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Specialty: Neurology
Management: National Institutes of Health (NIH)

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Total 425 results found since Jan 2013.

National Institutes of Health Stroke Scale Correlates Well with Initial Intracerebral Hemorrhage Volume
The US Centers for Medicare and Medicaid Services (CMS) currently publicly reports hospital-quality, risk-adjusted mortality measure for ischemic stroke but not intracerebral hemorrhage (ICH). The NIHSS, which is captured in CMS administrative claims data, is a candidate metric for use in ICH risk adjustment and has been shown to predict clinical outcome with accuracy similar to the ICH Score. Correlation between early NIHSS and initial ICH volume would further support use of the NIHSS for ICH risk adjustment.
Source: Journal of Stroke and Cerebrovascular Diseases - February 10, 2022 Category: Neurology Authors: Salman Farooq, Kristina Shkirkova, Pablo Villablanca, Nerses Sanossian, David S. Liebeskind, Sidney Starkman, Gilda Avila, Latisha Sharma, May Kim-Tenser, Suzie Gasparian, Marc Eckstein, Robin Conwit, Scott Hamilton, Jeffrey L. Saver Tags: Original Article Source Type: research

Mechanical Thrombectomy for M1 Subocclusive Thrombus With Lateral Lenticulostriate Artery Occlusion: A Case Report and Literature Review
This article describes a treatment strategy for M1 subocclusive thrombus, focusing on the indications for mechanical thrombectomy. A 58-year-old male on admission for pneumonia had a sudden onset of dysarthria and motor deficits. He has a history of dilated cardiomyopathy and underwent left ventricular assist device implantation 3 years ago. At onset, his National Institutes of Health Stroke Scale (NIHSS) score was nine. Computed tomography angiography demonstrated a filling defect in the distal right M1 segment of the middle cerebral artery. Angiography confirmed the presence of a subocclusive thrombus within the distal r...
Source: Frontiers in Neurology - February 7, 2022 Category: Neurology Source Type: research

Posterior Circulation Stroke: Coma (More Than Time) is Brain
When it comes to finding clinical and radiological surrogates, there's been a lot of progress in strokes from the anterior circulation. The same may not be said about posterior circulation strokes, where outcomes are actually worse.1 Scores like the National Institutes of Health Stroke Scale (NIHSS) and the Alberta Stroke Programme Early CT Score for the posterior circulation (pc-ASPECTS), have proven to be underwhelming in predicting outcomes, with studies often establishing different cutoff values.
Source: Journal of Stroke and Cerebrovascular Diseases - January 27, 2022 Category: Neurology Authors: Hugo Mota D ória, Gonçalo Videira, Daniel Ferreira, Pedro Castro, Luís Albuquerque, João Pedro Filipe, Rui Felgueiras, José Pedro Rocha Pereira, Maria Luís Ribeiro, Viriato Alves, João Xavier, Denis Gabriel, Ângelo Carneiro Source Type: research

Acute telestroke evaluations during the COVID-19 pandemic
This study is a retrospective database review of all telestroke requests at one academic vascular neurology center telestroke network with seven remote sites in the USA between March 15 and April 30, 2020. Data were compared with historical cohort spanning same time frame in 2019 using parametric or nonparametric methods as appropriate. Among telestroke requests, characteristics of age, gender, race/ethnicity, National Institutes of Health Stroke Scale (NIHSS), primary diagnosis of AIS or transient ischemic attack (TIA), and number of patients receiving intravenous alteplase (IV-rtPA) and endovascular therapy (ET) were rec...
Source: Neurological Sciences - January 22, 2022 Category: Neurology Source Type: research

FLAIR vascular hyperintensity predicts early neurological deterioration in patients with acute ischemic stroke receiving endovascular thrombectomy
AbstractFluid-attenuated inversion recovery vascular hyperintensity (FVH) is frequently observed in patients with acute ischemic stroke (AIS). FVH is associated with functional outcome at 3  months in AIS patients receiving endovascular thrombectomy. In the present study, we assessed whether FVH predicted early neurological deterioration (END) and hemorrhagic transformation (HT) within 72 h in AIS patients receiving endovascular thrombectomy. We retrospectively analyzed 104 patients with acute internal-carotid-artery or proximal middle-cerebral-artery occlusion within 16 h after symptom onset. Before thrombectomy, all p...
Source: Neurological Sciences - January 22, 2022 Category: Neurology Source Type: research

Persistent challenges in endovascular treatment decision-making for acute ischaemic stroke
Purpose of review Although endovascular treatment (EVT) is the gold standard for treating acute stroke patients with large vessel occlusion (LVO), multiple challenges in decision-making for specific conditions persist. Recent evidence on a selection of patient subgroups will be discussed in this narrative review. Recent findings Two randomized controlled trials (RCTs) have been published in EVT of basilar artery occlusion (BAO). Large single arm studies showed promising results in Patients with low Alberta stroke program early CT score (ASPECTS) and more distal vessel occlusions. Recent data confirm patients wit...
Source: Current Opinion in Neurology - January 19, 2022 Category: Neurology Tags: CEREBROVASCULAR DISEASE: Edited by Diana Aguiar de Sousa Source Type: research

Anterior circulation large vessel occlusion outcomes in patients transferred from a peripheral primary stroke centre
DISCUSSION: Outcomes depended on stroke severity, age and vessel of occlusion. Prognosis was worse if the occlusion included M1, especially in octogenarians. Mothership and Drip-n-ship strategies should be compared in patients from remote locations stratified by stroke severity and patient age.PMID:34986748 | DOI:10.1080/01616412.2021.2024727
Source: Neurological Research - January 6, 2022 Category: Neurology Authors: Jussi O T Sipil ä Source Type: research

