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  • Collateral Recruitment Is Impaired by Cerebral Small Vessel Disease
    Stroke (IF 6.046) Pub Date : 2020-04-06
    Michelle P. Lin; Thomas G. Brott; David S. Liebeskind; James F. Meschia; Kevin Sam; Rebecca F. Gottesman

    Background and Purpose—Cerebral small vessel disease (SVD) is associated with increased stroke risk and poor stroke outcomes. We aimed to evaluate whether chronic SVD burden is associated with poor recruitment of collaterals in large-vessel occlusive stroke.Methods—Consecutive patients with middle cerebral artery or internal carotid artery occlusion presenting within 6 hours after stroke symptom onset

    更新日期:2020-04-06
  • Deep Learning–Derived High-Level Neuroimaging Features Predict Clinical Outcomes for Large Vessel Occlusion
    Stroke (IF 6.046) Pub Date : 2020-04-06
    Hidehisa Nishi; Naoya Oishi; Akira Ishii; Isao Ono; Takenori Ogura; Tadashi Sunohara; Hideo Chihara; Ryu Fukumitsu; Masakazu Okawa; Norikazu Yamana; Hirotoshi Imamura; Nobutake Sadamasa; Taketo Hatano; Ichiro Nakahara; Nobuyuki Sakai; Susumu Miyamoto

    Background and Purpose—For patients with large vessel occlusion, neuroimaging biomarkers that evaluate the changes in brain tissue are important for determining the indications for mechanical thrombectomy. In this study, we applied deep learning to derive imaging features from pretreatment diffusion-weighted image data and evaluated the ability of these features in predicting clinical outcomes for

    更新日期:2020-04-06
  • Thrombolysis With Alteplase at 0.6 mg/kg for Stroke With Unknown Time of Onset
    Stroke (IF 6.046) Pub Date : 2020-04-06
    Masatoshi Koga; Haruko Yamamoto; Manabu Inoue; Koko Asakura; Junya Aoki; Toshimitsu Hamasaki; Takao Kanzawa; Rei Kondo; Masafumi Ohtaki; Ryo Itabashi; Kenji Kamiyama; Toru Iwama; Taizen Nakase; Yusuke Yakushiji; Shuichi Igarashi; Yoshinari Nagakane; Shunya Takizawa; Yasushi Okada; Ryosuke Doijiri; Akira Tsujino; Yasuhiro Ito; Hideyuki Ohnishi; Takeshi Inoue; Yasushi Takagi; Yasuhiro Hasegawa; Yoshiaki

    Background and Purpose—We assessed whether lower-dose alteplase at 0.6 mg/kg is efficacious and safe for acute fluid-attenuated inversion recovery-negative stroke with unknown time of onset.Methods—This was an investigator-initiated, multicenter, randomized, open-label, blinded-end point trial. Patients met the standard indication criteria for intravenous thrombolysis other than a time last-known-well

    更新日期:2020-04-06
  • Protected Code Stroke
    Stroke (IF 6.046) Pub Date : 2020-04-01
    Houman Khosravani; Phavalan Rajendram; Lowyl Notario; Martin G. Chapman; Bijoy K. Menon

    Background and Purpose—Hyperacute assessment and management of patients with stroke, termed code stroke, is a time-sensitive and high-stakes clinical scenario. In the context of the current Coronavirus Disease 2019 (COVID-19) pandemic caused by the SARS-CoV-2 virus, the ability to deliver timely and efficacious care must be balanced with the risk of infectious exposure to the clinical team. Furthermore

    更新日期:2020-04-03
  • Temporary Emergency Guidance to US Stroke Centers During the COVID-19 Pandemic
    Stroke (IF 6.046) Pub Date : 2020-04-01

    During this unprecedented time of extraordinary stress on the US healthcare system, the AHA/ASA Stroke Council—as individuals in our localities and together as an entity at the national level—acknowledge the mounting concern regarding optimal stroke care during the COVID-19 pandemic among vascular neurologists and those clinicians who care for patients with stroke. We therefore seek to provide guidance

    更新日期:2020-04-03
  • Primate Version of Modified Rankin Scale for Classifying Dysfunction in Rhesus Monkeys
    Stroke (IF 6.046) Pub Date : 2020-04-01
    Di Wu; Longfei Wu; Jian Chen; Mitchell Huber; Xiaoduo He; Shengli Li; Yuchuan Ding; Xunming Ji

    Background and Purpose—Nonhuman primates are increasingly used in translational studies of ischemic stroke. However, current scoring systems in monkeys (eg, Nonhuman Primate Stroke Scale) do not focus on impairments in activities of daily living, so clinically relevant data are scarce for evaluating functional deficits in this model.Methods—Here, we referenced the modified Rankin Scale to provide a

    更新日期:2020-04-01
  • White Matter Hyperintensity, Immediate Antihypertensive Treatment, and Functional Outcome After Acute Ischemic Stroke
    Stroke (IF 6.046) Pub Date : 2019-10-28
    Shiguang Zhu; Sifan Qian; Tan Xu; Hao Peng; Ruiguo Dong; Dunjing Wang; Xiaodong Yuan; Libin Guo; Yonghong Zhang; Deqin Geng; Chongke Zhong

    Background and Purpose—It remains unknown that whether white matter hyperintensity (WMH) severity influences the effect of antihypertensive treatment in acute ischemic stroke. We aimed to investigate the effects of early antihypertensive treatment on death and disability among patients with acute ischemic stroke according to WMH severities.Methods—This study was a secondary analysis of the data from

    更新日期:2020-04-01
  • Independent Prognostic Value of MRproANP (Midregional Proatrial Natriuretic Peptide) Levels in Patients With Stroke Is Unaltered Over Time
    Stroke (IF 6.046) Pub Date : 2020-03-27
    Markus Arnold; Christos Nakas; Andreas Luft; Mirjam Christ-Crain; Alexander Leichtle; Mira Katan

