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Oscar H Del Brutto, Robertino M Mera, Mauricio Zambrano, Julio Lama, Victor J Del Brutto, Pablo R Castillo
BACKGROUND/OBJECTIVES: Evidence of a relationship between non-breathing-related sleep symptoms and silent markers of cerebral small vessel disease (SVD) is scarce. The present study aimed to evaluate this association in older people living in rural Ecuador, where the burden of stroke is on the rise. METHODS: A group of Atahualpa residents, aged ≥60 years, were interviewed with a validated Spanish version of the Pittsburgh Sleep Quality Index, and underwent magnetic resonance imaging (MRI) for identification of silent markers of SVD...
March 2015: Sleep Medicine
D Consoli, S Vidale, U Aguglia, P Bassi, A Cavallini, F Galati, D Guidetti, N Marcello, G Micieli, G Pracucci, M Rasura, A Siniscalchi, R Sterzi, D Toni, D Inzitari
BACKGROUND AND PURPOSE: There is an increasing interest in new risk factors for ischaemic stroke. Acute and chronic infections could contribute to different aetiological mechanisms of atherosclerosis that lead to cerebrovascular disease. The aim of this study was to investigate the hypothesis that previous infections and Chlamydia pneumoniae in particular increase the risk of ischaemic stroke in the population. METHODS: This was a prospective case-control study involving 11 Italian stroke units...
March 2015: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Hugh S Markus, Elizabeth Hayter, Christopher Levi, Adina Feldman, Graham Venables, John Norris
BACKGROUND: Extracranial carotid and vertebral artery dissection is an important cause of stroke, especially in young people. In some observational studies it has been associated with a high risk of recurrent stroke. Both antiplatelet drugs and anticoagulant drugs are used to reduce risk of stroke but whether one treatment strategy is more effective than the other is unknown. We compared their efficacy in the Cervical Artery Dissection in Stroke Study (CADISS), with the additional aim of establishing the true risk of recurrent stroke...
April 2015: Lancet Neurology
B Han, Y Lyu, H Sun, Y Wei, J He
BACKGROUND AND PURPOSE: Low serum levels of vitamin D have been associated with depression in non-stroke subjects. Our aim was to examine the possible association between serum vitamin D levels and the development of post-stroke depression (PSD). METHODS: In total, 189 patients with acute ischaemic stroke were consecutively recruited. Serum levels of 25-hydroxyvitamin D [25(OH)D] were measured by competitive protein-binding assay within 24 h after admission. The 17-item Hamilton Depression Scale was used for screening for the existence of depressive symptoms at 1 month after stroke...
September 2015: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Chun-Hsiang Tseng, Wen-Yi Chiu
The medulla contains complex nervous structures related to motor, sensory, coordination, and visceral autonomic functions. The medullary infarctions cause various symptoms and signs depending on the location of the lesion. Lateral medullary infarction is caused by a vascular event in the territory of the posterior inferior cerebellar artery or the vertebral artery. We report a case of a patient with falling tendency and whirling sensation. He reported no facial drop, arm drift, slurred speech, difficulty of swallowing, or weakness of his limbs...
July 2014: American Journal of Emergency Medicine
Jeffrey J Perry, Ian G Stiell, Marco L A Sivilotti, Michael J Bullard, Corinne M Hohl, Jane Sutherland, Marcel Émond, Andrew Worster, Jacques S Lee, Duncan Mackey, Merril Pauls, Howard Lesiuk, Cheryl Symington, George A Wells
IMPORTANCE: Three clinical decision rules were previously derived to identify patients with headache requiring investigations to rule out subarachnoid hemorrhage. OBJECTIVE: To assess the accuracy, reliability, acceptability, and potential refinement (ie, to improve sensitivity or specificity) of these rules in a new cohort of patients with headache. DESIGN, SETTING, AND PATIENTS: Multicenter cohort study conducted at 10 university-affiliated Canadian tertiary care emergency departments from April 2006 to July 2010...
September 25, 2013: JAMA: the Journal of the American Medical Association
Yongjun Wang, Yilong Wang, Xingquan Zhao, Liping Liu, David Wang, Chunxue Wang, Chen Wang, Hao Li, Xia Meng, Liying Cui, Jianping Jia, Qiang Dong, Anding Xu, Jinsheng Zeng, Yansheng Li, Zhimin Wang, Haiqin Xia, S Claiborne Johnston
BACKGROUND: Stroke is common during the first few weeks after a transient ischemic attack (TIA) or minor ischemic stroke. Combination therapy with clopidogrel and aspirin may provide greater protection against subsequent stroke than aspirin alone. METHODS: In a randomized, double-blind, placebo-controlled trial conducted at 114 centers in China, we randomly assigned 5170 patients within 24 hours after the onset of minor ischemic stroke or high-risk TIA to combination therapy with clopidogrel and aspirin (clopidogrel at an initial dose of 300 mg, followed by 75 mg per day for 90 days, plus aspirin at a dose of 75 mg per day for the first 21 days) or to placebo plus aspirin (75 mg per day for 90 days)...
July 4, 2013: New England Journal of Medicine
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