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Acute Stroke Patients (acute + stroke_patient)
Selected AbstractsSonography of the shoulder in hemiplegic patients undergoing rehabilitation after a recent strokeJOURNAL OF CLINICAL ULTRASOUND, Issue 4 2009Ya-Ping Pong MD Abstract Purpose. To examine the hemiplegic shoulders for soft-tissue injury by musculoskeletal sonography and to determine the relationship between the motor functions of the upper extremity and these injuries, which play an important role in hemiplegic shoulder pain and may impede rehabilitation. Methods. The following characteristics of 34 acute stroke patients were recorded: age, gender, height, body weight, side of hemiplegia, type and duration of stroke, Brunnstrom stage, subluxation, and degree of spasticity of the upper extremity. On the basis of the Brunnstrom stage, the patients were divided into 2 groups. Patients with stages I, II, or III were categorized under the lower Brunnstrom stage (LBS) group (n = 21), and those with stages IV, V, or VI were allocated to the higher Brunnstrom stage (HBS) group (n = 13). Both shoulders of each patient were examined by musculoskeletal sonography with a 5,10-MHz linear transducer on 2 separate occasions (i.e., at admission and 2 weeks after rehabilitation). Results. With the exception of age, there were no significant differences in the demographic and clinical characteristics of the patients in the 2 groups. Shoulder musculoskeletal sonography revealed soft-tissue injury in 7 patients (33%) and 15 patients (71%) in the LBS group at admission and 2 weeks after rehabilitation, respectively (p < 0.05), and in 4 patients (31%) in the HBS group both at admission and 2 weeks after rehabilitation. Conclusions. Acute stroke patients with poor upper limb motor functions are more prone to soft-tissue injury of the shoulder during rehabilitation. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009. [source] Carotid plaque computed tomography imaging in stroke and nonstroke patientsANNALS OF NEUROLOGY, Issue 2 2008Max Wintermark MD Objective To identify a set of computed tomographic (CT) features of carotid atherosclerotic plaques that is significantly associated with ischemic stroke. Methods In a cross-sectional study, we retrospectively identified 136 consecutive patients admitted to our emergency department with suspected stroke who underwent a CT-angiogram of the carotid arteries. CT-angiographic studies of the carotid arteries were processed automatically using automated computer classifier algorithm that quantitatively assesses a battery of carotid CT features. Acute stroke patients were categorized into "acute carotid stroke patients" and "nonacute carotid stroke patients" independent of carotid wall CT features, using the Causative Classification System for Ischemic Stroke, which includes the neuroradiologist's review of the imaging studies of the brain parenchyma and of the degree of carotid stenosis, and charted test results (such as electrocardiogram). Univariate followed by multivariate analyses were used to build models to differentiate between these patient groups and to differentiate between the infarct and unaffected sides in the "acute carotid stroke patients." Results Forty "acute carotid stroke" patients and 50 "nonacute carotid stroke" patients were identified. Multivariate modeling identified a small number of the carotid wall CT features that were significantly associated with acute carotid stroke, including wall volume, fibrous cap thickness, number and location of lipid clusters, and number of calcium clusters. Interpretation Patients with acute carotid stroke demonstrate significant differences in the appearance of their carotid wall ipsilateral to the side of their infarct, when compared with either nonacute carotid stroke patients or the carotid wall contralateral with the infarct side. Ann Neurol 2008;64:149,157 [source] EFNS guideline on neuroimaging in acute stroke.EUROPEAN JOURNAL OF NEUROLOGY, Issue 12 2006Report of an EFNS task force Neuroimaging techniques are necessary for the evaluation of stroke, one of the leading causes of death and neurological impairment in developed countries. The multiplicity of techniques available has increased the complexity of decision making for physicians. We performed a comprehensive review of the literature in English for the period 1965,2005 and critically assessed the relevant publications. The members of the panel reviewed and corrected an initial draft, until a consensus was reached on recommendations stratified according to the European Federation of Neurological Societies (EFNS) criteria. Non-contrast computed tomography (CT) scan is the established imaging procedure for the initial evaluation of stroke patients. However, magnetic resonance imaging (MRI) has a higher sensitivity than CT for the demonstration of infarcted or ischemic areas and depicts well acute and chronic intracerebral hemorrhage. Perfusion and diffusion MRI together with MR angiography (MRA) are very helpful for the acute evaluation of patients