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Prognostic value of histopathological thrombus age in large vessel occlusion related stroke. Cerebrovasc. Dis. Extra Pub Date : 2023-11-06 Bart Van Gorsel,Michel J M Remmers,Louwerens D Vos,Bas E Scholzel,Dirk A W Haans,Ruud A H M Aarts,Rob J Versteylen,Anouk G W Van Norden,Casper A M M Van Oers,Jeroen Vos,Sander J J IJsselmuiden,Ben J L Van Den Branden,Onno J De Boer,Farshad Imani,Marco Alings,Kartika R Pertiwi,Robbert J De Winter,Ishita Miah,Allard C Van Der Wal,Tim P Van De Hoef,Martijn Meuwissen
Introduction Acute mechanical thrombectomy is the preferred treatment for large vessel occlusion related stroke. Histopathological research on the obtained occlusive embolic thrombus may provide information regarding the etiology and pathology of the lesion to predict prognosis and propose possible future acute ischemic stroke therapy. Methods A total of 75 consecutive patients who presented to the
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Frequency and characteristics of spinal bleeding sources in non-traumatic angiogram-negative subarachnoid hemorrhage. Cerebrovasc. Dis. Extra Pub Date : 2023-10-28 Tim Lampmann,Simon Brandecker,Johannes Weller,Frederic Carsten Schmeel,Harun Asoglu,Motaz Hamed,Alexander Radbruch,Erdem Güresir,Hartmut Vatter,Mohammed Banat
INTRODUCTION Angiogram-negative subarachnoid hemorrhage (AN-SAH) accounts for 5-15% of spontaneous SAH. This study aims to analyze the frequency and characteristics of spinal bleeding sources in patients with AN-SAH. METHODS 140 patients suffering from AN-SAH treated at our institution from 2012 to 2022 were included in this retrospective cohort study. RESULTS 52.1% were diagnosed with perimesencephalic
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Clopidogrel-Related High Residual Platelet Reactivity Associated with Estimated Glomerular Filtration Rate in Patients with Acute Ischemic Stroke. Cerebrovasc. Dis. Extra Pub Date : 2023-10-09 Yongkang Zhang,Yuan Zong,Jiarui Liu,Kangli Yin,Yuzhen Wang,Yuefeng Bian,Yichen Huang,Wei Liu,Yemin Cao
INTRODUCTION There are few studies on the relationship between the occurrence of clopidogrel-related high residual platelet reactivity (HRPR) and estimated glomerular filtration rate (eGFR) at admission in patients with ischemic stroke. The aim of this study was to investigate the possible relationship between the two. METHODS Patients who were hospitalized and diagnosed with acute ischemic stroke
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Non hypertensives and those with normal cholesterol more likely to have concomitant cancer amongst patients with ischemic stroke: A retrospective cross sectional registry based study. Cerebrovasc. Dis. Extra Pub Date : 2023-09-29 Kendra Jing Ying Tang,Seyed Ehsan Saffari,Kaavya Narasimhalu,Kian Kheng Queck,Deidre Anne De Silva
INTRODUCTION Patients with cancer are known to have an increased risk of ischemic stroke (IS) around the time of their diagnosis. However, there is a paucity of data in Asian populations, and as such, we aimed to determine cancer incidence rates and patterns in Asian IS patients as well as investigate the differences in vascular risk profile of IS patients with and without concomitant cancer. METHODS
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Mechanical thrombectomy treatment beyond 16 hours from last known well in patients with large vessel occlusion. Cerebrovasc. Dis. Extra Pub Date : 2023-06-01 Takehiro Katano,Kentaro Suzuki,Ryutaro Kimura,Tomonari Saito,Yasuhiro Nishiyama,Kazumi Kimura
INTRODUCTION Mechanical thrombectomy (MT) has been reported to be effective within 24 h after last known well (LKW) by the DAWN (DWI or CTP Assessment with Clinical Mismatch in the Triage of Wake-Up and Late Presenting Strokes Undergoing Neurointervention with Trevo) trial and within 16 h after LKW by the DEFUSE-3 (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3) trial. However
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Comparative Study of Cerebral Venous Thrombosis-risk factors, clinical course and outcome in Subjects with and without Covid-19 infection Cerebrovasc. Dis. Extra Pub Date : 2023-04-25 Sajid Hameed, Anwar Hamza, Bushra Taimuri, Maria Khan, Man Mohan Mehndiratta, Mohammad Wasay
