scholarly journals Postural orientation with conflicting visual and graviceptive cues to ‘upright’ among individuals with and without a history of post-stroke ‘pushing’

2019 ◽  
Vol 25 (S1) ◽  
pp. 26-32
Author(s):  
A. Mansfield ◽  
B. Taati ◽  
C. J. Danells ◽  
L. E. Fraser ◽  
L. R. Harris ◽  
...  
Keyword(s):  
Post Stroke ◽  
Postural Orientation ◽  
History Of

scholarly journals Predictors of Pharmaco-Resistance in Patients with Post-Stroke Epilepsy

2021 ◽  
Vol 11 (4) ◽  
pp. 418
Author(s):  
Simona Lattanzi ◽  
Claudia Rinaldi ◽  
Claudia Cagnetti ◽  
Nicoletta Foschi ◽  
Davide Norata ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Intracerebral Hemorrhage ◽  
Stroke Onset ◽  
Study Cohort ◽  
Seizure Freedom ◽  
Clinical Predictors ◽  
Post Stroke ◽  
History Of ◽  
Stroke Type ◽  
Patients With Epilepsy

Objectives: The study aimed to explore the clinical predictors of pharmaco-resistance in patients with post-stroke epilepsy (PSE). Methods: Patients with epilepsy secondary to cerebral infarct or spontaneous intracerebral hemorrhage were included. The study outcome was the occurrence of pharmaco-resistance defined as the failure of adequate trials of two tolerated and appropriately chosen and used antiseizure medication schedules, whether as monotherapies or in combination, to achieve sustained seizure freedom. Results: One-hundred and fifty-nine patients with PSE and a median follow-up of 5 (3–9) years were included. The mean age of the patients at stroke onset was 56.7 (14.9) years, and 104 (65.4%) were males. In the study cohort, 29 participants were pharmaco-resistant. Age at stroke onset [odds ratio (OR) 0.97, 95% confidence interval (CI) 0.93–0.99; p = 0.044], history of intracerebral hemorrhage (OR 2.95, 95% CI 1.06–8.24; p = 0.039), severe stroke (OR 5.43, 95% CI 1.82–16.16; p = 0.002), status epilepticus as initial presentation of PSE (OR 7.90, 1.66–37.55; p = 0.009), and focal to bilateral tonic-clonic seizures (OR 3.19, 95% CI 1.16–8.79; p = 0.025) were independent predictors of treatment refractoriness. Conclusions: Pharmaco-resistance developed in approximately 20% of patients with PSE and was associated with younger age at stroke onset, stroke type and severity, status epilepticus occurrence, and seizure types.

scholarly journals Post-stroke psychosis: how long should we treat?

2017 ◽  
Vol 39 (2) ◽  
pp. 144-146 ◽  
Author(s):  
Maria do Céu Ferreira ◽  
Célia Machado ◽  
Beatriz Santos ◽  
Álvaro Machado
Keyword(s):  
Low Dose ◽  
Rare Complication ◽  
Acute Onset ◽  
Psychotic Symptoms ◽  
Antipsychotic Treatment ◽  
Antipsychotic Therapy ◽  
Post Stroke ◽  
History Of ◽  
One Year

Abstract Objective: To describe a rare case of a patient who developed psychotic symptoms after a right stroke that disappeared with antipsychotic treatment, but appears to need low-dose maintenance antipsychotic therapy. Case description: A 65-year-old man presented at the psychiatric emergency service with a history of persistent delusional jealousy, visual illusions and agitation with onset about 1 month after a right posterior cerebral artery ischemic stroke. These symptoms only disappeared with therapeutic dosages of an antipsychotic drug (3 mg/day of risperidone). At 2-year follow-up, he no longer had delusional activity and the antipsychotic treatment was gradually discontinued over the following year. However, 1 week after full cessation, the patient once more became agitated and suspicious and was put back on risperidone at 0.25 mg/day, resulting in rapid clinical remission. One year after the return to low-dose risperidone, the patient's psychopathology is still under control and he is free from psychotic symptoms. Comments: Psychosis is a relatively rare complication after stroke. To our knowledge, no cases of post-stroke psychosis that apparently require continuous low-dose antipsychotic treatment have been reported to date. Our case suggests that low-dose maintenance antipsychotic therapy may be needed for certain patients with post-stroke psychosis, especially for those with risk factors and non-acute onset.

