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Total 3080 results found since Jan 2013.

Microbiological Etiologies of Pneumonia Complicating Stroke Clinical Sciences
Conclusions—Although the analysis was limited by small and heterogeneous study populations, limiting determination of microbiological causality, this review suggests aerobic Gram-negative bacilli and Gram-positive cocci are frequently associated with pneumonia complicating stroke. This supports the need for appropriately designed studies to determine microbial cause and a consensus-based approach in antibiotic usage and further targeted antibiotic treatment trials for enhanced antibiotic stewardship.
Source: Stroke - June 25, 2018 Category: Neurology Authors: Amit K. Kishore, Andy Vail, Adam R. Jeans, Angel Chamorro, Mario Di Napoli, Lalit Kalra, Peter Langhorne, Christine Roffe, Willeke Westendorp, Paul J. Nederkoorn, Javier Garau, Diederik van de Beek, Joan Montaner, Mark Woodhead, Andreas Meisel, Craig J. S Tags: Complications, Meta Analysis, Cerebrovascular Disease/Stroke, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

Effects of Blood Pressure in the Early Phase of Ischemic Stroke and Stroke Subtype on Poststroke Cognitive Impairment Clinical Sciences
This study was to investigate the impact of BP levels in the early phase of ischemic stroke and stroke subtype on PSCI.Methods—Seven hundred and ninety-six patients with acute ischemic stroke were included. Cognitive function was assessed after stroke onset using the Montreal Cognitive Assessment. Patients were divided into quintiles according to systolic BP and diastolic BP levels in the early phase. Subtype analyses were according to Trial of ORG 10172 in Acute Stroke Treatment classification (infarct cause) and Oxfordshire Community Stroke Project classification (infarct location).Results—After adjusting for multipl...
Source: Stroke - June 25, 2018 Category: Neurology Authors: Mingli He, Jin’e Wang, Na Liu, Xiao Xiao, Shan Geng, Pin Meng, Niu Ji, Yong’an Sun, Bingchao Xu, Yingda Xu, Xinyu Zhou, Guanghui Zhang, Xiaobing He, Zenglin Cai, Zaipo Li, Bei Wang, Bei Xu, Rutai Hui, Yibo Wang Tags: High Blood Pressure, Cognitive Impairment, Ischemic Stroke Original Contributions Source Type: research

Long-Term Prognosis of Patients With Transient Ischemic Attack or Stroke and Symptomatic Vascular Disease in Multiple Arterial Beds Clinical Sciences
Background and Purpose—Cerebrovascular, coronary, and peripheral vascular disease have common underlying arterial pathology and risk factors, but the clinical significance of multiple-territory disease in patients with transient ischemic attack (TIA)/ischemic stroke is unclear, particularly whether the number of clinically affected territories still predicts long-term outcome on current standard secondary prevention therapies.Methods—In a population-based study of 92 728 individuals in Oxfordshire, United Kingdom (Oxford Vascular Study), we studied patients presenting with TIA/ischemic stroke (2002–2014) in relatio...
Source: Stroke - June 25, 2018 Category: Neurology Authors: Mirjam R. Heldner, Linxin Li, Nicola G. Lovett, Magdalena M. Kubiak, Shane Lyons, Peter M. Rothwell Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke, Transient Ischemic Attack (TIA), Vascular Disease Original Contributions Source Type: research

Efficacy of Endovascular Therapy in Acute Ischemic Stroke Depends on Age and Clinical Severity Clinical Sciences
Background and Purpose—Efficacy of endovascular treatment (EVT) for ischemic stroke because of large vessel occlusion may depend on patients’ age and stroke severity; we, therefore, developed a prognosis score based on these variables and examined whether EVT efficacy differs between patients with good, intermediate, or poor prognostic score.Methods—A total of 4079 patients with an acute ischemic stroke were identified from the Paris Stroke Consortium registry. We developed the stroke checkerboard (SC) score (SC score=1 point per decade ≥50 years of age and 2 points per 5 points on the National Institutes of Health...
Source: Stroke - June 25, 2018 Category: Neurology Authors: Raphael Le Bouc, Frederic Clarencon, Elena Meseguer, Bertrand Lapergue, Arturo Consoli, Guillaume Turc, Olivier Naggara, Duc Long Duong, Jerome Servan, Peggy Reiner, Marc Antoine Labeyrie, Mathieu Fisselier, Raphael Blanc, Wassim Farhat, Christine Pires, Tags: Revascularization, Cerebrovascular Disease/Stroke, Cerebrovascular Procedures, Ischemic Stroke Original Contributions Source Type: research

Impact of Transcranial Doppler Ultrasound on Logistics and Outcomes in Stroke Thrombolysis Clinical Sciences
Background and Purpose—Diagnostic transcranial Doppler ultrasound (TCD) is commonly used in patients with acute stroke before or during treatment with intravenous thrombolysis (IVT). We aimed to assess how much TCD delays IVT initiation and whether TCD influences outcomes.Methods—We analyzed data from the SITS-ISTR (Safe Implementation of Thrombolysis in Stroke–International Stroke Thrombolysis Register) collected from December 2002 to December 2011. Outcomes were door-to-needle time, symptomatic intracerebral hemorrhage, functional outcome per the modified Rankin Scale, and mortality at 3 months.Results—In hospita...
Source: Stroke - June 25, 2018 Category: Neurology Authors: Michael V. Mazya, Niaz Ahmed, Elsa Azevedo, Antoni Davalos, Laura Dorado, Michal Karlinski, Svetlana Lorenzano, Jiři Neumann, Danilo Toni, Tiago P. Moreira Tags: Ultrasound, Health Services, Ischemic Stroke Original Contributions Source Type: research

