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Acute Stroke Code Accuracy in the Inpatient Versus Emergency Department (ED) Setting (S16.003)
Conclusion FP were more common for inpatient versus ED codes AMS or SS were infrequently associated with stroke diagnosis. Better education for non-neuroscience hospital providers, regarding acute stroke criteria, is needed.Disclosure: Dr. Schneck has received research support from NIH (POINT, COSS, ARUBA, ALIAS, Lundbeck (DIAS4), TIMI-50 Consortium, and Local PI Multicenter Clincial trials. Dr. Bruzzone has nothing to disclose. Dr. Vlahovic has nothing to disclose. Dr. Durazo-Arvizu has nothing to disclose. Dr. Biller has received personal compensation in an editorial capacity for the Journal of Stroke and Cerebrovascular...
Source: Neurology - February 7, 2016 Category: Neurology Authors: Schneck, M., Bruzzone, M., Vlahovic, L., Durazo-Arvizu, R., Biller, J., Flaster, M., Morales-Vidal, S., Ruland, S., Ray, J. Tags: Prehospital/Emergency Room Stroke Care and Intracerebral Hemorrhage Source Type: research

Factors Associated with Follow-Up in Stroke Clinic after Hospital Discharge (P2.323)
Conclusions: Stroke clinic follow-up is best achieved in patients admitted to the neurology service. Ensuring standardized discharge instructions with provided time and date of outpatient appointment is the key for successful follow-up.Disclosure: Dr. Bakradze has nothing to disclose. Dr. Taboada has nothing to disclose. Dr. Narwal has nothing to disclose. Dr. Nouh has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Bakradze, E., Taboada, S., Narwal, P., Nouh, A. Tags: Stroke Systems of Care Source Type: research

MELAS Syndrome: How Stroke-like are the Stroke episodes? (P1.255)
Conclusions:Patients with MELAS syndrome may present with recurrent strokes in the arterial territory rather than SLEs. Clinicians should entertain the possibility of a mitochondrial disease in young patients with cryptogenic stroke and pursue appropriate diagnostic evaluations and treatment.Disclosure: Dr. Liaw has nothing to disclose. Dr. Lewis has nothing to disclose. Dr. Saini has nothing to disclose. Dr. Gultekin has nothing to disclose. Dr. Koch has nothing to disclose. Dr. Asdaghi has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Liaw, N., Lewis, R., Saini, V., Gultekin, S. H., Koch, S., Asdaghi, N. Tags: Genetic Stroke Syndromes, Biomarkers, and Translational/Basic Research Source Type: research

Getting the Most from the NIH Stroke Scale (P6.048)
Conclusions Adding picture description scores improves accuracy of NIHSS in accounting for lesion volume in LH stroke and yields complementary information about lesion localization, without adding time to administration of NIHSS.Disclosure: Dr. Hillis received personal compensation in an editorial capacity from Lippincott for serving as Associate Editor of Stroke and from Elsevier for serving as Associate Editor of Practice Update Neurology. Dr. Davis has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Hillis, A., Davis, C. Tags: Prehospital Stroke Care and Uses of NIHSS Source Type: research

Analysis of Run Sheets of EMS Serving a Metropolitan Comprehensive Stroke Center (P1.268)
Conclusions:Patients with acute stroke transported by EMS have better quality metrics and higher chance of receiving acute treatment. EMS documented assessment allows for the diagnosis or stroke in general but cannot identify LVO because the assessment of cortical signs is very limited.Disclosure: Dr. Hussein has nothing to disclose. Dr. Kashyap has nothing to disclose. Dr. Erickson has nothing to disclose. Dr. Forsberg has nothing to disclose. Dr. Burnett has nothing to disclose. Dr. Stanfield has nothing to disclose. Dr. Wewerka has nothing to disclose. Dr. Terwilliger has nothing to disclose. Dr. Hanson has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Hussein, H., Kashyap, B., Erickson, L., Forsberg, A., Burnett, A., Stanfield, S., Wewerka, S., Terwilliger, A., Hanson, L. Tags: Pre-Hospital Stroke, Tele-Stroke, and mHealth Source Type: research

