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Incidence, causes and predictors of neurological deterioration occurring within 24 h following acute ischaemic stroke: a systematic review with pathophysiological implications
Early neurological deterioration (END) following ischaemic stroke is a serious event with manageable causes in only a fraction of patients. The incidence, causes and predictors of END occurring within 24 h of acute ischaemic stroke (END24) have not been systematically reviewed. We systematically reviewed Medline and Embase from January 1990 to April 2013 for all studies on END24 following acute ischaemic stroke (<8 h from onset). We recorded the incidence and presumed causes of and factors associated with END24. Thirty-six studies were included. Depending on the definition used, the incidence of END24 markedly...
Source: Journal of Neurology, Neurosurgery and Psychiatry - December 17, 2014 Category: Neurosurgery Authors: Seners, P., Turc, G., Oppenheim, C., Baron, J.-C. Tags: Stroke Cerebrovascular disease Source Type: research

Predictors of Outcome in Patients Presenting with Acute Ischemic Stroke and Mild Stroke Scale Scores
Although National Institutes of Health Stroke Scale (NIHSS) is a known predictor of outcome in acute ischemic stroke, there are other factors like age, ambulatory status, and ability to swallow that may be predictors of outcome but are not assessed by the traditional NIHSS. The aim of this retrospective review was to identify predictors of outcome in mild ischemic stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - May 3, 2015 Category: Neurology Authors: Cynthia L. Kenmuir, Maxim Hammer, Tudor Jovin, Vivek Reddy, Lawrence Wechsler, Ashutosh Jadhav Source Type: research

The National Institutes of Health Stroke Scale Lacks Validity in Chronic Hemiparetic Stroke
This study determined the concurrent validity of the NIHSS with the Stroke Impact Scale (SIS), a previously validated measure of health status in chronic stroke survivors.
Source: Journal of Stroke and Cerebrovascular Diseases - July 28, 2015 Category: Neurology Authors: Heather T. Peters, Susan E. White, Stephen J. Page Source Type: research

Using Radiological Data to Estimate Ischemic Stroke Severity
Risk-adjusted poststroke mortality has been proposed for use as a measure of stroke care quality. Although valid measures of stroke severity (e.g., the National Institutes of Health Stroke Scale [NIHSS]) are not typically available in administrative datasets, radiology reports are often available within electronic health records. We sought to examine whether admission head computed tomography data could be used to estimate stroke severity.
Source: Journal of Stroke and Cerebrovascular Diseases - January 13, 2016 Category: Neurology Authors: Jason J. Sico, Michael S. Phipps, John Concato, Cynthia Brandt, Carolyn K. Wells, Albert C. Lo, Stephen E. Nadeau, Linda S. Williams, Mark Gorman, John L. Boice, Dawn M. Bravata Source Type: research

Higher Insulin Resistance Level is Associated with Worse Clinical Response in Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis
Abstract Insulin resistance is linked to atherosclerotic cardiovascular diseases and stroke. We investigated whether there is a relationship between insulin resistance and clinical findings and outcomes of acute ischemic stroke patients treated with intravenous thrombolysis. In our study, 180 acute ischemic stroke non-diabetic patients treated with intravenous recombinant tissue-type plasminogen activator (iv rt-PA) were evaluated for insulin resistance assessed by homeostasis model assessment insulin resistance (HOMA-IR). The threshold for HOMA-IR was determined as 2.7. Patients were grouped as HOMA-IR > 2...
Source: Translational Stroke Research - January 30, 2016 Category: Neurology Source Type: research

