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NIH Stroke Scale

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

with symptoms of neurological deficits. Aged 18 to 80 years(including the critical value). NIH Stroke Scale(NIHSS)scores of 4 to 25(including the critical value). Treatment within 4.5 hours after stroke onset. The symptoms of stroke last at least 30 minutes without significant improvement before treatment. CT showed negative or signs of early infarction. Informed Consent Form signed by the patients or family (legal representatives) must be provided. Exclusion Criteria: Patients with premorbid modified (...) achieving a Modified Rankin Scale(mRS,which has a range of 0 to 6, with 0 indicating no symptoms at all and 6 indicating death) of 0 to 1 at 90 days after treatment. Secondary Outcome Measures : Proportion of Neurological Improvement [ Time Frame: 90 days ] Proportion of patients achieving a NIHSS(national institutes of health stroke scale) ≦1 or reduction of ≥4 NIHSS points at 24 hours after treatment. Scores of Neurological Improvement [ Time Frame: 24 hours ] NIHSS changes from baseline at 24 hours

2018 Clinical Trials

42. Development and validation of a score to detect paroxysmal atrial fibrillation after stroke

with variable selection, age and the qualifying stroke event (categorized as stroke severity with NIH Stroke Scale [NIHSS] score ≤5 [odds ratio 2.4 vs TIA; 95% confidence interval 0.8-6.9, p = 0.112] or stroke with NIHSS score >5 [odds ratio 7.2 vs TIA; 95% confidence interval 2.4-21.8, p < 0.001]) were found to be predictive for the detection of pAF within 72 hours of Holter monitoring and included in the final score (Age: 0.76 points/year, Stroke Severity NIHSS ≤5 = 9 points, NIHSS >5 = 21 points; to Find (...) Development and validation of a score to detect paroxysmal atrial fibrillation after stroke Prolonged monitoring times (72 hours) are recommended to detect paroxysmal atrial fibrillation (pAF) after ischemic stroke but this is not yet clinical practice; therefore, an individual patient selection for prolonged ECG monitoring might increase the diagnostic yield of pAF in a resource-saving manner.We used individual patient data from 3 prospective studies (ntotal = 1,556) performing prolonged

2019 EvidenceUpdates

43. A novel biomarker-based prognostic score in acute ischemic stroke: The CoRisk score

, Switzerland, as well as Frankfurt a.M., Germany. The score components were copeptin levels, age, NIH Stroke Scale, and recanalization therapy (CoRisk score). Copeptin levels were measured in plasma drawn within 24 hours of AIS and before any recanalization therapy. The primary outcome of disability and death at 3 months was defined as modified Rankin Scale score of 3 to 6.Overall, 1,102 patients were included in the analysis; the derivation cohort contributed 319 patients, and the validation cohort (...) A novel biomarker-based prognostic score in acute ischemic stroke: The CoRisk score To derive and externally validate a copeptin-based parsimonious score to predict unfavorable outcome 3 months after an acute ischemic stroke (AIS).The derivation cohort consisted of patients with AIS enrolled prospectively at the University Hospital Basel, Switzerland. The validation cohort was prospectively enrolled after the derivation cohort at the University Hospital of Bern and University Hospital Basel

2019 EvidenceUpdates

44. Recommendations for the Implementation of Telehealth in Cardiovascular and Stroke Care: A Policy Statement From the American Heart Association

Recommendations for the Implementation of Telehealth in Cardiovascular and Stroke Care: A Policy Statement From the American Heart Association Recommendations for the Implementation of Telehealth in Cardiovascular and Stroke Care: A Policy Statement From the American Heart Association | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search March 2019 March 2019 March 2019 March 2019 March 2019 February 2019 February 2019 February 2019 February 2019 (...) January 2019 January 2019 January 2019 January 2019 January 2019 This site uses cookies. By continuing to browse this site you are agreeing to our use of cookies. Free Access article Share on Jump to Free Access article Recommendations for the Implementation of Telehealth in Cardiovascular and Stroke Care: A Policy Statement From the American Heart Association , MD, FAHA, Chair , PhD , MD , MD, FAHA , PhD , MSN, APRN, FAHA , DO, MHA, FAHA , DNS, RN , PhD , RN, MSEE, PhD , JD , RN, MPH, JD , MPH, JD

