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Upstate showcases services, expertise, offers health screenings at New York State Fair, beginning Aug. 22
On Aug. 31 Upstate will present a 15-foot tall brain that fairgoers can walk through to learn what happens to the brain during a traumatic injury, stroke or concussion.
Source: SUNY Upstate Medical - August 15, 2018 Category: Universities & Medical Training Tags: News Cancer Pediatrics Patient Care Research Stroke Source Type: news

Alternative Motor Task-Based Pattern Training With a Digital Mirror Therapy System Enhances Sensorimotor Signal Rhythms Post-stroke
Mirror therapy (MT) facilitates motor learning and induces cortical reorganization and motor recovery from stroke. We applied the new digital mirror therapy (DMT) system to compare the cortical activation under the three visual feedback conditions: (1) no mirror visual feedback (NoMVF), (2) bilateral synchronized task-based mirror visual feedback training (BMVF), and (3) reciprocal task-based mirror visual feedback training (RMVF). During DMT, EEG recordings, including time-dependent event-related desynchronization (ERD) signal amplitude in both mu and beta bands, were obtained from the standard C3 (ispilesional hemisphere...
Source: Frontiers in Neurology - November 21, 2019 Category: Neurology Source Type: research

ST-elevation myocardial infarction, pulmonary embolism, and cerebral ischemic stroke in a patient with critically low levels of natural anticoagulants
Publication date: Available online 22 November 2019Source: Journal of Cardiology CasesAuthor(s): Elena Vladimirovna Reznik, Ekaterina Sergeevna Shcherbakova, Svetlana Vasilievna Borisovskaya, Yurij Valerevich Gavrilov, Tatyana Mikhailovna Pajeva, Sergey Vladislavovich Lepkov, Aleksej Borisovich Mironkov, Eliso Murmanovna Dzhobava, Igor Gennadievich NikitinAbstractThis clinical case report describes the simultaneous development of an acute myocardial infarction, stroke, and a massive pulmonary thromboembolism in a 44-year-old patient — a carrier of the thrombophilia gene polymorphisms: MTHFR C677T, А1298C, PAI-1 4G/5G, I...
Source: Journal of Cardiology Cases - November 23, 2019 Category: Cardiology Source Type: research

Fuzzy cognitive map based approach for determining the risk of ischemic stroke
In this study, the soft computing method known as fuzzy cognitive mapping was proposed for diagnosis of the risk of ischemic stroke. Non-linear Hebbian learning method was used for fuzzy cognitive maps training. In the proposed method, the risk rate for each person was determined based on the opinions of the neurologists. The accuracy of the proposed model was tested using 10-fold cross-validation, for 110 real cases, and the results were compared with those of support vector machine and K-nearest neighbours. The proposed system showed a superior performance with a total accuracy of (93.6 ± 4.5)%. The da...
Source: IET Systems Biology - November 29, 2019 Category: Biology Source Type: research

A review of stroke in pregnancy: incidence, investigations and management
AbstractKey contentThe incidence of stroke in young and middle ‐aged adults is increasing, with pregnancy‐related strokes occurring in 30 in 100 000 pregnancies; strokes are three times more common among pregnant than among nonpregnant individuals aged 15–44 years.The investigation and management of stroke is changing because of the time ‐sensitive benefits of thrombolysis and thrombectomy in the acute management of ischaemic stroke.The approach to clinical assessment and investigation of a pregnant woman presenting with suspected stroke is not different from that of a non ‐pregnant patient:; timely brain imagi...
Source: The Obstetrician and Gynaecologist - November 13, 2019 Category: OBGYN Authors: Azy Khalid, Adriana Hadbavna, David Williams, Bridgette Byrne Tags: Reviews Source Type: research

The differentiated effect of the task complexity on retention and transfer of stroke survivors.
Abstract The aim of this study was to investigate the effects of task complexity on the motor learning of by stroke survivors. Participants (N = 24) performed 150 trials of a simple or complex balance task during three acquisition days. Level of complexity was determined by the number of sequential movements. Outcomes were recorded on pretest, posttest, retention and transfer test. Data were analyzed by considering measures of performance score and movement time. Results showed that only the low complexity group improved the performance from the pretest to posttest and maintained it in the retention test. Perfor...
Source: Human Movement Science - November 24, 2019 Category: Neurology Authors: Palma GCDS, Corrêa UC, Torriani-Pasin C Tags: Hum Mov Sci Source Type: research

