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Condition: Stroke
Management: National Institutes of Health (NIH)
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Total 1650 results found since Jan 2013.
e-NIHSS: an Expanded National Institutes of Health Stroke Scale Weighted for Anterior and Posterior Circulation Strokes
The National Institutes of Health Stroke Scale (NIHSS) is the most widespread clinical scale used in patients presenting with acute stroke. The merits of the NIHSS include simplicity, quickness, and agreement between clinicians. The clinical evaluation on posterior circulation stroke remains still a limit of NIHSS.
Source: Journal of Stroke and Cerebrovascular Diseases - September 27, 2016 Category: Neurology Authors: Silvia Olivato, Silvia Nizzoli, Milena Cavazzuti, Federica Casoni, Paolo Frigio Nichelli, Andrea Zini Source Type: research
Frequency and Predictors of Dysphagia in Patients With Recent Small Subcortical Infarcts Brief Report
Background and Purpose—Detailed data on the occurrence of swallowing dysfunction in patients with recent small subcortical infarcts (RSSI) in the context of cerebral small vessel disease are lacking. This prompted us to assess the frequency of and risk factors for dysphagia in RSSI patients.Methods—We identified all inpatients with magnetic resonance imaging–confirmed RSSI between January 2008 and February 2013. Demographic and clinical data were extracted from our stroke database, and magnetic resonance imaging scans were reviewed for morphological changes. Dysphagia was determined according to the Gugging Swallowin...
Source: Stroke - December 22, 2016 Category: Neurology Authors: Simon Fandler, Thomas Gattringer, Sebastian Eppinger, Kathrin Doppelhofer, Daniela Pinter, Kurt Niederkorn, Christian Enzinger, Joanna M. Wardlaw, Franz Fazekas Tags: Magnetic Resonance Imaging (MRI), Complications, Cerebrovascular Disease/Stroke, Ischemic Stroke Brief Reports Source Type: research
Re-evaluate the Efficacy and Safety of Human Urinary Kallidinogenase (RESK): Protocol for an Open-Label, Single-Arm, Multicenter Phase IV Trial for the Treatment of Acute Ischemic Stroke in Chinese Patients
AbstractAcute ischemic stroke (AIS) is a major medical challenge in China. Thrombolytic drugs recommended for the treatment of AIS usually have a narrow time window. Human urinary kallidinogenase (HUK) was approved by the China Food and Drug Administration (CFDA) in 2005 for the treatment of mild to moderate AIS, and it is thus widely used in China. However, large-scale clinical study data for a more complete understanding of various aspects of its safety and efficacy characteristics are still unavailable. The ongoing Reevaluate the Efficacy and Safety of Human Urinary Kallidinogenase (RESK) trial is designed to reevaluate...
Source: Translational Stroke Research - March 5, 2017 Category: Neurology Source Type: research
Influence of Penumbral Reperfusion on Clinical Outcome Depends on Baseline Ischemic Core Volume Clinical Sciences
This study included 1507 patients. Reperfused penumbral volume had moderate ability to predict 90-day mRS 0 to 1 (area under the curve, 0.77; R2, 0.28; P
Source: Stroke - September 25, 2017 Category: Neurology Authors: Chushuang Chen, Mark W. Parsons, Matthew Clapham, Christopher Oldmeadow, Christopher R. Levi, Longting Lin, Xin Cheng, Min Lou, Timothy J. Kleinig, Kenneth S. Butcher, Qiang Dong, Andrew Bivard Tags: Ischemic Stroke Original Contributions Source Type: research
Successful Reperfusion With Intravenous Thrombolysis Preceding Mechanical Thrombectomy in Large-Vessel Occlusions Brief Report
Background and Purpose—Although current guidelines advocate pretreatment with intravenous thrombolysis (IVT) in all eligible patients with acute ischemic stroke with large-vessel occlusion before mechanical thrombectomy, there are observational data questioning the efficacy of this approach. One of the main arguments in favor of IVT pretreatment is the potential for tissue-type plasminogen activator–induced successful reperfusion (SR) before the onset of endovascular procedure.Methods—We performed a systematic review and meta-analysis of randomized controlled clinical trials and observational cohorts providing rates ...
