Latest & greatest articles for stroke

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Top results for stroke

41. Thrombectomy for Stroke in the Public Health Care System of Brazil. (Abstract)

Thrombectomy for Stroke in the Public Health Care System of Brazil. Randomized trials involving patients with stroke have established that outcomes are improved with the use of thrombectomy for large-vessel occlusion. These trials were performed in high-resource countries and have had limited effects on medical practice in low- and middle-income countries.We studied the safety and efficacy of thrombectomy in the public health system of Brazil. In 12 public hospitals, patients with a proximal (...) intracranial occlusion in the anterior circulation that could be treated within 8 hours after the onset of stroke symptoms were randomly assigned in a 1:1 ratio to receive standard care plus mechanical thrombectomy (thrombectomy group) or standard care alone (control group). The primary outcome was the score on the modified Rankin scale (range, 0 [no symptoms] to 6 [death]) at 90 days.A total of 300 patients were enrolled, including 79 who had undergone thrombectomy during an open-label roll-in period

2020 NEJM

42. Residual Shunt After Patent Foramen Ovale Closure and Long-Term Stroke Recurrence: A Prospective Cohort Study. (Abstract)

Residual Shunt After Patent Foramen Ovale Closure and Long-Term Stroke Recurrence: A Prospective Cohort Study. Residual shunt is observed in up to 25% of patients after patent foramen ovale (PFO) closure, but its long-term influence on stroke recurrence currently is unknown.To investigate the association of residual shunt after PFO closure with the incidence of recurrent stroke and transient ischemic attack (TIA).Prospective cohort study comparing stroke or TIA recurrence in patients (...) with and without residual shunt after PFO closure.Single hospital center.1078 consecutive patients (mean age, 49.3 years) with PFO-attributable cryptogenic stroke who were undergoing percutaneous PFO closure were followed for up to 11 years.Residual shunt was evaluated by transthoracic echocardiography with saline contrast. Primary outcome was a composite of the first recurrent ischemic stroke or TIA after PFO closure.Compared with complete closure, the presence of residual shunt after PFO closure

2020 Annals of Internal Medicine

43. Association Between Thrombolytic Door-to-Needle Time and 1-Year Mortality and Readmission in Patients With Acute Ischemic Stroke. (Abstract)

Association Between Thrombolytic Door-to-Needle Time and 1-Year Mortality and Readmission in Patients With Acute Ischemic Stroke. Earlier administration of intravenous tissue plasminogen activator (tPA) in acute ischemic stroke is associated with reduced mortality by the time of hospital discharge and better functional outcomes at 3 months. However, it remains unclear whether shorter door-to-needle times translate into better long-term outcomes.To examine whether shorter door-to-needle times (...) with intravenous tPA for acute ischemic stroke are associated with improved long-term outcomes.This retrospective cohort study included Medicare beneficiaries aged 65 years or older who were treated for acute ischemic stroke with intravenous tPA within 4.5 hours from the time they were last known to be well at Get With The Guidelines-Stroke participating hospitals between January 1, 2006, and December 31, 2016, with 1-year follow-up through December 31, 2017.Door-to-needle times for intravenous tPA.The primary

2020 JAMA

44. Antithrombotic Treatment of Embolic Stroke of Undetermined Source: RE-SPECT ESUS Elderly and Renally Impaired Subgroups Full Text available with Trip Pro

Antithrombotic Treatment of Embolic Stroke of Undetermined Source: RE-SPECT ESUS Elderly and Renally Impaired Subgroups Antithrombotic Treatment of Embolic Stroke of Undetermined Source: RE-SPECT ESUS Elderly and Renally Impaired Subgroups - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Clipboard, Search History, and several other advanced features are temporarily unavailable. National Institutes of Health National (...) : Number of items displayed: Create RSS Cancel RSS Link Copy Actions Cite Share Permalink Copy Page navigation Stroke Actions . 2020 Jun;51(6):1758-1765. doi: 10.1161/STROKEAHA.119.028643. Epub 2020 May 14. Antithrombotic Treatment of Embolic Stroke of Undetermined Source: RE-SPECT ESUS Elderly and Renally Impaired Subgroups , , , , , , , , , , , , , , , , , , , , , , , Affiliations Expand Affiliations 1 From the Faculty of Medicine, Institute for Medical Informatics, Biometry and Epidemiology

2020 EvidenceUpdates

45. An extended stroke rehabilitation service for people who have had a stroke: the EXTRAS RCT Full Text available with Trip Pro

