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NIH Stroke Scale

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1. Comparison of lipid profiles and inflammation in pre- and post-menopausal women with cerebral infarction and the role of atorvastatin in such populations Full Text available with Trip Pro

Comparison of lipid profiles and inflammation in pre- and post-menopausal women with cerebral infarction and the role of atorvastatin in such populations The risks of atherosclerotic cardiovascular and cerebrovascular diseases in women rapidly increase with age in post-menopausal women. We aimed to investigate the lipid profiles in peri-menopausal women with cerebral infarction and to explore the effects of atorvastatin intervention.We collected women aged 40-60 with cerebral infarction between (...) January 2013 and December 2016. Atorvastatin was applied for 6 months in all included patients. Blood lipid profiles, serum pro-inflammation cytokines, intracranial plaque and NIH stroke scale (NIHSS) scores were evaluated before and after atorvastatin treatment.Totally 210 patients were included. Before atorvastatin treatment, post-menopausal patients had significantly higher levels of triglyceride, cholesterol, low-density lipoprotein and a reduced level of high-density lipoprotein than those in pre

2018 Lipids in health and disease

2. Recommendations for the Management of Cerebral and Cerebellar Infarction with Swelling

suffer neurological deterioration attributable to cerebral swelling after ischemia. Hemispheric Stroke Patients with significant swelling typically have occlusions of the internal carotid artery, MCA, or both. The natural history of a large infarction after internal carotid artery versus MCA infarction is not clear, especially when independent of ante- rior cerebral artery territory infarction. Infarctions from MCA branch occlusions typically do not result in swelling with clinically significant mass (...) Recommendations for the Management of Cerebral and Cerebellar Infarction with Swelling 1222 Background and Purpose—There are uncertainties surrounding the optimal management of patients with brain swelling after an ischemic stroke. Guidelines are needed on how to manage this major complication, how to provide the best comprehensive neurological and medical care, and how to best inform families facing complex decisions on surgical intervention in deteriorating patients. This scientific statement

2014 Congress of Neurological Surgeons

3. The Safety and Efficacy of Human Umbilical Cord Mesenchymal Stem Cells in the Treatment of Acute Cerebral Infarction

infarct (TACI), Partial Anterior circulation infarct (PACI), Posterior Anterior circulation infarct (POCI), or obvious neurological deficit lacunar infarction patient. Signed informed consent after understanding all possible benefits and harm. Exclusion Criteria: allergic to basic drug with progressive stroke, transient ischemia attach, cerebral infarction with posterior cerebral hemorrhage, and cerebral arteritis. tumor, injury, and parasites caused cerebral embolism rheumatic heart disease, coronary (...) Layout table for additional information Studies a U.S. FDA-regulated Drug Product: No Studies a U.S. FDA-regulated Device Product: No Product Manufactured in and Exported from the U.S.: No Keywords provided by Sclnow Biotechnology Co., Ltd.: acute cerebral infarction umbilical cord mesenchymal stem cells Additional relevant MeSH terms: Layout table for MeSH terms Infarction Cerebral Infarction Ischemia Pathologic Processes Necrosis Brain Infarction Brain Ischemia Cerebrovascular Disorders Brain

2017 Clinical Trials

4. Screening Tools to Identify Adults with Cognitive Impairment Associated with a Cerebrovascular Accident or Traumatic Brain Injury

No literature identified. Non-Randomized Studies Cerebrovascular Disease and Accident 2. Dong Y, Slavin MJ, Chan BP, Venketasubramanian N, Sharma VK, Collinson SL, et al. Improving screening for vascular cognitive impairment at three to six months after mild ischemic stroke and transient ischemic attack. Int Psychogeriatr. 2014 May;26(5):787-93. PubMed: PM24423626 3. Lees R, Lua J, Melling E, Miao Y, Tan J, Quinn TJ. Cog-4 has limited diagnostic test accuracy and validity for cognitive assessment in stroke (...) and hypertensive arteriopathy after transient ischemic attack or minor stroke. Stroke. 2014 Nov;45(11):3337-42. PubMed: PM25248911 6. Xu Q, Cao WW, Mi JH, Yu L, Lin Y, Li YS. Brief screening for mild cognitive impairment in subcortical ischemic vascular disease: a comparison study of the Montreal Cognitive Assessment with the Mini-mental State Examination. Eur Neurol. 2014;71(3-4):106-14. PubMed: PM24335198 7. Blackburn DJ, Bafadhel L, Randall M, Harkness KA. Cognitive screening in the acute stroke setting