scholarly journals Gambaran Fungsi Kognitif Pasien Pasca Stroke

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Reinaldi O. Boletimi ◽  
Mieke A. H. N. Kembuan ◽  
Junita M. Pertiwi
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Literature Review ◽  
Stroke Patients ◽  
Post Stroke ◽  
Low Education ◽  
History Of ◽  
Male Patients ◽  
Abstract Domains ◽  
And Gender

Abstract: Stroke or brain attack occurs directly and its incidence is still very high until now. It is reported that two-thirds of stroke patients suffered from cognitive impairment leading to dementia within three months after stroke that can interfere with one’s daily activities if left untreated. This study was aimed to obtain the description of cognitive function in post-stroke patients. This was a literature review study using three databases, as follows: Goggle Scholar, Pubmed, and Clinical Key, and the keywords were cognitive impairment, cognitive decline, post-stroke, and MoCA. There were 10 literatures that met the inclusion and exclusion criteria. The results showed that many post-stroke patients showed cognitive function decline in the visuospatial/executive, memory, language, attention, and abstract domains. Cognitive impairment occured mostly in male patients, age 60 years and over, low education, ischemic stroke, left hemisphere lesion, with a history of hypertension. In conclusion, there is a relationship between post-stroke cognitive impairment and the location of lesion, age, and education level, albeit, there was no relationship between the cognitive impairment and gender as well as diabetes mellitus.Keywords: cognitive impairment, post-stroke, MoCA Abstrak: Stroke menyerang otak secara langsung dengan angka kejadian yang masih sangat tinggi sampai saat ini. Dua pertiga pasien stroke dilaporkan mengalami gangguan fungsi kognitif yang berujung pada demensia dalam tiga bulan pasca stroke serta dapat mengganggu aktivitas sehari-hari bila dibiarkan. Penelitian ini bertujuan untuk mendapatkan gambaran fungsi kognitif pasien pasca stroke. Jenis penelitian ialah literature review, dengan pencarian literatur pada tiga database yaitu Goggle Scholar, Pubmed, dan Clinical Key. Kata kunci yang digunakan ialah penurunan fungsi kognitif, pasca stroke, dan MoCA. Hasil seleksi mendapatkan 10 literatur yang memenuhi kriteria inklusi dan eksklusi. Hasil penelitian menunjukkan bahwa pada pasien pasca stroke sering terjadi penurunan fungsi kognitif dengan domain visuospasial/eksekutif, memori, bahasa, atensi, dan abstrak yang paling sering terganggu. Penurunan fungsi kognitif banyak ditemukan pada pasien laki-laki, usia 60 tahun ke atas, jenjang pendidikan rendah, stroke iskemik, lesi hemisfer kiri, dengan riwayat hipertensi. Simpulan penelitian ini ialah adanya hubungan antara penurunan fungsi kognitif dengan lokasi lesi, usia, dan jenjang pendidikan namun tidak terdapat hubungan dengan jenis kelamin dan diabetes melitus.Kata kunci: gangguan kognitif, pasca stroke, MoCA

scholarly journals Early rehabilitation after haemorrhagic stroke in a patient with a history of heart transplantation. A case study

