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National institutes of health stroke scale

Haydn Hoffman, Robert Ziechmann, Amar Swarnkar, Hesham E Masoud, Grahame Gould
INTRODUCTION: There is continued interest in identifying factors that predict a favorable outcome after endovascular thrombectomy (EVT) for anterior circulation large vessel occlusion (ACLVO). We compared the predictive values of 2 different scoring systems for evaluating venous collateral circulation. METHODS: A retrospective review of patients who underwent EVT for ACLVO at a single institution was performed. Those who underwent preprocedural computed tomography angiography (CTA) were selected...
March 13, 2019: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Xin-Wei He, Yan-Hui Shi, Rong Zhao, Yi-Sheng Liu, Ge-Fei Li, Yue Hu, Wei Chen, Guo-Hong Cui, Jing-Jing Su, Jian-Ren Liu
INTRODUCTION: Multiple microRNAs (miRNAs) participate in the response to hypoxic/ischemic and ischemia-reperfusion events. However, the expression of these miRNAs in circulation from patients with acute ischemic stroke (AIS) receiving recanalization treatment has not been examined, and whether they are associated with the severity and outcome of stroke is still unknown. MATERIALS AND METHODS: In this prospective cohort study, plasma levels of miR-125b-5p, miR-15a-3p, miR-15a-5p, and miR-206 were measured at 24hours after thrombolysis with or without endovascular treatment in 94 patients with AIS, as determined by qRT-PCR...
March 14, 2019: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Andrei V Alexandrov, Martin Köhrmann, Lauri Soinne, Georgios Tsivgoulis, Andrew D Barreto, Andrew M Demchuk, Vijay K Sharma, Robert Mikulik, Keith W Muir, Gordon Brandt, John Alleman, James C Grotta, Christopher R Levi, Carlos A Molina, Maher Saqqur, Dimitris Mavridis, Theodora Psaltopoulou, Milan Vosko, Jochen B Fiebach, Pitchaiah Mandava, Thomas A Kent, Anne W Alexandrov, Peter D Schellinger
BACKGROUND: Pulsed-wave ultrasound increases the exposure of an intracranial thrombus to alteplase (recombinant tissue plasminogen activator), potentially facilitating early reperfusion. We aimed to ascertain if a novel operator-independent transcranial ultrasound device delivering low-power high-frequency ultrasound could improve functional outcome in patients treated with alteplase after acute ischaemic stroke. METHODS: We did a multicentre, double-blind, phase 3, randomised controlled trial (CLOTBUST-ER) at 76 medical centres in 14 countries...
April 2019: Lancet Neurology
Julian Teufel, Michael Strupp, Jennifer Linn, Roger Kalla, Katharina Feil
BACKGROUND AND PURPOSE: The initial diagnosis of medullary infarction can be challenging since CT and even MRI results in the very acute phase are often negative. METHODS: A retrospective, observer-blinded study of horizontal conjugate eye deviation was performed in 1) 50 consecutive patients [age 58±15 years (mean±SD), 74% male, National Institutes of Health Stroke Scale 2±1] with acute unilateral lateral medullary infarction as seen in MRI (infarction group), 2) 54 patients with transient brainstem symptoms [transient ischemic attack of brainstem (TIA) group; age 69±16 years, 59% male], and 3) 53 patients (age 59±20 years, 49% male) with diagnoses other than stroke (control group)...
March 11, 2019: Journal of Clinical Neurology
Thijs Landman, Yvonne Schoon, Michiel Warlé, Frank-Erik De Leeuw, Dick Thijssen
BACKGROUND: Remote ischemic postconditioning (rIPostC) refers to the observation that repeated, short periods of ischemia protect remote areas against tissue damage during and after prolonged ischemia. Based on previous observations of a potential neuroprotective effect of rIPostC, the aim of this study is to evaluate whether repeated rIPostC after an ischemic stroke can reduce infarct size, which could be translated to an improvement in clinical outcomes. METHODS/DESIGN: We will enroll 200 ischemic stroke patients to daily rIPostC or sham conditioning during hospitalization into a randomized single-blind placebo-controlled trial...
