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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

Influence of Sex on Stroke Prognosis: A Demographic, Clinical, and Molecular Analysis
Conclusion Our data suggest that women who suffer from IS present with a poorer functional outcome than men at 3-months, regardless of other preclinical and clinical factors during the acute phase. These relationships seem to be mediated by atrial dysfunction and inflammation. The inflammatory response is slightly higher in women; however, there are no sex differences in their functional behavior. There is a probable relationship between the molecular marker of atrial dysfunction NT-proBNP and worse functional outcome in women, and the connection seems to be more important in cardioembolic stroke patients. In patients wi...
Source: Frontiers in Neurology - April 16, 2019 Category: Neurology Source Type: research

Anticipatory Postural Adjustments During Gait Initiation in Stroke Patients
Conclusion This systematic review provides an update on GI-APA reorganization following stroke. Stroke patients present atypical GI-APA patterns, longer GI-APA duration and lower GI-APA amplitude compared to healthy people, regardless of which leg is used as the leading or trailing leg. GI is facilitated when the non-paretic leg is used as the trailing leg because the weakness of the paretic leg leads to difficulties in supporting body weight during the upcoming stance phase. Further experiments should include distinct groups of patients in order to describe GI-APA features in acute, subacute and chronic stroke, and the i...
Source: Frontiers in Neurology - April 16, 2019 Category: Neurology Source Type: research

Frequency of Hemorrhage on Follow Up Imaging in Stroke Patients Treated With rt-PA Depending on Clinical Course
Conclusions: Frequency of hemorrhagic transformation in Routine follow-up brain imaging and consecutive changes in therapeutic management were different depending on clinical course measured by NHISS score. Introduction Brain imaging 24–36 h after systemic thrombolysis for acute ischemic stroke is recommended in American Stroke Association and European Stroke Organization guidelines (1, 2). Brain imaging is performed to detect secondary bleeding or hemorrhagic transformation in order to adapt medical stroke prevention if necessary. Guideline recommendations are based on the results of the first study on rt-PA...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Platelet Count Predicts Adverse Clinical Outcomes After Ischemic Stroke or TIA: Subgroup Analysis of CNSR II
Conclusion: In ischemic stroke or TIA patients with platelet count within normal range, platelet count may be a qualified predictor for long-term recurrent stroke, mortality, and poor functional outcome. Introduction Platelets exert a critical role in the pathogenesis of atherosclerotic complications of cardio-cerebrovascular disease, contributing to thrombus formation, and embolism (1, 2). Previous literature reported that platelets of various size and density are produced by megakaryocytes of different size and stages of maturation in different clinical conditions, suggesting various platelet patterns in differen...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

Cardiac Imaging Within Emergency CT Angiography for Acute Stroke Can Detect Atrial Clots
This study was approved by the ethics committee of the medical faculty of the Ruhr University Bochum. FIGURE 1 Figure 1. Flow chart showing the selection of the study population. Results A total of 59 patients underwent emergency CCTA (Figure 2A) for suspected stroke, of which 44 received the final diagnosis ischemic stroke. There were 17 patients who had ischemic stroke or TIA and known or newly diagnosed atrial fibrillation (Table 1; mean age: 77.5 years, standard deviation: 8.4 years; 53% female). As hypothesized, intracardiac thrombi could be visualized: once in an artificially occluded left atrial appe...
Source: Frontiers in Neurology - April 9, 2019 Category: Neurology Source Type: research

Consecutive Slides on Axial View Is More Effective Than Transversal Diameter to Differentiate Mechanisms of Single Subcortical Infarctions in the Lenticulostriate Artery Territory
Conclusion: Consecutive slides on axial view (≥4 consecutive slices) might be more effective than transversal diameter to identify the atherosclerotic mechanisms of SSIs in the lenticulostriate artery territory. Clinical Trial Registration: http://www.clinicaltrials.gov. Unique identifier: NCT00664846 Introduction Single subcortical infarctions (SSIs) have been considered to be caused by lipohyalinosis degeneration in small artery disease, traditionally called lacunar infarct (1). However, atherosclerosis occurring in the parental artery blocking the orifice of the branch artery or atherosclerosis in the p...
Source: Frontiers in Neurology - April 8, 2019 Category: Neurology Source Type: research

Early Prophylactic Hypothermia for Patients With Severe Traumatic Injury: Premature to Close the Case
This study demonstrates that there is no role for the initiation of hypothermia during the acute phase of TBI (1, 2). However, it would be damaging to abandon the concept prematurely. Inflammation Also Paves the Way to Tissue Repair As soon as trauma occurs, the inflammatory cascade begins to take place. The deleterious role of inflammation in the secondary injury response is well-documented, hence the rationale to attempt early prophylactic hypothermia in TBI. However, inflammation also initiates tissue repair and regeneration (3–6). We now know that the secondary injury response accompanies the regenerating and...
Source: Frontiers in Neurology - April 8, 2019 Category: Neurology Source Type: research

