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NIH Stroke Scale

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21. Inpatient versus Outpatient Management of TIA or Minor Stroke: Clinical Outcome Full Text available with Trip Pro

Inpatient versus Outpatient Management of TIA or Minor Stroke: Clinical Outcome The management of patients with acute transient ischemic attack (TIA) or minor stroke is highly variable. Whether hospitalization of such patients significantly improves short-term clinical outcome is unknown. We assessed the short-term clinical outcome associated with inpatient versus outpatient management of patients with TIA or minor stroke.We evaluated a consecutive series of patients with acute TIA or minor (...) ischemic stroke (NIH Stroke Scale score ≤ 3) presenting to a single emergency department (ED). We randomized patients to either hospital-based or outpatient-based management. All patients underwent interview and examination 7-10 days following the index event.This study included 100 patients, 41 with TIA and 59 with minor stroke. Nineteen (46%) of the TIA patients and 29 (49%) of the minor stroke patients randomized to hospital management, and the remaining 22 TIA patients and 30 minor stroke patients

2017 Journal of vascular and interventional neurology Controlled trial quality: uncertain

22. The NIH Stroke Scale Has Limited Utility in Accurate Daily Monitoring of Neurologic Status Full Text available with Trip Pro

The NIH Stroke Scale Has Limited Utility in Accurate Daily Monitoring of Neurologic Status The National Institute of Health Stroke Scale (NIHSS) is rapid and reproducible, a seemingly attractive metric for the documentation of clinical progress in patients presenting with ischemic stroke. Many institutions have adopted it into daily clinical practice. Unfortunately, the scale may not adequately capture all forms of functional change. We evaluate its utility as a measure of recovery in patients (...) treated with intravenous tissue plasminogen activator (IV tPA) for ischemic stroke.We prospectively evaluated the difference in the rate of improvement based on NIHSS (a ≥4 point change based on previous trials) versus physician-documented subjective and objective measures in 41 patients' status post IV tPA treatment. The NIHSS 24 hours posttreatment, on discharge, and at follow-up were compared to NIHSS on admission using tests of proportions and McNemar tests of paired data. Secondary analyses were

2015 The Neurohospitalist

23. Stroke Survivors Scoring Zero on the NIH Stroke Scale Score Still Exhibit Significant Motor Impairment and Functional Limitation. Full Text available with Trip Pro

Stroke Survivors Scoring Zero on the NIH Stroke Scale Score Still Exhibit Significant Motor Impairment and Functional Limitation. Objective. To determine the National Institutes of Health Stroke Scale's (NIHSS's) association with upper extremity (UE) impairment and functional outcomes. Design. Secondary, retrospective analysis of randomized controlled trial data. Setting. Not applicable. Participants. 146 subjects with stable, chronic stroke-induced hemiparesis. Intervention. The NIHSS, the UE (...) = 0.089). Subjects scoring a "zero" on the NIHSS exhibited discernible UE motor deficits and varied scores on the UE FM and AMAT. Conclusion. While being used in stroke trials, the NIHSS may have limited ability to discriminate between treatment responses, even when only a relatively narrow array of impairment levels exists among patients. Given these findings, NIHSS use should be restricted to acute stroke studies and clinical settings with the goal of reporting stroke severity.

2014 Stroke research and treatment Controlled trial quality: uncertain

24. The association baseline NIH Stroke Scale score with ABO blood-subtypes in young patients with acute ischemic stroke. (Abstract)

The association baseline NIH Stroke Scale score with ABO blood-subtypes in young patients with acute ischemic stroke. The presence of the A and B blood group antigens has been associated with risk of arterial thrombosis. The aim of the current study was to design a new simpler form of National Institutes of Health Stroke Scale (NIHSS) for use on admission, and assess the association of blood groups with NIHSS score in young stroke patients.We conducted this study in 1311 young Chinese adults (...) with acute ischemic cerebral stroke. The outcome measures included a composite favorable outcome (defined as a modified Rankin Scale (mRS) of 0 or 2) and poor outcome (defined as a modified Rankin Scale score of 3 or 6) at discharge; a minor strokes (NIHSS scores 0-5) and severe strokes (NIHSS scores ≥6). Logistic regression analyses were used to determine the association between ABO blood groups and stroke severity.Regression analysis confirmed in relative to patients with AB subtype, Oxfordshire