March 15, 2019: Trials
B Winter, M Wendt, C Waldschmidt, M Rozanski, A Kunz, F Geisler, U Grittner, S Kaczmarek, M Ebinger, H J Audebert
BACKGROUND: Time to reperfusion treatment is closely related to outcome in ischemic stroke. Prehospital stroke work-up in CT-equipped mobile stroke units is effective in reducing time to thrombolytic treatment. Current evidence predominantly comes from mobile stroke units staffed with neurologists but telemedicine-guided management may be acceptable for providing neurological expertise in ambulances. With unsatisfactory experiences in third-generation (3G)-based approaches, fourth-generation (4G) networks may provide adequate audio-visual quality but systematic comparisons of technological parameters and decision-making are lacking...
March 15, 2019: International Journal of Stroke: Official Journal of the International Stroke Society
Lei Xia, Qiu Han, Xiao-Yu Ni, Bing Chen, Xiu Yang, Quan Chen, Guan-Liang Cheng, Chun-Feng Liu
OBJECTIVE: Efficacy of minimally invasive craniopuncture with the YL-1 puncture needle (hard-channel) and soft drainage tube (soft-channel) in treating hypertensive intracerebral hemorrhage (HICH). MATERIALS AND METHODS: Totally 150 HICH patients were randomly assigned into three groups, conservative group (n=50), hard-channel group (n=50) and soft-channel group (n=50). Computed tomography, National Institutes of Health Stroke Scale (NIHSS) and levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), superoxide dismutase (SOD) and malondialdehyde (MDA) in serum and in drainage fluid were examined on day2, 4, 6 post operation...
March 11, 2019: World Neurosurgery
Lin Jiang, Wen-Qing Xia, Huan Huang, Ke-Qin Liu, Xiao-Li Si, Xin-Yi Zhao, Cong-Guo Yin
BACKGROUND: Mechanical thrombectomy (MT) has demonstrated benefit in patients with acute ischemic stroke due to proximal large vessel occlusion. However, it is unclear, whether these results can be extrapolated to patients with an occlusion of the second segment (M2) of the middle cerebral artery (MCA). OBJECTIVE: To study outcomes in patients with M2 occlusion treated with MT and to better understand clinical predictors of these outcomes. METHODS: We performed a single-center retrospective analysis of consecutive patients with acute MCA M2 segment occlusion who underwent stent retriever MT...
March 11, 2019: World Neurosurgery
Suhail Al Rukn, Michael V Mazya, Faycal Hentati, Samia Ben Sassi, Fatma Nabli, Zakharia Said, Belahsen Faouzi, Husnain Hashim, Foad Abd-Allah, Benhan Mansouri, Selma Kesraoui, Souheil Gebeily, Husen Abdulrahman, Naveed Akhtar, Niaz Ahmed, Nils Wahlgren, Hany Aref, Mohammed Almekhlafi, Tiago Moreira
BACKGROUND AND METHODS: Stroke incidence and mortality are reported to have increased in the Middle-East and North African (MENA) countries during the last decade. This was a prospective observational study to examine the baseline characteristics of stroke patients in the MENA region and to compare the MENA vs. the non-MENA stroke cohort in the Safe Implementation of Treatments in Stroke (SITS) International Registry. RESULTS: Of the 13,822 patients with ischemic and hemorrhagic stroke enrolled in the SITS-All Patients Protocol between June 2014 and May 2016, 5897 patients (43%) were recruited in MENA...
March 12, 2019: International Journal of Stroke: Official Journal of the International Stroke Society
Paggie Kim, Kristofer Langheinrich, Brian Cristiano, Phillip Grigsby, Udo Oyoyo, Daniel Kido, J Paul Jacobson
OBJECTIVE: Hyperacute stroke affects various patient subgroups who may benefit from different management strategies. Magnetic resonance imaging (MRI) quantitative susceptibility mapping (QSM) is a recent MRI technique for measuring deoxyhemoglobin levels. The results of QSM thus have the potential to act as a quantitative biomarker for predicting the success of endovascular interventions. METHODS: Twenty-five patients with M1 occlusions were evaluated retrospectively...