Taurine Reduces tPA (Tissue-Type Plasminogen Activator)-Induced Hemorrhage and Microvascular Thrombosis After Embolic Stroke in Rat Basic Sciences
Conclusions—Our results suggest that taurine in combination with tPA may be a clinically feasible approach toward future attempts at combination stroke therapy.
Source: Stroke - June 25, 2018 Category: Neurology Authors: Rong Jin, Adam Y. Xiao, Shan Liu, Min Wang, Guohong Li Tags: Animal Models of Human Disease, Ischemic Stroke Original Contributions Source Type: research

Elevated Plasma D-Dimer Level Is Associated With Short-Term Risk of Ischemic Stroke in Patients With Acute Heart Failure Brief Report
We examined 721 consecutive hospitalized AHF patients with plasma D-dimer level on admission from our prospective registry between January 2013 and May 2016. The study end points were incidence of ischemic stroke during hospitalization and at 30 days after admission.Results—Of the total participants (mean age, 76 years; male, 60%; atrial fibrillation, 54%; mean left ventricular ejection fraction, 38%), in-hospital ischemic stroke occurred in 18 patients (2.5%) during a median hospitalization period of 21 days, and 30-day ischemic stroke occurred in 16 patients (2.2%). Higher D-dimer level on admission was an independent ...
Source: Stroke - June 25, 2018 Category: Neurology Authors: Yasuhiro Hamatani, Toshiyuki Nagai, Michikazu Nakai, Kunihiro Nishimura, Yasuyuki Honda, Hiroki Nakano, Satoshi Honda, Naotsugu Iwakami, Yasuo Sugano, Yasuhide Asaumi, Takeshi Aiba, Teruo Noguchi, Kengo Kusano, Kazunori Toyoda, Satoshi Yasuda, Hiroyuki Yo Tags: Heart Failure, Ischemic Stroke Brief Reports Source Type: research

Early Cerebral Vein After Endovascular Ischemic Stroke Treatment Predicts Symptomatic Reperfusion Hemorrhage Brief Report
Conclusions—ECV on postendovascular mechanical thrombectomy digital subtraction angiography is highly diagnostic of subsequent symptomatic reperfusion hemorrhage in this data set. This finding has important implications for post-treatment management of blood pressure and anticoagulation.
Source: Stroke - June 25, 2018 Category: Neurology Authors: Samuel C.D. Cartmell, Robyn L. Ball, Rajani Kaimal, Nicholas A. Telischak, Michael P. Marks, Huy M. Do, Robert L. Dodd, Gregory W. Albers, Maarten G. Lansberg, Jeremy J. Heit Tags: Cerebrovascular Procedures, Intracranial Hemorrhage, Ischemic Stroke Brief Reports Source Type: research

Continuation or Discontinuation of Anticoagulation in the Early Phase After Acute Ischemic Stroke Brief Report
Background and Purpose—There is no consensus on whether anticoagulation should be continued or temporarily stopped in patients suffering acute ischemic stroke while using anticoagulation. We assessed treatment variations and outcomes in these patients.Methods—Post hoc analysis of PASS (Preventive Antibiotics in Stroke Study). We included patients with acute ischemic stroke who used anticoagulation at admission. We compared clinical outcomes, thrombotic, and major bleeding events at 3 months.Results—Nine percent (192/2101) of the patients with acute ischemic stroke used anticoagulation at admission (186 vitamin K anta...
Source: Stroke - June 25, 2018 Category: Neurology Authors: Adrien E. Groot, Jan-Dirk M. Vermeij, Willeke F. Westendorp, Paul J. Nederkoorn, Diederik van de Beek, Jonathan M. Coutinho Tags: Secondary Prevention, Anticoagulants, Cerebrovascular Disease/Stroke, Ischemic Stroke Brief Reports Source Type: research

Stroke 112 Brief Report
Conclusions—Stroke 112, a universal stroke educational program without language barriers was developed. It could potentially be implemented worldwide, especially where 112 is used as an emergency phone number.
Source: Stroke - June 25, 2018 Category: Neurology Authors: Jing Zhao, Maryellen F. Eckenhoff, Wei-Zen Sun, Renyu Liu Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke Brief Reports Source Type: research

Population-Based Assessment of the Long-Term Risk of Seizures in Survivors of Stroke Clinical Sciences
Background and Purpose—We sought to determine the long-term risk of seizures after stroke according to age, sex, race, and stroke subtype.Methods—We performed a retrospective cohort study using administrative claims from 2 complementary patient data sets. First, we analyzed data from all emergency department visits and hospitalizations in California, Florida, and New York from 2005 to 2013. Second, we evaluated inpatient and outpatient claims from a nationally representative 5% random sample of Medicare beneficiaries. Our cohort consisted of all adults at the time of acute stroke hospitalization without a prior history...
Source: Stroke - May 25, 2018 Category: Neurology Authors: Alexander E. Merkler, Gino Gialdini, Michael P. Lerario, Neal S. Parikh, Nicholas A. Morris, Benjamin Kummer, Lauren Dunn, Michael E. Reznik, Santosh B. Murthy, Babak B. Navi, Zachary M. Grinspan, Costantino Iadecola, Hooman Kamel Tags: Risk Factors, Cerebrovascular Disease/Stroke Original Contributions Source Type: research

