scholarly journals Associations between stroke lesion location and verbal fluency tests in a sub-acute stroke population

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Ganesh M. Babulal
Keyword(s):  
Acute Stroke ◽  
Verbal Fluency ◽  
Lesion Location ◽  
Stroke Population ◽  
Stroke Lesion

Lesion location may attenuate response to strategy training in acute stroke

PM&R ◽  
2021 ◽  
Author(s):  
Elizabeth R. Skidmore ◽  
Minmei Shih ◽  
Lauren Terhorst ◽  
Erin O'Connor
Keyword(s):  
Acute Stroke ◽  
Strategy Training ◽  
Lesion Location

scholarly journals JOURNAL CLUB: Evaluation of Diffusion Kurtosis Imaging of Stroke Lesion With Hemodynamic and Metabolic MRI in a Rodent Model of Acute Stroke

2018 ◽  
Vol 210 (4) ◽  
pp. 720-727 ◽  
Author(s):  
Dongshuang Lu ◽  
Yinghua Jiang ◽  
Yang Ji ◽  
Iris Yuwen Zhou ◽  
Emiri Mandeville ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Journal Club ◽  
Rodent Model ◽  
Diffusion Kurtosis Imaging ◽  
Stroke Lesion ◽  
Diffusion Kurtosis

Abstract 70: Importance of Both Self-consent and Proxy- consent Enrollments to Avoid Bias in Acute Stroke Randomized Trials

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Kristina Shkirkova ◽  
Nelson Wu ◽  
Sidney Starkman ◽  
Nerses Sanossain ◽  
Scott Hamilton ◽  
...  
Keyword(s):  
Informed Consent ◽  
Acute Stroke ◽  
Randomized Trials ◽  
Proxy Consent ◽  
Long Term Outcomes ◽  
Stroke Population ◽  
Acute Cerebral Ischemia ◽  
Hemorrhage Volume ◽  
Artery Disease

Background: Informed consent options for acute stroke randomized trials include self-consent from patients with retained competency, proxy consent from a legally authorized representative (LAR), and exception from informed consent in emergency circumstances (EFIC). Mechanisms other than self-consent trespass upon the ethical principle of autonomy (respect for persons), and should be used only if self-consent alone would bias the patient population. Methods: We analyzed acute stroke patients enrolled within 2h of symptom onset in the NIH Phase 3 Field Administration of Stroke Therapy - Magnesium (FAST-MAG) trial, comparing entry characteristics and outcomes with different consent mechanisms. Results: Among 1700 patients, median time from onset to study entry was 45 min (IQR 35-62). Overall, 60% of patients were competent and provided self-consent, 39% noncompetent and enrolled by proxy consent from an on-scene LAR, and 1% noncompetent enrolled using EFIC/delayed consent. Compared to self-consented patients, proxy-consented patients were: older, 73.8 vs 66.5, p<0.001; more often female, 47% vs 40%, p<0.02; and a higher frequency of several vascular risk factors, including hypertension, 81% vs 76%, p<0.05, diabetes, 26% vs20%, p<0.01, atrial fibrillation, 29% vs 17%, p<0.001, and coronary artery disease, 24% vs 19%, p<0.01. Proxy consent patients had more severe initial stroke deficits, prehospital LAMS, 4.1 vs 3.5, p<0.001. Proxy consent patients with acute cerebral ischemia had more advanced initial ischemic stroke lesions, ASPECTS 8.3 vs 9.3, p<0.001, and received tPA more often, 35% vs 20%, p<0.001. Proxy consent patients with intracerebral hemorrhage patient had larger initial hemorrhage volume (cc), 42.2 vs 22.6, p<0.001. Proxy consent patients had worse final outcomes, with freedom from disability (mRS 0-1) at 90d, 23.6% vs 44.3%, p<0.001. Conclusions: Proxy-informed consent patients differ systematically from self-consent patients, with older age, more comorbidities, more severe deficits, and worse long term outcomes. To ensure that acute stroke trial cohorts are representative of the general stroke population, it is important that enrollment mechanisms include proxy and/or deferred consent.

