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Immune Responses and Anti-inflammatory Strategies in a Clinically Relevant Model of Thromboembolic Ischemic Stroke with Reperfusion
AbstractThe poor clinical relevance of experimental models of stroke contributes to the translational failure between preclinical and clinical studies testing anti-inflammatory molecules for ischemic stroke. Here, we (i) describe the time course of inflammatory responses triggered by a thromboembolic model of ischemic stroke and (ii) we examine the efficacy of two clinically tested anti-inflammatory drugs: Minocycline or anti-CD49d antibodies (tested in stroke patients as Natalizumab) administered early (1 h) or late (48 h) after stroke onset. Radiological (lesion volume) and neurological (grip test) outcomes were evalu...
Source: Translational Stroke Research - September 14, 2019 Category: Neurology Source Type: research
The First 10 Thrombolysis for Acute Ischemic Stroke in Lao People's Democratic Republic under Teleconsultation from Thailand
This study aimed to evaluate the feasibility and safety of thrombolytic therapy administration at Mittaphab Hospital, Lao PDR under the international telestroke consultation system from King Chulalongkorn Memorial Hospital, Thailand. Methods: Acute ischemic stroke patients who presented at Mittaphab Hospital within 4.5 hours after the onset and received thrombolytic therapy between December 2016 and June 2017 were studied.
Source: Journal of Stroke and Cerebrovascular Diseases - September 14, 2019 Category: Neurology Authors: Aurauma Chutinet, Saysavath Keosodsay, Pongpat Vorasayan, Jitlada Samajarn, Wasan Akarathanawat, Naruchorn Kijpaisalratana, Naly Norsakpeseuth, Ketmany Phetsiriseng, Snong Thongsna, Pakkawan Vongvasinkul, Nijasri C. Suwanwela Source Type: research
Use of 3-Dimensional, Black-Blood, Contrast-Enhanced, T1-Weighted Magnetic Resonance Imaging to Identify Vascular Occlusion in the Posterior Circulation After Acute Ischemic Stroke
Background: Three-dimensional, black-blood, contrast-enhanced, T1-weighted magnetic resonance imaging (3D-BB-ceT1-MRI) could play a role in detection of thrombi and symptomatic intracranial atherosclerotic stenosis. We investigated the role of 3D-BB-ceT1-MRI in patients with acute ischemic stroke in the posterior circulation, and compared our findings with those from susceptibility-weighted imaging (SWI). Materials and Methods: We retrospectively reviewed 3D-BB-ceT1-MRI for patients between January 2017 and August 2018 with acute ischemic symptoms in the posterior circulation.
Source: Journal of Stroke and Cerebrovascular Diseases - September 13, 2019 Category: Neurology Authors: Gyung Ho Chung, Seung Bae Hwang, Hyo Sung Kwak Source Type: research
Beneficial Effects of Theta-Burst Transcranial Magnetic Stimulation on Stroke Injury via Improving Neuronal Microenvironment and Mitochondrial Integrity
We report that rTMS significantly attenuated behavioral deficits and infarct volume after PT stroke. Fur ther investigation demonstrated that rTMS remarkably reduced synaptic loss and neuronal degeneration in the peri-infarct cortical region. Mechanistic studies displayed that beneficial effects of rTMS were associated with robust suppression of reactive micro/astrogliosis and the overproduction of pro -inflammatory cytokines, as well as oxidative stress and oxidative neuronal damage especially at the late stage following PT stroke. Intriguingly, rTMS could effectively induce a shift in microglial M1/M2 phenotype activatio...
Source: Translational Stroke Research - September 12, 2019 Category: Neurology Source Type: research
Subclinical Peripheral Arterial Disease in Patients with Acute Ischemic Stroke: A Study with Ultrasonography
Background: Peripheral arterial disease (PAD) is an advanced form of atherosclerosis defined by an abnormal ankle-brachial index (ABI). However, the ABI provides no information about the location of atherosclerosis. We investigated the clinical implication of PAD confirmed using lower-extremity ultrasonography (LEUS), with consideration of the atherosclerosis location. Methods: Patients with acute ischemic stroke who underwent LEUS were enrolled. Patients with PAD were further divided into those with PAD at the proximal (above-popliteal artery, PADP) and distal (below-tibialis artery, PADD) segments.
Source: Journal of Stroke and Cerebrovascular Diseases - September 12, 2019 Category: Neurology Authors: Yu Yong Shin, Sang Hee Ha, Ho Geol Woo, Sung Hyuk Heo, Dae-il Chang, Bum Joon Kim Source Type: research
Napping Once Or Twice A Week Could Lower Heart Attack & Stroke Risk, Study Finds
By Amy Woodyatt, CNN (CNN) — Some good news for nap fanatics — a new study has found that a daytime nap taken once or twice a week could lower the risk of heart attacks or strokes. Researchers from the University Hospital of Lausanne, Switzerland studied the association between napping frequency and duration and the risk of fatal and non-fatal cardiovascular disease complications. Tracking 3,462 people between the ages of 35 and 75 for just over five years, the report authors found that those who indulged in occasional napping — once or twice a week, for between five minutes to an hour — were 48% ...
Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - September 10, 2019 Category: Consumer Health News Authors: Health – CBS Boston Tags: Health News Syndicated CBSN Boston CNN Heart Attack Stroke Source Type: news
Prediction of Gait without Physical Assistance after Inpatient Rehabilitation in Severe Subacute Stroke Subjects
This study is aimed at describing the frequency of achievement of gait without physical assistance in poststroke subacute patients by the time of discharge from a rehabilitation hospitalized program. Secondarily, our goal is to identify gait without physical assistance predictors in this same population based on the admission's clinical and demographic conditions. Methods: Data from 185 first unilateral hemispheric stroke patients that need physical assistance to walk at admission were analyzed.
Source: Journal of Stroke and Cerebrovascular Diseases - September 10, 2019 Category: Neurology Authors: M.G. Gianella, C.F. Gath, L. Bonamico, L.E. Olmos, M.J. Russo Source Type: research
The Prevalence of Multiple Comorbidities in Stroke Survivors in Rural Appalachia and the Clinical Care Implications
Background: The majority of studies on multimorbidity have been in aging populations and there is a paucity of data on individuals following stroke. Objective: In order to better understand the overall complexity of the stroke population in rural Kentucky, we examined the prevalence of multimorbidity that impact the overall long-term health and health care for these individuals. Methods: A secondary analysis examined whether there are gender or age differences in this stroke population related to the prevalence of multimorbidity.
Source: Journal of Stroke and Cerebrovascular Diseases - September 10, 2019 Category: Neurology Authors: Patrick H. Kitzman, Kathleen M. Sutton, Marc Wolfe, Lisa Bellamy, Michael R. Dobbs Source Type: research
Contribution of Onset-to-Alarm Time to Prehospital Delay in Patients with Ischemic Stroke
Background: Stroke is a leading cause of death and disability. Tissue plasminogen activator (tPA) improves the clinical outcome when administered properly; however, the most important factor to receive tPA is time. The main reason for late hospital arrival is a considerable delay in onset-to-alarm time (OAT), comprising more than 50% of the onset-to-door time. Aims: To identify the factors associated with a delay in OAT and evaluate its contribution to onset-to-door time in ischemic stroke patients.
Source: Journal of Stroke and Cerebrovascular Diseases - September 10, 2019 Category: Neurology Authors: Alejandro Gonzalez-Aquines, Adolfo C. Cordero-P érez, Mario Cristobal-Niño, Gil Pérez-Vázquez, Fernando Góngora-Rivera, GECEN Investigators Source Type: research
Stroke Center Care and Outcome: Results from the CSPPC Stroke Program
AbstractThe aim of this study was to assess the association between admission to stroke centers for acute ischemic stroke and complications and mortality during hospitalization in a Chinese population by means of an observational study using data from the China Stroke Center Data-Sharing Platform. We compared in-hospital complications and mortality for patients admitted with acute ischemic stroke (N = 13,236) between November 1, 2018 and December 31, 2018 at stroke center (SH) and non-stroke center (CH) hospitals using distance to hospitals as an instrumental variable to adjust for potential prehospital selection bias....
Source: Translational Stroke Research - September 8, 2019 Category: Neurology Source Type: research
Serum Retinoic Acid Level and The Risk of Poststroke Cognitive Impairment in Ischemic Stroke Patients
This study aimed to detect the association between RA level and PSCI among patients with first-ever acute ischemic stroke. Methods: Two hundred and 61 consecutive patients were prospectively recruited during March 2018 and March 2019.
Source: Journal of Stroke and Cerebrovascular Diseases - September 6, 2019 Category: Neurology Authors: Le Hou, Caixia Ding, Zhao Chen, Yuanyue Liu, Haishan Shi, Cong Zou, Hui Zhang, Zhiwei Lu, Dong Zheng Source Type: research
Vegetarians May Be At Higher Risk Of Stroke, Study Finds
BOSTON (CBS) – Many people adopt a vegetarian lifestyle to help reduce their risk of cardiovascular disease, but a new study published in the BMJ finds people who avoid meat all together may be at a higher risk of stroke. Researchers in the U.K. looked at about 48 thousand adults over 18 years. They found that vegetarians, vegans, and pescatarians (people who eat fish but not meat) had a lower risk of ischemic heart disease, like heart attacks. But vegetarians had a 20% higher risk of stroke compared to meat eaters. It’s not clear why vegetarians may suffer more strokes. Perhaps it is due to lower levels of cer...
Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - September 5, 2019 Category: Consumer Health News Authors: Health – CBS Boston Tags: Boston News Health Healthwatch Syndicated Local Dr. Mallika Marshall Stroke Vegetarian Source Type: news
Stroke-Related Knowledge and Lifestyle Behavior among Stroke Survivors
Aims: Awareness of stroke symptoms and risk factors, and actions taken in order to reduce the risk of new stroke events, should be of great importance among stroke survivors. The aims of this study were to assess changes in stroke-related knowledge and lifestyle behavior among patients experiencing a cerebrovascular event, and to assess the agreement between the patients ’ self-reported diagnosis, and the discharge diagnosis. Methods: All patients discharged with a diagnosis of stroke or transient ischemic attack during a 1-year period, received postal survey questionnaires at 3 and 12 months after discharge.
