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Specialty: Neurology
Management: National Institutes of Health (NIH)
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Total 425 results found since Jan 2013.
Successful Reperfusion With Intravenous Thrombolysis Preceding Mechanical Thrombectomy in Large-Vessel Occlusions Brief Report
Background and Purpose—Although current guidelines advocate pretreatment with intravenous thrombolysis (IVT) in all eligible patients with acute ischemic stroke with large-vessel occlusion before mechanical thrombectomy, there are observational data questioning the efficacy of this approach. One of the main arguments in favor of IVT pretreatment is the potential for tissue-type plasminogen activator–induced successful reperfusion (SR) before the onset of endovascular procedure.Methods—We performed a systematic review and meta-analysis of randomized controlled clinical trials and observational cohorts providing rates ...
Source: Stroke - December 22, 2017 Category: Neurology Authors: Georgios Tsivgoulis, Aristeidis H. Katsanos, Peter D. Schellinger, Martin Kohrmann, Panayiotis Varelas, Georgios Magoufis, Maurizio Paciaroni, Valeria Caso, Anne W. Alexandrov, Edip Gurol, Andrei V. Alexandrov Tags: Ischemic Stroke Brief Reports Source Type: research
Thrombolytic Therapy in Severe Cardioembolic Stroke After Reversal of Dabigatran with Idarucizumab: Case Report and Literature Review
Whether idarucizumab, an antidote of dabigatran, can be used effectively and safely before thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) in patients with stroke undergoing treatment with dabigatran remains unknown. We herein describe a 57-year-old man who developed severe cardioembolic stroke with a National Institutes of Health Stroke Scale score of 22 in the left middle cerebral artery territory while undergoing treatment with dabigatran for nonvalvular atrial fibrillation and who was treated with rt-PA after the reversal of dabigatran with idarucizumab.
Source: Journal of Stroke and Cerebrovascular Diseases - March 16, 2018 Category: Neurology Authors: Yuichiro Ohya, Noriko Makihara, Kayo Wakisaka, Takao Morita, Tetsuro Ago, Takanari Kitazono, Hitonori Takaba Tags: Case Studies Source Type: research
Delays in the Air or Ground Transfer of Patients for Endovascular Thrombectomy Clinical Sciences
Background and Purpose—For suspected large vessel occlusion patients efficient transfer to centers that provide endovascular therapy (ET) is critical to maximizing treatment opportunity. Our objective was to examine associations between transfer time, modes of transfer, ET, and outcomes within a hub-and-spoke telestroke network.Methods—Patients with ischemic stroke were included if transferred to a single hub hospital between January 2011 and October 2015 with National Institutes of Health Stroke Scale>6, onset
Source: Stroke - May 25, 2018 Category: Neurology Authors: Robert W. Regenhardt, Adam P. Mecca, Stephanie A. Flavin, Gregoire Boulouis, Arne Lauer, Kori Sauser Zachrison, James Boomhower, Aman B. Patel, Joshua A. Hirsch, Lee H. Schwamm, Thabele M. Leslie-Mazwi Tags: Revascularization, Quality and Outcomes, Cerebrovascular Disease/Stroke, Cerebrovascular Procedures, Ischemic Stroke Original Contributions Source Type: research
Laterality is an Independent Predictor of Endovascular Thrombectomy in Patients With Low National Institute of Health Stroke Scale
Endovascular thrombectomy (ET) for acute ischemic stroke (AIS) due to large-vessel occlusion (LVO) is offered to select patients meeting strict criteria. One of the criteria is stroke severity as indicated by the National Institute of Health Stroke Scale (NIHSS). Inherently, NIHSS is biased towards left hemisphere strokes (LHS) with median NIHSS score 4 points higher than right hemisphere strokes (RHS). This may potentially affect clinical decision making and thrombectomy eligibility. We sought to test this hypothesis.
