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Reliability of brain CT evaluation by stroke neurologists in telemedicine
Conclusions: Clinically relevant misinterpretation of the CT scans was rare in our acute telestroke service. ASPECTS is a reliable tool to assess the extent of EIC by stroke neurologists in telemedicine in real time.
Source: Neurology - January 21, 2013 Category: Neurology Authors: Puetz, V., Bodechtel, U., Gerber, J. C., Dzialowski, I., Kunz, A., Wolz, M., Hentschel, H., Schultheiss, T., Kepplinger, J., Schneider, H., Wiedemann, B., Wojciechowski, C., Reichmann, H., Gahn, G., von Kummer, R. Tags: Diagnostic test assessment, CT, All Cerebrovascular disease/Stroke ARTICLE Source Type: research

Thrombolysis Despite Recent Stroke: A Case Series Brief Reports
Conclusions— In our center, we thrombolysed 6 patients despite recent stroke. Three patients had asymptomatic petechial hemorrhagic transformation within the area of subacute infarct, without apparent neurological worsening. Prospective studies are needed to explore the possible safety of tissue-type plasminogen activator in the context of previous subacute stroke in otherwise eligible patients.
Source: Stroke - May 24, 2013 Category: Neurology Authors: Alhazzaa, M., Sharma, M., Blacquiere, D., Stotts, G., Hogan, M., Dowlatshahi, D. Tags: Acute Cerebral Infarction, Thrombolysis Brief Reports 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

Quantitative Measurement of Physical Activity in Acute Ischemic Stroke and Transient Ischemic Attack Clinical Sciences
Conclusions— This study demonstrates the feasibility of using accelerometers to quantitatively and continuously measure physical activity simultaneously from all 4 extremities and the hip in patients with acute ischemic stroke and transient ischemic attack. Our study provides quantitative evidence of physical inactivity in patients with acute ischemic stroke. The method offers a low cost and noninvasive tool for future clinical interventional physiotherapeutic and early mobilization studies. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01560520.
Source: Stroke - November 24, 2014 Category: Neurology Authors: Strommen, A. M., Christensen, T., Jensen, K. Tags: Acute Cerebral Infarction Clinical Sciences Source Type: research

Stroke in Bahrain: rising incidence, multiple risk factors, and suboptimal care
The incidence of stroke in Bahrain is rising in the Bahraini population and has nearly doubled over the last 16 years, while the incidence in the non‐Bahraini population has not changed. Incidence of stroke in the Bahraini population (110/100 000) is now much greater than in the non‐Bahraini population (27/100 000). The Bahraini stroke population is 10 years younger than Western comparators with a much higher prevalence of many of the risk factors for stroke, including diabetes (54%), hypertension (75%) and hyperlipidemia (34%). The combination of an ageing Bahraini population alongside a high prevalence of risk fa...
Source: International Journal of Stroke - April 1, 2015 Category: Neurology Authors: Mona Al Banna, Hassan Baldawi, Ali Kadhim, Hani Humaidan, David L. Whitford Tags: Panorama Source Type: research

Pre-hospital imaging and thrombolysis in acute stroke in an urban US setting: results of the Cleveland Pre-Hospital Acute Stroke Treatment (PHAST) study group. (S21.002)
CONCLUSIONS: Close to a fifth of patients received acute stroke treatment on MSTU. These findings demonstrate the successful reduction in time to diagnosis and treatment of acute stroke patients using a MSTU. Study Supported by:Disclosure: Dr. Briggs has nothing to disclose. Dr. Taqui has nothing to disclose. Dr. Cerejo has nothing to disclose. Dr. Itrat has nothing to disclose. Dr. Donohue has nothing to disclose. Dr. Organek has nothing to disclose. Dr. Buletko has nothing to disclose. Dr. Sheikhi has nothing to disclose. Dr. Buttrick has nothing to disclose. Dr. Khawaja has nothing to disclose. Dr. Wisco has nothing to ...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Briggs, F., Taqui, A., Cerejo, R., Itrat, A., Donohue, M., Organek, N., Buletko, A., Sheikhi, L., Buttrick, M., Khawaja, Z., Wisco, D., Winners, S., Reimer, A., Frontera, J., Manno, E., Hustey, F., Kralovic, D., Peter, R., Hussain, M., Uchino, K. Tags: Cerebrovascular Disease and Interventional Neurology: Prehospital and Acute Ischemic Stroke Treatment Source Type: research

