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Total 32 results found since Jan 2013.

Current status of acute stroke management in Korea: a report on a multicenter, comprehensive acute stroke registry
There are limited data on the utilization of diagnostics and the variation of treatments at the national level in acute stroke care. Clinical Research Center for Stroke – 5th division stroke registry aimed to describe stroke statistics and quality of care in Korea and to implement quality indicators. Clinical Research Center for Stroke – 5th division registry was established in April 2008 and covers pretreatment demographics, medical and stroke severity measures, diagnostic evaluation, hyperacute revascularization, in‐hospital management, discharge disposition, quality indicators, and long‐term functional outcomes....
Source: International Journal of Stroke - November 21, 2013 Category: Neurology Authors: Beom Joon Kim, Moon‐Ku Han, Tai Hwan Park, Sang‐Soon Park, Kyung Bok Lee, Byung‐Chul Lee, Kyung‐Ho Yu, Jae Kwan Cha, Dae‐Hyun Kim, Jun Lee, Soo Joo Lee, Youngchai Ko, Jong‐Moo Park, Kyusik Kang, Yong‐Jin Cho, Keun‐Sik Hong, Ki‐Hyun Cho, Tags: Panorama Source Type: research

Solitaire™ with the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke (SWIFT PRIME) trial: protocol for a randomized, controlled, multicenter study comparing the Solitaire revascularization device with IV tPA with IV tPA alone in acute ischemic stroke
RationaleEarly reperfusion in patients experiencing acute ischemic stroke is critical, especially for patients with large vessel occlusion who have poor prognosis without revascularization. Solitaire™ stent retriever devices have been shown to immediately restore vascular perfusion safely, rapidly, and effectively in acute ischemic stroke patients with large vessel occlusions. AimThe aim of the study was to demonstrate that, among patients with large vessel, anterior circulation occlusion who have received intravenous tissue plasminogen activator, treatment with Solitaire revascularization devices reduces degree of disab...
Source: International Journal of Stroke - March 16, 2015 Category: Neurology Authors: Jeffrey L. Saver, Mayank Goyal, Alain Bonafe, Hans‐Christoph Diener, Elad I. Levy, Vitor M. Pereira, Gregory W. Albers, Christophe Cognard, David J. Cohen, Werner Hacke, Olav Jansen, Tudor G. Jovin, Heinrich P. Mattle, Raul G. Nogueira, Adnan H. Siddiqu Tags: Protocols Source Type: research

Ischemic Volume and Neurological Deficit: Correlation of Computed Tomography Perfusion with the National Institutes of Health Stroke Scale Score in Acute Ischemic Stroke
The National Institutes of Health Stroke Scale (NIHSS) is the most adopted stroke patients' evaluation tool in emergency settings to assess the severity of stroke and to determine the patients' eligibility for specific treatments. Computed tomography perfusion (CTP) is crucial to identify salvageable tissue that can benefit from the reperfusion treatment. The aim of this study is to identify the relation between the NIHSS scores and the hypoperfused volumes evaluated by CTP in patients with hyperacute ischemic stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - April 30, 2018 Category: Neurology Authors: Giovanni Furlanis, Milo š Ajčević, Lara Stragapede, Carlo Lugnan, Mariana Ridolfi, Paola Caruso, Marcello Naccarato, Maja Ukmar, Paolo Manganotti Source Type: research

Influence of Penumbral Reperfusion on Clinical Outcome Depends on Baseline Ischemic Core Volume Clinical Sciences
This study included 1507 patients. Reperfused penumbral volume had moderate ability to predict 90-day mRS 0 to 1 (area under the curve, 0.77; R2, 0.28; P
Source: Stroke - September 25, 2017 Category: Neurology Authors: Chushuang Chen, Mark W. Parsons, Matthew Clapham, Christopher Oldmeadow, Christopher R. Levi, Longting Lin, Xin Cheng, Min Lou, Timothy J. Kleinig, Kenneth S. Butcher, Qiang Dong, Andrew Bivard Tags: Ischemic Stroke Original Contributions 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

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

Prognostic Value of Venous Outflow Profiles on Multiphase CT Angiography for the Patients with Acute Ischemic Stroke After Endovascular Thrombectomy
This study supports that favorable peak venous VO profiles on mCTA might be a promising biomarker in predicting the good outcome in patients with AIS after EVT.
Source: Translational Stroke Research - September 5, 2023 Category: Neurology Source Type: research

Thrombectomy in stroke of unknown onset, wake up stroke and late presentations: Australian experience from 2 comprehensive stroke centres
This study shows good ‘real world’ outcomes, comparable to published RCTs, in patients with unknown-onset, or late presentation, stroke treated with EVT more than 6 h from stroke onset.
Source: Journal of Clinical Neuroscience - November 8, 2018 Category: Neuroscience Source Type: research

Alteplase versus tenecteplase for thrombolysis after ischaemic stroke (ATTEST): a phase 2, randomised, open-label, blinded endpoint study
This study is registered with ClinicalTrials.gov, number NCT01472926. Findings Between Jan 1, 2012, and Sept 7, 2013, 355 patients were screened, of whom 157 were eligible for intravenous thrombolysis, and 104 patients were enrolled. 52 were assigned to the alteplase group and 52 to tenecteplase. Of 71 patients (35 assigned tenecteplase and 36 assigned alteplase) contributing to the primary endpoint, no significant differences were noted for percentage of penumbral salvaged (68% [SD 28] for the tenecteplase group vs 68% [23] for the alteplase group; mean difference 1·3% [95% CI −9·6 to 12·1]; p=0·81). Neither incide...
Source: The Lancet Neurology - February 26, 2015 Category: Neurology Source Type: research