with ischemic stroke. MRI and MRA are the recommended techniques for screening cerebral aneurysms and for the diagnosis of cerebral venous thrombosis and arterial dissection. For the non-invasive study of extracranial vessels, MRA is less portable and more expensive than ultrasonography but it has higher sensitivity and specificity for carotid stenosis. Transcranial Doppler is very useful for monitoring arterial reperfusion after thrombolysis, for the diagnosis of intracranial stenosis and of right-to-left shunts, and for monitoring vasospasm after subarachnoid hemorrhage. Currently, single photon emission computed tomography and positron emission tomography have a more limited role in the evaluation of the acute stroke patient. [source] Effect of daytime, weekday and year of admission on outcome in acute ischaemic stroke patients treated with thrombolytic therapyEUROPEAN JOURNAL OF NEUROLOGY, Issue 4 2010M. Jauss Background:, Since doubts were raised, if a challenging medical procedure such as acute stroke treatment including thrombolysis with recombinant tissue plasminogen activator (rTPA) is available with identical standard and outcome 24 h and 7 days a week our aim was to examine if acute stroke patients defined by onset-admission time (OAT) of , 3 h were treated differently or had distinct outcome when admitted during off duty hours (day versus night and weekend versus weekdays) and if any differences in treatment or outcome were apparent when comparing patients admitted in the year 2003 with patients admitted in the year 2006. Methods:, We analyzed 2003,2006 data of a prospective registry and grouped patients by time, day, and year of admission. The evaluation was limited to patients that were diagnosed with ischaemic stroke and with OAT of , 3 h. Medical and sociodemographic items, use of thrombolytic treatment, complications during clinical course and place of discharge were obtained. Clinical state on admission and discharge was assessed using the modified Rankin scale. Comparison with chi-square test, t -test and logistic regression was performed. Results:, Patient's characteristics, rate of thrombolysis, and outcome were independent from time or day of admission. Proportion of patients with good clinical state at discharge increased significantly from 2003 to 2006 together with a higher rate of rTPA treatment without increase of intracranial hemorrhage. Proportion of patients discharged in good clinical condition after rTPA treatment increased from 34% to 44%. Conclusions:, Stroke treatment in potential candidates for thrombolytic therapy revealed no impairment on weekend or at night already in 2003. During 4 years, it was possible to increase rate of rTPA treatment from 8.9% to 21.8% without increment of complications or death, confirming that rTPA is safe and can be implemented with full daily and weekly coverage. [source] Clinical application of transcranial colour-coded duplex sonography , a reviewEUROPEAN JOURNAL OF NEUROLOGY, Issue 1 2002Stephan G. Zipper Transcranial colour-coded duplex sonography (TCCS) is a new and non-invasive ultrasound application that combines both imaging of intracranial vessels and parenchymal structures at a high spatial resolution. This manuscript reviews the clinical applications of TCCS with focus on its diagnostic abilities in acute stroke patients. Furthermore, new experimental imaging techniques are discussed. [source] Association Between Migraine and Headache Attributed to Stroke: A Case,Control StudyHEADACHE, Issue 10 2008Katiuscia Nardi MD Background., Several studies were carried out to investigate the occurrence of headache attributed to acute stroke in patients with a lifetime history of migraine. Methods., In a case,control series of 96 acute stroke patients with a lifetime history of migraine (M+) and 96 stroke patients without (M,), ischemic stroke patients only, without secondary infarction, were selected. The headache attributed to acute ischemic stroke was then analyzed. Results., (M+) patients complained of headache more often than (M,) patients (P < .0001), mainly in the 24 hours before stroke onset (P < .0001). Migraine-like features of headache were recognized in a greater proportion of cases in the (M+) patient group with ischemic stroke (P < .018). A preferential brainstem location of ischemic stroke in (M+) patients emerged compared with (M,) patients (P = .014). Discussion., The high prevalence of headache attributed to stroke in (M+) patients, in a relevant proportion of cases presenting as a sentinel headache, suggests that cerebral ischemia lowers the threshold for head pain more easily in these "susceptible" patients. The most frequent involvement of the brainstem in (M+) patients with ischemic infarction concurs with recent reports that emphasized a greater headache frequency when cerebral infarctions are localized in this structure or deep brain gray matter. [source] Stroke units: many questions, some answersINTERNATIONAL JOURNAL OF STROKE, Issue 1 2009Blanca Fuentes Background The development of specialized stroke units has