scholarly journals Undetected and underserved: the untold story of patients who had a minor stroke

2017 ◽  
Vol 206 (8) ◽  
pp. 337-338 ◽  
Author(s):  
Emma C Finch ◽  
Michele M Foster ◽  
Jennifer Fleming ◽  
Philip D Aitken ◽  
Ian Williams ◽  
...  
Keyword(s):  
Minor Stroke ◽  
A Minor

scholarly journals Extraintracranial Bypass as a Rescue Therapy for Symptomatic Flow Diverter Thrombosis

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Luigi A. Lanterna ◽  
Alessandro Lunghi ◽  
Carlo Brembilla ◽  
Paolo Gritti ◽  
Claudio Bernucci
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Rescue Therapy ◽  
Flow Diverter ◽  
Minor Stroke ◽  
Transient Ischemic Attacks ◽  
Postoperative Course ◽  
A Minor ◽  
Ischemic Events

A 56-year-old female with a giant partially thrombosed unruptured carotid-ophthalmic aneurysm was treated with a Pipeline flow diverter. Three months after the procedure, in concomitance with the discontinuation of one of the antiplatelet medications, the patient suffered from a minor stroke and relapsing transient ischemic attacks. The angiography demonstrated the occlusion of the internal carotid artery, and a perfusion-weighted CT scan showed a condition of hypoperfusion. The patient underwent a double-barrel extraintracranial bypass. The postoperative course was uneventful and she has experienced no further ischemic events to date.

Early carotid endarterectomy in patients with a nondisabling ischemic stroke: Results of a retrospective analysis

VASA ◽  
2004 ◽  
Vol 33 (1) ◽  
pp. 30-35 ◽  
Author(s):  
Wölfle ◽  
Pfadenhauer ◽  
Bruijnen ◽  
Becker ◽  
Engelhardt ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Endarterectomy ◽  
Daily Living ◽  
Operative Mortality ◽  
Postoperative Outcome ◽  
Minor Stroke ◽  
Stroke Severity ◽  
Severity Grading ◽  
A Minor ◽  
Median Interval

Background: There are several recent recommendations not to delay carotid endarterectomy (CEA) for at least 4 weeks in patients experiencing a nondisabling ischemic stroke. Therefore, we re-examined if these patients could be safely operated on earlier: The aim of our study was to review the perioperative stroke and death rates of CEA performed within 30 days of stroke onset. Patients and methods: During a 4 year period until December 2001, in 66 neurologically stable patients suffering a nondisabling stroke ipsilateral to a carotid artery stenosis > 50% CEA was performed after a median interval of 10 (1–28) days. The modified Rankin scale (mRS) was applied to characterize the severity of impairment of daily living activities pre- and postoperatively: Any postoperative deterioration > 24 hours on the mRS was considered as a new stroke. Results: Operative mortality was 0%, and postoperative neurologic worsening > 24 hours occurred in 8/66 patients (12,1%). In 5/8 patients neurologic deterioration resolved within 5 days after surgery, only one stroke was permanent (1,5%). There was no correlation between timing of surgery or the presence of acute ipsilateral cranial CT defects with the occurrence of postoperative stroke. Stroke severity grading on admission according to the mRS, however, emerged to be a significant determinant of postoperative outcome: While 6/23 patients (26%) with an initial deficit ≥ 3 on the mRS developed neurologic worsening, this was the case in only 2/43 patients (4,6%) with a deficit ≤ 2 (Odds Ratio 7.2; 95% CI 1.32–39.49; two-sided p = 0.01). Conclusion: Our results suggest that selected patients with a minor stroke (mRS ≤ 2 on admission) can safely undergo early CEA.

scholarly journals Stent-assisted coiling of cerebral aneurysms with the Neuroform Atlas stent

2018 ◽  
Vol 24 (3) ◽  
pp. 263-269 ◽  
Author(s):  
Ferdi Cay ◽  
Ahmet Peker ◽  
Anıl Arat
Keyword(s):  
Cerebral Aneurysms ◽  
Minor Stroke ◽  
Parent Artery ◽  
Technical Success ◽  
Technical Success Rate ◽  
Patient Demographics ◽  
Clinical Events ◽  
Angular Change ◽  
A Minor