    Background and Purpose—MRproANP (midregional proatrial natriuretic peptide) is known to be independently associated with cardioembolic stroke cause and to improve risk stratification for 90-day mortality when measured within 24 to 72 hours after symptom onset in patients with acute ischemic stroke. However, the optimal time point for assessment remains unclear. This study aimed to evaluate prognostic

    更新日期:2020-03-27
  • Incidence of Ischemic Stroke in Individuals With and Without Aortic Valve Stenosis
    Stroke (IF 6.046) Pub Date : 2020-03-27
    Charlotte Andreasen; Gunnar H. Gislason; Lars Køber; Jawdat Abdulla; Andreas Martinsson; J. Gustav Smith; Christian Torp-Pedersen; Charlotte Andersson

    Background and Purpose—Aortic valve stenosis may lead to atrial and ventricular remodeling, predisposes to atrial fibrillation, and may also be an independent risk factor of ischemic stroke. However, information on stroke rates among persons with aortic valve stenosis are sparse. We aimed to determine the incidence rates and relative risks of ischemic stroke in individuals with diagnosed aortic valve

    更新日期:2020-03-27
  • PERK (Protein Kinase RNA-Like ER Kinase) Branch of the Unfolded Protein Response Confers Neuroprotection in Ischemic Stroke by Suppressing Protein Synthesis
    Stroke (IF 6.046) Pub Date : 2020-03-26
    Ya-chao Wang; Xuan Li; Yuntian Shen; Jingjun Lyu; Huaxin Sheng; Wulf Paschen; Wei Yang

    Background and Purpose—Ischemic stroke impairs endoplasmic reticulum (ER) function, causes ER stress, and activates the unfolded protein response. The unfolded protein response consists of 3 branches controlled by ER stress sensor proteins, which include PERK (protein kinase RNA-like ER kinase). Activated PERK phosphorylates eIF2α (eukaryotic initiation factor 2 alpha), resulting in inhibition of global

    更新日期:2020-03-27
  • Focal Cerebral Arteriopathy in Young Adult Patients With Stroke
    Stroke (IF 6.046) Pub Date : 2020-03-26
    Mary Clare McKenna; Noel Fanning; Simon Cronin

    Background and Purpose—Focal cerebral arteriopathy is monophasic inflammatory stenosis of the distal internal carotid artery or the proximal segment of the middle cerebral artery. It is one of the most common causes of acute arterial ischemic stroke in young children but is a less familiar entity for adult neurologists.Methods—We retrospectively reviewed stroke service radiology records at a tertiary

    更新日期:2020-03-27
  • Stroke Prognostic Scores and Data-Driven Prediction of Clinical Outcomes After Acute Ischemic Stroke
    Stroke (IF 6.046) Pub Date : 2020-03-25
    Koutarou Matsumoto; Yasunobu Nohara; Hidehisa Soejima; Toshiro Yonehara; Naoki Nakashima; Masahiro Kamouchi

    Background and Purpose—Several stroke prognostic scores have been developed to predict clinical outcomes after stroke. This study aimed to develop and validate novel data-driven predictive models for clinical outcomes by referring to previous prognostic scores in patients with acute ischemic stroke in a real-world setting.Methods—We used retrospective data of 4237 patients with acute ischemic stroke

    更新日期:2020-03-26
  • Trends in Stroke Incidence in High-Income Countries in the 21st Century
    Stroke (IF 6.046) Pub Date : 2020-03-25
    Linxin Li; Catherine A. Scott; Peter M. Rothwell; on behalf of the Oxford Vascular Study

    Background and Purpose—Population-based studies provide the most reliable data on stroke incidence. A previous systematic review of population-based studies suggested that stroke incidence in high-income countries decreased by 42% between the 1970s and early 2000s. However, it is uncertain whether this trend of steady decline has been maintained in more recent periods.Methods—Data from OCSP (Oxfordshire

    更新日期:2020-03-26
  • Impact of Treatment Delay on Outcome in the International Subarachnoid Aneurysm Trial
    Stroke (IF 6.046) Pub Date : 2020-03-25
    Carlina E. van Donkelaar; Nicolaas A. Bakker; Jacqueline Birks; Alison Clarke; Mary Sneade; Richard S.C. Kerr; Nic J.G.M. Veeger; J. Marc C. van Dijk; Andrew J. Molyneux

    Background and Purpose—ISAT (International Subarachnoid Aneurysm Trial) demonstrated that 1 year after aneurysmal subarachnoid hemorrhage, coiling resulted in a significantly better clinical outcome than clipping. After 5 years, this difference did not reach statistical significance, but mortality was still higher in the clipping group. Here, we present additional analyses, reporting outcome after

    更新日期:2020-03-26
  • Dabigatran Reversal Before Intravenous Tenecteplase in Acute Ischemic Stroke
    Stroke (IF 6.046) Pub Date : 2020-03-25
    James Beharry; Michael J. Waters; Roy Drew; John N. Fink; Duncan Wilson; Bruce C.V. Campbell; Mark W. Parsons; Timothy J. Kleinig; Teddy Y. Wu

    Background and Purpose—Reversal of dabigatran before intravenous thrombolysis in patients with acute ischemic stroke has been well described using alteplase but experience with intravenous tenecteplase is limited. Tenecteplase seems at least noninferior to alteplase in patients with intracranial large vessel occlusion. We report on the experience of dabigatran reversal before tenecteplase thrombolysis

    更新日期:2020-03-26
  • Subarachnoid Extension Predicts Lobar Intracerebral Hemorrhage Expansion
    Stroke (IF 6.046) Pub Date : 2020-03-23
    Andrea Morotti; Loris Poli; Eleonora Leuci; Federico Mazzacane; Paolo Costa; Valeria De Giuli; Elisa Candeloro; Giorgio Busto; Ilaria Casetta; Giuseppe Micieli; Anna Cavallini; Massimo Gamba; Mauro Magoni; Alessandro Padovani; Alessandro Pezzini; Enrico Fainardi

