Query: stroke

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Source: Journal of Neurology

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Total 191 results found since Jan 2013.

Detailed phenotyping of posterior vs. anterior circulation ischemic stroke: a multi-center MRI study
ConclusionIschemic stroke subtypes differ between the two phenotypes. Diabetes and male sex have a stronger association with PCiS than ACiS. Definitive MRI-based PCiS diagnosis aids etiological investigation and contributes additional insights into specific risk factors and mechanisms of injury in PCiS.
Source: Journal of Neurology - November 11, 2019 Category: Neurology Source Type: research

White matter burden does not influence the outcome of mechanical thrombectomy
ConclusionsWMHs burden does not seem to influence clinical outcome and imaging parameters in patients treated by MT.
Source: Journal of Neurology - November 8, 2019 Category: Neurology Source Type: research

Prognostic utility of serum 25-hydroxyvitamin D in patients with stroke: a meta-analysis
ConclusionsLower serum 25-hydroxyvitamin D level is significantly associated with poorer prognosis in stroke patients. Future prospective studies are warranted to verify the prognostic role and to examine the association in different subtypes of stroke.
Source: Journal of Neurology - November 8, 2019 Category: Neurology Source Type: research

Symptomatic carotid near-occlusion causes a high risk of recurrent ipsilateral ischemic stroke
ConclusionsSymptomatic carotid near-occlusion has a high short-term risk of recurrent ipsilateral ischemic stroke, especially near-occlusion with full collapse.
Source: Journal of Neurology - November 7, 2019 Category: Neurology Source Type: research

Cardiorespiratory fitness as a quantitative predictor of the risk of stroke: a dose –response meta-analysis
ConclusionThis meta-analysis provides the evidence that better CRF was with a lower risk of stroke incidence.
Source: Journal of Neurology - November 4, 2019 Category: Neurology Source Type: research

Use of anticoagulant therapy and cerebral microbleeds: a systematic review and meta-analysis
ConclusionAnticoagulant use is associated with higher prevalence and incidence of CMBs. This association appears to depend on location of CMBs and type of anticoagulants. More longitudinal investigations with adjustment for confounders are required to establish the causality.
Source: Journal of Neurology - October 15, 2019 Category: Neurology Source Type: research

Relationship between ‘on-treatment platelet reactivity’, shear stress, and micro-embolic signals in asymptomatic and symptomatic carotid stenosis
DiscussionRecently symptomatic moderate –severe carotid stenosis patients had a lower prevalence of aspirin–HTPR than their asymptomatic counterparts on the PFA-100®, likely related to higher aspirin doses. The prevalence of antiplatelet –HTPR was positively influenced by higher shear stress levels, but not MES status.
Source: Journal of Neurology - October 12, 2019 Category: Neurology Source Type: research

Clinical features distinguish cerebral amyloid angiopathy-associated convexity subarachnoid haemorrhage from suspected TIA
ConclusionSimple clinical features could help distinguish cSAH-associated TFNE from suspected TIA, with relevance for investigation and management, including the use of antithrombotic drugs.
Source: Journal of Neurology - October 3, 2019 Category: Neurology Source Type: research

Stroke in supplementary motor area mimicking functional disorder: a case report
We report a 59-year-old man with previous history for myocardial infarction, referred to emergency room with an acute dense right-side hemiplegia, positive Hoover sign, asymmetrical Babinski responses and intermittent ability to move his arm in some specific reflex actions despite plegia. Since brain computed tomography scan was unremarkable we could not be sure whether his symptoms were organic or functional until a diffusion weighted imaging of magnetic resonance imaging elucidated the situation. To our knowledge, there is only one case report in the literature prior to ours, presenting a supplementary motor area stroke ...
Source: Journal of Neurology - September 28, 2019 Category: Neurology Source Type: research