Longitudinal Change of Perceived Salt Intake and Stroke Risk in a Chinese Population Clinical Sciences
Conclusions—Change in salt intake was associated with the stroke risk. These data support the dietary recommendation to the reduction of salt intake.
Source: Stroke - May 25, 2018 Category: Neurology Authors: Yun Li, Zhe Huang, Cheng Jin, Aijun Xing, Yesong Liu, Chunmei Huangfu, Alice H. Lichtenstein, Katherine L. Tucker, Shouling Wu, Xiang Gao Tags: Diet and Nutrition, Epidemiology, Lifestyle, Risk Factors, Cerebrovascular Disease/Stroke Original Contributions Source Type: research

Genetic Study of White Matter Integrity in UK Biobank (N=8448) and the Overlap With Stroke, Depression, and Dementia Clinical Sciences
Conclusions—Genetic variants within the VCAN gene may play a role in the mechanisms underlying microstructural integrity of the white matter in the brain measured as FA and MD. Mechanisms underlying white matter alterations are shared with cerebrovascular disease, and inherited differences in white matter microstructure impact on Alzheimer disease and major depressive disorder.
Source: Stroke - May 25, 2018 Category: Neurology Authors: Loes C.A. Rutten-Jacobs, Daniel J. Tozer, Marco Duering, Rainer Malik, Martin Dichgans, Hugh S. Markus, Matthew Traylor Tags: Genetic, Association Studies, Magnetic Resonance Imaging (MRI), Cerebrovascular Disease/Stroke Original Contributions Source Type: research

Declining Rate and Severity of Hospitalized Stroke From 2004 to 2013 Clinical Sciences
Background and Purpose—Stroke is a leading cause of morbidity and disability. We assessed trends in rates of hospitalized stroke and stroke severity on admission in a prospective national registry of stroke from 2004 to 2013.Methods—All 6693 acute ischemic strokes and intracerebral hemorrhage in the National Acute Stroke Israeli participants ≥20 years old were included. Data were prospectively collected in 2004 (February–March), 2007 (March–April), 2010 (April–May), and 2013 (March–April). Rates of hospitalized stroke from 2004 to 2013 were studied using generalized linear models assuming a quasi-Poisson erro...
Source: Stroke - May 25, 2018 Category: Neurology Authors: Silvia Koton, Diklah Geva, Jonathan Y. Streifler, Sagi Harnof, Yoav Pougach, Olga Azrilin, Shoshana Hadar, Natan M. Bornstein, David Tanne Tags: Cardiovascular Disease, Epidemiology, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

Prediction of Tissue Outcome and Assessment of Treatment Effect in Acute Ischemic Stroke Using Deep Learning Clinical Sciences
Background and Purpose—Treatment options for patients with acute ischemic stroke depend on the volume of salvageable tissue. This volume assessment is currently based on fixed thresholds and single imagine modalities, limiting accuracy. We wish to develop and validate a predictive model capable of automatically identifying and combining acute imaging features to accurately predict final lesion volume.Methods—Using acute magnetic resonance imaging, we developed and trained a deep convolutional neural network (CNNdeep) to predict final imaging outcome. A total of 222 patients were included, of which 187 were treated with...
Source: Stroke - May 25, 2018 Category: Neurology Authors: Anne Nielsen, Mikkel Bo Hansen, Anna Tietze, Kim Mouridsen Tags: Magnetic Resonance Imaging (MRI), Treatment, Quality and Outcomes, Statements and Guidelines, Ischemic Stroke Original Contributions Source Type: research

Magnetic Resonance Imaging Selection for Endovascular Stroke Therapy Clinical Sciences
Conclusions—Workflow in GOLIATH demonstrates that magnetic resonance imaging selection for endovascular therapy can be accomplished rapidly and within a similar time frame as computed tomography-based selection.Clinical Trial Registration—URL: https://www.clinicaltrials.gov. Unique identifier: NCT02317237.
Source: Stroke - May 25, 2018 Category: Neurology Authors: Claus Z. Simonsen, Albert J. Yoo, Mads Rasmussen, Kristina E. Sorensen, Thabele Leslie–Mazwi, Grethe Andersen, Leif H. Sorensen Tags: Magnetic Resonance Imaging (MRI), Revascularization, Ischemic Stroke Original Contributions 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

Antiplatelet Treatment After Transient Ischemic Attack and Ischemic Stroke in Patients With Cerebral Microbleeds in 2 Large Cohorts and an Updated Systematic Review Clinical Sciences
Background and Purpose—In patients with transient ischemic attack/ischemic stroke, microbleed burden predicts intracerebral hemorrhage (ICH), and ischemic stroke, but implications for antiplatelet treatment are uncertain. Previous cohort studies have had insufficient follow-up to assess the time course of risks, have not stratified risks by antithrombotic use, and have not reported extracranial bleeds or functional outcome of ICH versus ischemic stroke.Methods—In 2 independent prospective cohorts with transient ischemic attack/ischemic stroke (Oxford Vascular Study/mainly white; University of Hong Kong/mainly Chinese),...
Source: Stroke - May 25, 2018 Category: Neurology Authors: Kui Kai Lau, Caroline E. Lovelock, Linxin Li, Michela Simoni, Sergei Gutnikov, Wilhelm Kuker, Henry Ka Fung Mak, Peter M. Rothwell Tags: Magnetic Resonance Imaging (MRI), Intracranial Hemorrhage, Ischemic Stroke, Transient Ischemic Attack (TIA) Original Contributions Source Type: research

