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Spinal epidural hematoma as a stroke mimic
Spinal epidural hematoma is a rare disease with an annual incidence of 1 per 1,000,000 individuals;1 however, it is a critical stroke mimic.2 As patients with spinal epidural hematoma typically present with acute hemiparesis,3,4 such a presentation is not expected to be detected by a computed tomography (CT) scan of the brain, which is the most common neuroimaging choice in patients with an activated stroke code. Indeed, there are several case reports in which patients with spinal epidural hematoma were misdiagnosed with ischemic stroke and treated with anti-thrombotic therapy, including intravenous thrombolysis,5 –10 oc...
Source: Journal of Stroke and Cerebrovascular Diseases - August 15, 2020 Category: Neurology Authors: Yuichiro Inatomi, Makoto Nakajima, Toshiro Yonehara Source Type: research

Isolated Infarction of the Medullary Pyramid – A Rare Pure Motor Stroke
Acute pure motor hemiparesis can occur due to a vascular insult along the cortico spinal pathway. Rarely such a stroke can occur as a result of involvement of the pyramids located on the ventral aspect of the medulla. Neurological localization can be difficult in such strokes and moreover they can also pose imaging challenges since they are missed on the CT scans. So far only 4 such cases have been reported in literature. Here we present two cases of pure motor strokes caused by infarction of the medullary pyramids.
Source: Journal of Stroke and Cerebrovascular Diseases - August 11, 2020 Category: Neurology Authors: Sanjith Aaron, Amal Al Hashmi, Divyan Pancharatnam Tags: Case Report Source Type: research

Hemichorea as Presentation of Acute Cortical Ischemic Stroke. Case Series and Review of the Literature
We report 4 cases of acute ischemic cortical strokes presenting as hemichorea, with the infarction being limited to the parietal and insular cortex in perfusion computed tomography scans and magnetic resonance imaging.
Source: Journal of Stroke and Cerebrovascular Diseases - August 11, 2020 Category: Neurology Authors: Álvaro Carbayo, Jordi Sarto, Daniel Santana, Yaroslau Compta, Xabier Urra Source Type: research

Tilt-Corrected Region Boundaries May Enhance the Alberta Stroke Program Early Computed Tomography Score for Less Experienced Raters
Background: The Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is widely used to quantify early ischemic changes in the anterior circulation but has limited inter-rater reliability. Aims: We investigated whether application of 3-dimensional boundaries outlining the ASPECTS regions improves inter-rater reliability and accuracy. Methods: We included all patients from our DEFUSE 2 database who had a pretreatment noncontrast computed tomography scan (NCCT) of acceptable quality. Six raters (2 neuroradiologists, 2 vascular neurologists, and 2 neurology residents) scored ASPECTS of each NCCT without ( “CT-nat...
Source: Journal of Stroke and Cerebrovascular Diseases - April 15, 2020 Category: Neurology Authors: Collin J. Culbertson, S øren Christensen, Michael Mlynash, Jeremy J. Heit, Christian Federau, Christina Mijalski Sells, Catherine Legault, Addason F.H. McCaslin, Katherine Werbaneth, Gregory W. Albers, Maarten G. Lansberg 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

MRI Room Service: Portable Machine Brings In-Room Scans to Stroke Patients
Bedside MRI could offer stroke patients a safer alternative to conventional MRI.
Source: Diagnostic Imaging - February 12, 2020 Category: Radiology Authors: Whitney J. Palmer Tags: Brain MRI New Products Stroke Source Type: news

Cognitive training in an everyday-like virtual reality enhances visual-spatial memory capacities in stroke survivors with visual field defects.
Conclusions: The results of the current study suggest that VR training can improve particularly visual-spatial skills in patients with hemianopia or quadrantanopia. Our study thus introduces an interesting novel treatment approach to improve cognitive functions relevant to daily life in stroke patients with visual field defects. PMID: 31960760 [PubMed - as supplied by publisher]
Source: Topics in Stroke Rehabilitation - January 20, 2020 Category: Neurology Authors: Dehn LB, Piefke M, Toepper M, Kohsik A, Rogalewski A, Dyck E, Botsch M, Schäbitz WR Tags: Top Stroke Rehabil Source Type: research

Lateralization of Insular Ischemic Stroke is Not Associated With Any Stroke Clinical Outcomes: The Athens Stroke Registry
Background: Controversial evidence suggests that right insular stroke may be associated with worse outcomes compared to the left insular ischemic lesion. Objectives: We investigated whether lateralization of insular stroke is associated with early and late outcome in terms of in-hospital complications, stroke recurrence, cardiovascular events, and death. Methods: Data were prospectively collected from the Athens Stroke Registry. Insular cortex involvement was identified based on brain CT scans or MRI images.
Source: Journal of Stroke and Cerebrovascular Diseases - December 2, 2019 Category: Neurology Authors: Sophia Vassilopoulou, Eleni Korompoki, Argyro Tountopoulou, Dimos D. Mitsikostas, Efstathios Manios, Georgios Georgiopoulos, George Ntaios, Haralampos Milionis, Sophia Fontara, Konstantinos Vemmos Source Type: research