Objectives The Neuroform Atlas stent (AS) is the smallest intracranial stent with an open-cell design. This study reports the first clinical experience with AS. Methods All intracranial aneurysms treated by stent-assisted coiling using a single AS in a single institution were retrospectively evaluated. Patient demographics, aneurysm characteristics, angles between the parent artery and stented branch, technical success, and clinical and angiographic follow-up were analyzed. Results Fifty-five consecutive aneurysms treated with AS-assisted coiling were included. Of these, 69.1% were located distal to the circle of Willis. Technical success rate was 100%. The mean diameters of proximal and distal parent arteries were 2.62 mm (range 1.5–4.4) and 1.8 mm (range 0.8–3.5), respectively. Except for a minor stroke in a patient who completely discontinued antiplatelet therapy on postoperative day 4, there were no clinical events with permanent sequelae, and 94.1% of patients had Raymond-Roy score of 1 or 2 aneurysmal occlusion at a mean follow-up duration of 7.9 months. Although the angle between the parent artery and the stented branch increased significantly ( p < 0.001) with time, the angular change at follow-up was only 16.45 ± 11.03 degrees and was inversely correlated both with preoperative angle and the diameter of the distal parent artery ( r = −0.465 and r = −0.433, respectively, p = 0.004 for both). Conclusion AS-assisted coiling was associated with a favorable early clinical outcome and angiographic results in this series. This stent can be used for distally located aneurysms and results in minimal alteration of the arterial anatomy.

scholarly journals Even a minor stroke might lead to stress and anxiety

Neurology ◽  
2006 ◽  
Vol 66 (4) ◽  
pp. E15-E16 ◽  
Author(s):  
K. J.M. McCoy
Keyword(s):  
Minor Stroke ◽  
A Minor

MR perfusion lesions after TIA or minor stroke are associated with new infarction at 7 days

Neurology ◽  
2017 ◽  
Vol 88 (24) ◽  
pp. 2254-2259 ◽  
Author(s):  
Jun Lee ◽  
Manabu Inoue ◽  
Michael Mlynash ◽  
Sharanpal K. Mann ◽  
Carlo W. Cereda ◽  
...  
Keyword(s):  
Brain Infarction ◽  
Clinical Information ◽  
Minor Stroke ◽  
Ischemic Lesion ◽  
Fluid Attenuated Inversion Recovery ◽  
Abcd2 Score ◽  
Revascularization Therapy ◽  
A Minor ◽  
The Relationship

Objective:To investigate the relationship between acute perfusion-weighted imaging (PWI) lesions occurring within the first hours after a TIA or a minor brain infarction (BI) and the incidence of new BI detected on a systematic MRI at 1 week.Methods:Consecutive patients who experienced a TIA or BI with a neurologic deficit that lasted <24 hours, did not receive any revascularization therapy (thrombolysis/thrombectomy), and underwent DWI/PWI at baseline and fluid-attenuated inversion recovery (FLAIR)/DWI 1 week after symptom onset were enrolled. Investigators blinded to clinical information independently assessed the presence of acute ischemic lesions on baseline DWI/PWI and follow-up DWI and FLAIR. Baseline and follow-up MRIs were then compared to determine the occurrence and location of new infarctions.Results:Sixty-four patients met the inclusion criteria. Median (IQR) ABCD2 score was 4 (3–5). Median delay from onset to baseline and follow-up MRI was 5 (2–10) hours and 6 (5–7) days, respectively. MRI revealed an acute ischemic lesion on DWI and/or PWI in 38 patients. Nine patients (14%) had a new infarction on follow-up MRI. Each had a PWI and 4 had a DWI lesion on baseline MRI. All new BIs except one were asymptomatic and in the same location as the acute PWI lesion.Conclusions:Our results showed that 30% of the acute focal PWI lesions detected after a TIA are associated with a new BI at 1 week. Those new BIs may result from the progression of the initial ischemic injury.

scholarly journals Result of Neck Clipping and Coil Embolization as a Treatment for Unruptured Aneurysm