2014 Canadian Agency for Drugs and Technologies in Health - Rapid Review

5. Re-evaluation of the stroke prognostication using age and NIH Stroke Scale index (SPAN-100 index) in IVT patients - the-SPAN 100<sup>65</sup> index. Full Text available with Trip Pro

Re-evaluation of the stroke prognostication using age and NIH Stroke Scale index (SPAN-100 index) in IVT patients - the-SPAN 10065 index. The SPAN-100 index adds patient age and baseline NIHSS-score and was introduced to predict clinical outcome after acute ischemic stroke (AIS). Even with high NIHSS-scores younger patients cannot reach a SPAN-100-positive status (index ≥100). We aimed to evaluate the SPAN-100 index among a large, contemporary cohort of i.v.-thrombolysed AIS-patients

2018 BMC Neurology

6. Design and validation of a clinical scale for prehospital stroke recognition, severity grading and prediction of large vessel occlusion: the shortened NIH Stroke Scale for emergency medical services. Full Text available with Trip Pro

Design and validation of a clinical scale for prehospital stroke recognition, severity grading and prediction of large vessel occlusion: the shortened NIH Stroke Scale for emergency medical services. To develop an NIH Stroke Scale (NIHSS)-compatible, all-in-one scale for rapid and comprehensive prehospital stroke assessment including stroke recognition, severity grading and progression monitoring as well as prediction of large vessel occlusion (LVO).Emergency medical services (EMS) personnel (...) and stroke physicians (n=326) rated each item of the NIHSS regarding suitability for prehospital use; best rated items were included. Stroke recognition was evaluated retrospectively in 689 consecutive patients with acute stroke or stroke mimics, prediction of LVO in 741 consecutive patients with ischaemic stroke with acute vessel imaging independent of admission NIHSS score.Nine of the NIHSS items were rated as 'suitable for prehospital use.' After excluding two items in order to increase specificity

2017 BMJ open

7. Post-insult valproate treatment potentially improved functional recovery in patients with acute middle cerebral artery infarction. (Abstract)

Post-insult valproate treatment potentially improved functional recovery in patients with acute middle cerebral artery infarction. Animal stroke models suggest that valproate has multiple neuroprotective mechanisms against ischemic brain damage. This study investigated whether valproate improves functional recovery in patients with acute middle cerebral artery (MCA) infarction. This was an open-label controlled trial. Three to 24 hours after acute MCA infarction, patients were assigned (...) or baseline characteristics. All patients were elderly, had a high pretreatment score on the NIH stroke scale (NIHSS), and slow stroke lesion growth with a final large infarct volume at two-week follow-up. At the three-month follow-up, functional outcome between pre- and post-treatment had improved significantly in the valproate group (NIHSS, p = 0.004; modified Rankin scale (mRS), p = 0.007; Barthel index (BI), p = 0.001). No such improvement was noted in the NIHSS or mRS for the non-valproate group

2015 American journal of translational research Controlled trial quality: uncertain

8. [Performance evaluation of integrated cytoprotective therapy of different duration in patients with cerebral infarction]. (Abstract)

[Performance evaluation of integrated cytoprotective therapy of different duration in patients with cerebral infarction]. The paper reviews the preliminary results of a multicenter randomized clinical research. The aim of the study was to determine the optimal duration of different types of energy-correction therapy. 99 case report forms of patients with cerebral infarction were reviewed with their prior envelope randomization into three groups. Patients in the first group (experimental group (...) ), consisting of 32 patients, as part of combined therapy received ascorbic acid (5% solution twice a day in a recommended dosage of 20 ml/day for 20 days); the second group (37 patients) received 10 ml of cytoflavin intravenously by drop infusion twice a day for 10 days; the third group received cytoflavin for 20 days (from day 1 to day 10 - 20 ml a day, from day 11 to day 20 - 10 ml a day). The average NIH scale score on admission was 14.9 ± 2.6. Prescription of cytoflavin came with average 1.7 - 1.8 time

2015 Eksperimental'naia i klinicheskaia farmakologiia Controlled trial quality: uncertain

9. Abbreviation of the Follow-Up NIH Stroke Scale Using Factor Analysis Full Text available with Trip Pro

Abbreviation of the Follow-Up NIH Stroke Scale Using Factor Analysis The NIH Stroke Scale (NIHSS) is a 15-item measure of stroke-related neurologic deficits that, when measured at 24 h, is highly predictive of long-term functional outcome. We hypothesized that a simplified 24-h scale that incorporates the most predictive components of the NIHSS can retain prognostic accuracy and have improved interrater reliability.In a post hoc analysis of the Interventional Management of Stroke-3 (IMS-3 (...) weighted kappa 0.80 vs. 0.73, p < 0.001).At 24 h following ischemic stroke, aphasia, neglect, and arm weakness are the most prognostically relevant neurologic findings. The aNIHSS appears to have excellent prognostic accuracy with higher reliability and may be clinically useful.© 2017 The Author(s). Published by S. Karger AG, Basel.