Cost-Effectiveness of Patent Foramen Ovale Closure Versus Medical Therapy for Secondary Stroke Prevention Clinical Sciences
Conclusions—PFO closure for cryptogenic strokes in the right setting is cost-effective, producing benefit in QALYs gained and potential cost savings. However, patient selection remains vitally important as marginal declines in treatment effectiveness can dramatically affect cost-effectiveness.
Source: Stroke - May 25, 2018 Category: Neurology Authors: Michelle H. Leppert, Sharon N. Poisson, John D. Carroll, David E. Thaler, Chong H. Kim, Karen D. Orjuela, P. Michael Ho, James F. Burke, Jonathan D. Campbell Tags: Treatment, Cost-Effectiveness, Ischemic Stroke, Embolism Original Contributions Source Type: research

Association of Blood Pressure With Short- and Long-Term Functional Outcome After Stroke Thrombectomy Clinical Sciences
This study aims to assess the association of BP changes during general anesthesia versus conscious sedation with functional outcome after mechanical thrombectomy.Methods—SIESTA (Sedation vs Intubation for Endovascular Stroke Treatment) was a monocentric randomized trial of general anesthesia versus conscious sedation during mechanical thrombectomy involving BP target protocols. In this post hoc analysis, BP measurements were divided into 4 phases: preintervention, prerecanalization, postrecanalization, and postintervention. We examined the association between BP and functional outcomes (defined by improvement of 24-hour ...
Source: Stroke - May 25, 2018 Category: Neurology Authors: Silvia Schonenberger, Lorenz Uhlmann, Matthias Ungerer, Johannes Pfaff, Simon Nagel, Christina Klose, Martin Bendszus, Wolfgang Wick, Peter A. Ringleb, Meinhard Kieser, Markus A. Mohlenbruch, Julian Bosel Tags: Ischemic Stroke Original Contributions Source Type: research

Early Blood-Brain Barrier Disruption in Ischemic Stroke Initiates Multifocally Around Capillaries/Venules Basic Sciences
Conclusions—Early BBBD in focal cerebral ischemia initiates multifocally in the distal capillary and venular bed of the cerebral microvasculature. It is closely associated with perimicrovascular vasogenic edema and microglial activation and predicts the extent of final infarction.
Source: Stroke - May 25, 2018 Category: Neurology Authors: Angelika Hoffmann, Tassilo Dege, Reiner Kunze, Anne–Sophie Ernst, Holger Lorenz, Laura–Ines Bohler, Thomas Korff, Hugo H. Marti, Sabine Heiland, Martin Bendszus, Xavier Helluy, Mirko Pham Tags: Biomarkers, Vascular Biology, Magnetic Resonance Imaging (MRI), Blood-Brain Barrier, Ischemic Stroke Original Contributions Source Type: research

Low Levels of Caveolin-1 Predict Symptomatic Bleeding After Thrombolytic Therapy in Patients With Acute Ischemic Stroke Brief Report
Background and Purpose—Experimental models of cerebral ischemia demonstrate that the decrease in the caveolin-1 membrane protein results in an increase in endothelial permeability. Because this phenomenon is responsible for hemorrhagic transformation (HT) after cerebral ischemia, we aimed to determine whether caveolin-1 levels may predict bleeding after recombinant tissue-type plasminogen activator (r-tPA) administration in patients with acute stroke.Methods—We studied 133 patients with a first hemispheric stroke treated with r-tPA within 4.5 hours of symptom onset. HT was evaluated and classified on cranial computed t...
Source: Stroke - May 25, 2018 Category: Neurology Authors: Mar Castellanos, Cecile van Eendenburg, Carme Gubern, Elisabet Kadar, Gemma Huguet, Josep Puig, Tomas Sobrino, Gerard Blasco, Joaquin Serena, Juan Manuel Sanchez Tags: Biomarkers, Endothelium/Vascular Type/Nitric Oxide, Blood-Brain Barrier, Ischemic Stroke Brief Reports Source Type: research

Time to Decision and Treatment With tPA (Tissue-Type Plasminogen Activator) Using Telemedicine Versus an Onboard Neurologist on a Mobile Stroke Unit Brief Report
Conclusions—Assessment by a TM-VN is comparable with an OB-VN in making decisions about tPA administration on an MSU and does not lead to treatment delays.Clinical Trial Registration—URL: https://www.clinicaltrials.gov. Unique identifier: NCT02190500.
Source: Stroke - May 25, 2018 Category: Neurology Authors: Ritvij Bowry, Stephanie A. Parker, Jose-Miguel Yamal, Hyunsoo Hwang, Savitri Appana, Nicole Rangel-Gutierrez, Tzu-Ching Wu, Suja S. Rajan, James C. Grotta Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke Brief Reports Source Type: research

Primary Results of the Multicenter ARISE II Study (Analysis of Revascularization in Ischemic Stroke With EmboTrap) Major Clinical Trials
Background and Purpose—EmboTrap is a novel stent retriever designed to achieve rapid and substantial flow restoration in acute ischemic stroke secondary to large-vessel occlusions. Here, we evaluated EmboTrap’s safety and efficacy compared with established stent retrievers.Methods—ARISE II (Analysis of Revascularization in Ischemic Stroke With EmboTrap) was a single-arm, prospective, multicenter study, comparing the EmboTrap device to a composite performance goal criterion derived using a Bayesian meta-analysis from the pivotal SWIFT (Solitaire device) and TREVO 2 (Trevo device) trials. Patients at 11 US and 8 Europe...
Source: Stroke - April 23, 2018 Category: Neurology Authors: Osama O. Zaidat, Hormozd Bozorgchami, Marc Ribo, Jeffrey L. Saver, Heinrich P. Mattle, Rene Chapot, Ana Paula Narata, Olivier Francois, Ashutosh P. Jadhav, Jonathan A. Grossberg, Christian H. Riedel, Aleȷandro Tomasello, Wayne M. Clark, Hannes Nord Tags: Ischemia, Revascularization, Cerebrovascular Disease/Stroke, Ischemic Stroke Major Clinical Trial Source Type: research