Magnetic Resonance Imaging Selection for Endovascular Stroke Therapy Clinical Sciences
Conclusions—Workflow in GOLIATH demonstrates that magnetic resonance imaging selection for endovascular therapy can be accomplished rapidly and within a similar time frame as computed tomography-based selection.Clinical Trial Registration—URL: https://www.clinicaltrials.gov. Unique identifier: NCT02317237.
Source: Stroke - May 25, 2018 Category: Neurology Authors: Claus Z. Simonsen, Albert J. Yoo, Mads Rasmussen, Kristina E. Sorensen, Thabele Leslie–Mazwi, Grethe Andersen, Leif H. Sorensen Tags: Magnetic Resonance Imaging (MRI), Revascularization, Ischemic Stroke Original Contributions Source Type: research

Clinical Utility of Electronic Alberta Stroke Program Early Computed Tomography Score Software in the ENCHANTED Trial Database Clinical Sciences
Background and Purpose—Clinical utility of electronic Alberta Stroke Program Early CT Score (e-ASPECTS), an automated system for quantifying signs of infarction, was evaluated in a large database of thrombolyzed patients with acute ischemic stroke.Methods—All baseline noncontrast computed tomographic scans of patients with anterior circulation acute ischemic stroke who participated in the alteplase dose arm of the randomized controlled trial ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study) were reviewed; poor quality and large (>6 mm) slice thickness were excluded. Included scans had e-ASPECTS...
Source: Stroke - May 25, 2018 Category: Neurology Authors: Simon Nagel, Xia Wang, Cheryl Carcel, Thompson Robinson, Richard I. Lindley, John Chalmers, Craig S. Anderson Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research

Boosted Tree Model Reforms Multimodal Magnetic Resonance Imaging Infarct Prediction in Acute Stroke Clinical Sciences
Background and Purpose—Stroke imaging is pivotal for diagnosis and stratification of patients with acute ischemic stroke to treatment. The potential of combining multimodal information into reliable estimates of outcome learning calls for robust machine learning techniques with high flexibility and accuracy. We applied the novel extreme gradient boosting algorithm for multimodal magnetic resonance imaging–based infarct prediction.Methods—In a retrospective analysis of 195 patients with acute ischemic stroke, fluid-attenuated inversion recovery, diffusion-weighted imaging, and 10 perfusion parameters were derived from...
Source: Stroke - March 26, 2018 Category: Neurology Authors: Michelle Livne, Jens K. Boldsen, Irene K. Mikkelsen, Jochen B. Fiebach, Jan Sobesky, Kim Mouridsen Tags: Magnetic Resonance Imaging (MRI), Ischemic Stroke Original Contributions Source Type: research

Time From Imaging to Endovascular Reperfusion Predicts Outcome in Acute Stroke Clinical Sciences
Conclusions—Compared with target mismatch patients, those with the malignant profile experience faster infarct growth and a steeper decline in the odds of functional independence, with longer delays between baseline imaging and reperfusion. However, this does not exclude the possibility of treatment benefit in patients with a malignant profile.
Source: Stroke - March 26, 2018 Category: Neurology Authors: Jenny P. Tsai, Michael Mlynash, Soren Christensen, Stephanie Kemp, Sun Kim, Nishant K. Mishra, Christian Federau, Raul G. Nogueira, Tudor G. Jovin, Thomas G. Devlin, Naveed Akhtar, Dileep R. Yavagal, Roland Bammer, Matus Straka, Gregory Zaharchuk, Michael Tags: Revascularization, Cerebrovascular Procedures, Ischemic Stroke Original Contributions Source Type: research

Relationship Between Visceral Infarction and Ischemic Stroke Subtype Brief Report
Conclusions—The prevalence of visceral infarction differed significantly across ischemic stroke subtypes. Cardioembolic and cryptogenic strokes were associated with a higher prevalence of visceral infarcts than noncardioembolic strokes.
Source: Stroke - February 26, 2018 Category: Neurology Authors: Caitlin Finn, Peter Hung, Praneil Patel, Ajay Gupta, Hooman Kamel Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke, Embolism Brief Reports Source Type: research

DWI-ASPECTS (Diffusion-Weighted Imaging-Alberta Stroke Program Early Computed Tomography Scores) and DWI-FLAIR (Diffusion-Weighted Imaging-Fluid Attenuated Inversion Recovery) Mismatch in Thrombectomy Candidates Brief Report
Conclusions—Agreement between clinicians assessing DWI-ASPECTS and DWI-FLAIR mismatch may not be sufficient to make repeatable clinical decisions in mechanical thrombectomy. The dichotomization of the DWI-ASPECTS (0–5 versus 0–6 or 0–6 versus 7–10) improved interrater and intrarater agreement, however, its relevance for patients selection for mechanical thrombectomy needs to be validated in a randomized trial.
Source: Stroke - December 22, 2017 Category: Neurology Authors: Robert Fahed, Augustin Lecler, Candice Sabben, Naim Khoury, Celina Ducroux, Vanessa Chalumeau, Daniele Botta, Erwah Kalsoum, William Boisseau, Loic Duron, Dominique Cabral, Patricia Koskas, Azzedine Benaissa, Hasmik Koulakian, Michael Obadia, Benȷa Tags: Magnetic Resonance Imaging (MRI), Ischemic Stroke Brief Reports Source Type: research

