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Prevalence of Intracranial Stenosis in a Norwegian Ischemic Stroke Population
Conclusions: IS occurs in approximately 10% and is symptomatic in about 7% of a Norwegian ischemic stroke/TIA population. Diabetes mellitus appears to be the major risk factor for IS.
Source: Journal of Stroke and Cerebrovascular Diseases - March 28, 2014 Category: Neurology Authors: Nicola Logallo, Halvor Naess, Ulrike Waje-Andreassen, Lars Thomassen Tags: Original Articles Source Type: research

Six-Minute Magnetic Resonance Imaging Protocol for Evaluation of Acute Ischemic Stroke: Pushing the Boundaries Clinical Sciences
Conclusions— A 6-minute multimodal MR protocol with good diagnostic quality is feasible for the evaluation of patients with acute ischemic stroke and can result in significant reduction in scan time rivaling that of the multimodal computed tomographic protocol.
Source: Stroke - June 23, 2014 Category: Neurology Authors: Nael, K., Khan, R., Choudhary, G., Meshksar, A., Villablanca, P., Tay, J., Drake, K., Coull, B. M., Kidwell, C. S. Tags: CT and MRI, Acute Cerebral Infarction, Computerized tomography and Magnetic Resonance Imaging Clinical Sciences Source Type: research

Cervical Arterial Dissections and Association With Cervical Manipulative Therapy: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association AHA/ASA Scientific Statement
Conclusions— CD is an important cause of ischemic stroke in young and middle-aged patients. CD is most prevalent in the upper cervical spine and can involve the internal carotid artery or vertebral artery. Although current biomechanical evidence is insufficient to establish the claim that CMT causes CD, clinical reports suggest that mechanical forces play a role in a considerable number of CDs and most population controlled studies have found an association between CMT and VAD stroke in young patients. Although the incidence of CMT-associated CD in patients who have previously received CMT is not well established, an...
Source: Stroke - September 22, 2014 Category: Neurology Authors: Biller, J., Sacco, R. L., Albuquerque, F. C., Demaerschalk, B. M., Fayad, P., Long, P. H., Noorollah, L. D., Panagos, P. D., Schievink, W. I., Schwartz, N. E., Shuaib, A., Thaler, D. E., Tirschwell, D. L., on behalf of the American Heart Association Strok Tags: AHA Statements and Guidelines AHA/ASA Scientific Statement Source Type: research

Effective Mechanical Thrombectomy in a Patient with Hyperacute Ischemic Stroke Associated with Cardiac Myxoma
We describe a patient with hyperacute stroke caused by cardiac myxoma who had a good outcome with rapid recanalization through mechanical thrombectomy. A 46-year-old man was admitted with acute symptoms of right side hemiplegia and global aphasia. Brain computed tomography (CT) angiography showed a T occlusion of the left internal carotid artery. Intravenous recombinant tissue plasminogen activator was administered. However, his clinical symptoms did not improve. Thus, we performed endovascular treatment and had a successful outcome. A pathologic examination of the retrieved clot revealed a tumor emboli from a cardiac myxo...
Source: Journal of Stroke and Cerebrovascular Diseases - September 1, 2014 Category: Neurology Authors: Seol-Hee Baek, Soonchan Park, Nam Joon Lee, Youngjin Kang, Kyung-Hee Cho Tags: Case Reports Source Type: research

Outcomes After Acute Ischemic Stroke in the United States: Does Residential ZIP Code Matter? Stroke
Conclusions Patients from lower-income quartiles had decreased reperfusion on the first admission day, compared with patients from higher-income quartiles. The cost of hospitalization of patients from higher-income quartiles was significantly higher than that of patients from lowest-income quartiles, despite longer hospital stays in the latter group. This might be partially attributable to a lower use of key procedures among patients from lowest-income quartile.
Source: JAHA:Journal of the American Heart Association - March 15, 2015 Category: Cardiology Authors: Agarwal, S., Menon, V., Jaber, W. A. Tags: Stroke Source Type: research

