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Total 1186 results found since Jan 2013.

Review, Historical Context, and Clarifications of the NINDS rt-PA Stroke Trials Exclusion Criteria: Part 1: Rapidly Improving Stroke Symptoms Clinical Sciences
Conclusions— A structured framework and quantitative approach toward defining RISS emerged through expert opinion and consensus. The term, RISS, should be reserved for those who improve to a mild deficit, specifically one which is perceived to be nondisabling. This is recommended to guide decision making on intravenous tPA eligibility going forward, including the design of future studies. An additional study of patients with rapid improvement to nonmild deficits is not justified because these patients should be treated.
Source: Stroke - August 26, 2013 Category: Neurology Authors: The Re-examining Acute Eligibility for Thrombolysis (TREAT) Task Force:, Levine, S. R., Khatri, P., Broderick, J. P., Grotta, J. C., Kasner, S. E., Kim, D., Meyer, B. C., Panagos, P., Romano, J., Scott, P., NINDS rt-PA Stroke Trial Investigators* Tags: Acute Cerebral Infarction, Acute Stroke Syndromes, Emergency treatment of Stroke, Thrombolysis Clinical Sciences Source Type: research

Intravenous Thrombolysis for Stroke Recurring Within 3 Months From the Previous Event Clinical Sciences
Conclusions— Patients currently treated with alteplase, despite a history of previous stroke ≤3 months, do not seem to achieve worse outcome than those with first-ever stroke. Although careful patient selection was probably of major importance, our findings provide reassurance that this group of patients may safely benefit from thrombolysis and should not be arbitrarily excluded as a whole. Further studies are needed to identify the shortest safe time lapse from the previous event to treatment with alteplase.
Source: Stroke - October 26, 2015 Category: Neurology Authors: Karlinski, M., Kobayashi, A., Czlonkowska, A., Mikulik, R., Vaclavik, D., Brozman, M., Gdovinova, Z., Švigelj, V., Csiba, L., Fekete, K., Korv, J., Demarin, V., Bašic-Kes, V., Vilionskis, A., Jatuzis, D., Krespi, Y., Shamalov, N., Andonova, Tags: Emergency treatment of Stroke, Thrombolysis Clinical Sciences Source Type: research

Intravenous Thrombolysis in Unknown-Onset Stroke Clinical Sciences
Conclusions—Our data suggest no excess risk of symptomatic intracerebral hemorrhage but increased mortality and reduced favorable outcome in patients with UKO stroke compared with patients treated within the approved time window.
Source: Stroke - February 26, 2017 Category: Neurology Authors: Laura Dorado, Niaz Ahmed, Gotz Thomalla, Manuel Lozano, Branko Maloȷcic, Mushtaq Wani, Monica Millan, Ales Tomek, Antoni Davalos Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research

Effects of Alteplase for Acute Stroke on the Distribution of Functional Outcomes: A Pooled Analysis of 9 Trials Clinical Sciences
Conclusions— Treatment with intravenous alteplase initiated within 4.5 hours of stroke onset increases the chance of achieving an improved level of function for all patients across the age spectrum, including the over 80s and across all severities of stroke studied (top versus bottom fifth means: 22 versus 4); the earlier that treatment is initiated, the greater the benefit.
Source: Stroke - August 21, 2016 Category: Neurology Authors: Lees, K. R., Emberson, J., Blackwell, L., Bluhmki, E., Davis, S. M., Donnan, G. A., Grotta, J. C., Kaste, M., von Kummer, R., Lansberg, M. G., Lindley, R. I., Lyden, P., Murray, G. D., Sandercock, P. A. G., Toni, D., Toyoda, K., Wardlaw, J. M., Whiteley, Tags: Treatment, Cerebrovascular Disease/Stroke, Cerebrovascular Procedures, Ischemic Stroke Clinical Sciences Source Type: research

Novel Telestroke Program Improves Thrombolysis for Acute Stroke Across 21 Hospitals of an Integrated Healthcare System Clinical Sciences
This study included 310 patients treated with alteplase in the pre–EXpediting the PRrocess of Evaluating and Stopping Stroke period and 557 patients treated with alteplase in the EXpediting the PRrocess of Evaluating and Stopping Stroke period. After implementation, alteplase administrations increased to 62/mo from 34/mo at baseline (P
Source: Stroke - December 22, 2017 Category: Neurology Authors: Mai N. Nguyen-Huynh, Jeffrey G. Klingman, Andrew L. Avins, Vivek A. Rao, Abigail Eaton, Sunil Bhopale, Anne C. Kim, John W. Morehouse, Alexander C. Flint Tags: Treatment, Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research

