Cerebrovascular Diseases Extra

Early assessment and management of patients with mild stroke and transient ischemic attack (TIA) by specialists were recommended. OBJECTIVES: To evaluate the outcomes of these patients, and identify the predictive factors of clinical progression, unfavorable outcomes and recurrent stroke. MATERIALS AND METHODS: Patients with mild ischemic stroke (NIHSS≤5) and high-risk TIA were studied. All patients were managed by stroke specialists within 24 hours of stroke onset...

BACKGROUND: Prealbumin is a marker of malnutrition and inflammation. It has been associated with poor prognosis in cardiovascular disease, but less is known in stroke patients. Our objective was to evaluate the association of prealbumin levels at admission with prognosis in patients with stroke treated with mechanical thrombectomy. MATERIAL & METHODS: Retrospective study of a prospective database of consecutive patients treated with mechanical thrombectomy. Clinical, radiological and blood parameters including serum prealbumin, and prognostic variables such as respiratory infection, in-hospital mortality, and modified Rankin scale at 3 months were collected...

Introduction Pure arterial malformations (PAMs) are rare vascular abnormalities defined as dilated, tortuous arterial loops without any associated venous compartment. PAMs are thought to be benign developmental anomalies that can be safely managed conservatively. Methods We present a case of life-threatening hemorrhage in a patient with a PAM associated with two aneurysms and review the literature describing hemorrhages associated with PAMs. Results A 65-year-old female presented with subarachnoid and intraventricular hemorrhage...

BACKGROUND: Risk factors for stroke in symptomatic and asymptomatic moyamoya disease (MMD) patients has recently been reported in a Japanese cohort. Such information in a North American population is lacking. OBJECTIVE: We sought to elucidate the prevalence of stroke risk factors among North American patients with ischemic, hemorrhagic, and asymptomatic MMD. METHODS: We retrospectively reviewed our institution's database between 1990 to 2021...

BACKGROUND AND PURPOSE: The coronavirus 2019 (COVID-19) pandemic has been continuing its global spread ever since it's onset and efforts to curb the infection in multiple reports have contrasting effects on stroke severity, admissions and outcomes. In the Philippines, where the COVID-19 pandemic shows no signs of slowing down and has been in the world's longest lockdown, we investigated the effect of the pandemic in the stroke admissions and outcomes in one of the largest tertiary hospitals in the Philippines...

Introduction Early restoration of blood flow in stroke patients can be achieved by reducing the door-to-computed tomography (DTC) time. A previous study has proposed several methods to reduce the DTC time, but the implementation costs limit its transferability. This study aimed to propose a novel, simple, and low-cost method for reducing the DTC time by providing feedback on each patient's DTC time to a small group of medical workers and physicians. Methods A field experiment was conducted for 233 days, and the DTC time of 249 patients with stroke symptoms who were transported via ambulance to a medium-sized university hospital in Japan within 24 hours after stroke onset was obtained...

Malaysia is located in the heart of South East Asia with two land masses, Peninsular Malaysia and East Malaysia which are separated by the South China Sea. Stroke or cerebrovascular disease is Malaysia's third leading cause of death. There were 47, 911 incident cases, 19,928 deaths, 443,995 prevalent cases, and 512,726 DALYs lost due to stroke in 2019. Successive national health and morbidity surveys from 2006 demonstrated a continuous rise in the prevalence of risk factor such as diabetes, hyperlipidaemia and obesity...

Developing nations face the double burden of communicable and non-communicable diseases. Bhutan is a developing country, and has achieved significant milestones in its health indicators. Increasing burden of stroke and the lack of evidence based stroke care system in the country's hospitals is proving to be a challenge to provide quality stroke care. Despite the logistical challenge of referring stroke patients on time, lack of trained health care professionals and resources, Bhutan has recently started various initiatives to improve stroke care with the help of WHO-SEARO, WHO-Geneva, and Christian Medical College, Ludhiana, India...

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Introduction; Cerebral amyloid angiopathy (CAA) is a common cause of lobar intracerebral hemorrhage [ICH]. Sporadic CAA is far more common than hereditary CAA [h-CAA]. Familial cerebral amyloid angiopathy has not yet been described from India. Case report; Two elderly Indian women (a mother and daughter) presented seven years apart with features of CAA. The mother had presented with features of CAA-related inflammation that responded to steroids, whereas the daughter presented with features of CAA-related intracerebral haemorrhage...

INTRODUCTION: Risk factor control is an important predictor of risk of stroke recurrence. The attributable fraction which estimates the excess risk among the exposed stroke survivors has not been studied previously. We studied the attributable fraction for stroke recurrence in consecutive incident cases of recurrent stroke. METHODS: A case-control study with incident cases of recurrent stroke and controls matched for age and poststroke period was done. A structured interview was done to collect data on sociodemographic variables, lifestyle, and medication adherence...

