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Early blood pressure management in hemorrhagic stroke: a meta-analysis
AbstractThe aim of the present meta-analysis was to evaluate the outcomes and effects of different systolic blood pressure (SBP) lowering in patients with hemorrhagic stroke using data from randomized controlled trials. A total of 2592 records were identified for this meta-analysis. We finally included 8 studies (6119 patients; mean age 62.8  ± 13.0, 62.7% men). No evidence of heterogeneity between estimates (I2 = 0% <  50%,P = 0.26), or publication bias in the funnel plots (P = 0.065, Egger statistical test) was detected. Death or major disability rates were similar between patients with intensive ...
Source: Journal of Neurology - March 8, 2023 Category: Neurology Source Type: research

Psychological impact of COVID-19 containment on CADASIL patients
ConclusionPsychological impact of the containment was limited in CADASIL patients and did not appear related to the disease status. About 9% of patients presented with significant posttraumatic and stressor-related disorder manifestations which were predicted by living alone, unemployment, or exhaustion related to parental burden.
Source: Journal of Neurology - March 4, 2023 Category: Neurology Source Type: research

Clinical and neuroimaging risk factors associated with the development of intracerebral hemorrhage while taking direct oral anticoagulants
ConclusionsRisk factors including diabetes, prior stroke, and smoking history as well as MRI biomarkers including CMBs and cSS are associated with ICH in DOAC users. Although screening MRIs are not typically performed prior to initiating DOAC therapy, these data suggest that patients of high-hemorrhagic risk may be identified.
Source: Journal of Neurology - October 31, 2022 Category: Neurology Source Type: research

Neuroimmune disorders in COVID-19
AbstractSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the aetiologic agent of the coronavirus disease 2019 (COVID-19), is now rapidly disseminating throughout the world with 147,443,848 cases reported so far. Around 30 –80% of cases (depending on COVID-19 severity) are reported to have neurological manifestations including anosmia, stroke, and encephalopathy. In addition, some patients have recognised autoimmune neurological disorders, including both central (limbic and brainstem encephalitis, acute disseminated encephalomyelitis [ADEM], and myelitis) and peripheral diseases (Guillain–Barré and Miller ...
Source: Journal of Neurology - May 20, 2022 Category: Neurology Source Type: research

Time trends in stroke severity in the years 2005 to 2020: results from the Austrian Stroke Unit Registry
ConclusionDespite an aging population and generally increasing AF frequency, we observed a consistent trend towards less disabling strokes on admission.
Source: Journal of Neurology - March 21, 2022 Category: Neurology Source Type: research

Delirium on stroke units: a prospective, multicentric quality-improvement project
ConclusionsImplementation of delirium-management on SU is feasible and can be delivered to most patients, but with limited effects. Nursing interventions as first choice could be delivered to the majority of patients, and only the half required pharmacological treatments. Delirium-management may lead to reduced severity of POD but had only partial effects on duration of POD or length of stay. POD hampers rehabilitation, especially in patients with more severe stroke.RegistryDRKS, DRKS00021436. Registered 04/17/2020,www.drks.de/DRKS00021436.
Source: Journal of Neurology - February 14, 2022 Category: Neurology Source Type: research

Premorbid frailty predicts short- and long-term outcomes of reperfusion treatment in acute stroke
DiscussionFrailty is an important predictor of efficacy of acute treatment of stroke beyond classical predictors of stroke outcomes. Larger longitudinal studies are, thus, warranted to evaluate the risk –benefit of reperfusion treatment in the growing elderly frail population.
Source: Journal of Neurology - January 17, 2022 Category: Neurology Source Type: research

Incidence, prevalence and disability associated with neurological disorders in Italy between 1990 and 2019: an analysis based on the Global Burden of Disease Study 2019
ConclusionsThe increase in YLDs associated with neurological conditions is mostly due to population ageing and growth: nevertheless, lived disability and, as a consequence, impact on health systems has increased. Actions are needed to improve outcome and mitigate disability associated with neurological conditions, spanning among diagnosis, treatment, care pathways and workplace interventions.
Source: Journal of Neurology - September 8, 2021 Category: Neurology Source Type: research

Stroke care in Italy at the time of the COVID-19 pandemic: a lesson to learn
AbstractFrom March to May 2020, the Italian health care system, as many others, was almost entirely devoted to the fight against the COVID-19 pandemic. In this context, a number of questions arose, from the increased stroke risk due to COVID-19 infection to the quality of stroke patient care. The overwhelming need of COVID-19 patient management made mandatory a complete re-organization of the stroke pathways: many health professionals were reallocated and a number of stroke units was turned into COVID-19 wards. As a result, acute stroke care suffered from a shortage of services and delays in time-dependent treatments and d...
Source: Journal of Neurology - June 21, 2021 Category: Neurology Source Type: research

Sex-specific differences in presentations and determinants of outcomes after endovascular thrombectomy for large vessel occlusion stroke
ConclusionIn a real-world analysis of ELVO stroke patients treated with EVT, we found that despite advanced age and more pre-stroke disability, women have comparable reperfusion rates and functional outcomes compared to men. Sex-specific determinants of reperfusion and functional outcome were identified that require further study.
Source: Journal of Neurology - May 29, 2021 Category: Neurology Source Type: research

Stroke-unit care for stroke patients in China: the results from Bigdata Observatory platform for Stroke of China
ConclusionsAmong patients with stroke, admission to a designated SU was associated with modestly lower mortality at discharge, reduced probability of death, or being disabled at the end of follow-up.
Source: Journal of Neurology - April 22, 2021 Category: Neurology Source Type: research

Early apixaban therapy after ischemic stroke in patients with atrial fibrillation
ConclusionsSymptomatic HT rates are likely to be low in randomized trials of DOAC initiation post-stroke. Recurrent ischemic stroke may be the major clinical outcome. These data may be used as expected event rates when calculating sample size requirements for future safety/efficacy trials of early versus late DOAC initiation after AF-related stroke.
Source: Journal of Neurology - January 3, 2021 Category: Neurology Source Type: research

Inter-hospital transfer for mechanical thrombectomy within the supraregional stroke network NEVAS
ConclusionWithin a telemedicine network stroke care can successfully be organized as only a minority of patients has to be transferred. Our data provide clinical evidence that all MT-eligible patients should be shipped with the fastest transportation modality as possible.
Source: Journal of Neurology - September 4, 2020 Category: Neurology Source Type: research

Platelet function/reactivity testing and prediction of risk of recurrent vascular events and outcomes after TIA or ischaemic stroke: systematic review and meta-analysis
DiscussionAntiplatelet –HTPR may predict risks of recurrent vascular events/outcomes in CVD patients. Given the heterogeneity between studies, further prospective, multi-centre studies are warranted.
Source: Journal of Neurology - June 8, 2020 Category: Neurology Source Type: research

A parsimonious score with a free web tool for predicting disability after an ischemic stroke: the Parsifal Score
ConclusionsThe Parsifal Score is a model that predicts disability at the third month, with only five variables, with good discrimination and calibration, and being replicated in an independent cohort.
Source: Journal of Neurology - May 25, 2020 Category: Neurology Source Type: research

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