2007 ◽  
Vol 13 (1_suppl) ◽  
pp. 151-156 ◽  
Author(s):  
Y. Iwamuro ◽  
I. Nakahara ◽  
T. Higashi ◽  
M. Iwaasa ◽  
Y. Watanabe ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Abducens Nerve ◽  
Unruptured Aneurysm ◽  
Minor Stroke ◽  
Subdural Effusion ◽  
Unruptured Aneurysms ◽  
International Subarachnoid Aneurysm Trial ◽  
Duration Of Hospitalization ◽  
A Minor ◽  
Major Stroke

The report of the International Subarachnoid Aneurysm Trial (ISAT) study showed that coil embolization was superior to neck clipping as a treatment for subarachnoid hemorrhage (SAH) 1. Recently, some results of treatments for unruptured aneurysm via coil embolization and neck clipping have been reported2,3. We compared the results of coil embolization and neck clipping in our institute. Generally better outcomes were obtained by endovascular surgery than by neck clipping. Postoperative ischemic strokes occurred in one case (1.8%) as a major stroke and in three cases (5.6%) as a minor stroke among coil-treated cases, and in two cases(2.6%) as a major stroke, and in seven cases(9.0%) as a minor stroke among neck clipping cases. Other complications after these treatments were six cases of subdural effusion/hematoma, four cases of infection, two cases of epidural hematoma, one abducens nerve palsy, one hydrocephalus, and one acute myocardial infarction among 78 neck clipping cases, and two subcutaneous hematoma, one pseudoaneurysm at the puncture points, one direct carotid-cavernous fistula among 54 coil-treated cases. Four coil-treated cases, in which introduction of microcatheters to the aneurysm was impossible, were treated completely by neck clipping after endovascular treatments. In terms of modified Rankin Scale(mRS) three months after treatments, while mRS 3 was noted in only one case in the endovascular treatment group, there were one case of mRS 3, two cases of mRS 4, and two cases of mRS 5 in the neck clipping group. Duration of hospitalization averaged 11.9 days in the endovascular group and 24.1 days in the neck clipping group. The results of endosaccular enbolizations as treatment of the unruptured aneurysm seems to be better than neck clipping. However, not all cases of unruptured aneurysms can be treated by coil embolization due to the width of aneurysmal neck and relation of the aneurysm to parent arteries. Therefore, surgeons should also be able to perform neck clipping as an alternative modality.

scholarly journals Cognition in the First Year After a Minor Stroke, Transient Ischemic Attack, or Mimic Event and the Role of Vascular Risk Factors

2020 ◽  
Vol 11 ◽  
Author(s):  
Korinne Nicolas ◽  
Christopher Levi ◽  
Tiffany-Jane Evans ◽  
Patricia T. Michie ◽  
Parker Magin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Transient Ischemic Attack ◽  
Vascular Risk Factors ◽  
Minor Stroke ◽  
First Year ◽  
Vascular Risk ◽  
Ischemic Attack ◽  
A Minor

scholarly journals Long-term Prognosis After a Minor Stroke

Stroke ◽  
1998 ◽  
Vol 29 (1) ◽  
pp. 126-132 ◽  
Author(s):  
Massimiliano Prencipe ◽  
Franco Culasso ◽  
Maurizia Rasura ◽  
Alexia Anzini ◽  
Mario Beccia ◽  
...  
Keyword(s):  
Minor Stroke ◽  
Long Term Prognosis ◽  
A Minor

Defining Minor Intracerebral Hemorrhage

2021 ◽  
pp. 1-8
Author(s):  
Alejandra Gómez-González ◽  
Uxue Lazcano ◽  
Rosa Maria Vivanco-Hidalgo ◽  
Luis Prats-Sánchez ◽  
Daniel Guisado-Alonso ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
External Validation ◽  
Area Under The Curve ◽  
Cutoff Point ◽  
University Hospital ◽  
Minor Stroke ◽  
Operating Characteristics ◽  
Discovery Cohort ◽  
Definition Of ◽  
A Minor