Source: Stroke - December 22, 2017 Category: Neurology Authors: Georgios Tsivgoulis, Aristeidis H. Katsanos, Peter D. Schellinger, Martin Kohrmann, Panayiotis Varelas, Georgios Magoufis, Maurizio Paciaroni, Valeria Caso, Anne W. Alexandrov, Edip Gurol, Andrei V. Alexandrov Tags: Ischemic Stroke Brief Reports Source Type: research
Thrombolytic Therapy in Severe Cardioembolic Stroke After Reversal of Dabigatran with Idarucizumab: Case Report and Literature Review
Whether idarucizumab, an antidote of dabigatran, can be used effectively and safely before thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) in patients with stroke undergoing treatment with dabigatran remains unknown. We herein describe a 57-year-old man who developed severe cardioembolic stroke with a National Institutes of Health Stroke Scale score of 22 in the left middle cerebral artery territory while undergoing treatment with dabigatran for nonvalvular atrial fibrillation and who was treated with rt-PA after the reversal of dabigatran with idarucizumab.
Source: Journal of Stroke and Cerebrovascular Diseases - March 16, 2018 Category: Neurology Authors: Yuichiro Ohya, Noriko Makihara, Kayo Wakisaka, Takao Morita, Tetsuro Ago, Takanari Kitazono, Hitonori Takaba Tags: Case Studies Source Type: research
Delays in the Air or Ground Transfer of Patients for Endovascular Thrombectomy Clinical Sciences
Background and Purpose—For suspected large vessel occlusion patients efficient transfer to centers that provide endovascular therapy (ET) is critical to maximizing treatment opportunity. Our objective was to examine associations between transfer time, modes of transfer, ET, and outcomes within a hub-and-spoke telestroke network.Methods—Patients with ischemic stroke were included if transferred to a single hub hospital between January 2011 and October 2015 with National Institutes of Health Stroke Scale>6, onset
Source: Stroke - May 25, 2018 Category: Neurology Authors: Robert W. Regenhardt, Adam P. Mecca, Stephanie A. Flavin, Gregoire Boulouis, Arne Lauer, Kori Sauser Zachrison, James Boomhower, Aman B. Patel, Joshua A. Hirsch, Lee H. Schwamm, Thabele M. Leslie-Mazwi Tags: Revascularization, Quality and Outcomes, Cerebrovascular Disease/Stroke, Cerebrovascular Procedures, Ischemic Stroke Original Contributions Source Type: research
Laterality is an Independent Predictor of Endovascular Thrombectomy in Patients With Low National Institute of Health Stroke Scale
Endovascular thrombectomy (ET) for acute ischemic stroke (AIS) due to large-vessel occlusion (LVO) is offered to select patients meeting strict criteria. One of the criteria is stroke severity as indicated by the National Institute of Health Stroke Scale (NIHSS). Inherently, NIHSS is biased towards left hemisphere strokes (LHS) with median NIHSS score 4 points higher than right hemisphere strokes (RHS). This may potentially affect clinical decision making and thrombectomy eligibility. We sought to test this hypothesis.
Source: Journal of Stroke and Cerebrovascular Diseases - August 2, 2018 Category: Neurology Authors: Shashvat M. Desai, Marcelo Rocha, Matthew Starr, Bradley J. Molyneaux, Cynthia L. Kenmuir, Bradley A. Gross, Brian T. Jankowitz, Tudor G. Jovin, Ashutosh P. Jadhav Source Type: research
Complement Complex C5b-9 Levels Are Associated with the Clinical Outcomes of Acute Ischemic Stroke and Carotid Plaque Stability
AbstractThe terminal complement complex C5b-9 plays an important role in acute ischemic stroke (AIS) and carotid atherosclerosis. However, the associations between serum C5b-9, the severity and outcome of AIS, and the stability of carotid plaques have not been well investigated. In this clinical study, 70 patients with AIS and 70 healthy controls were enrolled. Serum C5b-9 levels at 72 h after stroke onset were measured by enzyme-linked immunosorbent assay (ELISA). Infarct size, the National Institutes of Health Stroke Scale (NIHSS), the 90-day modified Rankin Scale (mRS), and carotid plaque and stenosis were evaluated. ...