Ischemic preconditioning provides long-lasting neuroprotection against ischemic stroke: The role of Nrf2.
CONCLUSIONS: IPC provides long-lasting neuroprotection against ischemic brain injury and post-stroke cognitive dysfunction. Nrf2 activation plays a key role in this beneficial outcome and is a promising therapeutic target for the attenuation of ischemic brain injury. PMID: 31812555 [PubMed - as supplied by publisher]
Source: Experimental Neurology - December 4, 2019 Category: Neurology Authors: Yang T, Sun Y, Li Q, Li S, Shi Y, Leak RK, Chen J, Zhang F Tags: Exp Neurol Source Type: research

Using machine learning models to improve stroke risk level classification methods of China national stroke screening
With the character of high incidence, high prevalence and high mortality, stroke has brought a heavy burden to families and society in China. In 2009, the Ministry of Health of China launched the China nationa...
Source: BMC Medical Informatics and Decision Making - December 10, 2019 Category: Information Technology Authors: Xuemeng Li, Di Bian, Jinghui Yu, Mei Li and Dongsheng Zhao Tags: Research article Source Type: research

A New Approach to Transcranial Direct Current Stimulation in Improving Cognitive Motor Learning and Hand Function with the Nintendo Switch in Stroke Survivors.
CONCLUSIONS Our results suggest that inclusion of motor tasks with the application of tDCS may be effective in improving cognitive and hand function of stroke survivors. PMID: 31837648 [PubMed - in process]
Source: Medical Science Monitor - December 15, 2019 Category: Research Tags: Med Sci Monit Source Type: research

Brain age prediction in stroke patients: Highly reliable but limited sensitivity to cognitive performance and response to cognitive training
Publication date: Available online 30 December 2019Source: NeuroImage: ClinicalAuthor(s): Geneviève Richard, Knut Kolskår, Kristine M. Ulrichsen, Tobias Kaufmann, Dag Alnæs, Anne-Marthe Sanders, Erlend S. Dørum, Jennifer Monereo Sánchez, Anders Petersen, Hege Ihle-Hansen, Jan Egil Nordvik, Lars T. WestlyeAbstractCognitive deficits are important predictors for outcome, independence and quality of life after stroke, but often remain unnoticed and unattended because other impairments are more evident. Computerized cognitive training (CCT) is among the candidate interventions that may alleviate cognitive difficulties, but...
Source: NeuroImage: Clinical - December 30, 2019 Category: Radiology Source Type: research

Automated Segmentation of Acute Stroke Lesions Using a Data-driven Anomaly Detection on Diffusion Weighted MRI
ConclusionsThe current method is straightforward, fast, and shows good agreement with the lesions identified by human experts.
Source: Journal of Neuroscience Methods - January 3, 2020 Category: Neuroscience Source Type: research

Assessing stroke severity using electronic health record data: a machine learning approach
Stroke severity is an important predictor of patient outcomes and is commonly measured with the National Institutes of Health Stroke Scale (NIHSS) scores. Because these scores are often recorded as free text i...
Source: BMC Medical Informatics and Decision Making - January 8, 2020 Category: Information Technology Authors: Emily Kogan, Kathryn Twyman, Jesse Heap, Dejan Milentijevic, Jennifer H. Lin and Mark Alberts Tags: Research article Source Type: research

Academic outcome in pediatric ischemic stroke.
Abstract An important cause of acquired brain injury in children, pediatric ischemic stroke can cause sequelae across a wide range of cognitive domains, including verbal reasoning and processing speed. As a result, survivors are especially vulnerable to academic difficulties and face unique challenges compared to their peers. Despite this knowledge, pediatric stroke remains an understudied neurological condition, and its impact on school functioning poorly understood. The present clinical study addressed academic outcome in this population using a multifaceted approach. Patients were recruited for participation fr...
Source: Child Neuropsychology - January 8, 2020 Category: Child Development Authors: Champigny CM, Deotto A, Westmacott R, Dlamini N, Desrocher M Tags: Child Neuropsychol Source Type: research