2014 Atherosclerosis

25. The Evolution of the Modified Rankin Scale and Its Use in Future Stroke Trials Full Text available with Trip Pro

The Evolution of the Modified Rankin Scale and Its Use in Future Stroke Trials 28626052 2018 03 09 2019 01 15 1524-4628 48 7 2017 07 Stroke Stroke Evolution of the Modified Rankin Scale and Its Use in Future Stroke Trials. 2007-2012 10.1161/STROKEAHA.117.017866 Broderick Joseph P JP From the Departments of Neurology and Rehabilitation Medicine (J.P.B.) and Emergency Medicine (O.A.), University of Cincinnati Gardner Neuroscience Institute, University of Cincinnati, OH; and Division (...) .), University of Cincinnati Gardner Neuroscience Institute, University of Cincinnati, OH; and Division of Biostatistics, Medical University of South Carolina, Charleston (J.E.). eng U01 NS086872 NS NINDS NIH HHS United States U01 NS087748 NS NINDS NIH HHS United States U10 NS058982 NS NINDS NIH HHS United States Journal Article Research Support, N.I.H., Extramural Review 2017 06 16 United States Stroke 0235266 0039-2499 IM Clinical Trials as Topic Humans Stroke therapy Treatment Outcome clinical trial

2017 Stroke

26. National Institutes of Health Stroke Scale in Plain English Is Reliable for Novice Nurse Users with Minimal Training. (Abstract)

National Institutes of Health Stroke Scale in Plain English Is Reliable for Novice Nurse Users with Minimal Training. The National Institutes of Health Stroke Scale (NIHSS) is commonly used in Comprehensive Stroke Centers, but it has not been easily implemented in smaller centers. The aim of this study was to assess whether nurse providers who were naive to stroke assessment scales could obtain accurate stroke severity scores using our previously validated NIH Stroke Scale in Plain English (...) (NIHSS-PE) with minimal or no training.We randomly assigned 122 nursing students who were naive to stroke assessment scales to 1 of 4 groups: trained on the NIHSS, untrained on the NIHSS, trained on the NIHSS-PE, or untrained on the NIHSS-PE. The Trained/NIHSS and Trained/NIHSS-PE groups watched assessment scale-specific training DVDs. All 4 study groups scored the same 3 patients from the National Institute of Neurological Disorders and Stroke certification DVD, in randomly assigned order. Two-way

2017 Journal of Emergency Nursing

27. ACR–ASNR–SIR–SNIS Practice Parameter for the Performance of Endovascular Embolectomy and Revascularization in Acute Stroke

ischemic injury in a PRACTICE PARAMETER 3 Acute Stroke defined vascular distribution, or clinical evidence of cerebral, spinal cord, or retinal focal ischemic injury based on symptoms persisting >24 hours or until death, and other etiologies excluded. (Note: CNS infarction includes hemorrhagic infarctions (HI), types I and II; see “Hemorrhagic Infarction” [15-18].) Diagnostic catheter angiography – a minimally invasive procedure involving percutaneous catheterization of any of the arteries or veins (...) who have suffered a stroke. It is a measure of overall functional outcome, rather than specific symptom severity. The scale ranges from 0 (no symptoms) to 6 (dead) (see Appendix). Modified thrombolysis in cerebral infarction (mTICI) score – A scale ranging from 0 to 3 that describes the degree of (re)perfusion of an artery past its initial occlusion and into its distal branches. A score of 0 indicates no perfusion, whereas a score of 3 indicates full reperfusion with filling of all the distal

2019 American Society of Neuroradiology

28. Management of Stroke in Neonates and Children Full Text available with Trip Pro

in a delayed manner, that are presumed to have occurred in the perinatal period. These infants typically present with pathological early handedness or seizures, leading to brain imaging and the diagnosis of a remote infarction. As in adults, pediatric stroke can also be classified according to whether the underlying cause is ischemic or hemorrhagic, as detailed in the NIH Common Data Elements. Ischemic stroke includes arterial ischemic stroke (AIS) and venous infarction caused by cerebral sinovenous (...) % and hemiparesis in 36% to 75% and are clinically covert in 14% to 40%. Braun et al found that cardioembolic stroke may present with abrupt onset compared with a stuttering or fluctuating presentation in children with stroke caused by arteriopathy. Diagnosis of cerebral infarction is often made when imaging is obtained for other reasons (cardiac arrest, extracorporeal membrane oxygenation cannulation). Children with moyamoya-type arteriopathies are distinguished by a high prevalence of transient ischemic

