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Frequency and predictors of poststroke epilepsy after mechanical thrombectomy for large vessel occlusion stroke: results from a multicenter cohort study
ConclusionIn our study, patients with large vessel occlusion stroke receiving MT had a 9% prevalence of PSE over a median follow-up period of 6.5  years. Besides larger infarct size, presence of cerebral microbleeds on brain MRI predicted PSE occurrence.
Source: Journal of Neurology - September 2, 2023 Category: Neurology Source Type: research

Intravenous thrombolysis and mechanical recanalization for acute ischemic stroke in deep brain stimulation patients: a case series
ConclusionIVT and MT were tolerated by four patients with ischemic stroke more than 6  months after DBS surgery without bleeding complications.
Source: Journal of Neurology - August 12, 2023 Category: Neurology Source Type: research

Identifying large vessel occlusion at first glance in telemedicine
ConclusionThese findings confirm that the presence of head and/or gaze deviation serves as a reliable biomarker in stroke-based telemedicine for the diagnosis of LVO, as well as a strong indicator for MT. Furthermore, this marker is just as reliable as the NIHSS score but easier to assess. We therefore suggest that any stroke patient who displays head and/or gaze deviation should immediately be scheduled for vessel imaging and subsequently transported to a MT-competent center.
Source: Journal of Neurology - August 12, 2023 Category: Neurology Source Type: research

Safety and efficacy of intravenous thrombolysis in patients with acute ischemic stroke taking direct oral anticoagulants prior to stroke: a meta-analysis
ConclusionThe meta-analysis indicated that taking DOACs prior to stroke does not significantly increase the risk of sICH in selected patients with AIS treated with IVT. Furthermore, the benefits of IVT in selected patients taking DOACs appear to be comparable to those not taking anticoagulants. Further research is warranted to confirm the findings.
Source: Journal of Neurology - June 14, 2023 Category: Neurology Source Type: research

Data lake-driven analytics identify nocturnal non-dipping of heart rate as predictor of unfavorable stroke outcome at discharge
ConclusionsOur data suggest that a lack of circadian HR modulation, specifically nocturnal non-dipping, is associated with short-term unfavorable functional outcome after stroke, and that including HR into machine learning-based prediction models may lead to improved stroke outcome prediction.
Source: Journal of Neurology - April 20, 2023 Category: Neurology Source Type: research

Early blood pressure management in hemorrhagic stroke: a meta-analysis
AbstractThe aim of the present meta-analysis was to evaluate the outcomes and effects of different systolic blood pressure (SBP) lowering in patients with hemorrhagic stroke using data from randomized controlled trials. A total of 2592 records were identified for this meta-analysis. We finally included 8 studies (6119 patients; mean age 62.8  ± 13.0, 62.7% men). No evidence of heterogeneity between estimates (I2 = 0% <  50%,P = 0.26), or publication bias in the funnel plots (P = 0.065, Egger statistical test) was detected. Death or major disability rates were similar between patients with intensive ...
Source: Journal of Neurology - March 8, 2023 Category: Neurology Source Type: research

Endovascular treatment achieves better outcomes than best medical management in patients with M2 occlusion and high stroke severity: a meta-analysis
ConclusionEVT may be only beneficial for patients with M2 occlusion and high stroke severity, but not for those with NIHSS scores 0 –5.
Source: Journal of Neurology - March 2, 2023 Category: Neurology Source Type: research

Proximal hyperdense middle cerebral artery sign is associated with increased risk of asymptomatic hemorrhagic transformation after endovascular thrombectomy: a multicenter retrospective study
ConclusionProximal HMCAS on initial NCCT was independently associated with aHT in patients who received EVT for acute MCA occlusion. Both aHT and sHT had a detrimental effect on clinical outcome.
Source: Journal of Neurology - February 28, 2023 Category: Neurology Source Type: research

Patterns of acute ischemic stroke and intracranial hemorrhage in patients with COVID-19
In this study, we sought to investigate associations between neuroimaging findings with clinical, demographic, blood and cerebrospinal fluid (CSF) parameters, pre-existing conditions and the severity of acute COVID-19.Materials and methodsRetrospective multicenter data retrieval from 10 university medical centers in Germany, Switzerland and Austria between February 2020 and September 2021. We included patients with COVID-19, acute neurological symptoms and cranial imaging. We collected demographics, neurological symptoms, COVID-19 severity, results of cranial imaging, blood and CSF parameters during the hospital stay.Resul...
Source: Journal of Neurology - February 23, 2023 Category: Neurology Source Type: research

RCVS: by clinicians for clinicians —a narrative review
ConclusionIn general, the outcome of reversible cerebral vasoconstriction syndrome is very good. Vasospasm as well as thunderclap headache attacks can be fully reversible, and  >  90% of patients are functionally independent at discharge.
Source: Journal of Neurology - January 30, 2023 Category: Neurology Source Type: research

Association between intravenous tirofiban and intracranial hemorrhage in acute large vessel occlusion stroke: insight from the RESCUE BT randomized placebo-controlled trial
ConclusionsIn patients with acute large vessel occlusion stroke, intravenous tirofiban before EVT within 24  h of time from last known well is not associated with increased risk of SICH. Patients who are older, have more severe neurological deficits, or with cardioembolism are at higher risk of SICH with intravenous tirofiban.Trial registration numberURL:http://www.chictr.org.cn; Unique identifier: ChiCTR-INR-17014167.
Source: Journal of Neurology - January 25, 2023 Category: Neurology Source Type: research

The optimum anticoagulation time after endovascular thrombectomy for atrial fibrillation-related large vessel occlusion stroke: a real-world study
ConclusionsIn AF-related AIS, the time of EVT to anticoagulation is an independent factor of the functional outcome and hemorrhage events after anticoagulation. The optimal initiate time of anticoagulant after EVT is 4.5  days.ClinicalTrialRegisterNCT03754738.
Source: Journal of Neurology - January 3, 2023 Category: Neurology Source Type: research

Cerebral hemorrhage after thrombolysis in stroke patients with unruptured intracranial aneurysms: a systemic review and meta-analysis
ConclusionsIVT is unlikely to induce hemorrhage of pre-existing unruptured aneurysms in stroke patients. Further randomized control studies are warranted to validate these conclusions.Graphical abstract
Source: Journal of Neurology - December 22, 2022 Category: Neurology Source Type: research

Clinical and neuroimaging risk factors associated with the development of intracerebral hemorrhage while taking direct oral anticoagulants
ConclusionsRisk factors including diabetes, prior stroke, and smoking history as well as MRI biomarkers including CMBs and cSS are associated with ICH in DOAC users. Although screening MRIs are not typically performed prior to initiating DOAC therapy, these data suggest that patients of high-hemorrhagic risk may be identified.
Source: Journal of Neurology - October 31, 2022 Category: Neurology Source Type: research

Endovascular thrombectomy with or without intravenous alteplase in acute stroke: a systematic review and meta-analysis of randomized clinical trials
ConclusionsNo statistical difference was found in functional and safety outcomes between direct EVT and bridging therapy groups in acute stroke within 4.5  h after symptom onset. EVT alone was non-inferior to bridging therapy for several, but not the more stringent, non-inferiority margins.
Source: Journal of Neurology - October 5, 2022 Category: Neurology Source Type: research

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