2016 American Heart Association

45. Guidelines for adult stroke rehabilitation and recovery

care for the foreseeable future. Despite the extensive resources devoted to stroke rehabili- tation and aftercare, large-scale, rigorous, clinical trials in this field have been few and have been conducted only in the past decade or so. Thus, many gaps continue to be seen in the evi- dence base for stroke rehabilitation, for which smaller trials of less rigorous design provide the only available data, and in some cases, even these are not yet available. Certain aspects of stroke rehabilitation care (...) in the 43 prevention studies reviewed was the Morse Fall Scale. 184 The Berg Balance Scale has demonstrated good sensitivity and specificity in predicting falls in individuals with stroke. 185 Several federal and professional associations have developed fall prevention toolkits that include risk assessment instru- ments and protocols (eg, the National Center of Patient Safety Falls Toolkit, the Centers for Disease Control and Prevention Stopping Elderly Accidents, Deaths and Injuries Toolkit, the AHRQ

2016 American Academy of Neurology

46. Telemedicine quality and outcomes in stroke

this paradigm. The 2009 policy statement included guidelines that contained 14 recommendations, 9 of which were based on Class I evidence. They emphasized the value of telestroke to support the immediate assessment of stroke severity via the National Institutes of Health Stroke Scale (NIHSS) and other instruments and its equivalence to that of a bedside assessment, the review of brain computed tomography (CT) scans by stroke specialists to decide about thrombolysis eligibility, urgent decisions about (...) on a 3G connection was shown not to be sufficient for reliable NIHSS assessment. The new 4G technology with higher bandwidth and optional prioritization in public mobile networks appears to be more appropriate for the use of ambulance-based telestroke applications. , A streamlined unassisted telestroke scale was evaluated with healthy volunteers mimicking stroke syndromes during ambulance transportation and demonstrated sufficient stability in a moving ambulance using 4G connectivity. Further testing

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2016 American Academy of Neurology

47. Prevention of stroke in patients with silent cerebrovascular disease

in the general population, measured with the Fazekas scale (Figure 6). Data were derived from 2 population-based studies of aging. , The most consistently identified risk factors for WMH are advanced age and hypertension. , , , Cerebral Microbleeds CMBs were found in up to 5% to 21% of the general population, , 30% to 40% of patients with ischemic stroke, and 60% to 68% of patients with primary intracerebral hemorrhage (ICH) with the use of gradient-recalled echo sequences. Microbleeds are strongly (...) Prevention of stroke in patients with silent cerebrovascular disease Prevention of Stroke in Patients With Silent Cerebrovascular Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association | Stroke Search Hello Guest! Login to your account Email Password Keep me logged in Search 2019 This site uses cookies. By continuing to browse this site you are agreeing to our use of cookies. Free Access article Share on Jump to Free Access

2016 American Academy of Neurology

48. AHA/ASA Guidelines for Adult Stroke Rehabilitation and Recovery

, and many of them remain with residual functional deficits. Thus, the need for effective stroke rehabilitation is likely to remain an essential part of the continuum of stroke care for the foreseeable future. Despite the extensive resources devoted to stroke rehabilitation and aftercare, large-scale, rigorous, clinical trials in this field have been few and have been conducted only in the past decade or so. Thus, many gaps continue to be seen in the evidence base for stroke rehabilitation, for which (...) for the prevention of shoulder pain after acute stroke. Each study used different strapping (or taping) techniques and measured different pain outcomes. In the largest of these, Pandian and others randomized 162 patients with acute stroke to either shoulder taping or sham taping. There was a trend toward a difference in visual analog pain scale and pain-related disability scores over 30 days, but these differences were not statistically or clinically significant. Currently, there is insufficient evidence

