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Source: Journal of Neurology, Neurosurgery and Psychiatry

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Total 415 results found since Jan 2013.

MRI-visible perivascular spaces: relationship to cognition and small vessel disease MRI markers in ischaemic stroke and TIA
Conclusions PVS do not have an independent association with cognitive impairment in patients with ischaemic stroke or TIA. The associations with clinical-radiological factors are consistent with the hypothesis that PVS reflect cerebral small vessel disease; the different associations for basal ganglia and centrum semiovale PVS might indicate different underlying small vessel arteriopathies according to PVS anatomical distribution, but this requires further study.
Source: Journal of Neurology, Neurosurgery and Psychiatry - April 10, 2014 Category: Neurosurgery Authors: Hurford, R., Charidimou, A., Fox, Z., Cipolotti, L., Jager, R., Werring, D. J. Tags: Open access, Stroke, Hypertension, Memory disorders (psychiatry) Cerebrovascular disease Source Type: research

Incidence, causes and predictors of neurological deterioration occurring within 24 h following acute ischaemic stroke: a systematic review with pathophysiological implications
Early neurological deterioration (END) following ischaemic stroke is a serious event with manageable causes in only a fraction of patients. The incidence, causes and predictors of END occurring within 24 h of acute ischaemic stroke (END24) have not been systematically reviewed. We systematically reviewed Medline and Embase from January 1990 to April 2013 for all studies on END24 following acute ischaemic stroke (<8 h from onset). We recorded the incidence and presumed causes of and factors associated with END24. Thirty-six studies were included. Depending on the definition used, the incidence of END24 markedly...
Source: Journal of Neurology, Neurosurgery and Psychiatry - December 17, 2014 Category: Neurosurgery Authors: Seners, P., Turc, G., Oppenheim, C., Baron, J.-C. Tags: Stroke Cerebrovascular disease Source Type: research

Obesity-stroke paradox and initial neurological severity
Conclusions In our study, although obesity was associated with better short-term functional outcomes, INS might be a more important prognostic factor. Therefore, initial status should also be considered when considering an ‘obesity paradox’ in chronic diseases.
Source: Journal of Neurology, Neurosurgery and Psychiatry - June 12, 2015 Category: Neurosurgery Authors: Kim, Y., Kim, C. K., Jung, S., Yoon, B.-W., Lee, S.-H. Tags: Stroke Cerebrovascular disease Source Type: research

Transcranial direct current stimulation facilitates motor learning post-stroke: a systematic review and meta-analysis
Transcranial direct current stimulation (tDCS) is an attractive protocol for stroke motor recovery. The current systematic review and meta-analysis investigated the effects of tDCS on motor learning post-stroke. Specifically, we determined long-term learning effects by examining motor improvements from baseline to at least 5 days after tDCS intervention and motor practise. 17 studies reported long-term retention testing (mean retention interval=43.8 days; SD=56.6 days) and qualified for inclusion in our meta-analysis. Assessing primary outcome measures for groups that received tDCS and motor practise versus ...
Source: Journal of Neurology, Neurosurgery and Psychiatry - March 15, 2016 Category: Neurosurgery Authors: Kang, N., Summers, J. J., Cauraugh, J. H. Tags: Editor's choice, Stroke Cerebrovascular disease Source Type: research

Measuring arm function early after stroke: is the DASH good enough?
Conclusions RMT methods identified limitations missed by CTT and indicate areas for improvement of the DASH as an upper limb measure for acute stroke. Findings, similar to those identified in multiple sclerosis, highlight the need for scales to have strong conceptual underpinnings, with their development and modification guided by sophisticated psychometric methods.
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 12, 2016 Category: Neurosurgery Authors: Baker, K., Barrett, L., Playford, E. D., Aspden, T., Riazi, A., Hobart, J. Tags: Immunology (including allergy), Multiple sclerosis, Stroke Cerebrovascular disease Source Type: research