Predictors for Cerebral Edema in Acute Ischemic Stroke Treated With Intravenous Thrombolysis Clinical Sciences
Background and Purpose—Cerebral edema (CED) is a severe complication of acute ischemic stroke. There is uncertainty regarding the predictors for the development of CED after cerebral infarction. We aimed to determine which baseline clinical and radiological parameters predict development of CED in patients treated with intravenous thrombolysis.Methods—We used an image-based classification of CED with 3 degrees of severity (less severe CED 1 and most severe CED 3) on postintravenous thrombolysis imaging scans. We extracted data from 42 187 patients recorded in the SITS International Register (Safe Implementation of Trea...
Source: Stroke - August 28, 2017 Category: Neurology Authors: Magnus Thoren, Elsa Azevedo, Jesse Dawson, Jose A. Egido, Anne Falcou, Gary A. Ford, Staffan Holmin, Robert Mikulik, Jyrki Ollikainen, Nils Wahlgren, Niaz Ahmed Tags: Risk Factors, Imaging, Blood-Brain Barrier, Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research

Microbleeds, Cerebral Hemorrhage, and Functional Outcome After Stroke Thrombolysis Clinical Sciences
Background and Purpose—We assessed whether the presence, number, and distribution of cerebral microbleeds (CMBs) on pre-intravenous thrombolysis MRI scans of acute ischemic stroke patients are associated with an increased risk of intracerebral hemorrhage (ICH) or poor functional outcome.Methods—We performed an individual patient data meta-analysis, including prospective and retrospective studies of acute ischemic stroke treated with intravenous tissue-type plasminogen activator. Using multilevel mixed-effects logistic regression, we investigated associations of pre-treatment CMB presence, burden (1, 2–4, ≥5, and>10...
Source: Stroke - July 24, 2017 Category: Neurology Authors: Andreas Charidimou, Guillaume Turc, Catherine Oppenheim, Shenqiang Yan, Jan F. Scheitz, Hebun Erdur, Pascal P. Klinger–Gratz, Marwan El–Koussy, Wakoh Takahashi, Yusuke Moriya, Duncan Wilson, Chelsea S. Kidwell, Jeffrey L. Saver, Asma Sallem, S Tags: Magnetic Resonance Imaging (MRI), Prognosis, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

In-Patient Code Stroke Clinical Sciences
Conclusions—Our study reveals the efficacy of an inpatient code stroke algorithm and educational intervention directed at nurses and allied health personnel to optimize the prompt management of inpatient strokes. Prompt assessment may lead to faster stroke interventions, which are associated with better outcomes.
Source: Stroke - July 24, 2017 Category: Neurology Authors: Charles D. Kassardjian, Jacqueline D. Willems, Krystyna Skrabka, Rosane Nisenbaum, Judith Barnaby, Pawel Kostyrko, Daniel Selchen, Gustavo Saposnik Tags: Quality and Outcomes, Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research

Multiparametric Model for Penumbral Flow Prediction in Acute Stroke Clinical Sciences
In this study, we established a multiparametric perfusion imaging model and cross-validated it using positron emission tomography perfusion for detection of penumbral flow.Methods—In a retrospective analysis of 17 subacute stroke patients with consecutive magnetic resonance imaging and H2O15 positron emission tomography scans, perfusion maps of cerebral blood flow, cerebral blood volume, mean transit time, time-to-maximum, and time-to-peak were constructed and combined using a generalized linear model (GLM). Both the GLM maps and the single perfusion maps alone were cross-validated with positron emission tomography-cereb...
Source: Stroke - June 26, 2017 Category: Neurology Authors: Michelle Livne, Tabea Kossen, Vince I. Madai, Olivier Zaro-Weber, Walter Moeller-Hartmann, Kim Mouridsen, Wolf-Dieter Heiss, Jan Sobesky Tags: Imaging, Magnetic Resonance Imaging (MRI), Ischemic Stroke Original Contributions Source Type: research

Clinical Correlates, Ethnic Differences, and Prognostic Implications of Perivascular Spaces in Transient Ischemic Attack and Ischemic Stroke Clinical Sciences
Background and Purpose—Perivascular spaces (PVSs) are considered markers of small vessel disease. However, their long-term prognostic implications in transient ischemic attack/ischemic stroke patients are unknown. Ethnic differences in PVS prevalence are also unknown.Methods—Two independent prospective studies were conducted, 1 comprising predominantly whites with transient ischemic attack/ischemic stroke (OXVASC [Oxford Vascular] study) and 1 comprising predominantly Chinese with ischemic stroke (University of Hong Kong). Clinical and imaging correlates, prognostic implications for stroke and death, and ethnic differe...
Source: Stroke - May 22, 2017 Category: Neurology Authors: Kui–Kai Lau, Linxin Li, Caroline E. Lovelock, Giovanna Zamboni, Tsz–Tai Chan, Man–Fung Chiang, Kin–Ting Lo, Wilhelm Kuker, Henry Ka–Fung Mak, Peter M. Rothwell Tags: Imaging, Magnetic Resonance Imaging (MRI), Prognosis, Ischemic Stroke, Transient Ischemic Attack (TIA) Original Contributions Source Type: research