INTRODUCTION: This study investigates gender differences among stroke patients treated in the telestroke network using specific risk factors that contribute to stroke severity. METHODS: We examined gender differences in stroke severity among 454 patients hospitalized with acute ischemic stroke (AIS). The logistic regression model was used to predict clinical risk factors associated with stroke severity in men and women AIS patients. RESULTS: In the adjusted analysis among women patients, increasing age (odds ratio [OR] = 1...

Stroke is a major cause of death and disability in Indonesia. Stroke requires high-quality, fast, and precise management to prevent and avoid disability and death. Stroke can be prevented by adequately controlling the risk factors and encouraging healthy lifestyles. Efforts are needed to organize health promotion programs at the community level. More and a better distribution of neurologists and neurointerventionalists is needed. All hospitals should have a CT scan machine and stroke units. Telemedicine for stroke patients is a very promising endeavor for an integrated acute stroke management system...

INTRODUCTION: The aim of this study was to clarify whether magnetic resonance angiography (MRA)-based road mapping of the para-aortic transfemoral access route can reduce the procedural time of mechanical thrombectomy in patients with acute ischemic stroke. We further investigated the role of pre-procedural MRA-based road mapping in optimal initial catheter selection for rapid mechanical thrombectomy. MATERIALS AND METHODS: We retrospectively reviewed 57 consecutive patients with acute ischemic stroke who underwent mechanical thrombectomy at our hospital between April 2018 and May 2021...

BACKGROUND: Patient selection for reperfusion therapies requires significant expertise in neuroimaging. Increasingly, machine learning-based analysis is used for faster and standardized patient selection. However, there is little information on how such software influences real-world patient management. AIMS: We evaluated changes in thrombolysis and thrombectomy delivery following implementation of automated analysis at a high volume primary stroke centre. METHODS: We retrospectively collected data on consecutive stroke patients admitted to a large university stroke centre from two identical 7-month periods in 2017 and 2018 between which the e-Stroke Suite (Brainomix, Oxford, UK) was implemented to analyse non-contrast CT and CT angiography results...

BACKGROUND: Obesity is associated with an increased prevalence of vascular risk factors and incidence of stroke. As such weight loss is recommended for patients living with obesity in the secondary prevention of stroke. Few studies, however, have examined the stages and processes of change for weight loss in stroke patients living with obesity. OBJECTIVE: The aim of the study was to evaluate the stages and processes of change for weight loss in patients living with obesity who have had a recent stroke or TIA...

INTRODUCTION: Diabetes mellitus (DM) is known to influence outcomes in the short-term following stroke. However, the impact of DM on long-term functional outcomes after stroke is unclear. We compared functional outcomes periodically over 7 years between diabetic and non-diabetic ischemic stroke patients and investigated the impact of DM on the long-term trajectory of post-stroke functional outcomes. We also studied the influence of age on the diabetes-functional outcome association. METHODS: This is a longitudinal observational cohort study of 802 acute ischemic stroke patients admitted to the Singapore General Hospital from 2005 to 2007...

Egypt, a low-middle-income country, is the most populated nation in the Middle East. In Egypt, the overall crude prevalence rate of stroke is high (963/100,000 inhabitants), and the incidence of stroke annually is approximately 150 000 to 210 000. The official national statistics indicate that diseases of the circulatory system, including stroke, are the primary cause of death in Egypt, where stroke accounts for 6.4% of all deaths and ranks third after cardiovascular and gastrointestinal diseases. Although the number of deaths attributed to stroke have declined in many countries, in Egypt, it was relatively unchanged in the past 10 years...

The Asia Pacific Stroke Organization is the largest international and professional stroke group in the region. It has worked consistently over the last 10 years to gain visibility and reliability across the Asia Pacific and beyond. The 10 year journey will be reviewed in the background of many internal and external developments including changes in Asia Pacific stroke epidemiology, stroke care systems, stroke service developments as well as major research studies in the Asia Pacific.

BACKGROUND: The impact of the length of the occluded vessel in acute large-vessel occlusion on successful reperfusion by mechanical thrombectomy remains unclear. This study evaluated whether diameter and length of the occluded vessel in acute middle cerebral artery (MCA) occlusion might relate to successful reperfusion following mechanical thrombectomy. METHODS: This retrospective study included patients with acute MCA occlusion who underwent intra-aortic injection of contrast medium to obtain maximum intensity projection (MIP) images acquired by flat-panel detector computed tomography (FD-CT) equipped with an angiographic system...