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NIH Stroke Scale

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181. Study Evaluating the MindMotionPRO for Early Post-stroke Upper-limb Rehabilitation

of stroke symptoms as measured by the NIH stroke scale (NIHSS) [ Time Frame: baseline, 4 weeks, 16 weeks ] Change from Baseline in arm function in daily activities as measured by the Motor Activity Log (MAL) [ Time Frame: baseline, 4 weeks, 16 weeks ] Motivation measured by the Intrinsic Motivation Index (IMI) [ Time Frame: 1 week and 4 weeks ] Other Outcome Measures: Resource utilization: time spent administrating rehabilitation exercises [ Time Frame: 4 weeks ] therapist (physiotherapist or other (...) will be evaluated by validated rehabilitation performance scales. Cost-effectiveness will be assessed by the resource utilization. Condition or disease Intervention/treatment Phase Stroke Motor Disorders Device: MindMotionPRO Other: Self-Directed Prescribed Exercises Not Applicable Detailed Description: The goal of the study is to show that MindMotionPRO is a tool that allows a patient to increase the amount of rehabilitation therapy performed. This study will measure the rehabilitation dose, as measured

2016 Clinical Trials

182. Clinical Trial Study About Human Adipose-Derived Stem Cells in the Stroke

stroke indices: National Institutes of Health Stroke Scale (NIHSS), European Stroke Scale (ESS), European Stroke Motor Subscale (EMS), Barthel Index, MMSE and Gait analyses at 1 month, 3 months, and 6 months after treatment. Drug: ADSCs Autologous ADSCs Other Name: hADSCs Outcome Measures Go to Primary Outcome Measures : Neurological function [ Time Frame: 6 months ] Blood biochemical, Neurobehavioral examination (NIH Stroke Scale 16-20) Eligibility Criteria Go to Information from the National (...) : ADSCs Phase 1 Detailed Description: This open-label clinical trial will compare outcomes of subjects with chronic stroke. Six subjects will be to treatment (n=3) groups. The treatment group will receive brain transplants of autologous ADSCs. Treatment group will receive rehabilitation after the transplantation. Subjects will be assessed by magnetic resonance imaging (MRI) and eight standardized stroke indices: National Institutes of Health Stroke Scale (NIHSS), ( Barthel Index )、 ( Berg balance

2016 Clinical Trials

183. Moderate Dose Hydroxyurea for Secondary Stroke Prevention in Children With Sickle Cell Disease in Sub-Saharan Africa

1 to 16 years of age with SCA will be randomized to receive moderate dose HU therapy at 20 mg/kg/day (study group) or low dose HU therapy at 10 mg/kg/day (control group) with monthly follow-up for at least 36 months per participant. Parents will be educated on how to recognize signs and symptoms of a stroke. The rate of stroke recurrence will be measured using standardized neurological examinations (Pediatric NIH Stroke Scale). Secondary Outcome Measures : Incidence of all cause hospitalizations (...) Moderate Dose Hydroxyurea for Secondary Stroke Prevention in Children With Sickle Cell Disease in Sub-Saharan Africa Moderate Dose Hydroxyurea for Secondary Stroke Prevention in Children With Sickle Cell Disease in Sub-Saharan Africa - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number

2016 Clinical Trials

184. MR-based Collateral Imaging to Predict Response to Endovascular Treatment of Stroke (FAST-COLL Study)

Endovascular mechanical thrombectomy or endovascular delivery of thrombolytic agent Outcome Measures Go to Primary Outcome Measures : 90-days functional outcome [ Time Frame: 90-days ] 90-days modified Rankin Scale ≤ 2 Secondary Outcome Measures : Early neurologic improvement [ Time Frame: 24 hours ] An 8-point or more improvement on the NIH score when comparing the baseline score or a NIHSS score of 0-1, at 24 hours. Symptomatic hemorrhagic transformation [ Time Frame: During initial admission (...) ] Occurrence of an increase in the National Institutes of Health Stroke Scale (NIHSS) score of 4 or more points in the setting of local or remote parenchymal hematoma. Successful recanalization [ Time Frame: within 24 hours of symptom onset ] Defined as modified Thrombolysis in Cerebral Infarction (mTICI) ≥ 2b Eligibility Criteria Go to Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends

2016 Clinical Trials

185. Glial Fibrillary Acidic Protein Serum Levels Distinguish between Intracerebral Hemorrhage and Cerebral Ischemia in the Early Phase of Stroke. (PubMed)