been a landmark innovation in acute stroke care. However, the high scientific evidence level for the recommendation for stroke units to provide clinical attention for acute stroke patients does not correspond to the level of stroke unit implementation. A narrative, nonsystematic review on published studies on stroke units was conducted, with special emphasis on those demonstrating their efficacy and effectiveness. We also attempt to provide some answers to several open questions regarding practical issues of stroke units. Summary of review Stroke units represent the most efficacious model for care provision compared with general ward care and stroke teams. Every stroke patient can benefit from stroke unit care. These units are efficient, cost-effective and their benefits are consistent over time. Compared with other specific stroke therapies such as aspirin or intravenous thrombolytic agents, stroke units have a higher target population and higher benefit in terms of number of deaths and/or dependencies avoided. New approaches in stroke unit management such as the implementation of noninvasive monitoring or alternative clinical pathways could improve their benefit even further. Conclusion Stroke units are cost-effective and need to be considered as a priority in health-care provision for stroke patients. [source] Sonography of the shoulder in hemiplegic patients undergoing rehabilitation after a recent strokeJOURNAL OF CLINICAL ULTRASOUND, Issue 4 2009Ya-Ping Pong MD Abstract Purpose. To examine the hemiplegic shoulders for soft-tissue injury by musculoskeletal sonography and to determine the relationship between the motor functions of the upper extremity and these injuries, which play an important role in hemiplegic shoulder pain and may impede rehabilitation. Methods. The following characteristics of 34 acute stroke patients were recorded: age, gender, height, body weight, side of hemiplegia, type and duration of stroke, Brunnstrom stage, subluxation, and degree of spasticity of the upper extremity. On the basis of the Brunnstrom stage, the patients were divided into 2 groups. Patients with stages I, II, or III were categorized under the lower Brunnstrom stage (LBS) group (n = 21), and those with stages IV, V, or VI were allocated to the higher Brunnstrom stage (HBS) group (n = 13). Both shoulders of each patient were examined by musculoskeletal sonography with a 5,10-MHz linear transducer on 2 separate occasions (i.e., at admission and 2 weeks after rehabilitation). Results. With the exception of age, there were no significant differences in the demographic and clinical characteristics of the patients in the 2 groups. Shoulder musculoskeletal sonography revealed soft-tissue injury in 7 patients (33%) and 15 patients (71%) in the LBS group at admission and 2 weeks after rehabilitation, respectively (p < 0.05), and in 4 patients (31%) in the HBS group both at admission and 2 weeks after rehabilitation. Conclusions. Acute stroke patients with poor upper limb motor functions are more prone to soft-tissue injury of the shoulder during rehabilitation. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009. [source] Aortic Dissection Presenting as an Acute Ischemic Stroke for ThrombolysisJOURNAL OF NEUROIMAGING, Issue 3 2005Ken Uchino MD ABSTRACT Thrombolysis for the treatment of acute ischemic stroke requires careful selection of patients. The authors report a case of aortic dissection presenting with acute ischemic stroke for which emergent ultrasonographic evaluation was helpful in the diagnosis and subsequent treatment. The patient presented with acute middle cerebral artery ischemic stroke symptoms and complained of bilateral ear and chest pain. Chest x-ray, cardiac enzymes, and transthoracic echocardiogram were normal, and she was considered for thrombolytic therapy. Carotid ultrasound revealed right common carotid occlusion that led to the diagnosis of aortic dissection, confirmed by chest computed tomography. An experienced sonographer with skills to perform rapid intra- and extracranial examinations may help to change the treatment plan for acute stroke patients. [source] Multiple spin-echo spectroscopic imaging for rapid quantitative assessment of N-acetylaspartate and lactate in acute strokeMAGNETIC RESONANCE IN MEDICINE, Issue 2 2004Astrid Stengel Abstract Monitoring the signal levels of lactate (Lac) and N-acetylaspartate (NAA) by chemical shift imaging can provide additional knowledge about tissue damage in acute stroke. Despite the need for this metabolic information, spectroscopic imaging (SI) has not been used routinely for acute stroke patients, mainly due to the long acquisition time required. The presented data demonstrate that the application of a fast multiple spin-echo (MSE) SI sequence can reduce the measurement time to 6 min (four spin echoes per echo train, 32 × 32 matrix). Quantification of Lac and NAA in terms of absolute concentrations (i.e., mmol/l) can be achieved by means of the phantom replacement approach, with correction terms for the longitudinal and transversal