Frequency of Patent Foramen Ovale and Migraine in Patients With Cryptogenic Stroke Clinical Sciences
Conclusions—In patients with cryptogenic stroke who have migraine, there is a high prevalence (79%) of PFO with right-to-left shunt. The timing of the stroke in migraineurs is usually not related to a migraine attack. These observations are consistent with the hypothesis that the mechanism of stroke in migraineurs is most likely because of a paradoxical embolus. Future cryptogenic stroke classification schemes should consider including PFO as a separate etiologic category.
Source: Stroke - April 23, 2018 Category: Neurology Authors: Brian H. West, Nabil Noureddin, Yakov Mamzhi, Christopher G. Low, Alexandra C. Coluzzi, Evan J. Shih, Rubine Gevorgyan Fleming, Jeffrey L. Saver, David S. Liebeskind, Andrew Charles, Jonathan M. Tobis Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke, Embolism Original Contributions Source Type: research

Infections and Risk of Peripartum Stroke During Delivery Admissions Clinical Sciences
Conclusions—Infections present on admission increased stroke risk during delivery admissions in women with and without hypertensive disorders of pregnancy. The results were driven by genitourinary infections and sepsis. Infections may be an underrecognized precipitant of peripartum stroke.
Source: Stroke - April 23, 2018 Category: Neurology Authors: Eliza C. Miller, Marisa Gallo, Erin R. Kulick, Alexander M. Friedman, Mitchell S.V. Elkind, Amelia K. Boehme Tags: Pregnancy, Risk Factors, Women, Cerebrovascular Disease/Stroke Original Contributions Source Type: research

Long-Term Risk of Hemorrhagic Stroke in Young Patients With Congenital Heart Disease Clinical Sciences
Conclusions—The relative risk of hemorrhagic stroke among children and young adults with CHD was almost 8× higher than that of matched controls from the general population, although the absolute risk was low. The highest risk of ICH and SAH occurred in patients with severe nonconotruncal defects and coarctation of the aorta.
Source: Stroke - April 23, 2018 Category: Neurology Authors: Kok Wai Giang, Zacharias Mandalenakis, Mikael Dellborg, Georgios Lappas, Peter Eriksson, Per-Olof Hansson, Annika Rosengren Tags: Epidemiology, Cerebrovascular Disease/Stroke, Cerebrovascular Malformations, Intracranial Hemorrhage Original Contributions Source Type: research

Impact of Smoking on Clinical Outcome and Recanalization After Intravenous Thrombolysis for Stroke Clinical Sciences
Conclusions—Our study suggests that good outcome in smokers is mainly related to differences in baseline characteristics and not to biological effects of smoking. The higher recanalization rates in smokers, however, call for further studies.
Source: Stroke - April 23, 2018 Category: Neurology Authors: Rebekka Kurmann, Stefan T. Engelter, Patrik Michel, Andreas R. Luft, Susanne Wegener, Meret Branscheidt, Elissavet Eskioglou, Gaia Sirimarco, Philippe A. Lyrer, Henrik Gensicke, Thomas Horvath, Urs Fischer, Marcel Arnold, Hakan Sarikaya Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions 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

Evolution of a US County System for Acute Comprehensive Stroke Care Clinical Sciences
We examined relationships between stroke details, reperfusion therapies, hospital transfers, and their change over time.Methods—All patients from January 1, 2013, to December 31, 2015, for whom 911 was called within 7 hours of onset in whom Emergency Medical Services personnel suspected acute stroke were evaluated.Results—Among 6132 patients, 3924 (64%) had confirmed diagnosis of stroke (74% ischemic/26% hemorrhagic), yielding diagnostic precision of 64% in the field. Of the 2892 patients with acute ischemic stroke, acute reperfusion therapy was given to 29.2% (21.7% intravenous tPA [tissue-type plasminogen activator] ...
Source: Stroke - April 23, 2018 Category: Neurology Authors: Radoslav I. Raychev, Dana Stradling, Nirav Patel, Joey R. Gee, David A. Lombardi, Johnson L. Moon, David M. Brown, Mayank Pathak, Wengui Yu, Samuel J. Stratton, Steven C. Cramer Tags: Cerebrovascular Disease/Stroke, Cerebrovascular Procedures, Ischemic Stroke Original Contributions Source Type: research

Human Neural Stem Cell Extracellular Vesicles Improve Recovery in a Porcine Model of Ischemic Stroke Basic Sciences
Conclusions—This study demonstrated for the first time that in a large animal model novel NSC EVs significantly improved neural tissue preservation and functional levels post-MCAO, suggesting NSC EVs may be a paradigm changing stroke therapeutic.
Source: Stroke - April 23, 2018 Category: Neurology Authors: Robin L. Webb, Erin E. Kaiser, Brian J. Jurgielewicz, Samantha Spellicy, Shelley L. Scoville, Tyler A. Thompson, Raymond L. Swetenburg, David C. Hess, Franklin D. West, Steven L. Stice Tags: Animal Models of Human Disease, Basic Science Research, Translational Studies, Treatment, Ischemic Stroke Original Contributions Source Type: research