Expression of Cytokines and Chemokines as Predictors of Stroke Outcomes in Acute Ischemic Stroke
Conclusions: Machine learning algorithms can be employed to develop prognostic predictive biomarkers for stroke outcomes in ischemic stroke patients, particularly in regard to identifying acute gene expression changes that occur during stroke.
Source: Frontiers in Neurology - January 14, 2020 Category: Neurology Source Type: research

Predicting Chronic Subdural Hematoma Recurrence and Stroke Outcomes While Withholding Antiplatelet and Anticoagulant Agents
Conclusion: ML modeling is feasible. However, large well-designed prospective multicenter studies are needed for accurate ML so that clinicians can balance the risks of recurrence with the risk of TEEs, especially for high-risk anticoagulated patients.
Source: Frontiers in Neurology - January 14, 2020 Category: Neurology Source Type: research

Quantifying the Impact of Chronic Ischemic Injury on Clinical Outcomes in Acute Stroke With Machine Learning
Acute stroke is often superimposed on chronic damage from previous cerebrovascular events. This background will inevitably modulate the impact of acute injury on clinical outcomes to an extent that will depend on the precise anatomical pattern of damage. Previous attempts to quantify such modulation have employed only reductive models that ignore anatomical detail. The combination of automated image processing, large-scale data, and machine learning now enables us to quantify the impact of this with high-dimensional multivariate models sensitive to individual variations in the detailed anatomical pattern. We introduce and ...
Source: Frontiers in Neurology - January 23, 2020 Category: Neurology Source Type: research

Beneficial actions of prothymosin alpha-mimetic hexapeptide on central post-stroke pain, reduced social activity, learning-deficit and depression following cerebral ischemia in mice
Publication date: Available online 23 January 2020Source: PeptidesAuthor(s): Keita Sasaki, Sebok Kumar Halder, Hayato Matsunaga, Hiroshi UedaAbstractProthymosin alpha (ProTα)-mimetic hexapeptide (amino acid: NEVDQE, P6Q) inhibits cerebral or retinal ischemia-induced behavioral, electrophysiological and histological damage. P6Q also abolishes cerebral hemorrhage induced by ischemia with tissue plasminogen activator (tPA). In the present study we examined the beneficial effects of P6Q on other post-stroke prognostic psychology-related symptoms, which obstruct the motivation toward physical therapy. Intravenous (i.v.) admini...
Source: Peptides - January 24, 2020 Category: Biochemistry Source Type: research

A Hybrid Approach for Sub-Acute Ischemic Stroke Lesion Segmentation Using Random Decision Forest and Gravitational Search Algorithm.
CONCLUSION: This paper provides a new hybrid GSA-RDF classifier technique to segment the ischemic stroke lesions in MR images. The experimental results demonstrate that the proposed technique has the Root Mean Square Error (RMSE), Mean Absolute Percentage Error (MAPE), and Mean Bias Error (MBE) ranges are 16.5485 %, 7.2654 %, and 2.4585 %individually. The proposed RDF-GSA algorithm has better precision and execution when compared with the existing ischemic stroke segmentation method. PMID: 31975663 [PubMed - in process]
Source: Current Medical Imaging Reviews - January 26, 2020 Category: Radiology Tags: Curr Med Imaging Rev Source Type: research

Effects of contextual interference on feeding training in patients with stroke.
This study investigated the CI effect on spooning training in such patients. Fourteen right hemiparetic patients with stroke were assigned to one of two groups: a group with a random practice schedule or a group with a blocked practice schedule. The spooning task involved scooping go stones from a bowl 30 cm away in 3 different directions to a bowl in front of the patient. We evaluated the acquisition, retention, and transfer of motor learning for spooning. The transfer was evaluated while participants ate cereal in a bowl with a spoon. Upper extremity function, defined as far-transfer, was also evaluated using the box-an...
Source: Human Movement Science - January 30, 2020 Category: Neurology Authors: Jo EJ, Noh DH, Kam KY Tags: Hum Mov Sci Source Type: research