Source: Journal of Stroke and Cerebrovascular Diseases - September 5, 2019 Category: Neurology Authors: Kashif Waqar Faiz, Angela Susan Labberton, Bente Thommessen, Ole Morten R ønning, Mathias Barra Source Type: research
Computer-Based Cognitive Rehabilitation in Patients with Visuospatial Neglect or Homonymous Hemianopia after Stroke
Objectives: The purpose of this pilot study was to investigate the feasibility and effects of computer-based cognitive rehabilitation (CBCR) in patients with symptoms of visuospatial neglect or homonymous hemianopia in the subacute phase following stroke. Method: A randomized, controlled, unblinded cross-over design was completed with early versus late CBCR including 7 patients in the early intervention group (EI) and 7 patients in the late intervention group (LI). EI received CBCR training immediately after inclusion (m = 19 days after stroke onset) for 3 weeks and LI waited for 3 weeks after inclusion before receivi...
Source: Journal of Stroke and Cerebrovascular Diseases - September 5, 2019 Category: Neurology Authors: Katrine Wordenskjold Svaerke, Kenneth Viktor Omkvist, Inger Birgitte Havsteen, Hanne Krarup Christensen Source Type: research
The Yield of Multimodal Computed Tomography among Emergency Department Patients with Suspected Large Vessel Occlusion Stroke
Objectives: Endovascular therapy (EVT) improves outcomes for appropriately selected acute ischemic stroke patients. Guidelines suggest rapid acquisition of noninvasive vascular imaging to screen suspected ischemic stroke patients for large vessel occlusion (LVO) and candidacy for EVT. We sought to quantify the yield of an LVO stroke screening process in an undifferentiated emergency department (ED) suspected stroke population as well as identify predictors of successful EVT. Methods: We identified a cohort of consecutive ED patients who received CT angiography and brain perfusion (CTA/P) imaging to determine candidacy for EVT during 2016.
Source: Journal of Stroke and Cerebrovascular Diseases - September 4, 2019 Category: Neurology Authors: Yalda Serena Dastmalchi, J. Adam Oostema Source Type: research
Poor Sleep Quality I Related to Impaired Functional Status Following Stroke
Introduction: Sleep disorders are more prevalent in patients with previous stroke compared to healthy individuals. The main objective of the present study was to investigate the impact of sleep quality on the functional status of patients with a history of stroke, upon admission to inpatient rehabilitation. Methods: Fifty patients (mean age: 69 ± 11 years) with previous stroke were consecutively included in this single center cross-sectional observational study upon admission to inpatient rehabilitation.
Source: Journal of Stroke and Cerebrovascular Diseases - September 3, 2019 Category: Neurology Authors: Ipek Sonmez, Seide Karasel Source Type: research
Letter to the Editor Regarding “Relationship of Malnutrition during Hospitalization with Functional Recovery and Postdischarge Destination in Elderly Stroke Patients”
We read with great interest the article by Sato et al on the relationship of malnutrition with acute stroke in 205 patients hospitalized at the Shinshu University hospital, Japan.1 We would like to provide an additional nationwide United States (US) perspective on outcomes of hospitalized stroke patients with protein energy malnutrition (PEM).
Source: Journal of Stroke and Cerebrovascular Diseases - September 3, 2019 Category: Neurology Authors: Rupak Desai, Alok R. Amraotkar Tags: Letter to the Editor Source Type: research
Cardioembolic Ischemic Stroke Gene Expression Fingerprint in Blood: a Systematic Review and Verification Analysis
AbstractAn accurate etiological classification is key to optimize secondary prevention after ischemic stroke, but the cause remains undetermined in one third of patients. Several studies pointed out the usefulness of circulating gene expression markers to discriminate cardioembolic (CE) strokes, mainly due to atrial fibrillation (AF), while only exploring them in small cohorts. A systematic review of studies analyzing high-throughput gene expression in blood samples to discriminate CE strokes was performed. Significantly dysregulated genes were considered as candidates, and a selection of them was validated by RT-qPCR in 1...
Source: Translational Stroke Research - September 2, 2019 Category: Neurology Source Type: research
Determination of Clinical Cut-Off Values for Serum Cystatin C Levels to Predict Ischemic Stroke Risk
Background: The association between cystatin C and risk of ischemic stroke is inconsistent and the cut-off values of cystatin C are diverse in different articles. We aimed to investigate the association between cystatin C levels and the development of ischemic stroke and to explore the clinical cut-off values of serum cystatin C levels for ischemic stroke. Methods: This prospective cohort study included 7658 participants from the China Health and Retirement Longitudinal Study who were free of cardiovascular diseases and cancer at baseline.