, bleeding size, and localization.We included patients with a persistent neurological deficit (NIH Stroke Scale ≥4) suggestive of stroke within 6 h of symptom onset. Blood samples were drawn at hospital admission. GFAP serum concentrations were measured using an electrochemiluminometric immunoassay. Primary endpoint was the final diagnosis established at hospital discharge (ICH, IS, or stroke mimic).202 patients were included (45 with ICH, 146 with IS, 11 stroke mimics). GFAP concentrations were (...) Glial Fibrillary Acidic Protein Serum Levels Distinguish between Intracerebral Hemorrhage and Cerebral Ischemia in the Early Phase of Stroke. Recent studies have suggested that glial fibrillary acidic protein (GFAP) serum concentrations distinguish between intracerebral hemorrhage (ICH) and ischemic stroke (IS) shortly after symptom onset. In this prospective multicenter trial we validated GFAP in an independent patient cohort and assessed the quantitative relationship between GFAP release

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2016 Clinical Chemistry

186. Proportion of single-chain recombinant tissue plasminogen activator and outcome after stroke. (PubMed)

with the modified Rankin Scale (mRS) at 3 months (prespecified analysis) and occurrence of epileptic seizures (post hoc analysis). We registered Outcome of Patients Treated by IV Rt-PA for Cerebral Ischaemia According to the Ratio Sc-tPA/Tc-tPA (OPHELIE) under ClinicalTrials.gov identifier no. NCT01614080.We recruited 1,004 patients (515 men, median age 75 years, median onset-to-needle time 170 minutes, median NIH Stroke Scale score 10). We found no statistical association between sc/(sc + tc) ratios (...) Proportion of single-chain recombinant tissue plasminogen activator and outcome after stroke. To determine whether the ratio single chain (sc)/(sc + 2 chain [tc]) recombinant tissue plasminogen activator (rtPA) influences outcomes in patients with cerebral ischemia.We prospectively included consecutive patients treated with IV rtPA for cerebral ischemia in 13 stroke centers and determined the sc/(sc + tc) ratio in the treatment administered to each patient. We evaluated the outcome

2016 Neurology

187. Leukocyte response is regulated by microRNA let7i in patients with acute ischemic stroke. (PubMed)

change -1.70, p < 0.00001). A modest inverse correlation between let7i and NIH Stroke Scale score at admission (r = -0.32, p = 0.02), infarct volume (r = -0.21, p = 0.04), and plasma MMP9 (r = -0.46, p = 0.01) was identified. The decrease in let7i was associated with increased expression of several of its mRNA targets, including CD86, CXCL8, and HMGB1. In vitro studies confirm let7i posttranscriptional regulation of target genes CD86, CXCL8, and HMGB1. Functional analysis predicted let7i regulates (...) Leukocyte response is regulated by microRNA let7i in patients with acute ischemic stroke. To evaluate microRNA let7i in ischemic stroke and its regulation of leukocytes.A total of 212 patients were studied: 106 with acute ischemic stroke and 106 controls matched for risk factors. RNA from circulating leukocytes was isolated from blood collected in PAXgene tubes. Let7i microRNA expression was assessed using TaqMan quantitative reverse transcription PCR. To assess let7i regulation of gene

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2016 Neurology

188. Comparison of non-stent retriever and stent retriever mechanical thrombectomy devices for the endovascular treatment of acute ischemic stroke. (PubMed)

of mRS Score 3-6, mortality, and TICI Score 3. RESULTS A total of 99 patients were treated with non-stent retriever devices (Merci and Penumbra) and 67 with stent retrievers (Solitaire and Trevo). Stent retrievers yielded lower 90-day NIH Stroke Scale scores and higher rates of 90-day mRS scores ≤ 2 (22.54% [non-stent retriever] vs 61.67% [stent retriever]; p < 0.001), TICI Score 2b-3 recanalization rates (79.80% [non-stent retriever] vs 97.01% [stent retriever]; p < 0.001), percentage of parenchyma (...) January 2008 and June 2014, 166 patients treated at Jefferson Hospital for Neuroscience for acute ischemic stroke with mechanical thrombectomy using Merci, Penumbra, Solitaire, or Trevo devices were retrospectively reviewed. Primary outcomes included 90-day modified Rankin Scale (mRS) score, recanalization rate (thrombolysis in cerebral infarction [TICI score]), and incidence of symptomatic intracranial hemorrhages (ICHs). Univariate analysis and multivariate logistic regression determined predictors