Background/ Objective: Cerebral venous thrombosis (CVT) has been increasingly reported in patients with COVID-19. Most published literature is descriptive and focuses only on CVT in COVID-19 patients. The objective of our study is to compare CVT patients’ characteristics with and without an associated COVID-19 infection. Materials and Methods: This is a retrospective cross-sectional study. All adult
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Artificial intelligence-assisted software significantly decreases all workflow metrics for large vessel occlusion transfer patients, within a large spoke and hub system Cerebrovasc. Dis. Extra Pub Date : 2023-02-14 Stavros Matsoukas, Laura K. Stein, Johanna T. Fifi
Background: Artificial intelligence (AI) software is increasingly applied in stroke diagnostics. Viz LVO (large vessel occlusion) is an AI-based software that is FDA-approved for LVO detection in CT Angiography (CTA) scans. We sought to investigate differences in transfer times [from peripheral (spoke) to central (hub) hospitals] for LVO patients between spoke hospitals that utilize Viz LVO and those
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Soluble ST2 Predicts Poor Functional Outcome in Acute Ischemic Stroke Patients Cerebrovasc. Dis. Extra Pub Date : 2023-02-08 Soumya Krishnamoorthy, Gurpreet Singh, Sapna Erat Sreedharan, Deepa Damayanthi, Srinivas Gopala, Madhusoodanan UK, Padmavathy N. Sylaja
Introduction: There is very limited data on the role of biomarkers correlating with the outcome in acute ischemic stroke (AIS). We evaluated the predictive values of the plasma concentrations of soluble Serum Stimulation-2 (sST2), Matrix Metalloproteinase-9 (MMP-9), and Claudin-5 in AIS. Methods: The biomarker levels in the plasma samples of consecutive AIS patients collected at baseline, 12 hours
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A pilot study of application of the Stroke Riskometer mobile app for assessment of the course and clinical outcomes of COVID-19 among hospitalised patients Cerebrovasc. Dis. Extra Pub Date : 2023-01-26 Alexander Merkin, Sofya Akinfieva, Oleg N. Medvedev, Rita V. Krishnamurthi, Alexey Gutsaluk, Ulf-Dietrich Reips, Rufat Kuliev, Evgeny Dinov, Igor Nikiforov, Nikolay Shamalov, Polina Shafran, Lyudmila Popova, Dmitry Burenchev, Valery L. Feigin
Background: Early determination of COVID-19 severity and health outcomes could facilitate better treatment of patients. Different methods and tools have been developed for predicting outcomes of COVID-19, but they are difficult to use in routine clinical practice. Methods: We conducted a prospective cohort study of inpatients aged 20-92 years, diagnosed with COVID-19 to determine whether their individual
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Evaluation of miCRovascular rarefaction in vascUlar Cognitive Impairment and heArt faiLure (CRUCIAL): Study protocol for an observational study Cerebrovasc. Dis. Extra Pub Date : 2023-01-16 Maud van Dinther, Jonathan Bennett, George D. Thornton, Paulien H.M. Voorter, Ana Ezponda Casajús, Alun Hughes, Gabriella Captur, Robert J. Holtackers, Julie Staals, Walter H. Backes, Gorka Bastarika, Elizabeth A.V. Jones, Arantxa González, Robert van Oostenbrugge, Thomas Alexander Treibel
Introduction: Microvascular rarefaction, the functional reduction in perfused microvessels and structural reduction of microvascular density, seems to be an important mechanism in the pathophysiology of small blood vessel related disorders including vascular cognitive impairment (VCI) due to cerebral small vessel disease and heart failure with preserved ejection fraction (HFpEF). Both diseases share
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Predicting atrial fibrillation after ischemic stroke: clinical, genetics and electrocardiogram modelling Cerebrovasc. Dis. Extra Pub Date : 2022-12-15 Mervyn Qi Wei Poh, Carol Huilian Tham, Jeremiah David Ming Siang Chee, Seyed Ehsan Saffari, Kenny Wee Kian Tan, Li Wei Tan, Ebonne Yulin Ng, Celestia Pei Xuan Yeo, Christopher Ying Hao Seet, Joanne Peiting Xie, Jonathan Yexian Lai, Rajinder Singh, Eng-King Tan, Tian Ming Tu
Introduction: Detection of atrial fibrillation (AF) is challenging in patients after ischemic stroke due to its paroxysmal nature. We aim to determine the utility of a combined clinical, electrocardiographic and genetic variables model to predict AF in a post-stroke population. Materials and Methods: We performed a cohort study at a single comprehensive stroke centre from 09/11/2009 to 31/10/2017.