2016 ◽  
Vol 16 (4) ◽  
pp. 208-211
Author(s):  
Anna Grygielska ◽  
◽  
Elżbieta Miller ◽  
◽  
Keyword(s):  
Heart Rate ◽  
Heart Transplantation ◽  
Functional Status ◽  
Barthel Index ◽  
Stroke Rehabilitation ◽  
Haemorrhagic Stroke ◽  
National Institutes Of Health ◽  
Exercise Heart Rate ◽  
Post Stroke ◽  
History Of

Introduction: Stroke is the most common form of central nervous system condition. An average of about 80 heart transplantations are performed in Poland yearly. A transplanted heart is prone to tachycardia. Early, complex post-stroke rehabilitation requires physical effort from the patient. Case report: We present a clinical case of a patient with left-sided hemiparesis after a haemorrhagic stroke and on immunosuppressive treatment after heart transplantation (2005). Methods: The outcomes of rehabilitation therapy were assessed based on the following scales: the Barthel Index, a modified Rankin Scale, the Rivermead Motor Index, the National Institutes of Health Stroke Scale, the Mini–Mental State Examination, and the Geriatric Depression Scale. Moreover, pre- and post-exercise heart rate monitoring was performed. Results: As a result of comprehensive rehabilitation treatment, functional status improvement was observed in all estimated scales. The highest change was reported for Barthel Index (50%) and National Institutes of Health Stroke Scale (30%). Heart rate was between 75 and 180 bpm. Conclusions: A patient with a history of heart transplantation shows good tolerance of physical exercise despite tachycardia. Early post-stroke rehabilitation significantly improves functional status.

scholarly journals ANTIDEPRESSANT USE AND MORTALITY RISK IN OLDER ADULTS WITH HISTORY OF STROKE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S269-S269
Author(s):  
Madison B Lenox ◽  
Victor Tran ◽  
Grace Tworek ◽  
Andrew Solow ◽  
Diana Hincapie
Keyword(s):  
Older Adults ◽  
Mortality Risk ◽  
The United States ◽  
Mortality Rates ◽  
Lower Mortality ◽  
Public Health Issue ◽  
Post Stroke ◽  
Cognitive Limitations ◽  
History Of ◽  
Antidepressant Use

Abstract The American Stroke Association reports stroke as the fourth leading cause of death in the United States, with 66% of hospitalized cases being older adults. Recovery from stroke is a public health issue, as post-stroke depression (PSD) is a significant concern. Approximately 20-23% of stroke survivors identified co-occurring diagnoses, which are associated with physical, functional, and cognitive limitations and increased mortality risk. Antidepressant use has exhibited its efficacy in treating PSD. This study explores the association between antidepressant use and mortality risk in older adults with history of stroke. Older adults aged 65 and older (N=3631, 55.4% female, 72.6% Caucasian, Mage=79.64 years, SDage=7.29 years, MEd=14.55 years, SDEd=8.269 years) with history of stroke were selected from the National Alzheimer’s Coordinating Center database to explore the association between antidepressant use and mortality. A chi-squared test of independence was calculated comparing antidepressant use and mortality rates. A significant association was found (χ2 (1) = 15.933, p < .001) between current antidepressant use and mortality. Findings suggest antidepressant use is associated with lower mortality rates in subjects with a history of stroke. Implications include highlighting the role psychologists play in the early identification of PSD and early antidepressant intervention post-stroke to increase life longevity. Although findings only infer association, they demonstrate evidence for the link between PSD, antidepressant use, and lower mortality rates. Future directions include exploring other forms of depression treatment and mechanisms of antidepressant use. Limitations include examining potential moderators (e.g., gender, SES, type of stroke), and substance use within this population.