Improving Door-to-Needle Times for Acute Ischemic Stroke: Effect of Rapid Patient Registration, Moving Directly to Computed Tomography, and Giving Alteplase at the Computed Tomography Scanner Original Articles
Conclusions— Taking the patient to CT on the emergency medical services stretcher, registering the patient as unknown, STAT stroke protocol, and administering alteplase in CT are associated with lower DTN time.
Source: Circulation: Cardiovascular Quality and Outcomes - January 16, 2017 Category: Cardiology Authors: Kamal, N., Holodinsky, J. K., Stephenson, C., Kashayp, D., Demchuk, A. M., Hill, M. D., Vilneff, R. L., Bugbee, E., Zerna, C., Newcommon, N., Lang, E., Knox, D., Smith, E. E. Tags: Quality and Outcomes, Ischemic Stroke Original Articles Source Type: research

Structural MRI markers of brain aging early after ischemic stroke
Conclusions: Brain structure is likely to be compromised before ischemic stroke by vascular risk factors. Smaller hippocampal and total brain volumes and increased WMH load represent proxies for underlying vascular brain injury.
Source: Neurology - July 10, 2017 Category: Neurology Authors: Werden, E., Cumming, T., Li, Q., Bird, L., Veldsman, M., Pardoe, H. R., Jackson, G., Donnan, G. A., Brodtmann, A. Tags: MRI, All Cerebrovascular disease/Stroke, Clinical trials Observational study (Cohort, Case control), Alzheimer's disease, Vascular dementia ARTICLE Source Type: research

Route of Feeding as a Proxy for Dysphagia After Stroke and the Effect of Transdermal Glyceryl Trinitrate: Data from the Efficacy of Nitric Oxide in Stroke Randomised Controlled Trial
AbstractPost-stroke dysphagia is common, associated with poor outcome and often requires non-oral feeding/fluids. The relationship between route of feeding and outcome, as well as treatment with glyceryl trinitrate(GTN), was studied prospectively. The Efficacy of Nitric Oxide in Stroke (ENOS) trial assessed transdermal GTN (5  mg versus none for 7 days) in 4011 patients with acute stroke and high blood pressure. Feeding route (oral = normal or soft diet; non-oral = nasogastric tube, percutaneous endoscopic gastrostomy tube, parenteral fluids, no fluids) was assessed at baseline and day 7. The primary outcome was the mo d...
Source: Translational Stroke Research - August 2, 2017 Category: Neurology Source Type: research

Early Progressive Changes in White Matter Integrity Are Associated with Stroke Recovery
AbstractInformation on microstructural white matter integrity has been shown to explain post-stroke recovery beyond clinical measures and focal brain damage. Especially, knowledge about early white matter changes might improve prediction of outcome. We investigated 42 acute reperfused ischemic stroke patients (mean age 66.5  years, 40% female, median admission NIHSS 9.5) with a symptomatic MRI-confirmed unilateral middle cerebral artery territory infarction 24–72 h post-stroke and after 3 months. All patients underwent neurological examination and brain MRI. Fifteen older healthy controls (mean age 57.3 years) we re ...
Source: Translational Stroke Research - March 3, 2020 Category: Neurology 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

Protocol for the perfusion and angiography imaging sub‐study of the Third International Stroke Trial (IST‐3) of alteplase treatment within six‐hours of acute ischemic stroke
RationaleIntravenous thrombolysis with recombinant tissue Plasminogen Activator improves outcomes in patients treated early after stroke but at the risk of causing intracranial hemorrhage. Restricting recombinant tissue Plasminogen Activator use to patients with evidence of still salvageable tissue, or with definite arterial occlusion, might help reduce risk, increase benefit and identify patients for treatment at late time windows. AimsTo determine if perfusion or angiographic imaging with computed tomography or magnetic resonance help identify patients who are more likely to benefit from recombinant tissue Plasminogen Ac...
Source: International Journal of Stroke - January 22, 2013 Category: Neurology Authors: Joanna M. Wardlaw, Rudiger Kummer, Trevor Carpenter, Mark Parsons, Richard I. Lindley, Geoff Cohen, Veronica Murray, Adam Kobayashi, Andre Peeters, Francesca Chappell, Peter A. G. Sandercock Tags: Protocols Source Type: research

CT perfusion improves diagnostic accuracy and confidence in acute ischaemic stroke
Conclusions CTP in suspected stroke is widely applicable, rapid and increases diagnostic confidence.
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 7, 2013 Category: Neurosurgery Authors: Campbell, B. C. V., Weir, L., Desmond, P. M., Tu, H. T. H., Hand, P. J., Yan, B., Donnan, G. A., Parsons, M. W., Davis, S. M. Tags: Stroke Cerebrovascular disease 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