Alien limb phenomenon following posterior cerebral artery stroke: a distinct clinical entity
AbstractAlien limb syndrome following stroke within the territory of the posterior cerebral artery is exceedingly rare. A right-handed female experienced left homonymous hemianopia, visuospatial neglect, and proprioceptive loss of her left hemi-body. She experienced unintended, involuntary movements of her left arm and hand, which interfered with and disturbed motor actions of daily life performed with her right upper limb. There was no denial of ownership, but she interpreted movements of her left upper limb to be annoying, out of her will and unwanted. The alien limb phenomenon improved in parallel with improvement of pr...
Source: Journal of Neurology - September 27, 2019 Category: Neurology Source Type: research

“Thalamic aphasia” after stroke is associated with left anterior lesion location
ConclusionsAphasic symptoms in thalamic stroke are strongly associated with left anterior lesion location. In thalamo-cortical language networks, specifically the nuclei in the left anterior thalamus could play an important role in integration of left cortical information with disconnection leading to aphasic symptoms.
Source: Journal of Neurology - September 27, 2019 Category: Neurology Source Type: research

Frequency, aetiology, and impact of vestibular symptoms in the emergency department: a neglected red flag
ConclusionFrequency and impact of vestibular symptoms in patients visiting the ED were higher than previously reported, and life-threatening aetiologies such as strokes are common. Therefore, awareness among physicians regarding the importance of vestibular symptoms has to be improved.
Source: Journal of Neurology - September 17, 2019 Category: Neurology Source Type: research

Predisposing and precipitating factors for delirium in neurology: a prospective cohort study of 1487 patients
ConclusionsDelirium is common in elder neurological patients and associated with worse outcome. Primary cerebral conditions most frequently precipitate delirium in neurology. Neurologists are advised to monitor symptoms of delirium in the presence of risk factors to enable both timely diagnostic work-up and management of delirium.
Source: Journal of Neurology - September 13, 2019 Category: Neurology Source Type: research

MR-imaging pattern is not a predictor of occult atrial fibrillation in patients with cryptogenic stroke
ConclusionsIn this MRI-based analysis of patients with cryptogenic stroke who had received ICM implantation, the detection rate of AF in patients with ICM was not related to the imaging pattern. In addition, the lacunar infarct pattern should not be an exclusion criterion for ICM insertion in patients with cryptogenic stroke. ICM insertion in patients with cryptogenic stroke should not be evaluated solely on the basis of reference to infarct patterns.
Source: Journal of Neurology - September 11, 2019 Category: Neurology Source Type: research

Cumulative alcohol consumption and stroke risk in men
ConclusionsCumulative alcohol consumption is an independent risk factor of total stroke and IS in men in a community-based cohort. Even light alcohol intake increases the risk of total stroke and IS.
Source: Journal of Neurology - August 8, 2019 Category: Neurology Source Type: research

Circulating neurofilament light in ischemic stroke: temporal profile and outcome prediction
ConclusionsThe results from this study inform on sNfL in ischemic stroke and subtypes over time, and show that sNfL predicts short- and long-term neurological and functional outcomes. Our findings suggest a potential utility of sNfL in ischemic stroke outcome prediction.
Source: Journal of Neurology - August 2, 2019 Category: Neurology Source Type: research

Misjudgment of pre-stroke functional status contradicts beneficial outcomes after endovascular therapy for large vessel occlusion
In conclusion, thorough pre-EVT assessment of pre-stroke functional status appears decisive for proper selection of EVT candidates.
Source: Journal of Neurology - July 18, 2019 Category: Neurology Source Type: research

Influence of procedure time on outcome and hemorrhagic transformation in stroke patients undergoing thrombectomy
ConclusionsThe PT is an independent predictor for 90-day outcomes in stent-retriever thrombectomy patients. Postprocedural HT was partially responsible for the worse outcome in patients who experienced a longer PT.
Source: Journal of Neurology - July 3, 2019 Category: Neurology Source Type: research

Selection of anterior circulation acute stroke patients for mechanical thrombectomy
ConclusionsTVSS is a reliable tool for selection of AIS candidates for MT and optimization of transfer to comprehensive stroke centers.
Source: Journal of Neurology - July 3, 2019 Category: Neurology Source Type: research