Motor Performance But Neither Motor Learning Nor Motor Consolidation Are Impaired in Chronic Cerebellar Stroke Patients
AbstractThe capacity to acquire and retain new motor skills is essential for everyday behavior and a prerequisite to regain functional independence following impairments of motor function caused by brain damage, e.g., ischemic stroke. Learning a new motor skill requires repeated skill practice and passes through different online and offline learning stages that are mediated by specific dynamic interactions between distributed brain regions including the cerebellum. Motor sequence learning is an extensively studied paradigm of motor skill learning, yet the role of the cerebellum during online and offline stages remains cont...
Source: The Cerebellum - January 29, 2020 Category: Neurology Source Type: research

Impact of 25-Hydroxyvitamin D on the Prognosis of Acute Ischemic Stroke: Machine Learning Approach
Conclusions: 25-hydroxyvitamin D deficiency was highly prevalent in Korea and low 25-hydroxyvitamin D level was associated with poor outcome in patients with AIS. The machine learning approach of extreme gradient boosting was also useful to assess stroke prognosis along with logistic regression analysis.
Source: Frontiers in Neurology - January 30, 2020 Category: Neurology Source Type: research

Motor Performance But Neither Motor Learning Nor Motor Consolidation Are Impaired in Chronic Cerebellar Stroke Patients.
Abstract The capacity to acquire and retain new motor skills is essential for everyday behavior and a prerequisite to regain functional independence following impairments of motor function caused by brain damage, e.g., ischemic stroke. Learning a new motor skill requires repeated skill practice and passes through different online and offline learning stages that are mediated by specific dynamic interactions between distributed brain regions including the cerebellum. Motor sequence learning is an extensively studied paradigm of motor skill learning, yet the role of the cerebellum during online and offline stages re...
Source: Cerebellum - January 29, 2020 Category: Neuroscience Authors: Hermsdorf F, Fricke C, Stockert A, Classen J, Rumpf JJ Tags: Cerebellum Source Type: research

H2S prevents injury after ischemic stroke by diminishing the assembly of CaMKII with ASK1-MKK3-p38 signaling module.
Abstract Cerebral ischemia/reperfusion (I/R) injury is a leading cause of learning and memory dysfunction. Hydrogen sulfide (H2S) has been shown to confer neuroprotection in various neurodegenerative diseases, including cerebral I/R-induced hippocampal CA1 injury. However, the underlying mechanisms have not been completely understood. In the present study, rats were pretreated with SAM/NaHS (SAM, an H2S agonist, and NaHS, an H2S donor) only or SAM/NaHS combined with CaM (an activator of CaMKII) prior to cerebral ischemia. The Morris water maze test demonstrated that SAM/NaHS could alleviate learning and memory imp...
Source: Behavioural Brain Research - January 28, 2020 Category: Neurology Authors: Song YJ, Shi Y, Cui M, Li M, Wen XR, Zhou XY, Lou HQ, Wang YL, Qi DS, Tang M, Zhang XB Tags: Behav Brain Res Source Type: research

Providing Stroke and Hypertension Education in Amharic for Ethiopian Persons Living in Dallas, Texas, United States.
CONCLUSION: This study did not show a statistically significant increase in knowledge about stroke when presented learning materials in subjects' native language compared to in English. The use of video to present stroke and stroke-risk educational content can be used in future research and global health initiatives to increase stroke knowledge in the Amharic-speaking community. PMID: 32024741 [PubMed - in process]
Source: Creative Nursing - January 31, 2020 Category: Nursing Authors: Gebreyohanns M, Onuigbo CC, Ali A, Stutzman SE, Olson DM Tags: Creat Nurs Source Type: research