2016 American Heart Association

49. Poststroke Depression: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

of Epidemiological Studies-Depression Scale; HDRS, Hamilton Depression Rating Scale; PHQ, Patient Health Questionnaire; PSD, poststroke depression; QOL, quality of life; and RCT, randomized controlled trial. Incidence, Prevalence, and Natural History of PSD Depression is common after stroke, affecting approximately one third of stroke survivors at any one time after stroke (compared with 5%–13% of adults without stroke), with a cumulative incidence of 55%. Hackett et al performed a systematic review and meta (...) the first year after stroke (within 1 month from stroke, 1–6 months, or 6–12 months) or by setting (hospital, rehabilitation, or population based). The studies included in Hackett’s and Ayerbe’s reviews were heterogeneous in nature, using a variety of methods to diagnose depression and different thresholds for the same scale. The hospital- and rehabilitation-based studies had numerous exclusion criteria (such as excluding those with a history of depression), thus limiting their generalizability

2016 American Heart Association

50. Prognostic Value of Inflammatory and Cardiovascular Biomarkers for Prediction of 90-Day All-Cause Mortality after Acute Ischemic Stroke-Results from the Linz Stroke Unit Study. (PubMed)

and the NIH Stroke Scale (NIHSS), only NIHSS >3 [risk ratio (RR) 7.87, 95% CI, 3.61-17.16; P < 0.001], IL-6 > 7 pg/mL (RR 4.09, 95% CI, 2.02-8.29; P < 0.001), and NT-proBNP >447 ng/L (RR 4.88, 95% CI, 2.41-9.88; P < 0.001) remained independent predictors. Using a simple multimarker approach combining these 3 complementary markers, we demonstrated that patients with increased NIHSS, IL-6, and NT-proBNP had the poorest outcome with a mortality rate of 38%, whereas no patient with negative readings for all 3 (...) Prognostic Value of Inflammatory and Cardiovascular Biomarkers for Prediction of 90-Day All-Cause Mortality after Acute Ischemic Stroke-Results from the Linz Stroke Unit Study. Early outcome prediction after acute ischemic stroke is of great interest. The aim of our study was to evaluate the prognostic value of blood biomarkers in patients with acute ischemic stroke.We measured interleukin-6 (IL-6), d-dimer, amino-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity cardiac

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2017 Clinical Chemistry

51. CPAP as treatment of sleep apnea after stroke: A meta-analysis of randomized trials

] 3.97-5.08). The OR of dropping out with CPAP was 1.83 (95% CI 1.05-3.21, p = 0.033). The combined analysis of the neurofunctional scales (NIH Stroke Scale and Canadian Neurological Scale) showed an overall neurofunctional improvement with CPAP (SMD 0.5406, 95% CI 0.0263-1.0548) but with a considerable heterogeneity (I2 = 78.9%, p = 0.0394) across the studies. Long-term survival was improved with CPAP in 1 trial.CPAP use after stroke is acceptable once the treatment is tolerated. The data indicate (...) CPAP as treatment of sleep apnea after stroke: A meta-analysis of randomized trials To perform a systematic review and meta-analysis of randomized controlled trials (RCTs) examining the effectiveness of continuous positive airway pressure (CPAP) in stroke patients with sleep disordered breathing (SDB).In a systematic literature search of electronic databases (MEDLINE, Embase, and the Cochrane Library) from 1980 to November 2016, we identified RCTs that assessed CPAP compared to standard care

2018 EvidenceUpdates

52. NIHSS cut-point for predicting outcome in supra- vs infratentorial acute ischemic stroke

NIHSS cut-point for predicting outcome in supra- vs infratentorial acute ischemic stroke To determine the optimal cut point on the NIH Stroke Scale (NIHSS) for predicting poor 90-day clinical outcome in patients with supratentorial and infratentorial acute ischemic stroke (AIS).Data are from participants of the alteplase-dose arm of the randomized controlled trial, Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED). Associations between baseline characteristics (...) of clinically defined supratentorial and infratentorial AIS patients and poor functional outcome, defined by scores 3-6 on the modified Rankin Scale, were evaluated in logistic regression models, with area under the curve (AUC) receiver operating characteristics defining the optimal NIHSS predictor cut point.Patients with infratentorial AIS (n = 289) had lower baseline NIHSS scores than those with supratentorial AIS (n = 2,613) (median 7 vs 9; p < 0.001). NIHSS cut points for poor outcome were 10 (AUC 76