Intra-arterial thrombectomy for acute ischaemic stroke patients with active cancer
ConclusionsAlthough baseline characteristics and recanalisation rate after IAT up to 24  h after stroke onset were similar between acute ischaemic stroke patients with active cancer and without any cancer, stroke-related death and short-term outcome were significantly poorer in patients with active cancer than the controls. Post-procedural haemorrhage and active cancer itself were ind ependent predictors of a decrease in functional independence at 3 months.
Source: Journal of Neurology - June 7, 2019 Category: Neurology Source Type: research

Stroke severity in patients with preceding direct oral anticoagulant therapy as compared to vitamin K antagonists
AbstractBackgroundAlthough direct oral anticoagulants (DOAC) have proven at least equally effective in the prevention of acute ischemic stroke (AIS) in patients with atrial fibrillation as compared to the vitamin K antagonists (VKA), no reliable data on the severity of AIS of DOAC patients as compared to VKA is available.MethodsUsing a prospectively collected cohort of AIS patients, we performed univariate and multivariate (displayed as adjusted Odds Ratios, OR and 95% confidence intervals, 95% CI) analyses regarding the severity of AIS in patients with preceding DOAC (N = 210) versus VKA (N = 173) therapy. Additio...
Source: Journal of Neurology - June 4, 2019 Category: Neurology Source Type: research

Risk factors for in-hospital and follow-up mortality after childhood arterial ischemic stroke
ConclusionsThis study identified groups with greater acute and long-term  mortality after a first episode of AIS in childhood. Specific interventions focused on these risk groups may decrease mortality rates. Further studies need to confirm our findings by adding children from other centers.
Source: Journal of Neurology - May 14, 2019 Category: Neurology Source Type: research

Specific mechanisms of subarachnoid hemorrhage accompanied by ischemic stroke in essential thrombocythemia: two case reports and a literature review
ConclusionsThe current study describes rare cases of SAH accompanied by ischemic stroke secondary to ET along with a review of the current literature, implying specific mechanisms for cerebral artery disorders associated withJAK2 V617F mutation.
Source: Journal of Neurology - May 2, 2019 Category: Neurology Source Type: research

Prevalence and risk factors of stroke in the elderly in Northern China: data from the National Stroke Screening Survey
AbstractBackgroundThe overall global burden of stroke is considerable and increasing. In China, stroke is the leading cause of death and disability.MethodsFor this study, we used data from the National Stroke Screening Survey in 2012 and the 2010 Chinese population from sixth National Census of Populations to calculate a standardized (by age, gender, and education) stroke prevalence. Prevalence, risk factors, and management of stroke were compared by gender, age, and site.FindingsThe standardized prevalence rate of survival stroke patients in study population aged 60 and older was 4.94% in total. Hypertension was the most ...
Source: Journal of Neurology - April 15, 2019 Category: Neurology Source Type: research

Effect of small-vessel disease on cognitive trajectory after atrial fibrillation-related ischaemic stroke or  TIA
AbstractPost-stroke dementia is common but has heterogenous mechanisms that are not fully understood, particularly in patients with atrial fibrillation (AF)-related ischaemic stroke or TIA. We investigated the relationship between MRI small-vessel disease markers (including a composite cerebral amyloid angiopathy, CAA, score) and cognitive trajectory over 12  months. We included patients from the CROMIS-2 AF study without pre-existing cognitive impairment and with Montreal Cognitive Assessment (MoCA) data. Cognitive impairment was defined as MoCA<  26. We defined “reverters” as patients with an “acute” MoCA (...
Source: Journal of Neurology - March 7, 2019 Category: Neurology Source Type: research

Cerebral microbleeds are associated with cognitive decline early after ischemic stroke
ConclusionCognitive abilities are more severely impaired in CMB-positive stroke patients compared to CMB-free controls, whereby memory-associated functions are most affected. CMB might be associated with post-stroke cognitive decline, particularly with impaired memory and phonemic fluency.
Source: Journal of Neurology - February 14, 2019 Category: Neurology Source Type: research