CT radiomics unlocks basal ganglia stroke onset time
The combination of radiomics and a machine-learning algorithm can determine...Read more on AuntMinnie.comRelated Reading: AI may help improve management of stroke patients AI finds infarction in stroke patients on unenhanced CT CT plus CT perfusion predicts stroke surgery outcomes CTA lowers costs, improves outcomes for minor stroke Can AI find brain hemorrhage as well as radiologists?
Source: AuntMinnie.com Headlines - February 11, 2020 Category: Radiology Source Type: news

Vascular Cellular Adhesion Molecule-1 (VCAM-1) and Memory Impairment in African-Americans after Small Vessel-Type Stroke
We examined whether inflammatory/endothelial dysfunction biomarkers are associated with cognition after SVS in AAs. Methods: Biomarkers were obtained in 24 subjects (median age 56.5 years, 54% women, median 12 years education). Cognition was assessed more than 6 weeks poststroke using the memory composite score (MCS), which was generated using recall from the Hopkins Verbal Learning Test-II and Brief Visuospatial Memory Test-Revised.
Source: Journal of Stroke and Cerebrovascular Diseases - February 13, 2020 Category: Neurology Authors: Nada El Husseini, Cheryl Bushnell, Candice M. Brown, Deborah Attix, Natalia S. Rost, Gregory P. Samsa, Carol A. Colton, Larry B. Goldstein Source Type: research

Radiation exposure and fluoroscopy time in mechanical thrombectomy of anterior circulation ischemic stroke depending on the interventionalist ’s experience—a retrospective single center experience
ConclusionThis retrospective analysis demonstrates a significant influence of interventionalist ’s experience on procedure time, fluoroscopy time, and radiation exposure in mechanical thrombectomy in the anterior circulation.Key Points• There is a significant influence of interventionalist’s experience on procedure time, fluoroscopy time, and radiation exposure in mechanical thrombectomy in the anterior circulation.• Interventionalists’ learning curve is steepest during the first 25 cases.• These circumstances should be considered when reference levels or guide values are established and in training of physicia...
Source: European Radiology - February 20, 2020 Category: Radiology Source Type: research

Abstract No. 720 Identification of irreversibly damaged brain tissue on computed tomography perfusion using convolutional neural network to assist selection for mechanical thrombectomy in ischemic stroke patients
Endovascular treatment of ischemic stroke has shown positive clinical outcomes. Further optimization requires identifying patients who will benefit from reperfusion. We propose using deep learning, specifically 3D convolutional neural networks (CNN), to identify infarcted tissue (core) on CT perfusion (CTP) with diffusion weighted imaging (DWI) MRI as gold standard for irreversible brain infarction and evaluate lesion size impact on the network ’s performance.
Source: Journal of Vascular and Interventional Radiology : JVIR - February 20, 2020 Category: Radiology Authors: R. Wang, K. Chang, H. Zhou, J. Wu, G. Cohan, M. Jayaraman, R. Huang, J. Boxerman, L. Yang, F. Hui, J. Woo, H. Bai Tags: Scientific Traditional Poster Source Type: research

Potential benefits of music playing in stroke upper limb motor rehabilitation
Publication date: Available online 21 February 2020Source: Neuroscience & Biobehavioral ReviewsAuthor(s): Jennifer Grau-Sánchez, Thomas F. Münte, Eckart Altenmüller, Esther Duarte, Antoni Rodríguez-FornellsAbstractMusic-based interventions have emerged as a promising tool in stroke motor rehabilitation as they integrate most of the principles of motor training and multimodal stimulation. This paper aims to review the use of music in the rehabilitation of upper extremity motor function after stroke. First, we review the evidence supporting current music-based interventions including Music-supported Therapy, Music glove,...
Source: Neuroscience and Biobehavioral Reviews - February 23, 2020 Category: Neuroscience Source Type: research

