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Diffusion-weighted Imaging–Fluid Attenuated Inversion Recovery Mismatch in Nocturnal Stroke Patients with Unknown Time of Onset
Background: More than a quarter of patients with ischemic stroke (IS) are excluded from thrombolysis because of an unknown time of symptom onset. Recent evidence suggests that a mismatch between diffusion-weighted imaging (DWI) and fluid attenuated inversion recovery (FLAIR) imaging could be used as a surrogate for the time of stroke onset. We compared used the DWI–FLAIR mismatch and the FLAIR/DWI ratio to estimate the time of onset in a group of patients with nocturnal strokes and unknown time of onset.Methods: We used a prospectively collected acute IS patient database with MRI as the initial imaging modality. Nineteen...
Source: Journal of Stroke and Cerebrovascular Diseases - February 13, 2012 Category: Neurology Authors: Branko N. Huisa, David S. Liebeskind, Rema Raman, Qing Hao, Brett C. Meyer, Dawn M. Meyer, Thomas M. Hemmen, University of California, Los Angeles Stroke Investigators Tags: Original Articles Source Type: research

Blood Pressure Control among Stroke Patients in Thailand—The i-STROKE Study
Background: Direct correlation between stroke mortality and hypertension calls for a tight blood pressure (BP) control. Our study determined the prevalence of the BP control and evaluated current clinical practices on hypertension management in stroke patients in Thailand.Methods: This multicenter, cross-sectional, retrospective, observational study was carried out between February 2010 and January 2011 and enrolled stroke patients aged 45 years or older with ictus incidence 12,030 days before the enrollment. The events were confirmed by either computerized tomography scan or magnetic resonance imaging. Patient data incl...
Source: Journal of Stroke and Cerebrovascular Diseases - June 24, 2013 Category: Neurology Authors: Samart Nidhinandana, Disya Ratanakorn, Nijasri Charnnarong, Sombat Muengtaweepongsa, Somchai Towanabut, i-STROKE Investigators Tags: Original Articles Source Type: research

Body Mass Index and Stroke: Overweight and Obesity Less Often Associated with Stroke Recurrence
Background: Although obesity is associated with excess mortality and morbidity, mortality is lower in obese than in normal weight stroke patients (the obesity paradox). Studies now indicate that obesity is not associated with increased risk of recurrent stroke in the years after first stroke. We studied the association between body mass index (BMI) and stroke patient's risk of having a history of previous stroke (recurrent stroke).Methods: A registry designed to collect data on all hospitalized stroke patients in Denmark 2000-2010 includes 61,872 acute stroke patients with information on BMI in 38,506. Data include age, se...
Source: Journal of Stroke and Cerebrovascular Diseases - July 22, 2013 Category: Neurology Authors: Klaus Kaae Andersen, Tom Skyhøj Olsen Tags: Original Articles Source Type: research

Cause-specific Mortality after Stroke: Relation to Age, Sex, Stroke Severity, and Risk Factors in a 10-Year Follow-up Study
We investigated cause-specific mortality in relation to age, sex, stroke severity, and cardiovascular risk factor profile in the Copenhagen Stroke Study cohort with 10 years of follow-up. In a Copenhagen community, all patients admitted to the hospital with stroke during 1992-1993 (n = 988) were registered on admission. Evaluation included stroke severity, computed tomography scan, and a cardiovascular risk profile. Cause of death within 10 years according to death certificate information was classified as stroke, heart/arterial disease, or nonvascular disease. Competing-risks analyses were performed by cause-specific Co...
Source: Journal of Stroke and Cerebrovascular Diseases - May 14, 2012 Category: Neurology Authors: Ulla Brasch Mogensen, Tom Skyhøj Olsen, Klaus Kaae Andersen, Thomas Alexander Gerds Tags: Original Articles Source Type: research

Conditions that Mimic Stroke in Elderly Patients Admitted to the Emergency Department
Conclusions: In older patients, stroke-mimicking conditions can cause signs and symptoms indistinguishable from true stroke, representing about 12.7% of elderly patients admitted to an ED with these diagnoses.
Source: Journal of Stroke and Cerebrovascular Diseases - July 8, 2013 Category: Neurology Authors: Ataman Kose, Taylan Inal, Erol Armagan, Ramazan Kıyak, Aylin B. Demir Tags: Original Articles Source Type: research