Source: Journal of Stroke and Cerebrovascular Diseases - September 2, 2019 Category: Neurology Authors: Youyi Wang, Ying Zhang, Qinghua Ma, Congju Wang, Yong Xu, Hongpeng Sun, Yana Ma Source Type: research
Association of Prevalent Stroke with Hospitalization for Seizure: Patterns and Prognoses
Introduction: Despite the close relationship between stroke and seizures, little is known about stroke trends and inpatient mortality among patients with seizures. Materials and Methods: The National Inpatient Sample was used to analyze the prevalence and trends of stroke among patients discharged with a primary diagnosis of seizures between 2006 and 2014. International Classification of Diseases, Ninth Revision, Clinical Modification was used to identify patients discharged with a primary diagnosis of seizures and those with a secondary diagnosis of stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - September 2, 2019 Category: Neurology Authors: Alain Lekoubou, Kinfe G. Bishu, Bruce Ovbiagele Source Type: research
The Value of the CHADS2 and CHA2DS2-VASc Score for Predicting the Prognosis in Lacunar Stroke with or without Atrial Fibrillation Patients
Background: The CHADS2 and CHA2DS2-VASc scoring systems have been proved efficacy to stratify stroke and thromboembolism risk in patients with atrial fibrillation (AF). Whether CHADS2 and CHA2DS2-VASc score has predictive value for the prognosis in lacunar stroke (LS) patients remains unclear. Methods: A total of 763 consecutive patients with LS (mean age: 66 ± 12 years; 464 male) were enrolled in this study between January 2013 and December 2014. Patients were divided into LS without AF (LS; n = 679) and LS with AF (LS-AF; n = 84) groups.
Source: Journal of Stroke and Cerebrovascular Diseases - August 30, 2019 Category: Neurology Authors: Hong-Jie Yang, Guang-Ji Wang, Wei Shuai, Cai-Jie Shen, Bin Kong, He Huang Source Type: research
Baseline Neutrophil Counts and Neutrophil Ratio May Predict a Poor Clinical Outcome in Minor Stroke Patients with intravenous Thrombolysis
Background: Evidence about whether neutrophil counts, neutrophil ratio linked with clinical outcome in patients with minor stroke after thrombolysis is scarce. The purpose of this study is to explore the association of neutrophil counts, neutrophil ratio with the 90-day clinical outcome in patients with minor stroke treated with intravenous thrombolysis. Materials and methods: A total of 163 patients with minor stroke treated with thrombolysis within window time were recruited from 2013 to 2017.
Source: Journal of Stroke and Cerebrovascular Diseases - August 26, 2019 Category: Neurology Authors: Huihui Liu, Ruojun Wang, Jijun Shi, Yanlin Zhang, Zhichao Huang, Shoujiang You, Guodong Xiao, Dapeng Wang, Yongjun Cao Source Type: research
Computational Fluid Dynamics Analysis of Lateral Striate Arteries in Acute Ischemic Stroke Using 7T High-resolution Magnetic Resonance Angiography
Background: Infarcts in the lateral striate artery (LSA) territory can be caused by several pathological changes, including lipohyalinosis and microatheroma. However, fluid dynamic effects on these changes remain unknown. Thus, we investigated whether the fluid dynamic metrics of the LSAs were altered in patients with acute ischemic stroke using computational fluid dynamics (CFD) analysis. Methods: Fifty-one patients with acute ischemic stroke confined in the basal ganglia and/or corona radiata underwent high-resolution magnetic resonance angiography (HR-MRA) at 7T.
Source: Journal of Stroke and Cerebrovascular Diseases - August 24, 2019 Category: Neurology Authors: Futoshi Mori, Fujimaro Ishida, Tatsunori Natori, Haruna Miyazawa, Hiroyuki Kameda, Taisuke Harada, Kunihiro Yoshioka, Fumio Yamashita, Ikuko Uwano, Kenji Ito, Makoto Sasaki Source Type: research
Health Care Use and Its Associated Factors 5-8 Years after Stroke
Objectives: To describe health care use and its associated factors in the chronic phase after stroke. Methods: Patients completed a questionnaire on health care use, 5-8 years after hospital admission for stroke. It comprised the number of visits to physicians or other health care professionals over the past 6 months (Physician-visits; Low ≤1 or High ≥2) and other health care professionals (Low = 0 or High ≥ 1). In addition the Longer-term Unmet Needs after Stroke (LUNS), Frenchay Activity Index (FAI) and Physical and Mental Component Summary Scales of the Short Form 12 (PCS and MCS) were administered.
Source: Journal of Stroke and Cerebrovascular Diseases - August 24, 2019 Category: Neurology Authors: Henk J. Arwert, Iris F. Groeneveld, Thea P.M. Vliet Vlieland, Jorit J.L. Meesters Source Type: research
Phase I Safety Trial: Extended Daily Peripheral Sensory Stimulation Using a Wrist-Worn Vibrator in Stroke Survivors
AbstractPeripheral sensory stimulation augments post-stroke upper extremity rehabilitation outcomes. Most sensory stimulations interfere with natural hand tasks and the stimulation duration is limited. We developed TheraBracelet, low-level random-frequency vibration applied via a wristwatch, to enable stimulation during hand tasks and potentially extend stimulation durations. To determine safety of prolonged exposure to TheraBracelet. Single-site double-blind crossover randomized controlled trial. Chronic stroke survivors were instructed to wear a device on the affected wrist for> 8 h/day everyday for 2 months while...