    Background and Purpose—We investigated whether subarachnoid extension (SAHE) of intracerebral hemorrhage (ICH) is associated with hematoma expansion (HE).Methods—Retrospective analysis of patients with primary spontaneous ICH admitted at 3 academic hospitals in Italy. The study population was divided into a development and a replication cohort. SAHE was rated on baseline noncontrast computed tomography

    更新日期:2020-03-24
  • Derivation and Application of a Tool to Estimate Benefits From Multiple Therapies That Reduce Recurrent Stroke Risk
    Stroke (IF 6.046) Pub Date : 2020-03-23
    Adam Richards; Nicholas J. Jackson; Eric M. Cheng; Robert J. Bryg; Arleen Brown; Amytis Towfighi; Nerses Sanossian; Frances Barry; Ning Li; Barbara G. Vickrey

    Background and Purpose—Lowering blood pressure and cholesterol, antiplatelet/antithrombotic use, and smoking cessation reduce risk of recurrent stroke. However, gaps in risk factor control among stroke survivors warrant development and evaluation of alternative care delivery models that aim to simultaneously improve multiple risk factors. Randomized trials of care delivery models are rarely of sufficient

    更新日期:2020-03-24
  • Exome Sequencing in Suspected Monogenic Stroke
    Stroke (IF 6.046) Pub Date : 2020-03-16
    Christopher D. Anderson

    See related article, p 1056 Technical and informatic advances have led to increased availability and reduced cost of whole-exome sequencing (WES) and whole-genome sequencing for clinical purposes.1 Simultaneously, adoption of standards for classification of variants according to their potential pathogenicity has helped to facilitate the interpretation of identified variants for both the clinician and

    更新日期:2020-03-24
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  • Measuring Outcome After Stroke: More Lessons Learned Again.
    Stroke (IF 6.046) Pub Date : 2020-02-27
    Patrick D Lyden

    更新日期:2020-03-24
  • Whole-Exome Sequencing in 22 Young Ischemic Stroke Patients With Familial Clustering of Stroke
    Stroke (IF 6.046) Pub Date : 2020-03-16
    Andreea Ilinca; Nicolas Martinez-Majander; Sofie Samuelsson; Paul Piccinelli; Katarina Truvé; John Cole; Steven Kittner; Maria Soller; Ulf Kristoffersson; Turgut Tatlisumak; Andreas Puschmann; Jukka Putaala; Arne Lindgren

    Backgrounds and Purpose—Although new methods for genetic analyses are rapidly evolving, there are currently knowledge gaps in how to detect Mendelian forms of stroke.Methods—We performed whole-exome sequencing in 22 probands, under 56 years at their first ischemic stroke episode, from multi-incident stroke families. With the use of a comprehensive stroke-gene panel, we searched for variants in stroke-related

    更新日期:2020-03-24
  • Race and Ethnic Disparities in Stroke Incidence in the Northern Manhattan Study.
    Stroke (IF 6.046) Pub Date : 2020-02-12
    Hannah Gardener,Ralph L Sacco,Tatjana Rundek,Valeria Battistella,Ying Kuen Cheung,Mitchell S V Elkind

    Background and Purpose- An excess incidence of strokes among blacks versus whites has been shown, but data on disparities related to Hispanic ethnicity remain limited. This study examines race/ethnic differences in stroke incidence in the multiethnic, largely Caribbean Hispanic, NOMAS (Northern Manhattan Study), and whether disparities vary by age. Methods- The study population included participants

    更新日期:2020-03-24
  • Temporal Trends in Stroke Incidence Over Time by Sex and Age in the GCNKSS.
    Stroke (IF 6.046) Pub Date : 2020-02-12
    Tracy E Madsen,Jane C Khoury,Michelle Leppert,Kathleen Alwell,Charles J Moomaw,Heidi Sucharew,Daniel Woo,Simona Ferioli,Sharyl Martini,Opeolu Adeoye,Pooja Khatri,Matthew Flaherty,Felipe De Los Rios La Rosa,Jason Mackey,Eva Mistry,Stacie L Demel,Elisheva Coleman,Adam Jasne,Sabreena J Slavin,Kyle Walsh,Michael Star,Joseph P Broderick,Brett M Kissela,Dawn O Kleindorfer

    Background and Purpose- Sex differences in stroke incidence over time were previously reported from the GCNKSS (Greater Cincinnati/Northern Kentucky Stroke Study). We aimed to determine whether these differences continued through 2015 and whether they were driven by particular age groups. Methods- Within the GCNKSS population of 1.3 million, incident (first ever) strokes among residents ≥20 years of

    更新日期:2020-03-24
  • Self-Reported Fatigue Predicts Incident Stroke in a General Population: EPIC-Norfolk Prospective Population-Based Study.
    Stroke (IF 6.046) Pub Date : 2020-03-04
    Genevieve Barlas,Robert L Luben,Samuel R Neal,Nicholas J Wareham,Kay-Tee Khaw,Phyo K Myint

    Background and Purpose- Fatigue is a common symptom among stroke survivors and in general practice. However, the clinical significance of fatigue and its relationship to incident stroke is unclear. The aim of this study was to examine the relationship between self-reported fatigue and the incidence of stroke in a general population. Methods- This was a prospective, population-based study. The study

    更新日期:2020-03-24
  • Association Between High-Sensitivity Cardiac Troponin and Risk of Stroke in 96 702 Individuals: A Meta-Analysis.
    Stroke (IF 6.046) Pub Date : 2020-02-10
    Leonie H A Broersen,Helena Stengl,Christian H Nolte,Dirk Westermann,Matthias Endres,Bob Siegerink,Jan F Scheitz

    Background and Purpose- Our study aim was to estimate risk of incident stroke based on levels of hs-cTn (high-sensitivity cardiac troponin), a specific biomarker indicating myocardial injury, in the general population, patients with atrial fibrillation, and patients with previous stroke. Methods- Embase, PubMed, and Web of Science were searched until March 14, 2019 to identify relevant articles. Randomized