2019 American Heart Association

29. Heart Disease and Stroke Statistics Full Text available with Trip Pro

. Physical Inactivity e99 5. Nutrition e119 6. Overweight and Obesity e138 Health Factors and Other Risk Factors 7. High Blood Cholesterol and Other Lipids e161 8. High Blood Pressure e174 9. Diabetes Mellitus e193 10. Metabolic Syndrome e212 11. Kidney Disease e233 12. Sleep e249 Cardiovascular Conditions/Diseases 13. Total Cardiovascular Diseases e257 14. Stroke (Cerebrovascular Disease) e281 15. Congenital Cardiovascular Defects and Kawasaki Disease e327 16. Disorders of Heart Rhythm e346 17. Sudden (...) (95% CI, 17.3–18.1 million) deaths were attributed to CVD globally, which amounted to an increase of 14.5% (95% CI, 12.1%–17.1%) from 2006. The age-adjusted death rate per 100 000 population was 277.9 (95% CI, 272.1–284.6), which represents a decrease of 14.5% (95% CI, −16.2% to −12.5%) from 2006. Stroke (Cerebrovascular Disease) (Chapter 14) An estimated 7.0 million Americans ≥20 years of age self-report having had a stroke, and the overall stroke prevalence was an estimated 2.5%. In the National

2019 American Heart Association

30. Guidelines for the Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack (Secondary Stroke Prevention)

, will experience a transient ischemic attack (TIA). 2 Although a TIA leaves no immediate impairment, affected individuals have a Abstract—The aim of this updated guideline is to provide comprehensive and timely evidence-based recommendations on the prevention of future stroke among survivors of ischemic stroke or transient ischemic attack. The guideline is addressed to all clinicians who manage secondary prevention for these patients. Evidence-based recommendations are provided for control of risk factors (...) of antithrombotic and anticoagulation therapy after an intracranial hemorrhage and implementation of guidelines. (Stroke. 2014;45:2160-2236.) Key Words: AHA Scientific Statements ? atrial fibrillation ? carotid stenosis ? hypertension ? ischemia ? ischemic attack, transient ? prevention ? stroke Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association The American Academy

2014 Congress of Neurological Surgeons

31. Predictive value of ABCD2 and ABCD3-I scores in TIA and minor stroke in the stroke unit setting. (Abstract)

(NIH Stroke Scale score <4).A total of 5,237 TIA and minor stroke patients met inclusion criteria, with 3-month follow-up data available on 2,457. Early and 3-month stroke were observed in 2.4% and 4.2% of the study population. The probability of early stroke during the stroke unit stay (median 2 [interquartile range 1-3] days) steadily increased from 0% to 4.8% and 0% to 16.7% with increasing ABCD2 and ABCD3-I score points, respectively. On 3-month follow-up, stroke risk increased from 0% to 8.0 (...) % and 0% to 23.8% with increasing ABCD2 and ABCD3-I score points, respectively. Of the individual score components, age, blood pressure, and diabetes were not related to early or 3-month stroke, whereas clinical presentation (C), symptom duration (D), and cerebral as well as carotid imaging (I) were and accounted for the information provided by the full scores.Standard ABCD2 and ABCD3-I scores are useful instruments to estimate the probability of early and 3-month stroke in TIA and minor stroke

2016 Neurology

32. 2015 American Heart Association/American Stroke Association Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment Full Text available with Trip Pro

for Small Core and Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT to Recanalization Times; EXTEND-IA, Extending the Time for Thrombolysis in Emergency Neurological Deficits–Intra-Arterial; IA, intra-arterial; IAT, intra-arterial therapy; ICA, internal carotid artery; IMS III, Interventional Management of Stroke Trial III; IV, intravenous; MCA, middle cerebral artery; MERCI, Mechanical Embolus Removal in Cerebral Ischemia; MR, magnetic resonance; MR CLEAN, Multicenter Randomized (...) , Thrombolysis in Cerebral Infarction. Table 4. Selected Clinical Outcomes for Recent Randomized, Clinical Trials of Endovascular Treatments for Acute Ischemic Stroke Outcomes Primary End Point Death (90 d/3 mo) Symptomatic ICH mRS 0 to 2 at 90 d IV r-tPA Subgroups Time Subgroups ASPECTS Subgroups NIHSS Subgroups Age Subgroups Vessel Subgroups Study Active, % Control, % Comparison Active, % Control, % Comparison Time Active, % Control, % Comparison Active, % Control, % Comparison IV r-tPA n Comparison Time n