Smoking and Risk of Ischemic Stroke in Young Men Brief Report
We examined the dose–response relationship between the quantity of cigarettes smoked and the odds of developing an ischemic stroke in men under age 50 years.Methods—The Stroke Prevention in Young Men Study is a population-based case–control study of risk factors for ischemic stroke in men ages 15 to 49 years. The χ2 test was used to test categorical comparisons. Logistic regression models were used to calculate the odds ratio for ischemic stroke occurrence comparing current and former smokers to never smokers. In the first model, we adjusted solely for age. In the second model, we adjusted for potential confounding ...
Source: Stroke - April 23, 2018 Category: Neurology Authors: Janina Markidan, John W. Cole, Carolyn A. Cronin, Jose G. Merino, Michael S. Phipps, Marcella A. Wozniak, Steven J. Kittner Tags: Epidemiology, Primary Prevention, Risk Factors, Secondary Prevention, Ischemic Stroke Brief Reports Source Type: research

Association of Cancer Cell Type and Extracellular Vesicles With Coagulopathy in Patients With Lung Cancer and Stroke Brief Report
Conclusions—Our findings indicate that cancer cell type is associated with circulating EV levels and coagulopathy in patients with lung cancer and stroke.
Source: Stroke - April 23, 2018 Category: Neurology Authors: Jong-Won Chung, Yeon Hee Cho, Myung-Ju Ahn, Mi Ji Lee, Gyeong-Moon Kim, Chin-Sang Chung, Oh Young Bang Tags: Biomarkers, Mechanisms, Translational Studies, Cerebrovascular Disease/Stroke, Thrombosis Brief Reports Source Type: research

Distribution and Temporal Trends From 1993 to 2015 of Ischemic Stroke Subtypes Clinical Sciences
Background and Purpose—Preventive strategies, together with demographic and socioeconomic changes, might have modified the worldwide distribution of ischemic stroke (IS) subtypes. We investigated those changes by means of a systematic review and meta-analysis.Methods—We evaluated all population- and hospital-based studies reporting the distribution of IS etiologic subtypes according to the TOAST criteria (Trial of ORG 10172 in Acute Stroke Treatment). Studies were identified by searching articles indexed on PubMed and Scopus from January 1, 1993, to June 30, 2017. Two independent investigators extracted data and checke...
Source: Stroke - March 26, 2018 Category: Neurology Authors: Raffaele Ornello, Diana Degan, Cindy Tiseo, Caterina Di Carmine, Laura Perciballi, Francesca Pistoia, Antonio Carolei, Simona Sacco Tags: Epidemiology, Race and Ethnicity, Meta Analysis, Ischemic Stroke Original Contributions Source Type: research

Association Between Onset-to-Door Time and Clinical Outcomes After Ischemic Stroke Clinical Sciences
Conclusions—Early hospital arrival within 6 hours after stroke onset is associated with favorable outcomes after ischemic stroke, regardless of reperfusion treatment or stroke severity.
Source: Stroke - October 23, 2017 Category: Neurology Authors: Ryu Matsuo, Yuko Yamaguchi, Tomonaga Matsushita, Jun Hata, Fumi Kiyuna, Kenȷi Fukuda, Yoshinobu Wakisaka, Junya Kuroda, Tetsuro Ago, Takanari Kitazono, Masahiro Kamouchi, on behalf of the Fukuoka Stroke Registry Investigators† Tags: Ischemic Stroke Original Contributions Source Type: research

Characteristics and Outcomes of Very Elderly Enrolled in a Prehospital Stroke Research Study Clinical Sciences
Conclusions— Inclusion of the very elderly population in acute stroke clinical trials would both significantly increase study participation and generalizability of future acute stroke clinical trials. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00059332.
Source: Stroke - October 24, 2016 Category: Neurology Authors: Sanossian, N., Apibunyopas, K. C., Liebeskind, D. S., Starkman, S., Burgos, A. M., Conwit, R., Eckstein, M., Pratt, F., Stratton, S., Hamilton, S., Saver, J. L., FAST-MAG (Field Administration of Stroke Therapy-Magnesium) Investigators and Coordinators Tags: Cerebrovascular Disease/Stroke, Neuroprotectants Clinical Sciences Source Type: research

Underutilization of Ambulatory ECG Monitoring After Stroke and Transient Ischemic Attack: Missed Opportunities for Atrial Fibrillation Detection Clinical Sciences
Conclusions— Less than one third of patients in our cohort received guideline-recommended 24-hour Holter monitoring, and <1% received prolonged ambulatory ECG monitoring. These findings highlight a modifiable evidence-practice gap that likely contributes to an overdiagnosis of strokes as cryptogenic, an underdiagnosis of atrial fibrillation, and missed anticoagulant treatment opportunities for secondary stroke prevention.
Source: Stroke - July 25, 2016 Category: Neurology Authors: Edwards, J. D., Kapral, M. K., Fang, J., Saposnik, G., Gladstone, D. J., Investigators of the Registry of the Canadian Stroke Network Tags: Atrial Fibrillation, Secondary Prevention, Electrocardiology (ECG), Ischemic Stroke, Transient Ischemic Attack (TIA) Clinical Sciences Source Type: research

Smoking-Thrombolysis Relationship Depends on Ischemic Stroke Subtype Clinical Sciences
Conclusions— In patients treated with intravenous thrombolysis, smoking could be related to a better chance of functional independence if their subtype of stroke was noncardioembolic, and a lower risk of symptomatic intracranial hemorrhage and mortality in those with large artery atherosclerosis.
Source: Stroke - June 27, 2016 Category: Neurology Authors: Tong, X., Wang, C., Liao, X., Pan, Y., Yan, H., Cao, Y., Liu, L., Zheng, H., Zhao, X., Wang, C., Li, H., Wang, D., Wang, Y., Wang, Y., on behalf of the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China (TIMS-China) Investigators* Tags: Clinical Studies, Risk Factors, Pharmacology, Treatment, Ischemic Stroke Clinical Sciences Source Type: research

