Descripción del proyecto

Stroke - recientes

New Horizons for Stroke Medicine: Understanding the Value of Social Media [InterSECT]
22/1/2018
Jose Maria Cabrera-Maqueda, Jatinder S. Minhas
ver resumen

Supplementary Motor Area Stroke Mimicking Functional Disorder [Illustrative Teaching Case]
22/1/2018
Paul Mathew, Prem Pradeep Batchala, Thomas Jose Eluvathingal Muttikkal
ver resumen

Letter by Shiue and Sands Regarding Article, “Incorporating Nonphysician Stroke Specialists Into the Stroke Team” [Letter to the Editor]
22/1/2018
Harn J. Shiue, Kara A. Sands
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Letter by Cooper et al Regarding the Article, “Incorporating Nonphysician Stroke Specialists Into the Stroke Team” [Letter to the Editor]
22/1/2018
Jon Cooper, Jennifer Tsui, Alastair Bailey
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Response by Miller to Letter Regarding Article, “Incorporating Nonphysician Stroke Specialists into the Stroke Team” [Letter to the Editor]
22/1/2018
Eliza C. Miller
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Letter by Yu et al Regarding Article, “Island Sign: An Imaging Predictor for Early Hematoma Expansion and Poor Outcome in Patients With Intracerebral Hemorrhage” [Letter to the Editor]
22/1/2018
Zhiyuan Yu, Jun Zheng, Chao You
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Response by Li to Letter Regarding Article, “Island Sign: An Imaging Predictor for Early Hematoma Expansion and Poor Outcome in Patients With Intracerebral Hemorrhage” [Letter to the Editor]
22/1/2018
Qi Li
ver resumen

Letter by Liu et al Regarding Article, “Thrombolysis in Postoperative Stroke” [Letter to the Editor]
22/1/2018
Fujun Liu, Wei Chen, Jing Chen
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Response by Voelkel and Hubert to Letter Regarding Article, “Thrombolysis in Postoperative Stroke” [Letter to the Editor]
22/1/2018
Nicolas Voelkel, Gordian Jan Hubert
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Correction to: Enlightenment and Challenges Offered by DAWN Trial (DWI or CTP Assessment With Clinical Mismatch in the Triage of Wake Up and Late Presenting Strokes Undergoing Neurointervention With Trevo) [Corrections]
22/1/2018
ver resumen

Richard Joel Traystman, PhD [In Memoriam]
22/1/2018
Michael A. Moskowitz, Patrician D. Hurn, Costantino Iadecola
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Ischemic Stroke Mandates Cross-Disciplinary Collaboration [Editorial]
22/1/2018
Marc Fisher, Joseph A. Hill
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Optimal Blood Pressure After Intracerebral Hemorrhage [Editorial]
22/1/2018
Alejandro A. Rabinstein
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Transient Ischemic Attack and Minor Stroke [Editorial]
22/1/2018
Dominique Deplanque, Michele Bastide, Regis Bordet
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The LAST Word on Coaching as a Stroke Intervention? [Editorial]
22/1/2018
Katie Gallacher, Terence J. Quinn
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Stroke: Highlights of Selected Articles [Stroke: Highlights of Selected Articles]
22/1/2018
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Burden of Dilated Perivascular Spaces, an Emerging Marker of Cerebral Small Vessel Disease, Is Highly Heritable [Clinical Sciences]
22/1/2018
Marie–Gabrielle Duperron, Christophe Tzourio, Muralidharan Sargurupremraȷ, Bernard Mazoyer, Aicha Soumare, Sabrina Schilling, Philippe Amouyel, Ganesh Chauhan, Yi–Cheng Zhu, Stephanie Debette
ver resumen
Background and Purpose—The genetic contribution to dilated perivascular space (dPVS) burden—an emerging MRI marker of cerebral small vessel disease—is unknown. We measured the heritability of dPVS burden and its shared heritability with other MRI markers of cerebral small vessel disease.Methods—The study sample comprised 1597 participants from the population-based Three City (3C) Dijon Study, with brain MRI and genome-wide genotyping (mean age, 72.8±4.1 years; 61% women). dPVS burden and lacunar brain infarcts were rated on a semiquantitative scale, whereas an automated algorithm generated white matter hyperintensity volume (WMHV). We estimated dPVS burden heritability and shared heritability with WMHV and lacunar brain infarcts using the genome-wide complex trait analysis tool, on unrelated participants, adjusting for age, sex, intracranial volume, and principal components of population stratification.Results—dPVS burden was significantly correlated with WMHV and lacunar brain infarcts, the strongest correlation being found between WMHV and dPVS in basal ganglia. Heritability estimates were h2=0.59±0.24 (P=0.007) for dPVS burden, h2=0.54±0.24 (P=0.010) for WMHV, and h2=0.48±0.81 (P=0.278) for lacunar brain infarcts. We found a nonsignificant trend toward shared heritability between dPVS and WMHV (rg=0.41±0.28; P=0.096), which seemed driven by dPVS in basal ganglia (rg=0.72±0.61; P=0.126) and not dPVS in white matter (rg=−0.10±0.36; P=0.393). A genetic risk score for WMHV based on published loci was associated with increased dPVS burden in basal ganglia (P=0.031).Conclusions—We provide evidence for important genetic contribution to dPVS burden in older community-dwelling people, some of which may be shared with WMHV. Differential heritability patterns for dPVS in white matter and basal ganglia suggest at least partly distinct underlying biological processes.

