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NIH Stroke Scale

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161. Diffuse microvascular dysfunction and loss of white matter integrity predict poor outcomes in patients with acute ischemic stroke. Full Text available with Trip Pro

hyperintensity (WMH), acute infarct, and PWI-derived mean transit time lesion volumes were calculated. Mean BBB leakage rates (K2 coefficient) and mean diffusivity values were measured in contralesional normal-appearing white matter (NAWM). Plasma matrix metalloproteinase-2 (MMP-2) levels were studied at baseline and 48 h. Admission stroke severity was evaluated using the NIH Stroke Scale (NIHSS). Modified Rankin Scale (mRS) was obtained at 90-days post-stroke. We found that higher mean K2 and diffusivity (...) dysfunction may improve prediction of cerebral tissue infarction and functional post-stroke outcomes.

2017 Journal of Cerebral Blood Flow and Metabolism

162. Stroke etiology is associated with outcome in posterior circulation stroke Full Text available with Trip Pro

%) and large artery dissection (25.9%) were the two most common etiologies, followed by large artery atherosclerotic stenosis/occlusion (LAA, 20.6%), cardioembolism (CE, 18.5%) and small vessel disease (7.0%). Age, vascular risk factors, infarct locations and patterns, and outcomes were different among these five etiology groups. Multivariate analyses showed that age >70 y/o (discharge/3 month, OR, 95% CI: 3.05, 1.23-7.56/8.39, 2.32-30.33), admission NIH Stroke Scale >9 (19.50, 8.69-43.75/13.45, 5.59-32.39 (...) and registered in Taipei Veterans General Hospital Stroke Registry between 1 January 2012 to 28 February 2014. We demonstrated the distribution of etiologies, compared the clinical characteristics/outcomes among different etiology groups, and used univariate/multivariate analyses to identify the predictors for poor functional outcome (modified Rankin Scale ≥5) at discharge and 3 month.About 286 patients of PCS were included for analyses. Basilar artery atheromatous branch occlusive disease (BABO, 28.0

2015 Annals of clinical and translational neurology

163. Sleep Disorders Managed and Assessed Rapidly in Transient Ischemic Attack (TIA) and In Early Stroke

, 2014 Last Verified: November 2014 Keywords provided by Sunnybrook Health Sciences Centre: Stroke Ischemic Attack, Transient Sleep Disorders Sleep Apnea Syndromes Restless Legs Syndrome Chronobiology Disorders Additional relevant MeSH terms: Layout table for MeSH terms Disease Syndrome Stroke Ischemia Sleep Apnea Syndromes Sleep Wake Disorders Parasomnias Psychomotor Agitation Restless Legs Syndrome Ischemic Attack, Transient Pathologic Processes Cerebrovascular Disorders Brain Diseases Central (...) Sleep Disorders Managed and Assessed Rapidly in Transient Ischemic Attack (TIA) and In Early Stroke Sleep Disorders Managed and Assessed Rapidly in Transient Ischemic Attack (TIA) and In Early Stroke - 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

2012 Clinical Trials

164. 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

165. Primary Care Corner with Geoffrey Modest MD: The elusive search for afib in stroke patients; and an app

of atrial fibrillation than standard monitoring, the Find-AF RANDOMISED trial (see Wachter R. Lancet Neurol 2017; 16: 282–90). Details: –398 patients were recruited from 2013-2014 in 4 German centers, all with acute ischemic stroke and symptoms for 7 days or less, aged 60 years or older, in sinus rhythm and no history of atrial fibrillation (AF). — Mean age 73, 40% women, 80% hypertension/27% diabetes/41% hyperlipidemia/18% current smoker/29% previous smokers/20% previous ischemic stroke/8% previous TIA (...) in picking up AF by age, sex, CHADS 2 , NIH Stroke Scale, symptoms at admission, or if the stroke was considered “cryptogenic”)​ Commentary: — The rationale for looking aggressively for atrial fibrillation is that strokes from AF can be more severe, there is a high risk of recurrent strokes, and the detection of AF really changes therapy from antiplatelet drugs to oral anticoagulants, the latter decreasing the risk of recurrent strokes by 60 to 70%. Since there are significant adverse events associated

2017 Evidence-Based Medicine blog

166. Replication and extension of the simplified modified rankin scale in 150 Chinese stroke patients. (Abstract)

Replication and extension of the simplified modified rankin scale in 150 Chinese stroke patients. Recently, a simplified modified Rankin Scale (mRS) questionnaire (smRSq) showed good reliability but has not been tested for its validity by its original creators. Our study aimed to test its reliability and validity in Chinese stroke patients.Randomly chosen paired raters scored the smRSq, the conventional mRS, and the NIH Stroke Scale (NIHSS) face-to-face in 150 hospitalized stroke patients (...) ), and κw = 0.83 (95% CI 0.79-0.88). The correlation between the NIHSS and the smRSq (concurrent validity) was moderate (Spearman's correlation coefficient 0.70, p < 0.0001).Our results confirm the value of the smRSq in the assessment of stroke functional outcome in China. As this is a novel stroke tool, further validations are needed.Copyright © 2012 S. Karger AG, Basel.