Source: Translational Stroke Research - August 23, 2019 Category: Neurology Source Type: research
The quantification of task-difficulty of upper limb motor function skill based on Rasch analysis.
Conclusion: The therapist can confirm items that the patient can or cannot perform. By understanding the level of difficulty of each item, the most appropriate functional skill to focus on acquiring next can be identified. PMID: 31433271 [PubMed - as supplied by publisher]
Source: Topics in Stroke Rehabilitation - August 21, 2019 Category: Neurology Authors: Miyasaka H, Kondo I, Yamamura C, Fujita N, Orand A, Sonoda S Tags: Top Stroke Rehabil Source Type: research
Floating Aortic Thrombus: A Rare Cause of Acute Ischemic Stroke Necessitating Modification of Access Route for Thrombectomy
We report 2 patients with acute occlusion of middle cerebral artery successfully treated by mechanical thrombectomy performed via transbrachial access. Both patients had floating aortic arch thrombi precluding safe transfemoral access due to risk of further iatrogenic embolization. Moreover both patients were diagnosed with hypercoagulopathy secondary to lung malignancy (paraneoplastic etiology, Trousseau's syndrome) as the cause of both aortic thrombi and acute ischemic stroke. Mechanical thrombectomy in the setting of a floating aortic thrombus has been mentioned only once as part of general management of floating aortic...
Source: Journal of Stroke and Cerebrovascular Diseases - August 21, 2019 Category: Neurology Authors: Sinan Balci, Ethem Murat Arsava, Mehmet Akif Topcuoglu, Anil Arat Source Type: research
Comment on: External Validation of the PREMISE Score in the Athens Stroke Registry
This study externally validated our proposed predicting early mortality from ischemic stroke (PREMISE) score, derived from the nationwide Austrian Stroke Unit registry.2 While we feel obliged to point out that the original PREMISE score publication2 was incorrectly referenced3 by Ntaios et al, it is reassuring that the authors confirmed prognostic accuracy (with excellent calibration and good discrimination) of the PREMISE score as an instrument for predicting early (within one week after admission) death after ischemic stroke in 2608 patients from the Athens Stroke Unit registry.
Source: Journal of Stroke and Cerebrovascular Diseases - August 20, 2019 Category: Neurology Authors: Thomas Gattringer, Alexandra Posekany, Stefan Kiechl, Franz Fazekas, Christian Enzinger Tags: Letter to the Editor Source Type: research
The reliability and validity of the Turkish version of Brunel Balance Assessment (BBA-T).
Conclusions: The results of our study indicate that the Turkish version of BBA-T is a reliable and valid balance and mobility scale that can be used in the rehabilitation of stroke patients. PMID: 31430231 [PubMed - as supplied by publisher]
Source: Topics in Stroke Rehabilitation - August 20, 2019 Category: Neurology Authors: Aydoğan Arslan S, Yakut H, Demirci CS, Sertel M, Kutluhan S Tags: Top Stroke Rehabil Source Type: research
The Effect of Motor and Cognitive Tasks on Gait in People with Stroke
Objective: Gait of people with unilateral stroke is characterized by pronounced asymmetry. The aim of the study was to investigate the effect of cognitive and motor tasks on asymmetry of gait in people with stroke. Materials and Methods: Nine individuals with stroke walked over the GAITRite walkway while performing motor (holding a cup with water) or cognitive (reciting the alphabet) tasks or walked with no additional task. Gait velocity, cadence, and symmetry indexes for the stance phase, swing phase, and single support phase of a gait cycle were calculated.
Source: Journal of Stroke and Cerebrovascular Diseases - August 19, 2019 Category: Neurology Authors: Etem Curuk, Nikita Goyal, Alexander S. Aruin Source Type: research
Nephrotic Syndrome is Associated with Increased Risk of Ischemic Stroke
Background: To determine if the nephrotic syndrome (NS) is an independent risk factor of ischemic stroke. Methods: This is a retrospective nationwide cohort study through an analysis of the National Health Insurance Research Database in Taiwan. To evaluate the risk of stroke, the corresponding controls were selected at a 4:1 ratio in the number of subjects, and they were matched with the study group in age, gender, Charlson comorbidity index (CCI), and index date. Results: From a total of 16,245 surveyed subjects, ischemic stroke occurred in 1235 (7.6%) and hemorrhagic stroke in 129 (.74%) of them.
Source: Journal of Stroke and Cerebrovascular Diseases - August 16, 2019 Category: Neurology Authors: Jin-An Huang, Ching-Heng Lin, Yao-Tien Chang, Cheng-Ting Lee, Ming-Ju Wu Source Type: research
Change in CSF Dynamics Responsible for ICP Elevation After Ischemic Stroke in Rats: a New Mechanism for Unexplained END?
