Home About us Contact
|
Home About us Contact | ||
|
|
||
Stroke Scale Score (stroke + scale_score)
Kinds of Stroke Scale Score Selected AbstractsCircadian 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] Vinpocetine treatment in acute ischaemic stroke: a pilot single-blind randomized clinical trialEUROPEAN JOURNAL OF NEUROLOGY, Issue 1 2001V. L. Feigin The aim of the study was to assess the safety and feasibility of a clinical trial on the effect of vinpocetine, a synthetic ethyl ester of apovincamine, in acute ischaemic stroke. Thirty consecutive patients with computed tomography verified diagnosis of acute ischaemic stroke, who could receive drug treatment within 72 h of stroke onset, were enrolled. The patients were randomly allocated to receive either low-molecular weight dextran alone or in combination with vinpocetine. Poor outcome was defined as being dead or having a Barthel index of <,70 or a Rankin score of 3,5. Intention-to-treat analysis was applied. One-tenth of all hospitalized patients with acute ischaemic stroke were eligible for the trial. Thirty eligible patients were treated with either low-molecular weight dextran alone (mean age 57.9 ± 11.6 years, n = 15) or in combination with vinpocetine (mean age 60.8 ± 6.6 years, n = 15). The two treatment groups were comparable with respect to major prognostic variables. A relative risk (RR) reduction of poor outcome at 3 months follow-up was 30% (RR = 0.7; 95% confidence interval [CI] 0.1,3.4), as defined by the modified Barthel Index, and 60% as defined by the modified Ranking score (RR = 0.4, 95% CI: 0.1,1.7). The National Institute of Health (NIH,NINDS) Stroke Scale score was marginally significantly better in the vinpocetine treated group at 3 months of follow-up (P = 0.05, anova). No significant adverse effects were seen. This pilot study shows that a full-scale randomized double-blind, placebo-controlled trial of vinpocetine treatment in acute ischaemic stroke is feasible and warranted. [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] 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] Combined thrombolysis with abciximab and rtPA in patients with middle cerebral artery occlusionACTA NEUROLOGICA SCANDINAVICA, Issue 1 2010G. Gahn Background,,, In patients with acute middle cerebral artery (MCA) occlusion, recanalization rates with intravenous (IV) recombinant tissue plasminogen activator (rtPA) are limited. Aim, We evaluated the feasibility and safety of combined IV thrombolysis with abciximab and reduced dose rtPA in a 3- to 6-h time window. Methods,,, We prospectively (March 2002 to February 2005) studied patients with symptomatic MCA occlusion on computed tomography (CT) angiography and absence of major early ischemic changes (EIC) on non-contrast CT (NCCT) within 3,6 h from symptom onset. Patients were treated with IV abciximab and half-standard dose rtPA. Outcome parameters were symptomatic intracerebral hemorrhage (sICH), early clinical improvement and functional independence at discharge (modified Rankin Scale score , 2). Results,,, Of 13 patients, mean age was 62 ± 11 years, onset-to-treatment time 4.8 ± 0.9 h and median baseline National Institutes of Health Stroke Scale score 11 (interquartile range 6.5,13.5). sICH occurred in one patient (8%). We observed early clinical improvement in four patients (31%). Six patients (46%) were functionally independent at discharge. Conclusions,,, In patients with acute symptomatic MCA occlusion and absence of major EIC on NCCT, combined IV thrombolysis with abciximab and half-standard dose rtPA was feasible and seemed to be safe if applied within 3,6 h from symptom onset. [source] Basilar artery atherosclerotic disease is related to subacute lesion volume increase in pontine base infarctionACTA NEUROLOGICA SCANDINAVICA, Issue 2 2009J. S. Kim Background,,, Although basilar artery atherosclerotic disease (BAD) is frequent in patients with pontine base infarction, it remains unknown whether BAD is related to the lesion size or clinical outcome. Methods,,, We studied 56 patients with unilateral pontine base infarction who underwent (i) diffusion-weighted MRI within 48 h after stroke onset and (ii) follow-up MRI and MR angiography in the subacute stage. Neurologic progression was defined as increased National Institutes of Health Stroke Scale score by , 2 during admission. Clinical outcome was dichotomized as good and poor (, 3) according to the modified Rankin Scale at 1 month after stroke onset. Results,,, Twenty-two patients (39%) had BAD and 15 patients (27%) had neurologic progression. Follow-up MRI performed at median 3.5 ± 1.1 days after the initial MRI showed the lesion volume significantly increased (P < 0.001). The BAD was not significantly related to demographic characteristics, risk factors, initial and follow-up lesion volume, neurologic progression and clinical outcome, but was closely related to the subacute increase in lesion volume (P = 0.004 for 20% increase, P = 0.029 for 50% increase). Conclusions,,, BAD is related to subacute increase in lesion volume, but not to ultimate poor clinical outcome in patients with pontine base infarction. [source] The Impact of a Concurrent Trauma Alert Evaluation on Time to Head Computed Tomography in Patients with Suspected StrokeACADEMIC EMERGENCY MEDICINE, Issue 3 2006Esther H. Chen MD Background: Emergency department (ED) overcrowding threatens quality of care by delaying the time to diagnosis and treatment of patients with time-sensitive diseases, such as acute stroke. Objective: The authors hypothesized that the presence of a trauma alert evaluation would impede the time to head computed tomography (hCT) in patients with stroke-like symptoms. Methods: This was a secondary analysis of prospectively collected data on patients with potential stroke who received an hCT in an urban trauma center ED from January 1, 2004, to November 30, 2004. Structured data collection included historical and examination items, National Institutes of Health (NIH) stroke scale score, laboratory and radiographic results, and final diagnosis. Admitted patients were followed in hospital. Patients who presented within one hour following a trauma evaluation were compared with patients who presented without concurrent trauma for triage time until completion of hCT. Chi-square, t-tests, and 95% confidence intervals (95% CIs) were used for comparisons. Results: The 171 patients enrolled had a mean (± standard deviation) age of 60.7 (± 7) years; 60% were female; and 58% were African American. Of these, 72 patients had a significant cerebrovascular event (38 [22%] ischemic stroke, 25 [15%] transient ischemic attack, seven [4%] intracranial hemorrhage, one [0.6%] subarachnoid hemorrhage, and one [0.6%] subdural hematoma). The remaining diagnoses included 4.6% migraine, 2.3% seizure, 2.9% syncope, 2.3% Bell's palsy, and 2.9% vertigo. There was no significant difference in time to hCT in patients who presented during a trauma activation and those who did not (99 minutes [interquartile range (IQR) = 24,156] vs. 101 minutes [IQR = 43,151.5]; p = 0.537). In subgroup analysis of patients with a significant cerebrovascular event, times to hCT were also similar (24 minutes [IQR = 12,99] vs. 61 minutes [IQR = 15,126]; p = 0.26). Conclusions: In the authors' institution, the presence of concurrent trauma evaluation does not delay CT imaging of patients with potential stroke. [source] | ||||||||||