2018 EvidenceUpdates

53. Return to work after ischemic stroke in young adults: A registry-based follow-up study

Return to work after ischemic stroke in young adults: A registry-based follow-up study We aimed to investigate the proportion of young patients not returning to work (NRTW) at 1 year after ischemic stroke (IS) and during follow-up, and clinical factors associated with NRTW.Patients from the Helsinki Young Stroke Registry with an IS occurring in the years 1994-2007, who were at paid employment within 1 year before IS, and with NIH Stroke Scale score ≤15 points at hospital discharge, were (...) Stroke Scale score at admission, factors associated with NRTW at 1 year after IS were large anterior strokes, strokes caused by large artery atherosclerosis, high-risk sources of cardioembolism, and rare causes other than dissection compared with undetermined cause, moderate to severe aphasia vs no aphasia, mild and moderate to severe limb paresis vs no paresis, and moderate to severe visual field deficit vs no deficit.NRTW is a frequent adverse outcome after IS in young adults with mild to moderate

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2018 EvidenceUpdates

54. Early MoCA predicts long-term cognitive and functional outcome and mortality after stroke

neuropsychological testing, the Clinical Dementia Rating (CDR) scale, the modified Rankin Scale (mRS), and Instrumental Activities of Daily Living (IADL) and analyzed with generalized estimating equations. All-cause mortality was investigated by Cox proportional hazard models. Analyses were adjusted for demographic variables, education, vascular risk factors, premorbid cognitive status, and NIH Stroke Scale scores. The additive predictive value of MoCA was examined with receiver operating characteristic (...) Early MoCA predicts long-term cognitive and functional outcome and mortality after stroke To examine whether the Montreal Cognitive Assessment (MoCA) administered within 7 days after stroke predicts long-term cognitive impairment, functional impairment, and mortality.MoCA was administered to 274 patients from 2 prospective hospital-based cohort studies in Germany (n = 125) and France (n = 149). Cognitive and functional outcomes were assessed at 6, 12, and 36 months after stroke by comprehensive

2018 EvidenceUpdates

55. Endovascular Stroke Treatment

Endovascular Stroke Treatment Emergency Medicine > Journal Club > Archive > May 2015 Toggle navigation May 2015 Endovascular Stroke Treatment Vignette A 67 year old white female presents to a moderate sized community hospital (also a Primary Stroke Center) 90 minutes after the onset of right-arm and leg hemiplegia as well as aphasia. The initial NIH Stroke Scale (NIHSS) is 13. A non-contrast head CT is negative, though there is a possible hyperdense "MCA sign" per the preliminary read. All labs (...) ( ) was not stopped early. Finally, ordinal analysis has become a common statistical tool in stroke trials, and has been accepted as a means of identifying smaller (but clinically significant) differences in outcomes than using a dichotomous cutoff for the modified Rankin scale. Both sides in the debate over endovascular therapy for stroke make salient points. The current tide, however, seems to be in favor of its proponents. Many institutions have begun to perform endovascular procedures, with strict protocols

2015 Washington University Emergency Medicine Journal Club

56. Is Alteplase Beneficial for Treating Ischemic Stroke?

raised the age for “administer carefully” from 75-year and older to 81-year and older, and the NIHSS scores for “administer carefully” from 23 and above to 26 and above [6]. In any case, the revised guidelines allow wider use by listing many “contraindications” in the package insert under “administer carefully” and raising the upper age limit for the administration. Note: The NIHSS is a scale to assess severity of stroke developed by National Institute of Health (NIH) in the US. Scores are given (...) Is Alteplase Beneficial for Treating Ischemic Stroke? MED CHECK - TIP DECEMBER 2015 / Vol.1 No.3 · Page 33 -The Informed Prescriber C N o 3 M ED HECK Volume 1 December 2 0 1 5 Anti-HCV agent LDV/SOF combination 8 week treatment may be better to reduce harm and costs with same efficacy Is Alteplase Beneficial for Treating Ischemic Stroke? Editorial: “Surrogate endpoint” qualify “real advance”? New Products Anti-HCV agent LDV/SOF combination (brand name: Harvoni) 8 week treatment may be better