Gender Differences in Post Stroke Fatigue (P5.290)
Conclusions:In our urban predominately minority cohort, women had more severe PSF than men. The basis for the protective effect of HTN on PSF severity is unclear and deserves further study.Disclosure: Dr. Balucani has nothing to disclose. Dr. Gilles has nothing to disclose. Dr. Singer has nothing to disclose. Dr. Stefanov has nothing to disclose. Dr. Halket has nothing to disclose. Dr. Mlastabi has nothing to disclose. Dr. Huang has nothing to disclose. Dr. Weingast has nothing to disclose. Dr. Levine has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Balucani, C., Gilles, N., Singer, J., Stefanov, D., Halket, D., Mlastabi, J., Huang, A., Weingast, S., Levine, S. Tags: Stroke Recovery and Rehabilitation Source Type: research

Medication Self-Administration after Stroke (P5.181)
Conclusion: Stroke patients performed poorly on the HMS, and though performance improved after medication education, this may be related to spontaneous stroke recovery. MSA problems, assessed by HMS performance, may strongly predict post-acute care needs. Funded by: NJ Brain Injury Commission and Kessler FoundationDisclosure: Dr. Oyawusi has nothing to disclose. Dr. Levy has nothing to disclose. Dr. Gentile has nothing to disclose. Dr. March has nothing to disclose. Dr. Hreha has received personal compensation for activities with Kessler Institute for Rehabilitation. Dr. Pagaoa-Cruz has nothing to disclose. Dr. Masmela has...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Oyawusi, M., Levy, B., Gentile, A., March, G., Hreha, K., Pagaoa-Cruz, G., Masmela, J., Galletta, E., Holman, S., McKenna, C., Zhang, J., Barrett, A. Tags: Neuro-rehabilitation: Stroke Source Type: research

Aphasia Is an Independent Risk Factor Affecting Acute Stroke Outcomes (P1.186)
CONCLUSIONS: Aphasia is independently associated with increased length of stay and complications during the acute stroke admission, with an impact at least comparable to hemiparesis. There was equivalent disability at discharge. These data suggest that greater attention is needed on developing adaptive communication skills during this period to improve outcomes.Disclosure: Dr. Lazar has received personal compensation for activities with Claret Medical, Inc. Dr. Boehme has nothing to disclose. Dr. Marshall has received personal compensation in an editorial capacity for JAMA Neurology. Dr. Martin-Schild has received personal...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Lazar, R., Boehme, A., Marshall, R., Martin-Schild, S. Tags: Ischemic Stroke Outcomes Source Type: research

Effect of aphasia on acute stroke outcomes
Conclusion: Aphasia is independently associated with increased LOS and complications during the acute stroke admission, adding $2.16 billion annually to US acute stroke care. The presence of aphasia was more likely to produce a poor functional outcome than hemiparesis. These data suggest that further research is necessary to determine whether establishing adaptive communication skills can mitigate its consequences in the acute stroke setting.
Source: Neurology - November 27, 2016 Category: Neurology Authors: Boehme, A. K., Martin-Schild, S., Marshall, R. S., Lazar, R. M. Tags: All Clinical Neurology, All Cerebrovascular disease/Stroke ARTICLE Source Type: research

Memantine Treatment for Post-stroke Aphasia: A Case Control Study (P5.173)
CONCLUSION Memantine treatment showed no statistically significant improvement for patients with post-stroke aphasia based on FIM Scores for Motor and Cognition. Long-term follow-up and larger study groups, however, could provide additional information which may warrant further exploration into the benefits of memantine.Disclosure: Dr. Valles has nothing to disclose. Dr. Kennedy has nothing to disclose. Dr. Elashvili has nothing to disclose. Dr. Dohle has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Valles, J., Kennedy, J., Elashvili, M., Dohle, C. Tags: Neuro-rehabilitation: Stroke Source Type: research