2012 European neurology Controlled trial quality: uncertain

167. Cerebral Venous Sinus Thrombosis: Re-exploration of Clinical Assessment Scales

: resources: Groups and Cohorts Go to Outcome Measures Go to Primary Outcome Measures : baseline CSF pressure [ Time Frame: baseline ] CSF pressure at baseline baseline mRS [ Time Frame: baseline ] mRS at baseline baseline papilledema grade [ Time Frame: baseline ] Frisen grade of papilledema at baseline Secondary Outcome Measures : baseline NIHSS [ Time Frame: baseline ] NIH Stroke Scale at baseline Eligibility Criteria Go to Information from the National Library of Medicine Choosing to participate (...) Cerebral Venous Sinus Thrombosis: Re-exploration of Clinical Assessment Scales Cerebral Venous Sinus Thrombosis: Re-exploration of Clinical Assessment Scales - 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

2017 Clinical Trials

168. Targeting Recombinant Tissue-Type Plasminogen Activator in Acute Ischemic Stroke Based on Risk of Intracranial Hemorrhage or Poor Functional Outcome: An Analysis of the Third International Stroke Trial. Full Text available with Trip Pro

with r-tPA in patients at a low, medium, or high predicted risk of sICH or poor functional outcome.Prediction models for sICH or poor outcome (Hemorrhage After Thrombolysis [HAT]; Sugar, Early Infarct Signs, Dense Artery, Age, National Institutes of Health (NIH) Stroke Score (SEDAN); Glucose Race Age Sex Pressure Stroke Severity [GRASPS]; Stroke Thrombolytic Predictive Instrument; Dense Artery, Rankin Score, Age, Glucose, Onset to Treatment Time, NIHSS [DRAGON]; Totaled Health Risks in Vascular (...) Targeting Recombinant Tissue-Type Plasminogen Activator in Acute Ischemic Stroke Based on Risk of Intracranial Hemorrhage or Poor Functional Outcome: An Analysis of the Third International Stroke Trial. Intravenous recombinant tissue-type plasminogen activator (r-tPA), despite a risk of early symptomatic intracranial hemorrhage (sICH), is of net clinical benefit to acute stroke patients. We tested if predictive models could identify patients least likely to be harmed by sICH or those who gained

2014 Stroke Controlled trial quality: uncertain

169. Factors associated with unfavorable outcome in minor ischemic stroke Full Text available with Trip Pro

Factors associated with unfavorable outcome in minor ischemic stroke The purpose of this study was to elucidate the factors that correlate with unfavorable outcomes and to develop a simple validated model for assessing risk of unfavorable outcomes in patients with minor ischemic stroke.The derivation cohort included 1,313 patients hospitalized within 72 hours after onset with an initial NIH Stroke Scale score of 0 to 3 enrolled in a prospective, multicenter, observational study. Unfavorable (...) vascular imaging, NIH Stroke Scale items such as leg weakness and extinction/inattention, and their combination, as well as female sex and advanced age, may be useful for predicting unfavorable outcomes in patients with minor stroke.© 2014 American Academy of Neurology.

2014 EvidenceUpdates

170. Long-term increased risk of unemployment after young stroke: A long-term follow-up study (Abstract)

Long-term increased risk of unemployment after young stroke: A long-term follow-up study To investigate the prevalence, excess risk, and risk factors of unemployment in patients after a TIA, ischemic stroke, or intracerebral hemorrhage at ages 18 through 50 years, compared with nationwide controls.We performed a hospital-based cohort study among 694 patients, aged 18-50 years, with a first-ever TIA, ischemic stroke, or intracerebral hemorrhage. After a mean follow-up duration of 8.1 (SD 7.7 (...) ) years, we used logistic regression analysis to calculate odds ratio (OR) with 95% confidence interval (CI) for being unemployed as a young stroke patient, compared with the Dutch population of vocational age (n = 7,803,000), with subsequent assessment of risk factors of unemployment.Young stroke patients had a higher risk of being unemployed than their peers in the Dutch population: women OR 2.3 (1.8-2.9), men OR 3.2 (2.5-4.0). A higher NIH Stroke Scale score at admission (OR 1.1 [95% CI 1.0-1.1

