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Telestroke a viable option to improve stroke care in India
In India, stroke care services are not well developed. There is a need to explore alternative options to tackle the rising burden of stroke. Telemedicine has been used by the Indian Space Research Organization (ISRO) to meet the needs of remote hospitals in India. The telemedicine network implemented by ISRO in 2001 presently stretches to around 100 hospitals all over the country, with 78 remote/rural/district health centers connected to 22 specialty hospitals in major cities, thus providing treatment to more than 25 000 patients, which includes stroke patients. Telemedicine is currently used in India for diagnosing stro...
Source: International Journal of Stroke - July 18, 2014 Category: Neurology Authors: Padma V. Srivastava, Paulin Sudhan, Dheeraj Khurana, Rohit Bhatia, Subash Kaul, P. N. Sylaja, Majaz Moonis, Jeyaraj Durai Pandian Tags: Panorama Source Type: research

Association Between In-Hospital Mortality and Renal Dysfunction in 186 219 Patients Hospitalized for Acute Stroke in the Emilia-Romagna Region of Italy
Using a regional Italian database, we evaluated the relationship between renal dysfunction and in-hospital mortality (IHM) in patients with acute stroke (ischemic/hemorrhagic). Patients were classified on the basis of renal damage: without renal dysfunction, with chronic kidney disease (CKD), and with end-stage renal disease (ESRD). Of a total of 186 219 patients with a first episode of stroke, 1626 (0.9%) had CKD and 819 (0.4%) had ESRD. Stroke-related IHM (total cases) was independently associated with CKD, ESRD, atrial fibrillation (AF), age, and Charlson comorbidity index (CCI). In patients with ischemic stroke (n = 15...
Source: Angiology - October 20, 2014 Category: Cardiology Authors: Fabbian, F., Gallerani, M., Pala, M., De Giorgi, A., Salmi, R., Dentali, F., Ageno, W., Manfredini, R. Tags: Stroke Source Type: research

Canadian Stroke Best Practice Recommendations: secondary prevention of stroke guidelines, update 2014
Every year, approximately 62 000 people with stroke and transient ischemic attack are treated in Canadian hospitals. The 2014 update of the Canadian Secondary Prevention of Stroke guideline is a comprehensive summary of current evidence‐based recommendations for clinicians in a range of settings, who provide care to patients following stroke. Notable changes in this 5th edition include an emphasis on treating the highest risk patients who present within 48 h of symptom onset with transient or persistent motor or speech symptoms, who need to be transported to the closest emergency department with capacity for advanced...
Source: International Journal of Stroke - December 23, 2014 Category: Neurology Authors: Shelagh B. Coutts, Theodore H. Wein, M. Patrice Lindsay, Brian Buck, Robert Cote, Paul Ellis, Norine Foley, Michael D. Hill, Sharon Jaspers, Albert Y. Jin, Brenda Kwiatkowski, Carolyn MacPhail, Dana McNamara‐Morse, Michael S. McMurtry, Tania Mysak, Andr Tags: Guidelines Source Type: research

Countrywide stroke incidence, subtypes, management and outcome in a multiethnic Asian population: the Singapore Stroke Registry – methodology
DiscussionThe Registry has many features of an ‘ideal’ incidence study. Previously unavailable countrywide data on an Asian population will be acquired. The unique data on inter‐ethnic differences will help fill knowledge gaps in stroke epidemiology.
Source: International Journal of Stroke - March 1, 2015 Category: Neurology Authors: Narayanaswamy Venketasubramanian, Hui Meng Chang, Bernard Poon Lap Chan, Sherry H. Young, Keng He Kong, Kok Foo Tang, Yan Hoon Ang, Aftab Ahmad, Khuan Yew Chow, Tags: Protocol Source Type: research

Acute Stroke Registry Malaysia, 2010-2014: Results from the National Neurology Registry
Background: Stroke remains a major health burden worldwide. The incidence and prevalence rates of stroke are decreasing in developed countries, an opposite trend is taking place in the Asia Pacific, where an increasing number of patients are being diagnosed with acute stroke. The results of the present study on acute stroke in multi-ethnic Malaysia will significantly contribute to the global stroke epidemiological data. We aimed to present epidemiological data of stroke including incidence and prevalence rates as well as associated risk factors from a prospective nationwide hospital-based registry from 2010 to 2014.
Source: Journal of Stroke and Cerebrovascular Diseases - August 31, 2015 Category: Neurology Authors: Zariah A. Aziz, Yvonne Y.L. Lee, Bahari Awang Ngah, Norsima Nafizah Sidek, Irene Looi, Md. Rafia Hanip, Hamidon B. Basri Source Type: research

