共查询到20条相似文献，搜索用时 24 毫秒
1.
Bo Shen Xu YANG Ru-bo Sui Bo Yang 《Journal of stroke and cerebrovascular diseases》2018,27(10):2877-2886
Background
Acute ischemic stroke (AIS) has a higher morbidity and mortality rate. Many prediction tools have been developed to predict the risk of poor outcomes in patients after AIS, such as the THRIVE score, the iScore score, and the ASTRAL score. However, the predictive value of above 3 prediction tools in Chinese patients with AIS need to be further verified. So, this study aimed to determine the ability of the THRIVE score, the iScore score, and the ASTRAL score in predicting clinical poor outcomes in Chinese patients with AIS at 1 year.Methods
A total of 772 patients with AIS were included in this study. The baseline data of all patients were collected. The THRIVE score, the iScore score, and the ASTRAL score were calculated. All patients were followed up at 1 year. The poor outcome was defined as death, moderate/severe disabilities (modified Rankin scale, mRS > 2), most severe disability (mRS ≥ 5). Model discrimination was quantified by calculating the area under the receiver operating characteristic curve (AUC). The calibration was assessed using Hosmer–Lemeshow goodness-of-fit test and Pearson correlation coefficient.Results
We identified 576 (74.6%) patients with good prognosis and 196 (25.4%) patients with poor prognosis. AUC values of THRIVE score in predicting 1-year poor prognosis was lower than the iScore score and the ASTRAL scores (P < .05). The chi-square values of Hosmer-Lemeshow for the 3 prediction tools were 2.114, 4.877, 5.838 (all P < .05), respectively. There was a high correlation between the observed and the expected poor prognosis (Pearson correlation coefficient, .985, .693, and .620; all P < .05). AUC values of THRIVE score in predicting 1-year mortality and severe disability were lower than the iScore scores (all P < .05).Conclusions
The iScore score and the ASTRAL score reliably predict 1-year poor outcomes in Chinese patients with AIS, and the iScore score can accurately predict 1-year mortality and severe disability in Chinese AIS patients. 相似文献2.
Takahiro Ota Keigo Shigeta Tatsuo Amano Masayuki Ueda Teruyuki Hirano Yuji Matsumaru Yoshiaki Shiokawa 《Journal of stroke and cerebrovascular diseases》2018,27(11):3350-3355
Background and Purpose
To improve results of acute thrombectomy, the time from stroke onset to efficient recanalization must be minimized. Studies have confirmed the importance of rapid treatment, workflow, and efficient team-based care for acute thrombectomy in large vessel occlusion. This study examined the challenges facing mechanical thrombectomy in the Tama area (population, 4.3 million), a densely populated urban area of Tokyo, Japan, and analyzed retrospective data from the Tama-REgistry of Acute endovascular Thrombectomy.Methods
This study was a retrospective observational study using data from Tama-REgistry of Acute endovascular Thrombectomy, a multicenter registry of mechanical thrombectomy for acute ischemic stroke in the Tama area of Tokyo. The survey covered 396 patients with large vessel occlusion who underwent acute thrombectomy between January 2015 and March 2017. Participating facilities are 12 of the 13 recanalization therapy-capable stroke centers.Results
We analyzed 326 cases for which modified Rankin Scale score at 90days was available, of which 264 cases were directly admitted, and 62 cases were transferred from other stroke centers. Median time from stroke onset to hospital arrival was 111 minutes, and from arrival to efficient recanalization was 135 minutes. Efficient recanalization was achieved in 257 cases (78.8%), symptomatic hemorrhage developed in 19 cases (5.8%), and modified Rankin Scale 0-2 at 90days was seen in 129 cases (39.6%). The vast majority of patients (n?=?299, 94.3%) were transferred within 10km to the enrolling hospital.Conclusions
These results provide useful information about the emergent transfer system for patients with large vessel occlusion in a densely populated urban area. 相似文献3.