2015 American Heart Association

33. Stroke in childhood - clinical guideline for diagnosis, management and rehabilitation

Stereotactic radiosurgery SSNAP Sentinel Stroke National Audit Programme STOP Stroke Prevention Trial in Sickle Cell Anaemia SWiTCH trial Stroke With Transfusions Changing to Hydroxyurea trial TAC/F Team Around the Child/Family TBI Traumatic brain injury TCD Transcranial Doppler ultrasonography TIA Transient ischaemic attack TIPS trial Thrombolysis in Pediatric Stroke trial TMS Transcranial magnetic stimulation tPA Tissue plasminogen activator UKHCDO United Kingdom Haemophilia Centre Doctors' Organisation (...) ) Indications for referral to neurosurgery in children and young people with AIS • Discuss any impairment of conscious level or decline in Pediatric National Institutes of Health Stroke Scale (PedNIHSS) in a child with AIS with a neurosurgical team. • Consider decompressive hemicraniectomy in children/young people with middle cerebral artery (MCA) infarction under the circumstances listed in 6.2.3. Indications for referral to interventional neuroradiology • Patients with acute AIS causing a disabling

2017 Royal College of Paediatrics and Child Health

34. ACR/ASNR/SIR/SNIS Practice Parameter for the Performance of Endovascular Embolectomy and Revascularization in Acute Stroke

ischemic injury in a PRACTICE PARAMETER 3 Acute Stroke defined vascular distribution, or clinical evidence of cerebral, spinal cord, or retinal focal ischemic injury based on symptoms persisting >24 hours or until death, and other etiologies excluded. (Note: CNS infarction includes hemorrhagic infarctions (HI), types I and II; see “Hemorrhagic Infarction” [15-18].) Diagnostic catheter angiography – a minimally invasive procedure involving percutaneous catheterization of any of the arteries or veins (...) who have suffered a stroke. It is a measure of overall functional outcome, rather than specific symptom severity. The scale ranges from 0 (no symptoms) to 6 (dead) (see Appendix). Modified thrombolysis in cerebral infarction (mTICI) score – A scale ranging from 0 to 3 that describes the degree of (re)perfusion of an artery past its initial occlusion and into its distal branches. A score of 0 indicates no perfusion, whereas a score of 3 indicates full reperfusion with filling of all the distal

2018 Society of Interventional Radiology

35. The cognitive burden of stroke emerges even with an intact NIH Stroke Scale Score: a cohort study. (Abstract)

The cognitive burden of stroke emerges even with an intact NIH Stroke Scale Score: a cohort study. We aim to facilitate recognition of the cognitive burden of stroke by describing the parallels between cognitive deficits and the National Institutes of Health Stroke Scale (NIHSS), a widely used measure of stroke severity.A consecutive cohort of 223 working-age patients with an acute first-ever ischaemic stroke was assessed neuropsychologically within the first weeks after stroke and at a 6 (...) factors.Cognitive deficits were common even in patients with the lowest NIHSS scores. Thus, low NIHSS scores are not effective indicators of good cognitive outcomes after stroke.

2013 Neurosurgery and Psychiatry

36. Stroke prognostication using age and NIH Stroke Scale: SPAN-100. Full Text available with Trip Pro

Stroke prognostication using age and NIH Stroke Scale: SPAN-100. 23918864 2013 10 17 2018 12 02 1526-632X 81 6 2013 Aug 06 Neurology Neurology Stroke prognostication using age and NIH Stroke Scale: SPAN-100. 603 10.1212/01.wnl.0000433418.06773.33 Yufe Robert R eng Letter Comment United States Neurology 0401060 0028-3878 EC 3.4.21.68 Tissue Plasminogen Activator AIM IM Neurology. 2013 Jan 1;80(1):21-8 23175723 Neurology. 2013 Aug 6;81(6):603 24069616 Female Humans Male Severity of Illness Index (...) Stroke diagnosis drug therapy Tissue Plasminogen Activator therapeutic use 2013 8 7 6 0 2013 8 7 6 0 2013 10 18 6 0 ppublish 23918864 81/6/603-a 10.1212/01.wnl.0000433418.06773.33

