scholarly journals Neuropsychological Profiles of 5-Year Ischemic Stroke Survivors by Oxfordshire Stroke Classification and Hemisphere of Lesion

Stroke ◽  
2012 ◽  
Vol 43 (1) ◽  
pp. 50-55 ◽  
Author(s):  
Suzanne Barker-Collo ◽  
Nicola Starkey ◽  
Carlene M.M. Lawes ◽  
Valery Feigin ◽  
Hugh Senior ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Stroke Survivors ◽  
Stroke Classification

scholarly journals Association between physical exercise and stroke recurrence among first-ever ischemic stroke survivors

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lisha Hou ◽  
Mier Li ◽  
Ju Wang ◽  
Yawen Li ◽  
Qianwen Zheng ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Exercise Duration ◽  
Stroke Recurrence ◽  
Stroke Survivors ◽  
Face To Face ◽  
Baseline Information ◽  
Exercise Type ◽  
The Relationship

AbstractThe relationship between exercise and stroke recurrence is controversial. This study was designed to test whether an association exists between exercise and ischemic stroke recurrence in first-ever ischemic stroke survivors. Data were collected from January 2010 to June 2016. Baseline information was obtained during face-to-face interviews, and follow-up phone interviews were conducted every 3 months. Exercise type, frequency, intensity, and duration were recorded. Discrete-time survival analysis was used to determine the relationship between exercise and stroke recurrence. 760 first-ever ischemic stroke survivors who were able to exercise were enrolled. After adjusting for covariates, patients who exercised 3.5–7 h per week and more than 7 h per week had a lower relapse risk than patients who did not exercise (3.5–7: OR 0.415; > 7: OR 0.356). Moreover, if the fluctuation of exercise duration was over 4 h, the patients had a higher risk of stroke recurrence than those with variability of less than 2 h (OR 2.153, P = 0.013). Stroke survivors who engage in long-term regular mild exercise (more than 5 sessions per week and lasting on average 40 min per session) have a lower recurrence rate. Irregular exercise increases the risk of stroke recurrence.

scholarly journals Differential effects of body mass index on domain-specific cognitive outcomes after stroke

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Minwoo Lee ◽  
Mi Sun Oh ◽  
San Jung ◽  
Ju-Hun Lee ◽  
Chul-Ho Kim ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Ischemic Stroke ◽  
Cognitive Function ◽  
Frontal Lobe ◽  
Body Mass ◽  
Cognitive Outcomes ◽  
Stroke Survivors ◽  
Word Fluency ◽  
Domain Specific ◽  
Z Scores

AbstractAlthough the obesity paradox is an important modifiable factor in cardiovascular diseases, little research has been conducted to determine how it affects post-stroke cognitive function. We aimed to investigate the association between body mass index (BMI) and domain-specific cognitive outcomes, focusing on the subdivision of each frontal domain function in post-ischemic stroke survivors. A total of 335 ischemic stroke patients were included in the study after completion of the Korean-Mini Mental Status Examination (K-MMSE) and the vascular cognitive impairment harmonization standards neuropsychological protocol at 3 months after stroke. Frontal lobe functions were analyzed using semantic/phonemic fluency, processing speed, and mental set shifting. Our study participants were categorized into four groups according to BMI quartiles. The z-scores of K-MMSE at 3 months differed significantly between the groups after adjustment for initial stroke severity (p = 0.014). Global cognitive function in stroke survivors in the Q1 (the lowest quartile) BMI group was significantly lower than those in Q2 and Q4 (the highest quartile) BMI groups (K-MMSE z-scores, Q1: − 2.10 ± 3.40 vs. Q2: 0.71 ± 1.95 and Q4: − 1.21 ± 1.65). Controlled oral word association test findings indicated that phonemic and semantic word fluency was lower in Q4 BMI group participants than in Q2 BMI group participants (p = 0.016 and p = 0.023 respectively). BMI might differentially affect cognitive domains after ischemic stroke. Although being underweight may negatively affect global cognition post-stroke, obesity could induce frontal lobe dysfunctions, specifically phonemic and semantic word fluency.