    更新日期:2020-03-24
  • Migraine With Aura as Early Disease Marker in Hereditary Dutch-Type Cerebral Amyloid Angiopathy.
    Stroke (IF 6.046) Pub Date : 2020-03-02
    Emma A Koemans,Sabine Voigt,Ingeborg Rasing,Ellis S van Etten,Erik W van Zwet,Marianne A A van Walderveen,Marieke J H Wermer,Gisela M Terwindt

    Background and Purpose- To determine whether migraine, which has often been described as an inaugural manifestation in monogenic cerebrovascular syndromes, is associated with cerebral amyloid pathology, we assessed migraine and its correlation with magnetic resonance imaging markers in Hereditary Dutch-Type Cerebral Amyloid Angiopathy (D-CAA or Hereditary Cerebral Hemorrhage With Amyloidosis-Dutch

    更新日期:2020-03-24
  • Electrocardiographic ST-T Abnormities Are Associated With Stroke Risk in the REGARDS Study.
    Stroke (IF 6.046) Pub Date : 2020-03-04
    Mitsuaki Sawano,Ya Yuan,Shun Kohsaka,Taku Inohara,Takeki Suzuki,Tomonori Okamura,George Howard,Virginia J Howard,Suzanne Judd,Elsayed Z Soliman,Mary Cushman

    Background and Purpose- In previous studies, isolated nonspecific ST-segment and T-wave abnormalities (NSSTTAs), a common finding on ECGs, were associated with greater risk for incident coronary artery disease. Their association with incident stroke remains unclear. Methods- The REGARDS (Reasons for Geographic and Racial Differences in Stroke) study is a population-based, longitudinal study of 30 239

    更新日期:2020-03-24
  • Calculation of Prognostic Scores, Using Delayed Imaging, Outperforms Baseline Assessments in Acute Intracerebral Hemorrhage
    Stroke (IF 6.046) Pub Date : 2020-03-10
    Ronda Lun; Vignan Yogendrakumar; Andrew M. Demchuk; Richard I. Aviv; David Rodriguez-Luna; Carlos A. Molina; Yolanda Silva; Imanuel Dzialowski; Adam Kobayashi; Jean-Martin Boulanger; Gordon Gubitz; Padma Srivastava; Jayanta Roy; Carlos S. Kase; Rohit Bhatia; Michael D. Hill; Dar Dowlatshahi

    Background and Purpose—Patients with intracerebral hemorrhage (ICH) are often subject to rapid deterioration due to hematoma expansion. Current prognostic scores are largely based on the assessment of baseline radiographic characteristics and do not account for subsequent changes. We propose that calculation of prognostic scores using delayed imaging will have better predictive values for long-term

    更新日期:2020-03-24
  • Statins and Risk of Intracerebral Hemorrhage in Individuals With a History of Stroke.
    Stroke (IF 6.046) Pub Date : 2020-03-02
    Anette Riisgaard Ribe,Claus Høstrup Vestergaard,Mogens Vestergaard,Henrik Schou Pedersen,Anders Prior,Lone Winther Lietzen,Peter Krogh Brynningsen,Morten Fenger-Grøn

    Background and Purpose- It has been suggested that statins increase the risk of intracerebral hemorrhage in individuals with a history of stroke, which has led to a precautionary principle of avoiding statins in patients with prior intracerebral hemorrhage. However, such prescribing reticence may be unfounded and potentially harmful when considering the well-established benefits of statins. This study

    更新日期:2020-03-24
  • Redefining Hematoma Expansion With the Inclusion of Intraventricular Hemorrhage Growth.
    Stroke (IF 6.046) Pub Date : 2020-02-06
    Vignan Yogendrakumar,Tim Ramsay,Dean A Fergusson,Andrew M Demchuk,Richard I Aviv,David Rodriguez-Luna,Carlos A Molina,Yolanda Silva,Imanuel Dzialowski,Adam Kobayashi,Jean-Martin Boulanger,Gord Gubitz,Padma Srivastava,Jayanta Roy,Carlos S Kase,Rohit Bhatia,Michael D Hill,Joshua N Goldstein,Dar Dowlatshahi,

    Background and Purpose- Definitions of significant hematoma expansion traditionally focus on changes in intraparenchymal volume. The presence of intraventricular hemorrhage (IVH) is a predictor of poor outcome, but current definitions of hematoma expansion do not include IVH expansion. We evaluated whether including IVH expansion to current definitions of hematoma expansion improves the ability to

    更新日期:2020-03-24
  • Soluble ST2 Is Associated With New Epileptiform Abnormalities Following Nontraumatic Subarachnoid Hemorrhage
    Stroke (IF 6.046) Pub Date : 2020-03-11
    India A. Lissak; Sahar F. Zafar; M. Brandon Westover; Riana L. Schleicher; Jennifer A. Kim; Thabele Leslie-Mazwi; Christopher J. Stapleton; Aman B. Patel; W. Taylor Kimberly; Eric S. Rosenthal

    Background and Purpose—We evaluated the association between 2 types of predictors of delayed cerebral ischemia after nontraumatic subarachnoid hemorrhage, including biomarkers of the innate immune response and neurophysiologic changes on continuous electroencephalography.Methods—We studied subarachnoid hemorrhage patients that had at least 72 hours of continuous electroencephalography and blood samples

    更新日期:2020-03-24
  • Selective Serotonin Reuptake Inhibitors and Intracerebral Hemorrhage Risk and Outcome.
    Stroke (IF 6.046) Pub Date : 2020-03-04
    Li Liu,Matthew Fuller,Tyler P Behymer,Yisi Ng,Thomas Christianson,Shreyansh Shah,Nicolas Kon Kam King,Daniel Woo,Michael L James

    Background and Purpose- Selective serotonin reuptake inhibitors (SSRIs) have a well-established association with bleeding complications and conflicting reports on outcome after stroke. We sought to evaluate whether pre-intracerebral hemorrhage (ICH) SSRI use increased ICH risk and post-ICH SSRI use improved ICH outcome. Methods- Through post hoc analysis of the ERICH study (Ethnic/Racial Variations