<b><i>Background and Purpose:</i></b> The minor stroke concept has not been analyzed in intracerebral hemorrhage (ICH) patients. Our purpose was to determine the optimal cut point on the NIH Stroke Scale (NIHSS) for defining a minor ICH (mICH) in patients with primary ICH. <b><i>Methods:</i></b> An ICH was considered minor if associated with a favorable 3-month outcome (modified Rankin Scale score ≤2). For supratentorial ICH, the discovery cohort consisted of 478 patients prospectively admitted at University Hospital del Mar. Association between NIHSS at admission and 3-month outcome was evaluated with area under the curve-receiver operating characteristics (AUC-ROC) and Youden’s index to identify the optimal NIHSS cutoff point to define mICH. External validation was performed in a cohort of 242 supratentorial ICH patients from University Hospital Sant Pau. For infratentorial location, patients from both hospitals (<i>n</i> = 85) were analyzed together. <b><i>Results:</i></b> The best ­NIHSS cutoff point defining supratentorial-mICH was 6 (AUC-ROC = 0.815 [0.774–0.857] in the discovery cohort and AUC-ROC = 0.819 [0.756–0.882] in the external validation cohort). For infratentorial ICH, the best cutoff point was 4 (AUC-ROC = 0.771 [0.664–0.877]). Using these cutoff points, 40.5% of all primary ICH cases were mICH. Of these, 70.2% were living independently at 3-month follow-up (72% for supratentorial ICH and 56.1% for infratentorial ICH) and 6.5% had died (5.3% for supratentorial ICH, and 14.6% for infratentorial ICH). For patients identified as non-mICH, good 3-month outcome was observed in 11.3% of cases; mortality was 51%. <b><i>Conclusions:</i></b> The definition of mICH using the NIHSS cutoff point of 6 for supratentorial ICH and 4 for infratentorial ICH is useful to identify good outcome in ICH patients.

scholarly journals Association between Striatal Brain Iron Deposition, Microbleeds and Cognition 1 Year After a Minor Ischaemic Stroke

2019 ◽  
Vol 20 (6) ◽  
pp. 1293
Author(s):  
Maria Valdés Hernández ◽  
Tessa Case ◽  
Francesca Chappell ◽  
Andreas Glatz ◽  
Stephen Makin ◽  
...  
Keyword(s):  
Magnetic Resonance Images ◽  
Community Dwelling ◽  
White Matter Hyperintensity ◽  
Minor Stroke ◽  
Brain Iron ◽  
Post Stroke ◽  
Visuospatial Abilities ◽  
Adult Reading ◽  
A Minor

Brain iron deposits (IDs) are inversely associated with cognitive function in community-dwelling older people, but their association with cognition after ischemic stroke, and whether that differs from microbleeds, is unknown. We quantified basal ganglia IDs (BGID) and microbleeds (BMBs) semi-automatically on brain magnetic resonance images from patients with minor stroke (NIHSS < 7), at presentation and 12 months after stroke. We administered the National Adult Reading Test (NART, estimates premorbid or peak adult cognition) and the Revised Addenbrooke’s Cognitive Examination (ACE-R; current cognition) at 1 and 12 months after stroke. We adjusted analyses for baseline cognition, age, gender, white matter hyperintensity (WMH) volume and vascular risk factors. In 200 patients, mean age 65 years, striatal IDs and BMBs volumes did not change over the 12 months. Baseline BGID volumes correlated positively with NART scores at both times (ρ = 0.19, p < 0.01). Baseline and follow-up BGID volumes correlated positively with age (ρ = 0.248, p < 0.001 and ρ = 0.271, p < 0.001 respectively), but only baseline (and not follow-up) BMB volume correlated with age (ρ = 0.129, p < 0.05). Both smoking and baseline WMH burden predicted verbal fluency and visuospatial abilities scores (B = −1.13, p < 0.02 and B = −0.22, p = 0.001 respectively) at 12 months after stroke. BGIDs and BMBs are associated differently with cognition post-stroke; studies of imaging and post-stroke cognition should adjust for premorbid cognition. The positive correlation of BGID with NART may reflect the lower premorbid cognition in patients with stroke at younger vs older ages.

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