Anger, hostility and risk of stroke: a meta-analysis of cohort studies
ConclusionA higher level of anger and hostility is not associated with elevated risk of stroke. However, the association is positive among people with lower socioeconomic status.
Source: Journal of Neurology - February 11, 2019 Category: Neurology Source Type: research

Early microvascular cerebral blood flow response to head-of-bed elevation is related to outcome in acute ischemic stroke
ConclusionsEarly CBF response to mild HOB elevation in the ipsilesional hemisphere is related to functional outcome. Further studies may enable optical monitoring at the bedside to individualize management strategies in the early phase of AIS.
Source: Journal of Neurology - February 9, 2019 Category: Neurology Source Type: research

Pre-treatment cerebral microbleeds and intracranial hemorrhage in patients with ischemic stroke receiving endovascular therapy: a systematic review and meta-analysis
ConclusionsThere is no evidence that pre-treatment CMBs were associated with an increased incidence of ICH in patients with ischemic stroke receiving EVT.
Source: Journal of Neurology - January 28, 2019 Category: Neurology Source Type: research

Determining factors of better leptomeningeal collaterals: a study of 857 consecutive acute ischemic stroke patients
ConclusionsYounger age, dyslipidemia and lower creatinine levels were predictors of better collaterals in AIS patients from proximal MCA occlusions. Greater degree of collaterals related to lower stroke severity on admission. On neuroimaging, better collaterals were independently associated with minor early ischemic changes and lower clot burden. These data may add knowledge on pathophysiology of collaterals development and may help to identify patients with better collaterals for late or aggressive recanalization treatments.
Source: Journal of Neurology - January 4, 2019 Category: Neurology Source Type: research

Impact of virtual reality-based rehabilitation on functional outcomes in patients with acute stroke: a retrospective case-matched study
ConclusionsThis study suggests that the combination of VR-based rehabilitation and traditional therapy could be more effective for neurorehabilitation than CT alone in the early improvement of symptom severity, functional outcomes, and lower medical expenditure in acute stroke patients.
Source: Journal of Neurology - January 4, 2019 Category: Neurology Source Type: research

Effect of mechanical thrombectomy alone or in combination with intravenous thrombolysis for acute ischemic stroke
ConclusionsOur study suggests that mechanical thrombectomy alone is effective and safe in patients with contraindications to intravenous thrombolysis. Preceding use of IVT in eligible patients was not associated with increased harm or benefit. Randomized controlled trials are needed to clarify whether intravenous thrombolysis before mechanical thrombectomy is associated with additional benefit.
Source: Journal of Neurology - November 14, 2018 Category: Neurology Source Type: research

Early MRI-negative posterior circulation stroke presenting as acute dizziness
AbstractThe aim of this study was to determine the frequency, clinical and radiological features, and efficacy of clinical evaluation and perfusion-weighted imaging (PWI) for the prediction of final stroke in patients with DWI/MRI-negative posterior circulation stroke (PCS) presenting acute dizziness/vertigo. From our comprehensive prospective stroke registry of acute ischemic stroke during a 7-year period, we identified 1846 consecutive patients with PCS, 850 of whom presented with acute dizziness/vertigo. Of these 850 patients, initial DWI-MRI was negative in 35 (4.1%). In these 35 patients, dizziness/vertigo was acute p...
Source: Journal of Neurology - November 14, 2018 Category: Neurology Source Type: research

Worse endovascular mechanical recanalization results for patients with in-hospital onset acute ischemic stroke
ConclusionThe recognition, assessment and pre-interventional procedures of patients with in-hospital strokes and subsequent mechanical thrombectomy are favorable. Nevertheless, in-hospital stroke patients display inferior recanalization results and poorer clinical outcomes. Furthermore, we find mechanical thrombectomy seems safe for treatment of in-hospital strokes.
Source: Journal of Neurology - October 12, 2018 Category: Neurology Source Type: research