Thrombolysis with Low-Dose Tissue Plasminogen Activator 3–4.5 h After Acute Ischemic Stroke in Five Hospital Groups in Japan
We present data from 2005 to 2012 using a therapeutic window <3 h showing comparable results. tPA following endovascular therapy with recanalization might be superior to tPA only with recanalization (81.0 vs. 59.1 %). Compared with administration within 3 h of ischemic stroke onset, tPA administration within 3–4.5 h of ischemic stroke onset in real-world stroke emergency settings at multiple sites in Japan is as safe and has the same outcomes.
Source: Translational Stroke Research - January 27, 2016 Category: Neurology Source Type: research

Cerebral collateral circulation in experimental ischemic stroke
Abstract Cerebral collateral circulation is a subsidiary vascular network, which is dynamically recruited after arterial occlusion, and represents a powerful determinant of ischemic stroke outcome. Although several methods may be used for assessing cerebral collaterals in the acute phase of ischemic stroke in humans and rodents, they are generally underutilized. Experimental stroke models may play a unique role in understanding the adaptive response of cerebral collaterals during ischemia and their potential for therapeutic modulation. The systematic assessment of collateral perfusion in experimental stroke model...
Source: Experimental and Translational Stroke Medicine - March 1, 2016 Category: Neurology Source Type: research

Stroke systems of care: The sum is greater than the parts
To improve stroke patient care, the American Heart Association/American Stroke Association (AHA/ASA) provided policy recommendations in 2013 for key elements of stroke systems of care, including emergency medical services (EMS) routing policies, use of telemedicine where specialists are scarce, multidisciplinary and protocol-driven in-hospital care, conduction of quality improvement programs, and access to poststroke rehabilitation.1 In 2014, the AHA/ASA considered the evidence for factors that may have contributed to the accelerated decline in stroke mortality over the past few decades and found surprisingly sparse eviden...
Source: Neurology - March 7, 2016 Category: Neurology Authors: Fletcher, J. J., Majersik, J. J. Tags: Stroke prevention, All Cerebrovascular disease/Stroke EDITORIALS Source Type: research

Kelsey’s transformation: From stroke survivor to motivational speaker
“When I woke up after my stroke, all I wanted was to be normal again,” recalls Kelsey Tainsh. Normal — as in a healthy teen athlete who could brush her teeth and shower on her own, who wasn’t wheelchair-bound, who wasn’t compelled to hide her paralyzed right hand in her pocket everywhere she went, one who hadn’t lost all of her high school friends except for her two triplet sisters. Now, this world-champion athlete not only learned to walk and talk again but also to embrace her differences. “Our hardest obstacles can be our biggest opportunities,” she says. Kelsey’s first taste of being different came at ...
Source: Thrive, Children's Hospital Boston - March 16, 2016 Category: Pediatrics Authors: Lisa Fratt Tags: Our Patients’ Stories Brain tumor Mark Rockoff R. Michael Scott stroke Source Type: news

Impact of Increased Early Statin Administration on Ischemic Stroke Outcomes: A Multicenter Electronic Medical Record Intervention Stroke
We examined the relationship between intervention and outcome using autoregressive integrated moving average (ARIMA) time‐series modeling. The EMR intervention increased both overall in‐hospital statin administration (from 87.2% to 90.7%, P
Source: JAHA:Journal of the American Heart Association - July 28, 2016 Category: Cardiology Authors: Flint, A. C., Conell, C., Klingman, J. G., Rao, V. A., Chan, S. L., Kamel, H., Cullen, S. P., Faigeles, B. S., Sidney, S., Johnston, S. C. Tags: Ischemic Stroke, Neuroprotectants Original Research Source Type: research