Stroke Incidence and Outcomes in Northeastern Greece [Clinical Sciences]
22/1/2018
Georgios Tsivgoulis, Athanasia Patousi, Maria Pikilidou, Theodosis Birbilis, Aristeidis H. Katsanos, Michalis Mantatzis, Aristeidis Asimis, Nikolaos Papanas, Panagiotis Skendros, Aikaterini Terzoudi, Aikaterini Karamanli, Ioannis Kouroumichakis, Pantelis Zebekakis, Efstratios Maltezos, Charitomeni Piperidou, Konstantinos Vadikolias, Ioannis Heliopoulos
ver resumen
Background and Purpose—Data are scarce on both stroke incidence rates and outcomes in Greece and in rural areas in particular. We performed a prospective population-based study evaluating the incidence of first-ever stroke in the Evros prefecture, a region of a total 147 947 residents located in North Eastern Greece.Methods—Adult patients with first-ever stroke were registered during a 24-month period (2010–2012) and followed up for 12 months. To compare our stroke incidence with that observed in other studies, we standardized our incidence rate data according to the European Standard Population, World Health Organization, and Segi population. We also applied criteria of data quality proposed by the Monitoring Trends and Determinants in Cardiovascular Disease project. Stroke diagnosis and classification were performed using World Health Organization criteria on the basis of neuroimaging and autopsy data.Results—We prospectively documented 703 stroke cases (mean age: 75±12 years; 52.8% men; ischemic stroke: 80.8%; intracerebral hemorrhage: 11.8%; subarachnoid hemorrhage: 4.4%; undefined: 3.0%) with a total follow-up time of 119 805 person-years. The unadjusted and European Standard Population–adjusted incidences of all strokes were 586.8 (95% confidence interval [CI], 543.4–630.2) and 534.1 (95% CI, 494.6–573.6) per 100 000 person-years, respectively. The unadjusted incidence rates for ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage were 474.1 (95% CI, 435–513), 69.3 (95% CI, 54–84), and 25.9 (95% CI, 17–35) per 100 000 person-years, respectively. The corresponding European Standard Population–adjusted incidence rates per 100 000 person-years were 425.9 (95% CI, 390.9–460.9), 63.3 (95% CI, 49.7–76.9), and 25.8 (95% CI, 16.7–34.9) for ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage, respectively. The overall 28-day case fatality rate was 21.3% (95% CI, 18.3%–24.4%) for all strokes and was higher in hemorrhagic strokes than ischemic stroke (40.4%, 95% CI, 31.3%–49.4% versus 16.2%, 95% CI, 13.2%–19.2%).Conclusions—This is the largest to date population-based study in Greece documenting one of the highest stroke incidences ever reported in South Europe, highlighting the need for efficient stroke prevention and treatment strategies in Northeastern Greece.

