First-ever Stroke Patients (first-ever + stroke_patient)

Distribution by Scientific Domains


Selected Abstracts


High prevalence of unrecognized cerebral infarcts in first-ever stroke patients with cardioembolic sources

EUROPEAN JOURNAL OF NEUROLOGY, Issue 7 2009
A.-H. Cho
Background:, With magnetic resonance imaging (MRI) analysis, we investigated the prevalence, clinical significance, and factors related to the presence of unrecognized cerebral infarcts in patients with first-ever ischaemic stroke. Methods:, We consecutively included patients who were admitted with first-ever stroke. Unrecognized cerebral infarct was defined as an ischaemic infarction or primary intracerebral hemorrhage on MRI irrelevant to the index stroke, without acute lesions on diffusion-weighted image. Results:, Of the total 203 patients, 78 (39.4%) patients were observed as having unrecognized cerebral infarct. Patients with high-risk cardioembolic sources (e.g., atrial fibrillation) more frequently had unrecognized stroke than those without (P = 0.008, 21/36 [58.3%] vs. 57/167 [34.1%]). On univariate analysis, male sex (P = 0.027) and cardioembolic source (P = 0.008) were associated with the presence of unrecognized cerebral infarcts. After adjustment for gender, age and risk factors, the presence of cardioembolic sources independently increased the risk of unrecognized cerebral infarct (P = 0.002, odds ratio 3.56, 95% confidence interval 1.58,8.02). Regarding clinical outcome at 3 months, the presence of unrecognized cerebral infarct was not associated with the poor clinical outcome. Conclusion:, In our study, the presence of cardioembolic sources was an independent risk factor for the unrecognized cerebral infarct in patients with first-ever stroke. [source]


Patterns of stroke recurrence according to subtype of first stroke event: the North East Melbourne Stroke Incidence Study (NEMESIS)

INTERNATIONAL JOURNAL OF STROKE, Issue 3 2008
Mahmoud Reza Azarpazhooh
Background Specific information about the nature of recurrent events that occur after each subtype of index stroke may be useful for refining preventive therapies. We aimed to determine whether stroke recurrence rates, the pattern of subtype recurrence, and prescription of secondary prevention agents differed according to initial stroke subtype. Methods Multiple overlapping sources were used to recruit all first-ever stroke patients from a geographically defined region of Melbourne, Australia over a 3-year period from 1996 to 1999. Potential stroke recurrences (fatal and nonfatal) occurring within 2 years of the initial event were identified following patient interview and follow up of death records. Subjects were classified into the different Oxfordshire groups and the type of first-ever stroke was compared with recurrent stroke events. Results One thousand, three hundred and sixteen first-ever strokes were registered during the 3-year period (mean age 74.4 years). A total of 103 first recurrent stroke events (fatal and nonfatal) occurred among those with a first-ever ischemic stroke or intracerebral hemorrhage (ICH) during the 2-year follow-up period. The recurrent stroke subtype was different to the index stroke subtype in most (78%) patients. People with partial anterior circulation infarct had the greatest proportion of recurrences (13%), with a third of these being the more severe total anterior circulation infarct subgroup. The relative risk of ICH after an index lacunar infarct (LACI) compared with an index non-LACI was 4.06 (95% CI 1.10,14.97, P=0.038). Prescription of secondary prevention agents was greater at 2 years after stroke than at hospital discharge, and was similar between ischemic stroke subtypes. Conclusion Approximately 9% of people with first-ever stroke suffered a recurrent event, despite many being prescribed secondary prevention agents. This has implications for the uptake of current preventive strategies and the development of new strategies. The possibility that ICH is greater among index LACI cases needs to be confirmed. [source]


Development of entrapment neuropathies in acute stroke patients

ACTA NEUROLOGICA SCANDINAVICA, Issue 1 2009
L. 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]


Prediction of length of stay for stroke patients

ACTA NEUROLOGICA SCANDINAVICA, Issue 1 2007
P. Appelros
Objectives ,, To examine the factors that influence acute and total length of stay (LOS) for stroke patients. Materials and methods ,, The basis of this investigation was a population-based cohort of first-ever stroke patients (n = 388). Subjects were survivors of the initial hospitalization (n = 295). Age, sex, social factors, risk factors, dementia, stroke type, and stroke severity, measured with the NIH stroke scale (NIHSS), were registered. Results ,, Mean acute LOS was 12 days and mean total LOS was 29 days. Independent predictors of acute LOS were stroke severity, lacunar stroke, prestroke dementia, and smoking. Independent predictors of total LOS were stroke severity and prestroke activities of daily living (ADL) dependency. The NIHSS items that best correlated with LOS were paresis, unilateral neglect and level of consciousness. Conclusions ,, Stroke severity is a strong and reliable predictor of LOS. The results of this study can be used as a baseline for evaluating cost-effectiveness of stroke care changes, e.g. organizational changes or evaluation of new drugs. [source]