relaxation adapted to the multiple spin-echo sequence. In this pilot study of 10 stroke patients (symptom onset < 24 hr), metabolite concentrations obtained from MSE-SI add important information regarding tissue viability that is not provided by other sequences (e.g., diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI)). Metabolic changes extended beyond the borders of the apparent diffusion coefficient (ADC) lesion in nine of the 10 patients, showing a rise in Lac concentrations up to 18 mmol/l, while NAA levels sometimes dropped below the detection level. Considerable differences among the patients in terms of the Lac concentrations and the size of the SI-ADC mismatch were observed. Magn Reson Med 52:228,238, 2004. © 2004 Wiley-Liss, Inc. [source] Central facial palsy revisited: A clinical-radiological study,ANNALS OF NEUROLOGY, Issue 3 2010Luigi Cattaneo MD We investigated the pattern of volitional facial motor deficits in acute stroke patients. We assessed the strength of single facial movements and correlated it to the site of infarct classified on computed tomography scans. Exclusion criteria were previous stroke, cerebral hemorrhage, and subcortical stroke. Results showed that weakness in eyelid closure was associated with anterior cerebral artery (ACA) stroke. Weakness in lip opening was associated with middle cerebral artery (MCA) stroke. We suggest that sparing of upper facial movements in MCA stroke is due to the presence of an upper face motor representation in both the MCA and ACA territories. ANN NEUROL 2010;68:404,408 [source] Resting interhemispheric functional magnetic resonance imaging connectivity predicts performance after strokeANNALS OF NEUROLOGY, Issue 3 2010Alex R. Carter MD Objective Focal brain lesions can have important remote effects on the function of distant brain regions. The resulting network dysfunction may contribute significantly to behavioral deficits observed after stroke. This study investigates the behavioral significance of changes in the coherence of spontaneous activity in distributed networks after stroke by measuring resting state functional connectivity (FC) using functional magnetic resonance imaging. Methods In acute stroke patients, we measured FC in a dorsal attention network and an arm somatomotor network, and determined the correlation of FC with performance obtained in a separate session on tests of attention and motor function. In particular, we compared the behavioral correlation with intrahemispheric FC to the behavioral correlation with interhemispheric FC. Results In the attention network, disruption of interhemispheric FC was significantly correlated with abnormal detection of visual stimuli (Pearson r with field effect = ,0.624, p = 0.002). In the somatomotor network, disruption of interhemispheric FC was significantly correlated with upper extremity impairment (Pearson r with contralesional Action Research Arm Test = 0.527, p = 0.036). In contrast, intrahemispheric FC within the normal or damaged hemispheres was not correlated with performance in either network. Quantitative lesion analysis demonstrated that our results could not be explained by structural damage alone. Interpretation These results suggest that lesions cause state changes in the spontaneous functional architecture of the brain, and constrain behavioral output. Clinically, these results validate using FC for assessing the health of brain networks, with implications for prognosis and recovery from stroke, and underscore the importance of interhemispheric interactions. ANN NEUROL 2010;67:365,375 [source] Copeptin: A novel, independent prognostic marker in patients with ischemic stroke,ANNALS OF NEUROLOGY, Issue 6 2009Mira Katan MD Objective Early prediction of outcome in patients with ischemic stroke is important. Vasopressin is a stress hormone. Its production rate is mirrored in circulating levels of copeptin, a fragment of provasopressin. We evaluated the prognostic value of copeptin in acute stroke patients. Methods In a prospective observational study, copeptin was measured using a new sandwich immunoassay on admission in plasma of 362 consecutive patients with an acute ischemic stroke. The prognostic value of copeptin to predict the functional outcome (defined as a modified Rankin Scale score of ,2 or ,3), mortality within 90 days, was compared with the National Institutes of Health Stroke Scale score and with other known outcome predictors. Results Patients with an unfavorable outcomes and nonsurvivors had significantly increased copeptin levels on admission (p <0.0001 and p <0.0001). Receiver operating characteristics to predict functional outcome and mortality demonstrated areas under the curve of copeptin of 0.73 (95% confidence interval [CI], 0.67,0.78) and 0.82 (95% CI, 0.76,0.89), which was comparable with the National Institutes of Health Stroke Scale score but superior to C-reactive protein and glucose (p <0.01). In multivariate logistic regression analysis, copeptin was an independent predictor of functional outcome and mortality, and improved the prognostic