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Carotid endarterectomy for symptomatic carotid stenosis: differences in patient profile in a Low-Middle Income Country Cerebrovasc. Dis. Extra Pub Date : 2022-12-08 Naveen Kumar Paramasivan, Padmavathy N. Sylaja, Shivanesan Pitchai, Unnikrishnan Madathipat, Sapna Erat Sreedharan, Sajith Sukumaran, Jissa Vinoda Thulaseedharan
Introduction: Carotid Endarterectomy (CEA) is the standard treatment for patients with symptomatic carotid stenosis. Data from Low- and Middle-Income Countries (LMIC) is sparse on CEA and its outcomes. We aimed to describe the profile of our patients, and factors associated with periprocedural cerebral ischemic events in patients with symptomatic carotid stenosis who underwent CEA in our institute
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Impact of patency of the carotid terminus and middle cerebral artery on early clinical outcomes in patients with acute internal carotid artery occlusion and mild symptoms Cerebrovasc. Dis. Extra Pub Date : 2022-10-24 Ryo Itabashi, Takuya Saito, Yuichi Kawabata, Yuya Kobayashi, Yukako Yazawa
Introduction: Both collateral flow via the internal carotid artery (ICA) terminus (ICT) and initial mild symptoms might be associated with favorable outcomes in patients with acute ICA occlusion (ICAO). This study aimed to address the association between early clinical outcomes and patency of the ICT and middle cerebral artery (MCA) in patients with acute ICAO with mild symptoms. Methods: Of 1214 consecutive
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Outcomes of Mild Stroke and High-risk Transient Ischemic Attack in Current Clinical Practice Cerebrovasc. Dis. Extra Pub Date : 2022-09-21 Apiluk Wesanonthawech, Pornpatr A. Dharmasaroja
Early assessment and management of patients with mild stroke and transient ischemic attack (TIA) by specialists were recommended. Objectives: To evaluate the outcomes of these patients, and identify the predictive factors of clinical progression, unfavorable outcomes and recurrent stroke. Materials and Methods: Patients with mild ischemic stroke (NIHSS≤5) and high-risk TIA were studied. All patients
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Serum prealbumin levels on admission as a prognostic marker in stroke patients treated with mechanical thrombectomy Cerebrovasc. Dis. Extra Pub Date : 2022-08-25
Background: Prealbumin is a marker of malnutrition and inflammation. It has been associated with poor prognosis in cardiovascular disease, but less is known in stroke patients. Our objective was to evaluate the association of prealbumin levels at admission with prognosis in patients with stroke treated with mechanical thrombectomy. Material Methods: Retrospective study of a prospective database of
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Serum Prealbumin Levels on Admission as a Prognostic Marker in Stroke Patients Treated with Mechanical Thrombectomy. Cerebrovasc. Dis. Extra Pub Date : 2022-08-25 Begoña López,Maria Castañón-Apilánez,Javier Molina-Gil,Santiago Fernández-Gordón Sánchez,Gemma González,Antía Reguera Acuña,Jose Maria Jimenez,Davinia Larrosa Campo,Montserrat González Delgado,Lorena Benavente-Fernández,Maria Rico-Santos,Carmen García-Cabo,Sergio Calleja Puerta,Elena López-Cancio
INTRODUCTION Prealbumin is a marker of malnutrition and inflammation. It has been associated with poor prognosis in cardiovascular disease, but less is known in stroke patients. Our objective was to evaluate the association of prealbumin levels at admission with prognosis in patients with stroke treated with mechanical thrombectomy. METHODS Retrospective study of a prospective database of consecutive
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Subarachnoid and Intraventricular Hemorrhage in a Patient with a Pure Arterial Malformation and Two Associated Aneurysms in the Posterior Inferior Cerebellar Artery: a Case Report and Literature Review Cerebrovasc. Dis. Extra Pub Date : 2022-08-10 Katarzyna Wójtowicz, Lukasz Przepiórka, Przemyslaw Kunert, Andrzej Marchel
Introduction Pure arterial malformations (PAMs) are rare vascular abnormalities defined as dilated, tortuous arterial loops without any associated venous compartment. PAMs are thought to be benign developmental anomalies that can be safely managed conservatively. Methods We present a case of life-threatening hemorrhage in a patient with a PAM associated with two aneurysms and review the literature
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Treatment in stroke unit and risk factor control reduce recurrent stroke risk Cerebrovasc. Dis. Extra Pub Date : 2022-07-06 S.D. Shani, Ravi Prasad Varma, Sankara P. Sarma, R.S. Sreelakshmi, R. Harikrishnan, V. Raman Kutty, P.N. Sylaja
Introduction: The risk factor control is an important predictor of risk of stroke recurrence. The attributable fraction which estimates the excess risk among the exposed stroke survivors has not been studied previously. We studied the attributable fraction for stroke recurrence in consecutive incident cases of recurrent stroke. Methods: A case control study with incident cases of recurrent stroke and
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Stroke severity among men and women acute ischemic stroke patients in the telestroke network Cerebrovasc. Dis. Extra Pub Date : 2022-06-08 Nicolas Poupore, Camron Edrissi, Mareshah Sowah, Madison Stanley, Jonah Joffe, Donovan Lewis, Teanda Cunningham, Carolyn Breauna Sanders, Krista Knisely, Chase Rathfoot, Thomas I. Nathaniel