Peripheral tumor necrosis factor-a-induced protein 8-like 2 mRNA level for predicting 3-month mortality of patients with acute ischemic stroke
In conclusion, TIPE2 mRNA improved the diagnostic value of NIHSS score, and patients with NIHSS ≥ 5.5 and TIPE2 mRNA <  5.2 had high 3-month mortality.
Source: Journal of Neurology - October 12, 2018 Category: Neurology Source Type: research

High-sensitivity cardiac troponin T and severity of cerebral white matter lesions in patients with acute ischemic stroke
ConclusionElevated hs-cTnT levels were associated with extent of WML in acute stroke patients. Further studies are needed to assess whether hs-cTnT can be used to identify stroke patients at risk for cognitive decline.
Source: Journal of Neurology - October 11, 2018 Category: Neurology Source Type: research

Management of patients with stroke treated with direct oral anticoagulants
AbstractSince their market approval, direct oral anticoagulants (DOACs) are being increasingly used for stroke prevention in patients with atrial fibrillation. However, the management of DOAC-treated patients with stroke poses several challenges for physicians in everyday clinical practice, both in the acute setting and in long-term care. This has spurred extensive research activity in the field over the past few years, which we review here.
Source: Journal of Neurology - October 6, 2018 Category: Neurology Source Type: research

Comparison of outcome in stroke patients admitted during working hours vs. off-hours; a single-center cohort study
Discussion and conclusionsThe overall outcome of stroke patients admitted to a large Dutch teaching hospital is not influenced by time of admission. When studying OH effects, adjustment for disease severity and poor prognostic findings on imaging is crucial before drawing conclusions on staffing and material.
Source: Journal of Neurology - October 5, 2018 Category: Neurology Source Type: research

Occult paroxysmal atrial fibrillation in non-cryptogenic ischemic stroke
ConclusionLong-term monitoring of non-CIS patients detected PAF in a clinically relevant proportion of patients, resulting in stroke prevention therapy optimization. Further study to confirm these findings and refine the subset that would benefit from long-term cardiac monitoring is warranted.
Source: Journal of Neurology - October 1, 2018 Category: Neurology Source Type: research

Aspirin plus clopidogrel may reduce the risk of early neurologic deterioration in ischemic stroke patients carrying CYP2C19 * 2 reduced-function alleles
ConclusionsDual therapy with clopidogrel and aspirin may be adequate for prevention of END in carriers ofCYP2C19 reduced-function alleles, but not for noncarriers. Our findings may be useful to guide precise antiplatelet therapy, and decrease the risk of END.
Source: Journal of Neurology - August 20, 2018 Category: Neurology Source Type: research

Stroke recurrence and mortality in northeastern Greece: the Evros Stroke Registry
AbstractUp to date there is no population-based study from Greece providing long-term data on incidence of both all-cause mortality and stroke recurrence for patients with first ever stroke (FES). Adult patients with FES were registered during a 24-month period (2010 –2012) and followed-up for 12 months. We calculated cumulative incidences of stroke mortality and recurrence. Univariable and multivariable Cox proportional hazards regression analyses were used to identify independent determinants of 1-year mortality and 1-year stroke recurrence. We prospectivel y documented 703 first ever stroke cases (mean age 75 ± ...
Source: Journal of Neurology - August 20, 2018 Category: Neurology Source Type: research

Clinical, imaging, and histological presentations and outcomes of stroke related to sarcoidosis
ConclusionsCerebrovascular events may be the first manifestation of neurosarcoidosis, and have a prognosis impact in such patients, leading to death and permanent neurological impairment.
Source: Journal of Neurology - August 14, 2018 Category: Neurology Source Type: research