Source: Journal of Stroke and Cerebrovascular Diseases - August 2, 2018 Category: Neurology Authors: Shashvat M. Desai, Marcelo Rocha, Matthew Starr, Bradley J. Molyneaux, Cynthia L. Kenmuir, Bradley A. Gross, Brian T. Jankowitz, Tudor G. Jovin, Ashutosh P. Jadhav Source Type: research
Complement Complex C5b-9 Levels Are Associated with the Clinical Outcomes of Acute Ischemic Stroke and Carotid Plaque Stability
AbstractThe terminal complement complex C5b-9 plays an important role in acute ischemic stroke (AIS) and carotid atherosclerosis. However, the associations between serum C5b-9, the severity and outcome of AIS, and the stability of carotid plaques have not been well investigated. In this clinical study, 70 patients with AIS and 70 healthy controls were enrolled. Serum C5b-9 levels at 72 h after stroke onset were measured by enzyme-linked immunosorbent assay (ELISA). Infarct size, the National Institutes of Health Stroke Scale (NIHSS), the 90-day modified Rankin Scale (mRS), and carotid plaque and stenosis were evaluated. ...
Source: Translational Stroke Research - September 1, 2018 Category: Neurology Source Type: research
Initial National Institute of Health Stroke Scale to Early Predict the Improvement of Swallowing in Patients with Acute Ischemic Stroke
Objectives: To study the applicability of National Institutes of Health Stroke Scale (NIHSS) in early predicting the prognosis of poststroke dysphagia in an acute ward. Methods: This is an observational retrospective cohort study including adult patients with ischemic stroke. Patients with various factors affecting swallowing were excluded to obtain a representative sample of 165 patients. The main outcome measure was the improvements of oral intake function. Results: The scores of facial palsy (NIHSS item 4) (odds ratio [OR]: 0.484, 95% confidence interval [CI]: 0.279-0.838, P = .0096] and language/aphasia (NIHSS item 9) ...
Source: Journal of Stroke and Cerebrovascular Diseases - July 26, 2019 Category: Neurology Authors: Wen-Chih Lin, Chih-Yuan Huang, Lin-Fu Lee, Yun-Wen Chen, Chung-Han Ho, Yuan-Ting Sun Source Type: research
Impact of endovascular reperfusion on low National Institutes of Health Stroke Scale score large-vessel occlusion stroke
The benefit of mechanical thrombectomy (MT) in patients presenting with mild ischemic stroke symptoms (National Institutes of Health Stroke Scale [NIHSS] score
Source: Journal of Stroke and Cerebrovascular Diseases - May 13, 2020 Category: Neurology Authors: Felix Chin, Muhammad Waqas, Ryan Chou, Peter G. Gerace, Hamid H. Rai, Kunal Vakharia, Rimal H. Dossani, Jason M. Davies, Kenneth V. Snyder, Adnan H. Siddiqui, Elad I. Levy Source Type: research
Role of Non-Perfusion Factors in Mildly Symptomatic Large Vessel Occlusion Stroke
Recent reperfusion trials after acute large vessel occlusion (LVO) stroke did not include patients with low national institute of health stroke scale (NIHSS) except for MR CLEAN trial in which they enrolled subjects with NIHSS ranging between 3 and 38. Very few subjects had NIHSS ≤5. Other trials like REVASCAT, ESCAPE, SWIFT PRIME, EXTEND-IA, DAWN, and DIFFUSE 3 had their enrolled patients’ NIHSS at ≥6, interquartile range (IQR) 12-20, IQR 13-20, IQR 9-20, IQR 13-21, and IQR 10-21 respectively.1–3 The most likely rationale is that these low-NIHSS stroke patients have well-developed collateral circulations that allo...
Source: Journal of Stroke and Cerebrovascular Diseases - August 11, 2020 Category: Neurology Authors: Omar Hussein, Ahmed Abd Elazim, Khalid Sawalha, Smeer Salam, Kasser Saba, Mohammad Hamed, Juan Peng, Archana Hinduja Source Type: research
Risk of Early Bleeding with Dual Antiplatelet Therapy in Acute Stroke and Transient Ischemic Attack Regardless of NIHSS Admission
Background: Dual antiplatelet therapy (DAT) is a therapeutic option for patients with minor ischemic stroke (IS) or transient ischemic attack (TIA). No study has evaluated the incidence of early bleeding in patients with moderate to major ischemic stroke. The current study aimed to analyze both the frequency of early bleeding and hospital morbidity related to DAT for either acute IS or TIA regardless of admission National Institute of Health Stroke Scale (NIHSS) score. Methods: This was a retrospective analysis based on data collected from a prospective data bank of a single center.
