Utility-Weighted Modified Rankin Scale as Primary Outcome in Stroke Trials [Clinical Sciences]
Conclusions—The UW-mRS as primary outcome does not capture individual variation in utility values and may reduce the statistical power of a randomized trial. (Source: Stroke)
Source: Stroke - March 26, 2018 Category: Neurology Authors: Simone A. Dijkland, Daphne C. Voormolen, Esmee Venema, Bob Roozenbeek, Suzanne Polinder, Juanita A. Haagsma, Daan Nieboer, Vicky Chalos, Albert J. Yoo, Jennifer Schreuders, Aad van der Lugt, Charles B.L.M. Majoie, Yvo B.W.E.M. Roos, Wim H. van Zwam, Rober Tags: Quality and Outcomes, Cerebrovascular Disease/Stroke Original Contributions Source Type: research
Rescue Stenting for Failed Mechanical Thrombectomy in Acute Ischemic Stroke [Clinical Sciences]
Conclusions—RS was independently associated with good outcomes without increasing symptomatic intracranial hemorrhage or mortality. RS seemed considered in MT-failed internal carotid artery or middle cerebral artery M1 occlusion. (Source: Stroke)
Source: Stroke - March 26, 2018 Category: Neurology Authors: Yoonkyung Chang, Byung Moon Kim, Oh Young Bang, Jang-Hyun Baek, Ji Hoe Heo, Hyo Suk Nam, Young Dae Kim, Joonsang Yoo, Dong Joon Kim, Pyoung Jeon, Seung Kug Baik, Sang Hyun Suh, Kyung-Yul Lee, Hyo Sung Kwak, Hong Gee Roh, Young-Jun Lee, Sang Heum Kim, Chan Tags: Revascularization, Stent, Cerebrovascular Disease/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)
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
Ambulance Clinical Triage for Acute Stroke Treatment [Clinical Sciences]
Background and Purpose—Clinical triage scales for prehospital recognition of large vessel occlusion (LVO) are limited by low specificity when applied by paramedics. We created the 3-step ambulance clinical triage for acute stroke treatment (ACT-FAST) as the first algorithmic LVO identification tool, designed to improve specificity by recognizing only severe clinical syndromes and optimizing paramedic usability and reliability.Methods—The ACT-FAST algorithm consists of (1) unilateral arm drift to stretcher (Source: Stroke)
Source: Stroke - March 26, 2018 Category: Neurology Authors: Henry Zhao, Lauren Pesavento, Skye Coote, Edrich Rodrigues, Patrick Salvaris, Karen Smith, Stephen Bernard, Michael Stephenson, Leonid Churilov, Nawaf Yassi, Stephen M. Davis, Bruce C.V. Campbell Tags: Cerebrovascular Disease/Stroke Original Contributions Source Type: research
Posttreatment National Institutes of Health Stroke Scale Is Superior to the Initial Score or Thrombolysis in Cerebral Ischemia for 3-Month Outcome [Clinical Sciences]
Background and Purpose—The majority of ischemic stroke patients receiving endovascular recanalization therapy (EVT) experience variable changes of neurological severities during the hyperacute period. We hypothesized that the National Institutes of Health Stroke Scale (NIHSS) score after EVT is a better prognostic factor compared with the initial NIHSS score or revascularization status.Methods—We identified 566 stroke patients who received EVT at Seoul National University Bundang Hospital between April 2008 and December 2015. We prospectively collected post-EVT NIHSS score, which was measured in the angiography suite b...
Source: Stroke - March 26, 2018 Category: Neurology Authors: Han-Gil Jeong, Beom Joon Kim, Jay Chol Choi, Keun-Sik Hong, Mi Hwa Yang, Cheolkyu Jung, Moon-Ku Han, Hee-Joon Bae Tags: Ischemic Stroke Original Contributions Source Type: research
Thalamic Diaschisis in Acute Ischemic Stroke [Clinical Sciences]
Background and Purpose—Ipsilateral thalamic diaschisis (ITD) describes the reduction of thalamic function, metabolism, and perfusion resulting from a distant lesion of the ipsilateral hemisphere. Our aim was to evaluate the perfusion characteristics and clinical impact of ITD in acute middle cerebral artery stroke, which does not directly affect the thalamus.Methods—One hundred twenty-four patients with middle cerebral artery infarction were selected from a prospectively acquired cohort of 1644 patients who underwent multiparametric computed tomography (CT), including CT perfusion for suspected stroke. Two blinded read...