2017 Cerebrovascular Diseases Extra

10. NIH Stroke Scale

Scale II. Precautions NIH Stroke Scale has imperfect interrater reliability (i.e. different scores by different providers) NIH Stroke Scale may be low despite severe, disabling symptoms and signs (e.g. in posterior CVA) Facial droop may be subtle Consider counting visible teeth on each side for comparison When a patient is too weak overall to perform a particular exam element Default to a lower score (as if patient could perform that element) Obviously this does not apply to a focal weakness (...) window. Related Studies (from Trip Database) Ontology: NIH stroke scale (C1697238) Concepts Diagnostic Procedure ( T060 ) LNC LP145895-1, MTHU043309 Dutch NIH stroke scale French Échelle NIH d'accident vasculaire cérébral German NIH-Stroke-Skala Italian Scala per l'ictus dell'NIH Portuguese Escala NIH de AVC Spanish Escala de accidente cerebrovascular de NIH Japanese NIH脳卒中スケール , NIHノウソッチュウスケール Czech Stupnice mrtvice NIH English NIH stroke scale (physical finding) , NIH stroke scale Hungarian NIH

2018 FP Notebook

11. Disability after minor stroke and TIA: A secondary analysis of the SOCRATES trial. (Abstract)

Disability after minor stroke and TIA: A secondary analysis of the SOCRATES trial. To examine factors associated with disability following TIA and minor stroke, including poststroke complications such as stroke recurrence, major bleeding, and other adverse medical events.The SOCRATES trial randomized patients with TIA/minor stroke (NIH Stroke Scale [NIHSS] score ≤5) within 24 hours of onset. We performed a post hoc analysis of factors associated with disability (modified Rankin Scale [mRS (...) ] score >1). TIA and minor stroke were analyzed separately. Patients with premorbid mRS >0 were excluded.At 90 days, 687/3,663 (19%) patients with stroke were disabled; for TIA, 122/2,384 (5%) were disabled. In multivariate analyses, age, diabetes, and NIHSS were associated with disability in the stroke cohort, and age with disability in the TIA cohort. Postrandomization events (recurrent stroke, myocardial infarction, major bleeding, serious adverse events) were strongly associated with disability

2019 Neurology Controlled trial quality: predicted high

12. Prognostic value of "tissue-based" definitions of TIA and minor stroke: Population-based study. Full Text available with Trip Pro

with TIA or minor stroke (NIH Stroke Scale [NIHSS] ≤3) in the population-based Oxford Vascular Study underwent brain MRI at baseline. Stroke risk on 10-year follow-up was stratified by NIHSS (0/1 vs 2/3) and Trial of Org 10172 in Acute Stroke Treatment classification of the initial event.Among 1,033 patients (633 TIA; 400 minor stroke), 248 (24.0%) had acute lesions on DWI (13.9% of TIAs; 40.0% of minor strokes). A positive DWI was associated with an increased 10-year risk of recurrent ischemic stroke (...) after an index TIA (hazard ratio [HR] 2.66, 95% confidence interval [CI] 1.28-5.54, p = 0.009) or a stroke with NIHSS 0-1 (3.03, 1.29-7.08, p = 0.011), but not after a stroke with NIHSS 2-3 (0.70, 0.24-2.10, p = 0.53). Ischemic stroke risk after DWI-positive TIA was at least equivalent to that after DWI-negative stroke (1.81, 0.82-4.00, p = 0.14). Among all patients, DWI positivity was most predictive of 10-year risk after cryptogenic events (4.68, 1.70-12.92, p = 0.003).DWI positivity is associated

2019 Neurology

13. Effect of Dysphagia Screening Strategies on Clinical Outcomes After Stroke: A Systematic Review for the 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Full Text available with Trip Pro

; P=0.05) All-cause mortality at 90 d: 7.8% (6 of 77) vs 20% (17 of 85) (P=0.02) (adjusted OR, 0.33; 95% CI, 0.12–0.90; P=0.03) mRS score =2 at 90 d: 57.1% (44 of 77) vs 57.6% (49 of 85) (P=NS) ASSIST indicates Acute Screening of Swallow in Stroke or TIA [transient ischemic attack]; CI, confidence interval; mRS, modified Rankin Scale; NS, not significant; OR, odds ratio; and RCT, randomized controlled trial. Downloaded from http://ahajournals.org by on March 27, 2019Smith et al Dysphagia Screening (...) from http://ahajournals.org by on March 27, 2019Smith et al Dysphagia Screening and Clinical Outcomes After Stroke e125 randomized to receive either a fever, sugar, and swallowing intervention designed to improve nursing adherence to evi- dence-based protocols or a comparator intervention consist- ing of an abridged version of existing guidelines. The Acute Screening of Swallow in Stroke or TIA [transient ischemic attack] tool was used as the dysphagia screen. 16 This tool uses patient symptoms