Pulse pressure and in-hospital outcome of acute ischemic stroke
We aimed to evaluate the association between pulse pressure, a readily available marker of arterial stiffness, and the in-hospital outcome of patients with acute ischemic stroke. We prospectively studied 790 consecutive patients who were admitted with acute ischemic stroke (41.0% males, age 79.4±6.8 years). The severity of stroke was assessed at admission with the National Institutes of Health Stroke Scale (NIHSS). The outcome was assessed with dependency rates at discharge (modified Rankin scale between 2 and 5) and with in-hospital mortality.
Source: Journal of the American Society of Hypertension - March 31, 2016 Category: Cardiology Authors: Konstantinos Tziomalos, Stella Bouziana, Marianna Spanou, Stavroula Kostaki, Stella-Maria Angelopoulou, Maria Papadopoulou, Vasilios Giampatzis, Maria Tsopozidi, Christos Savopoulos, Apostolos I. Hatzitolios Tags: Stroke Source Type: research

Patients with Low National Institutes of Health Stroke Scale Scores Have Longer Door-to-Needle Times: Analysis of a Telestroke Network
The benefits of intravenous tissue-type plasminogen activator (IV-tPA) in acute ischemic stroke (AIS) are time dependent. Because emergency rooms quickly initiate a stroke alert with more severe symptoms, we hypothesized that patients with lower National Institutes of Health Stroke Scale (NIHSS) scores, indicating a less severe stroke, would have longer door-to-needle (DTN) times compared to patients with higher NIHSS scores.
Source: Journal of Stroke and Cerebrovascular Diseases - June 2, 2016 Category: Neurology Authors: Archit Bhatt, Alexandra Lesko, Lindsay Lucas, Amit Kansara, Elizabeth Baraban Source Type: research

Intrathecal Injection of Allogenic Bone Marrow-Derived Mesenchymal Stromal Cells in Treatment of Patients with Severe Ischemic Stroke: Study Protocol for a Randomized Controlled Observer-Blinded Trial
AbstractMesenchymal stromal cells (MSCs) can differentiate into multiple tissues. Preclinical studies have shown that MSC-based therapy is a potential new treatment approach for ischemic stroke. These results support the urgent need for further studies of MSC transplantation in the treatment of ischemic stroke in humans. Here, we develop a prospective, randomized, controlled, observer-blinded phase II trial to assess the clinical safety, feasibility, and therapeutic mechanisms of allogenic bone marrow-derived MSCs (BM-MSCs) by intrathecal infusion in the treatment of patients with cerebral infarction within the middle cere...
Source: Translational Stroke Research - May 23, 2018 Category: Neurology Source Type: research

Plasma Levels of Brain-Derived Neurotrophic Factor are Associated with Prognosis in the Acute Phase of Ischemic Stroke
Context: Brain-derived neurotrophic factor (BDNF) is a neurotrophin involved in neuronal survival, differentiation, and maturation. Purpose: To evaluate the levels of BDNF in the acute phase of stroke and their potential association with neurological impairment. Methods: Patients in the acute phase of ischemic stroke were evaluated with the following clinical tools: National Institutes of Health Stroke Scale, modified Rankin scale, Gugging Swallowing Screen and Alberta Stroke Program Early CT Score.
Source: Journal of Stroke and Cerebrovascular Diseases - December 3, 2018 Category: Neurology Authors: Aline Mansueto Mour ão, Laélia Cristina Caseiro Vicente, Mery Natali Silva Abreu, Romeu Vale Sant'Anna, Erica Leandro Marciano Vieira, Leonardo Cruz de Souza, Aline Silva de Miranda, Milene Alvarenga Rachid, Antônio Lucio Teixeira Source Type: research

Obstructive Sleep Apnea before Ischemic Stroke: Clinical Relevance to Infarction Volume and Neurological Recovery
Background: Obstructive sleep apnea (OSA) is a probable risk factor with speculative roles in the induction or aggravation of acute ischemic stroke (AIS). Methods: The association between OSA and AIS severity was retrospectively analyzed using clinical data of first-onset AIS patients, admitted to our hospital between January 2013 and September 2016. Eligible patients were categorized based on the presence of OSA prior to stroke. Stroke severity and functional outcomes were evaluated using the National Institute of Health Stroke Severity Scale (NIHSS) and the modified Rankin scale (mRS), respectively.
Source: Journal of Stroke and Cerebrovascular Diseases - May 20, 2019 Category: Neurology Authors: Li Zhang, Ran Meng, Shuling Shang, Chuanjie Wu, Di Wu, Shuyi Shang, Lifeng Chen, Yunshu Zhang, Xunming Ji Source Type: research