Acute Reperfusion Therapy and Stroke Care in Asia After Successful Endovascular Trials Understanding and Applying the Endovascular Trials
The current status of and prospects for acute stroke care in Asia in the situation where both intravenous thrombolysis and endovascular therapies have been recognized as established strategies for acute stroke are reviewed. Of 15 million people annually having stroke worldwide, 9 million are Asians. The burdens of both ischemic and hemorrhagic strokes are severe in Asia. The unique features of stroke in Asia include susceptibility to intracranial atherosclerosis, high prevalence of intracerebral hemorrhage, effects of dietary and lifestyle habits, and several disorders with genetic causes. These features affect acute strok...
Source: Stroke - May 22, 2015 Category: Neurology Authors: Toyoda, K., Koga, M., Hayakawa, M., Yamagami, H. Tags: Emergency treatment of Stroke, Anticoagulants, Thrombolysis, Angioplasty and Stenting Understanding and Applying the Endovascular Trials Source Type: research

SCIL-STROKE (Subcutaneous Interleukin-1 Receptor Antagonist in Ischemic Stroke) Clinical Sciences
Background and Purpose—The proinflammatory cytokine IL-1 (interleukin-1) has a deleterious role in cerebral ischemia, which is attenuated by IL-1 receptor antagonist (IL-1Ra). IL-1 induces peripheral inflammatory mediators, such as interleukin-6, which are associated with worse prognosis after ischemic stroke. We investigated whether subcutaneous IL-1Ra reduces the peripheral inflammatory response in acute ischemic stroke.Methods—SCIL-STROKE (Subcutaneous Interleukin-1 Receptor Antagonist in Ischemic Stroke) was a single-center, double-blind, randomized, placebo-controlled phase 2 trial of subcutaneous IL-1Ra (100 mg a...
Source: Stroke - April 23, 2018 Category: Neurology Authors: Craig J. Smith, Sharon Hulme, Andy Vail, Calvin Heal, Adrian R. Parry-Jones, Sylvia Scarth, Karen Hopkins, Margaret Hoadley, Stuart M. Allan, Nancy J. Rothwell, Stephen J. Hopkins, Pippa J. Tyrrell Tags: Inflammation, Treatment, Ischemic Stroke Original Contributions Source Type: research

Uric Acid Therapy Prevents Early Ischemic Stroke Progression Brief Report
Conclusions—UA therapy may prevent EIW after acute stroke in thrombolysed patients. Optimal access of UA to its molecular targets through appropriate collaterals may modify the magnitude of the neuroprotective effect.Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT00860366.
Source: Stroke - October 23, 2016 Category: Neurology Authors: Amaro, S., Laredo, C., Renu, A., Llull, L., Rudilosso, S., Obach, V., Urra, X., Planas, A. M., Chamorro, A. Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke, Neuroprotectants Brief Reports Source Type: research

Clinical Utility of Electronic Alberta Stroke Program Early Computed Tomography Score Software in the ENCHANTED Trial Database Clinical Sciences
Background and Purpose—Clinical utility of electronic Alberta Stroke Program Early CT Score (e-ASPECTS), an automated system for quantifying signs of infarction, was evaluated in a large database of thrombolyzed patients with acute ischemic stroke.Methods—All baseline noncontrast computed tomographic scans of patients with anterior circulation acute ischemic stroke who participated in the alteplase dose arm of the randomized controlled trial ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study) were reviewed; poor quality and large (>6 mm) slice thickness were excluded. Included scans had e-ASPECTS...
Source: Stroke - May 25, 2018 Category: Neurology Authors: Simon Nagel, Xia Wang, Cheryl Carcel, Thompson Robinson, Richard I. Lindley, John Chalmers, Craig S. Anderson Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research

Remote Ischemic Perconditioning as an Adjunct Therapy to Thrombolysis in Patients With Acute Ischemic Stroke: A Randomized Trial Clinical Sciences
Conclusions— Although the overall results were neutral, a tissue survival analysis suggests that prehospital rPerC may have immediate neuroprotective effects. Future clinical trials should take such immediate effects, and their duration, into account. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00975962.
Source: Stroke - December 23, 2013 Category: Neurology Authors: Hougaard, K. D., Hjort, N., Zeidler, D., Sorensen, L., Norgaard, A., Hansen, T. M., von Weitzel-Mudersbach, P., Simonsen, C. Z., Damgaard, D., Gottrup, H., Svendsen, K., Rasmussen, P. V., Ribe, L. R., Mikkelsen, I. K., Nagenthiraja, K., Cho, T.-H., Reding Tags: Emergency treatment of Stroke, Computerized tomography and Magnetic Resonance Imaging, Neuroprotectors, Thrombolysis Clinical Sciences Source Type: research