2018 American Heart Association

14. Accuracy of Prediction Instruments for Diagnosing Large Vessel Occlusion in Individuals With Suspected Stroke: A Systematic Review for the 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke

, Starkman S, Liebeskind DS, Ovbiagele B, Kim D, Sanossian N, Ali L, Buck B, Villablanca P, Vinuela F, Duckwiler G, Jahan R, Saver JL . A brief prehospital stroke severity scale identifies ischemic stroke patients harboring persisting large arterial occlusions. Stroke . 2008 ; 39 :2264–2267. doi: 10.1161/STROKEAHA.107.508127. Olavarría VV, Delgado I, Hoppe A, Brunser A, Cárcamo D, Díaz-Tapia V, Lavados PM . Validity of the NIHSS in predicting arterial occlusion in cerebral infarction is time-dependent (...) , Liebeskind DS, Starkman S, Eckstein M, Stratton S, Woolf GG, Chatfield F, Conwit R, Saver JL . Field validation of prehospital LAMS score to identify large vessel occlusion ischemic stroke patients for direct routing to emergency neuroendovascular centers [abstract]. Stroke . 2016 ; 47 (suppl 1):83. Cooray C, Fekete K, Mikulik R, Lees KR, Wahlgren N, Ahmed N . Threshold for NIH Stroke Scale in predicting vessel occlusion and functional outcome after stroke thrombolysis. Int J Stroke . 2015 ; 10 :822–829

2018 American Heart Association

15. Eye-Movement Training Results in Changes in qEEG and NIH Stroke Scale in Subjects Suffering from Acute Middle Cerebral Artery Ischemic Stroke: A Randomized Control Trial. Full Text available with Trip Pro

Eye-Movement Training Results in Changes in qEEG and NIH Stroke Scale in Subjects Suffering from Acute Middle Cerebral Artery Ischemic Stroke: A Randomized Control Trial. Eye-movement training (EMT) can induce altered brain activation and change the functionality of saccades with changes of the brain in general.To determine if EMT would result in changes in quantitative electroencephalogram (qEEG) and NIH Stroke Scale (NIHSS) in patients suffering from acute middle cerebral artery (MCA (...) ) infarction. Our hypothesis is that there would be positive changes in qEEG and NIHSS after EMT in patients suffering from acute MCA ischemic stroke.Double-blind randomized controlled trial.Thirty-four subjects with acute MCA ischemic stroke treated at university affiliated hospital intensive care unit.Subjects were randomized into a "control" group treated only with aspirin (125 mg/day) and a "treatment" group treated with aspirin (125 mg/day) and a subject-specific EMT.Delta-alpha ratio, power ratio

2016 Frontiers in neurology Controlled trial quality: predicted high

16. The Utility of Quantifiable Neurologic Assessments After Stroke: In response to Marsh et al, “The NIH Stroke Scale Has Limited Utility in Accurate Daily Monitoring of Neurologic Status” Full Text available with Trip Pro

The Utility of Quantifiable Neurologic Assessments After Stroke: In response to Marsh et al, “The NIH Stroke Scale Has Limited Utility in Accurate Daily Monitoring of Neurologic Status” 27366290 2016 07 01 2018 11 13 1941-8744 6 3 2016 Jul The Neurohospitalist Neurohospitalist The Utility of Quantifiable Neurologic Assessments After Stroke: In response to Marsh et al, "The NIH Stroke Scale Has Limited Utility in Accurate Daily Monitoring of Neurologic Status". 95-6 10.1177/1941874416641469 (...) Siegler James E JE Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA. eng Journal Article 2016 04 05 United States Neurohospitalist 101558199 1941-8744 National Institutes of Health Stroke Scale outcomes research stroke 2016 7 2 6 0 2016 7 2 6 0 2016 7 2 6 1 ppublish 27366290 10.1177/1941874416641469 10.1177_1941874416641469 PMC4906560 QJM. 2006 Sep;99(9):625-33 16905751 J Stroke Cerebrovasc Dis. 2013 Jul;22(5):675-82 22727922 Int J Stroke. 2015 Feb;10(2):140-2