Source: Journal of Stroke and Cerebrovascular Diseases - March 4, 2021 Category: Neurology Authors: Valeria Cristina Scavasine, Rubens Mendes Barbosa, Francisco Diego Negrao Lopes Neto, Francisco Manoel Branco Germininani, Rodrigo Bazan, Viviane Flumignan Z étola, Ayrton Roberto Massaro, Marcos Christiano Lange Source Type: research
Neurological Instability in Ischemic Stroke: Relation with Outcome, Latency Time, and Molecular Markers
AbstractThe National Institutes of Health Stroke Scale (NIHSS) is commonly used to evaluate stroke neurological deficits and to predict the patient ’s outcome. Neurological instability (NI), defined as the variation of the NIHSS in the first 48 h, is a simple clinical metric that reflects dynamic changes in the area of the brain affected by the ischemia. We hypothesize that NI may represent areas of cerebral instability known as penumbra, wh ich could expand or reduce brain injury and its associated neurological sequels. In this work, our aim was to analyze the association of NI with the functional outcome at 3 months ...
Source: Translational Stroke Research - June 24, 2021 Category: Neurology Source Type: research
Evaluation of stroke prognostication using age and NIH Stroke Scale index (SPAN-100 index) in delayed intravenous thrombolysis patients (beyond 4.5 hours)
the efficacy of delayed intravenous tissue plasminogen activator (tPA), beyond the 4.5 h window, is evolving. Advanced age and high admission National Institutes of Health Stroke Scale (NIHSS) score are proposed to adversely affect the outcome of delayed thrombolysis and limit the inclusion criteria. The summation of patient age and admission NIHSS score was introduced as the SPAN-100 index as a tool of prediction of the clinical outcome after acute ischemic stroke (AIS). We aimed to assess the SPAN-100 index in AIS thrombolysed patients after 4.5 h.
Source: Journal of Stroke and Cerebrovascular Diseases - February 16, 2022 Category: Neurology Authors: Nada Elsaid, Guido Bigliardi, Maria Luisa Dell'Acqua, Laura Vandelli, Ludovico Ciolli, Livio Picchetto, Giuseppe Borz ì, Riccardo Ricceri, Roberta Pentore, Stefano Vallone, Stefano Meletti, Ahmed Saied Source Type: research
Intravenous thrombolysis for mild stroke: NIHSS 3 –5 Versus NIHSS 0–2
Studies have shown that mild stroke patients with National Institutes of Health Stroke Scale (NIHSS) score 3 –5 but not 0–2 may benefit from the intravenous thrombolysis when compared with antiplatelet therapy. We aimed to compare the safety and effectiveness of thrombolysis in mild stroke with NIHSS score of 0–2 vs. 3–5 and identify the predictors of an excellent functional outcome in a real world longitudinal registry.
Source: Journal of Stroke and Cerebrovascular Diseases - March 10, 2023 Category: Neurology Authors: Liyuan Wang, Guangshuo Li, Yahui Hao, Manjun Hao, Yunyun Xiong Source Type: research
Association between clinician reported outcome and patient reported outcome measures one year after stroke
In evaluating the burden of stroke and the effect of stroke treatment, several clinicians ’ outcome measures regarding physical functioning are used, such as National Institutes of Health Stroke Scale (NIHSS),1 Barthel index,2 and modified Rankin Scale (mRS).3
Source: Journal of Stroke and Cerebrovascular Diseases - May 11, 2023 Category: Neurology Authors: Astrid Glimmerveen, Suzanne Holewijn, Sarah Vermeer Source Type: research
REVASCAT: a randomized trial of revascularization with SOLITAIRE FR® device vs. best medical therapy in the treatment of acute stroke due to anterior circulation large vessel occlusion presenting within eight‐hours of symptom onset
REVASCAT is a prospective, multicenter, randomized trial seeking to establish whether subjects meeting following main inclusion criteria: age 18‐80, baseline National Institutes of Health Stroke Scale ≥6, evidence of intracranial internal carotid artery or proximal (M1 segment) middle cerebral artery occlusion, Alberta Stroke Program Early Computed Tomography score of >7 on non‐contrast CT or >6 on diffusion‐weighted magnetic resonance imaging , ineligible for or with persistent occlusion after intravenous alteplase and procedure start within 8 hours from symptom onset, have higher rates of favorable outcome ...
Source: International Journal of Stroke - November 10, 2013 Category: Neurology Authors: Carlos A. Molina, Angel Chamorro, Àlex Rovira, Angeles Miquel, Joaquin Serena, Luis San Roman, Tudor G. Jovin, Antoni Davalos, Erik Cobo Tags: Protocols Source Type: research