Source: Stroke - March 26, 2018 Category: Neurology Authors: Paul Reidler, Kolja M. Thierfelder, Matthias P. Fabritius, Wieland H. Sommer, Felix G. Meinel, Franziska Dorn, Frank A. Wollenweber, Marco Duering, Wolfgang G. Kunz Tags: Computerized Tomography (CT), Ischemic Stroke Original Contributions Source Type: research
Correction for Delay and Dispersion Results in More Accurate Cerebral Blood Flow Ischemic Core Measurement in Acute Stroke [Clinical Sciences]
This study aimed to assess how the ischemic core measured by perfusion computed tomography (CTP) was affected by the delay and dispersion effect.Methods—Ischemic stroke patients having CTP performed within 6 hours of onset were included. The CTP data were processed twice, generating standard cerebral blood flow (sCBF) and delay- and dispersion-corrected CBF (ddCBF), respectively. Ischemic core measured by the sCBF and ddCBF was then compared at the relative threshold (Source: Stroke)
Source: Stroke - March 26, 2018 Category: Neurology Authors: Longting Lin, Andrew Bivard, Timothy Kleinig, Neil J. Spratt, Christopher R. Levi, Qing Yang, Mark W. Parsons Tags: Computerized Tomography (CT), Ischemic Stroke Original Contributions Source Type: research
Association of White Matter Hyperintensities With Short-Term Outcomes in Patients With Minor Cerebrovascular Events [Clinical Sciences]
Conclusions—Our data suggest that quantitative and qualitative WML assessments are highly correlated and comparable in TIA/minor stroke patients. WML burden is associated with short-term outcome of patients with good prestroke function in the presence of intracranial stenosis/occlusion. (Source: Stroke)
Source: Stroke - March 26, 2018 Category: Neurology Authors: Charlotte Zerna, Amy Y.X. Yu, Jayesh Modi, Shiel K. Patel, Jonathan I. Coulter, Eric E. Smith, Shelagh B. Coutts Tags: Cerebrovascular Disease/Stroke, Transient Ischemic Attack (TIA) 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
Hyperintense Plaque on Intracranial Vessel Wall Magnetic Resonance Imaging as a Predictor of Artery-to-Artery Embolic Infarction [Clinical Sciences]
Background and Purpose—The aim of the present study was to investigate atherosclerotic plaque characteristics in patients with artery-to-artery (A-to-A) embolic infarction by whole-brain high-resolution magnetic resonance imaging.Methods—Seventy-four patients (mean age, 54.7±12.1 years; 59 men) with recent stroke in the territory of middle cerebral artery because of intracranial atherosclerotic disease were prospectively enrolled. Whole-brain high-resolution magnetic resonance imaging was performed in all the patients both precontrast and postcontrast administration by using a 3-dimensional T1-weighted vessel wall mag...
Source: Stroke - March 26, 2018 Category: Neurology Authors: Fang Wu, Haiqing Song, Qingfeng Ma, Jiayu Xiao, Tao Jiang, Xiaoqin Huang, Xiaoming Bi, Xiuhai Guo, Debiao Li, Qi Yang, Xunming Ji, Zhaoyang Fan, on behalf of the WISP Investigators† Tags: Atherosclerosis, Embolism, Vascular Disease Original Contributions Source Type: research
Age-Specific Associations of Renal Impairment With Magnetic Resonance Imaging Markers of Cerebral Small Vessel Disease in Transient Ischemic Attack and Stroke [Clinical Sciences]
Background and Purpose—It has been hypothesized that cerebral small vessel disease (SVD) and chronic renal impairment may be part of a multisystem small-vessel disorder, but their association may simply be as a result of shared risk factors (eg, hypertension) rather than to a systemic susceptibility to premature SVD. However, most previous studies were hospital based, most had inadequate adjustment for hypertension, many were confined to patients with lacunar stroke, and none stratified by age.Methods—In a population-based study of transient ischemic attack and ischemic stroke (OXVASC [Oxford Vascular Study]), we evalu...
