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Academic Year-end Changeover and Stroke Outcomes
Lower quality of care and poorer outcomes are suspected when new trainees (eg, residents) start in July in teaching hospitals, the so-called “the July effect.” We evaluated outcomes and processes of care among patients with an acute ischemic stroke (AIS) admitted in July versus other 11 months of the year.
Source: Journal of Stroke and Cerebrovascular Diseases - December 23, 2014 Category: Neurology Authors: Tai Hwan Park, Donald A. Redelmeier, Shudong Li, Jitphapa Pongmoragot, Gustavo Saposnik, Investigators of the Registry of the Canadian Stroke network (RCSN) for the Stroke Outcomes Research (SORCan) Working Group Source Type: research

Acute Kidney Injury Is Associated with Increased Hospital Mortality after Stroke
Conclusions: AKI occurs frequently after stroke and is associated with increased hospital mortality. Additional studies are needed to establish if the association is causal and if measures to prevent AKI would result in decreased mortality.
Source: Journal of Stroke and Cerebrovascular Diseases - July 23, 2012 Category: Neurology Authors: Minesh Khatri, Jonathan Himmelfarb, Derk Adams, Kyra Becker, W.T. Longstreth, David L. Tirschwell Tags: Original Articles Source Type: research

Variability in the Use of Intravenous Thrombolysis for Mild Stroke: Experience Across the SPOTRIAS Network
In this study, we describe the variability of treatment of mild stroke patients across a network of academic stroke centers.Methods: Stroke centers within the Specialized Program of Translational Research in Acute Stroke (SPOTRIAS) prospectively collect data on patients treated with intravenous recombinant tissue plasminogen activator (IV rt-PA), including demographics, pretreatment National Institutes of Health Stroke Scale (NIHSS) scores, and in-hospital mortality. We examined the variability in proportion of total tissue plasminogen activator–treated patients in the NIHSS categories (0-3, 4-5, or ≥6) and associated ...
Source: Journal of Stroke and Cerebrovascular Diseases - December 16, 2011 Category: Neurology Authors: Joshua Z. Willey, Pooja Khatri, Jane C. Khoury, José G. Merino, Andria L. Ford, Natalia S. Rost, Nicole R. Gonzales, Latisha K. Ali, Brett C. Meyer, Joseph P. Broderick Tags: Original Articles Source Type: research

A Stroke Care Model at an Academic, Comprehensive Stroke Center During the 2020 COVID-19 Pandemic
The COVID-19 pandemic has required the adaptation of hyperacute stroke care (including stroke code pathways) and hospital stroke management. There remains a need to provide rapid and comprehensive assessment to acute stroke patients while reducing the risk of COVID-19 exposure, protecting healthcare providers, and preserving personal protective equipment (PPE) supplies. While the COVID infection is typically not a primary cerebrovascular condition, the downstream effects of this pandemic force adjustments to stroke care pathways to maintain optimal stroke patient outcomes.
Source: Journal of Stroke and Cerebrovascular Diseases - May 6, 2020 Category: Neurology Authors: Dawn Meyer, Brett C. Meyer, Karen S. Rapp, Royya Modir, Kunal Agrawal, Lovella Hailey, Melissa Mortin, Richard Lane, Tamra Ranasinghe, Brian Sorace, Tara D. von Kleist, Emily Perrinez, Mohammed Nabulsi, Thomas Hemmen Source Type: research

Impact of Telemedicine Implementation in Thrombolytic Use for Acute Ischemic Stroke: The University of Pittsburgh Medical Center Telestroke Network Experience
Background: Intravenous thrombolysis is the only therapy for acute ischemic stroke that is approved by the US Food and Drug Association. The use of telemedicine in stroke makes it possible to bring the expertise of academic stroke centers to underserved areas, potentially increasing the quality of stroke care.Methods: All consecutive admissions for stroke were reviewed for 1 year before telemedicine implementation and for variable periods thereafter. A retrospective review identified 2588 admissions for acute stroke between March 2005 and December 2008 at 12 hospitals participating in a telestroke network, including 919 pa...
Source: Journal of Stroke and Cerebrovascular Diseases - March 13, 2013 Category: Neurology Authors: Edilberto Amorim, Min-Mei Shih, Steven A. Koehler, Lori L. Massaro, Syed F. Zaidi, Mouhammad A. Jumaa, Vivek K. Reddy, Maxim D. Hammer, Tudor G. Jovin, Lawrence R. Wechsler Tags: Original Articles Source Type: research