Introduction. This study investigates gender differences among stroke patients treated in the telestroke network using specific risk factors that contribute to stroke severity. Methods. We examined gender differences in stroke severity among 454 patients hospitalized with acute ischemic stroke (AIS). The logistic regression model was used to predict clinical risk factors associated with stroke severity
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Comparison of Stroke Risk Factors Between Symptomatic and Asymptomatic Patients in a North American Moyamoya Disease Cohort Cerebrovasc. Dis. Extra Pub Date : 2022-05-19 Mukaish Kumar, Anthony Larson, Mohamed Sobhi Jabal, Lorenzo Rinaldo, Luis Savastano, Giuseppe Lanzino, Fredric Meyer, Vance Lehman, James P. Klaas
Background: Risk factors for stroke in symptomatic and asymptomatic moyamoya disease (MMD) patients has recently been reported in a Japanese cohort. Such information in a North American population is lacking. Objective: We sought to elucidate the prevalence of stroke risk factors among North American patients with ischemic, hemorrhagic, and asymptomatic MMD. Methods: We retrospectively reviewed our
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Impact of the COVID-19 Pandemic in the Acute Stroke Admissions and Outcomes in a Philippine Tertiary Hospital Cerebrovasc. Dis. Extra Pub Date : 2022-05-19 Liz Edenberg P. Quiles, Pearl Angeli B. Diamante, Jose Leonard V. Pascual
BACKGROUND AND PURPOSE: The coronavirus 2019 (COVID-19) pandemic has been continuing its global spread ever since it’s onset and efforts to curb the infection in multiple reports have contrasting effects on stroke severity, admissions and outcomes. In the Philippines, where the COVID-19 pandemic shows no signs of slowing down and has been in the world’s longest lockdown, we investigated the effect
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Low-Cost Feedback Program for Reducing the Door-to-Computed Tomography Time Cerebrovasc. Dis. Extra Pub Date : 2022-04-28 Takashi Mitsuhashi, Joji Tokugawa, Hitoshi Mitsuhashi
Introduction Early restoration of blood flow in stroke patients can be achieved by reducing the door-to-computed tomography (DTC) time. A previous study has proposed several methods to reduce the DTC time, but the implementation costs limit its transferability. This study aimed to propose a novel, simple, and low-cost method for reducing the DTC time by providing feedback on each patient’s DTC time
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Stroke Burden in Malaysia Cerebrovasc. Dis. Extra Pub Date : 2022-03-24 Kay Sin Tan, Narayanaswamy Venketasubramanian
Malaysia is located in the heart of South East Asia with two land masses, Peninsular Malaysia and East Malaysia which are separated by the South China Sea. Stroke or cerebrovascular disease is Malaysia’s third leading cause of death. There were 47, 911 incident cases, 19,928 deaths, 443,995 prevalent cases, and 512,726 DALYs lost due to stroke in 2019. Successive national health and morbidity surveys
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Stroke Burden and Stroke Services in Indonesia Cerebrovasc. Dis. Extra Pub Date : 2022-03-21 Narayanaswamy Venketasubramanian, Fenny L Yudiarto, Dodik Tugasworo
Stroke is a major cause of death and disability in Indonesia. Stroke requires high quality, fast and precise management to prevent and avoid disability and death. Stroke can be prevented by adequately controlling for risk factors and encouraging healthy life styles. Efforts are needed to organize health promotion programs at the community level. More and a better distribution of neurologists and n
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Efficacy of the MRA-based road mapping of the para-aortic access route before mechanical thrombectomy in patients with acute ischemic stroke Cerebrovasc. Dis. Extra Pub Date : 2022-03-17 Satoshi Kobayashi, Toshiya Osanai, Noriyuki Fujima, Akiyoshi Hamaguchi, Taku Sugiyama, Toshitaka Nakamura, Kazutoshi Hida, Miki Fujimura
Introduction: The aim of this study was to clarify whether magnetic resonance angiography (MRA) -based road mapping of the para-aortic trans-femoral access route can reduce the procedural time of mechanical thrombectomy in patients with acute ischemic stroke. We further investigated the role of pre-procedural MRA-based road mapping in optimal initial catheter selection for rapid mechanical thrombectomy
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Improving Stroke Care In Bhutan Cerebrovasc. Dis. Extra Pub Date : 2022-03-04 Yangchen Yangchen, Tashi Tenzin, Nar Bahadur Rai, Sonam Yangzom, Narayanaswamy Venketasubramanian
Developing nations face the double burden of communicable and non-communicable diseases. Bhutan is a developing country, and has achieved significant milestones in its health indicators. Increasing burden of stroke and the lack of evidence based stroke care system in the country’s hospitals is proving to be a challenge to provide quality stroke care. Despite the logistical challenge of referring stroke
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Prognostic factors of the lethality of stroke at the Sourô Sanou University Teaching Hospital (CHUSS) of Burkina Faso. Cerebrovasc. Dis. Extra Pub Date : 2022-03-02 Hervé B.N. Kpoda, Léon G.B. Savadogo, Délwendé R.S. Samadoulougou, Isidore T Traoré, Serge M.A. Somda, Daniel Lemogoum, Issiaka Sombié, Athanase Millogo, Michèle Dramaix, Philippe Donnen