Haihua Yang Ning Ma Lian Liu Feng Gao Dapeng Mo Xuan Sun Zhongrong Miao 《Journal of stroke and cerebrovascular diseases》2018,27(10):2822-2828
Background
The diffusion-weighted imaging (DWI) brain stem score (BSS) is an easy to use and can predict the clinical outcome of acute basilar artery occlusion (BAO) who underwent endovascular thrombectomy. The purpose of the current study was to validate its performance in Chinese acute BAO patients treated with mechanical thrombectomy.Methods
Fifty consecutive patients with acute BAO who received early magnetic resonance imaging and treated with mechanical thrombectomy in a single-center were included. Early ischemic damage on DWI was evaluated by applying BSS system. Receiver operating characteristic (ROC) curve analysis was used to evaluate the performance of the score system and multivariate logistic regression analysis was performed to identify predictor of clinical outcome.Results
Favorable outcomes were achieved in 38% patients (19 of 50 patients). Recanalization was successful in 92% patients (46 of 50 patients). Mortality rate was 26% (n?=?13/50). In ROC curve analysis, the area under ROC curve of BSS .864 (95% confidence interval [CI], .738-.945) to predict favorable and .769 (95% CI, .628-.877) to predictor mortality. In logistic regression adjusted for age, baseline National Institute of Health Stroke Scale and time to puncture, DWI BSS ≤2 (odds ratio [OR], 12.416; 95% CI, 2.520-61.179; P?=?.002) and DWI BSS >3 (OR, 7.871; 95% CI, 1.353-45.797; P?=?.022) were the independent predictor for favorable outcome and mortality at 3 months respectively.Conclusions
The results of this study suggest that the DWI BSS can be used to predict clinical outcome in patients with acute BAO treated with mechanical thrombectomy at 3 months. 相似文献4.
Edgar A. Samaniego Jorge A Roa Kaustubh Limaye Harold P. Adams 《Journal of stroke and cerebrovascular diseases》2018,27(10):2555-2571
Background
The treatment of acute ischemic stroke due to large vessel occlusion (LVO) has revolutionized in the last decade. We sought to compile the most relevant literature published about the evolution in treating this disabling and fatal disease.Methods
A literature review of recent studies describing early treatment options like intravenous tissue plasminogen activator to the latest mechanical thrombectomy (MT) techniques was performed. We described in a chronological order the evolution of LVO treatment.Results
Recanalization rates with newer techniques and MT devices approach a 90% of effectiveness. Timely interventions have also resulted in better clinical outcomes with approximately 50% of patient achieving functional independence at 90 days. At least 14 new third generation thrombectomy devices are currently being evaluated in in vitro and clinical studies.Conclusions
The treatment of LVO with MT is feasible and safe. MT is standard of care in treating acute ischemic stroke due to LVO. 相似文献5.
Grace Vincent-Onabajo Hadiza Y. Musa Emmanuel Joseph 《Journal of stroke and cerebrovascular diseases》2018,27(12):3487-3492
Background
Poststroke balance impairment adversely affects stroke outcomes and addressing the impairment is expected to constitute an important focus of neurorehabilitation.Aims
To examine the prevalence and factors associated with balance impairment after stroke.Methods
Ninety-five stroke survivors undergoing neurorehabilitation at 2 government hospitals in Northern Nigeria participated in this cross-sectional study. Berg Balance Scale (BBS) was used to assess the presence of balance impairment (BBS score of 0-20). Prevalence of balance impairment was presented as frequency and percentage while demographic and stroke-related determinants of balance impairments were identified using logistic regression analysis.Results
Thirty-five (36.8%) stroke survivors had balance impairment, and age, gender, and poststroke duration were statistically significant determinants. Stroke survivors aged less than 40 years (odds ratio [OR]?=?.14 [confidence interval [CI]?=?.20-.94]) and 40-59 years (OR?=?.23 [CI?=?.06-.81]) had a lower likelihood of having balance impairment compared to stroke survivors aged 60 years and above. Similarly, males had a lower likelihood of having balance impairment (OR?=?1.60 [CI?=?.05-.55]) compared to females while those in the acute/subacute phase of stroke had a 7-fold likelihood of having balance impairment (OR?=?7.74 [CI?=?2.63-22.79]) compared to those with chronic stroke.Conclusions
Poststroke balance impairment appears to be significantly influenced by stroke survivors’ age, gender, and poststroke duration. Hence, these variables should be considered when planning rehabilitation strategies for improving balance after stroke. 相似文献6.