Johnson & Johnson Launches Heartline ™, the First-of-its-Kind, Virtual Study Designed to Explore if a New iPhone App and Apple Watch Can Help Reduce the Risk of Stroke
New Brunswick, NJ, February 25, 2020 — Johnson & Johnson (NYSE: JNJ) today announced that the Janssen Pharmaceutical Companies of Johnson & Johnson, in collaboration with Apple, opened enrollment for the Heartline™ Study. The study is designed to explore if the Heartline™ Study app on iPhone and heart health features on Apple Watch can improve health outcomes, including reducing the risk of stroke, with earlier detection of atrial fibrillation (AFib). AFib, a common form of irregular heart rhythm, is a leading cause of stroke in the U.S. To enroll in the Heartline™ Study, individuals must be age 65 or older...
Source: Johnson and Johnson - February 25, 2020 Category: Pharmaceuticals Tags: Innovation Source Type: news

Effects of the brain-damaged side after stroke on the learning of a balance task in a non-immersive virtual reality environment.
Conclusion: Stroke survivors can learn balance tasks (H1), and the right hemisphere damaged patients demonstrate more errors than those with left hemisphere injury in higher complexity conditions (H2). PMID: 32090670 [PubMed - as supplied by publisher]
Source: Physiotherapy Theory and Practice - February 23, 2020 Category: Physiotherapy Authors: Bonuzzi GMG, de Freitas TB, Palma GCDS, Soares MAA, Lange B, Pompeu JE, Torriani-Pasin C Tags: Physiother Theory Pract Source Type: research

A nurse-led health coaching intervention for stroke survivors and their family caregivers in hospital to home transition care in Chongqing, China: a study protocol for a randomized controlled trial
Hospital to home transition care is a most stressful period for stroke survivors and their caregivers to learn self-management of stroke-related health conditions and to engage in rehabilitation. Health coachi...
Source: Trials - March 4, 2020 Category: General Medicine Authors: Shuanglan Lin, Lily Dongxia Xiao and Diane Chamberlain Tags: Study protocol Source Type: research

Preserved motor skill learning in acute stroke patients
AbstractRecovery is dynamic during acute stroke, but whether new motor skills can be acquired with the paretic upper limb (UL) during this recovery period is unknown. Clarifying this unknown is important, because neurorehabilitation largely relies on motor learning. The aim was to investigate whether, during acute stroke, patients achieved motor skill learning and retention with the paretic UL. Over 3 consecutive days (D1 –D3), 14 patients practiced with their paretic UL the CIRCUIT, a motor skill learning task with a speed/accuracy trade-off (SAT). A Learning Index (LI) was used to quantify normalised SAT changes in com...
Source: Acta Neurologica Belgica - March 8, 2020 Category: Neurology Source Type: research

IJERPH, Vol. 17, Pages 1828: Stroke Prediction with Machine Learning Methods among Older Chinese
ang Timely stroke diagnosis and intervention are necessary considering its high prevalence. Previous studies have mainly focused on stroke prediction with balanced data. Thus, this study aimed to develop machine learning models for predicting stroke with imbalanced data in an elderly population in China. Data were obtained from a prospective cohort that included 1131 participants (56 stroke patients and 1075 non-stroke participants) in 2012 and 2014, respectively. Data balancing techniques including random over-sampling (ROS), random under-sampling (RUS), and synthetic minority over-sampling technique (SMOTE) were used...
Source: International Journal of Environmental Research and Public Health - March 11, 2020 Category: Environmental Health Authors: Yafei Wu Ya Fang Tags: Article Source Type: research

Deep Learning Predicts Stroke-Lesion Changes at 1 Week Deep Learning Predicts Stroke-Lesion Changes at 1 Week
Armed with only baseline MRI findings, a new deep learning algorithm may accurately estimate size and location of acute stroke lesions at 3 to 7 days.Medscape Medical News
Source: Medscape Radiology Headlines - March 20, 2020 Category: Radiology Tags: Neurology & Neurosurgery News Source Type: news