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Improved stroke care in a primary stroke centre using AI-decision support Cerebrovasc. Dis. Extra Pub Date : 2022-02-08 Bence Gunda, Ain Neuhaus, Ildikó Sipos, Rita Stang, Péter Pál Böjti, Tímea Takács, Daniel Bereczki, Balázs Kis, István Szikora, George Harston
Background Patient selection for reperfusion therapies requires significant expertise in neuroimaging. Increasingly, machine learning based analysis is used for faster and standardized patient selection. However, there is little information on how such software influences real-world patient management. Aims We evaluated changes in thrombolysis and thrombectomy delivery following implementation of automated
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Cerebral Amyloid Angiopathy with Lobar Hemorrhages and CAA-Related Inflammation [CAA-RI] in an Indian Family Cerebrovasc. Dis. Extra Pub Date : 2022-01-27 Boby Varkey Maramattom
Introduction; Cerebral amyloid angiopathy (CAA) is a common cause of lobar intracerebral hemorrhage [ICH]. Sporadic CAA is far more common than hereditary CAA [h-CAA]. Familial cerebral amyloid angiopathy has not yet been described from India. Case report; Two elderly Indian women (a mother and daughter) presented seven years apart with features of CAA. The mother had presented with features of CAA-related
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Long term Post-Stroke Functional Outcomes: a comparison of diabetics and non-diabetics Cerebrovasc. Dis. Extra Pub Date : 2021-12-13 Deidre Anne de Silva, Kaavya Narasimhalu, Ian Wang Huang, Fung Peng Woon, John C. Allen, Meng Cheong Wong
Introduction: Diabetes mellitus (DM) is known to influence outcomes in the short-term following stroke. However, the impact of DM on long-term functional outcomes after stroke is unclear. We compared functional outcomes periodically over 7 years between diabetic and non-diabetic ischemic stroke patients and investigated the impact of DM on the long-term trajectory of post-stroke functional outcomes
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Stages and Processes of Change for Weight Loss in Acute Stroke or TIA Patients Living with Obesity Cerebrovasc. Dis. Extra Pub Date : 2021-12-10 Mitch Wilson, Hailey Orgass, Jennifer Dearborn-Tomazos
Background: Obesity is associated with an increased prevalence of vascular risk factors and incidence of stroke. As such weight loss is recommended for patients living with obesity in the secondary prevention of stroke. Few studies, however, have examined the stages and processes of change for weight loss in stroke patients living with obesity. Objective: To evaluate the stages and processes of change
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Changing the landscape of stroke in Egypt Cerebrovasc. Dis. Extra Pub Date : 2021-12-03 Hany Aref, Magd Zakaria, Hossam Shokri, Tamer Roushdy, Ahmed El Basiouny, Nevine El Nahas
Egypt, a low–middle-income country, is the most populated nation in the Middle East. In Egypt, the overall crude prevalence rate of stroke is high (963/100,000 inhabitants), and the incidence of stroke annually is approximately 150 000 to 210 000. The official national statistics indicate that diseases of the circulatory system, including stroke, are the primary cause of death in Egypt, where stroke
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10th Anniversary of Asia Pacific Stroke Organization: State of Stroke Care and Stroke Research in the Asia Pacific Cerebrovasc. Dis. Extra Pub Date : 2021-12-02 Kay-Sin Tan, Byung-Woo Yoon, Ruey-Tay Lin, Man Mohan Mehndiratta, Nijasri C. Suwanwela, Narayanaswamy Venketasubramanian
The Asia Pacific Stroke Organization is the largest international and professional stroke group in the region. It has worked consistently over the last 10 years to gain visibility and reliability across the Asia Pacific and beyond. The 10 year journey will be reviewed in the background of many internal and external developments including changes in Asia Pacific stroke epidemiology, stroke care systems
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Modeling the Impact of Prehospital Triage on a True-Life Drip and Ship Mechanical Thrombectomy Urban Patient Cohort Cerebrovasc. Dis. Extra Pub Date : 2021-11-25 Stavros Matsoukas, Brian Giovanni, Liorah Rubinstein, Shahram Majidi, Laura K. Stein, Johanna T. Fifi
Objective: The aim of the study was to model the effect of prehospital triage of emergent large vessel occlusion (ELVO) to endovascular capable center (ECC) on the timing of thrombectomy and intravenous (IV) thrombolysis using real-world data from a multihospital system. Methods: We selected a cohort of 77 consecutive stroke patients who were brought by emergency medical services (EMS) to a nonendovascular
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Long-term cognitive changes after revascularization surgery in adult patients with ischemic moyamoya disease Cerebrovasc. Dis. Extra Pub Date : 2021-11-22 Shun Uchida, Yoshitaka Kubo, Daisuke Oomori, Masahiro Yabuki, Kei Kitakami, Shunrou Fujiwara, Kenji Yoshida, Masakazu Kobayashi, Kazunori Terasaki, Kuniaki Ogasawara
Introduction: Revascularization surgery for adult moyamoya disease (MMD) with ischemic presentation changes cognitive function and prevents further cerebral ischemic events. Most studies, however, repeated neuropsychological evaluation within 1 year after surgery. Our previous prospective cohort study of adult patients with MMD with misery perfusion who underwent direct revascularization surgery showed