AbstractIt has been proposed that intracranial pressure (ICP) elevation and collateral failure are responsible for unexplained early neurological deterioration (END) in stroke. The study ’s aims were to investigate whether cerebral spinal fluid (CSF) dynamics, rather than edema, are responsible for elevation of ICP after ischemic stroke. Permanent middle cerebral artery occlusion (pMCAO) was induced with an intraluminal filament. At 24 h after stroke, baseline ICP was measured an d CSF dynamics were probed via a steady-state infusion method. Diffusion-weighted imaging (DWI) and T2-weighted magnetic resonance imaging wer...
Source: Translational Stroke Research - August 15, 2019 Category: Neurology Source Type: research
Cerebral Blood Flow Response During Bolus Normal Saline Infusion After Ischemic Stroke
Goals: We quantified cerebral blood flow response to a 500 cc bolus of 0.9%% normal saline (NS) within 96 hours of acute ischemic stroke (AIS) using diffuse correlation spectroscopy (DCS). Materials and Methods: Subjects with AIS in the anterior, middle, or posterior cerebral artery territory were enrolled within 96 hours of symptom onset. DCS measured relative cerebral blood flow (rCBF) in the bilateral frontal lobes for 15 minutes at rest (baseline), during a 30-minute infusion of 500 cc NS (bolus), and for 15 minutes after completion (post-bolus).
Source: Journal of Stroke and Cerebrovascular Diseases - August 13, 2019 Category: Neurology Authors: Michael T. Mullen, Ashwin B. Parthasarathy, Ali Zandieh, Wesley B. Baker, Rickson C. Mesquita, Caitlin Loomis, Jose Torres, Wensheng Guo, Christopher G. Favilla, Steven R. Mess é, Arjun G. Yodh, John A. Detre, Scott E. Kasner Source Type: research
Health related quality of life and manual ability 5 years after neonatal ischemic stroke.
CONCLUSION: Five years after NAIS, HRQOL is comparable to that of typically developing peers, but reduced in children with CP. Poorer manual ability is associated with lower HRQOL. Interventions improving hand function might influence HRQOL and should be considered early on. PMID: 31473077 [PubMed - as supplied by publisher]
Source: European Journal of Paediatric Neurology - August 12, 2019 Category: Neurology Authors: Caspar-Teuscher M, Studer M, Regényi M, Steinlin M, Grunt S, Swiss Neuropediatric Stroke Registry Group Tags: Eur J Paediatr Neurol Source Type: research
Timing of symptomatic intracerebral hemorrhage after rt-PA treatment in ischemic stroke
Conclusions Our findings suggest that rt-PA patients have the highest risk of post rt-PA sICH within the first 24 hours after treatment. This supports monitoring of rt-PA-treated patients in specialized settings such as neuro-intensive care units or stroke units. Our findings suggest that the probability of sICH is low 36 hours post rt-PA. Future larger studies are warranted to identify the patterns of bleeding after rt-PA administration.
Source: Neurology Clinical Practice - August 12, 2019 Category: Neurology Authors: Chen, P. M., Lehmann, B., Meyer, B. C., Rapp, K., Hemmen, T., Modir, R., Agrawal, K., Hailey, L., Mortin, M., Meyer, D. M. Tags: All Cerebrovascular disease/Stroke, Intracerebral hemorrhage Research Source Type: research
Urban Versus Rural Egypt: Stroke Risk Factors and Clinical Profile: Cross-Sectional Observational Study
Background: Egypt is a densely populated country with living habits and health care services that differ from urban to rural regions. We aimed to study how characteristics of stroke vary among these regions. Methods: This is a cross-sectional observational study of ischemic stroke, thus hemorrhagic and venous strokes were excluded. A total of 1475 ischemic stroke patients were recruited for analysis from a tertiary hospital in Cairo representing urban area and from a secondary care hospital in Suhag representing rural region.
Source: Journal of Stroke and Cerebrovascular Diseases - August 12, 2019 Category: Neurology Authors: Nevine M. El Nahas, Hossam M. Shokri, Tamer M. Roushdy, Hany M. Aref, Salma M. Hamed, Ali S. Shalash, Mohamed I. Abdelrahem, Noha L. Dawood, Eman M. Abushady, Shady S. Georgy, Amr S. Zaki, Rady Y. Bedros Source Type: research
Cardiac Arrhythmias and Acute Cerebrovascular Events: A Case of QT Prolongation and Torsades de Pointes Early After Right Insular Stroke
Stroke involving some areas of the cerebral hemisphere, such as insula, amygdala, and lateral hypothalamus, may cause changes in autonomic control of cardiac function. A 58-year-old woman presented to the emergency department for acute onset of left facial-brachial-crural hemiparesis and dysarthria. A brain CT scan showed subacute ischemic lesion with hemorrhagic infarction in right insular-rolandic cortex. Over the next few days ECG showed severe bradycardia with elongation of QTc, significative pauses (5 seconds), runs of nonsustained ventricular tachycardia and torsades de pointes.
