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Total 669 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

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

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

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

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

Unequal Access to Treatment With Intravenous Alteplase for Women With Acute Ischemic Stroke Brief Reports
Conclusions— Fewer women present themselves within 4 hours from stroke onset than men and consequently less often receive thrombolytic treatment. This difference may be caused by the older age of women on average and consequently women more often living alone. Clinical Trial Registration— URL: http://www.controlled-trials.com. Unique identifier: ISRCTN20405426.
Source: Stroke - August 26, 2013 Category: Neurology Authors: de Ridder, I., Dirks, M., Niessen, L., Dippel, D., on behalf of the PRACTISE Investigators Tags: Acute Cerebral Infarction, Emergency treatment of Stroke, Thrombolysis Brief Reports Source Type: research

Coagulation and Fibrinolytic Activity of Tenecteplase and Alteplase in Acute Ischemic Stroke Brief Reports
Conclusions— In patients with acute ischemic stroke, alteplase 0.9 mg/kg caused significant disruption of the fibrinolytic system, whereas tenecteplase 0.25 mg/kg did not, consistent with the trend toward lower intracerebral hemorrhage incidence with tenecteplase in the ATTEST study. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01472926.
Source: Stroke - November 23, 2015 Category: Neurology Authors: Huang, X., Moreton, F. C., Kalladka, D., Cheripelli, B. K., MacIsaac, R., Tait, R. C., Muir, K. W. Tags: Treatment, Ischemic Stroke, Thrombosis Brief Reports Source Type: research

Efficacy of Alteplase in a Mouse Model of Acute Ischemic Stroke: A Retrospective Pooled Analysis Basic Sciences
Conclusions— Our results provide the basis needed for the design of future preclinical studies on recanalization therapies using this model of thromboembolic stroke in mice. The power analysis reveals that a multicenter trial would require 123 animals per group instead of 40 for a single-center trial.
Source: Stroke - April 24, 2016 Category: Neurology Authors: Orset, C., Haelewyn, B., Allan, S. M., Ansar, S., Campos, F., Cho, T. H., Durand, A., El Amki, M., Fatar, M., Garcia-Yebenes, I., Gauberti, M., Grudzenski, S., Lizasoain, I., Lo, E., Macrez, R., Margaill, I., Maysami, S., Meairs, S., Nighoghossian, N., Or Tags: Animal Models of Human Disease, Ischemic Stroke Basic Sciences Source Type: research

Influence of Renal Impairment on Outcome for Thrombolysis-Treated Acute Ischemic Stroke Brief Report
Background and Purpose—Renal dysfunction (RD) is associated with poor prognosis after stroke. We assessed the effects of RD on outcomes and interaction with low- versus standard-dose alteplase in a post hoc subgroup analysis of the ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study).Methods—A total of 3220 thrombolysis-eligible patients with acute ischemic stroke (mean age, 66.5 years; 37.8% women) were randomly assigned to low-dose (0.6 mg/kg) or standard-dose (0.9 mg/kg) intravenous alteplase within 4.5 hours of symptom onset. Six hundred and fifty-nine (19.8%) patients had moderate-to-severe R...
Source: Stroke - August 28, 2017 Category: Neurology Authors: Susan J. Carr, Xia Wang, Veronica V. Olavarria, Pablo M. Lavados, Jorge A. Rodriguez, Jong S. Kim, Tsong-Hai Lee, Richard I. Lindley, Octavio M. Pontes-Neto, Stefano Ricci, Shoichiro Sato, Vijay K. Sharma, Mark Woodward, John Chalmers, Craig S. Anderson, Tags: Clinical Studies, Intracranial Hemorrhage, Ischemic Stroke Brief Reports Source Type: research

Survivor gives us a lens into regional systems of care for acute ischemic stroke in North Dakota
I just got back from the North Dakota Mission: Lifeline STEMI and Acute Stroke Conference in Bismark, ND. I had a great time and I learned a lot. I often get asked to speak in various venues about acute STEMI and 12-lead ECG interpretation, but for this conference they wanted me to talk mostly about stroke. That turned out to be a good thing because it forced me to read the 2013 AHA / ASA Guildelines for the Early Management of Patients With Acute Ischemic Stroke to make sure I was asking intelligent questions during the panel discussion (which I moderated) and also giving accurate information for the class I taught about ...
Source: EMS 12-Lead - May 31, 2013 Category: Cardiology Authors: Tom Bouthillet Tags: ems-topics patient-management North Dakota Mission Lifeline Stroke Source Type: research