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Short-Vessel Occlusion Might Indicate Higher Possibility of Success in Reperfusion following Mechanical Thrombectomy in Acute Middle Cerebral Artery Occlusion Cerebrovasc. Dis. Extra Pub Date : 2021-11-12 Tomoyuki Yoshihara, Ryuzaburo Kanazawa, Takanori Uchida, Tetsuhiro Higashida, Hidenori Ohbuchi, Naoyuki Arai, Yuichi Takahashi
Background: The impact of the length of the occluded vessel in acute large-vessel occlusion on successful reperfusion by mechanical thrombectomy remains unclear. This study evaluated whether diameter and length of the occluded vessel in acute middle cerebral artery (MCA) occlusion might relate to successful reperfusion following mechanical thrombectomy. Methods: This retrospective study included patients
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Accession Site Does Not Influence the Risk of Stroke after Diagnostic Coronary Angiography or Intervention: Results from a Large Prospective Registry Cerebrovasc. Dis. Extra Pub Date : 2021-10-28 Jan Matějka, Ivo Varvařovský, Jan Tužil, Tomáš Doležal, Martin Bobak, Jan Pospíchal, Petr Geier, Jiří Vondrák, Karel Bláha, Jan Málek, Alena Staňková, Juraj Bujdák, Vladimír Rozsíval, Vojtěch Novotný, Tomáš Lazarák, Milan Plíva, Jan Večeřa, Petr Vojtíšek
Introduction: Periprocedural stroke represents a rare but serious complication of cardiac catheterization. Pooled data from randomized trials evaluating the risk of stroke following cardiac catheterization via transradial versus transfemoral access showed no difference. On the other hand, a significant difference in stroke rates favoring transradial access was found in a recent meta-analysis of observational
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Stroke Care in Pakistan Cerebrovasc. Dis. Extra Pub Date : 2021-10-25 Anjum Farooq, Narayanaswamy Venketasubramanian, Mohammad Wasay
Increasing incidence of stroke and lack of infrastructure in both urban and rural areas needs immediate attention in Pakistan. There is a high proportion of young stroke with poor stroke outcomes. Acute stroke care is scarce in Pakistan due to the small number of neurologists (1 neurologist per 1 million population), few stroke units, and limited availability of alteplase (recombinant tissue plasminogen
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The Feasibility of Mechanical Thrombectomy on Single-Plane Angiosuite: An In-Depth Analysis of Procedure Time Cerebrovasc. Dis. Extra Pub Date : 2021-10-15 Hiroyasu Inoue, Masahiro Oomura, Yusuke Nishikawa, Mitsuhito Mase, Noriyuki Matsukawa
Introduction: Mechanical thrombectomy (MT) is usually performed on biplane (BP) angiosuites. When the BP angiosuite is not available, the single-plane (SP) angiosuite may be a substitute. However, the feasibility of MT performed on the SP angiosuite is yet to be elucidated. Therefore, we investigated the alternative effect of the SP angiosuite on the detailed division of procedure time, recanalization
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Self-Efficacy Is a Modifiable Factor Associated with Frailty in Those with Minor Stroke: Secondary Analysis of 200 Cohort Respondents Cerebrovasc. Dis. Extra Pub Date : 2021-10-08 Abodunrin Quadri Aminu, Roderick Wondergem, Yvonne Van Zaalen, Martijn Pisters
Background: Owing to the improvement in acute care, there has been an increase in the number of people surviving stroke and living with its impairments. Frailty is common in people with stroke and has a significant impact on the prognosis after stroke. To reduce frailty progression, potentially modifiable factors should be identified. Increasing levels of self-efficacy influence both behaviour and
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Women and Stroke: Different, yet Similar Cerebrovasc. Dis. Extra Pub Date : 2021-10-08 Nandini Mitta, Sapna Erat Sreedharan, Sankara P. Sarma, Padmavathy N. Sylaja
Background: The impact of gender on acute ischemic stroke, in terms of presentation, severity, etiology, and outcome, is increasingly getting recognized. Here, we analyzed the gender-related differences in etiology and outcome of ischemic stroke in South India. Methods: Patients with first ever ischemic stroke within 1 week of onset presenting to the Comprehensive Stroke Care Centre, Sree Chitra Tirunal
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Attack Interval Is the Key to the Likely Pathogenesis of Multiple Transient Ischemic Attacks Cerebrovasc. Dis. Extra Pub Date : 2021-09-30 Yoshinari Nagakane, Tomoyuki Ohara, Eijirou Tanaka, Takehiro Yamada, Shinji Ashida, Yuta Kojima, Keiko Maezono, Shiori Ogura, Daisuke Nakashima, Takamasa Kitaoji, Yasumasa Yamamoto
Introduction: The aim of this study was to test the hypothesis that the attack interval of multiple transient ischemic attacks (TIAs) is correlated with the underlying pathogenesis of ischemia. Methods: Patients with multiple TIAs, defined as 2 or more motor deficits within 7 days, were studied. The attack interval between the last 2 episodes was classified into 3 groups: 2 episodes within an hour
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Left Atrial Enlargement on Non-Gated CT Is Associated with Large Vessel Occlusion in Acute Ischaemic Stroke Cerebrovasc. Dis. Extra Pub Date : 2021-09-22 Waleed Butt, Permesh Singh Dhillon, Robert Lenthall, Luqman Malik, Wazim Izzath, Kailash Krishnan, Bindu George, Kate Pointon