Depressive symptoms in stroke patients treated and non-treated with intravenous thrombolytic therapy: a 1-year follow-up study
Conclusions(1) Thrombolysed and non-thrombolysed stroke survivors had similar frequency of depressive symptoms although the thrombolysed patients had more severe neurological deficits in the acute phase. It can be assumed that if thrombolysis had not been used, depressive symptoms would have been more frequent. (2) Lack of the rt-PA treatment was associated with three-time greater odds of screening for PSD at 3  months post-stroke, after adjustment for other PSD correlates. (3) Therefore, thrombolytic therapy seems to have a positive, but indirect, effect on patients’ mood, especially in the first months after stroke. (...
Source: Journal of Neurology - June 18, 2018 Category: Neurology Source Type: research

Minocycline for acute stroke treatment: a systematic review and meta-analysis of randomized clinical trials
ConclusionsAlthough data is limited, minocycline demonstrated efficacy and seems a promising neuroprotective agent in acute stroke patients, especially  in AIS subgroup. Further RCTs are needed to evaluate the efficacy and safety of minocycline among ICH patients.
Source: Journal of Neurology - June 14, 2018 Category: Neurology Source Type: research

Rheumatoid arthritis significantly increased recurrence risk after ischemic stroke/transient ischemic attack
This study provides the first evidence that RA significantly increased recurrence IS/TIA risk. The changes of TG/HDL-C ratio may play some roles in the recurrence IS/TIA risk in RA patients. In addition, our results suggest that smoking increases the risk of recurrent IS/TIA in RA patients and reinforces the need for aggressive smoking cessation efforts in RA patients.
Source: Journal of Neurology - June 2, 2018 Category: Neurology Source Type: research

The occurrence of seizures after ischemic stroke does not influence long-term mortality; a 26-year follow-up study
ConclusionBoth early-onset and late-onset seizures do not influence long-term mortality after ischemic stroke.
Source: Journal of Neurology - May 29, 2018 Category: Neurology Source Type: research

The silver effect of admission glucose level on excellent outcome in thrombolysed stroke patients
AbstractHigher admission glucose levels (AGL) are associated with less favorable outcome in thrombolysis. But, could AGL ’s impact on outcome vary by onset-to-treatment (OTT) time? Is hyperglycemia associated with a shorter therapeutic time window for excellent outcome for thrombolysed stroke patients? We assessed predictive values of AGL, baseline NIHSS, age, and OTT time quartiles on excellent outcome (3-month mod ified Rankin score of 0–1) in 773 patients treated by rt-Pa. We added the AGL × OTT time quartile interaction in the model and separately analyzed the predictive values of AGL, age, and NIHSS for each ...
Source: Journal of Neurology - May 18, 2018 Category: Neurology Source Type: research

A startling acoustic stimulus facilitates voluntary lower extremity movements and automatic postural responses in people with chronic stroke
AbstractA startling acoustic stimulus (SAS) involuntary releases prepared movements at accelerated latencies, known as the StartReact effect. Previous work has demonstrated intact StartReact in paretic upper extremity movements in people after stroke, suggesting preserved motor preparation. The question remains whether motor preparation of lower extremity movements is also unaffected after stroke. Here, we investigated StartReact effects on ballistic lower extremity movements and on automatic postural responses (APRs) following perturbations to standing balance. These APRs are particularly interesting as they are critical ...
Source: Journal of Neurology - May 14, 2018 Category: Neurology Source Type: research

Haemorrhagic stroke related to the use of 4-fluoroamphetamine
We report on two patients who presented with headache and mild hypertension after 4-FA use. Patient A developed one-sided weakness and decreased consciousness after a few hours. A computed tomography scan showed a left-sided intracerebral haemorrhage. Because of life-threatening cerebral herniation, haematoma evacuation was performed. Postoperatively, she suffered from a right-sided hemiparalysis and severe aphasia, requiring clinical rehabilitation. Patient B had a subarachnoid haemorrhage without neurological deficits. In total, 939 4-FA-intoxicated patients were registered. These patients used 4-FA alone (44%) or in com...
Source: Journal of Neurology - May 8, 2018 Category: Neurology Source Type: research