Baseline Hemodynamic Impairment and Future Stroke Risk in Adult Idiopathic Moyamoya Phenomenon Clinical Sciences
Conclusions—The risk of new or recurrent stroke was lower than expected. The low event rate, low prevalence of increased OEF, and potential selection bias introduced by revascularization surgery limit strong conclusions about the association of increased OEF and future stroke risk.Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT00629915.
Source: Stroke - March 27, 2017 Category: Neurology Authors: Colin P. Derdeyn, Gregory J. Zipfel, Allyson R. Zazulia, Patricia H. Davis, Shyam Prabhakaran, Cristina S. Ivan, Venkatesh Aiyagari, James R. Sagar, Nancy Hantler, Lina Shinawi, John J. Lee, Hussain Jafri, Robert L. Grubb Jr, J. Philip Miller, Ralph G. Da Tags: Ischemic Stroke, Moyamoya Original Contributions Source Type: research

Effects of low-frequency repetitive transcranial magnetic stimulation and neuromuscular electrical stimulation on upper extremity motor recovery in the early period after stroke: a preliminary study.
CONCLUSION: LF-rTMS with or without NMES seems to facilitate the motor recovery in the paretic hand of patients with acute/subacute ischemic stroke. TMS or the combination of TMS + NMES may be a promising additional therapy in upper limb motor training. Further studies with larger numbers of patients are needed to establish their effectiveness in upper limb motor rehabilitation of stroke. PMID: 28327054 [PubMed - as supplied by publisher]
Source: Topics in Stroke Rehabilitation - March 22, 2017 Category: Neurology Authors: Tosun A, Türe S, Askin A, Yardimci EU, Demirdal SU, Kurt Incesu T, Tosun O, Kocyigit H, Akhan G, Gelal FM Tags: Top Stroke Rehabil Source Type: research

Quantification of Serial Cerebral Blood Flow in Acute Stroke Using Arterial Spin Labeling Clinical Sciences
Background and Purpose—Perfusion-weighted imaging is used to select patients with acute ischemic stroke for intervention, but knowledge of cerebral perfusion can also inform the understanding of ischemic injury. Arterial spin labeling allows repeated measurement of absolute cerebral blood flow (CBF) without the need for exogenous contrast. The aim of this study was to explore the relationship between dynamic CBF and tissue outcome in the month after stroke onset.Methods—Patients with nonlacunar ischemic stroke underwent ≤5 repeated magnetic resonance imaging scans at presentation, 2 hours, 1 day, 1 week, and 1 month....
Source: Stroke - December 22, 2016 Category: Neurology Authors: George W.J. Harston, Thomas W. Okell, Fintan Sheerin, Ursula Schulz, Phil Mathieson, Ian Reckless, Kunal Shah, Gary A. Ford, Michael A. Chappell, Peter Jezzard, James Kennedy Tags: Ischemic Stroke Original Contributions Source Type: research

Effect of Right Insular Involvement on Death and Functional Outcome After Acute Ischemic Stroke in the IST-3 Trial (Third International Stroke Trial) Clinical Sciences
Conclusions—We found an association between right insular involvement and higher odds of death and worse functional outcome. The difference between right- and left-sided insular lesions on outcomes seemed to be most evident for mild/moderate strokes.Clinical Trial Registration—URL: http://www.isrctn.com. Unique identifier: ISRCTN25765518.
Source: Stroke - November 27, 2016 Category: Neurology Authors: Luciano A. Sposato, Geoffrey Cohen, Joanna M. Wardlaw, Peter Sandercock, Richard I. Lindley, Vladimir Hachinski, on behalf of the IST-3 Expert Reading Panel and the IST-3 Collaborative Group Tags: Computerized Tomography (CT), Magnetic Resonance Imaging (MRI), Mortality/Survival, Ischemic Stroke Original Contributions Source Type: research

Optimal Computed Tomographic Perfusion Scan Duration for Assessment of Acute Stroke Lesion Volumes Clinical Sciences
Background and Purpose—The minimal scan duration needed to obtain reliable lesion volumes with computed tomographic perfusion (CTP) has not been well established in the literature.Methods—We retrospectively assessed the impact of gradual truncation of the scan duration on acute ischemic lesion volume measurements. For each scan, we identified its optimal scan time, defined as the shortest scan duration that yields measurements of the ischemic lesion volumes similar to those obtained with longer scanning, and the relative height of the fitted venous output function at its optimal scan time.Results—We analyzed 70 compu...
Source: Stroke - November 27, 2016 Category: Neurology Authors: Aimen S. Kasasbeh, Soren Christensen, Matus Straka, Nishant Mishra, Michael Mlynash, Roland Bammer, Gregory W. Albers, Maarten G. Lansberg Tags: Computerized Tomography (CT), Ischemic Stroke Original Contributions Source Type: research