Wanhong Chen Fang Huang Min Li Yongjun Jiang Jianbo He Huiqi Li Zheng Dai Wei Shi Mingyue Zhu Guanghui Chen Fang Yang Renliang Zhang 《Journal of stroke and cerebrovascular diseases》2018,27(11):3030-3035
Background
The incidence and predictors for in-stent restenosis (ISR) was not fully explored. We aim to investigate the incidence and predictors of ISR after stenting at the origin of vertebral artery.Materials and Methods
Two hundred and six patients with 229 stents implantation between July 1, 2005 and July 31, 2015 were included in the study. All patients underwent conventional clinical and angiographic (digital subtraction angiography) follow-up at around 6 months post procedure. ISR was defined as greater than 50% stenosis within or immediately (within 5 mm) adjacent to the stent. Multivariate Cox regression analyses were utilized to investigate the predictors for ISR.Results
The ISR was found in 30 patients (30/206, 14.6%) with 31 lesions (31/229, 13.5%) with the mean follow-up duration of 11.1-month (range: 3 - 92 months). Stent diameter (hazard ratio 0.504, 95% confidence interval 0.294 - 0.864) was an independent predictor for ISR.Conclusion
ISR rate after Vertebral artery ostium stent placement is acceptable, which was conversely associated with the stent diameter. 相似文献7.
Shashvat M. Desai Marcelo Rocha Matthew Starr Bradley J. Molyneaux Cynthia L. Kenmuir Bradley A. Gross Brian T. Jankowitz Tudor G. Jovin Ashutosh P. Jadhav 《Journal of stroke and cerebrovascular diseases》2018,27(11):3172-3176
Objective
Endovascular thrombectomy (ET) for acute ischemic stroke (AIS) due to large-vessel occlusion (LVO) is offered to select patients meeting strict criteria. One of the criteria is stroke severity as indicated by the National Institute of Health Stroke Scale (NIHSS). Inherently, NIHSS is biased towards left hemisphere strokes (LHS) with median NIHSS score 4 points higher than right hemisphere strokes (RHS). This may potentially affect clinical decision making and thrombectomy eligibility. We sought to test this hypothesis.Methods
Data were analyzed from consecutive AIS patients with LVO admitted to our comprehensive stroke center (June 2015-December 2016). Following variables were studied: NIHSS score, occlusion location, time to presentation, and treatment received.Results
Three hundred and fifty-one proximal-anterior circulation LVOs (ACLVO) were identified. 211 patients harboring a proximal ACLVO, were treated <24-hour from symptom onset, had a baseline mRS 0-1, ASPECTS ≥6, and NIHSS score ≥6. One hundred and twelve (53%) were LHS and 99 (47%) were RHS. ET was performed in 87% of LHS and 78% of RHS (P = .09). In the NIHSS score >12 range, 88% of LHS and RHS received ET (P = .93). In the NIHSS score 6-12 range, 81% of LHS and 52% of RHS received ET (P = .03).Conclusions
We find comparable rates of ET between right and LHS in patients with high NIHSS but lower rates of ET of RHS than LHS in patients at lower NIHSS. A hemisphere-laterality based adjustment to the NIHSS may better identify the full extent of patients that may benefit from ET. 相似文献8.
9.
Nyeonju Kang James H. Cauraugh 《Journal of stroke and cerebrovascular diseases》2018,27(11):3218-3223
Background
Bilateral motor control deficits poststroke may be lateralized by hemisphere damage. This preliminary study investigated bilateral force control between left and right hemisphere-damaged groups at baseline and after coupled bilateral movement training with neuromuscular stimulation.Methods
Stroke participants (8 left hemisphere and 6 right hemisphere cerebrovascular accidents) performed a bilateral isometric force control task at 3 submaximal force levels (5%, 25%, and 50% of maximum voluntary contraction [MVC]) before and after training. Force accuracy, force variability, and interlimb force coordination were analyzed in 3-way mixed design ANOVAs (2?×?2?×?3; Group?×?Test Session?×?Force Level) with repeated measures on test session and force level.Results
The findings indicated that force accuracy and variability at 50% of MVC in the right hemisphere-damaged group were more impaired than lower targeted force levels at baseline, and the impairment at the highest target level was improved after coupled bilateral movement training. However, these patterns were not observed in the left hemisphere-damaged group.Conclusions
Current findings support a proposition that the right hemisphere presumably contributes to controlling bilateral force production. 相似文献10.