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2016 Journal of Neurosurgery

189. Early Blood Pressure Reduction in Acute Ischemic Stroke with Various Severities: A Subgroup Analysis of the CATIS Trial. (PubMed)

Antihypertensive Trial in Acute Ischemic Stroke, 4,071 patients with acute ischemic stroke and elevated BP were randomly assigned to receive antihypertensive treatment or to discontinue all hypertension medications within 48 h of symptom onset. The primary outcome was a combination of death and major disability at 14 days or hospital discharge. In this subgroup analysis, participants were categorized into 3 groups according to their baseline NIH Stroke Scale (NIHSS) scores (0-4, 5-15, or ≥16).At 24 h after (...) Early Blood Pressure Reduction in Acute Ischemic Stroke with Various Severities: A Subgroup Analysis of the CATIS Trial. Clinical trials have generally showed a neutral effect of blood pressure (BP) reduction on clinical outcomes among acute ischemic stroke patients. We conducted a prespecified subgroup analysis to assess whether disease severity modifies the effect of early antihypertensive treatment on death and disability among patients with acute ischemic stroke.In the China

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2016 Cerebrovascular diseases (Basel, Switzerland)

190. Statin pretreatment is associated with better outcomes in large artery atherosclerotic stroke. (PubMed)

centers during a 3-year period. Statin pretreatment, demographics, vascular risk factors, and admission and discharge stroke severity were recorded. The outcome events of interest were neurologic improvement during hospitalization (quantified as the relative decrease in NIH Stroke Scale score at discharge in comparison to hospital admission), favorable functional outcome (FFO) (defined as modified Rankin Scale score of 0-1), recurrent stroke, and death at 1 month. Statistical analyses were performed (...) using univariable and multivariable Cox regression models adjusting for potential confounders. All analyses were repeated following propensity score matching.Statin pretreatment was documented in 192 (37.2%) of 516 consecutive patients with LAA (mean age: 65 ± 13 years; 60.8% men; median NIH Stroke Scale score: 9 points, interquartile range: 5-18). Statin pretreatment was associated with greater neurologic improvement during hospitalization and higher rates of 30-day FFO in unmatched and matched

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2016 Neurology

191. Why are acute ischemic stroke patients not receiving IV tPA? Results from a national registry. (PubMed)

April 2003 through December 2011, comparing those who received tPA to those who did not. Multivariable generalized estimating equation logistic regression modeling identified factors associated with not receiving tPA.Of 61,698 eligible patients with AIS presenting within 2 hours of onset (median age 73 years, 51% female, 74% non-Hispanic white, median NIH Stroke Scale score 11, interquartile range 6-18), 15,282 (25%) were not treated with tPA within 3 hours. Failure to give tPA decreased over time (...) from 55% in 2003 to 2005 to 18% in 2010 to 2011 (p < 0.0001). After adjustment for all covariates, including stroke severity, factors associated with failure to treat included older age, female sex, nonwhite race, diabetes mellitus, prior stroke, atrial fibrillation, prosthetic heart valve, NIH Stroke Scale score <5, arrival off-hours and not via emergency medical services, longer onset-to-arrival and door-to-CT times, earlier calendar year, and arrival at rural, nonteaching, non-stroke center

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2016 Neurology

192. Efficacy of transcranial alternating current stimulation over bilateral mastoids (tACSbm) on enhancing recovery of subacute post-stroke patients. (PubMed)

and intracranial hemodynamics of subacute post-stroke patients.Sixty subacute post-stroke patients (mean age: 65.4 ± 9.8 years), 15 to 60 days after the onset, were randomly assigned to receiving 15 sessions of usual rehabilitation program without (n = 30) or with tACSbm (20 Hz and < 400 μA for 30-min; n = 30). The outcome measures included the NIH Stroke Scale (NIHSS) and measures of intracranial hemodynamics before and after treatment.At the fifteenth session, when compared with the baseline, the mean NIHSS (...) Efficacy of transcranial alternating current stimulation over bilateral mastoids (tACSbm) on enhancing recovery of subacute post-stroke patients. Transcranial alternating current stimulation (tACS) offers another method of non-invasive brain stimulation in post-stroke rehabilitation. Because it is not known if tACS over bilateral mastoids (tACSbm) can promote the functional recovery in subacute post-stroke patients, we wish to learn the effect of tACSbm on improving neurological function