Effect of Middle Cerebral Artery Territory Ischemic Stroke on QT Interval
In this study, we investigated whether QT interval dynamics is different in patients with right and left middle cerebral artery (MCA) territory stroke.Method: Electrocardiogram (ECG) intervals were compared between baseline (retrieved retrospectively from medical records) and admission (acquired at the acute hospital admission) in 33 patients (65 ± 9.5 years) with right or left MCA territory ischemic stroke. Head computed tomography (CT), cardiac ultrasound, and cardiac CT scans were undertaken.Results: Stroke was located in the right MCA territory in 21 (64%) and in the left MCA territory in 12 (36%) patients. Patients w...
Source: Journal of Stroke and Cerebrovascular Diseases - September 16, 2013 Category: Neurology Authors: Sakari Simula, Antti T. Muuronen, Mikko Taina, Pekka Jäkälä, Petri Sipola, Ritva Vanninen, Marja Hedman Tags: Original Articles Source Type: research

Wake-up Stroke Within 3 Hours of Symptom Awareness: Imaging and Clinical Features Compared to Standard Recombinant Tissue Plasminogen Activator Treated Stroke
Background: Patients with wake-up stroke (WUS) are excluded from thrombolysis because of unknown time of symptom onset. Previous studies have reported similar stroke severity and early ischemic changes (EICs) in patients with WUS and stroke of known onset. These studies, however, included patients within a large timeframe to imaging or did not quantify EICs. The aim of our study was to quantify EICs of patients with WUS presenting within 3 hours of symptom recognition compared to standard 3-hours recombinant tissue plasminogen activator (rt-PA)–treated patients and assess the extent of ischemic lesion and functional ind...
Source: Journal of Stroke and Cerebrovascular Diseases - December 1, 2011 Category: Neurology Authors: Luisa Roveri, Sara La Gioia, Chiara Ghidinelli, Nicoletta Anzalone, Costantino De Filippis, Giancarlo Comi Tags: Original Articles Source Type: research

Acute Kidney Injury Is Associated with Increased Hospital Mortality after Stroke
Conclusions: AKI occurs frequently after stroke and is associated with increased hospital mortality. Additional studies are needed to establish if the association is causal and if measures to prevent AKI would result in decreased mortality.
Source: Journal of Stroke and Cerebrovascular Diseases - July 23, 2012 Category: Neurology Authors: Minesh Khatri, Jonathan Himmelfarb, Derk Adams, Kyra Becker, W.T. Longstreth, David L. Tirschwell Tags: Original Articles Source Type: research

Hospital Prenotification of Stroke Patients by Emergency Medical Services Improves Stroke Time Targets
Background: Prenotification to hospitals by emergency medical services of patients with suspected stroke is recommended to reduce delays in time-dependent therapies. We hypothesized that hospital prenotification would reduce recommended stroke time targets.Methods: We used the Robert Wood Johnson University Hospital (RWJUH) Brain Attack Database, which includes demographic and clinical data on all emergency department (ED) patients alerted as a Brain Attack between January 1, 2009 and June 30, 2010. Outcome variables included the time from door to stroke team arrival, computed tomographic (CT) scan completion, CT scan inte...
Source: Journal of Stroke and Cerebrovascular Diseases - August 8, 2011 Category: Neurology Authors: James S. McKinney, Krishna Mylavarapu, Judith Lane, Virginia Roberts, Pamela Ohman-Strickland, Mark A. Merlin Tags: Original Articles Source Type: research

Discrimination of Acute Ischemic Stroke from Nonischemic Vertigo in Patients Presenting with Only Imbalance
We examined 332 consecutive patients with an acute feeling of imbalance who showed no neurologic findings or responsible lesions on CT scan at the hyperacute phase. We examined their clinical backgrounds, physical findings, and laboratory examinations, with ischemic stroke diagnosed by later CT and/or magnetic resonance imaging (MRI). We identified 41 (12.3%) ischemic stroke patients. Atrial fibrillation (odds ratio 4.1; 95% confidence interval 1.4-11.5), white blood cell count (103/μL, 1.4; 1.2-1.6), head and/or neck pain (4.6; 2.1-10.3), first attack of imbalance feeling (3.3; 1.1-12.2), and dizziness (3.7; 1.7-8.3) wer...
Source: Journal of Stroke and Cerebrovascular Diseases - October 10, 2013 Category: Neurology Authors: Shoji Honda, Yuichiro Inatomi, Toshiro Yonehara, Yoichiro Hashimoto, Teruyuki Hirano, Yukio Ando, Makoto Uchino Tags: Original Articles Source Type: research