Kamal Narayan Arya Shanta Pandian Vinod Puri 《Journal of stroke and cerebrovascular diseases》2018,27(11):3236-3246
Background
Poststroke, sensory deficits are not uncommon. In spite of the close association between the sensory and motor recovery, the deficits are usually underemphasized. Mirror therapy (MT), a neural-based approach for the motor deficit has not been explored for the sensory impairment. The objective of the present study was to develop and determine the effect of a MT program for sensori-motor impairment among poststroke subjects.Methods Design
Randomized controlled trial.Setting
Functional therapy laboratory of Rehabilitation Institute.Participants
Thirty-one chronic poststroke subjects (17 experimental and 14 controls), aged between 30 and 60years, with ≤ diminished light touch in the hand.Outcome Measure
Semmes Weinstein Monofilament (cutaneous threshold), 2-Point discrimination test (touch discrimination) and Fugl-Meyer Assessment (hand motor recovery).Intervention
The experimental group received sensory stimulus such as tactile perception and motor tasks on the less-affected hand using mirror box. The control counterparts underwent only dose-matched conventional program. 30 sessions with a frequency of 5/week were imparted to the groups.Results
Post intervention, there was a significant (P < .004) increase up to 30% positive touch-response for the hand quadrants among the experimental group in comparison to only 13.5% rise for the same among the controls. The cutaneous threshold of the less-affected palm also improved significantly among the experimental subjects in comparison to the controls (P = .04).Conclusion
MT may be considered as a promising regime for enhancing cutaneous sensibility in stroke. The mirror illusion induced by MT may be utilized for sensory and motor deficits as well as for the more-affected and less-affected hands. 相似文献11.
Aryandhito Widhi Nugroho Hisatomi Arima Naoyuki Takashima Takako Fujii Satoshi Shitara Naomi Miyamatsu Yoshihisa Sugimoto Satoru Nagata Masaru Komori Yoshikuni Kita Katsuyuki Miura Kazuhiko Nozaki 《Journal of stroke and cerebrovascular diseases》2018,27(10):2579-2586
Background and Purpose
Most available scoring system to predict outcome after acute ischemic stroke (AIS) were established in Western countries. We aimed to develop a simple prediction score of 1-month severe disability/death after onset in AIS patients ineligible for recanalization therapy based on readily and widely obtainable on-admission clinical, laboratory and radiological examinations in Asian developing countries.Methods
Using the Shiga Stroke Registry, a large population-based registry in Japan, multivariable logistic regression analysis was conducted in 1617 AIS patients ineligible for recanalization therapy to yield ß-coefficients of significant predictors of 1-month modified Rankin Scale score of 5-6, which were then multiplied by a specific constant and rounded to nearest integer to develop 0-10 points system. Model discrimination and calibration were evaluated in the original and bootstrapped population.Results
Japan Coma Scale score (J), age (A), random glucose (G), untimely onset-to-arrival time (U), atrial fibrillation (A), and preadmission dependency status according to the modified Rankin Scale score (R), were recognized as independent predictors of outcome. Each of their β-coefficients was multiplied by 1.3 creating the JAGUAR score. Its area under the curve (95% confidence interval) was .901 (.880- .922) and .901 (.900- .901) in the original and bootstrapped population, respectively. It was found to have good calibration in both study population (P = .27).Conclusions
The JAGUAR score can be an important prediction tool of severe disability/death in AIS patients ineligible for recanalization therapy that can be applied on admission with no complicated calculation and multimodal neuroimaging necessary, thus suitable for Asian developing countries. 相似文献12.
Hikaru Kamo Nobukazu Miyamoto Hana Otani Naohide Kurita Sho Nakajima Yuji Ueno Kazuo Yamashiro Ryota Tanaka Nobutaka Hattori 《Journal of stroke and cerebrovascular diseases》2018,27(11):3095-3099
Introduction
Capsular warning syndrome (CWS) is characterized by recurrent conventional episodes of motor and/or sensory deficits without cortical symptoms. The purpose of this case series study was to evaluate the safety and appropriate treatment for CWS to prevent the development of complete stroke.Methods
We reviewed our hospital records and previous reports to find patients with neurologically fluctuating profiles, and excluded those with unknown details of initial treatment/final treatment of antiplatelet therapy or radiological findings.Results
We retrieved two cases of CWS from our hospital, which presented motor and/or sensory symptoms followed by complete resolution without complete ischemia. The recurring episodes in both were unable to be stabilized by single antiplatelet therapy but were successfully managed using two or more antiplatelet drugs. In 11 previously reported cases of CWS, the recurring episode was frequency stabilized with plural antiplatelet therapy.Conclusion
Multiplicate antiplatelet therapy is important for treatment of CWS, and caution is needed regarding hemorrhagic complications. 相似文献13.