An extended stroke rehabilitation service for people who have had a stroke: the EXTRAS RCT An extended stroke rehabilitation service for people who have had a stroke: the EXTRAS RCT Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found. Please choose a page from the navigation or try a website search above to find the information you need. >> >> >> >> Issue {{metadata (...) .Issue }} Toolkit 1)"> 0)"> 1)"> {{metadata.Title}} {{metadata.Headline}} This rehabilitation service did not improve stroke survivors' performance in extended daily living activities at 24 months. {{author}} {{($index , , , , , , , , , , , , , , , & . Lisa Shaw 1 , Nawaraj Bhattarai 2 , Robin Cant 3 , Avril Drummond 4 , Gary A Ford 1, 5 , Anne Forster 6 , Richard Francis 1 , Katie Hills 1 , Denise Howel 2 , Anne Marie Laverty 7 , Christopher McKevitt 8 , Peter McMeekin 9 , Christopher Price 1, 7

2020 NIHR HTA programme

46. Fluoxetine to improve functional outcomes in patients after acute stroke: the FOCUS RCT Full Text available with Trip Pro

Fluoxetine to improve functional outcomes in patients after acute stroke: the FOCUS RCT Fluoxetine to improve functional outcomes in patients after acute stroke: the FOCUS RCT Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found. Please choose a page from the navigation or try a website search above to find the information you need. >> >> >> >> Issue {{metadata .Issue (...) }} Toolkit 1)"> 0)"> 1)"> {{metadata.Title}} {{metadata.Headline}} Fluoxetine taken daily for 6 months after acute stroke did not improve patients' functional outcome. {{author}} {{($index , , , , , , , , & . Martin Dennis 1, * , John Forbes 2 , Catriona Graham 3 , Maree Hackett 4 , Graeme J Hankey 5 , Allan House 6 , Stephanie Lewis 7 , Erik Lundström 8, 9 , Peter Sandercock 1 , Gillian Mead 1 1 Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK 2 Health Research Institute

2020 NIHR HTA programme

47. Mental practice for treating upper extremity deficits in individuals with hemiparesis after stroke. (Abstract)

Mental practice for treating upper extremity deficits in individuals with hemiparesis after stroke. Stroke is caused by the interruption of blood flow to the brain (ischemic stroke) or the rupture of blood vessels within the brain (hemorrhagic stroke) and may lead to changes in perception, cognition, mood, speech, health-related quality of life, and function, such as difficulty walking and using the arm. Activity limitations (decreased function) of the upper extremity are a common finding (...) for individuals living with stroke. Mental practice (MP) is a training method that uses cognitive rehearsal of activities to improve performance of those activities.To determine whether MP improves outcomes of upper extremity rehabilitation for individuals living with the effects of stroke. In particular, we sought to (1) determine the effects of MP on upper extremity activity, upper extremity impairment, activities of daily living, health-related quality of life, economic costs, and adverse effects; and (2

2020 Cochrane

48. Endovascular Thrombectomy with or without Intravenous Alteplase in Acute Stroke. (Abstract)

Endovascular Thrombectomy with or without Intravenous Alteplase in Acute Stroke. In acute ischemic stroke, there is uncertainty regarding the benefit and risk of administering intravenous alteplase before endovascular thrombectomy.We conducted a trial at 41 academic tertiary care centers in China to evaluate endovascular thrombectomy with or without intravenous alteplase in patients with acute ischemic stroke. Patients with acute ischemic stroke from large-vessel occlusion in the anterior (...) (adjusted common odds ratio, 1.07; 95% confidence interval, 0.81 to 1.40; P = 0.04 for noninferiority) but was associated with lower percentages of patients with successful reperfusion before thrombectomy (2.4% vs. 7.0%) and overall successful reperfusion (79.4% vs. 84.5%). Mortality at 90 days was 17.7% in the thrombectomy-alone group and 18.8% in the combination-therapy group.In Chinese patients with acute ischemic stroke from large-vessel occlusion, endovascular thrombectomy alone was noninferior

2020 NEJM

49. In older adults with acute ischemic stroke, the Clinical Frailty Scale predicted mortality at 28 days. (Abstract)

In older adults with acute ischemic stroke, the Clinical Frailty Scale predicted mortality at 28 days. Evans NR, Wall J, To B, et al. Clinical frailty independently predicts early mortality after ischaemic stroke. Age Ageing. 2020. [Epub ahead of print]. 31951248.