Source: Journal of Stroke and Cerebrovascular Diseases - August 12, 2019 Category: Neurology Authors: Ilaria Jane Romano, Antonio Lippolis, Margherita D'Anna, Francesco Gentile Tags: Case Report Source Type: research
Acute Ischemic Stroke with Vessel Occlusion —Prevalence and Thrombectomy Eligibility at a Comprehensive Stroke Center
Introduction: Endovascular thrombectomy (ET) for acute ischemic stroke (AIS) caused by large vessel occlusion (LVO) can prevent severe disability and mortality. There is currently limited data on the epidemiology of LVO strokes and ET eligibility. We aim to determine the incidence of intracranial vessel occlusion (IVO) strokes eligible for ET per 2018 American Heart Association (AHA) guidelines and characteristics of an AHA ineligible population at a comprehensive stroke center (CSC). Methods: Retrospective chart review of all consecutive AISs at a CSC between November 2014 and February 2017.
Source: Journal of Stroke and Cerebrovascular Diseases - August 10, 2019 Category: Neurology Authors: Shashvat M. Desai, Matthew Starr, Bradley J. Molyneaux, Marcelo Rocha, Tudor G. Jovin, Ashutosh P. Jadhav Source Type: research
Migraine History: A Predictor of Negative Diffusion-Weighted Imaging in IV-tPA-Treated Stroke Mimics
Background: Migraine, seizures, and psychiatric disorders are frequently reported as “stroke mimics” in patients with negative diffusion-weighted imaging (DWI) after IV-tPA. We sought to determine predictors of negative DWI in suspected stroke patients treated with IV-tPA. Method: A retrospective case-control study encompassing all acute stroke patients treated with IV-tPA (at o ur hospital or “dripped and shipped”) from January 2013 to December 2014 was con- ducted. A total of 275 patients were identified with 47 negative DWI cases and 228 positive DWI controls.
Source: Journal of Stroke and Cerebrovascular Diseases - August 8, 2019 Category: Neurology Authors: Jussie Lima, Tapan Mehta, Neil Datta, Ekaterina Bakradze, Ilene Staff, Dawn Beland, Amre Nouh Source Type: research
Educating Stroke/TIA Patients about Obstructive Sleep Apnea after Stroke: A Randomized Feasibility Study
This study aimed to develop and conduct a preliminary assessment of educational materials for poststroke/TIA OSA.
Source: Journal of Stroke and Cerebrovascular Diseases - August 7, 2019 Category: Neurology Authors: Laavanya Dharmakulaseelan, Nardin Kirolos, Maneesha Kamra, Armi Armesto-Heys, Cathy Bouthillier, Sharron Runions, Elizabeth Linkewich, Brian J. Murray, Mark I., Boulos Source Type: research
The Effect of Continuous Theta-Burst Transcranial Magnetic Stimulation Combined with Prism Adaptation on the Neglect Recovery in Stroke Patients
This study was designed to investigate the effect of prism adaptation (PA) combined with continuous theta-burst transcranial magnetic stimulation (cTBS) on the neglect recovery of stroke patients with unilateral neglect. Methods: A total of 14 stroke patients with unilateral neglect were randomly assigned to 2 groups including an intervention group undergone PA combined with cTBS over the left intact parietal cortex and a control group. PA combined with sham cTBS was perfomed for 2 weeks in 10 daily sessions.
Source: Journal of Stroke and Cerebrovascular Diseases - August 6, 2019 Category: Neurology Authors: Shole Vatanparasti, Anoshirvan Kazemnejad, Ali Yoonessi, Shahram Oveisgharan Source Type: research
Prognostic Value of Clot Burden Score in Acute Ischemic Stroke after Reperfusion Therapies: A Systematic Review and Meta-Analysis
Background and Aim: Clot burden score (CBS) was designed to weight the thrombus status in cerebral anterior circulation. We performed a systematic review and meta-analysis to investigate the prognostic value of CBS in acute ischemic stroke (AIS) patients undergoing reperfusion therapies. Methods: We searched relevant databases for eligible articles reporting CBS in AIS patients. The effect sizes of good functional outcome, recanalization, or hemorrhagic transformation (HT) were pooled with random-/fixed-effect models.
Source: Journal of Stroke and Cerebrovascular Diseases - August 3, 2019 Category: Neurology Authors: Guoming Li, Guangliang Wu, Zhengjie Qin, Huiping Li, Xiao Cheng, Yefeng Cai Source Type: research
A Case of Juvenile Stroke due to Carotid Artery Dissection from an Elongated Styloid Process —Revisiting Conservative Management
Carotid artery dissection is a significant etiology of juvenile stroke. Blunt trauma from an elongated styloid process can rarely cause carotid artery dissection, which is one of well-known clinical presentations of Eagle's syndrome as known as stylocarotid syndrome. Growing number of publications contributed improved awareness and diagnostic modalities for this clinical entity, thus the carotid artery dissection from an elongated styloid process is often diagnosed appropriately. The management of carotid artery dissection in stylocarotid syndrome tends to be nonconservative (ie, removal of the process or carotid stenting)...