Han-Jin Cho Kyung-Hye Kim Eun-Joo Kim Tae Hong Lee Sang Min Sung Ji Hoe Heo Dae Soo Jung 《Journal of stroke and cerebrovascular diseases》2018,27(12):3591-3598
Background
Using high-resolution magnetic resonance imaging (HR-MRI), we investigated the impact of basilar artery plaques that were not detected by magnetic resonance angiography (MRA) on the functional outcomes of patients with acute pontine infarction.Methods
A total of 40 patients with acute pontine infarction and normal basilar findings on MRA prospectively underwent HR-MRI for detection of basilar artery plaques. A relevant plaque was defined as one on the dorsal side of basilar artery, the same side of the ischemic lesion, and the same axial slices of the ischemic lesion. We analyzed the relationship between the relevant basilar artery plaques and the functional outcomes at 3 months.Results
The initial National Institutes of Health Stroke Scale score (3.5 versus 2.0, P?=?.012), and the incidences of neurological deterioration (42.9% versus 6.3%, P?=?.031) and unfavorable functional outcome (71.4% versus 12.5%, P?=?.001) were higher in patients with relevant basilar artery plaques than in those without. On multiple regression analysis, the relevant basilar artery plaque was a significant and independent predictor of unfavorable functional outcome (odds ratio, 6.662; 95% confidence interval, 1.117-39.735; P?=?.037).Conclusions
The presence of a relevant basilar artery plaque was closely related with unfavorable functional outcome in patients with acute pontine infarction even if the patients’ MRA showed normal basilar findings. 相似文献14.
Yong Huang Yasuyuki Ohta Jingwei Shang Xianghong Li Xia Liu Xiaowen Shi Tian Feng Toru Yamashita Kota Sato Mami Takemoto Nozomi Hishikawa Eriko Suzuki Keiji Hasumi Koji Abe 《Journal of stroke and cerebrovascular diseases》2018,27(12):3521-3528
Background
Stachybotrys microspora triprenyl phenol-7 (SMTP-7) has both thrombolytic and anti-inflammatory effects, but its neuroprotective effects on cerebral ischemia are still unclear. The present study assessed the antioxidative and neurovascular unit (NVU) protective effects of SMTP-7 using transient middle cerebral artery occlusion (tMCAO) mice.Methods
After 60 minutes tMCAO, 0.9% NaCl, tissue-type plasminogen activator (tPA), SMTP-7 or tPA?+?SMTP-7 was intravenously administrated through subclavian vein just before the reperfusion, and these mice were examined at 24 hours after reperfusion. We histologically assessed the hemorrhage and expressive changes of antioxidative markers in brains.Results
SMTP-7 treatment showed a similar antithrombotic effect to tPA, but significantly decreased the hemorrhage volumes and the number of 4-HNE, 3-NT and 8-OHdG positive cells, meanwhile, ameliorated the decrease of collagen IV in the ischemic brains. However, tPA?+?SMTP-7 treatment did not decrease hemorrhage volumes nor showed NVU protective effect.Conclusions
The present study suggested that SMTP-7 provided therapeutic benefits for ischemic stroke through antioxidative and NVU protective effects unlike tPA alone or tPA?+?SMTP-7. 相似文献15.