accuracy of the National Institutes of Health Stroke Scale to predict functional outcome (combined areas under the curve, 0.79; 95% CI, 0.74,0.84; p <0.01) and mortality (combined areas under the curve, 0.89; 95% CI, 0.84,0.94; p <0.01). Interpretation Copeptin is a novel, independent prognostic marker improving currently used risk stratification of stroke patients. Ann Neurol 2009;66:799,808 [source] Circulating endothelial microparticles as a marker of cerebrovascular disease,ANNALS OF NEUROLOGY, Issue 2 2009Keun-Hwa Jung MD Objective Circulating endothelial microparticles (EMPs) have been reported to reflect vascular damage. Detailed profiling of these blood endothelial markers may adumbrate the pathogenesis of stroke or enable determination of the risk for stroke. We investigated EMP profiles in patients at risk for cerebrovascular disease. Methods We prospectively examined 348 consecutive patients: 73 patients with acute stroke and 275 patients with vascular risk factors but no stroke events. We quantified various types of EMPs by flow cytometry using CD31, CD42b, annexin V (AV), and CD62E antibodies in the peripheral blood of patients. This method allowed fractionation of CD31+/CD42b,, CD31+/AV+, and CD62E+ EMPs. Clinical and laboratory factors associated with EMPs were assessed. Results Recent ischemic episodes were found to be more strongly associated with greater CD62E+ EMP levels than with levels of other phenotypes. Increased National Institutes of Health Stroke Scale scores and infarct volumes in acute stroke patients were significantly associated with greater CD62E+ EMP levels. In the risk factor group, patients with extracranial arterial stenosis had greater CD62E+ EMP levels, whereas those with intracranial arterial stenosis had greater CD31+/CD42b, and CD31+/AV+ EMP levels. The ratio of CD62E+ to CD31+/CD42b, or CD31+/AV+ EMP level significantly discriminated extracranial and intracranial arterial stenosis. Interpretation Circulating EMP phenotypic profiles reflect distinct phenotypes of cerebrovascular disease and are markers of vascular pathology and an increased risk for ischemic stroke. Ann Neurol 2009;66:191,199 [source] Depression predicts unfavourable functional outcome and higher mortality in stroke patients: The Bergen Stroke StudyACTA NEUROLOGICA SCANDINAVICA, Issue 2010H. Naess Naess H, Lunde L, Brogger J, Waje-Andreassen U. Depression predicts unfavourable functional outcome and higher mortality in stroke patients: The Bergen Stroke Study. Acta Neurol Scand: 2010: 122 (Suppl. 190): 34,38. © 2010 John Wiley & Sons A/S. Objective,,, To assess the influence of depression prior to stroke (PD) on stroke severity on admittance, functional outcome (short- and long-term), mortality, and long-term depression (PSD). Methods,,, Consecutive acute stroke patients were screened for PD. The National Institute of Health Stroke Scale score was obtained on admission. Short-term functional state was registered by the modified Rankin scale and on long-term functional outcome by the Barthel Index. PSD was defined as depression subscale of the hospital anxiety and depression scale (HADSD) ,11. HADSD and Barthel Index were obtained by postal questionnaire. Survival analyses were performed. Results,,, Among 771 patients 21.7% had PD. Among 376 patients returning the questionnaire, 8.8% were depressed. On logistic regression analyses severity of stroke on admission, short-term, and long-term functional outcome were independently associated with PD. Logistic regression showed PSD to be independently associated with PD and being unmarried. Cox regression analyses showed that both PD and PSD were associated with high long-term mortality. Conclusions,,, This study has identified several factors associated with PSD. PD predicts more severe stroke on admittance and less functional improvement both in the short- and the long-term. Both PD and PSD predict higher long-term mortality. [source] Delirium in acute stroke , prevalence and risk factorsACTA NEUROLOGICA SCANDINAVICA, Issue 2010M. H. Dahl Dahl MH, Rønning OM, Thommessen B. Delirium in acute stroke , prevalence and risk factors. Acta Neurol Scand: 2010: 122 (Suppl. 190): 39,43. © 2010 John Wiley & Sons A/S. Background,,, Delirium is frequently seen as a major complication among elderly stroke patients. Few studies have prospectively studied delirium as a complication of acute stroke. In these studies, the results are conflicting regarding risk factors and estimated prevalence. The aims of the present study are to assess the prevalence of delirium in patients with acute stroke treated in an acute Stroke Unit, identify characteristics of patients with delirium and important factors associated with the development of delirium. Methods,,, We conducted a prospective study of patients with delirium and acute stroke consecutively admitted to a Stroke Unit. The diagnosis of delirium was based on Confusion Assessment Method (CAM). CAM is devised from DSM-III-R criteria based on the diagnosis of delirium, and is a simple test with high sensitivity and