Validation of international stroke scales for use by nurses in Greek settings.
CONCLUSIONS: The Greek version of the stroke tools show that both SSS and BI have high internal consistency and reliability and together with the mRS could be used in any Greek stroke care delivery setting. PMID: 27680397 [PubMed - as supplied by publisher]
Source: Topics in Stroke Rehabilitation - September 28, 2016 Category: Neurology Authors: Theofanidis D Tags: Top Stroke Rehabil Source Type: research

Remote Lower White Matter Integrity Increases the Risk of Long-Term Cognitive Impairment After Ischemic Stroke in Young Adults Clinical Sciences
Conclusions— These findings indicate that although stroke has an acute onset, it might have long lasting effects on remote white matter integrity and thereby increases the risk of long-term cognitive impairment.
Source: Stroke - September 25, 2016 Category: Neurology Authors: Schaapsmeerders, P., Tuladhar, A. M., Arntz, R. M., Franssen, S., Maaijwee, N. A. M., Rutten-Jacobs, L. C. A., Schoonderwaldt, H. C., Dorresteijn, L. D. A., van Dijk, E. J., Kessels, R. P. C., de Leeuw, F.-E. Tags: Magnetic Resonance Imaging (MRI), Cognitive Impairment, Ischemic Stroke Clinical Sciences Source Type: research

The Capillary Index Score as a Marker of Viable Cerebral Tissue: Proof of Concept--The Capillary Index Score in the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Trial Clinical Sciences
Conclusions— The absence of capillary blush on pretreatment digital subtraction angiogram seems to correspond to nonviable cerebral tissue. Successful revascularization reduces the chance of tissue hypodensity (infarction), when capillary blush is present. Clinical Trial Registration— URL: http://www.trialregister.nl. Unique identifier: NTR number 1804. URL: http://www.isrctn.com. Unique identifier: ISRCTN10888758.
Source: Stroke - August 21, 2016 Category: Neurology Authors: Al-Ali, F., Berkhemer, O. A., Yousman, W. P., Elias, J. J., Bender, E. N., Lingsma, H. F., van der Lugt, A., Dippel, D. W. J., Roos, Y. B. W. E. M., van Oostenbrugge, R. J., van Zwam, W. H., Dillon, W. P., Majoie, C. B. L. M. Tags: Computerized Tomography (CT), Revascularization, Ischemic Stroke Clinical Sciences Source Type: research

Leukoaraiosis, Cerebral Hemorrhage, and Outcome After Intravenous Thrombolysis for Acute Ischemic Stroke: A Meta-Analysis (v1) Clinical Sciences
Conclusions— Leukoaraiosis might increase post-intravenous thrombolysis sICH risk and poor outcome poststroke. Despite increased sICH risk, intravenous tissue-type plasminogen activator treatment has net clinical benefit in patients with leukoaraiosis. Given the risk of bias/confounding, these results should be considered hypothesis-generating and do not justify withholding intravenous thrombolysis.
Source: Stroke - August 21, 2016 Category: Neurology Authors: Charidimou, A., Pasi, M., Fiorelli, M., Shams, S., von Kummer, R., Pantoni, L., Rost, N. Tags: Cerebrovascular Disease/Stroke, Intracranial Hemorrhage, Ischemic Stroke Clinical Sciences Source Type: research

Identification of Reversible Disruption of the Human Blood-Brain Barrier Following Acute Ischemia Brief Reports
Conclusions— This study demonstrates that diffuse, mild BBB disruption in the acutely ischemic human brain is reversible with reperfusion. This study also confirms prior findings that focal severe BBB disruption confers an increased risk of hemorrhagic transformation in patients treated with intravenous tissue-type plasminogen activator.
Source: Stroke - August 21, 2016 Category: Neurology Authors: Simpkins, A. N., Dias, C., Leigh, R., on behalf of the National Institutes of Health Natural History of Stroke Investigators, Benson, Hsia, Latour, Luby, Lynch, Merino, Nadareishvili, Warach Tags: Magnetic Resonance Imaging (MRI), Blood-Brain Barrier, Intracranial Hemorrhage, Ischemic Stroke Brief Reports Source Type: research

Cortical Sparing in Preterm Ischemic Arterial Stroke Brief Reports
Conclusions— The pattern of cortical injury after middle cerebral artery stroke changes with gestational age and may be related to maturational changes of the vascular system. Outcome did not vary between the different patterns of cortical injury.
Source: Stroke - February 22, 2016 Category: Neurology Authors: van der Aa, N. E., Benders, M. J. N. L., Nikkels, P. G., Groenendaal, F., de Vries, L. S. Tags: Magnetic Resonance Imaging (MRI), Cerebrovascular Disease/Stroke, Ischemic Stroke Brief Reports Source Type: research