Setareh Salehi Omran Srikanth Reddy Boddu Aaron M. Gusdon Benjamin Kummer Hediyeh Baradaran Praneil Patel Iván Díaz Babak B. Navi Ajay Gupta Hooman Kamel Athos Patsalides 《Journal of stroke and cerebrovascular diseases》2018,27(11):3124-3130
Background and Purpose
Risk factors for hemorrhagic transformation of ischemic stroke after mechanical thrombectomy (MT) are not well established. We conducted a study to determine if prominent angiographic cerebral vascularity following recanalization with thrombectomy (angiographic blush) is associated with hemorrhagic transformation.Methods
Using the Cornell AcutE Stroke Academic Registry, we identified stroke patients who had thrombectomy and achieved recanalization of anterior circulation large-vessel occlusion between 2012 and 2015. The exposure variable was presence of angiographic blush after recanalization, defined as capillary blush with or without early venous drainage. The primary outcome was volume of hemorrhagic transformation on brain imaging after thrombectomy, as determined by semiautomated volumetric analysis on computed tomography or magnetic resonance imaging among those adjudicated to have hemorrhagic conversion by neuroradiology investigators blinded to angiography results. Using a doubly robust estimator with propensity scores and outcome regression adjusting for demographics and known risk factors for hemorrhagic transformation, we evaluated whether angiographic blush after recanalization is associated with an increased volume of hemorrhagic transformation.Results
Among 48 eligible patients, 31 (64.6%) had angiographic blush and 26 (54.2%) had radiographic hemorrhagic transformation (mean volume, 7.6 ml). Patients with angiographic blush averaged lower thrombolysis in cerebral infarction scores and more often received intravenous thrombolysis. In adjusted analysis, angiographic blush was associated with an increased volume of hemorrhagic transformation: mean volume, 10.3ml (95% CI, 3.7-16.9 ml) with blush versus 1.8ml (95% Confidence Interval (CII = Confidence Interval), 0.1-3.4 ml) without (P?=?.01).Conclusions
Presence of angiographic blush after MT was independently associated with the volume of hemorrhagic transformation. 相似文献16.
Carlos de la Cruz-Cosme Marc Stefan Dawid-Milner Guillermo Ojeda-Burgos Alejandro Gallardo-Tur Tomás Segura 《Journal of stroke and cerebrovascular diseases》2018,27(12):3425-3435
Introduction and Goal
Lacunar stroke is defined as an <1.5 cm diameter infarct located in the territory of a perforating artery, that is not accessible for direct study using conventional imaging techniques. Diagnosis requires exclusion of other causes. It usually occurs in the context of chronic cerebral small vessel disease, which can be suspected during the neurosonography study in the form of high pulsatility [PI] or resistance index [RI]. Clinical research was performed to confirm that PI and RI correlate with cerebral small vessel lesion burden and to determine whether these parameters are useful for supporting a lacunar origin (LO) in acute stroke.Material and Methods
We prospectively recorded internal carotid artery resistivity and the Fazekas score for all patients with acute ischemic stroke who met inclusion but not exclusion criteria over a 6-month period.Results
The study population comprised 74 patients. A correlation was observed between the Fazekas score and resistivity. Both parameters predicted a LO, with an area under the curve of .78 and .696, respectively. The optimal cut-offs were PI?=?.96/RI?=?.58 for screening (sensitivity, 96%) and PI?=?1.46/RI?=?.83 for confirmation (specificity, 89%).Conclusions
Doppler ultrasound is a useful technique for determining the LO of acute stroke. 相似文献17.
Ramin Zand Shima Shahjouei Georgios Tsivgoulis Mantinderpreet Singh Michael McCormack Nariman Noorbakhsh-Sabet Nitin Goyal Andrei V Alexandrov 《Journal of stroke and cerebrovascular diseases》2018,27(11):3036-3042
Background
Several studies have shown that cerebral microbleeds (CMBs) increase the risk of long-term stroke-related mortality. The purpose of this study was to determine if the existence and burden of CMBs are a predictor of in-hospital death among patients with acute ischemic stroke (AIS).Methods
We studied consecutive ischemic stroke patients who admitted to our tertiary center over a 2-year period (2013-2014). Patients who underwent thrombolysis were excluded. Baseline characteristics of patients, number and topography of CMBs, white matter lesions, and spontaneous symptomatic hemorrhagic transformation were recorded. Outcome measure in our study was in-hospital death.Results
Out of 1126 consecutive AIS patients evaluated in this study, 772 patients included in the study (mean age 61.9 ± 14.2years [18-95 years], 51.6% men, and 58.2% African American). CMBs were present on the magnetic resonance imaging (MRI) sequences of 124 (16.1%) patients. The overall rate of in-hospital mortality was 4.1%. The presence or absence of CMBs was not predictive of in-hospital mortality (P?=?.058). After adjusting for potential confounders, the presence of ≥4 CMBs on T2*-weighted MRI was independently (P?=?.004) associated with a higher likelihood of in-hospital death (odds ratio: 6.6, 95% confidential interval: 2.50 and 17.46) in multivariable logistic regression analyses. Older age, higher National Institute of Health stroke scale, and history of atrial fibrillation were also associated with greater chance of in-hospital death.Conclusions
The presence or absence of CMBs was not predictive of in-hospital mortality. However, the presence of multiple CMBs was associated with a higher in-hospital mortality rate among AIS patients. 相似文献18.
