcome measure was sICH per the European Cooperative Acute Str...
Source: Stroke - January 22, 2018 Category: Neurology Authors: Manuel Cappellari, Gianni Turcato, Stefano Forlivesi, Cecilia Zivelonghi, Paolo Bovi, Bruno Bonetti, Danilo Toni Tags: Cerebrovascular Disease/Stroke Original Contributions Source Type: research

Intracerebral Hemorrhage and Outcome After Thrombolysis in Stroke Patients Using Selective Serotonin-Reuptake Inhibitors Clinical Sciences
Background and Purpose—Selective serotonin-reuptake inhibitors (SSRIs) impair platelet function and have been linked to a higher risk of spontaneous intracerebral hemorrhage—an association that may be augmented by oral anticoagulants (OAC). We aimed to assess whether preadmission treatment with SSRIs in patients with acute ischemic stroke is associated with post-thrombolysis symptomatic intracerebral hemorrhage (sICH) and functional outcome.Methods—A multicenter retrospective analysis was conducted in prospective registries of patients treated by thrombolysis within 4.5 hours of stroke onset. The association between ...
Source: Stroke - November 27, 2017 Category: Neurology Authors: Jan F. Scheitz, Guillaume Turc, Linda Kuȷala, Alexandros A. Polymeris, Mirȷam R. Heldner, Thomas P. Zonneveld, Hebun Erdur, Sami Curtze, Christopher Traenka, Celine Breniere, Roland Wiest, Andrea Rocco, Gerli Sibolt, Henrik Gensicke, Matthia Tags: Complications, Ischemic Stroke Original Contributions Source Type: research

Plasma Glial Fibrillary Acidic Protein in the Differential Diagnosis of Intracerebral Hemorrhage Brief Report
Background and Purpose—Plasma GFAP (glial fibrillary acidic protein) has recently emerged as a potential biomarker for the differentiation of acute intracerebral hemorrhage (ICH) from acute ischemic stroke (AIS). We prospectively assessed the diagnostic accuracy of GFAP in the differential diagnosis of ICH.Methods—Consecutive patients presenting to the emergency department within 6 hours from symptom onset were evaluated. All patients underwent extensive diagnostic work-up and were classified according to discharge diagnosis in AIS, ICH, subarachnoid hemorrhage, and stroke mimics. GFAP was also measured in healthy volu...
Source: Stroke - August 28, 2017 Category: Neurology Authors: Aristeidis H. Katsanos, Konstantinos Makris, Dimitra Stefani, Katerina Koniari, Eleni Gialouri, Moses Lelekis, Maria Chondrogianni, Christina Zompola, Efthymios Dardiotis, Ioannis Rizos, John Parissis, Eleni Boutati, Konstantinos Voumvourakis, Georgios Ts Tags: Intracranial Hemorrhage, Ischemic Stroke Brief Reports Source Type: research

Use of Noncontrast Computed Tomography and Computed Tomographic Perfusion in Predicting Intracerebral Hemorrhage After Intravenous Alteplase Therapy Clinical Sciences
Background and Purpose—Intracerebral hemorrhage is a feared complication of intravenous alteplase therapy in patients with acute ischemic stroke. We explore the use of multimodal computed tomography in predicting this complication.Methods—All patients were administered intravenous alteplase with/without intra-arterial therapy. An age- and sex-matched case–control design with classic and conditional logistic regression techniques was chosen for analyses. Outcome was parenchymal hemorrhage on 24- to 48-hour imaging. Exposure variables were imaging (noncontrast computed tomography hypoattenuation degree, relative volume...
Source: Stroke - May 22, 2017 Category: Neurology Authors: Connor Batchelor, Pooneh Pordeli, Christopher D. d’Esterre, Mohamed Naȷm, Fahad S. Al–Aȷlan, Mari E. Boesen, Connor McDougall, Lisa Hur, Enrico Fainardi, Jai Jai Shiva Shankar, Marta Rubiera, Alexander V. Khaw, Michael D. Hill, Tags: Blood-Brain Barrier, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

Natural History of Perihematomal Edema and Impact on Outcome After Intracerebral Hemorrhage Clinical Sciences
Background and Purpose—Edema may worsen outcome after intracerebral hemorrhage (ICH). We assessed its natural history, factors influencing growth, and association with outcome.Methods—We estimated edema volumes in ICH patients from the Helsinki ICH study using semiautomated planimetry. We assessed the correlation between edema extension distance (EED) and time from ICH onset, creating an edema growth trajectory model up to 3 weeks. We interpolated expected EED at 72 hours and identified clinical and imaging characteristics associated with faster edema growth. Association of EED and mortality was assessed using logistic...
Source: Stroke - March 27, 2017 Category: Neurology Authors: Teddy Y. Wu, Gagan Sharma, Daniel Strbian, Jukka Putaala, Patricia M. Desmond, Turgut Tatlisumak, Stephen M. Davis, Atte Meretoja Tags: Intracranial Hemorrhage Original Contributions Source Type: research