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The Need for Structured Strategies to Improve Stroke Care in a Rural Telestroke Network in Northern New South Wales, Australia: An Observational Study
Conclusion: In our telestroke network, acute stroke timing metrics did not improve over time. There is the need for targeted education and training focusing on both stroke reperfusion competencies and the technical aspects of telestroke in areas with limited workforce and high turnover.
Source: Frontiers in Neurology - April 9, 2021 Category: Neurology Source Type: research

Network Mapping of Time to Antithrombotic Therapy Among Patients With Ischemic Stroke and Transient Ischemic Attack (TIA)
Conclusion: The proportion of patients receiving antithrombotics within 48 h was higher than previously reported in Australia but remained lower than the standard achieved in North American hospitals. Our process map and network analysis show avenues to shorten the time to antithrombotic.
Source: Frontiers in Neurology - June 7, 2021 Category: Neurology Source Type: research

Risk Stratification Tool for Ischemic Stroke: A Risk Assessment Model Based on Traditional Risk Factors Combined With White Matter Lesions and Retinal Vascular Caliber
Conclusion: The risk assessment model of ischemic stroke combined with Fazekas grade of WML and CRAE is superior to the traditional risk factor and the single-index model. This model is helpful for risk stratification of high-risk stroke patients.
Source: Frontiers in Neurology - August 4, 2021 Category: Neurology Source Type: research

Telestroke Assessment With Perfusion CT Improves the Diagnostic Accuracy of Stroke vs. Mimic
Conclusions: In the telehealth setting, the absence of an ischaemic lesion on CTP adds to the diagnostic accuracy in distinguishing mimic from stroke, above that from clinical features.
Source: Frontiers in Neurology - December 3, 2021 Category: Neurology Source Type: research

Googling Location for Operating Base of Mobile Stroke Unit in Metropolitan Sydney
Conclusions: Any of the ECR capable hospital can serve as a hub for MSU. We provide a method to identify the hub based on location of suburbs less well served by other hospital.
Source: Frontiers in Neurology - August 5, 2019 Category: Neurology Source Type: research

The Characteristics of Patients With Possible Transient Ischemic Attack and Minor Stroke in the Hunter and Manning Valley Regions, Australia (the INSIST Study)
Conclusion: This study provides the first contemporary data on TIAMS or TIAMS-mimics in Australia. Community and health provider education is required to address the under-use of anticoagulation therapy in patients with known AF, possibly inappropriate use of antiplatelet therapy and possibly inappropriate discontinuation of antiplatelet or anticoagulation therapy.
Source: Frontiers in Neurology - May 14, 2020 Category: Neurology Source Type: research

Regional Differences in Early BP Management After Acute Ischemic Stroke in the ENCHANTED International Randomized Controlled Trials
Conclusion: Regional variations in early BP management in acute stroke translated into differences in early BP control parameters.
Source: Frontiers in Neurology - August 27, 2021 Category: Neurology Source Type: research

Task-specific training versus usual care to improve upper limb function after stroke: the “Task-AT Home” randomised controlled trial protocol
The objective is to determine whether task-specific training is a more effective treatment than usual care, for improving upper limb function, amount of upper limb use, and health related quality of life at 6 weeks and 6 months after intervention commencement. Our primary hypothesis is that upper limb function will achieve a ≥ 5 point improvement on the ARAT in the task-specific training group compared to the usual care group, after 6 weeks of intervention.MethodsParticipants living at home, with remaining upper limb deficit, are recruited at 3 months after stroke from sites in NSW and Victoria, Australia. Fo...
Source: Frontiers in Neurology - June 29, 2023 Category: Neurology Source Type: research

Real-World Cost-Effectiveness of Late Time Window Thrombectomy for Patients With Ischemic Stroke
Conclusions: Treating patients not meeting the DAWN or DEFUSE 3 clinical trial criteria in the extended time window for EVT was associated with less gain in QALYs and higher cost. Caution should be exercised when considering this procedure for patients not satisfying the trial perfusion imaging criteria for EVT.
Source: Frontiers in Neurology - December 14, 2021 Category: Neurology Source Type: research

Application of Strategic Transport Model and Google Maps to Develop Better Clot Retrieval Stroke Service
Discussion: The results from strategic transport model are similar to those from Google Maps. In this paper we illustrate how this method can be applied in designing and forecast stroke service model in different cities in Australia and around the world.
Source: Frontiers in Neurology - June 27, 2019 Category: Neurology Source Type: research

Robot-Assisted Therapy in Upper Extremity Hemiparesis: Overview of an Evidence-Based Approach
Conclusion Robotic therapy has matured and represents an embodiment of a paradigm shift in neurorehabilitation following a stroke: instead of focusing on compensation, it affords focus in ameliorating the impaired limb in line with concepts of neuroplasticity. This technology-based treatment provides intensity, interactivity, flexibility, and adaptiveness to patient's performance and needs. Furthermore, it increases the productivity of rehabilitation care. Of course, efficiency must be discussed within a local perspective. For example, following the cost containment shown in the VA ROBOTICS study (46), the UK Nati...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

Stenosis Length and Degree Interact With the Risk of Cerebrovascular Events Related to Internal Carotid Artery Stenosis
Conclusion: We found a statistically insignificant tendency for the ultrasound-measured length of sICAS<70% to be longer than that of sICAS≥70%. Moreover, the ultrasound-measured length of sICAS<90% was significantly longer than that of sICAS 90%. Among patients with sICAS≥70%, the degree and length of stenosis were inversely correlated. Larger studies are needed before a clinical implication can be drawn from these results. Introduction Internal carotid artery stenosis (ICAS) causes around one-fifth of ischemic cerebrovascular stroke and has the highest risk of early stroke recurrence...
Source: Frontiers in Neurology - April 8, 2019 Category: Neurology Source Type: research

Asymptomatic Carotid Stenosis Is Associated With Circadian and Other Variability in Embolus Detection
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this t...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Angiographical Identification of Intracranial, Atherosclerosis-Related, Large Vessel Occlusion in Endovascular Treatment
Conclusions Among only a few identification methods, the ICAS-LVO can be feasibly identified by angiographical findings. The identification of ICAS-LVO based on based on occlusion type, is a reliable and practical identification method for ICAS-LVO. Procedural details by occlusion type and its predictability to endovascular results were reported. Furthermore, occlusion type can be determined before or in the early stages of the procedure, which may be most helpful in setting up an optimal endovascular treatment strategy. Author Contributions J-HB established the study idea, designed the manuscript structure, acquired an...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Correlation Between Intracranial Arterial Calcification and Imaging of Cerebral Small Vessel Disease
Conclusion: Intracranial artery calcification is common in patients with ischemic cerebrovascular disease and the intracranial carotid artery is most frequently affected. Intracranial arterial calcifications might be associated with imaging markers of SVD and are highly correlated with WMHs, lacunes, and CMBs. Quantification of calcification on CT provides additional information on the pathophysiology of SVD. Intracranial arterial calcification could act as a potential marker of SVD. Introduction Atherosclerosis is a systemic vascular process that is considered a major cause of cerebrovascular and cardiovascular di...
Source: Frontiers in Neurology - April 30, 2019 Category: Neurology Source Type: research

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