Source: Translational Stroke Research - September 1, 2018 Category: Neurology Source Type: research
Initial National Institute of Health Stroke Scale to Early Predict the Improvement of Swallowing in Patients with Acute Ischemic Stroke
Objectives: To study the applicability of National Institutes of Health Stroke Scale (NIHSS) in early predicting the prognosis of poststroke dysphagia in an acute ward. Methods: This is an observational retrospective cohort study including adult patients with ischemic stroke. Patients with various factors affecting swallowing were excluded to obtain a representative sample of 165 patients. The main outcome measure was the improvements of oral intake function. Results: The scores of facial palsy (NIHSS item 4) (odds ratio [OR]: 0.484, 95% confidence interval [CI]: 0.279-0.838, P = .0096] and language/aphasia (NIHSS item 9) ...
Source: Journal of Stroke and Cerebrovascular Diseases - July 26, 2019 Category: Neurology Authors: Wen-Chih Lin, Chih-Yuan Huang, Lin-Fu Lee, Yun-Wen Chen, Chung-Han Ho, Yuan-Ting Sun Source Type: research
Impact of endovascular reperfusion on low National Institutes of Health Stroke Scale score large-vessel occlusion stroke
The benefit of mechanical thrombectomy (MT) in patients presenting with mild ischemic stroke symptoms (National Institutes of Health Stroke Scale [NIHSS] score
Source: Journal of Stroke and Cerebrovascular Diseases - May 13, 2020 Category: Neurology Authors: Felix Chin, Muhammad Waqas, Ryan Chou, Peter G. Gerace, Hamid H. Rai, Kunal Vakharia, Rimal H. Dossani, Jason M. Davies, Kenneth V. Snyder, Adnan H. Siddiqui, Elad I. Levy Source Type: research
Role of Non-Perfusion Factors in Mildly Symptomatic Large Vessel Occlusion Stroke
Recent reperfusion trials after acute large vessel occlusion (LVO) stroke did not include patients with low national institute of health stroke scale (NIHSS) except for MR CLEAN trial in which they enrolled subjects with NIHSS ranging between 3 and 38. Very few subjects had NIHSS ≤5. Other trials like REVASCAT, ESCAPE, SWIFT PRIME, EXTEND-IA, DAWN, and DIFFUSE 3 had their enrolled patients’ NIHSS at ≥6, interquartile range (IQR) 12-20, IQR 13-20, IQR 9-20, IQR 13-21, and IQR 10-21 respectively.1–3 The most likely rationale is that these low-NIHSS stroke patients have well-developed collateral circulations that allo...
Source: Journal of Stroke and Cerebrovascular Diseases - August 11, 2020 Category: Neurology Authors: Omar Hussein, Ahmed Abd Elazim, Khalid Sawalha, Smeer Salam, Kasser Saba, Mohammad Hamed, Juan Peng, Archana Hinduja Source Type: research
Risk of Early Bleeding with Dual Antiplatelet Therapy in Acute Stroke and Transient Ischemic Attack Regardless of NIHSS Admission
Background: Dual antiplatelet therapy (DAT) is a therapeutic option for patients with minor ischemic stroke (IS) or transient ischemic attack (TIA). No study has evaluated the incidence of early bleeding in patients with moderate to major ischemic stroke. The current study aimed to analyze both the frequency of early bleeding and hospital morbidity related to DAT for either acute IS or TIA regardless of admission National Institute of Health Stroke Scale (NIHSS) score. Methods: This was a retrospective analysis based on data collected from a prospective data bank of a single center.
Source: Journal of Stroke and Cerebrovascular Diseases - March 4, 2021 Category: Neurology Authors: Valeria Cristina Scavasine, Rubens Mendes Barbosa, Francisco Diego Negrao Lopes Neto, Francisco Manoel Branco Germininani, Rodrigo Bazan, Viviane Flumignan Z étola, Ayrton Roberto Massaro, Marcos Christiano Lange Source Type: research
Neurological Instability in Ischemic Stroke: Relation with Outcome, Latency Time, and Molecular Markers
AbstractThe National Institutes of Health Stroke Scale (NIHSS) is commonly used to evaluate stroke neurological deficits and to predict the patient ’s outcome. Neurological instability (NI), defined as the variation of the NIHSS in the first 48 h, is a simple clinical metric that reflects dynamic changes in the area of the brain affected by the ischemia. We hypothesize that NI may represent areas of cerebral instability known as penumbra, wh ich could expand or reduce brain injury and its associated neurological sequels. In this work, our aim was to analyze the association of NI with the functional outcome at 3 months ...
Source: Translational Stroke Research - June 24, 2021 Category: Neurology Source Type: research