AIM2 inflammasome contributes to brain injury and chronic post-stroke cognitive impairment in mice.
Abstract Although over one-third of stroke patients may develop post-stroke cognitive impairment (PSCI), the mechanisms underlying PSCI remain unclear. We explored here, the involvement of post-stroke inflammasomes in long-term PSCI development, using a 45 min-middle cerebral artery occlusion (MCAO)/reperfusion-induced PSCI model. Immunohistological assessment on day 1, 3, and 7 was followed by cognitive function test 28 days post-stroke. Evaluation of inflammasome sensor gene expression in aged mouse brains showed dominant expression of absent in melanoma 2 (Aim2) in 6-, 12-, and 18-month-old mouse brains. AIM2 m...
Source: Brain, Behavior, and Immunity - March 18, 2020 Category: Neurology Authors: Kim H, Seo JS, Lee SY, Ha KT, Choi BT, Shin YI, Ju Yun Y, Shin HK Tags: Brain Behav Immun Source Type: research

Epidemiology and Primary Prevention of Stroke
This article provides an update on the epidemiology and prevention of a first stroke. Risk factor modification plays a large role in stroke prevention. Strategies for early intervention, particularly for hypertension, are critical for reducing stroke morbidity and mortality. RECENT FINDINGS Because of the new criteria for hypertension, more people are now classified as hypertensive and can benefit from lifestyle or medical management. Direct oral anticoagulants have made it easier to safely treat patients with atrial fibrillation and are now considered first-line therapy for patients with an additional stroke risk facto...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Update on Treatment of Acute Ischemic Stroke
This article provides an update on the state of the art of the treatment of acute ischemic stroke with particular emphasis on the indications for reperfusion therapy. RECENT FINDINGS In addition to the previously established indications for intravenous (IV) thrombolysis with recombinant tissue plasminogen activator (rtPA) within 4.5 hours of stroke symptom onset and endovascular therapy with mechanical thrombectomy for patients with large artery occlusion who can be treated within 6 hours of symptom onset, recent randomized controlled trials have now established new indications for emergency reperfusion in patients with ...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Neuroimaging in Acute Stroke
This article describes how imaging can be used by physicians in diagnosing, determining prognosis, and making appropriate treatment decisions in a timely manner in patients with acute stroke. RECENT FINDINGS Advances in acute stroke treatment, including the use of endovascular thrombectomy in patients with large vessel occlusion and, more recently, of IV thrombolysis in an extended time window, have resulted in a paradigm shift in how imaging is used in patients with acute stroke. This paradigm shift, combined with the understanding that “time is brain,” means that imaging must be fast, reliable, and available aroun...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Endovascular Treatment of Acute Ischemic Stroke
This article reviews the actual indications for mechanical thrombectomy in patients with acute ischemic stroke and how the opportunities for endovascular therapy can be expanded by using the concept of clinical-imaging or perfusion-imaging mismatch (as a surrogate for salvageable tissue) rather than time of ischemia. RECENT FINDINGS Six randomized controlled trials undoubtedly confirmed the benefits of using endovascular thrombectomy on the clinical outcome of patients with stroke with large vessel occlusion within 6 hours from symptom onset compared with those receiving only standard medical care. In a meta-analysis of...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