specificity. Results,,, One hundred and seventy-eight patients with a diagnosis of stroke were eligible for the study. The prevalence of delirium in acute stroke in our study was 10% (18 of 178 patients). Patients with delirium had significantly longer length of stay in the Stroke Unit (12.3 vs 8.5 days, P < 0.004). Prestroke dementia [odds ratio (OR) 18.7], hemianopsia (OR 12.3), apraxia (OR 11.0), higher age (OR 5.5) and infection (UTI or pneumonia) (OR 4.9) during in-hospital stay were associated with increased risk of delirium. Conclusion,,, One of 10 stroke patients had delirium. This is the lowest prevalence of delirium shown in acute stroke patients. In our study, all patients were treated in a Stroke Unit. A Stroke Unit like the Scandinavian model may be beneficial in preventing delirium. [source] Long-term effect of repetitive transcranial magnetic stimulation on motor function recovery after acute ischemic strokeACTA NEUROLOGICA SCANDINAVICA, Issue 1 2010E. M. Khedr Objective,,, Although there is evidence for short term benefits of rTMS in stroke, longer term effects have not been reported. The aim of the study was to evaluate the effect of two different frequencies of rTMS on motor recovery and on cortical excitability up to 1 year post-treatment. Methods,,, Forty-eight patients with acute ischemic stroke were randomly classified into three groups. The first two groups received real rTMS over motor cortex (3 and 10 Hz respectively) of the affected hemisphere and the third group received sham stimulation of the same site, daily for five consecutive days. Disability was assessed before, after fifth sessions, and then after 1, 2, 3 and 12 months. Cortical excitability was assessed for both hemispheres before and after the second and fifth sessions. Results,,, A significant ,rTMS × time' interaction was obtained indicating that real and sham rTMS had different effects on rating scales. This was because real rTMS produced greater improvement than sham that was evident even at one year follow-up. These improvements were associated with changes in cortical excitability over the period of treatment. Conclusion,,, These results confirm that real rTMS over motor cortex can enhance and maintain recovery and may be a useful add on therapy in treatment of acute stroke patients. [source] Feasibility and logistics of MRI before thrombolytic treatmentACTA NEUROLOGICA SCANDINAVICA, Issue 3 2009C. Sølling Objectives,,, The study analyzes feasibility and time-delays in Magnetic resonance imaging (MRI) based thrombolysis and estimate the impact of MRI on individual tissue plasminogen activator (rtPA) treatment. Materials and methods,,, Feasibility of MRI and time logistics were prospectively recorded in patients referred with presumed acute stroke over a 2 year time period. Door-to-needle-times (DNT) were compared with those of patients treated with rtPA after conventional CT during the same time period, and to published open label studies. Results,,, We received 174 patients with presumed stroke. MRI was feasible in 141 of 161 (88%) of those requiring acute imaging. MRI supported the decision to treat 11 patients with mild symptoms or seizures, and not to treat four patients with extensive infarctions. Median ,door-to-needle time' (DNT) in MR scanned patients (70 min), did not differ significantly from DNT after conventional CT (n = 17, DNT = 66 min, P = 0.27) or the Safe Implementation of Thrombolysis in Stroke (SITS-MOST) registry (DNT = 68 min). Conclusions,,, Magnetic resonance imaging can be performed in the majority of acute stroke patients without delaying treatment. MRI may affect decision making in a large proportion of patients. [source] Development of entrapment neuropathies in acute stroke patientsACTA NEUROLOGICA SCANDINAVICA, Issue 1 2009L. Kabayel Background,,, Stroke is the third most common cause of mortality and is one of the most common causes of morbidity in the world. Polyneuropathies and entrapment neuropathies are known as the complications of stroke. Aims of the study,,, In this study we aimed to evaluate the development of entrapment neuropathies in severe stroke patients within the first month of the event. Methods,,, Twenty first-ever stroke patients were included in the study. The nerve conduction studies were performed within the first 48 h and repeated 1 month later. Results,,, At the end of the first month, seven of the 20 patients had median nerve entrapment at the wrist, five had ulnar nerve entrapment at the elbow and seven had peroneal nerve entrapment at the fibular head in the hemiparetic side. Three patients had median nerve entrapment at the wrist, one patient had ulnar nerve entrapment at the elbow, and none had peroneal nerve entrapment in the non-paretic side. Conclusion,,, Our results confirm that, in severe hemiparetic patients, the entrapment neuropathies may be commonly seen, especially in the paretic extremities. The early rehabilitation programs against the development of entrapment neuropathies may be beneficial in stroke patients. [source] | ||||||||||||||||||||||