Crossed Cerebellar Diaschisis Indicates Hemodynamic Compromise in Ischemic Stroke Patients
AbstractCrossed cerebellar diaschisis (CCD) in internal carotid artery (ICA) stroke refers to attenuated blood flow and energy metabolism in the contralateral cerebellar hemisphere. CCD is associated with an interruption of cerebro-cerebellar tracts, but the precise mechanism is unknown. We hypothesized that in patients with ICA occlusions, CCD might indicate severe hemodynamic impairment in addition to tissue damage. Duplex sonography and clinical data from stroke patients with unilateral ICAO who underwent blood oxygen-level-dependent MRI cerebrovascular reserve (BOLD-CVR) assessment were analysed. The presence of CCD (e...
Source: Translational Stroke Research - June 5, 2020 Category: Neurology Source Type: research

Thrombectomy for Stroke Caused by Cardiac Myxoma
Large vessel occlusion stroke, caused by cardiac myxoma, is a rare and severe condition with poor neurological outcomes. Currently, there are no clear guidelines for treating patients with this condition. In our case, we describe a rare case of acute ischemic stroke caused by cardiac myxoma which was successfully treated with mechanical thrombectomy. At the end of a 6 months' follow-up, her National Institutes of Health Stroke Scale score (NIHSS) had significantly improved, from 20 to 3. This result is encouraging and suggests that mechanical thrombectomy may be a feasible therapy for large vessel occlusion stroke induced ...
Source: Journal of Stroke and Cerebrovascular Diseases - October 29, 2020 Category: Neurology Authors: Biao Zhou, Shanshan Huang, Shuyun Liu, Lijie Ren, Can Huang, Zongde Lian Tags: Case Report Source Type: research

Endovascular Thrombectomy VS. Medical Treatment for Mild Stroke Patients: A Systematic Review and Meta-Analysis
At present, endovascular thrombectomy (EVT) has been gradually became a standard therapy for stroke patients caused by emergent large-vessel occlusion (ELVO). However, the question about whether EVT is superior to medical treatment for mild stroke patients presenting with a low baseline National Institutes of Health Stroke Scale (NIHSS) score remains unclear. The aim of this systematic review and meta-analysis was to compare the safety and efficacy of EVT with medical treatment in mild stroke patients.
Source: Journal of Stroke and Cerebrovascular Diseases - September 25, 2020 Category: Neurology Authors: Yongli Zhao, Ying Song, Yingchang Guo, Yanru Li, Yi Zhang, Pengju Ma, Guangpeng Li, Fenbao Li Source Type: research

Letter to the editor regarding ‘prediction of intracerebral hemorrhage after endovascular treatment of acute ischemic stroke: Combining quantitative parameters on dual-energy CT with clinical related factors’
This study recruited 72 acute ischemic stroke patients treated with endovascular treatment, forty of whom developed intracerebral hemorrhage (ICH). According to the results of receiver operating characteristic curve and multivariate logistic regression analysis, the authors have found that hyperdensity areas (HDA) volumes, alberta stroke program early CT score (ASPECTS), National Institutes of Health Stroke Scale (NIHSS) score and some other parameters may be related to and be able to predict ICH after endovascular treatment.
Source: Journal of Stroke and Cerebrovascular Diseases - September 22, 2021 Category: Neurology Authors: Meidi Peng, Yachi Gong, Yupei Chen, Wenxuan Zhao Tags: Letter to the Editor Source Type: research