White Matter Changes on Magnetic Resonance Imaging: A Risk Factor for Stroke in an African Population?
Background: White matter changes are frequently observed incidental findings in elderly individuals. Many studies in Europe and the United States have assessed the association of white matter changes with stroke and other diseases. No similar study has been conducted in sub-Saharan Africa, where risk factors for stroke differ. Our objective was to explore the association between severity of white matter changes (based on visual rating scales) and stroke in a Nigerian population.Methods: Magnetic resonance imaging (MRI) scans of 50 patients were retrospectively assessed and scored using 3 different visual rating scales (by ...
Source: Journal of Stroke and Cerebrovascular Diseases - February 4, 2013 Category: Neurology Authors: Godwin I. Ogbole, Mayowa O. Owolabi, Bolutife P. Yusuf Tags: Original Articles Source Type: research

Outcome and Risk Factors Presented in Old Patients Above 80 Years of Age Versus Younger Patients After Ischemic Stroke
Background: Older patients are associated with increased stroke prevalence, worse outcome, and risk of undertreatment in comparison with younger patients. The aim of the present study was to compare risk factor distribution and functional outcome in stroke survivors older and younger than 80 years.Methods: The analysis was based on consecutive patients admitted within 6 hours after stroke onset and discharged with ischemic stroke, surviving at least 3 months after ictus. To prevent bias, the analysis was based on a registry from before implementation of tissue plasminogen activator treatment; all patients received strok...
Source: Journal of Stroke and Cerebrovascular Diseases - May 2, 2014 Category: Neurology Authors: Line Bentsen, Louisa Christensen, Anders Christensen, Hanne Christensen Tags: Original Articles Source Type: research

Pooled Assessment of Computed Tomography Interpretation by Vascular Neurologists in the STRokE DOC Telestroke Network
Conclusions: Both vascular neurologists and reports from spoke radiologists had excellent reliability in identifying radiologic rt-PA contraindications. These pooled findings demonstrate that telestroke evaluation of head CT scans for acute rt-PA assessments is reliable.
Source: Journal of Stroke and Cerebrovascular Diseases - May 21, 2013 Category: Neurology Authors: Ilana Spokoyny, Rema Raman, Karin Ernstrom, Bart M. Demaerschalk, Patrick D. Lyden, Thomas M. Hemmen, Amy K. Guzik, James Y. Chen, Brett C. Meyer Tags: Original Articles Source Type: research

Stroke Volume Predicts Nocturnal Hypoxemia in the Acute Ischemic Stroke after Intravenous Thrombolysis
The Goal: The aim of the study was to investigate whether stroke volume or the presence of ischemic stroke lesion on follow-up computed tomography 1 day after admission had association with sleep apnea among ischemic stroke patients undergoing thrombolysis. Materials and Methods: We prospectively recruited 110 consecutive ischemic stroke patients and performed computed tomography on admission and after 24 hours after intravenous thrombolysis. Stroke volume was measured from post-thrombolysis computed tomography scans.
Source: Journal of Stroke and Cerebrovascular Diseases - July 1, 2019 Category: Neurology Authors: Jaana K. Huhtakangas, Tarja Saaresranta, Michaela K. Bode, Risto Bloigu, Juha Huhtakangas Source Type: research

Lateralization of Insular Ischemic Stroke is Not Associated With Any Stroke Clinical Outcomes: The Athens Stroke Registry
Background: Controversial evidence suggests that right insular stroke may be associated with worse outcomes compared to the left insular ischemic lesion. Objectives: We investigated whether lateralization of insular stroke is associated with early and late outcome in terms of in-hospital complications, stroke recurrence, cardiovascular events, and death. Methods: Data were prospectively collected from the Athens Stroke Registry. Insular cortex involvement was identified based on brain CT scans or MRI images.
Source: Journal of Stroke and Cerebrovascular Diseases - December 2, 2019 Category: Neurology Authors: Sophia Vassilopoulou, Eleni Korompoki, Argyro Tountopoulou, Dimos D. Mitsikostas, Efstathios Manios, Georgios Georgiopoulos, George Ntaios, Haralampos Milionis, Sophia Fontara, Konstantinos Vemmos Source Type: research

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