March 12, 2019: Journal of International Medical Research
Tomas Dobrocky, Johannes Kaesmacher, Sebastian Bellwald, Eike Piechowiak, Pascal J Mosimann, Felix Zibold, Simon Jung, Marcel Arnold, Urs Fischer, Jan Gralla, Pasquale Mordasini
BACKGROUND AND PURPOSE: Data on the management of large vessel occlusion in patients with anterior circulation acute ischemic stroke (AIS) due to underlying intracranial stenosis are scarce. The aim of this retrospective study was to compare endovascular treatment and outcome in AIS patients with and without underlying stenosis of the M1 segment. MATERIALS AND METHODS: A total of 533 acute stroke patients with an isolated M1 occlusion who underwent mechanical thrombectomy between 02/2010 and 08/2017 were included...
March 11, 2019: Cardiovascular and Interventional Radiology
Kena Zhou, Congbo Cai
Autologous fat injection is becoming a more and more widely accepted procedure in plastic surgery nowadays. Concomitantly, there are many complications. The most serious one is arterial fat embolism, for which there is only poor prognosis and no effective treatment. Here, we report the first case of successful treatment of cerebral fat embolization with the help of mechanical lipectomy. Our patient was found unconscious with left-sided hemiparesis after a facial fat injection surgery 4 hours before. Cerebral artery computed tomography angiography indicated it was multiple fat embolism...
January 2019: Plastic and Reconstructive Surgery. Global Open
Muhammad E Haque, Refaat E Gabr, Sarah D George, Seth B Boren, Farhaan S Vahidy, Xu Zhang, Octavio D Arevalo, Susan Alderman, Ponnada A Narayana, Khader M Hasan, Elliott R Friedman, Clark W Sitton, Sean I Savitz
Purpose: Cell-based therapy offers new opportunities for the development of novel treatments to promote tissue repair, functional restoration, and cerebral metabolic balance. N-acetylasperate (NAA), Choline (Cho), and Creatine (Cr) are three major metabolites seen on proton magnetic resonance spectroscopy (MRS) that play a vital role in balancing the biochemical processes and are suggested as markers of recovery. In this preliminary study, we serially monitored changes in these metabolites in ischemic stroke patients who were treated with autologous bone marrow-derived mononuclear cells (MNCs) using non-invasive MRS...
2019: Frontiers in Neurology
Ginenus Fekadu, Hunduma Wakassa, Firew Tekle
Background: The fact that the majority of patients come late creates management difficulties as these first hours are important to avoid secondary insults to the brain and preserve the ischemic penumbra. Although thrombolytic treatments are currently not available in our hospital, significant delays during the prehospital or in-hospital phases of care create management difficulties and would make such advanced treatments impossible in the future in Ethiopia. Methods: Prospective observational study was carried at stroke unit of Jimma University Medical Center for 4 consecutive months from March 10 to July 10, 2017...
2019: Stroke Research and Treatment
Daoxia Guo, Zhengbao Zhu, Chongke Zhong, Hao Peng, Aili Wang, Tian Xu, Yanbo Peng, Tan Xu, Chung-Shiuan Chen, Qunwei Li, Zhong Ju, Deqin Geng, Jing Chen, Yonghong Zhang, Jiang He
Background and Purpose- Previous experimental studies suggested that serum netrin-1 was associated with the progression of ischemic stroke. Knowledge about netrin-1 among ischemic stroke patients may provide new ideas for the prognostic assessment of ischemic stroke. The aim of this study was to investigate the association between serum netrin-1 and prognosis of ischemic stroke. Methods- Serum netrin-1 levels at baseline were measured for 3346 ischemic stroke patients from the CATIS (China Antihypertensive Trial in Acute Ischemic Stroke), and all patients were followed up at 3 months after stroke onset...