A stroke mimic; focal neurological deficits in benign hereditary chorea?
Conclusion This case highlights the difficulties in assessing patients with new focal neurological symptoms in the presence of known, pre existing, neurological disease. It also serves to highlight how often erroneously progressive weakness is mislabelled as a ‘stroke’. Neurologists working together with acute physicians in liaison posts in MAU, provides a unique opportunity to improve overall recognition of neurological disease, and for patients potentially provides a more timely diagnostic work–up and the opportunity for early treatment.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Maw, K., Johnston, J., Rowntree, C., Kalhan, A. Tags: Immunology (including allergy), Headache (including migraine), Movement disorders (other than Parkinsons), Neurooncology, Pain (neurology), Stroke, CNS cancer, Neuropathology, Radiology, Surgical diagnostic tests, Surgical oncology Association of Britis Source Type: research

Genetics of ischaemic stroke
Recent advances in genomics and statistical computation have allowed us to begin addressing the genetic basis of stroke at a molecular level. These advances are at the cusp of making important changes to clinical practice of some monogenic forms of stroke and, in the future, are likely to revolutionise the care provided to these patients. In this review we summarise the state of knowledge in ischaemic stroke genetics particularly in the context of how a practicing clinician can best use this knowledge.
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 13, 2013 Category: Neurosurgery Authors: Sharma, P., Yadav, S., Meschia, J. F. Tags: Editor's choice, Stroke Cerebrovascular disease Source Type: research

Predicting delirium after a stroke
Clinicians treating patients with stroke will be familiar with delirium: a syndrome characterised by the rapid onset of disorganised thought, inattention and altered level of consciousness, with a characteristically fluctuant course. Limited data suggest that up to a quarter of patients with stroke admitted to hospital are affected at some point.1 In addition to being distressing for patients and carers, delirium doubles the risk of death and dependency.2 If diagnosed correctly, delirium can be treated by searching for precipitating factors such as infection, altering predisposing factors such as medication and taking step...
Source: Journal of Neurology, Neurosurgery and Psychiatry - March 5, 2014 Category: Neurosurgery Authors: Makin, S. D. J., Wardlaw, J. Tags: Open access, Stroke, Delirium, Memory disorders (psychiatry), Disability Editorial commentaries Source Type: research

Anxiety and working memory after stroke: implications for norm-referenced methods of identifying cognitive deficits
It is well established that stroke can result in impairments of cognitive functioning, particularly early after stroke onset.1 These cognitive impairments have a negative impact on activities of daily living,2 and are associated with lower mood and poorer quality of life.3 Improvement of cognitive functioning is therefore an important goal of rehabilitation. In clinical settings, the presence of cognitive impairment is usually determined by means of standardised psychometric assessment. A patient's cognitive test performance is compared to the performance of a non-stroke control group on the same test(s). The most appropri...
Source: Journal of Neurology, Neurosurgery and Psychiatry - April 13, 2015 Category: Neurosurgery Authors: Gillespie, D. C. Tags: Stroke, Memory disorders (psychiatry) Editorial commentaries Source Type: research

Impact of collaterals on the efficacy and safety of endovascular treatment in acute ischaemic stroke: a systematic review and meta-analysis
Conclusions Good pretreatment collateral status is associated with higher rates of favourable functional outcome, and lower rates of symptomatic intracranial haemorrhage and mortality, in patients with acute ischaemic stroke receiving endovascular therapies.
Source: Journal of Neurology, Neurosurgery and Psychiatry - April 13, 2016 Category: Neurosurgery Authors: Leng, X., Fang, H., Leung, T. W. H., Mao, C., Miao, Z., Liu, L., Wong, K. S., Liebeskind, D. S. Tags: Stroke Cerebrovascular disease Source Type: research