Comparison of Risk Factor Control in the Year After Discharge for Ischemic Stroke Versus Acute Myocardial Infarction [Clinical Sciences]
22/1/2018
Dawn M. Bravata, Joanne Daggy, Jared Brosch, Jason J. Sico, Fitsum Baye, Laura J. Myers, Christianne L. Roumie, Eric Cheng, Jessica Coffing, Greg Arling
ver resumen
Background and Purpose—The Veterans Health Administration has engaged in quality improvement to improve vascular risk factor control. We sought to examine blood pressure (<140/90 mm Hg), lipid (LDL [low-density lipoprotein] cholesterol <100 mg/dL), and glycemic control (hemoglobin A1c <9%), in the year post-hospitalization for acute ischemic stroke or acute myocardial infarction (AMI).Methods—We identified patients who were hospitalized (fiscal year 2011) with ischemic stroke, AMI, congestive heart failure, transient ischemic attack, or pneumonia/chronic obstructive pulmonary disease. The primary analysis compared risk factor control after incident ischemic stroke versus AMI. Facilities were included if they cared for ≥25 ischemic stroke and ≥25 AMI patients. A generalized linear mixed model including patient- and facility-level covariates compared risk factor control across diagnoses.Results—Forty thousand two hundred thirty patients were hospitalized (n=75 facilities): 2127 with incident ischemic stroke and 4169 with incident AMI. Fewer stroke patients achieved blood pressure control than AMI patients (64%; 95% confidence interval, 0.62–0.67 versus 77%; 95% confidence interval, 0.75–0.78; P<0.0001). After adjusting for patient and facility covariates, the odds of blood pressure control were still higher for AMI than ischemic stroke patients (odds ratio, 1.39; 95% confidence interval, 1.21–1.51). There were no statistical differences for AMI versus stroke patients in hyperlipidemia (P=0.534). Among patients with diabetes mellitus, the odds of glycemic control were lower for AMI than ischemic stroke patients (odds ratio, 0.72; 95% confidence interval, 0.54–0.96).Conclusions—Given that hypertension control is a cornerstone of stroke prevention, interventions to improve poststroke hypertension management are needed.

Carotid Intima-Media Thickness Is Associated With White Matter Hyperintensities [Clinical Sciences]
22/1/2018
David Della-Morte, Chuanhui Dong, Matthew S. Markert, Mitchell S.V. Elkind, Ralph L. Sacco, Clinton B. Wright, Tatjana Rundek
ver resumen
Background and Purpose—Brain white matter hyperintensities (WMH) have been associated with increased risk of stroke, cognitive decline, and dementia. WMH can be a manifestation of small vessel disease, although the total microvascular contribution to multifactorial WMH pathophysiology remains unknown. We hypothesized a possible relationship between carotid intima-media thickness (cIMT), an ultrasound imaging marker of subclinical vascular disease, and brain WMH in a multiethnic, elderly stroke-free community-based cohort.Methods—We evaluated the relationship between cIMT and WMH in the population-based Northern Manhattan Study, among individuals free of stroke. We used linear regression to examine the association of continuous measures of cIMT with quantitatively derived WMH volume, as a proportion of cranial volume, measured from fluid-attenuaded inversion recovery magnetic resonance imaging while adjusting for sociodemographics, lifestyle, and vascular risk factors.Results—In a cohort of 1229 participants (mean age, 71±9 years; 60% women, 15% White; 18% Black; 65% Hispanics), the mean cIMT was 0.71±0.08 mm and the median log-transformed WMH volume was 0.36 (interquartile range, 0.21–0.76). In a multivariable model, larger cIMT was significantly associated with greater WMH volume (β=0.046 per SD cIMT; P=0.04). Age and race/ethnicity were significant modifiers (P for age, 0.02; and P for race/ethnicity, 0.04). cIMT was associated with WMH volume in participants 70 years or older (β=0.088 per SD cIMT; P=0.01) and among Hispanics (β=0.084 per SD cIMT; P=0.003).Conclusions—Larger cIMT was associated with greater burden of cerebral WM lesions independently of demographics and traditional vascular risk factors, particularly among elderly and Hispanic participants, who are at high risk for stroke and cognitive decline.







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