Background: Recent reports have suggested that atrial fibrillation (AF) is more prevalent in the large vessel occlusion (LVO) subgroup of acute ischaemic stroke patients. Given the association between left atrial enlargement (LAE) and AF, we sought to evaluate the feasibility of assessing LAE on non-gated CT and its association with LVO in the hyperacute stroke setting. Methods: We analysed our prospectively
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The Benefit of Endovascular Thrombectomy for Stroke on Functional Outcome Is Sustained at 12 Months Cerebrovasc. Dis. Extra Pub Date : 2021-08-06 Balaki Parameshwaran, Dennis Cordato, Mark Parsons, Andrew Cheung, Nathan Manning, Jason Wenderoth, Cecilia Cappelen-Smith
Background and Purpose: The short-term benefits of endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) have been widely documented, yet there is limited evidence to show that this is sustained in the long term. We aimed to determine whether the benefit of EVT on functional outcome at 3 months is maintained at 12 months and the factors correlating with functional independence and quality
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Endovascular Treatment in Acute Ischemic Stroke Adoption and Practice: A Single-Center Indonesian Experience Cerebrovasc. Dis. Extra Pub Date : 2021-07-20 Taufik Mesiano, Mohammad Kurniawan, Kevin M. Saputri, Rakhmad Hidayat, Affan P. Permana, Al Rasyid, Salim Harris
Indonesia is facing increasing stroke prevalence in the past 5 years. Ischemic stroke imposes economic and productivity burden if it is not addressed properly. Endovascular treatment studies are conducted in developed countries where facilities and cost do not count in therapy consideration if it is indicated. Developing countries like Indonesia should work hard to provide the best hyperacute stroke
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Warning Signs in the Era of Unruptured Intracranial Aneurysms: Report on 2 Cases of Fatal Aneurysmal Hemorrhage Cerebrovasc. Dis. Extra Pub Date : 2021-07-20 Katarzyna Wójtowicz, Przemysław Kunert, Łukasz Przepiórka, Andrzej Marchel
Introduction: The timing of treatment remains unresolved for patients with unruptured intracranial aneurysms (UIAs) and headaches, particularly when the pain is short term, localized, and related to the aneurysm site. We lack evidence to support the notion that when a headache accompanies an aneurysm, it elevates the risk of rupture. Results: We describe 2 cases of fatal subarachnoid hemorrhage in
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Stroke Burden and Stroke Services in Bangladesh Cerebrovasc. Dis. Extra Pub Date : 2021-07-09 Narayanaswamy Venketasubramanian, Muzharul Mannan
Cerebrovasc Dis Extra 2021;11:69–71
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Superb Microvascular Imaging Ultrasound for Cervical Carotid Artery Stenosis for Prediction of the Development of Microembolic Signals on Transcranial Doppler during Carotid Exposure in Endarterectomy Cerebrovasc. Dis. Extra Pub Date : 2021-05-25 Takayuki Chiba, Shunrou Fujiwara, Kazumasa Oura, Kohki Oikawa, Kokei Chida, Masakazu Kobayashi, Kenji Yoshida, Yoshitaka Kubo, Tetsuya Maeda, Ryo Itabashi, Kuniaki Ogasawara
Introduction: During exposure of the carotid arteries, embolism from the surgical site is recognized as a primary cause of neurological deficits or new cerebral ischemic lesions following carotid endarterectomy (CEA), and associations have been reported between histological neovascularization in the carotid plaque and both plaque vulnerability and the development of artery-to-artery embolism. Superb
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Stroke Burden and Services in the Philippines Cerebrovasc. Dis. Extra Pub Date : 2021-05-11 Jose C. Navarro, Narayanaswamy Venketasubramanian
Cerebrovasc Dis Extra 2021;11:52–54
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Cerebral Venous Thrombosis Associated with COVID-19 Infection: An Observational, Multicenter Study Cerebrovasc. Dis. Extra Pub Date : 2021-05-11 Sajid Hameed, Mohammad Wasay, Bashir A. Soomro, Ossama Mansour, Foad Abd-allah, Tianming Tu, Raja Farhat, Naila Shahbaz, Husnain Hashim, Wasim Alamgir, Athar Iqbal, Maria Khan
Background and Purpose: Coronavirus disease 2019 (COVID-19) has an increased propensity for systemic hypercoagulability and thromboembolism. An association with cerebrovascular diseases, especially cerebral venous thrombosis (CVT), has been reported among these patients. The objective of the present study was to identify risk factors for CVT as well as its presentation and outcome in COVID-19 patients
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Burden of Stroke in Myanmar Cerebrovasc. Dis. Extra Pub Date : 2021-05-10 Narayanaswamy Venketasubramanian, Yee Mon Khine, Ohnmar Ohnmar, Myat Po Po Kyaw Khin, Min Thit Win
Myanmar is home to over 51 million people. The age- and sex-standardized mortality rate due to stroke is 165.4/100,000, while the rate of age- and sex-standardized disability-adjusted life years lost due to stroke is 2971.3/100,000. The prevalence of stroke among adults aged 40–99 years is 1.5%. Stroke is the leading cause of morbidity and mortality and comprises 20% of the neurological workload. There
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Stroke in Sri Lanka: How Can We Minimise the Burden? Cerebrovasc. Dis. Extra Pub Date : 2021-04-28 Udaya K. Ranawaka, Narayanaswamy Venketasubramanian