March 11, 2019: Stroke; a Journal of Cerebral Circulation
Kosmas Macha, Armin Marsch, Gabriela Siedler, Lorenz Breuer, Erwin F Strasser, Tobias Engelhorn, Stefan Schwab, Bernd Kallmünzer
Background and Purpose- In patients with ischemic stroke on therapy with vitamin K antagonists, stroke severity and clinical course are affected by the quality of anticoagulation at the time of stroke onset, but clinical data for patients using direct oral anticoagulants (DOACs) are limited. Methods- Data from our registry including all patients admitted with acute cerebral ischemia while taking oral anticoagulants for atrial fibrillation between November 2014 and October 2017 were investigated. The activity of vitamin K antagonists was assessed using the international normalized ratio on admission and categorized according to a threshold of 1...
March 11, 2019: Stroke; a Journal of Cerebral Circulation
Nicole Anne Wysocki, Arvind Bambhroliya, Christy Ankrom, Farhaan Vahidy, César Astudillo, Alyssa Trevino, Rene Malazarte, T C Cossey, Amanda Jagolino-Cole, Sean Savitz, Tzu-Ching Wu, Anjail Sharrief
Background and Purpose- Telemedicine is increasingly utilized for intravenous tPA (tissue-type plasminogen activator) delivery. The comparative safety of leaving tPA-treated patients at a presenting (spoke) hospital (drip-and-stay) or transferring patients to a central treating (hub) hospital (drip-and-ship) is not established. We sought to compare outcomes between drip-and-ship and drip-and-stay patients treated with tPA via telemedicine. We hypothesized that there would be no differences in short-term outcomes of in-hospital mortality, length of stay, or discharge disposition or in 90-day outcomes between groups...
March 11, 2019: Stroke; a Journal of Cerebral Circulation
Masatomo Miura, Shinichi Yoshimura, Nobuyuki Sakai, Hiroshi Yamagami, Kazutaka Uchida, Yoichiro Nagao, Takeshi Morimoto
OBJECTIVE: To compare the efficacy of endovascular therapy (EVT) with that of medical treatment in 'real-world 'patients with M2 occlusion. METHODS: This was a post hoc analysis of the Recovery by Endovascular Salvage for Cerebral Ultra-acute Embolism Japan Registry 2. Among 2420 patients in the registry, we evaluated patients with isolated M2 occlusion and those with functional independence before the stroke. Multivariable logistic regression analysis was used to evaluate and compare clinical outcomes between EVT and medical treatment...
March 9, 2019: Journal of Neurointerventional Surgery
Ho Jun Yi, Jae Hoon Sung, Min Hyung Lee, Dong Hoon Lee
BACKGROUND: We report the experience of the FlowGate2 (FG2) as a new balloon guide catheter (BGC) in endovascular stroke intervention. METHODS: We evaluated the various outcomes and complications of patients with intracranial large artery occlusion undergoing endovascular stroke intervention with FG2 at our center. Baseline characteristics (failure rate of device application, sex, age, risk factors, arterial occlusion sites, and time intervals) were reviewed. Outcomes were evaluated according to National Institutes of Health Stroke Scale (NIHSS) score, Modified Rankin Scale (mRS) score, number of stent passages required, and Thrombolysis in Cerebral Infarction (TICI) score...
March 6, 2019: World Neurosurgery
Emilio Rubén Pego-Pérez, Isaac Fernández-Rodríguez, José Manuel Pumar-Cebreiro
Whereas mortality from ischemic stroke is decreasing in all age groups, the prevalence of stroke continues to increase. Its increasing incidence in the younger population adds to the large number of survivors who will live many years with their disabilities related to stroke. Thus, the objectives of this study are to determine the National Institutes of Health Stroke Scale (NIHSS), the modified Rankin Scale (mRS), and the modified Thrombolysis in Cerebral Infarction (mTICI) as adequate prognostic functionality tools for stroke patients and to analyze the relation between stroke and rehabilitation...
March 9, 2019: Reviews in the Neurosciences
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