Arterial Reocclusion And Distal Embolization During Endovascular Treatment Using New Generation Stent Retrievers In Acute Ischemic Stroke Patients (P4.299)
CONCLUSIONS: Arterial reocclusion and distal embolization occur in 16[percnt]-18[percnt] of acute ischemic stroke patients undergoing mechanical thrombectomy with new stent retrievers. The rates are no higher than those observed in cohorts treated without stent retrievers.Disclosure: Dr. Herial has nothing to disclose. Dr. Qureshi has nothing to disclose. Dr. Khan has nothing to disclose. Dr. Jahangir has nothing to disclose. Dr. Zeb has nothing to disclose. Dr. Janjua has nothing to disclose. Dr. Suri has nothing to disclose. Dr. Qureshi has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Herial, N., Qureshi, M., Khan, A., Jahangir, N., Zeb, H., Janjua, N., Suri, M., Qureshi, A. Tags: Cerebrovascular Disease and Interventional Neurology: Acute Interventional Treatment for Ischemic Stroke Source Type: research

Detection of Paroxysmal Atrial Fibrillation in Very Young Cryptogenic Ischemic Stroke Patients under 40 Years: A Three Week ECG-Holter Monitoring Study (P7.121)
CONCLUSIONS: PAF was detected in 5 [percnt] of very young CIS patients < 40 years. Long-term ECG-Holter monitoring seems to be beneficial in the detection of PAF also in very young stroke population. Study supported by: IGA MH CR grants NT11046-6/2010, NT14288-3/2013 and by RVO FNOL 00098892.Disclosure: Dr. Kral has nothing to disclose. Dr. Sanak has received personal compensation for activities with Boehringer Ingelheim Pharmaceuticals, Inc. as a scientific advisory board member and/or speaker. Dr. Hutyra has nothing to disclose. Dr. Fedorco has nothing to disclose. Dr. Skoloudik has nothing to disclose. Dr. Kanovsky h...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Kral, M., Sanak, D., Hutyra, M., Fedorco, M., Skoloudik, D., Kanovsky, P. Tags: Cerebrovascular Disease and Interventional Neurology: Stroke in Young Source Type: research

Sulcal Effacement With Preserved Gray-White Junction: A Sign of Reversible Ischemia Brief Reports
Conclusions— Sulcal effacement with preserved gray–white delineation is occasionally visualized in patients with proximal occlusion strokes, relates to robust leptomeningeal collaterals, and indicates preserved underlying parenchyma. ISE should not be used to exclude patients from thrombectomy.
Source: Stroke - May 22, 2015 Category: Neurology Authors: Haussen, D. C., Lima, A., Frankel, M., Anderson, A., Belagaje, S., Nahab, F., Rangaraju, S., Nogueira, R. G. Tags: Acute Cerebral Infarction, Emergency treatment of Stroke, Angiography, Computerized tomography and Magnetic Resonance Imaging Brief Reports Source Type: research

Effect Size Estimates for the ESCAPE Trial: Proportional Odds Regression Versus Other Statistical Methods Clinical Sciences
Conclusions— The mRS distribution for both treatment and control groups influences the power of the investigated statistical models to assess treatment efficacy. A careful evaluation of the expected outcome distribution across the mRS scale is required to determine the best choice of primary analysis.
Source: Stroke - June 22, 2015 Category: Neurology Authors: Sajobi, T. T., Zhang, Y., Menon, B. K., Goyal, M., Demchuk, A. M., Broderick, J. P., Hill, M. D. Tags: Thrombolysis, Other Stroke Treatment - Surgical Clinical Sciences Source Type: research

Multi‐modal CT in acute stroke: wait for a serum creatinine before giving intravenous contrast? No!
ConclusionsThe incidence of CIN is low when MMCT is used routinely to assess acute stroke patients. In this population, CIN was a biochemical phenomenon that did not have clinical manifestations, cause chronic kidney disease, require dialysis, or negatively impact on 90‐day mRS outcomes. Renal profiling and waiting for a baseline serum‐creatinine are an unnecessary delay to emergency reperfusion treatment.
Source: International Journal of Stroke - August 26, 2015 Category: Neurology Authors: Timothy E. Ang, Andrew Bivard, Christopher Levi, Henry Ma, Chung Y. Hsu, Bruce Campbell, Geoffrey Donnan, Stephen M. Davis, Mark Parsons Tags: Research Source Type: research