Jung-Soo Park Hyo-Sung Kwak Gyung Ho Chung Seungbae Hwang 《Journal of stroke and cerebrovascular diseases》2018,27(10):2797-2803
Background
The objective of this study was to investigate the prognostic value of computed tomographic angiography (CTA) based on leptomeningeal collateral (LMC) status and other parameters in acute ischemic stroke (AIS) patients with internal carotid artery (ICA) terminus occlusion treated with endovascular treatment (EVT).Methods
All eligible patients from January 2013 to December 2017 undergoing EVT were retrospectively reviewed. The regional leptomeningeal score was used to assess the LMCs on baseline CTA. The collateral status measured by the LMC score (0-20) was trichotomized into 3 groups: good (17-20), intermediate (11-16), and poor (0-10).Results
Our sample included a total of 119 eligible patients (60 males; mean age, 73 years) with a median baseline National Institute of Health Stroke Scale (NIHSS) score of 14. Patients with a good LMC score had a lower baseline mean NIHSS score, a higher mean Alberta Stroke Program Early CT score, and a higher mean clot burden score (CBS). Baseline NIHSS score <15 (odds ratio [OR] 3.69 95% confidence ratio [CI]: 1.32-10.29, P?=?.013), CBS ≥ 6 (OR 3.97 95%CI: 1.05-14.99, P?=?.042), good LMC score (OR 5.14 95%CI: 1.62-16.26, P?=?.005) and successful recanalization (OR 11.55 95%CI: 2.72-48.99 P?=?.001) were independent predictors of good clinical outcomes.Conclusions
CTA-based LMC status and CBS are powerful predictors of clinical outcomes in patients with an acute ICA terminus occlusion treated with EVT. 相似文献19.
Impaired Brachial Flow-Mediated Dilatation May Predict Symptomatic Intracranial Arterial Dissections
Tomonori Iwata Takahisa Mori Yuhei Tanno Shigen Kasakura Kazuhiro Yoshioka 《Journal of stroke and cerebrovascular diseases》2018,27(10):2691-2695
Background and Purpose
Spontaneous intracranial arterial dissections are characterized by the sudden disruption of the internal elastic lamina in the intracranial arteries. The purpose of our retrospective study was to investigate whether patients with nontraumatic intracranial arterial dissections had normal endothelial function.Methods
The study included symptomatic patients with nontraumatic intracranial arterial dissections who underwent an endothelial function test. Controls were selected from headache patients matched for sex and age. Endothelial function was assessed using flow-mediated dilatation. We investigated patients’ ankle brachial index and pulse wave velocity to determine the degree of atherosclerosis. Patient characteristics, brachial flow-mediated dilatation, ankle brachial index, and pulse wave velocity were compared between the 2 groups.Results
During the study period, there were 22 patients with nontraumatic intracranial arterial dissections matched with 22 controls. Clinical characteristics were compared between the groups. Although there were no significant differences in ankle brachial index or pulse wave velocity between the 2 groups, patients with intracranial arterial dissections had lower flow-mediated dilatation values than controls (median flow-mediated dilatation, 3.95% in dissection patients versus 7.3% in controls, P = .0035). Brachial flow-mediated dilatation was impaired in symptomatic patients with nontraumatic intracranial arterial dissections despite the normal ankle brachial index and pulse wave velocity.Conclusions
Impaired brachial flow-mediated dilatation is a probable predictor of intracranial arterial dissections. 相似文献20.
Yongwoo Kim Mohammad Faysel Clotilde Balucani Daohai Yu Nadege Gilles Steven R Levine 《Journal of stroke and cerebrovascular diseases》2018,27(12):3419-3424