Dynamic Magnetic Resonance Angiography Provides Collateral Circulation and Hemodynamic Information in Acute Ischemic Stroke Brief Reports
Conclusions— As a fast, direct, feasible, noninvasive, and reliable method to assess site of occlusion, collateral circulation and hemodynamic alterations, dMRA provides profound insights in acute stroke.
Source: Stroke - January 25, 2016 Category: Neurology Authors: Hernandez-Perez, M., Puig, J., Blasco, G., Perez de la Ossa, N., Dorado, L., Davalos, A., Munuera, J. Tags: Imaging, Cerebrovascular Disease/Stroke, Ischemic Stroke Brief Reports Source Type: research

Stroke patients admitted within normal working hours are more likely to achieve process standards and to have better outcomes
Conclusions Patients with stroke admitted out of hours and at weekends or public holidays are less likely to be managed according to current guidelines. They experience poorer short-term outcomes than those admitted during normal working hours, after correcting for known independent predictors of outcome and early mortality.
Source: Journal of Neurology, Neurosurgery and Psychiatry - January 14, 2016 Category: Neurosurgery Authors: Turner, M., Barber, M., Dodds, H., Dennis, M., Langhorne, P., Macleod, M.-J., on behalf of the Scottish Stroke Care Audit Tags: Open access, Stroke, Radiology Cerebrovascular disease Source Type: research

Positron Emission Tomographic Imaging in Stroke: Cross-Sectional and Follow-Up Assessment of Amyloid in Ischemic Stroke Clinical Sciences
Conclusions— There was no significant increase in 11C-PiB accumulation in or around the infarct. There was no increase in ipsilesional hemispheric 11C-PiB accumulation over time. We found no evidence that infarction leads to sustained or increased β-amyloid deposition ≤18 months after stroke.
Source: Stroke - December 28, 2015 Category: Neurology Authors: Sahathevan, R., Linden, T., Villemagne, V. L., Churilov, L., Ly, J. V., Rowe, C., Donnan, G., Brodtmann, A. Tags: Nuclear Cardiology and PET, Cognitive Impairment, Ischemic Stroke Clinical Sciences Source Type: research

Influence of Amyloid-{beta} on Cognitive Decline After Stroke/Transient Ischemic Attack: Three-Year Longitudinal Study Clinical Sciences
Conclusions— Compared with subjects without Alzheimer’s disease–like Aβ deposition, those with Aβ deposition experienced a more severe and rapid cognitive decline over 3 years after stroke/transient ischemic attack. Aβ was associated with changes in multiple cognitive domains.
Source: Stroke - October 26, 2015 Category: Neurology Authors: Liu, W., Wong, A., Au, L., Yang, J., Wang, Z., Leung, E. Y. L., Chen, S., Ho, C. L., Mok, V. C. T. Tags: Behavioral Changes and Stroke, PET and SPECT Clinical Sciences Source Type: research

Quantifying the Benefit of Prehospital Rapid Treatment in Acute Stroke: Benchmark for Future Innovative Clinical Trials Clinical Sciences
Conclusions— Reducing the OTT has robust beneficial effects for acute stroke patients. Prehospital tissue-type plasminogen activator treatment without brain imaging may become conceivable under several preconditions, including a point-of-care test with >75% to 80% sensitivity to detect intracerebral hemorrhage and a time gain of >32 to 40 minutes. Ethical implications remain to be addressed.
Source: Stroke - October 26, 2015 Category: Neurology Authors: Lorenz, M. W., Lauer, A., Foerch, C. Tags: Acute Cerebral Infarction, Emergency treatment of Stroke, Thrombolysis Clinical Sciences Source Type: research

Effect of Hyperacute Administration (Within 6 Hours) of Transdermal Glyceryl Trinitrate, a Nitric Oxide Donor, on Outcome After Stroke: Subgroup Analysis of the Efficacy of Nitric Oxide in Stroke (ENOS) Trial Clinical Sciences
Conclusions— In a subgroup analysis of the large ENOS trial, transdermal GTN was safe to administer and associated with improved functional outcome and fewer deaths when administered within 6 hours of stroke onset. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00989716.
Source: Stroke - October 26, 2015 Category: Neurology Authors: Woodhouse, L., Scutt, P., Krishnan, K., Berge, E., Gommans, J., Ntaios, G., Wardlaw, J., Sprigg, N., Bath, P. M., on behalf of the ENOS Investigators Tags: Acute Cerebral Hemorrhage, Acute Cerebral Infarction, Emergency treatment of Stroke Clinical Sciences Source Type: research

Prevalence of Stroke and Its Risk Factors in Urban Sri Lanka: Population-Based Study Brief Reports
Conclusions— Age-adjusted stroke prevalence in urban Sri Lanka lies between high-income and low-/middle-income countries. The prevalence of stroke and its risk factors were higher among men.
Source: Stroke - September 28, 2015 Category: Neurology Authors: Chang, T., Gajasinghe, S., Arambepola, C. Tags: Cerebrovascular disease/stroke, Acute Cerebral Hemorrhage, Acute Cerebral Infarction Brief Reports Source Type: research