    更新日期:2020-03-24
  • Single-Dose Intraventricular Nimodipine Microparticles Versus Oral Nimodipine for Aneurysmal Subarachnoid Hemorrhage
    Stroke (IF 6.046) Pub Date : 2020-03-06
    Andrew P. Carlson; Daniel Hänggi; George K. Wong; Nima Etminan; Stephan A. Mayer; François Aldrich; Michael N. Diringer; Erich Schmutzhard; Herbert J. Faleck; David Ng; Benjamin R. Saville; Thomas Bleck; Robert Grubb Jr; Michael Miller; Jose I. Suarez; Howard M. Proskin; R. Loch Macdonald

    Background and Purpose—EG-1962 is a sustained release formulation of nimodipine administered via external ventricular drain in patients with aneurysmal subarachnoid hemorrhage. A randomized, open-label, phase 1/2a, dose-escalation study provided impetus for this study to evaluate efficacy and safety of a single intraventricular 600 mg dose of EG-1962 to patients with aneurysmal subarachnoid hemorrhage

    更新日期:2020-03-24
  • Atrial Fibrillation-Associated Ischemic Stroke Patients With Prior Anticoagulation Have Higher Risk for Recurrent Stroke.
    Stroke (IF 6.046) Pub Date : 2020-02-26
    Kanta Tanaka,Masatoshi Koga,Keon-Joo Lee,Beom Joon Kim,Eun Lyeong Park,Juneyoung Lee,Tadataka Mizoguchi,Sohei Yoshimura,Jae-Kwan Cha,Byung-Chul Lee,Jin Nakahara,Norihiro Suzuki,Hee-Joon Bae,Kazunori Toyoda,

    Background and Purpose- Ischemic stroke associated with nonvalvular atrial fibrillation (NVAF) despite prior anticoagulation may indicate underlying problems that nullify the stroke-preventing effects of oral anticoagulants. We aimed to evaluate the risk for recurrent stroke in patients with NVAF with prior anticoagulation, compared with that in patients without prior anticoagulation. Methods- This

    更新日期:2020-03-24
  • Reduced Cognitive Assessment Scores Among Individuals With Magnetic Resonance Imaging-Detected Vascular Brain Injury.
    Stroke (IF 6.046) Pub Date : 2020-03-04
    Sonia S Anand,Matthias G Friedrich,Dipika Desai,Karleen M Schulze,Philip Awadalla,David Busseuil,Trevor J B Dummer,Sébastien Jacquemont,Alexander Dick,David Kelton,Anish Kirpalani,Scott A Lear,Jonathan Leipsic,Michael D Noseworthy,Louise Parker,Grace Parraga,Paul Poirier,Paula Robson,Jean-Claude Tardif,Koon Teo,Jennifer Vena,Salim Yusuf,Alan R Moody,Sandra E Black,Eric E Smith,

    Background and Purpose- Little is known about the association between covert vascular brain injury and cognitive impairment in middle-aged populations. We investigated if scores on a cognitive screen were lower in individuals with higher cardiovascular risk, and those with covert vascular brain injury. Methods- Seven thousand five hundred forty-seven adults, aged 35 to 69 years, free of cardiovascular

    更新日期:2020-03-24
  • White Matter Integrity in Tanzanian Children With Sickle Cell Anemia
    Stroke (IF 6.046) Pub Date : 2020-03-06
    Mboka Jacob; Hanne Stotesbury; Jamie M. Kawadler; Winok Lapadaire; Dawn E. Saunders; Raphael Z. Sangeda; Clara Chamba; Ramadhan Kazema; Julie Makani; Fenella J. Kirkham; Chris A. Clark

    Background and Purpose—Widespread reductions in white matter integrity are associated with cognitive dysfunction in sickle cell anemia. Silent cerebral infarction (SCI), vasculopathy (VSC), and low hemoglobin concentration (Hb) are implicated; we aimed to determine independent contributions to microstructural white matter injury and whether white matter integrity differs across arterial territories

    更新日期:2020-03-24
  • Early Recanalization in Patients With Cerebral Venous Thrombosis Treated With Anticoagulation.
    Stroke (IF 6.046) Pub Date : 2020-03-02
    Diana Aguiar de Sousa,Lia Lucas Neto,Antonio Arauz,Ana Luísa Sousa,Denis Gabriel,Manuel Correia,Raquel Gil-Gouveia,Sara Penas,Mariana Carvalho Dias,Manuel A Correia,Marta Carvalho,Patrícia Canhão,José M Ferro

    Background and Purpose- The hypothesis that venous recanalization prevents progression of venous infarction is not established in patients with cerebral venous thrombosis (CVT). Evidence is also scarce on the association between residual symptoms, particularly headache, and the recanalization grade. We aimed to assess, in patients with CVT treated with standard anticoagulation, (1) the rate of early

    更新日期:2020-03-24
  • Does Device Selection Impact Recanalization Rate and Neurological Outcome?: An Analysis of the Save ChildS Study.
    Stroke (IF 6.046) Pub Date : 2020-03-02
    Peter B Sporns,Ronald Straeter,Jens Minnerup,Heinz Wiendl,Uta Hanning,René Chapot,Hans Henkes,Elina Henkes,Astrid Grams,Franziska Dorn,Omid Nikoubashman,Martin Wiesmann,Georg Bier,Anushe Weber,Gabriel Broocks,Jens Fiehler,Alex Brehm,Marios Psychogios,Daniel Kaiser,Umut Yilmaz,Andrea Morotti,Wolfgang Marik,Richard Nolz,Ulf Jensen-Kondering,Bernd Schmitz,Stefan Schob,Oliver Beuing,Friedrich Goetz,Johannes

    Background and Purpose- The recent Save ChildS study provides multicenter evidence for the use of mechanical thrombectomy in children with large vessel occlusion arterial ischemic stroke. However, device selection for thrombectomy may influence rates of recanalization, complications, and neurological outcomes, especially in pediatric patients of different ages. We, therefore, performed additional analyses