Risk and Predictors of Depression Following Acute Ischemic Stroke in the Elderly

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000011828
Author(s):  
Naomi Mayman ◽  
Laura Katherine Stein ◽  
John Erdman ◽  
Alana Kornspun ◽  
Stanley Tuhrim ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cox Regression ◽  
Cumulative Risk ◽  
The Elderly ◽  
Stroke Patients ◽  
Post Stroke ◽  
Medicare Data ◽  
Kaplan Meier ◽  
Post Stroke Depression ◽  
History Of

Objective:We sought to comprehensively evaluate predictors of PSD in the US and compare PSD to post-myocardial infarction (MI) depression, in order to determine whether ischemic stroke (IS) uniquely elevates risk of depression.Methods:This is a retrospective cohort study of 100% de-identified inpatient, outpatient, and subacute nursing Medicare data from 2016-2017 for US patients aged ≥65 years from July 1, 2016 to December 31, 2017. We calculated Kaplan-Meier unadjusted cumulative risk of depression up to 1.5 years following index admission. We performed Cox regression to report the hazard ratio for diagnosis of depression up to 1.5 years post-stroke vs. MI, and independent predictors of PSD, and controlled for patient demographics, comorbidities, length of stay and acute stroke interventions.Results:In fully adjusted models, stroke patients (n=174,901) were ∼50% more likely than MI patients (n=193,418) to develop depression during the 1.5-year follow-up period (Kaplan-Meier cumulative risk 0.1596±0.001 in stroke patients versus 0.0973±0.000778 in MI patients, log-rank p<0.0001). History of anxiety was the strongest predictor of PSD, while discharge home was most protective. Female patients, White patients, and patients younger than 75 years were more likely to be diagnosed with depression post-stroke.Conclusions:Despite the similarities between MI and stroke, patients who suffer from stroke were significantly more likely to develop depression. There were several predictors of post-stroke depression, most significantly history of anxiety. Our findings lend credibility to a stroke-specific process causing depression and highlight the need for consistent depression screening in all stroke patients.

History of post-stroke epilepsy in ancient China

2011 ◽  
Vol 258 (8) ◽  
pp. 1555-1558 ◽  
Author(s):  
Yan Wang ◽  
Yun-Cao Fan ◽  
Cheng-Long Xie ◽  
Guo-Qing Zheng
Keyword(s):  
Ancient China ◽  
Post Stroke ◽  
History Of

scholarly journals Acute splenic responses in patients with ischemic stroke and intracerebral hemorrhage

2015 ◽  
Vol 36 (6) ◽  
pp. 1012-1021 ◽  
Author(s):  
Farhaan S Vahidy ◽  
Kaushik N Parsha ◽  
Mohammad H Rahbar ◽  
MinJae Lee ◽  
Thanh-Tung Bui ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Past History ◽  
Clinical Findings ◽  
Spleen Volume ◽  
Stroke Patients ◽  
Post Stroke ◽  
Cytokine Analysis ◽  
Cytokine Levels ◽  
History Of ◽  
Using Data

Animal models provide evidence of spleen mediated post-stroke activation of the peripheral immune system. Translation of these findings to stroke patients requires estimation of pre-stroke spleen volume along with quantification of its day-to-day variation. We enrolled a cohort of 158 healthy volunteers and measured their spleen volume over the course of five consecutive days. We also enrolled a concurrent cohort of 158 stroke patients, measured initial spleen volume within 24 h of stroke symptom onset followed by daily assessments. Blood samples for cytokine analysis were collected from a subset of patients. Using data from healthy volunteers, we fit longitudinal quantile regression models to construct gender and body surface area based normograms of spleen volume. We quantified day-to-day variation and defined splenic contraction. Based on our criteria, approximately 40% of stroke patients experienced substantial post-stroke reduction in splenic volume. African Americans, older patients, and patients with past history of stroke have significantly higher odds of post-stroke splenic contraction. All measured cytokine levels were elevated in patients with splenic contraction, with significant differences for interferon gamma, interleukin 6, 10, 12, and 13. Our work provides reference standards for further work, validation of pre-clinical findings, and characterization of patients with post-stroke splenic contraction.