Source: Journal of Stroke and Cerebrovascular Diseases - August 2, 2019 Category: Neurology Authors: Takafumi Shindo, Masaki Ito, Juntaro Matsumoto, Koichi Miki, Fumiaki Fujihara, Shunsuke Terasaka, Toyohiko Isu, Masanori Isobe Tags: Case Report Source Type: research
Ankle torque steadiness and gait speed after a single session of robot therapy in individuals with chronic hemiparesis: a pilot study.
Conclusion: People with chronic hemiparesis presented short-term performance gains in torque steadiness, especially during dorsiflexion, after a single robotic therapy session. The robotic therapy did not influence the walking speed, although low to moderate correlations between torque steadiness variables and walking speed were observed. PMID: 31369366 [PubMed - as supplied by publisher]
Source: Topics in Stroke Rehabilitation - August 1, 2019 Category: Neurology Authors: Silva-Couto MA, Siqueira AAG, Santos GL, Russo TL Tags: Top Stroke Rehabil Source Type: research
Cognitive Rehabilitation Improves Ischemic Stroke-Induced Cognitive Impairment: Role of Growth Factors
Cognitive dysfunction is the most common nonphysical impairment in the stroke survivors. This impairment has a negative impact on patients ’ quality of life affects their daily living activities. Both pharmacological and nonpharmacological interventions are employed to improve cognitive impairment. Recently, nonpharmacological interventions have attracted great attention. Cognitive rehabilitation is considered as a therapeutic strate gy to improve and maintain cognitive skills in patients with stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - July 30, 2019 Category: Neurology Authors: Fatemeh Farokhi-Sisakht, Mehdi Farhoudi, Saeed Sadigh-Eteghad, Javad Mahmoudi, Gisou Mohaddes Tags: Review Article Source Type: research
Safety and Efficacy of Repeated Thrombolysis with Alteplase in Early Recurrent Ischemic Stroke: A Systematic Review
Background and Aim: The current American Heart Association guidelines for the management of acute ischemic stroke advise against the use of intravenous (IV) alteplase in patients with recurrent stroke occurring within 90 days of their index event. Following these guidelines strictly, patients having early recurrent ischemic stroke would be unable to avail of this reperfusion strategy that has been proven to confer superior clinical outcomes. While some registry-based studies have demonstrated the safety of IV alteplase in this subgroup of patients, data on the repeated use of the drug are lacking.
Source: Journal of Stroke and Cerebrovascular Diseases - July 29, 2019 Category: Neurology Authors: Robert Joseph Cruz Sarmiento, Jose Danilo Bengzon Diestro, Adrian Isidoro Espiritu, Maria Cristina Zarsadias San Jose 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 27, 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
Prevalence of Nonstenotic Carotid Plaque in Stroke Due to Atrial Fibrillation Compared to Embolic Stroke of Undetermined Source
Background: Embolic stroke of undetermined source (ESUS) accounts for about 20% of strokes. Nonstenotic cervical arterial plaque may be a mechanism of stroke in a subset of these patients. Methods: A cohort of consecutive patients with ischemic stroke was retrospectively identified from a stroke registry. Patients with unilateral anterior circulation embolic stroke due to atrial fibrillation (AF) or consistent with ESUS who underwent computed tomographic neck angiography were included. The prespecified primary outcome was a comparison of the prevalence of carotid plaque greater than or equal to 3 mm thickness ipsilateral v...
Source: Journal of Stroke and Cerebrovascular Diseases - July 25, 2019 Category: Neurology Authors: James E. Siegler, Jesse M. Thon, John H. Woo, David Do, Steven R. Mess é, Brett Cucchiara Source Type: research
Community cycling exercise for stroke survivors is feasible and acceptable.
Conclusion: A cycling-based exercise program delivered through local leisure center staff and facilities was shown to be feasible and acceptable for people living with stroke. PMID: 31327311 [PubMed - as supplied by publisher]
Source: Topics in Stroke Rehabilitation - July 20, 2019 Category: Neurology Authors: Kerr A, Cummings J, Barber M, McKeown M, Rowe P, Mead G, Doucet A, Berlouis K, Grealy M Tags: Top Stroke Rehabil Source Type: research
A follow-up study of the effect of training using the Hybrid Assistive Limb on Gait ability in chronic stroke patients.
Conclusions: This study showed that gait training using the HAL resulted in significant improvement of gait ability after the intervention and the effect was maintained for 3 months after the training. PMID: 31318323 [PubMed - as supplied by publisher]
Source: Topics in Stroke Rehabilitation - July 18, 2019 Category: Neurology Authors: Tanaka H, Nankaku M, Nishikawa T, Yonezawa H, Mori H, Kikuchi T, Nishi H, Takagi Y, Miyamoto S, Ikeguchi R, Matsuda S Tags: Top Stroke Rehabil Source Type: research