    更新日期:2020-03-24
  • Dabigatran Treatment of Acute Noncardioembolic Ischemic Stroke.
    Stroke (IF 6.046) Pub Date : 2020-02-26
    Ken S Butcher,Kelvin Ng,Patrick Sheridan,Thalia S Field,Shelagh B Coutts,Muzzafar Siddiqui,Laura C Gioia,Brian Buck,Michael D Hill,Jodi Miller,Ana C Klahr,Leka Sivakumar,Oscar R Benavente,Robert G Hart,Mike Sharma

    Background and Purpose- Patients with transient ischemic attack (TIA) and minor ischemic stroke are at risk for early recurrent cerebral ischemia. Anticoagulants are associated with reduced recurrence but also increased hemorrhagic transformation (HT). The safety of the novel oral anticoagulant dabigatran in acute stroke has not been evaluated. Methods- DATAS II (Dabigatran Treatment of Acute Stroke

    更新日期:2020-03-24
  • Effect of Steady and Dynamic Blood Pressure Parameters During Thrombectomy According to the Collateral Status
    Stroke (IF 6.046) Pub Date : 2020-03-11
    Benjamin Maïer; Cyril Dargazanli; Romain Bourcier; Maëva Kyheng; Julien Labreuche; Pascal J. Mosimann; Francesco Puccinelli; Guillaume Taylor; Morgan Le Guen; Romuald Riem; Jean-Philippe Desilles; William Boisseau; Robert Fahed; Hocine Redjem; Stanislas Smajda; Gabriele Ciccio; Simon Escalard; Raphaël Blanc; Michel Piotin; Betrand Lapergue; Mikael Mazighi; on behalf of the ASTER Trial

    Background and Purpose—Guidelines regarding blood pressure (BP) management during endovascular therapy (EVT) for anterior circulation strokes are questionable since the optimal BP target is a matter of debate. To evaluate the importance of hemodynamic control during EVT, we investigated the impact of dynamic and steady BP parameters during EVT on functional outcome (part 1) and according to the collateral

    更新日期:2020-03-24
  • Endovascular Thrombectomy for Acute Ischemic Strokes: Current US Access Paradigms and Optimization Methodology.
    Stroke (IF 6.046) Pub Date : 2020-02-12
    Amrou Sarraj,Sean Savitz,Deep Pujara,Haris Kamal,Kirsten Carroll,Faris Shaker,Sujan Reddy,Kaushik Parsha,Lauren E Fournier,Erica M Jones,Anjail Sharrief,Sheryl Martin-Schild,James Grotta

    Background and Purpose- Timely access to endovascular thrombectomy (EVT) centers is vital for best acute ischemic stroke outcomes. Methods- US stroke-treating centers were mapped utilizing geo-mapping and stratified into non-EVT or EVT if they reported ≥1 acute ischemic stroke thrombectomy code in 2017 to Center for Medicare and Medicaid Services. Direct EVT-access, defined as the population with the

    更新日期:2020-03-24
  • Impact of Body Temperature Before and After Endovascular Thrombectomy for Large Vessel Occlusion Stroke.
    Stroke (IF 6.046) Pub Date : 2020-02-27
    William K Diprose,Bernard Liem,Michael T M Wang,James A Sutcliffe,Stefan Brew,James R Caldwell,Ben McGuinness,Doug Campbell,P Alan Barber

    Background and Purpose- In ischemic stroke, body temperature is associated with functional outcome. However, the relationship between temperature and outcome may differ in the intraischemic and postischemic phases of stroke. We aimed to determine whether body temperature before or after endovascular thrombectomy (EVT) for large vessel occlusion stroke is associated with clinical outcomes. Methods-

    更新日期:2020-03-24
  • Redefined Measure of Early Neurological Improvement Shows Treatment Benefit of Alteplase Over Placebo.
    Stroke (IF 6.046) Pub Date : 2020-02-27
    Shashank Agarwal,Erica Scher,Aaron Lord,Jennifer Frontera,Koto Ishida,Jose Torres,Sara Rostanski,Eva Mistry,Brian Mac Grory,Shawna Cutting,Tina Burton,Brian Silver,Ava L Liberman,Mackenzie P Lerario,Karen Furie,James Grotta,Pooja Khatri,Jeffrey Saver,Shadi Yaghi

    Background and Purpose- The first of the 2 NINDS (National Institute of Neurological Disorders and Stroke) Study trials did not show a significant increase in early neurological improvement, defined as National Institutes of Health Stroke Scale (NIHSS) improvement by ≥4, with alteplase treatment. We hypothesized that early neurological improvement defined as a percentage change in NIHSS (percent change

    更新日期:2020-03-24
  • Benefit of Targeting a LDL (Low-Density Lipoprotein) Cholesterol <70 mg/dL During 5 Years After Ischemic Stroke.
    Stroke (IF 6.046) Pub Date : 2020-02-20
    Pierre Amarenco,Jong S Kim,Julien Labreuche,Hugo Charles,Maurice Giroud,Byung-Chul Lee,Marie-Hélène Mahagne,Norbert Nighoghossian,Philippe Gabriel Steg,Éric Vicaut,Eric Bruckert,

    Background and Purpose- The TST trial (Treat Stroke to Target) evaluated the benefit of targeting a LDL (low-density lipoprotein) cholesterol of <70 mg/dL to reduce the risk of cardiovascular events in 2860 patients with ischemic stroke with atherosclerotic stenosis of cerebral vasculature or aortic arch plaque >4 mm, in a French and Korean population. The follow-up lasted a median of 5.3 years in

    更新日期:2020-03-24
  • Trends of r-tPA (Recombinant Tissue-Type Plasminogen Activator) Treatment and Treatment-Influencing Factors in Acute Ischemic Stroke.
    Stroke (IF 6.046) Pub Date : 2020-03-02
    Martha Marko,Alexandra Posekany,Simon Szabo,Sebastian Scharer,Stefan Kiechl,Michael Knoflach,Wolfgang Serles,Julia Ferrari,Wilfried Lang,Peter Sommer,Stefan Greisenegger,