Alteplase for Acute Ischemic Stroke: Outcomes by Clinically Important Subgroups in the Third International Stroke Trial Clinical Sciences
Conclusions— Among the types of patient in the Third International Stroke Trial, this secondary analysis did not identify any subgroups for whom treatment should be avoided. Given the limitations of the analysis, we found no clear evidence to avoid treatment in patients with prior ischemic stroke, diabetes mellitus, or hypertension. Clinical Trial Registration— URL: http://www.controlled-trials.com. Unique identifier: ISRCTN25765518. http://www.controlled-trials.com/ISRCTN25765518.
Source: Stroke - February 23, 2015 Category: Neurology Authors: Lindley, R. I., Wardlaw, J. M., Whiteley, W. N., Cohen, G., Blackwell, L., Murray, G. D., Sandercock, P. A. G., on behalf of the IST-3 Collaborative Group, Trial Steering Committee, Baigent, Chadwick, Tyrrell, Lowe, Dennis, Innes, Goodare, CT and MR readi Tags: Acute Cerebral Infarction, Emergency treatment of Stroke, Thrombolysis Clinical Sciences Source Type: research

In-Transit Telemedicine Speeds Ischemic Stroke Treatment: Preliminary Results Brief Reports
Conclusions— Improvement in time to treat seems comparable with in-transit telestroke and mobile stroke transport units. The low cost/unit makes this approach scalable, potentially providing rapid management of more patients.
Source: Stroke - August 21, 2016 Category: Neurology Authors: Belt, G. H., Felberg, R. A., Rubin, J., Halperin, J. J. Tags: Clinical Studies, Ischemic Stroke Brief Reports Source Type: research

Vessel Wall Enhancement and Blood-Cerebrospinal Fluid Barrier Disruption After Mechanical Thrombectomy in Acute Ischemic Stroke Clinical Sciences
Conclusions—These findings may support the clinical relevance of direct vessel damage and BCSFB disruption after acute stroke and reinforce the need for further improvements in reperfusion strategies. Further validation in larger cohorts of patients is warranted.
Source: Stroke - February 26, 2017 Category: Neurology Authors: Arturo Renu, Carlos Laredo, Antonio Lopez–Rueda, Laura Llull, Raul Tudela, Luis San–Roman, Xabier Urra, Jordi Blasco, Juan Macho, Laura Oleaga, Angel Chamorro, Sergio Amaro Tags: Blood-Brain Barrier, Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research

Uric Acid Therapy Improves Clinical Outcome in Women With Acute Ischemic Stroke Clinical Sciences
Conclusions— In women with acute ischemic stroke treated with alteplase, the administration of UA reduced infarct growth in selected patients and was better than placebo to reach excellent outcome. Clinical Trial Registration— URL: https://clinicaltrials.gov. Unique identifier: NCT00860366.
Source: Stroke - July 27, 2015 Category: Neurology Authors: Llull, L., Laredo, C., Renu, A., Perez, B., Vila, E., Obach, V., Urra, X., Planas, A., Amaro, S., Chamorro, A. Tags: Cerebrovascular disease/stroke, Acute Cerebral Infarction, Emergency treatment of Stroke, Neuroprotectors, Oxidant stress Clinical Sciences Source Type: research

Delays in Door-to-Needle Times and Their Impact on Treatment Time and Outcomes in Get With The Guidelines-Stroke Clinical Sciences
Conclusions—Hospital and eligibility delays such as delay diagnosis and inability to determine eligibility were associated with longer door-to-needle times. Improved stroke recognition and management of acute comorbidities may help to reduce door-to-needle times.
Source: Stroke - March 27, 2017 Category: Neurology Authors: Noreen Kamal, Shubin Sheng, Ying Xian, Roland Matsouaka, Michael D. Hill, Deepak L. Bhatt, Jeffrey L. Saver, Mathew J. Reeves, Gregg C. Fonarow, Lee H. Schwamm, Eric E. Smith Tags: Quality and Outcomes, Ischemic Stroke Original Contributions Source Type: research