Arterial Tortuosity: An Imaging Biomarker of Childhood Stroke Pathogenesis? Clinical Sciences
Conclusions— In children with dissection and transient cerebral arteriopathy, cerebral arteries demonstrate increased tortuosity. Quantified arterial tortuosity may represent a clinically relevant imaging biomarker of vascular biology in pediatric stroke.
Source: Stroke - April 25, 2016 Category: Neurology Authors: Wei, F., Diedrich, K. T., Fullerton, H. J., deVeber, G., Wintermark, M., Hodge, J., Kirton, A., the Vascular Effects of Infection in Pediatric Stroke (VIPS) Investigators, Dowling, Benedict, Bernard, Fox, Friedman, Lo, Ichord, Tan, Mackay, Hernandez, Hump Tags: Risk Factors, Angiography, Magnetic Resonance Imaging (MRI), Ischemic Stroke, Vascular Disease Clinical Sciences Source Type: research

Ischemic Stroke Risk in Patients With Atrial Fibrillation and CHA2DS2-VASc Score of 1: Systematic Review and Meta-Analysis Brief Reports
Conclusions— Our meta-analysis of ischemic stroke risk in atrial fibrillation patients suggests that those with CHA2DS2-VASc score of 1 may be considered for a novel oral anticoagulant, but because of high heterogeneity, the decision should be based on individual patient characteristics.
Source: Stroke - April 25, 2016 Category: Neurology Authors: Joundi, R. A., Cipriano, L. E., Sposato, L. A., Saposnik, G., on behalf of the Stroke Outcomes Research Working Group Tags: Atrial Fibrillation, Meta Analysis, Ischemic Stroke Brief Reports Source Type: research

Use of Warfarin at Discharge Among Acute Ischemic Stroke Patients With Nonvalvular Atrial Fibrillation in China Clinical Sciences
Conclusions— The rate of warfarin use remains low among patients with ischemic stroke and known nonvalvular atrial fibrillation in China. Hospital size and academic status together with patient age, heart failure, heavy alcohol drinking, international normalized ratio in hospital, and stroke severity on admission were each independently associated with the use of warfarin at discharge. There is much room for improvement for secondary stroke prevention in nonvalvular atrial fibrillation patients in China.
Source: Stroke - January 25, 2016 Category: Neurology Authors: Yang, X., Li, Z., Zhao, X., Wang, C., Liu, L., Wang, C., Pan, Y., Li, H., Wang, D., Hart, R. G., Wang, Y., Wang, Y., on behalf of the China National Stroke Registry II Investigators Tags: Anticoagulants, Treatment, Quality and Outcomes, Ischemic Stroke Clinical Sciences Source Type: research

Enrollment Yield and Reasons for Screen Failure in a Large Prehospital Stroke Trial Brief Reports
Conclusions— In this large, multicenter prehospital trial, nearly 40% of every calls from the field to physician-investigators resulted in trial enrollments. The most common reasons for nonenrollment were out of window last known well time, prestroke confounding medical condition, and absence of a consent provider. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00059332.
Source: Stroke - December 28, 2015 Category: Neurology Authors: Kim, D.-H., Saver, J. L., Starkman, S., Liebeskind, D. S., Ali, L. K., Restrepo, L., Kim-Tenser, M., Valdes-Sueiras, M., Eckstein, M., Pratt, F., Stratton, S., Hamilton, S., Conwit, R., Sanossian, N., on behalf of the Field Administration of Stroke Therap Tags: Cardiopulmonary Resuscitation and Emergency Cardiac Care, Cerebrovascular Disease/Stroke, Intracranial Hemorrhage, Ischemic Stroke, Neuroprotectants Brief Reports Source Type: research

Mechanical Thrombectomy in and Outside the REVASCAT Trial: Insights From a Concurrent Population-Based Stroke Registry Clinical Sciences
Conclusions— REVASCAT enrolled nearly all eligible patients representing one third of all patients treated with EVT. Patients treated with EVT within and outside REVASCAT had similar outcomes, reinforcing the therapeutic value of EVT. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01692379.
Source: Stroke - November 23, 2015 Category: Neurology Authors: Urra, X., Abilleira, S., Dorado, L., Ribo, M., Cardona, P., Millan, M., Chamorro, A., Molina, C., Cobo, E., Davalos, A., Jovin, T. G., Gallofre, M., Catalan Stroke Code and Reperfusion Consortium, Catalan Stroke Code and Reperfusion Consortium Stroke Prog Tags: Cardiopulmonary Resuscitation and Emergency Cardiac Care, Treatment, Cerebrovascular Disease/Stroke, Cerebrovascular Procedures, Ischemic Stroke Clinical Sciences Source Type: research