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2016 Topics in stroke rehabilitation

193. Recognition of Stroke by EMS is Associated with Improvement in Emergency Department Quality Measures. (PubMed)

diagnosis of transient ischemic attack (TIA), ischemic stroke (IS), or intracerebral hemorrhage (ICH). Hospital and EMS databases were used to determine EMS impression, prehospital and in-hospital time intervals, EMS prenotification, NIH stroke scale (NIHSS), symptom duration, and thrombolysis rate.399 cases were identified: 14.5% TIA, 67.2% IS, and 18.3% ICH. EMS providers correctly recognized 57.6% of cases. Compared to cases missed by EMS, correctly recognized cases had longer median on-scene time (...) Recognition of Stroke by EMS is Associated with Improvement in Emergency Department Quality Measures. Hospital arrival via Emergency Medical Services (EMS) and EMS prenotification are associated with faster evaluation and treatment of stroke. We sought to determine the impact of diagnostic accuracy by prehospital providers on emergency department quality measures.A retrospective study was performed of patients presenting via EMS between September 2009 and December 2012 with a discharge

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2016 Prehospital emergency care

194. Early effect of intra-arterial treatment in ischemic stroke on aphasia recovery in MR CLEAN. (PubMed)

with a proximal anterior circulation stroke were randomized to usual care plus IAT (<6 hours after stroke, mainly stent retrievers) or usual care alone. We estimated the effect of IAT on the shift on the NIH Stroke Scale (NIHSS) item language and the NIHSS item motor arm at 24 hours and 1 week after stroke with multivariable ordinal logistic regression as a common odds ratio, adjusted for prognostic variables (acOR). Differences between the effect of IAT on aphasia and on motor deficits were tested (...) Early effect of intra-arterial treatment in ischemic stroke on aphasia recovery in MR CLEAN. To investigate the effect of intra-arterial treatment (IAT) on early recovery from aphasia in acute ischemic stroke. We hypothesized that the early effect of IAT on aphasia is smaller than the effect on motor deficits.We included patients with aphasia from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN), in which 500 patients

2016 Neurology

195. Utility of EEG measures of brain function in patients with acute stroke (PubMed)

(PLS) modeling, captured extent of acute stroke behavioral deficits and varied in relation to acute brain injury. In 24 patients admitted for acute ischemic stroke, 3 min of resting-state EEG was acquired at bedside, including in the ER and ICU. Traditional quantitative EEG measures (power in a specific lead, in any frequency band) showed a modest association with behavioral deficits [NIH Stroke Scale (NIHSS) score] in bivariate models. However, PLS models of delta or beta power across whole brain (...) Utility of EEG measures of brain function in patients with acute stroke EEG has been used to study acute stroke for decades; however, because of several limitations EEG-based measures rarely inform clinical decision-making in this setting. Recent advances in EEG hardware, recording electrodes, and EEG software could overcome these limitations. The present study examined how well dense-array (256 electrodes) EEG, acquired with a saline-lead net and analyzed with whole brain partial least squares

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2016 Journal of neurophysiology

196. ICAT: a simple score predicting critical care needs after thrombolysis in stroke patients (PubMed)

on strength of association.Seventy-two patients (24.8%) required critical care interventions. Black race (odds ratio [OR] 3.81, p=0.006), male sex (OR 3.79, p=0.008), systolic blood pressure (SBP; OR 1.45 per 10 mm Hg increase in SBP, p<0.001), and NIH stroke scale (NIHSS; OR 1.09 per 1 point increase in NIHSS, p=0.071) were independent predictors of critical care needs. The optimal model for score development, predicting critical care needs, achieved an AUC of 0.782 in the validation group. The score (...) ICAT: a simple score predicting critical care needs after thrombolysis in stroke patients Patients receiving intravenous thrombolysis (IVT) for acute ischemic stroke are at risk of developing complications, commonly necessitating admission to an intensive care unit (ICU). At present, most IVT is administered in the Emergency Department or in dedicated stroke units, but no evidence-based criteria exist that allow for early identification of patients at increased risk of developing ICU needs