Intracranial Carotid Calcification on Cranial Computed Tomography: Visual Scoring Methods, Semiautomated Scores, and Volume Measurements in Patients With Stroke Clinical Sciences
Conclusions— Visual scores correlate highly with quantitative intracranial internal carotid artery calcification measures, with excellent observer agreements. Visual intracranial internal carotid artery scores could be a rapid and practical method for epidemiological studies.
Source: Stroke - August 24, 2015 Category: Neurology Authors: Subedi, D., Zishan, U. S., Chappell, F., Gregoriades, M.-L., Sudlow, C., Sellar, R., Wardlaw, J. Tags: Cerebrovascular disease/stroke, CT and MRI, Carotid Stenosis, Risk Factors for Stroke Clinical Sciences Source Type: research

Effects of Centralizing Acute Stroke Services on Stroke Care Provision in Two Large Metropolitan Areas in England Clinical Sciences
Conclusions— Centralized systems admitting all stroke patients to hyperacute units, as in London, are significantly more likely to provide evidence-based clinical interventions. This may help explain previous research showing better outcomes associated with fully centralized models.
Source: Stroke - July 27, 2015 Category: Neurology Authors: Ramsay, A. I. G., Morris, S., Hoffman, A., Hunter, R. M., Boaden, R., McKevitt, C., Perry, C., Pursani, N., Rudd, A. G., Turner, S. J., Tyrrell, P. J., Wolfe, C. D. A., Fulop, N. J. Tags: Health policy and outcome research, Emergency treatment of Stroke Clinical Sciences Source Type: research

Stroke Neurologist's Perspective on the New Endovascular Trials Understanding and Applying the Endovascular Trials
In conclusion, stroke teams, including practicing neurologists caring for patients with stroke should now provide the option for intra-arterial thrombectomy for a subset of patients with acute stroke.
Source: Stroke - May 22, 2015 Category: Neurology Authors: Grotta, J. C., Hacke, W. Tags: Acute Cerebral Infarction, Emergency treatment of Stroke, Thrombolysis Understanding and Applying the Endovascular Trials Source Type: research

Implementing a Simple Care Bundle Is Associated With Improved Outcomes in a National Cohort of Patients With Ischemic Stroke Clinical Sciences
Conclusions— Achieving a care bundle for ischemic stroke is associated with reduced mortality at 30 days and 6 months and increased likelihood of discharge to usual residence at 6 months.
Source: Stroke - March 23, 2015 Category: Neurology Authors: Turner, M., Barber, M., Dodds, H., Murphy, D., Dennis, M., Langhorne, P., Macleod, M.-J., on behalf of the Scottish Stroke Care Audit Tags: Acute Cerebral Infarction, Emergency treatment of Stroke, Other Stroke Treatment - Medical Clinical Sciences Source Type: research

Imaging of a Clinically Relevant Stroke Model: Glucose Hypermetabolism Revisited Basic Sciences
Conclusions— The increased uptake of [2-18F]-2-fluoro-2-deoxy-d-glucose in cerebral ischemia most likely reflects hypermetabolism of glucose meeting increased energy needs of ischemic and hypoperfused brain tissue, and it occurs under both anaerobic and aerobic conditions measured by local lactate production. Infarct-related systemic hyperglycemia could serve to facilitate glucose supply to the ischemic brain. Glycemic control by insulin treatment could negatively influence this mechanism.
Source: Stroke - February 23, 2015 Category: Neurology Authors: Arnberg, F., Grafstrom, J., Lundberg, J., Nikkhou-Aski, S., Little, P., Damberg, P., Mitsios, N., Mulder, J., Lu, L., Soderman, M., Stone-Elander, S., Holmin, S. Tags: Acute Stroke Syndromes, Brain Circulation and Metabolism Basic Sciences Source Type: research

Effects of Blood Pressure-Lowering Treatment in Different Subtypes of Acute Ischemic Stroke Brief Reports
Conclusions— The results suggest that the effect of blood pressure–lowering treatment with candesartan may differ according to different types of acute ischemic stroke, but this needs to be confirmed in future trials. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00120003.
Source: Stroke - February 23, 2015 Category: Neurology Authors: Sandset, E. C., Jusufovic, M., Sandset, P. M., Bath, P. M. W., Berge, E., on behalf of the SCAST Study Group Tags: Cerebrovascular disease/stroke, Clinical Studies Brief Reports Source Type: research

Improved Prehospital Triage of Patients With Stroke in a Specialized Stroke Ambulance: Results of the Pre-Hospital Acute Neurological Therapy and Optimization of Medical Care in Stroke Study Clinical Sciences
Conclusions— The triage of patients with cerebrovascular events to specialized hospitals can be improved by STEMO ambulances. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01382862.
Source: Stroke - February 23, 2015 Category: Neurology Authors: Wendt, M., Ebinger, M., Kunz, A., Rozanski, M., Waldschmidt, C., Weber, J. E., Winter, B., Koch, P. M., Freitag, E., Reich, J., Schremmer, D., Audebert, H. J., for the STEMO Consortium Tags: Cerebrovascular disease/stroke, Acute Cerebral Hemorrhage, Acute Cerebral Infarction, Emergency treatment of Stroke, Other Stroke Treatment - Medical Clinical Sciences Source Type: research