2020 Annals of Internal Medicine

50. In ischemic stroke with viable hypoperfused tissue, alteplase > 4.5 h after last seen well improves function. (Abstract)

In ischemic stroke with viable hypoperfused tissue, alteplase > 4.5 h after last seen well improves function. Tsivgoulis G, Katsanos AH, Malhotra K, et al. Thrombolysis for acute ischemic stroke in the unwitnessed or extended therapeutic time window. Neurology. 2020;94:e1241-8. 31892636.

2020 Annals of Internal Medicine

51. Anti-inflammatory therapy for preventing stroke and other vascular events after ischaemic stroke or transient ischaemic attack. (Abstract)

Anti-inflammatory therapy for preventing stroke and other vascular events after ischaemic stroke or transient ischaemic attack. An increasing body of evidence suggests that inflammation plays a key role in stroke, in particular stroke of atherosclerotic origin. Anti-inflammatory medications are a widely heterogeneous group of drugs that are used to suppress the innate inflammatory pathway and thus prevent persistent or recurrent inflammation. Anti-inflammatory agents have the potential (...) history of ischaemic stroke or transient ischaemic attack (TIA).We searched the Cochrane Central Register of Controlled Trials (CENTRAL; last searched 29 May 2019); MEDLINE (1948 to 29 May 2019); Embase (1980 to 29 May 2019); the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982 to 29 May 2019); and Scopus (1995 to 29 May 2019). In an effort to identify additional published, unpublished, and ongoing trials, we searched several grey literature sources (last searched 30 May 2019

2020 Cochrane

52. Pharmacological, psychological and non-invasive brain stimulation interventions for preventing depression after stroke. (Abstract)

Pharmacological, psychological and non-invasive brain stimulation interventions for preventing depression after stroke. Depression is an important consequence of stroke that influences recovery yet often is not detected, or is inadequately treated. This is an update and expansion of a Cochrane Review first published in 2004 and previously updated in 2008.The primary objective is to test the hypothesis that pharmacological, psychological therapy, non-invasive brain stimulation, or combinations (...) of these interventions reduce the incidence of diagnosable depression after stroke. Secondary objectives are to test the hypothesis that pharmacological, psychological therapy, non-invasive brain stimulation or combinations of these interventions reduce levels of depressive symptoms and dependency, and improve physical functioning after stroke. We also aim to determine the safety of, and adherence to, the interventions.We searched the Specialised Register of Cochrane Stroke and the Cochrane Depression Anxiety

2020 Cochrane

53. Interventions for sexual dysfunction following stroke. (Abstract)

Interventions for sexual dysfunction following stroke. Sexual dysfunction following stroke is common but often is poorly managed. As awareness of sexual dysfunction following stroke increases as an important issue, a clearer evidence base for interventions for sexual dysfunction is needed to optimise management.To evaluate the effectiveness of interventions to reduce sexual dysfunction following stroke, and to assess adverse events associated with interventions for sexual dysfunction following (...) included randomised controlled trials (RCTs) that compared pharmacological treatments, mechanical devices, or complementary medicine interventions versus placebo. We also included other non-pharmacological interventions (such as education or therapy), which were compared against usual care or different forms of intervention (such as different intensities) for treating sexual dysfunction in stroke survivors.Two review authors independently selected eligible studies, extracted data, and assessed study

2020 Cochrane

54. Covid-19: Stroke

, stroke patients are advised to protect themselves from contagion, given they are at increased risk for complications if they get COVID-19. Moreover, based on current information, it appears that elderly people with coronary heart disease or hypertension are more likely to present with more severe symptoms. People affected by infectious diseases as COVID-19 are also at increased risk of ischaemic and haemorrhagic cerebrovascular complications. For this reason, an increased number of strokes could (...) be forecast. However, an unexpected reduction of stroke patients in the emergency room throughout Europe has been observed. It is reasonable to assume that patients with acute mild stroke or TIA remain at home, because they are asked to stay at home, limit emergency room visits, and minimise travel. The patients may be prioritising avoiding contagion. Another issue is that stroke care organization and pathways within hospitals are currently adapted to cover the requirements of dealing with COVID-19