    Background and Purpose- Frequencies of treatment with r-tPA (recombinant tissue-type plasminogen activator) are increasing over the past 15 years. However, published data on the influence of various demographic and clinical factors on r-tPA treatment as well as estimates of future trajectories are limited. We evaluated time trends and future trajectories of r-tPA treatment in patients with acute stroke

    更新日期:2020-03-24
  • Smoking Paradox in Stroke Survivors?
    Stroke (IF 6.046) Pub Date : 2020-03-10
    Hao-Kuang Wang; Chih-Yuan Huang; Yuan-Ting Sun; Jie-Yuan Li; Chih-Hung Chen; Yu Sun; Chung-Hsiang Liu; Ching-Huang Lin; Wei-Lun Chang; Jiunn-Tay Lee; Sheng-Feng Sung; Po-Yen Yeh; Ta-Chang Lai; I-Ju Tsai; Mei-Chen Lin; Cheng-Li Lin; Chi-Pang Wen; Chung Y. Hsu; for the Taiwan Stroke Registry Investigators

    Background and Purpose—The observation that smokers with stroke could have better outcome than nonsmokers led to the term “smoking paradox.” The controversy of such a complex claim has not been fully settled, even though different case mix was noted. Analyses were conducted on 2 independent data sets to evaluate and determine whether such a paradox truly exists.Methods—Taiwan Stroke Registry with 88 925

    更新日期:2020-03-24
  • Circulating SHBG (Sex Hormone-Binding Globulin) and Risk of Ischemic Stroke: Findings From the WHI.
    Stroke (IF 6.046) Pub Date : 2020-02-12
    Tracy E Madsen,Xi Luo,Mengna Huang,Ki E Park,Marcia L Stefanick,JoAnn E Manson,Simin Liu

    Background and Purpose- Circulating levels of SHBG (sex hormone-binding globulin) have been inversely linked to obesity, diabetes mellitus, and other cardiometabolic disorders. It remains uncertain whether low SHBG is prospectively predictive of stroke risk, particularly in women. We investigated whether SHBG is associated with risk of incident ischemic stroke (IS) among women in the WHI (Women's Health

    更新日期:2020-03-24
  • Cost-Effectiveness of a Multifaceted Quality Improvement Intervention for Acute Ischemic Stroke in China.
    Stroke (IF 6.046) Pub Date : 2020-02-05
    Yuesong Pan,Lei Zhang,Zixiao Li,Xia Meng,Yilong Wang,Hao Li,Liping Liu,Yongjun Wang

    Background and Purpose- Multifaceted quality improvement interventions of stroke care have been shown to improve hospital personnel adherence to evidence-based performance measures and subsequent stroke outcomes. This study aimed to evaluate the cost-effectiveness of a multifaceted quality improvement intervention for stroke care in China, the world's largest low- and middle-income country. Methods-

    更新日期:2020-03-24
  • Novel Chronic Mouse Model of Cerebral Cavernous Malformations.
    Stroke (IF 6.046) Pub Date : 2020-01-29
    Cécile Cardoso,Minh Arnould,Coralie De Luca,Cécile Otten,Salim Abdelilah-Seyfried,Alonso Heredia,Anne-Louise Leutenegger,Markus Schwaninger,Elisabeth Tournier-Lasserve,Gwénola Boulday

    Background and Purpose- Cerebral cavernous malformations (CCMs) are vascular malformations of the brain that lead to cerebral hemorrhages. A pharmacological treatment is needed especially for patients with nonoperable deep-seated lesions. We and others obtained CCM mouse models that were useful for mechanistic studies and rapid trials testing the preventive effects of candidate drugs. The shortened

    更新日期:2020-03-24
  • Bone Marrow Mononuclear Cells Activate Angiogenesis via Gap Junction-Mediated Cell-Cell Interaction.
    Stroke (IF 6.046) Pub Date : 2020-02-19
    Akie Kikuchi-Taura,Yuka Okinaka,Yukiko Takeuchi,Yuko Ogawa,Mitsuyo Maeda,Yosky Kataoka,Teruhito Yasui,Takafumi Kimura,Sheraz Gul,Carsten Claussen,Johannes Boltze,Akihiko Taguchi

    Background and Purpose- Bone marrow mononuclear cells (BM-MNCs) are a rich source of hematopoietic stem cells and have been widely used in experimental therapies for patients with ischemic diseases. Activation of angiogenesis is believed to be one of major BM-MNC mode of actions, but the essential mechanism by which BM-MNCs activate angiogenesis have hitherto been elusive. The objective of this study

    更新日期:2020-03-24
  • Global Assessment of Mendelian Stroke Genetic Prevalence in 101 635 Individuals From 7 Ethnic Groups.
    Stroke (IF 6.046) Pub Date : 2020-02-28
    Nickrooz Grami,Michael Chong,Ricky Lali,Pedrum Mohammadi-Shemirani,David E Henshall,Kristiina Rannikmäe,Guillaume Paré

    Background and Purpose- Mendelian stroke confers a high lifetime risk for mutation carriers; however, ethnicity-specific prevalence estimates have been difficult to establish. Methods- Eighteen genes responsible for Mendelian stroke were investigated using the Genome Aggregation Database. Genome Aggregation Database participants belonged to 1 of 7 populations: African/African-American, Latino/Admixed

    更新日期:2020-03-24
  • Embolic Stroke of Undetermined Source and Sleep Disorders.
    Stroke (IF 6.046) Pub Date : 2020-02-11
    Laavanya Dharmakulaseelan,Nathan Chan-Smyth,Sandra E Black,Richard H Swartz,Brian J Murray,Mark I Boulos

    Background and Purpose- Compared with other causes of ischemic stroke, the mechanism of action of embolic stroke of undetermined source (ESUS) remains unclear, with previous literature suggesting that ESUS may be due to an undetected cardioembolic source. This study aimed to improve our understanding of the pathophysiology of ESUS through current knowledge of sleep disorders. Methods- Patients were