Mortality Associated with Incident Mental Health Disorders After Stroke

2007 ◽  
Vol 41 (3) ◽  
pp. 274-281 ◽  
Author(s):  
Osvaldo P. Almeida ◽  
Jianguo Xiao
Keyword(s):  
Mental Health ◽  
Psychotic Disorders ◽  
Mental Health Disorders ◽  
Mental Health Disorder ◽  
Stroke Patients ◽  
Post Stroke ◽  
Australian Community ◽  
History Of ◽  
Health Disorders

Objective: Sparse information is currently available about the incidence of the major psychiatric syndromes following a stroke and their long-term contribution to morbidity and mortality. This study was designed to determine: (1) the incidence of first ever mental health disorder in amongst stroke patients; (2) the 10-year mortality associated with incident post-stroke mental health disorders. Methods: Design: Retrospective cohort study. Setting: Entire Western Australian community. Participants: First-ever stroke in 1990. Subjects with a prior recorded history of any mental health disorder were excluded from the study. Main outcomes of interest: Incident mental health diagnoses and 10-year mortality. Results: 1,129 hospital stroke contacts were recorded in 1990, with 21 people dying on the same day of contact. Between 1990-2002 36.6% of the survivors received a mental health diagnosis (6.1 per 1,000 person-years): alcohol-related disorders (16.2%), dementia (12.1%), delirium (7.6%), psychotic disorders (6.7%), and depression (5.5%). Mental health disorder onset was usually within 6 months of the stroke. Patients with an incident psychotic disorder were twice as likely to die during the subsequent 10 years as post-stroke controls with no mental health disorder (risk ratio = 2.03, 95%CI = 1.39-2.95). Being a widow (HR = 1.61, 95%CI = 1.13-2.30) or having been born in ‘other countries’ as opposed to Australia (HR = 1.56, 95%CI = 1.15-2.11) was also associated with increased death hazard. Conclusions: Approximately 1 in 3 patients develop a mental health disorder after stroke, although incidence estimates are relatively low. Post-stroke psychosis is associated with greater 10-year mortality, but the mechanisms underlying such an association are yet to be determined.

scholarly journals Cognitive Impairment At 3, 6 and 12 Month After the First-Ever Stroke Among Lebanese Survivors: Incidence and Risk Factors

2021 ◽  
Author(s):  
Celina Boutros ◽  
Walaa Khazaal ◽  
Maram Taliani ◽  
Pascale Salameh ◽  
Hassan Hosseini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Length Of Hospital Stay ◽  
Epileptic Seizures ◽  
Protective Role ◽  
P Value ◽  
Post Stroke ◽  
Physical Disorders ◽  
History Of

Abstract Cognitive impairment is a prevalent outcome of stroke, affecting the quality of life and increasing the disability. Its risk factors are unknown in Lebanon. Therefore, the aims of this study were to evaluate the cognitive impairment incidence among Lebanese stroke survivors at 3, 6 and 12 month post stroke, and to identify the associated factors. A multicenter longitudinal prospective study was conducted in 10 hospitals of Beirut and Mount Lebanon among 150 subjects aged ≥ 18 years old between February 2018 until May 2019. The Mini-Mental State Examination assessed the cognitive function. Univariate and Multivariable analyses were performed to identify the predictors of the post stroke cognitive impairment. A p-value <0.05 was considered statistically significant. At 3 month post stroke, 74.8% were cognitively impaired versus 46.7% and 37.6% at 6 and 12 month post stroke respectively. Older age, past smoking, presence of a caregiver, sedentary ≥ 12 hours, aphasia at the time of stroke occurrence, the length of hospital stay, severe stroke, high disability degree, post stroke anxiety and depression, epileptic seizures and physical disorders were the risk factors inducing cognitive decline. Whereas, the high education level, the employment and the history of diabetes mellitus played a protective role for the cognitive function. Findings reveal levels of cognitive impairment post-stroke that are concerning. Thus, primary and secondary prevention is essential to reduce its incidence and to cope with its burden.

Sign in / Sign up

Export Citation Format

Share Document