Venous Thromboembolism in the Get With The Guidelines-Stroke Acute Ischemic Stroke Population: Incidence and Patterns of Prophylaxis
Conclusions: Despite a high overall rate of VTE prophylaxis, VTE was found to occur in approximately 3% of GWTG-S patients. Reported rates of VTE prophylaxis differed among hospitals by region and hospital type, and among patients by age, race, and medical comorbidities.
Source: Journal of Stroke and Cerebrovascular Diseases - December 17, 2012 Category: Neurology Authors: G. Logan Douds, Anne S. Hellkamp, DaiWai M. Olson, Gregg C. Fonarow, Eric E. Smith, Lee H. Schwamm, Kevin M. Cockroft Tags: Original Articles Source Type: research

Racial and Gender Differences in Stroke Severity, Outcomes, and Treatment in Patients with Acute Ischemic Stroke
Background: Previous research has indicated that women and blacks have worse outcomes after acute ischemic stroke (AIS). Little research has been done to investigate the combined influence of race and gender in the presentation, treatment, and outcome of patients with AIS. We sought to determine the association of race and gender on initial stroke severity, thrombolysis, and functional outcome after AIS.Methods: AIS patients who presented to 2 academic medical centers in the United States (2004-2011) were identified through prospective registries. In-hospital strokes were excluded. Stroke severity, measured by admission Na...
Source: Journal of Stroke and Cerebrovascular Diseases - January 27, 2014 Category: Neurology Authors: Amelia K. Boehme, James E. Siegler, Michael T. Mullen, Karen C. Albright, Michael J. Lyerly, Dominique J. Monlezun, Erica M. Jones, Rikki Tanner, Nicole R. Gonzales, T. Mark Beasley, James C. Grotta, Sean I. Savitz, Sheryl Martin-Schild Tags: Original Articles Source Type: research

Tobacco Use and Cryptogenic Stroke in Young Adults
Objective: Cryptogenic stroke is the leading subtype of ischemic stroke in the young. We sought to evaluate the association between traditional cardiovascular risk factors and cryptogenic stroke by using a case–control study. Methods: Patients aged 18-54 years, consecutively treated for first-ever cryptogenic ischemic stroke in an academic stroke unit, were compared with subjects from the general population living in the same geographic area. Control subjects were matched for age and sex with patients.
Source: Journal of Stroke and Cerebrovascular Diseases - October 5, 2015 Category: Neurology Authors: Aude Jaffre, Jean Bernard Ruidavets, Nathalie Nasr, Brigitte Guidolin, Jean Ferrieres, Vincent Larrue Source Type: research

Decompressive Hemicraniectomy for Malignant Hemispheric Stroke in the Elderly: Comparison of Outcomes between Individuals 61-70 and >70 Years of Age
Conclusions: We suggest that the efficacy of DHC in malignant hemispheric stroke patients between 61 and 70 years of age be further investigated in future randomized trials. By contrast, it appears unlikely that patients>70 years of age would benefit from DHC.
Source: Journal of Stroke and Cerebrovascular Diseases - March 13, 2013 Category: Neurology Authors: Joji Inamasu, Takafumi Kaito, Takeya Watabe, Tsukasa Ganaha, Yasuhiro Yamada, Teppei Tanaka, Shuei Imizu, Takuro Hayashi, Motoharu Hayakawa, Yoko Kato, Yuichi Hirose Tags: Original Articles Source Type: research

Stroke Mimics under the Drip-and-Ship Paradigm
Conclusion: The drip-and-ship paradigm and any psychiatric history predict the diagnosis of SM. None of the SM had thrombolysis-related complications, and all were discharged to home. These findings may explain the superior outcomes associated with the drip-and-ship paradigm in the treatment for AIS.
Source: Journal of Stroke and Cerebrovascular Diseases - August 19, 2013 Category: Neurology Authors: Sonal Mehta, Nirav Vora, Randall C. Edgell, Hesham Allam, Aws Alawi, Jennifer Koehne, Abhay Kumar, Eliahu Feen, Salvador Cruz-Flores, Amer Alshekhlee Tags: Original Articles Source Type: research