2014 EvidenceUpdates

171. Thrombolytics for stroke: The evidence

. We tend to ignore these patients, because we were not the saviours – because we don’t get the credit – but patients rapidly resolving on their own are far more common than patients rapidly resolving after tPa. If a stroke patient’s symptoms resolve in the first 24 hours, whether or not you gave tPa, that is called a transient ischemic attack. I should also mention, it isn’t really clear how thrombolytics could have an effect at 3 months but not at 24 hours. This is one of the facts that leads me (...) therapy with intravenous alteplase in acute ischaemic stroke (ECASS II). Second European-Australasian Acute Stroke Study Investigators.. Lancet (London, England). 1998; 352(9136):1245-51. PMID: A multicenter randomized, double-blind, placebo controlled trial Patients: 800 adult stroke patients (aged 18-80) with a clinical diagnosis of moderate to severe hemispheric ischemic stroke within 6 hours of symptoms onset. Patients were excluded if they had brain swelling in more than 33% of the MCA territory

2017 First10EM

172. Glial Fibrillary Acidic Protein Serum Levels Distinguish between Intracerebral Hemorrhage and Cerebral Ischemia in the Early Phase of Stroke. Full Text available with Trip Pro

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 (...) , 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

2016 Clinical Chemistry

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

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

174. Effect of aphasia on acute stroke outcomes. Full Text available with Trip Pro

Effect of aphasia on acute stroke outcomes. To determine the independent effects of aphasia on outcomes during acute stroke admission, controlling for total NIH Stroke Scale (NIHSS) scores and loss of consciousness.Data from the Tulane Stroke Registry were used from July 2008 to December 2014 for patient demographics, NIHSS scores, length of stay (LOS), complications (sepsis, deep vein thrombosis), and discharge modified Rankin Scale (mRS) score. Aphasia was defined as a score >1 on question 9 (...) without aphasia, which was equivalent to those having hemiparesis (OR 1.47, CI 1.09-1.99, p = 0.0137). Controlling for NIHSS scores, aphasia patients had higher odds of discharge mRS 3-6 (OR 1.42 vs 1.15).Aphasia is independently associated with increased LOS and complications during the acute stroke admission, adding $2.16 billion annually to US acute stroke care. The presence of aphasia was more likely to produce a poor functional outcome than hemiparesis. These data suggest that further research

2016 Neurology

175. Leukocyte response is regulated by microRNA let7i in patients with acute ischemic stroke. Full Text available with Trip Pro

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

2016 Neurology

176. Statin pretreatment is associated with better outcomes in large artery atherosclerotic stroke. Full Text available with Trip Pro

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

2016 Neurology

177. Early Blood Pressure Reduction in Acute Ischemic Stroke with Various Severities: A Subgroup Analysis of the CATIS Trial. Full Text available with Trip Pro

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 (...) , and vascular events in acute ischemic stroke patients with a variety of disease severities.© 2016 S. Karger AG, Basel.

2016 Cerebrovascular diseases (Basel, Switzerland) Controlled trial quality: predicted high

178. Comparison of non-stent retriever and stent retriever mechanical thrombectomy devices for the endovascular treatment of acute ischemic stroke. Full Text available with Trip Pro

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 (...) 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

2016 Journal of Neurosurgery

179. Aspirin resistance is associated with increased stroke severity and infarct volume. (Abstract)

, defined as high residual platelet reactivity (HRPR) on aspirin treatment, was measured using the VerifyNow assay and defined as an aspirin reaction unit ≥550. Initial stroke severity was assessed using the NIH Stroke Scale (NIHSS) score. Infarct volume was measured using DWI.HRPR occurred in 86 patients (27.7%). The initial NIHSS score (median [interquartile range]) was higher in patients with HRPR than in the non-HRPR group (6 [3-15] vs 3 [1-8], p < 0.001). DWI infarct volumes were also larger (...) Aspirin resistance is associated with increased stroke severity and infarct volume. To investigate whether aspirin resistance is associated with initial stroke severity and infarct volume, using diffusion-weighted imaging (DWI) in patients with acute ischemic stroke that occurred while taking aspirin.We studied a total of 310 patients who were admitted within 48 hours of acute ischemic stroke onset. All patients had been taking aspirin for at least 7 days before stroke onset. Aspirin resistance

2016 Neurology

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

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 (...) in the MCA, ACA, and PCA than that of the control group (p < 0.001). The best predictor of the changes in the NIHSS scores was the decline in the pulsatility index in the vascular territory of both lesional and non-lesional MCA measured by the end of the last treatment session.tACSbm appeared to be effective for enhancing patients' functional recovery and cerebral hemodynamics in the subacute phase. The extent of recovery seems to be associated with the decline of the resistance in vascular bed

2016 Topics in stroke rehabilitation Controlled trial quality: uncertain

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