Extending thrombolysis to 4·5–9 h and wake-up stroke using perfusion imaging: a systematic review and meta-analysis of individual patient data
This study is registered with PROSPERO, number CRD42019128036.FindingsWe identified three trials that met eligibility criteria: EXTEND, ECASS4-EXTEND, and EPITHET. Of the 414 patients included in the three trials, 213 (51%) were assigned to receive alteplase and 201 (49%) were assigned to receive placebo. Overall, 211 patients in the alteplase group and 199 patients in the placebo group had mRS assessment data at 3 months and thus were included in the analysis of the primary outcome. 76 (36%) of 211 patients in the alteplase group and 58 (29%) of 199 patients in the placebo group had achieved excellent functional outcome a...
Source: The Lancet - May 24, 2019 Category: General Medicine Source Type: research

Perfusion computed tomography in patients with stroke thrombolysis
<span class="paragraphSection"><div class="boxTitle">Abstract</div>See Saver (doi:<strong><a href="article.aspx?volume=&page=">10.1093/awx020<span></span></a></strong>) for a scientific commentary on this article.Stroke shortens an individual’s disability-free life. We aimed to assess the relative prognostic influence of pre- and post-treatment perfusion computed tomography imaging variables (e.g. ischaemic core and penumbral volumes) compared to standard clinical predictors (such as onset-to-treatment time) on long-term stroke disability in patients undergoing th...
Source: Brain - December 30, 2016 Category: Neurology Source Type: research

A multicenter, randomized, controlled study to investigate EXtending the time for Thrombolysis in Emergency Neurological Deficits with Intra‐Arterial therapy (EXTEND‐IA)
Background and HypothesisThrombolysis with tissue plasminogen activator is proven to reduce disability when given within 4·5 h of ischemic stroke onset. However, tissue plasminogen activator only succeeds in recanalizing large vessel arterial occlusion in a minority of patients. We hypothesized that anterior circulation ischemic stroke patients, selected with ‘dual target’ vessel occlusion and evidence of salvageable brain using computed tomography or magnetic resonance imaging ‘mismatch’ within 4·5 h of onset, would have improved reperfusion and early neurological improvement when treated with intra‐arteri...
Source: International Journal of Stroke - November 10, 2013 Category: Neurology Authors: Bruce C. V. Campbell, Peter J. Mitchell, Bernard Yan, Mark W. Parsons, Søren Christensen, Leonid Churilov, Richard J. Dowling, Helen Dewey, Mark Brooks, Ferdinand Miteff, Christopher Levi, Martin Krause, Timothy J. Harrington, Kenneth C. Faulder, Brendan Tags: Protocols Source Type: research

Current trends in the management of acute ischemic stroke
Srinivasan ParamasivamNeurology India 2015 63(5):665-672Stroke is the leading cause of disability and most of the cases are those of ischemic stroke. Management strategies especially for large vessel occlusive stroke have undergone a significant change in the recent years that include widespread use of thrombolytic medications followed by endovascular clot removal. For successful treatment by endovascular thrombectomy, the important factors are patient selection based on clinical criterion including age, time of onset, premorbid clinical condition, co-morbidities, National Institute of Health Stroke Scale, and imaging crit...
Source: Neurology India - October 6, 2015 Category: Neurology Authors: Srinivasan Paramasivam Source Type: research

Detection of Crossed Cerebellar Diaschisis by Intravoxel Incoherent Motion MR Imaging in Subacute Ischemic Stroke.
Abstract Intravoxel incoherent motion has received extensive attention in brain studies for its potential as a non-invasive magnetic resonance perfusion method. However, studies on intravoxel incoherent motion imaging and crossed cerebellar diaschisis detection are relatively scarce. The aim of our study was to evaluate the feasibility of using intravoxel incoherent motion imaging in crossed cerebellar diaschisis diagnosis in subacute ischemic stroke patients by comparing results from intravoxel incoherent motion imaging, single-photon emission computed tomography, and arterial spin-labeling perfusion methods. In ...
Source: Cell Transplantation - June 13, 2019 Category: Cytology Authors: Wang J, Suo S, Zu J, Zhu W, Pan L, Song S, Li Y, Li L, Chen Z, Xu J Tags: Cell Transplant Source Type: research

Too good to treat? ischemic stroke patients with small computed tomography perfusion lesions may not benefit from thrombolysis
In this study, we tested the hypothesis that a small acute perfusion lesion predicts good clinical outcome regardless of thrombolysis administration. MethodsWe used a prospectively collected cohort of acute ischemic stroke patients being assessed for treatment with IV‐alteplase, who had CTP before a treatment decision. Volumetric CTP was retrospectively analyded to identify patients with a small perfusion lesion (<15ml in volume). The primary analysis was excellent 3‐month outcome in patients with a small perfusion lesion who were treated with alteplase compared to those who were not treated. ResultsOf 1526 patients...
Source: Annals of Neurology - July 25, 2016 Category: Neurology Authors: Andrew Bivard, Min Lou, Christopher R. Levi, Venkatesh Krishnamurthy, Xin Cheng, Richard I. Aviv, Patrick McElduff, Longting Lin, Tim Kleinig, Billy O'Brien, Kenneth Butcher, Zhang Jingfen, Jim Jannes, Qiang Dong, Mark W. Parsons Tags: Research Article Source Type: research