Frequency of Screening and Prevalence of Neurosyphilis in Stroke Population

2020 ◽  
Vol 49 (3) ◽  
pp. 301-306
Author(s):  
Rodrigo Targa Martins ◽  
Raphael Machado Castilhos ◽  
Pablo Silva da Silva ◽  
Leticia Scaranto Costa
Keyword(s):  
Acute Stroke ◽  
Venereal Disease ◽  
International Classification Of Diseases ◽  
Stroke Severity ◽  
Positive Serology ◽  
Csf Analysis ◽  
Stroke Population ◽  
Classification Of Diseases ◽  
Stroke Center ◽  
Ischemic Attack

Background and Aims: Syphilis and stroke are high prevalent diseases in south Brazil and estimates of concomitance and possible role of syphilis in acute stroke are lacking. Our aims are to estimate the prevalence of syphilis and neurosyphilis (NS) in a cohort of tertiary stroke center. Methods: We reviewed all hospital records of stroke/transitory ischemic attack (TIA) using International Classification of Diseases, 10th revision, at discharge, frequency of syphilis screen, serology positivity, cerebrospinal fluid (CSF) analysis, and prevalence of NS in this stroke population applying CDC criteria. Results: Between 2015 and 2016, there were 1,436 discharges for cerebrovascular events and in 78% (1,119) of these cases, some syphilis screening was performed. We have found a frequency of positive serology for syphilis of 13% (143/1,119), and higher stroke severity was the main determinant for non-screening. Applying standard NS criteria, 4.7% (53/1,119) cases with CSF analysis had NS diagnosis: 8 based on CSF-Venereal Disease Research Laboratory (VDRL) positive and 45 based on abnormal CSF white cells or protein, but CSF VDRL negative. NS VDRL positive cases were younger, had higher serum VDRL title, had more frequent HIV infection, and received NS treatment more often. Demographic and clinical characteristics were not different between NS VDRL negative and non-NS cases. Conclusion: Positive syphilis serology is frequent in patients with acute stroke/TIA in our region. Acute post-stroke CSF abnormalities make the diagnosis of NS difficult in the context of CSF VDRL negative.

scholarly journals Fast-tracking acute stroke care in China: Shenzhen Stroke Emergency Map

2019 ◽  
Vol 95 (1119) ◽  
pp. 46-47 ◽  
Author(s):  
Lijie Ren ◽  
Chao Li ◽  
Weiping Li ◽  
Yixuan Zeng ◽  
Shisheng Ye ◽  
...  
Keyword(s):  
Thrombolytic Therapy ◽  
Acute Stroke ◽  
Stroke Care ◽  
Developed Countries ◽  
Continuous Data ◽  
Acute Stroke Care ◽  
Fast Tracking ◽  
Stroke Population ◽  
The World ◽  
Emergency System

China has the largest stroke population and at-risk population in the world. However, it has a lower thrombolytic therapy rate and longer onset-to-needle time/door-to-needle time for patients who had an acute stroke compared with developed countries, which might be due to redundant procedures or inefficient systems. Things are changing due to some new initiatives. Two years ago, a new emergency system in China, Stroke Emergency Map, was first launched as a regional emergency system in Shenzhen, the bustling metropolis just north of Hong Kong. As a result of the Stroke Emergency Map in Shenzhen, the number of thrombolytic cases increased in the last 2 years, from 568 to 809 annually. The Stroke Emergency Map, first pioneered in Shenzhen and now spreading to the rest of China, is a comprehensive and interdisciplinary system. The benefits are not just the immediate improvements in the acute stroke care because the continuous data collection and audit allows for improvements in logistics and future strategies.

A Novel 3D U-Net Deep Network with Paralleling Structure for Stroke Lesion Image Segmentation

2020 ◽  
Vol 10 (3) ◽  
pp. 724-730
Author(s):  
Chunjiang Fan ◽  
Zijian Wang ◽  
Gang Li ◽  
Jian Luo ◽  
Yang Cao ◽  
...  
Keyword(s):  
Image Segmentation ◽  
Ct Scan ◽  
Improved Method ◽  
Feature Maps ◽  
Stroke Patients ◽  
Lesion Location ◽  
Deep Network ◽  
Valid Data ◽  
Spatial Dimensions ◽  
Stroke Lesion

Image segmentation technologies play a crucial role in medical diagnosis. This paper proposed a novel paralleling structure based on conventional 3D U-net deep network for improving the performance of CT image segmentation. In our model architecture, a new connection channel from analysis path to synthesis path was constructed for exploiting feature maps from deep spatial dimensions. 60 CT scan images of stroke patients were collected for lesion location. Finally, there were 36 valid data were selected for further analysis. The improved method led to better achievement for this task, which segment stroke CT scan images into healthy parts and injury parts. The performance on the test set obtained by our method was compared with other state-of-art U-net models, to demonstrate the effectiveness of our architecture. Furthermore, the result verified that paralleling structure was useful for the convergence of loss curve.

scholarly journals Associations between stroke severity, aphasia severity, lesion location, and lesion size in acute stroke, and aphasia severity one year post stroke

Aphasiology ◽  
2021 ◽  
pp. 1-23
Author(s):  
Hedda Døli ◽  
Wenche Andersen Helland ◽  
Turid Helland ◽  
Halvor Næss ◽  
Håkon Hofstad ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Lesion Size ◽  
Stroke Severity ◽  
Lesion Location ◽  
Post Stroke ◽  
One Year
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