Abstract WP206: Brain Natriuretic Peptide Should Be A Predictive Marker Of Long-term Mortality In Ischemic Stroke Survivors

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Kensaku Shibazaki ◽  
Kazumi Kimura ◽  
Shuichi Fujii ◽  
Kenichiro Sakai ◽  
Jyunya Aoki
Keyword(s):  
Ischemic Stroke ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Multiple Logistic Regression Analysis ◽  
Biological Marker ◽  
Predictive Marker ◽  
Stroke Survivors ◽  
Survival Group ◽  
Long Term Mortality

Background and Purpose We investigated whether brain natriuretic peptide (BNP) can serve as a biological marker of long-term mortality in ischemic stroke survivors. Methods We prospectively enrolled consecutive patients with ischemic stroke within 24 hours of onset from April 2007 to December 2010 and measured plasma BNP upon admission. Survivors were followed up to 12 month after stroke onset. Patients were divided into two groups: the deceased group and the survival group. The factors associated with long-term mortality were investigated by multiple logistic regression analysis. Results A total of 736 patients who were alive at hospital discharge were included (mean age, 72.8 years; 439 males). Death was observed in 130 (17.7%) patients. The median (interquartile range: IQR) of age (81(74-86) years for the deceased group vs. 72 (64-79) years for the survival group, P<0.0001), frequencies of prior ischemic stroke (30% vs. 20%, P=0.0104), hemodialysis (10% vs. 2%, P=0.0002), atrial fibrillation (42% vs. 30%, P=0.0058), mRS score at discharge (4 (3-5) vs. 2 (1-4), P<0.0001), cardioembolism (45% vs. 34%, P=0.0102), creatinine level (0.80 (0.60-1.19) vs. 0.73 (0.58-0.90), P=0.0044), and BNP level (170.0 (74.0-393.0) vs. 50.0 (19.0-146.0) pg/ml, P<0.0001) were significantly higher in the deceased group than in the survival group. In multivariate analysis, age >75 years (odds ratio [OR], 2.89; 95%CI, 1.80-4.65, P=0.0001), hemidialysis (OR, 6.59; 95%CI, 2.47-17.59, P=0.0002), mRS score >3 at discharge (OR, 4.39; 95%CI, 2.77-6.97, P<0.0001), and a plasma BNP >100.0 pg/ml (OR, 3.98; 95%CI, 2.35-6.72, P<0.0001) were found to be independently associated with long-term mortality. BNP remained independent predictors of long-term mortality not only cardioembolism [BNP >200.0pg/ml (OR, 2.45; 95%CI, 1.22-4.90, P=0.0114)] but also non-cardioembolism [BNP >50.0pg/ml (OR, 4.01; 95%CI, 2.15-7.48, P=0.0001)]. Thus, the mortality rate according to the BNP level was as follows: 6% of patients with <50 pg/ml, 16% with 50 to <100 pg/ml, 27% with 100 to <200 pg/ml, 28% with 200 to <400 pg/ml, and 45% with ≥400 pg/ml. Conclusions BNP level upon admission can predict long-term mortality in ischemic stroke survivors.

scholarly journals Incident Cancer in a Cohort of 3,247 Cancer Diagnosis Free Ischemic Stroke Patients

2015 ◽  
Vol 39 (5-6) ◽  
pp. 262-268 ◽  
Author(s):  
Adnan I. Qureshi ◽  
Ahmed A. Malik ◽  
Omar Saeed ◽  
Malik M. Adil ◽  
Gustavo J. Rodriguez ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
General Population ◽  
Annual Rate ◽  
Stroke Survivors ◽  
Stroke Patients ◽  
Incident Cancer ◽  
Race Ethnicity ◽  
Age Adjusted Rates

Background: Subclinical cancer can manifest as a thromboembolic event and may be detected at a later interval in ischemic stroke survivors. We determined the rate of incident cancer and effect on cardiovascular endpoints in a large cohort of ischemic stroke survivors. Methods: An analysis of 3,680 adults with nondisabling cerebral infarction who were followed for two years within the randomized, double-blinded VISP trial was performed. The primary intervention was best medical/surgical management plus a daily supplementation of vitamin B6, vitamin B12, and folic acid. We calculated age-adjusted rates of incidence of cancer among ischemic stroke survivors and standardized incidence ratios (SIR) with 95% confidence intervals (CI) based on comparison with age-adjusted rates in the general population. The significant variables from univariate analysis were entered in a Cox Proportional Hazards analysis to identify the association between various baseline factors and incident cancer after adjusting age, gender, and race/ethnicity. A logistic regression analysis evaluated the association between incident cancer and various endpoints including stroke, coronary heart disease, myocardial infarction, and death after adjusting age, gender, and race/ethnicity. Results: A total of 3,247 patients (mean age ± SD of 66 ± 11; 2,013 were men) were cancer free at the time of enrollment. The incidence of new cancer was 0.15, 0.80, 1.2, and 2.0 per 100 patients at 1 month, 6 months, 1 year, and 2 years, respectively. The age-adjusted annual rate of cancer in patients with ischemic stroke was higher than in persons in the general population at 1 year (581.8/100,000 persons vs. 486.5/100,000 persons, SIR 1.2, 95% CI 1.16-1.24) and 2 years (1,301.7/100,000 vs. 911.5/100,000, SIR 1.4, 95% CI 1.2-1.6) after recruitment. There was a higher risk for death (odds ratio (OR) 3.1, 95% CI 1.8-5.4), and composite endpoint of stroke, coronary heart disease, and/or death (OR 1.4, 95% CI 1.0-2.2) among participants who developed incident cancer compared with those who were cancer free after adjusting for potential confounders. Conclusions: The annual rate of age-adjusted cancer incidence was higher among ischemic stroke patients compared with those in the general population. The odds of mortality were three folds higher among stroke survivors who developed incident cancer.