Proteomics-Based Approach to Identify Novel Blood Biomarker Candidates for Differentiating Intracerebral Hemorrhage From Ischemic Stroke —A Pilot Study
Discussion: In this exploratory proteomics-based pilot study, nine candidate biomarkers for differentiation of IS and ICH were identified. The proteins belong to the immune system, the coagulation cascade, and the apoptosis system, respectively. Further investigations in larger cohorts of patients with stroke using additional biochemical analysis methods, such as ELISA or Western Blotting are now necessary to validate these markers, and to characterize diagnostic accuracy with regard to the development of a point-of-care-system for use in resource-limited areas.
Source: Frontiers in Neurology - December 17, 2021 Category: Neurology Source Type: research

Longitudinal, Quantitative, Multimodal MRI Evaluation of Patients With Intracerebral Hemorrhage Over the First Year
In most patients with intracerebral hemorrhage (ICH), the hematoma and perihematomal area decrease over the subsequent months but patients continue to exhibit neurological impairments. In this serial imaging study, we characterized microstructural and neurophysiological changes in the ICH-affected brain tissues and collected the National Institute of Health Stroke Scale (NIHSS) and modified Rankin Score (mRS), two clinical stroke scale scores. Twelve ICH patients were serially imaged on a 3T MRI at 1, 3, and 12 months (M) after injury. The hematoma and perihematomal volume masks were created and segmented using FLAIR imagi...
Source: Frontiers in Neurology - November 30, 2021 Category: Neurology Source Type: research

Transient Ischemic Attacks Preceding Ischemic Stroke and the Possible Preconditioning of the Human Brain: A Systematic Review and Meta-Analysis
Stroke is a leading cause of mortality and disability worldwide. Transient ischemic attack (TIA) is defined as transient brain ischemia with temporary neurological deficits. In animal models, prior TIA seems to enhance brain ischemic tolerance to withstand further ischemic events, which might be explained by brain preconditioning. Thus, this review aims to formulate evidence of whether TIAs can induce positive preconditioning and enhance the functional outcomes in patients suffering from subsequent ischemic strokes. Five databases were searched (PubMed, Embase, SAGE, Web of Science, and Scopus), and twelve studies were inc...
Source: Frontiers in Neurology - November 24, 2021 Category: Neurology Source Type: research

Drip-and-Ship for Thrombectomy Treatment in Patients With Acute Ischemic Stroke Leads to Inferior Clinical Outcomes in a Stroke Network Covering Vast Rural Areas Compared to Direct Admission to a Comprehensive Stroke Center
Discussion: Our data suggest that patients who had an acute ischemic stroke admitted directly to a CSC may have better 90-day outcomes than those transferred secondarily for thrombectomy from a PSC.
Source: Frontiers in Neurology - November 1, 2021 Category: Neurology Source Type: research

Interaction between stroke severity and quality indicators of acute stroke care: a single-center retrospective analysis
AbstractIschemic stroke leads to substantial mortality and morbidity worldwide. Door-to-CT time, door-to-needle time (DNT), and door-to-groin time (DGT) are important quality indicators of stroke care. However, patient characteristics remain important determinants of outcome as well. In this single-center study, we investigated the interaction between these quality indicators and stroke severity regarding long-term functional outcome. All consecutive stroke patients treated at the ZOL stroke center, Genk, Belgium, between 2017 and 2020 were included in this retrospective observational study. Stroke severity was graded as â...
Source: Acta Neurologica Belgica - October 3, 2021 Category: Neurology Source Type: research

Psychiatric sequelae of stroke affecting the non-dominant cerebral hemisphere
There are a plethora of cognitive sequelae in addition to neglect and extinction that arise with unilateral right hemispheric stroke (RHS). Cognitive deficits following non-dominant (right) hemisphere stroke are common with unilateral neglect and extinction being the most recognized examples. The severity of RHS is usually underestimated by the National Institutes of Health Stroke Scale (NIHSS), which in terms of lateralized right hemisphere cognitive deficits, tests only for visual inattention/extinction.
Source: Journal of the Neurological Sciences - September 26, 2021 Category: Neurology Authors: Cynthia Guo, Christoph Stretz, Jordan Roderick Anderson, Nada El-Husseini, Brian Mac Grory, Blake Werner, Stephanie Yarnell Tags: Review Article Source Type: research

Letter to the editor regarding ‘prediction of intracerebral hemorrhage after endovascular treatment of acute ischemic stroke: Combining quantitative parameters on dual-energy CT with clinical related factors’
This study recruited 72 acute ischemic stroke patients treated with endovascular treatment, forty of whom developed intracerebral hemorrhage (ICH). According to the results of receiver operating characteristic curve and multivariate logistic regression analysis, the authors have found that hyperdensity areas (HDA) volumes, alberta stroke program early CT score (ASPECTS), National Institutes of Health Stroke Scale (NIHSS) score and some other parameters may be related to and be able to predict ICH after endovascular treatment.
Source: Journal of Stroke and Cerebrovascular Diseases - September 22, 2021 Category: Neurology Authors: Meidi Peng, Yachi Gong, Yupei Chen, Wenxuan Zhao Tags: Letter to the Editor Source Type: research