2020 European Academy of Neurology

55. Timing of procedural stroke and death in asymptomatic patients undergoing carotid endarterectomy: individual patient analysis from four RCTs Full Text available with Trip Pro

complications (18 fatal strokes, 68 non-fatal strokes, 11 fatal myocardial infarctions and 6 deaths from other causes) [Correction added on 20 April, after first online publication: the percentage value has been corrected to 2·8]. Of the 86 strokes, 67 (78 per cent) were ipsilateral, 17 (20 per cent) were contralateral and two (2 per cent) were vertebrobasilar. Forty-five strokes (52 per cent) were ischaemic, nine (10 per cent) haemorrhagic, and stroke subtype was not determined in 32 patients (37 per cent (...) Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. 3 Department of Vascular Surgery, University Medical Centre, Utrecht, the Netherlands. 4 Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK. 5 Department of Neurology and Neurosurgery, UMC Utrecht Brain Centre, Utrecht, the Netherlands. 6 Julius Centre for Health Sciences and Primary Care, Utrecht University, Utrecht, the Netherlands. 7

2020 EvidenceUpdates

56. Dabigatran Treatment of Acute Noncardioembolic Ischemic Stroke

Institute, Cumming School of Medicine, University of Calgary, AB, Canada (S.B.C., M.D.H.). 6 University of Montreal, QC, Canada (L.C.G). PMID: 32098609 DOI: Item in Clipboard Full-text links Cite Abstract 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 II) was a phase II prospective, randomized open label, blinded end point trial. Patients with noncardioembolic stroke/transient ischemic attack (National Institutes of Health Stroke Scale score, ≤9; infarct volume, ≤25 mL) were randomized to dabigatran or aspirin. Magnetic resonance imaging was performed before randomization and repeated at day 30. Imaging end points were ascertained centrally

2020 EvidenceUpdates

57. Practice advisory update: Patent foramen ovale and secondary stroke prevention

in patients with cerebrovascular disease, and patent foramen ovale (PFO) and stroke; has received support from WL Gore and Associates for the REDUCE PFO closure study, from GlaxoSmithKline for a study of outcomes from proximal aortic surgeries, from Bayer for a study of rivaroxaban for secondary stroke prevention in patients with embolic stroke of undetermined source, from Mallinkrodt for a study of the impact of inhaled nitric oxide on cerebral perfusion, from Novartis for a study of BAF312 in patients (...) with intracerebral hemorrhage (ICH), from Biogen for a study of glibenclamide for cerebral edema following large hemispheric infarction; and received support from the National Institutes of Health (NIH) for work with the cardiothoracic surgery network, deferoxamine in ICH, neurologic outcomes in a renal insufficiency cohort; and has provided his expert opinion for medical-legal cases involving stroke. G. Gronseth serves as an associate editor for Neurology; has served as chief evidence-based medicine consultant

2020 American Academy of Neurology

58. Prevalence of dysphagia and economic burden of aspiration pneumonia in patients with stroke or head and neck cancer

Prevalence of dysphagia and economic burden of aspiration pneumonia in patients with stroke or head and neck cancer application/octet-stream

2020 Institute of Health Economics

59. Computerised speech and language therapy or attention control added to usual care for people with long-term post-stroke aphasia: the Big CACTUS three-arm RCT Full Text available with Trip Pro

Computerised speech and language therapy or attention control added to usual care for people with long-term post-stroke aphasia: the Big CACTUS three-arm RCT Computerised speech and language therapy or attention control added to usual care for people with long-term post-stroke aphasia: the Big CACTUS three-arm RCT Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found

2020 NIHR HTA programme

60. Association of CHA2 DS2 -VASc Score with Stroke, Thromboembolism, and Death in Hip Fracture Patients

, Denmark. 3 Department of Geriatrics, Aarhus University Hospital, Aarhus, Denmark. PMID: 32294240 DOI: Item in Clipboard Full-text links Cite Abstract Objectives: Patients undergoing hip fracture surgery have a 10 times increased risk of stroke compared with the general population. We aimed to evaluate the association between the CHA 2 DS 2 -VASc (congestive heart failure, hypertension, age ≥75 years, diabetes, previous stroke/TIA [transient ischemic attack]/systemic embolism (2 points), vascular (...) Registry. Measurements: We calculated incidence rates, cumulative incidences, and hazard ratios (HRs) with 95% confidence intervals (CIs) by CHA 2 DS 2 -VASc score, stratified on AF history. Results: The cumulative incidence of ischemic stroke 1 year after hip fracture increased with ascending CHA 2 DS 2 -VASc score, and it was 1.9% for patients with a score of 1 and 8.6% for patients with a score above 5 in the AF group. Corresponding incidences in the non-AF group were 1.6% and 7.6%. Compared

2020 EvidenceUpdates