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Consecutive Stroke Patients (consecutive + stroke_patient)
Selected AbstractsCardiological diagnostic work-up in stroke patients , a comprehensive study of test results and therapeutic implicationsEUROPEAN JOURNAL OF NEUROLOGY, Issue 2 2009B. Schaer Background and purpose:, In some Western countries, many stroke patients undergo routine tests including ECG, echocardiography, carotid ultrasound and Holter monitoring, even though they have been shown to express limited value in unselected patients. Comprehensive data on yield of tests, especially on consequences taken from positive test results, are scanty. Methods:, Consecutive stroke patients with evidence of ischaemic lesions by imaging techniques were included. Aetiology was determined using TOAST-classifications. Rates of positive test results and their impact on drug therapy, especially anticoagulation were evaluated. Results:, Two hundred and forty-one consecutive patients, age 69 ± 13 years were included. Positive test results were documented in 19% with 12-lead ECG, 24% with carotid ultrasound, 24% with echocardiography and never with Holter monitoring. Overall, in 41% positive test results were present. Apart from echocardiography (37%), a change of therapy resulted in 51,56% of patients with a positive test result. Conclusions:, Even though 12-lead ECG, carotid ultrasound and echocardiography only had relatively low incidences of positive findings, their impact on management in case of positive test results was quite high. Nevertheless, future studies to select patients more appropriately are needed. In contrast, Holter monitoring had no impact and should not be used in routine evaluation of stroke patients. [source] Racial disparity in stroke risk factors: the Berlin,Ibadan experience; a retrospective studyACTA NEUROLOGICA SCANDINAVICA, Issue 2 2009M. O. Owolabi Background,,, Different workers have reported racial disparities in the distribution of risk factors for stroke and stroke subtype (ischemic vs hemorrhagic). No transcultural transnational studies have been conducted to confirm and relate these disparities to one another. Our objective was to identify differences in the distribution of risk factors for stroke and stroke subtypes among urban-dwelling stroke patients in Nigeria, a developing country, and Germany, an industrialized country. Methods,,, Consecutive stroke patients in Ibadan (100) and Berlin (103) were studied. Their hospital records were screened to identify documented vascular risk factors and stroke subtype. Results,,, The stroke patients in Ibadan were younger than those in Berlin (t = 4.940, P = 0.000). Hypertension was significantly more common in Ibadan while cigarette smoking, dyslipidemia, atherosclerosis, and cardiac factors were significantly more frequent in Berlin. Cerebral infarction was more common in Berlin (80%) than in Ibadan (63%). Conclusion,,, The risk factors associated with cerebral infarction were more frequent in Berlin. We suspect that racial disparity in risk factors for stroke may account for the difference in proportions of stroke subtype in black and white populations. Larger prospective community-based multinational multiracial studies are required to confirm these disparities and identify possible underlying genetic, dietary, and socio-economic factors. [source] Mechanical embolectomy for large vessel ischemic strokes: A cardiologist's experience,CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 3 2010Dr. Mark Abelson FCP (Cardiology) Abstract Introduction: Large vessel acute ischemic stroke has a poor outcome. Intravenous (IV) thrombolysis is often contra-indicated and if given, usually ineffective. Mechanical embolectomy is an option in these patients and may be performed by an interventional cardiologist experienced in carotid interventions. Method: Consecutive stroke patients were assessed by the stroke physician and, if eligible, referred for possible mechanical embolectomy using the Merci retriever. All procedures were done by a single cardiologist. Patient information, procedural characteristics and clinical outcomes at 90 days were collected by retrospective chart review. Results: A total of 22 patients were referred for emergency cerebral angiography with 17 undergoing mechanical embolectomy. The mean National Institute of Health Stroke Scale (NIHSS) score was 20.1 and the mean stroke duration was 284 min. Recanalization was successful in 15 (88%) patients. Ten patients (59%) had a good outcome (modified Rankin Score ,2 at 90 days) and four died (mortality 23%). Three patients had significant intra-cerebral hemorrhage. There were no other major adverse events. Conclusions: For patients with large vessel occlusion strokes where IV thrombolysis was either contra-indicated or had failed, mechanical embolectomy performed by an interventional cardiologist had a high recanalization rate with an acceptable clinical outcome and safety profile. © 2010 Wiley-Liss, Inc. [source] The classic lacunar syndromes: clinical and neuroimaging correlatesEUROPEAN JOURNAL OF NEUROLOGY, Issue 7 2008J. De Reuck Background:, Although lacunar syndromes (LSs) are aimed to be linked to lacunar infarcts, the relation between both is still not very well defined. Purpose:, The present retrospective study tries to define more specifically the clinical and the neuroimaging characteristics of the five most classic LSs. Patients and methods:, Out of a series of 1617 consecutive stroke patients, admitted to the Ghent University Hospital, 293 presented a classic LS. Magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) was performed within 5 days after stroke onset in 227 patients. An acute territorial infarct was demonstrated in 54 patients. The study population finally consisted of 173 patients with a