Prevalence and covariates of masked hypertension in ischemic stroke survivors

2016 ◽  
Vol 21 (4) ◽  
pp. 244-250 ◽  
Author(s):  
Sahrai Saeed ◽  
Ulrike Waje-Andreassen ◽  
Annette Fromm ◽  
Halvor Øygarden ◽  
Halvor Naess ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Stroke Survivors ◽  
Masked Hypertension

Abstract WMP113: Serial Cognitive Testing Performance by Baseline Fazekas Category in Stroke Survivors: A Secondary Analysis of the SPS-3 Trial

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Adam H de Havenon ◽  
Natalia Rost ◽  
Shyam Prabhakaran
Keyword(s):  
Risk Factor ◽  
Ischemic Stroke ◽  
Cognitive Abilities ◽  
Secondary Analysis ◽  
College Education ◽  
Cognitive Testing ◽  
White Matter Hyperintensity ◽  
Absolute Difference ◽  
Stroke Survivors ◽  
One Year

Introduction: Prior research has shown that an increased burden of white matter hyperintensity (WMH) is an independent risk factor for the development of dementia. However, research has not focused specifically on stroke survivors, who are also predisposed to dementia. Methods: This is a secondary analysis of patients in the Secondary Prevention of Small Subcortical Strokes (SPS3) trial, who had a lacunar ischemic stroke within 6 months of enrollment and an MRI at study baseline. The primary outcome is change in the Cognitive Abilities Screening Instrument (CASI) from baseline to a 12 month follow-up. The primary predictor is the Fazekas score on the baseline MRI, with the scores of 0 and 1 collapsed to balance the cohort. We fit regression models to the 12 month CASI and adjusted for baseline CASI, patient age, gender, white race, Barthel Index score at 3 months from enrollment, college education, employment status, diabetes, COPD, and SPS3 randomization arm. Results: We included 2,413 patients with a mean (SD) age of 62.8 (10.6) years and 63.7% were male. There were 946 patients in Fazekas 0-1, 1,009 in Fazekas 2, and 458 in Fazekas 3. The mean (SD) CASI score at baseline and 12 months were 85.3 (12.4) and 86.0 (12.4). In the adjusted linear regression model, compared to a baseline Fazekas of 0-1, a baseline Fazekas of 2 was associated with a worse cognitive score (β coef = -0.55, 95% CI -1.01, -0.08, p=0.020), as was Fazekas of 3 (β coef = -0.76, 95% CI -1.36, -0.16, p=0.013). Conclusion: In patients with recent lacunar stroke, an increased baseline WMH burden is a risk factor for worse performance over a one year period on a validated test of global cognition. Although the absolute difference in score that we found was small (~0.5-0.8 points), this difference is over one year and, over years to decades, could become clinically significant. The implication of this finding is that lacunar ischemic stroke has additive cognitive consequences for patients with an established WMH burden, suggesting that primary stroke prevention in patients with WMH could be an important public health goal to reduce the burden of dementia.