2013 Neurology

37. Stroke Prognostication using Age and NIH Stroke Scale: SPAN-100. Full Text available with Trip Pro

Stroke Prognostication using Age and NIH Stroke Scale: SPAN-100. Age and stroke severity are major determinants of stroke outcomes, but systematically incorporating these prognosticators in the routine practice of acute ischemic stroke can be challenging. We evaluated the effect of an index combining age and stroke severity on response to IV tissue plasminogen activator (tPA) among patients in the National Institute of Neurological Disorders and Stroke (NINDS) tPA stroke trials.We created (...) the Stroke Prognostication using Age and NIH Stroke Scale (SPAN) index by combining age in years plus NIH Stroke Scale (NIHSS) ≥100. We applied the SPAN-100 index to patients in the NINDS tPA stroke trials (parts I and II) to evaluate its ability to predict clinical response and risk of intracerebral hemorrhage (ICH) after thrombolysis. The main outcome measures included ICH (any type) and a composite favorable outcome (defined as a modified Rankin Scale score of 0 or 1, NIHSS ≤1, Barthel index ≥95

2013 Neurology Controlled trial quality: uncertain

38. Study of rhPro-UK in Patients With Acute Ischaemic Stroke in 4.5 Hours After Stroke Onset(PROST)

Rankin Scale (mRS) score ≥2 CT showed multiple infarctions(low density> 1/3 cerebral hemisphere). Transient ischemic attack. Epileptic seizure after stroke. Intracranial tumor, arteriovenous malformation and aneurysm. Iatrogenic Stroke. Planned for thrombectomy. Cardioembolism and atrial fibrillation. Myocardial infarction history within 3 months. Severe cerebral trauma or stroke history within 3 months. Patients with systolic blood pressure ≥ 180mmHg or diastolic blood pressure ≥ 100mmHg after anti (...) Last Update Posted: January 11, 2019 Last Verified: April 2018 Individual Participant Data (IPD) Sharing Statement: Plan to Share IPD: Undecided 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 Additional relevant MeSH terms: Layout table for MeSH terms Stroke Ischemia Cerebral Infarction Cerebrovascular Disorders Brain Diseases Central Nervous System Diseases

2018 Clinical Trials

39. The Diagnosis and Acute Management of Childhood Stroke, Clinical Guideline

of arteriopathy (in addition to previous transient ischaemic attack, bilateral infarction, prior diagnosis and leucocytosis) has been independently associated with the incidence of clinically overt or silent re-infarction (82). Moyamoya disease is an occlusive cerebrovascular disorder characterised by the angiographic appearance of an abnormal vascular network at the base of the brain. Moyamoya accounts for a significant percentage of arteriopathies in children, and is more commonly found in Asian populations (...) of 70 consecutive children with arterial ischaemic stroke had varicella infection in the preceding year compared with 9% published rates of varicella in the healthy population (45). A more recent case series from the United Kingdom used anonymized electronic health records from four primary care databases to identify individuals who had documented clinical chickenpox and stroke or transient ischemic attack (TIA). Five hundred and sixty eligible participants (including 60 children) were identifi ed

2017 Stroke Foundation - Australia

40. Heart Disease and Stroke Statistics 2017 Update: A Report From the American Heart Association Full Text available with Trip Pro

14) • When considered separately from other CVDs, stroke ranks No. 5 among all causes of death, behind dis- eases of the heart, cancer, chronic lower respiratory disease, and unintentional injuries/accidents. • Globally, in 2013 there were 6.5 million stroke deaths, making stroke the second-leading cause of death behind ischemic heart disease. • Approximately 795 000 strokes occur in the United States each year. On average, every 40 seconds, someone in the United States has a stroke (...) University of South Carolina NINDS† None None None None None None John T. Wilkins Northwestern University None None None None None None None Joshua Z. Willey Columbia University NIH (NINDS K23 073104)†; NIH (StrokeNET, local PI of POINT trial aspirin and clopidogrel versus aspirin alone for minor stroke or TIA)*; Astra-Zeneca (Local PI for clinical trial SOCRATES aspirin versus ticagrelor)*; Genentech (Local PI for clinical trial PRISMS - alteplase versus placebo in minor stroke or TIA)* None None None

2017 American Heart Association

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