Chagas disease, cardioembolic ischemic stroke, INR control and bleeding
This report describes the history of this Brazilian engineer, also known as the King of Coffee, who achieved enormous business success and fortune in the late nineteenth century. In 1890, during the inspection of his farm, the world's largest coffee plantation at that time, he fell from a carriage, which left him a hemiplegic. This forced him to sell the farm and move to France for treatment. Before his death two years later, he gave his 18-year-old son bits of advice, and distributed his inheritance, which allowed Alberto to study in Paris and finance his experiments that would culminate in the development of the airplane...
Source: Arquivos de Neuro-Psiquiatria - February 11, 2019 Category: Neurology Source Type: research

Stroke care conditions in Brazil: can it still get worse?
This report describes the history of this Brazilian engineer, also known as the King of Coffee, who achieved enormous business success and fortune in the late nineteenth century. In 1890, during the inspection of his farm, the world's largest coffee plantation at that time, he fell from a carriage, which left him a hemiplegic. This forced him to sell the farm and move to France for treatment. Before his death two years later, he gave his 18-year-old son bits of advice, and distributed his inheritance, which allowed Alberto to study in Paris and finance his experiments that would culminate in the development of the airplane...
Source: Arquivos de Neuro-Psiquiatria - February 11, 2019 Category: Neurology Source Type: research

Current and future conditions of stroke care in Brazil
This report describes the history of this Brazilian engineer, also known as the King of Coffee, who achieved enormous business success and fortune in the late nineteenth century. In 1890, during the inspection of his farm, the world's largest coffee plantation at that time, he fell from a carriage, which left him a hemiplegic. This forced him to sell the farm and move to France for treatment. Before his death two years later, he gave his 18-year-old son bits of advice, and distributed his inheritance, which allowed Alberto to study in Paris and finance his experiments that would culminate in the development of the airplane...
Source: Arquivos de Neuro-Psiquiatria - February 11, 2019 Category: Neurology Source Type: research

Health policy for telestroke in France: A retrospective description from 2003 to 2016.
CONCLUSIONS: Using a health policy model allowed to describe the policies supporting telestroke implementation in France and to highlight the need for better evaluation. PMID: 30736986 [PubMed - as supplied by publisher]
Source: Revue Neurologique - February 10, 2019 Category: Neurology Tags: Rev Neurol (Paris) Source Type: research

Cost-effectiveness analysis of mechanical thrombectomy plus tissue-type plasminogen activator compared with tissue-type plasminogen activator alone for acute ischemic stroke in France.
CONCLUSION: Although there is no universally accepted willingness-to-pay threshold in France, our analysis suggest that MT combined to IV-tPA can be considered a cost-effective treatment compared with IV-tPA alone. PMID: 30642680 [PubMed - as supplied by publisher]
Source: Revue Neurologique - January 17, 2019 Category: Neurology Tags: Rev Neurol (Paris) Source Type: research

Adult moyamoya angiopathy in Bourgogne-Franche-Comt é: Epidemiology, diagnosis and management.
CONCLUSION: MMA remains a rare cerebrovascular disease in Europe and requires multidisciplinary care. Epidemiological analysis showed differences with the Asian population, especially the predominance of ischemic forms in adults. PMID: 30447881 [PubMed - as supplied by publisher]
Source: Revue Neurologique - November 19, 2018 Category: Neurology Tags: Rev Neurol (Paris) Source Type: research

Congenital muscular dystrophies
To determine the minimal clinically important difference (MCID) for the motor function measure (MFM-32) in congenital muscular dystrophy and congenital myopathy patient an observational, retrospective, multicentric study was conducted on 85 congenital muscular dystrophy or congenital myopathy patients, aged 5 to 22 years at the national institute of neurological disorders and stroke of the national institutes of health and 2 French departments of paediatric physical medicine and rehabilitation. Data were collected if at least 2 MFMs were performed (MFM1 and MFM2) within 8 to 36 months of each other and if during MFM2 paren...
Source: Neuromuscular Disorders - September 6, 2018 Category: Neurology Authors: L. Le Goff, M. Fink, G. Norato, P. Rippert, K. Meilleur, A.R. Foley, M. Jain, M. Waite, S. Donkervoort, C. B önnemann, C. Vuillerot Source Type: research

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