Ultra-acute CT perfusion imaging: A stroke in the scanner
A stroke patient with a mild right hemiparesis (NIH Stroke Scale score 4) underwent dual-slab CT perfusion (CTP). In the midst of acquiring the lower CTP slab, she became aphasic and developed a dense right hemiparesis (NIH Stroke Scale score 17). Reconstruction of the CTP into a dynamic CT angiogram demonstrates fragmentation of an internal carotid artery thrombus at the time of clinical worsening (figure 1; video on the Neurology® Web site at Neurology.org). The upper CTP slab, acquired 2 minutes later, provides the earliest known view of the hemodynamics of ischemic stroke in humans. It demonstrates total absence of...
Source: Neurology - November 9, 2015 Category: Neurology Authors: Christensen, S., Obi, C., Albers, G., Lansberg, M. Tags: CT, All Cerebrovascular disease/Stroke, Embolism, Infarction VIDEO NEUROIMAGES Source Type: research

Enrollment bias: frequency and impact on patient selection in endovascular stroke trials
Conclusions The majority of patients felt suitable for EST at our institution were excluded from recent trials. Formal entry criteria succeeded in selecting patients with better prognostic features, although many of these patients were treated outside of trials. Acknowledging and mitigating these biases will be crucial to ongoing investigations.
Source: Journal of NeuroInterventional Surgery - March 15, 2016 Category: Neurosurgery Authors: Sheth, S. A., Saver, J. L., Starkman, S., Grunberg, I. D., Guzy, J., Ali, L. K., Kim, D., Gonzalez, N. R., Jahan, R., Tateshima, S., Duckwiler, G., Liebeskind, D. S. Tags: Ischemic stroke Source Type: research

A Comparison of Door-to-Puncture Times in Expedited Management of Acute Ischemic Stroke Patients (P2.315)
Conclusions: We demonstrate that a substantial time difference exists in the treatment of traditional versus direct AIS patients. Transporting stroke patients directly to the angiography suite may result in significant time saving and lead to better functional outcomes. This should be evaluated in larger prospective studies.Disclosure: Dr. Nayan has nothing to disclose. Dr. See has nothing to disclose. Dr. Khandelwal has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Aziz-Sultan has received personal compensation for activities with Covidien.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Nayan, L., See, A., Khandelwal, P., Patel, N., Aziz-Sultan, M. Tags: Stroke Systems of Care Source Type: research

Inter-Rater Variability for Evaluation of ASPECT Score Between a Neurologist and Neuroradiologist in Acute Stroke Patients (P6.020)
Conclusion Inter-rater agreement of evaluation early acute CT ischemic changes in acute-stroke patients between a neurologist and neuroradiologist was almost perfect. That could improve management of the acute stroke and mechanical thrombectomy care. It would support the faster activation of the thrombectomy team, leading to shorter door-to-needle- times and eventually, better outcomes.Disclosure: Dr. Kral has nothing to disclose. Dr. Bar has nothing to disclose. Dr. Jonszta has nothing to disclose. Dr. Marcian has nothing to disclose. Dr. Kuliha has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Kral, J., Bar, M., Jonszta, T., Marcian, V., Kuliha, M. Tags: Ischemic Stroke Diagnosis Source Type: research

Sensitivity and Specificity of the Prehospital NIHSS for Screening Intra-Arterial Thrombectomy Candidates: Experience on a Mobile Stroke Unit (P6.049)
Conclusions: The NIHSS obtained in the prehospital setting can help identify IAT candidates according to current guidelines, but is imprecise. An NIHSS cutoff of >9 identifies 83[percnt] of candidates; while it also falsely identifies a substantial number of patients who could be screened out at CSCs after CTA. An NIHSS cutoff >4 identifies all IAT candidates. Further study of the NIHSS to identify patients who may require transfer to CSCs for IAT may be useful in settings without readily available CTA.Disclosure: Dr. Jagolino has nothing to disclose. Dr. Cai has nothing to disclose. Dr. Rahbar has nothing to disclos...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Jagolino, A., Cai, C., Rahbar, M., Bowry, R., Parker, S., Grotta, J. Tags: Prehospital Stroke Care and Uses of NIHSS Source Type: research