2015 Med Check - The Informed Prescriber

57. Large-Scale Online Studies of Motor Responses and Cognition

Large-Scale Online Studies of Motor Responses and Cognition Large-Scale Online Studies of Motor Responses and Cognition - 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 of saved studies (100). Please remove one or more studies before adding more. Large-Scale Online Studies of Motor (...) of Neurological Disorders and Stroke (NINDS) Information provided by (Responsible Party): National Institutes of Health Clinical Center (CC) ( National Institute of Neurological Disorders and Stroke (NINDS) ) Study Details Study Description Go to Brief Summary: Background: Our goal is to gain insight into motor and cognitive factors relevant to human sensorimotor function and learning by carrying out online substudies using online crowd-sourcing tools. Objective: To learn more about cognition and motor

2018 Clinical Trials

58. Topographic correlation of infarct area on CT perfusion with functional outcome in acute ischemic stroke. (PubMed)

at discharge were assessed using multivariable proportional odds logistic regression models.RESULTSThe median age was 67 years (range 19-95 years), and the median NIH Stroke Scale score was 16 (range 2-35). In a multivariable analysis adjusting for potential confounding variables, having an infarct on CTP scans in the following regions was associated with a worse mRS score at discharge: insula ribbon (p = 0.043), perisylvian fissure (p < 0.001), motor strip (p = 0.007), M2 (p < 0.001), and M5 (p = 0.023 (...) circulation ischemic stroke who underwent CT angiography (CTA) and CTP at admission between February 2011 and October 2014. On CTP, the volume of ischemic core and penumbra was measured using the Alberta Stroke Program Early CT Score (ASPECTS). CTA findings were also noted, including the site of occlusion and regional leptomeningeal collateral (rLMC) score. Functional outcome was defined by modified Rankin Scale (mRS) score obtained at discharge. Associations of CTP and CTA parameters with mRS scores

2019 Journal of Neurosurgery

59. Genome-wide association meta-analysis of functional outcome after ischemic stroke. (PubMed)

variables (0-2 vs 3-6 and 0-1 vs 2-6) and subsequently as an ordinal variable. GWA analyses were performed in each study independently and results were meta-analyzed. Analyses were adjusted for age, sex, stroke severity (baseline NIH Stroke Scale score), and ancestry. The significance level was p < 5 × 10-8.We identified one genetic variant associated with functional outcome with genome-wide significance (modified Rankin Scale scores 0-2 vs 3-6, p = 5.3 × 10-9). This intronic variant (rs1842681 (...) Genome-wide association meta-analysis of functional outcome after ischemic stroke. To discover common genetic variants associated with poststroke outcomes using a genome-wide association (GWA) study.The study comprised 6,165 patients with ischemic stroke from 12 studies in Europe, the United States, and Australia included in the GISCOME (Genetics of Ischaemic Stroke Functional Outcome) network. The primary outcome was modified Rankin Scale score after 60 to 190 days, evaluated as 2 dichotomous

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2019 Neurology

60. Lower serum retinoic acid level for prediction of higher risk of mortality in ischemic stroke. (PubMed)

. The significance of serum RA level, NIH Stroke Scale score, and established risk factors in predicting mortality were determined. The integrated discrimination improvement (IDI) and net reclassification improvement (NRI) statistics were applied in statistical analysis.Of the 1,530 patients enrolled, 325 died within 6 months of admission, with an all-cause mortality of 21.2% and CVD-related mortality of 13.1%. In multivariable analysis, RA levels were expressed as quartiles with the clinical variables (...) Lower serum retinoic acid level for prediction of higher risk of mortality in ischemic stroke. To explore the association between serum retinoic acid (RA) level in patients with acute ischemic stroke (AIS) and mortality risk in the 6 months after admission.From January 2015 through December 2016, patients admitted to 3 stroke centers in China for first-ever AIS were screened. The primary endpoint was all-cause mortality or cardiovascular disease (CVD) mortality in the 6 months after admission

2019 Neurology

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