Abstract WP190: Excessive Daytime Sleepiness and Depression in Stroke Survivors

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Quynh Huong Pham ◽  
Anjail Sharrief ◽  
Sean Savitz ◽  
Amrou Sarraj ◽  
Lauren Fournier ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Severe Depression ◽  
Stroke Survivors ◽  
Stroke Patients ◽  
Patient Health ◽  
Post Stroke Depression ◽  
The Relationship ◽  
Concentration Table

Introduction: Excessive daytime sleepiness (EDS) and post-stroke depression (PSD) are risk factors for stroke morbidity and mortality. EDS is commonly seen after stroke, but is not routinely assessed after stroke. EDS may be related to sleep disordered breathing (SDB) including obstructive and central sleep apneas, but can also occur in the absence of SDB. The relationship between EDS and PSD is not well understood. Hypothesis: We sought to assess the association between EDS and PSD. We hypothesized that patients with EDS are more likely to demonstrate symptoms of moderate to severe depression compared to patients without EDS. Methods: We identified ischemic stroke patients from the outpatient clinic registry (06/2014 - 10/2015). We screened for depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9; range 0-27, higher worse), and for EDS using the Epworth Sleepiness Scale (ESS; range 0-24, higher worse). Univariate and multivariate analyses were used to evaluate association between EDS and PHQ-9 (moderate to severe depression = PHQ-9 > 9). Regression analysis was also used to evaluate association between EDS and symptoms included in the PHQ-9. Results: Among 200 ischemic stroke patients, 166 completed ESS and PHQ-9 within 90 days of stroke occurrence. Mean age was 61.5 and 54.8% were male. EDS (ESS>9) and moderate to severe depression were each present in 28.9% of patients. Patients with EDS had 3.5 times odds of moderate to severe depression compared to patients without EDS (table 1). Moreover, EDS was associated with higher odds of anhedonia, impaired mood, sleep disturbance, low energy, poor appetite, and impaired concentration (table 1). Conclusion: The presence of EDS is associated with moderate to severe depression in stroke survivors. This is not related solely to SDB symptoms. Patients with fatigue and EDS should be screened for depression. Future studies are also needed to explore the role that SDB plays in this relationship.

Abstract W P291: Long-term Stroke Awareness Among Stroke Survivors is Suboptimal

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Carlos Corado ◽  
Deborah Bergman ◽  
Ilana Ruff ◽  
Yvonne Curran ◽  
Richard A Bernstein ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Multivariate Regression ◽  
Recurrent Stroke ◽  
Cognitive Status ◽  
Warning Signs ◽  
Stroke Survivors ◽  
Index Hospitalization ◽  
Factors Associated ◽  
Stroke Awareness

Background/Objective: Stroke survivors are at high-risk for recurrent stroke. Stroke education attempts to reduce this risk by emphasizing stroke warning signs and need to call 911. Long-term stroke awareness has been under-studied in stroke survivors. We aimed to assess stroke awareness at 1 year among stroke survivors and identify factors associated with poor performance. Methods: From a single center prospective cohort study of consecutive patients diagnosed with acute ischemic stroke or transient ischemic stroke (TIA), we identified stroke survivors able to complete telephone interviews at 1 year. All patients were provided standardized educational materials during index hospitalization. We used the validated Stroke Action Test (STAT) to assess stroke knowledge at 1 year. The STAT is a 28-item questionnaire that asks respondents to choose 1 of 4 answers to each scenario (call 911, call doctor, wait 1 hour, or wait 1 day). We also assessed cognitive status at 1 year using the validated telephone interview for Cognitive Status (TICS). We identified factors associated with STAT score (number of correct responses) using univariate and multivariate regression. Results: Among 254 patients who completed 1 year follow-up (65.8 years; 55.5% male; 68.5% white; 94.1% modified Rankin 0-1 at 1 year), the median STAT score was 57.1% (range 2.1-75.0%). In multivariate regression, TICS score (B=0.533; p<0.001) and ethnicity (B=-2.357, p=0.006) were independently associated with STAT score. Age, race, insurance, arrival by ambulance at time of index hospitalization, stroke unit admission, length of stay, discharge to rehabilitation, post-stroke hospital/clinic visits were not associated with STAT score. Conclusion: Despite hospitalization and standardized education at time of index event, most stroke survivors are unaware of stroke warning signs at 1 year. Besides cognitive status and Hispanic ethnicity, no other factors were identified that predicted STAT score performance. Future studies should focus on improving hospital-based stroke educational programs and consider novel strategies in patients with cognitive impairment and differing language/cultural backgrounds.

Precise neonatal arterial ischemic stroke classification with a three-dimensional map of the arterial territories of the neonatal brain

2019 ◽  
Vol 87 (7) ◽  
pp. 1231-1236 ◽  
Author(s):  
Christian Núñez ◽  
Gemma Arca ◽  
Thais Agut ◽  
Christian Stephan-Otto ◽  
Alfredo García-Alix
Keyword(s):  
Ischemic Stroke ◽  
Three Dimensional ◽  
Neonatal Brain ◽  
Arterial Ischemic Stroke ◽  
Stroke Classification
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