Differential Effect of Baseline Computed Tomographic Angiography Collaterals on Clinical Outcome in Patients Enrolled in the Interventional Management of Stroke III Trial Clinical Sciences
Conclusion— Using data from a large randomized controlled trial (IMS III), we show that baseline computed tomographic angiography collaterals are a robust determinant of final clinical outcome and could be used to select patients for endovascular therapy. Clinical Trial Registration— URL: http://www.clinicaltrials.gov/ct2/show/. Unique identifier: 0020NCT00359424.
Source: Stroke - April 27, 2015 Category: Neurology Authors: Menon, B. K., Qazi, E., Nambiar, V., Foster, L. D., Yeatts, S. D., Liebeskind, D., Jovin, T. G., Goyal, M., Hill, M. D., Tomsick, T. A., Broderick, J. P., Demchuk, A. M., for the Interventional Management of Stroke III Investigators Tags: Acute Cerebral Infarction, Emergency treatment of Stroke, Computerized tomography and Magnetic Resonance Imaging Clinical Sciences Source Type: research

Implementing a Simple Care Bundle Is Associated With Improved Outcomes in a National Cohort of Patients With Ischemic Stroke Clinical Sciences
Conclusions— Achieving a care bundle for ischemic stroke is associated with reduced mortality at 30 days and 6 months and increased likelihood of discharge to usual residence at 6 months.
Source: Stroke - March 23, 2015 Category: Neurology Authors: Turner, M., Barber, M., Dodds, H., Murphy, D., Dennis, M., Langhorne, P., Macleod, M.-J., on behalf of the Scottish Stroke Care Audit Tags: Acute Cerebral Infarction, Emergency treatment of Stroke, Other Stroke Treatment - Medical Clinical Sciences Source Type: research

Effects of Stroke Education of Junior High School Students on Stroke Knowledge of Their Parents: Tochigi Project Brief Reports
Conclusions— Improvement of stroke knowledge immediately after the stroke lesson was observed in parents as well as their children, which indicated that our teaching materials using the Manga was effective in delivering the stroke knowledge to parents through their children.
Source: Stroke - January 26, 2015 Category: Neurology Authors: Matsuzono, K., Yokota, C., Takekawa, H., Okamura, T., Miyamatsu, N., Nakayama, H., Nishimura, K., Ohyama, S., Ishigami, A., Okumura, K., Toyoda, K., Miyamoto, Y., Minematsu, K., on behalf of the Tochigi Junior High School Stroke Education Group, Participa Tags: Behavioral Changes and Stroke Brief Reports Source Type: research

Phase II Trial of the Sigma-1 Receptor Agonist Cutamesine (SA4503) for Recovery Enhancement After Acute Ischemic Stroke Clinical Sciences
Conclusions— Cutamesine was safe and well tolerated at both dosage levels. Although no significant effects on functional end points were seen in the population as a whole, greater improvement in National Institutes of Health Stroke Scale scores among patients with greater pretreatment deficits seen in post hoc analysis warrants further investigation. Additional studies should focus on the patient population with moderate-to-severe stroke. Clinical Trial Registration— URL: http://www.clinicaltrials.gov/show/NCT00639249. Unique identifier: NCT00639249. The EudraCT number is 2007-004840-60 (https://www.clinicaltr...
Source: Stroke - October 27, 2014 Category: Neurology Authors: Urfer, R., Moebius, H. J., Skoloudik, D., Santamarina, E., Sato, W., Mita, S., Muir, K. W., for the Cutamesine Stroke Recovery Study Group Tags: Other Stroke Treatment - Medical Clinical Sciences Source Type: research

Blood Pressure-Lowering Treatment With Candesartan in Patients With Acute Hemorrhagic Stroke Brief Reports
Conclusions— There was no evidence that blood pressure–lowering treatment with candesartan is beneficial during the first week of hemorrhagic stroke. Instead, there were signs that such treatment may be harmful, but this needs to be verified in larger studies. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00120003.
Source: Stroke - October 27, 2014 Category: Neurology Authors: Jusufovic, M., Sandset, E. C., Bath, P. M. W., Berge, E., on behalf of the Scandinavian Candesartan Acute Stroke Trial Study Group Tags: Cerebrovascular disease/stroke, Acute Cerebral Hemorrhage, Other Stroke Treatment - Medical Brief Reports Source Type: research

Geomagnetic Storms Can Trigger Stroke: Evidence From 6 Large Population-Based Studies in Europe and Australasia Clinical Sciences
Conclusions— Geomagnetic storms are associated with increased risk of stroke and should be considered along with other established risk factors. Our findings provide a framework to advance stroke prevention through future investigation of the contribution of geomagnetic factors to the risk of stroke occurrence and pathogenesis.
Source: Stroke - May 27, 2014 Category: Neurology Authors: Feigin, V. L., Parmar, P. G., Barker-Collo, S., Bennett, D. A., Anderson, C. S., Thrift, A. G., Stegmayr, B., Rothwell, P. M., Giroud, M., Bejot, Y., Carvil, P., Krishnamurthi, R., Kasabov, N., for the International Stroke Incidence Studies Data Pooling P Tags: Behavioral/psychosocial - stroke Clinical Sciences Source Type: research

Impaired Glucose Regulation Predicted 1-Year Mortality of Chinese Patients With Ischemic Stroke: Data From Abnormal Glucose Regulation in Patients With Acute Stroke Across China Brief Reports
Conclusions— IGR was an independent predictor for the mortality of patients with ischemic stroke. IGR should be highlighted and intervened actively in the patients with ischemic stroke.
Source: Stroke - April 28, 2014 Category: Neurology Authors: Jia, Q., Liu, G., Zheng, H., Zhao, X., Wang, C., Wang, Y., Liu, L., Wang, Y., on behalf of the Investigators for the Survey on Abnormal Glucose Regulation in Patients With Acute Stroke Across China Tags: Cerebrovascular disease/stroke, Glucose intolerance, Risk Factors for Stroke Brief Reports Source Type: research