The Evolving Concept of Cryptogenic Stroke
This article discusses cryptogenic stroke and the results of recent randomized trials that can inform its evaluation and management. RECENT FINDINGS Most cryptogenic strokes appear embolic, leading to the term embolic stroke of undetermined source. It was previously thought that embolic stroke of undetermined source was a single, therapeutically relevant entity, the underlying sources of which would respond to anticoagulant therapy; however, two large randomized trials found no benefit with anticoagulation compared to antiplatelet therapy for secondary stroke prevention after embolic stroke of undetermined source. A sin...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Stroke in Women
This article reviews sex differences in stroke risk and presentation, with a particular emphasis on the unique risk factors women experience throughout the lifespan. RECENT FINDINGS Although prior studies suggested women have worse outcomes after stroke, it is now clear that age, prestroke functional status, and comorbidities explain many of the differences between men and women in stroke severity, functional outcomes, and mortality. Several meta-analyses and large cohort studies have evaluated the risk factors for women related to reproductive factors and found that fewer years between menarche and menopause, pregnancy...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Ischemic Stroke in Young Adults
This article reviews current knowledge on epidemiology, risk factors and causes, diagnostic considerations, management, and prognosis of ischemic stroke in young adults (those 55 years old and younger). RECENT FINDINGS The incidence of ischemic stroke in young adults has been increasing since the 1980s, which has occurred in parallel with increasing prevalence of vascular risk factors and substance abuse among the younger population. Young adults have a considerably wider range of risk factors than older patients, including age-specific factors such as pregnancy/puerperium and oral contraceptive use. Behavioral risk fac...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Recovery After Stroke
This article describes restorative therapies to improve patient outcomes after stroke. These therapies contrast with acute stroke treatments such as recombinant tissue plasminogen activator (rtPA) and thrombectomy that target clots, aim to salvage threatened brain tissue to limit injury, and have a time window measured in hours. Restorative therapies target the brain, aim to promote plasticity within surviving brain tissue, and have a time window measured in days to weeks or longer. RECENT FINDINGS A number of drugs are under study. Preclinical studies are providing attractive therapeutic candidates for translation, suc...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Medical Management for Secondary Stroke Prevention
This article reviews the evidence base and recommendations for medical management for secondary stroke prevention. RECENT FINDINGS Recent developments for secondary stroke prevention include evidence to support the use of short-term dual antiplatelet therapy after minor stroke and transient ischemic attack, direct oral anticoagulants for nonvalvular atrial fibrillation, reversal agents for direct oral anticoagulant–associated hemorrhage, and aspirin rather than presumptive anticoagulation with a direct oral anticoagulant for embolic stroke of undetermined source. SUMMARY Most strokes are preventable. The mainstays ...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Surgical Approaches to Stroke Risk Reduction
This article examines the evidence for using the available options. RECENT FINDINGS Carotid endarterectomy is an effective treatment option for reducing the risk of stroke in appropriately selected patients. Patients should be stratified for future stroke risk based on both the degree of stenosis and the presence of symptoms referable to the culprit lesion. Carotid stenting is also useful in reducing stroke risk, again in carefully selected patients. Because of the publication of significant data regarding both carotid endarterectomy and carotid artery stenting in the last several years, selection can be far more person...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Innovations in Prehospital Stroke Management Utilizing Mobile Stroke Units
Using a representative case, this article discusses prehospital innovations for patients with acute large vessel occlusion ischemic stroke, including mobile stroke unit care supported by advanced field imaging.
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: PRACTICE ISSUES Source Type: research

Effects of EMG-triggered FES during trunk pattern in PNF on balance and gait performance in persons with stroke.
CONCLUSIONS: The results of this study showed that PNF trunk pattern affected the trunk control for stroke patients, and increased trunk control ability was effective in improving balance and walking. In addition, it was found that the EMG-triggered FES applied to the PNF trunk pattern affected the trunk control. PMID: 32250337 [PubMed - as supplied by publisher]
Source: Restorative Neurology and Neuroscience - April 8, 2020 Category: Neurology Tags: Restor Neurol Neurosci Source Type: research

Middle School Students Effectively Improve Stroke Knowledge and Pass Them to Family Members in China Using Stroke 1-2-0
Conclusion: Middle school and high school students can effectively use Stroke 1-2-0 to improve their stroke knowledge and pass this knowledge to their family members. Sustained educational efforts and repeated educational events are needed though.
Source: Frontiers in Neurology - April 7, 2020 Category: Neurology Source Type: research

Deathly Ill Coronavirus Patients Could Be Saved By Heart Attack And Stroke Drug
BOSTON (CBS) — TPA is a drug that is used to help stroke and heart attack victims. It works by breaking up or busting blood clots. Doctors at Beth Israel Deaconess Medical Center are now using it in a clinical trial on gravely ill coronavirus patients. “There’s a lot of very small blood clots accumulating in the lungs of these patients,” said Dr. Christopher Barrett. “And that seems to be at least contributory, if not the predominant reason, that their respiratory failure is so bad.” Dr. Barrett says TPA could help patients recover faster, free up ventilators and even prevent people from...
Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - April 8, 2020 Category: Consumer Health News Authors: Health – CBS Boston Tags: Boston News Health Syndicated CBSN Boston Syndicated Local Cheryl Fiandaca Coronavirus Health News Source Type: news