Sensitivity of Diffusion- and Perfusion-Weighted Imaging for Diagnosing Acute Ischemic Stroke Is 97.5% Clinical Sciences
Conclusions— The combination of DWI and PWI before intravenous tissue-type plasminogen activator confirms the diagnosis in 97.5% of all ischemic strokes.
Source: Stroke - December 22, 2014 Category: Neurology Authors: Simonsen, C. Z., Madsen, M. H., Schmitz, M. L., Mikkelsen, I. K., Fisher, M., Andersen, G. Tags: Imaging, Acute Cerebral Infarction, Emergency treatment of Stroke, Thrombolysis Clinical Sciences Source Type: research

Computed Tomography Identifies Patients at High Risk for Stroke After Transient Ischemic Attack/Nondisabling Stroke: Prospective, Multicenter Cohort Study Clinical Sciences
Conclusions— In patients with transient ischemic attack/nondisabling stroke, CT evidence of acute ischemia alone or acute ischemia with chronic ischemia or microangiopathy was associated with increased subsequent stroke risk within 90 days.
Source: Stroke - December 22, 2014 Category: Neurology Authors: Wasserman, J. K., Perry, J. J., Sivilotti, M. L. A., Sutherland, J., Worster, A., Emond, M., Jin, A. Y., Oczkowski, W. J., Sahlas, D. J., Murray, H., MacKey, A., Verreault, S., Wells, G. A., Dowlatshahi, D., Stotts, G., Stiell, I. G., Sharma, M. Tags: Emergency treatment of Stroke, Risk Factors for Stroke Clinical Sciences Source Type: research

Intravenous Autologous Bone Marrow Mononuclear Stem Cell Therapy for Ischemic Stroke: A Multicentric, Randomized Trial Clinical Sciences
Conclusions— With the methods used, results of this hitherto first randomized controlled trial indicate that intravenous infusion of BMSCs is safe, but there is no beneficial effect of treatment on stroke outcome. Clinical Trial Registration— URLs: http://ctri.nic.in/Clinicaltrials and http://www.clinicaltrials.gov. Unique identifiers: CTRI-ROVCTRI/2008/091/0004 and NCT0150177.
Source: Stroke - November 24, 2014 Category: Neurology Authors: Prasad, K., Sharma, A., Garg, A., Mohanty, S., Bhatnagar, S., Johri, S., Singh, K. K., Nair, V., Sarkar, R. S., Gorthi, S. P., Hassan, K. M., Prabhakar, S., Marwaha, N., Khandelwal, N., Misra, U. K., Kalita, J., Nityanand, S., for InveST Study Group Tags: Other Stroke Treatment - Medical Clinical Sciences Source Type: research

Hemorrhagic Stroke and Cerebral Paragonimiasis Brief Reports
Conclusions— Hemorrhagic stroke typically occurred during the acute stage and in the early stages of further Paragonimus migration. Delay of treatment increased the risk of initial and recurrent stroke.
Source: Stroke - October 27, 2014 Category: Neurology Authors: Xia, Y., Ju, Y., Chen, J., You, C. Tags: Acute Cerebral Hemorrhage, Computerized tomography and Magnetic Resonance Imaging, Primary and Secondary Stroke Prevention, Risk Factors for Stroke Brief Reports Source Type: research

Blood Pressure-Lowering Treatment With Candesartan in Patients With Acute Hemorrhagic Stroke Brief Reports
Conclusions— There was no evidence that blood pressure–lowering treatment with candesartan is beneficial during the first week of hemorrhagic stroke. Instead, there were signs that such treatment may be harmful, but this needs to be verified in larger studies. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00120003.
Source: Stroke - October 27, 2014 Category: Neurology Authors: Jusufovic, M., Sandset, E. C., Bath, P. M. W., Berge, E., on behalf of the Scandinavian Candesartan Acute Stroke Trial Study Group Tags: Cerebrovascular disease/stroke, Acute Cerebral Hemorrhage, Other Stroke Treatment - Medical Brief Reports Source Type: research

Community-Based Stroke System of Care for Chinese Rural Areas Clinical Sciences
Conclusions— A stroke system of care would be reliable and practical in Chinese rural areas. Clinical Trial Registration— URL: http://www.chictr.org. Unique identifier: ChiCTR-RCH-13003408.
Source: Stroke - July 28, 2014 Category: Neurology Authors: He, M., Wang, J., Gong, L., Dong, Q., Ji, N., Xing, H., Zhou, Y., Qin, S., Wang, H., Zhang, H., Hui, R., Wang, Y. Tags: Other Stroke Treatment - Medical Clinical Sciences Source Type: research