classic LS in whom the responsible lacune was demonstrated or in the absence of another type of infarct. Results:, The responsible lacune was demonstrated with DWI in 104 patients. Pure motor stroke (MS) correlated significantly with the presence of the responsible lacune in the internal capsule (P = 0.000147) and with the stroke severity (P = 0.00724). No significant correlation was observed between the location of the lacunes and the other LS's. Conclusion:, Pure MS has to be considered as the most specific lacunar syndrome. [source] Predicting motor recovery of the upper limb after stroke rehabilitation: value of a clinical examinationPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 1 2000Hilde Feys Abstract Background and Purpose Only a few studies have been conducted to predict motor recovery of the arm after stroke. The aims of this study were to identify which clinical variables, assessed at different points in time, were predictive of motor recovery, and to construct useful regression equations. Method One hundred consecutive stroke patients who had an obvious motor deficit of the upper limb were evaluated on entry to the study (two to five weeks post-stroke) and at two, six and 12 months after stroke. The Brunnström,Fugl-Meyer test was used as the outcome measure. Predictors included demographic data, overall disability, clinical neurological features, neuropsychological factors and secondary shoulder complications. Results In multiple regression analyses, motor performance was invariably retained as the predictive factor with the highest R-square. Other significant predictive variables were overall disability, muscle tone, proprioception and hemi-inattention. Between 53% and 89% of the total amount of variance was accounted for in all selected models. The accuracy of prediction from clinical measurement in the acute phase diminished as the time span of measurement of outcome increased. Similarly, assessment of the variables at two and six months, rather than in the acute stage, resulted in a considerable improvement in the percentage variance explained at 12 months. The highest accuracy was obtained when predictions were made step-by-step in time. Conclusions It is possible to predict motor recovery of the upper limb accurately through the use of a few clinical measures. Predictive equations are proposed, the use of which are practicable in both clinical practice and research. Copyright © 2000 Whurr Publishers Ltd. [source] Magnetic resonance imaging profiles predict clinical response to early reperfusion: The diffusion and perfusion imaging evaluation for understanding stroke evolution (DEFUSE) studyANNALS OF NEUROLOGY, Issue 5 2006Gregory W. Albers MD Objective To determine whether prespecified baseline magnetic resonance imaging (MRI) profiles can identify stroke patients who have a robust clinical response after early reperfusion when treated 3 to 6 hours after symptom onset. Methods We conducted a prospective, multicenter study of 74 consecutive stroke patients admitted to academic stroke centers in North America and Europe. An MRI scan was obtained immediately before and 3 to 6 hours after treatment with intravenous tissue plasminogen activator 3 to 6 hours after symptom onset. Baseline MRI profiles were used to categorize patients into subgroups, and clinical responses were compared based on whether early reperfusion was achieved. Results Early reperfusion was associated with significantly increased odds of achieving a favorable clinical response in patients with a perfusion/diffusion mismatch (odds ratio, 5.4; p = 0.039) and an even more favorable response in patients with the Target Mismatch profile (odds ratio, 8.7; p = 0.011). Patients with the No Mismatch profile did not appear to benefit from early reperfusion. Early reperfusion was associated with fatal intracranial hemorrhage in patients with the Malignant profile. Interpretation For stroke patients treated 3 to 6 hours after onset, baseline MRI findings can identify subgroups that are likely to benefit from reperfusion therapies and can potentially identify subgroups that are unlikely to benefit or may be harmed. Ann Neurol 2006 [source] Circadian rhythm of stroke onset during the month of RamadanACTA NEUROLOGICA SCANDINAVICA, Issue 2 2010A. El-Mitwalli El-Mitwalli A, Zaher AA, El Menshawi E. Circadian rhythm of stroke onset during the month of Ramadan. Acta Neurol Scand: 2010: 122: 97,101. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Background and purpose,,, The onset of acute stroke exhibits a circadian pattern occurring more frequently in late morning hours. The objective of this study was to investigate the diurnal pattern of stroke during the month of Ramadan. Patients and methods,,, We studied consecutive stroke patients 1 month before Ramadan (BR) and during Ramadan (DR) over two successive years 2007 and 2008. The age, gender, risk factor profiles were analyzed. The National Institute of Health and Stroke Scale Score (NIHSS) was used for clinical assessment at admission. The exact time of stroke onset in both groups was obtained. Results,,, A total of 507 patients were studied: 245 patients in the DR group and 262 patients in the BR group. The age distribution of patients was not significantly different between the two groups. There was no statistically significant difference in the sex ratio, risk factors, and NIHSS score between the two groups (P > 0.05). The higher frequency of stroke onset time in the BR group was in the time between 6:00 a.m. and noon; whereas the frequency was higher between noon and 6:00 p.m. in the DR group. Conclusion,,, A significant shift of the circadian pattern of stroke onset time from the period between 6:00 a.m. and noon to that between noon and 6:00 pm has been found during the month of Ramadan. [source] | ||||||||||