2016 The Neurohospitalist

17. Innovation in Stroke Care Quality: NIH Stroke Scale Change and Shewhart Charts. (Abstract)

Innovation in Stroke Care Quality: NIH Stroke Scale Change and Shewhart Charts. Stroke care, admission through discharge, is a process that should lead to symptomatic improvement. Improvement or decline in conditions of patients with acute stroke during hospitalization can be measured by the National Institutes of Health Stroke Scale (NIH Stroke Scale or NIHSS) at both admission and discharge and may indicate the overall quality of acute stroke care for a patient and the stability of care (...) in the system. Shewhart control charts were analyzed for 98 patients with stroke admissions in a random sample at a tertiary care stroke center to determine the feasibility of examining the NIHSS score change to detect statistical control or identify excess variance in outcomes. The study sample showed a mean improvement of 1.33 points from admission to discharge on the NIHSS. Three statistical outliers were found. Excess statistical variation clustered within a specific stroke team's tenure suggested

2015 Quality Management in Health Care

18. CT Angiography and Presentation NIH stroke Scale in Predicting TIA in Patients Presenting with Acute Stroke Symptoms Full Text available with Trip Pro

CT Angiography and Presentation NIH stroke Scale in Predicting TIA in Patients Presenting with Acute Stroke Symptoms Patient candidacy for acute stroke intervention, is currently assessed using brain computed tomography angiography (CTA) evidence of significant stenosis/occlusion (SSO) with a high National Institutes of Health Stroke Scale (NIHSS) (>6). This study examined the association between CTA without significant stenosis/occlusion (NSSO) and lower NIHSS (≤ 6) with transient ischemic (...) attack (TIA) and other good clinical outcomes at discharge. Patients presenting <8 hours from stroke symptom onset, had an NIHSS assessment and brain CTA performed at presentation. Good clinical outcomes were defined as: discharge diagnosis of TIA, modified Rankin Score [mRS] ≤ 1, and home as the discharge disposition. Eighty-five patients received both an NIHSS at presentation and a CTA at 4.2 ± 2.2 hours from stroke symptom onset. Patients with NSSO on CTA as well as those with NIHSS≤6 had better

2013 Journal of neurological disorders

19. Treatment and Outcome of Hemorrhagic Transformation After Intravenous Alteplase in Acute Ischemic Stroke: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Full Text available with Trip Pro

pressure at presentation, and severity of stroke at presentation (NIHSS); GWTG, Get With The Guidelines; HAT, Hemorrhage After Thrombolysis; MSS, Multicenter Stroke Survey; NIHSS, National Institutes of Health Stroke Scale; SEDAN, blood sugar, early infarct signs, hyperdense cerebral artery sign, age, NIHSS; SITS-ICH, Safe Implementation of Thrombolysis in Stroke–Intracranial Hemorrhage; SPAN, Stroke Prognostication Using Age and NIH Stroke Scale; and THRIVE, Totaled Health Risks in Vascular Events (...) computed tomography; ECASS, European Cooperative Acute Stroke Study; GWTG-S, Get With The Guidelines–Stroke; IST, International Stroke Trial; MRI, magnetic resonance imaging; NIHSS, National Institutes of Health Stroke Scale; NINDS, National Institute of Neurological Diseases and Stroke; PH, parenchymal hematoma; PROACT, Prolyse in Acute Cerebral Thromboembolism; and SITS-MOST, Safe Implementation of Thrombolysis in Stroke: Monitoring Study. Figure 1. Radiographic classification of hemorrhagic

2017 American Heart Association

20. Validity of the NIHSS in predicting arterial occlusion in cerebral infarction is time-dependent (Abstract)

Validity of the NIHSS in predicting arterial occlusion in cerebral infarction is time-dependent The NIH Stroke Scale (NIHSS) is used to assess acute ischemic stroke severity and outcome. High NIHSS scores are usually associated with arterial occlusion but it is unknown what the effect of time to clinical evaluation (TTCE) in this association is. We tested the NIHSS scores as an instrument to determine vessel occlusion (VO) at different time points from symptom onset.Patients were selected from (...) our prospective stroke database if they had admission NIHSS scores and intracranial vessel neuroimaging studies. We dichotomized patients according to VO and TTCE. Receiver operating curves, c statistics, and odds ratios were calculated to study the validity of the NIHSS score.Among 463 patients (mean age 70.2 years, 53.1% male, median NIHSS 4, median TTCE 3.3 hours), 22.5% had arterial occlusion. Median NIHSS scores were higher in patients with VO, 10.5 (interquartile range 5-18) vs 3 (2-7), p

2011 EvidenceUpdates

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