Venous imaging-based biomarkers in acute ischaemic stroke
Vascular neuroimaging plays a decisive role in selecting the best therapy in patients with acute ischaemic stroke. However, compared with the arterial system, the role of veins has not been thoroughly studied. In this review, we present the major venous imaging-based biomarkers in ischaemic stroke. First, the presence of hypodense veins in the monophasic CT angiography ipsilateral to the arterial occlusion. Second, the asymmetry of venous drainage in the pathological cerebral hemisphere on CT and MRI dynamic angiography. Finally, the presence of hypodense veins on T2* -based MRI. From the physiological point of view, the v...
Source: Journal of Neurology, Neurosurgery and Psychiatry - December 14, 2016 Category: Neurosurgery Authors: Munuera, J., Blasco, G., Hernandez-Perez, M., Daunis-i-Estadella, P., Davalos, A., Liebeskind, D. S., Wintermark, M., Demchuk, A., Menon, B. K., Thomalla, G., Nael, K., Pedraza, S., Puig, J. Tags: Stroke, Radiology, Radiology (diagnostics) Cerebrovascular disease Source Type: research

Newly detected paroxysmal atrial fibrillation after tia and ischaemic stroke on cardiac monitoring: systematic review and meta-analysis in relation to duration of recording
Conclusion Cardiac monitoring after TIA or ischaemic stroke detects clinically important rates of pAF in studies of unselected populations, with high rates of subsequent anticoagulation. A monitoring period of 5–7 days appears to be adequate.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Yiin, G. S., Lovett, N. G., Rothwell, P. M. Tags: Stroke Association of British Neurologists (ABN) joint meeting with the Royal College of Physicians (RCP), London, 23-24 October 2013 Source Type: research

Constraint-induced aphasia therapy following sub-acute stroke: a single-blind, randomised clinical trial of a modified therapy schedule
Conclusions Both CIAT and conventional therapy performed with equal intensity are efficacious methods for patients with sub-acute aphasia. The modified CIAT schedule is practical in an everyday therapeutic setting. Our results indicate that a short-term intensive therapy schedule in the early aphasia stage leads to substantial improvements in language functions. Clinical Trial Registration Information Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01625676
Source: Journal of Neurology, Neurosurgery and Psychiatry - December 10, 2013 Category: Neurosurgery Authors: Sickert, A., Anders, L.-C., Munte, T. F., Sailer, M. Tags: Stroke Cerebrovascular disease Source Type: research

Incidence, predictors and clinical characteristics of orolingual angio-oedema complicating thrombolysis with tissue plasminogen activator for ischaemic stroke
Conclusions Angio-oedema occurs more frequently than previously reported and is associated with preceding ACE-I treatment. Angio-oedema may be delayed and progress to life-threatening airway compromise, which has implications for the assessment and delivery of thrombolysis.
Source: Journal of Neurology, Neurosurgery and Psychiatry - April 13, 2015 Category: Neurosurgery Authors: Hurford, R., Rezvani, S., Kreimei, M., Herbert, A., Vail, A., Parry-Jones, A. R., Douglass, C., Molloy, J., Alachkar, H., Tyrrell, P. J., Smith, C. J. Tags: Immunology (including allergy), Stroke, Radiology Cerebrovascular disease Source Type: research

What causes intracerebral bleeding after thrombolysis for acute ischaemic stroke? Recent insights into mechanisms and potential biomarkers
The overall population benefit of intravascular recombinant tissue plasminogen activator (rtPA) on functional outcome in ischaemic stroke is clear, but there are some treated patients who are harmed by early symptomatic intracranial haemorrhage (ICH). Although several clinical and radiological factors increase the risk of rtPA-related ICH, none of the currently available risk prediction tools are yet useful for practical clinical decision-making, probably reflecting our limited understanding of the underlying mechanisms. Finding new methods to identify patients at highest risk of rtPA-related ICH, or new measures to limit ...
Source: Journal of Neurology, Neurosurgery and Psychiatry - September 13, 2015 Category: Neurosurgery Authors: Karaszewski, B., Houlden, H., Smith, E. E., Markus, H. S., Charidimou, A., Levi, C., Werring, D. J. Tags: Stroke Cerebrovascular disease Source Type: research