Detecting Cognitive Impairment in Acute Stroke Using the Oxford Cognitive Screen: Characteristics of Left and Right Hemisphere Strokes, with More Severe Impairment in AF Strokes (P1.190)
CONCLUSIONS: it is feasible to use the OCS in acute stroke, and it can detect deficits in multiple domains which might otherwise have eluded detection. The frequency of such deficits is high, and higher in patients in AF. The OCS can pick up differences in functional performance between left and right hemisphere strokes which can guide rehabilitation and monitor progress. A pie chart summarises the distribution of domains affected.Disclosure: Dr. Collas has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Collas, D. Tags: Ischemic Stroke Outcomes Source Type: research

Combined PET/MRI: Multimodality insights into acute stroke hemodynamics
A 61-year-old man underwent simultaneous PET/MRI 5.5 hours after sudden onset of aphasia (NIH Stroke Scale 4), which revealed a diffusion/perfusion mismatch of different extents as measured with pulsed arterial spin-labeling MRI (59 mL), perfusion-weighted MRI (27 mL), and [15O]H2O-PET (36 mL) (figure). Due to spontaneous recanalization, the penumbra tissue did not progress towards infarction. This demonstrates that the outcome of critically hypoperfused stroke brain tissue may be favorable even without sufficient collateral flow and without therapeutic intervention.1 Here, PET/MRI offers the chance to cross-evaluate MRI-b...
Source: Neurology - May 15, 2016 Category: Neurology Authors: Werner, P., Saur, D., Mildner, T., Moller, H., Classen, J., Sabri, O., Hoffmann, K.-T., Barthel, H. Tags: MRI, PET, DWI, All Cerebrovascular disease/Stroke NEUROIMAGES Source Type: research

Network dysfunction predicts speech production after left hemisphere stroke
Conclusions: Speech production is dependent on complex interactions among widely distributed brain networks, indicating that residual speech production after stroke depends on more than the restoration of local domain-specific functions. Our understanding of the recovery of function following focal lesions is not adequately captured by consideration of ipsilesional or contralesional brain regions taking over lost domain-specific functions, but is perhaps best considered as the interaction between what remains of domain-specific networks and domain-general systems that regulate behavior.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Geranmayeh, F., Leech, R., Wise, R. J. S. Tags: All Cerebrovascular disease/Stroke, Aphasia ARTICLE Source Type: research

Effect of informed consent on patient characteristics in a stroke thrombolysis trial
Conclusions: Patients recruited by proxy consent were older, had more severe strokes, and had higher prevalence of aphasia than those with capacity to give personal consent. Variations in the manner of consent across countries may influence trial results. Clinicaltrials.gov and Clinicaltrialsregister.eu identifiers: NCT01525290 (clinicaltrials.gov); 2011-005906-32 (clinicaltrialsregister.eu).
Source: Neurology - September 25, 2017 Category: Neurology Authors: Thomalla, G., Boutitie, F., Fiebach, J. B., Simonsen, C. Z., Nighoghossian, N., Pedraza, S., Lemmens, R., Roy, P., Muir, K. W., Heesen, C., Ebinger, M., Ford, I., Cheng, B., Cho, T.-H., Puig, J., Thijs, V., Endres, M., Fiehler, J., Gerloff, C. Tags: MRI, All Clinical trials, All Cerebrovascular disease/Stroke, Clinical trials Methodology/study design, All Ethics in Neurology/Legal issues ARTICLE Source Type: research

Mystery Case: An unexpected complication of IV thrombolysis for acute ischemic stroke
A 46-year-old man with psoriasis and morbid obesity developed acute aphasia and right hemiplegia. As a result of his weakness, he had fallen and struck his right eye on a desk. His presenting examination demonstrated right periorbital ecchymosis without accompanying ptosis, expressive aphasia, left gaze deviation with corresponding hemianopsia, and dense right hemiplegia, summating an NIH Stroke Scale score of 13.
Source: Neurology - August 12, 2013 Category: Neurology Authors: Sheth, S. A., Yee, A. H. Tags: Stroke in young adults, Optic nerve, Orbit, Visual loss, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research

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