Source: Stroke - March 26, 2018 Category: Neurology Authors: Bian Liu, Kui Kai Lau, Linxin Li, Caroline Lovelock, Ming Liu, Wilhelm Kuker, Peter M. Rothwell Tags: Magnetic Resonance Imaging (MRI), Ischemic Stroke, Transient Ischemic Attack (TIA) Original Contributions Source Type: research
Arterial Wall Imaging in Pediatric Stroke [Clinical Sciences]
Conclusions—AWI is a noninvasive, high-resolution magnetic resonance AWI technique, which can be successfully used in children presenting with AIS. Patterns of AWI enhancement are recognizable and associated with specific AIS pathogeneses. Further studies are required to assess the additional diagnostic utility of AWI over routine vascular imaging techniques, in childhood AIS. (Source: Stroke)
Source: Stroke - March 26, 2018 Category: Neurology Authors: Nomazulu Dlamini, Ivanna Yau, Prakash Muthusami, David J. Mikulis, Jorina Elbers, Mahmoud Slim, Rand Askalan, Daune MacGregor, Gabrielle deVeber, Manohar Shroff, Mahendranath Moharir Tags: Pediatrics, Imaging, Ischemic Stroke, Vascular Disease Original Contributions Source Type: research
Plasma A{beta} (Amyloid-{beta}) Levels and Severity and Progression of Small Vessel Disease [Clinical Sciences]
Background and Purpose—Cerebral small vessel disease (SVD) is a frequent pathology in aging and contributor to the development of dementia. Plasma Aβ (amyloid β) levels may be useful as early biomarker, but the role of plasma Aβ in SVD remains to be elucidated. We investigated the association of plasma Aβ levels with severity and progression of SVD markers.Methods—We studied 487 participants from the RUN DMC study (Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Imaging Cohort) of whom 258 participants underwent 3 MRI assessments during 9 years. We determined baseline plasma Aβ38, Aβ40, and AÎ...
Source: Stroke - March 26, 2018 Category: Neurology Authors: Esther M.C. van Leijsen, H. Bea Kuiperij, Iris Kersten, Mayra I. Bergkamp, Ingeborg W.M. van Uden, Hugo Vanderstichele, Erik Stoops, Jurgen A.H.R. Claassen, Ewoud J. van Dijk, Frank-Erik de Leeuw, Marcel M. Verbeek Tags: Biomarkers, Magnetic Resonance Imaging (MRI), Cerebrovascular Disease/Stroke Original Contributions Source Type: research
Increased Risk of Pregnancy Complications After Stroke [Clinical Sciences]
Background and Purpose—The study goal was to investigate the prevalence of pregnancy complications and pregnancy loss in women before, during, and after young ischemic stroke/transient ischemic attack.Methods—In the FUTURE study (Follow-Up of Transient Ischemic Attack and Stroke Patients and Unelucidated Risk Factor Evaluation), a prospective young stroke study, we assessed the occurrence of pregnancy, miscarriages, and pregnancy complications in 223 women aged 18 to 50 years with a first-ever ischemic stroke/transient ischemic attack. Pregnancy complications (gestational hypertension, diabetes mellitus, preeclampsia, ...
Source: Stroke - March 26, 2018 Category: Neurology Authors: Mayte E. van Alebeek, Myrthe de Vrijer, Renate M. Arntz, Noortje A.M.M. Maaijwee, Nathalie E. Synhaeve, Hennie Schoonderwaldt, Maureen J. van der Vlugt, Ewoud J. van Dijk, Roel de Heus, Loes C.A. Rutten-Jacobs, Frank-Erik de Leeuw Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research
Mean Platelet Volume as a Predictor for Restenosis After Carotid Angioplasty and Stenting [Clinical Sciences]
Conclusions—Elevated MPV may be associated with ISR after CAS. Patients with high preprocedural MPV may benefit from an intensified antiplatelet therapy after CAS. (Source: Stroke)
Source: Stroke - March 26, 2018 Category: Neurology Authors: Zhengze Dai, Jie Gao, Shun Li, Rongrong Li, Zhaoyao Chen, Meng Liang, Xinfeng Liu, Gelin Xu Tags: Stent, Ischemic Stroke, Atherosclerosis, Restenosis Original Contributions Source Type: research
