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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

Mechanical thrombectomy for ischaemic stroke in the anterior circulation: off-hours effect
ConclusionOur study did not show worse outcomes in patients treated at off-hours. This result suggests that the off-hours effect reported in other studies can be minimized by a coordinated organisation of stroke care providing similar levels of care at off-hours.
Source: Journal of Neurology - May 27, 2020 Category: Neurology Source Type: research

Sonography of optic nerve sheath diameter identifies patients with middle cerebral artery infarction at risk of a malignant course: a pilot prospective observational study
ConclusionsONSD measurement might be accurate for the noninvasive detection of increased ICP and for the recognition of patients being likely to develop mMCA.
Source: Journal of Neurology - May 21, 2020 Category: Neurology Source Type: research

Posterior circulation stroke: machine learning-based detection of early ischemic changes in acute non-contrast CT scans
ConclusionsQuantitative features of early hyperacute NCCTs can be used to detect early ischemic changes in pc-ASPECTS regions. The classifier performance was higher or equal to results of human raters. The proposed approach could facilitate reproducible analysis in research and may allow standardized assessments for outcome prediction and therapy planning in clinical routine.
Source: Journal of Neurology - May 10, 2020 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

Clinical feasibility of 1-min ultrafast brain MRI compared with routine brain MRI using synthetic MRI: a single center pilot study
ConclusionsAlthough the overall image quality and anatomical delineation of the 1-min ultrafast MRI were inferior to those of the routine brain MRI protocol, the ultrafast protocol showed at least sufficient image quality. Therefore, this protocol may be an option in specific clinical situations involving non-cooperative, restless, or pediatric patients, or patients with time-critical disease such as stroke. Further study is required to validate our findings.
Source: Journal of Neurology - December 7, 2018 Category: Neurology Source Type: research

Crossed aphasia following cerebral infarction in a right-handed patient with atypical cerebral language dominance
ConclusionThe findings suggest that the patient has right-sided cerebral language dominance, or that both hemispheres have linguistic functions. Not all patients show linguistic capabilities on the side opposite hand preference. The language dominance should be predicted by a combination of clinical manifestations and functional imaging techniques.
Source: Journal of Neurology - May 18, 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

The impact of cerebral microbleeds on intracerebral hemorrhage and poor functional outcome of acute ischemic stroke patients treated with intravenous thrombolysis: a systematic review and meta-analysis
AbstractIt is still controversial whether pre-existing cerebral microbleeds (CMBs) increase the risks of intracranial hemorrhage (ICH) and poor functional outcome (PFO) in acute ischemic stroke (AIS) patients treated with intravenous thrombolysis (IVT). Therefore, we performed a systematic review and meta-analysis to determine the impact of CMBs on ICH and PFO of AIS patients with IVT. We searched PubMed, EMBASE and Web of Science from inception to August 3, 2016, with language restriction in English. We included studies that reported the relationship between CMBs and ICH or PFO after thrombolysis. Two retrospective and ni...
Source: Journal of Neurology - July 1, 2017 Category: Neurology Source Type: research

Primary intraventricular hemorrhage in adults: etiological causes and prognostic factors in Chinese population
AbstractPrimary intraventricular hemorrhage (PIVH) is a rare type of hemorrhagic stroke that is poorly understood. We aimed to explore the features of this disease in Chinese population via an institutional prospective study. Adult patients diagnosed with PIVH from January 2013 to January 2016 were enrolled in this study. Data, including clinical variables, radiological features, and yield of angiography, were collected to evaluate the clinical features, etiological causes, and prognostic factors of this disease. A total of 67 patients (73.6%) were diagnosed with PIVH which constituted 3.2% of contemporary patients with he...
Source: Journal of Neurology - December 19, 2016 Category: Neurology Source Type: research

Screening tests for aphasia in patients with stroke: a systematic review
Abstract Aphasia has a large impact on the quality of life and adds significantly to the costs of stroke care. Early recognition of aphasia in stroke patients is important for prognostication and well-timed treatment planning. We aimed to identify available screening tests for differentiating between aphasic and non-aphasic stroke patients, and to evaluate test accuracy, reliability, and feasibility. We searched PubMed, EMbase, Web of Science, and PsycINFO for published studies on screening tests aimed at assessing aphasia in stroke patients. The reference lists of the selected articles were scanned, and several e...
Source: Journal of Neurology - June 2, 2016 Category: Neurology Source Type: research

Impaired renal function is related to deep and mixed, but not strictly lobar cerebral microbleeds in patients with ischaemic stroke and TIA
Abstract The vasculature of the brain and kidneys are similarly vulnerable to hypertension, so their microvascular damage may be correlated. We investigated the relationship of renal function to the anatomical distribution of cerebral microbleeds (CMBs), a marker of underlying cerebral small vessel disease (hypertensive arteriopathy or cerebral amyloid angiopathy), in a Western patient cohort. This was a retrospective study of referrals to a hospital stroke service. All patients with clinical data and a T2*-weighted gradient-recalled echo (T2*-GRE) MRI were included. MRI scans were rated for CMBs using the Microbl...
Source: Journal of Neurology - February 17, 2016 Category: Neurology Source Type: research

Factors associated with post-stroke depression and fatigue: lesion location and coping styles
Abstract Post-stroke depression (PSD) and post-stroke fatigue (PSF) are frequent and persistent problems among stroke survivors. Therefore, awareness of signs and symptoms of PSD and PSF is important for their treatment and recovery from stroke. Additionally, since sudden serious illness can result in disequilibrium, early institution of a coping process is essential to restoring stability. The brain damage of stroke leaves patients with unique physical and mental dysfunctions for which coping maybe a key resource while rebuilding lives. We evaluated 368 consecutive patients with acute ischemic stroke for post-str...
Source: Journal of Neurology - November 14, 2015 Category: Neurology Source Type: research

A multimodal neuroimaging study of a case of crossed nonfluent/agrammatic primary progressive aphasia
We report a case of crossed nfvPPA followed longitudinally and studied with advanced neuroimaging techniques. The results highlight a complex interaction between individual premorbid developmental differences and the clinical phenotype.
Source: Journal of Neurology - July 20, 2015 Category: Neurology Source Type: research