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2016 Critical Care

197. Intravenous rtPA versus mechanical thrombectomy in acute ischemic stroke: A historical cohort in Joinville, Brazil (PubMed)

by the NIH stroke scale (p = 0.011). After 90 days, 45% of patients in the IAT group and 27% in the IVT group were independent (0-1 points) according to the modified Rankin scale (adjusted odds ratio: 4.53; 95% CI: 1.22 to 16.75). Symptomatic hemorrhage was diagnosed in 10% of patients in both groups (p = 1.0). The 90-day case-fatality was 39% (32/82) in the IVT group and 26% (8/31) in the IAT group (p = 0.27). In this small cohort, a greater rate of functional independence was achieved in patients (...) Intravenous rtPA versus mechanical thrombectomy in acute ischemic stroke: A historical cohort in Joinville, Brazil Groundbreaking results concerning ischemic stroke (IS) hyperacute treatment worldwide were published in 2014 and 2015. We aimed to compare functional status after 3 months in patients treated with intra-arterial thrombectomy (IAT) and those treated with intravenous thrombolysis (IVT) alone in Joinville, Brazil. From the Joinville Stroke Registry, we extracted and compared all

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2016 eNeurologicalSci

198. Endovascular Treatment with Stent-Retriever Devices for Acute Ischemic Stroke: A Meta-Analysis of Randomized Controlled Trials. (PubMed)

Endovascular Treatment with Stent-Retriever Devices for Acute Ischemic Stroke: A Meta-Analysis of Randomized Controlled Trials. Acute ischemic stroke is a leading cause of death and disability worldwide. Several recent clinical trials have shown that endovascular treatment improves clinical outcomes among patients with acute ischemic stroke.To provide an overall and precise estimate of the efficacy of endovascular treatment predominantly using second-generation mechanical thrombectomy devices (...) (stent-retriever devices) compared to medical management on clinical and functional outcomes among patients with acute ischemic stroke.MEDLINE, EMBASE, Cochrane Collaboration Central Register of Controlled Clinical Trials, Web of Science, and NIH ClinicalTrials.gov were searched through November 2015.Searches returned 3,045 articles. After removal of duplicates, two authors independently screened titles and abstracts to assess eligibility of 2,495 potentially relevant publications. From these, 38

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2016 PloS one

199. Are all stroke patients eligible for fast alteplase treatment? An analysis of unavoidable delays. (PubMed)

of the Hurry Acute Stroke Treatment and Evaluation-2 (HASTE-2) project, we sought to identify patient and systems reasons associated with longer DNT.From June 2012 to June 2013 we collected data on DNT and potential reasons for delays from 102 consecutive patients presenting directly to the emergency department who were treated with alteplase within 4.5 hours of symptom onset.Mean age was 71 years, 56/113 (54%) were women, median NIH Stroke Scale score was 13, and median DNT was 53 minutes. Potential (...) Are all stroke patients eligible for fast alteplase treatment? An analysis of unavoidable delays. The National Quality Forum recently endorsed a performance measure for time to intravenous thrombolytic therapy which allows exclusions for circumstances in which fast alteplase treatment may not be possible. However, the frequency and impact of unavoidable patient reasons for long door-to-needle time (DNT), such as need for medical stabilization, are largely unknown in clinical practice. As part

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2016 Academic Emergency Medicine

200. Association between nasogastric tubes, pneumonia, and clinical outcomes in acute stroke patients. (PubMed)

of preventive antibiotics between April 21, 2008, and May 17, 2014. Generalized mixed models adjusted for age, comorbidities, stroke type and severity, and quality of care were used. No patients were lost to follow-up at 14 days, and 36 (3%) were lost at 90 days.Patients with NGT (298 of 1,217 [24.4%]) had more severe strokes (median NIH Stroke Scale score 17 vs 14, p = 0.0001) and impaired consciousness (39% vs 28%, p = 0.001). NGT did not increase PSP (43 of 298 [14.4%] vs 80 of 790 [10.1%], adjusted odds (...) Association between nasogastric tubes, pneumonia, and clinical outcomes in acute stroke patients. To investigate whether nasogastric tubes (NGTs) increase poststroke pneumonia (PSP), mortality, or poor outcomes in nil-by-mouth acute stroke patients.This study analyzed prespecified outcomes of PSP at 14 days and mortality and function measured by the modified Rankin Scale at 90 days in 1,217 nil-by-mouth stroke patients at ≤48 hours of symptom onset in a multicenter randomized controlled trial

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2016 Neurology

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