The burden of stroke in Sri Lanka is high and steadily increasing. Accurate estimation of the burden is hampered by a paucity of epidemiological data. More neurologists, stroke units, facilities for modern treatments and multi-disciplinary rehabilitation services are urgently needed. Essential drugs for risk factor control and secondary prevention are available in many hospitals. Aggressive preventive
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Management of Patients with Cranial Dural Arteriovenous Fistula and Secondary Parkinson's Syndrome: Comment Cerebrovasc. Dis. Extra Pub Date : 2021-04-12 Pinar Beyaz, Gerasimos Baltsavias
Cerebrovasc Dis Extra 2021;11:45
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Ten Years of Cerebrovascular Diseases EXTRA Cerebrovasc. Dis. Extra Pub Date : 2021-03-26
Cerebrovasc Dis Extra 2021;11:44–44
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Identification of Biomarkers in Patients with Thrombotic Thrombocytopenic Purpura Presenting with Large and Small Ischemic Stroke Cerebrovasc. Dis. Extra Pub Date : 2021-02-18 Chen Lin, Raima Memon, Jingrui Sui, X. Long Zheng
Background: Thrombotic thrombocytopenic purpura (TTP) is a rare blood disorder resulting in organ damage including ischemic strokes. We sought to characterize the neuroimaging patterns of stroke in a large cohort of patients with immune-mediated TTP (iTTP) and determined their associations with clinical and laboratory parameters and outcomes. Methods: We analyzed the Alabama TTP Registry who had laboratory
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Using Ultrasound and Inflammation to Improve Prediction of Ischemic Stroke: A Secondary Analysis of the Multi-Ethnic Study of Atherosclerosis Cerebrovasc. Dis. Extra Pub Date : 2021-02-18 Hediyeh Baradaran, Alen Delic, Ka-Ho Wong, Nazanin Sheibani, Matthew Alexander, J. Scott McNally, Jennifer J. Majersik, Adam De Havenon
Introduction: Current ischemic stroke risk prediction is primarily based on clinical factors, rather than imaging or laboratory markers. We examined the relationship between baseline ultrasound and inflammation measurements and subsequent primary ischemic stroke risk. Methods: In this secondary analysis of the Multi-Ethnic Study of Atherosclerosis (MESA), the primary outcome is the incident ischemic
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Detection of Major Cardioembolic Sources in Real-World Patients with Ischemic Stroke or Transient Ischemic Attack of Undetermined Cause Cerebrovasc. Dis. Extra Pub Date : 2021-02-01 Gerlinde van der Maten, Jorieke M.B. Reimer, Matthijs F.L. Meijs, Clemens von Birgelen, Marjolein G.J. Brusse-Keizer, Heleen M. den Hertog
Background/Aim: Current guidelines recommend transthoracic echocardiography (TTE) and ambulatory rhythm monitoring following ischemic stroke or transient ischemic attack (TIA) of undetermined cause for identifying cardioembolic sources (CES). Due to ongoing controversies about this routine strategy, we evaluated its yield in a real-world setting. Methods: In a tertiary medical center, we retrospectively
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Intracerebral Hemorrhage Recurrence in Patients with and without Cerebral Amyloid Angiopathy Cerebrovasc. Dis. Extra Pub Date : 2021-01-27 João Pinho, José Manuel Araújo, Ana Sofia Costa, Fátima Silva, Alexandra Francisco, Miguel Quintas-Neves, João Soares-Fernandes, Carla Ferreira, Tiago Gil Oliveira
Background: Intracerebral hemorrhage (ICH) recurrence risk is known to be higher in patients with cerebral amyloid angiopathy (CAA) as compared to other causes of ICH. Risk factors for ICH recurrence are not completely understood, and our goal was to study specific imaging microangiopathy markers. Methods: Retrospective case-control study of patients with non-traumatic ICH admitted to a single center
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Residual Stroke Risk in Patients with Atrial Fibrillation Treated with Non-Vitamin K Oral Anticoagulants: An 8-Year Retrospective Cohort Study Cerebrovasc. Dis. Extra Pub Date : 2021-01-18 Cheuk Ling Charing Szeto, Kwok Fai Hui
Background: Use of non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention in non-valvular atrial fibrillation (NVAF) is common and significantly reduces stroke occurrence. Yet little is known about patients who have a stroke despite treatment. Objective: The aim of this work was to study the epidemiology of patients with stroke despite being treated with NOACs. Methods: We identified
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Role of Favorable Perfusion Imaging in Predicting the Outcome of Patients with Acute Ischemic Stroke due to Large Vessel Occlusion Undergoing Effective Thrombectomy: A Single-Center Study Cerebrovasc. Dis. Extra Pub Date : 2021-01-15 Riccardo Di Iorio, Fabio Pilato, Iacopo Valente, Andrea Laurienzo, Simona Gaudino, Giovanni Frisullo, Paolo Profice, Simone Cottonaro, Andrea Alexandre, Pietro Caliandro, Roberta Morosetti, Emilio Lozupone, Francesco D'Argento, Alessandro Pedicelli, Cesare Colosimo, Paolo Calabresi, Giacomo Della Marca, Aldobrando Broccolini
Introduction: We sought to verify the predicting role of a favorable profile on computed tomography perfusion (CTP) in the outcome of patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO) undergoing effective mechanical thrombectomy (MT). Methods: We retrospectively enrolled 25 patients with AIS due to LVO and with a CTP study showing the presence of ischemic penumbra who underwent