    更新日期:2020-03-24
  • Plasma Estradiol and Testosterone Levels and Ischemic Stroke in Postmenopausal Women.
    Stroke (IF 6.046) Pub Date : 2020-02-14
    Jie Hu,Jennifer H Lin,Monik C Jiménez,JoAnn E Manson,Susan E Hankinson,Kathryn M Rexrode

    Background and Purpose- Although exogenous hormone therapy (HT) use has been associated with increased risk of ischemic stroke in postmenopausal women, it remains unknown whether sex hormone levels contribute to ischemic stroke risk. We aimed to estimate associations between plasma sex hormone levels and ischemic stroke risk, by HT status, in a nested case-control study of postmenopausal women from

    更新日期:2020-03-24
  • Vertebrobasilar Artery Calcification and Outcomes in Posterior Circulation Large Vessel Occlusion Thrombectomy.
    Stroke (IF 6.046) Pub Date : 2020-02-14
    William K Diprose,James P Diprose,Gregory P Tarr,James Sutcliffe,Andrew McFetridge,Stefan Brew,James Caldwell,Ben McGuinness,Michael T M Wang,P Alan Barber

    Background and Purpose- Intracranial carotid artery calcification is associated with worse outcome in anterior circulation stroke patients who undergo endovascular thrombectomy. We investigated the association between vertebrobasilar artery calcification (VBAC) and outcome in patients undergoing endovascular thrombectomy for posterior circulation large vessel occlusion. Methods- Consecutive patients

    更新日期:2020-03-24
  • Evaluating Hematoma Expansion Scores in Acute Spontaneous Intracerebral Hemorrhage: A Systematic Scoping Review.
    Stroke (IF 6.046) Pub Date : 2020-01-22
    Vignan Yogendrakumar,Margaret Moores,Lindsey Sikora,Michel Shamy,Tim Ramsay,Dean Fergusson,Dar Dowlatshahi

    Background and Purpose- In acute spontaneous intracerebral hemorrhage, multiple hematoma expansion scores have been proposed for use in clinical trial environments. We performed a systematic scoping review to identify all existing hematoma expansion scores and describe their development, validation, and relative performance. Methods- Two reviewers searched MEDLINE, PUBMED, EMBASE, and CENTRAL (Cochrane

    更新日期:2020-03-24
  • Influence of Hemoglobin Concentration on Stroke Recurrence and Composite Vascular Events.
    Stroke (IF 6.046) Pub Date : 2020-02-11
    Jun Young Chang,Ji Sung Lee,Beom Joon Kim,Joon-Tae Kim,Jun Lee,Jae Kwan Cha,Dae-Hyun Kim,Yong-Jin Cho,Keun-Sik Hong,Soo Joo Lee,Jong-Moo Park,Byung-Chul Lee,Mi Sun Oh,Dong-Eog Kim,Kyung Bok Lee,Tae Hwan Park,Jay Chol Choi,Dong-Ick Shin,Wook-Joo Kim,Sung-Il Sohn,Hee-Joon Bae,Moon-Ku Han

    Background and Purpose- We evaluated whether hemoglobin concentration at admission was associated with stroke recurrence and composite vascular events (stroke, myocardial infarction, and vascular death) in acute ischemic stroke. Methods- We collected data from patients with acute ischemic stroke or transient ischemic attack from a multicenter stroke registry database in Korea. The association of hemoglobin

    更新日期:2020-03-24
  • Sudden Recanalization: A Game-Changing Factor in Endovascular Treatment of Large Vessel Occlusion Strokes.
    Stroke (IF 6.046) Pub Date : 2020-02-14
    Álvaro García-Tornel,Marta Rubiera,Manuel Requena,Marian Muchada,Jorge Pagola,David Rodriguez-Luna,Matias Deck,Jesus Juega,Noelia Rodríguez-Villatoro,Sandra Boned,Marta Olivé-Gadea,Alejandro Tomasello,Carlos Piñana,David Hernández,Carlos A Molina,Marc Ribo

    Background and Purpose- First pass (FP) recanalization has been shown to be a predictor of favorable outcome in endovascular treatment of stroke. The reasons why FP recanalization leads to better outcome as compared with multiple passes (MP) are unknown. We aim to investigate the recanalization pattern and its relationship with outcome. Methods- Six hundred nine consecutive patients underwent endovascular

    更新日期:2020-03-24
  • Stroke Outcome Prediction by Blood Pressure Variability, Heart Rate Variability, and Baroreflex Sensitivity.
    Stroke (IF 6.046) Pub Date : 2020-01-22
    Shujin Tang,Li Xiong,Yuhua Fan,Vincent C T Mok,Ka Sing Wong,Thomas W Leung

    Background and Purpose- Poststroke autonomic dysfunction portended an unfavorable prognosis. We investigated whether blood pressure variability (BPV), heart rate variability, and baroreflex sensitivity might predict stroke functional outcome. Methods- We calculated BPV, heart rate variability, baroreflex slope, and baroreflex effectiveness index from a 5-minute beat-to-beat blood pressure and heart

    更新日期:2020-03-24
  • Industry Payment to Vascular Neurologists: A 6-Year Analysis of the Open Payments Program From 2013 Through 2018.
    Stroke (IF 6.046) Pub Date : 2020-02-12
    Krishna Nalleballe,Sen Sheng,Chenghui Li,Ruchira Mahashabde,Amarnath R Annapureddy,Kamran Mudassar,Krishna Pothineni,Poornachand Veerapaneni,Yohei Harada,Abhishek Chilkulwar,Saritha Ranabothu,Aliza Brown,Nidhi Kapoor,Sanjeeva Onteddu

    Background and Purpose- Industry payments to physicians raise concerns regarding conflicts of interest that could impact patient care. We explored nonresearch and nonownership payments from industry to vascular neurologists to identify trends in compensation. Methods- Using Centers for Medicare and Medicaid Services and American Board of Psychiatry and Neurology data, we explored financial relationships

    更新日期:2020-03-24
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