The role of hippocampal pathology in post-stroke cognitive impairment
Background Cognitive impairment is common following cerebrovascular disease. Recently it has been associated with hippocampal ultra-structural damage in stroke survivors. We aim to study the long-term cognitive profile of patients after ischaemic stroke and characterise the cognitive behaviours associated with any dynamic changes in the structure, function and metabolism of the hippocampi, using multimodal MRI at 3Tesla. Methods We are conducting a dual-centre study to investigate the predictive value of diagnostic MRI and resting-state fMRI based on observing natural history of cognitive function following stroke (at bas...
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Hosseini, A. A., Ispoglou, S., Hayton, T., Evans, R., Wilson, M., Sawlani, V., Rotshtein, P., Auer, D. P. Tags: Stroke, Memory disorders (psychiatry), Radiology, Radiology (diagnostics) ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

Recurrent stroke in a patient with vitamin B12 deficiency and MTHFR mutation
We report an unusual case of recurrent stroke in a patient with vitamin B12 deficiency who was also homozygous for the methylene tetrahydrofolate reductase (MTHFR) gene mutation. The patient was a 35-year-old male vegetarian with no known medical history who initially presented with global aphasia, slurred speech, right facial weakness, and right-sided hemiplegia and was found to have a stroke (NIH Stroke Scale score of 25). At that time a CT scan of the head ruled out intracranial hemorrhage and a CT angiogram of the head and neck was done. The patient was found to have occlusion of the M1 segment of the left middle cereb...
Source: Neurology Clinical Practice - February 12, 2017 Category: Neurology Authors: Zacharia, G., Shani, D., Ortiz, R. A. Tags: Stroke in young adults, Stroke prevention, Hematologic, All Cerebrovascular disease/Stroke Case Source Type: research

Continuing or Temporarily Stopping Prestroke Antihypertensive Medication in Acute StrokeNovelty and Significance Stroke
Over 50% of patients are already taking blood pressure–lowering therapy on hospital admission for acute stroke. An individual patient data meta-analysis from randomized controlled trials was undertaken to determine the effect of continuation versus temporarily stopping preexisting antihypertensive medication in acute stroke. Key databases were searched for trials against the following inclusion criteria: randomized design; stroke onset ≤48 hours; investigating the effect of continuation versus stopping prestroke antihypertensive medication; and follow-up of ≥2 weeks. Two randomized controlled trials were identified a...
Source: Hypertension - April 12, 2017 Category: Cardiology Authors: Lisa J. Woodhouse, Lisa Manning, John F. Potter, Eivind Berge, Nikola Sprigg, Joanna Wardlaw, Kennedy R. Lees, Philip M. Bath, Thompson G. Robinson Tags: High Blood Pressure, Hypertension, Intracranial Hemorrhage, Ischemic Stroke Original Articles Source Type: research

Cerebral collateral circulation in experimental ischemic stroke
AbstractCerebral collateral circulation is a subsidiary vascular network, which is dynamically recruited after arterial occlusion, and represents a powerful determinant of ischemic stroke outcome. Although several methods may be used for assessing cerebral collaterals in the acute phase of ischemic stroke in humans and rodents, they are generally underutilized. Experimental stroke models may play a unique role in understanding the adaptive response of cerebral collaterals during ischemia and their potential for therapeutic modulation. The systematic assessment of collateral perfusion in experimental stroke models may be us...
Source: Experimental and Translational Stroke Medicine - March 1, 2016 Category: Neurology Source Type: research

Self-perceived and Actual Risk of Further Stroke in Patients with Recurrent Stroke or Recurrent Transient Ischemic Attack in Thailand
Background: The correct perception in patients of their future risk of recurrent stroke may lead to changes in behavior and to successful secondary prevention of stroke. The primary aim was to compare patients ’ perceived risk with the actual risk of further stroke. Methods: This cross-sectional study was carried out in 2 tertiary hospitals in northeast Thailand. Self-perceived risk of further stroke was assessed by validated questionnaire and categorized as low, medium, or high. Actual risk was calcula ted using Stroke Prognosis Instrument II which classified patients into 3 risk groups: low, medium, and high.
Source: Journal of Stroke and Cerebrovascular Diseases - November 29, 2018 Category: Neurology Authors: Jittima Saengsuwan, Pathitta Suangpho Source Type: research