Ischemic Strokes in Pakistan: Observations from the National Acute Ischemic Stroke Database
Conclusions: Hypertension and dyslipidemia were the most common risk factors and large vessel atherosclerosis was the most common stroke etiology. Elderly patients were significantly more likely to have in-hospital complications, die during their hospital stay, and have a higher mRS score at discharge.
Source: Journal of Stroke and Cerebrovascular Diseases - April 7, 2014 Category: Neurology Authors: Bhojo A. Khealani, Maria Khan, Muhammad Tariq, Abdul Malik, Alam I. Siddiqi, Safia Awan, Mohammad Wasay Tags: Original Articles Source Type: research

Reliability of the Acutely Estimated Premorbid Modified Rankin Scale for Stroke Treatment Decision Making
Background: Premorbid functional status is an important factor in acute stroke treatment decision making. Determining the modified Rankin Score (mRS) accurately may be difficult due to deficits from stroke and lack of collateral information in the acute setting. Data on the reliability of the premorbid mRS in “real-world” practice outside of clinical trial or registry settings are limited. Methods: A retrospective study at a high volume academic primary stroke center. For patients with acute ischemic stroke treated with alteplase between July 2012 and July 2016, hospital electronic records were revie wed for detailed i...
Source: Journal of Stroke and Cerebrovascular Diseases - January 9, 2019 Category: Neurology Authors: WenWen Zhang, Skye Coote, Tanya Frost, Helen M. Dewey, Phillip M. Choi Source Type: research

Establishing the need for a stroke unit at Chris Hani Baragwanath Academic Hospital in South Africa
Stroke in Africa is a growing and neglected crisis with strokes more than doubling in low to middle income countries in the last four decades. Despite this growing threat to healthcare systems, implementation of stroke models of care in hospitals is lacking with most stroke patients being managed as part of a general medical service. Stroke units have shown to decrease mortality, reduce length of stay in hospital (LOS), and improve patient outcomes.
Source: Journal of Stroke and Cerebrovascular Diseases - March 30, 2023 Category: Neurology Authors: Stephanie Pillay, Azra Hoosen, Fiona Breytenbach, Roxann Redant, Nadia Umuneza, Sameera Haffejee, Zvifadzo Matsena-Zingoni, Kganetso Sekome Source Type: research

Apolipoproteins B and A1 in Ischemic Stroke Subtypes
Introduction: Elevated serum apolipoprotein B and the apolipoprotein B/A1 ratio have been associated with ischemic stroke and intracranial atherosclerotic disease. We sought to assess the relationship between serum levels of apolipoprotein B, apolipoprotein A1, and the apolipoprotein B/A1 ratio with ischemic stroke subtypes and large artery atherosclerosis location. Materials and Methods: We evaluated serum apolipoprotein B and apolipoprotein A1 levels in consecutive, statin-na ïve, adult ischemic stroke patients admitted to an academic medical center in southern India.
Source: Journal of Stroke and Cerebrovascular Diseases - February 9, 2020 Category: Neurology Authors: Rizwan Kalani, Soumya Krishnamoorthy, D. Deepa, Srinivas Gopala, Dorairaj Prabhakaran, David Tirschwell, P.N. Sylaja Source Type: research

Mechanical Thrombectomy Improves Outcome for Large Vessel Occlusion Stroke after Cardiac Surgery
Stroke is a feared complication of cardiac surgery. Modern clot-retrieval techniques provide effective treatment for large vessel occlusion (LVO) strokes. The purpose of this study was to 1) report the incidence of LVO stroke after cardiac surgery at a large academic center, and 2) describe outcomes of postoperative LVO strokes.
Source: Journal of Stroke and Cerebrovascular Diseases - May 19, 2021 Category: Neurology Authors: D. Andrew Wilkinson, Sravanthi Koduri, Sharath Kumar Anand, Badih J. Daou, Vikram Sood, Neeraj Chaudhary, Joseph J. Gemmete, James F. Burke, Himanshu J. Patel, Aditya S. Pandey Source Type: research

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