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Stroke
NIH - Medical Encyclopedia: Stroke
"The goal is to get the person to the emergency room immediately, determine if he or she is having a bleeding stroke or a stroke from a blood clot, and start therapy -- all within 3 hours of when the stroke began."
Highlighted ArticleTransient Ischemic Attack: A Dangerous Harbinger and an Opportunity to Intervene. (Semin Neurol. 2005)
"Transient ischemic attack (TIA) and ischemic stroke are both characterized by sudden onset of neurological symptoms due to focal cerebral ischemia, but they are distinguished by the duration of neurological symptoms, with TIA traditionally defined by resolution of symptoms within 24 hours and stroke reserved for symptoms of longer duration. ... The short-term risk of ischemic stroke after TIA is very high ..."
Stroke
General Information
NEWS:
Aspirin use not seen linked to stroke severity "When a stroke occurs, its severity does not seem to be related to whether the patient had be taking aspirin previously or not, according to a large, international study."
High blood calcium tied to better stroke outcome
Persistent Pain Common After Stroke
Predicting a Second Stroke "A new study reveals silent brain lesions after a stroke may be a predictor for another stroke. These lesions can be seen on an MRI but are called "silent" because the patient has no symptoms. … Patients found to have silent lesions during the 30 to 90 day MRI had about 6.5-times the odds of having a subsequent ischemic stroke, according to researchers."
Strokes in Children: A Medical Dilemma
Strokes May Follow 'Body Clock' "All three kinds of strokes had two periods of peak occurrence: one between 6 a.m. and 8 a.m. and another between 6 p.m. and 8 p.m. Stroke occurrence declined significantly during sleep."
ARTICLES:
JOURNAL ARTICLES:
A High Potassium Diet Reduces Infarct Size and Improves Vascular Structure in Hypertensive Rats. (Am J Physiol Regul Integr Comp Physiol. 2006) "These results suggest that potassium supplementation provides neuroprotection in a model of ischemic stroke independent of blood pressure and possibly through changes in vascular structure. Key words: Middle cerebral artery occlusion, growth factors, spontaneously hypertensive rats, smooth muscle cells, cerebral ischemia."
A review of stroke in patients with hypertension and coronary artery disease: focus on calcium channel blockers. (Int J Clin Pract. 2006)
Apolipoproteins as Predictors of Ischaemic Stroke in Patients with a Previous Transient Ischaemic Attack. (Cerebrovasc Dis. 2006)
Association between stroke and acute myocardial infarction and its related risk factors: hypertension and diabetes. (Anadolu Kardiyol Derg. 2006) "CONCLUSION: The present study supports the hypothesis that there is a strong association between stroke, AMI and related risk factors such as diabetes, hypertension and other cardiovascular disease risk factors. Furthermore, present study showed that 60% of stroke patients had AMI and nearly 46.4% of stroke patients had diabetes mellitus."
Central Periodic Breathing Observed on Hospital Admission Is Associated with an Adverse Prognosis in Conscious Acute Stroke Patients. (Cerebrovasc Dis. 2006)
[Cerebral infarction] (Nippon Rinsho. 2006)
Cerebral Microhemorrhage. (Stroke. 2006)
Chronic posttraumatic stress symptoms after nonsevere stroke. (Neurology. 2006)
[Clinical characteristics and prognosis in stroke patients with diabetes mellitus: retrospective evaluation using the Japanese Standard Stroke Registry database] (No To Shinkei. 2006) "In conclusions, stroke patients with diabetes mellitus showed more stroke recurrence and resulted in poorer functional recovery compared to patients without diabetes."
Clinical implications of headache in lacunar stroke: relevance of site of infarct. (Headache. 2006)
C-Reactive Protein and Risk of First-Ever Ischemic and Hemorrhagic Stroke in a General Japanese Population (Stroke. 2006)
C-Reactive Protein, Carotid Atherosclerosis, and Cerebral Small-Vessel Disease. Results of the Austrian Stroke Prevention Study. (Stroke. 2006)
Delirium within Three Days of Stroke in a Cohort of Elderly Patients. (J Am Geriatr Soc. 2006) "Delirium occurred frequently in acute stroke patients aged 65 and older. Factors independently associated with delirium included old age, intracerebral hemorrhage, metabolic factors, prestroke dementia, initial GCS less than 15, and inability to lift both arms on admission. Patients with delirium had higher long-term mortality and a worse functional outcome."
Differences in circadian variation of cerebral infarction, intracerebral haemorrhage and subarachnoid haemorrhage by situation at onset. (J Neurol Neurosurg Psychiatry. 2006) "CONCLUSIONS: Sleep or status in sleep tends to promote ischemic stroke and suppress hemorrhagic stroke. Some triggers or factors that promote ischemic stroke and prevent hemorrhagic stroke in the morning cause different variations in the waking state between ischemic and emorrhagic stroke."
Does prior aspirin use reduce stroke mortality? (eurologist. 2006)
Fatigue after stroke. (Ann Readapt Med Phys. 2006)
High blood pressure in early acute stroke: a sign of a poor outcome? (J Hypertens. 2006)
High-risk mini strokes (Bandolier Journal ) "A transient ischaemic attack (TIA) is usually defined as causing symptoms for less than 24 hours, but it is unlikely that brain or eye is actually ischaemic for more than a few minutes. What we observe is the clinical effects of reversible impairment of neuronal function resulting from a short period of ischaemia. The risk of stroke after a TIA is about 12% in the first year and then about 7% a year thereafter, with risk of stroke, heart attack or vascular death being about 10% a year. This is about seven times the risk in the background population. But there is also a high risk of stroke in the seven days after a TIA, possibly as high as 10%. . The likelihood of chance associations related to TIA and subsequent seven-day stroke was eliminated by using only factors previously significantly found to be independent predictors of stroke in the three months after a TIA. These were age, clinical features characterised (motor weakness and speech disturbance), duration of symptoms, diabetes, and hypertension. . "
Homocyst(e)ine and Stroke. (Semin Neurol. 2006)
Impact of acute blood pressure variability on ischemic stroke outcome. (Neurology. 2006) "CONCLUSION: Wide fluctuation of blood pressure in the first 3 hours of the emergency department stay in patients with acute ischemic stroke appears to be associated with an increased risk of death at 90 days."
Improvement in Stroke Mortality in Canada and the United States, 1990 to 2002 (Circulation. 2006) "Conclusions- The improvement in stroke mortality observed after folic acid fortification in the United States and Canada but not in England and Wales is consistent with the hypothesis that folic acid fortification helps to reduce deaths from stroke."
Increased frequency of cardioembolism and patent foramen ovale in patients with stroke and a positive travel history suggesting economy class stroke syndrome (Heart 2006) "Objective: To investigate the frequency of acute stroke in patients with a recent travel history and to analyse risk factors, stroke patterns and presence of a patent foramen ovale (PFO) in this patient group. … Conclusions: The finding that more PTH patients had a PFO and a cardioembolic stroke pattern but that fewer had other typical stroke risk factors led to the hypothesis that PFO is a risk factor for economy class stroke syndrome."
Increased plasma fibrinogen predicts one-year mortality in patients with acute ischemic stroke. (J Neurol Sci. 2006) "BACKGROUND AND PURPOSE: Increased plasma fibrinogen is a risk factor for vascular diseases related to atherosclerosis. . CONCLUSIONS: Increased concentration of plasma fibrinogen shortly after ischemic stroke independently increases risk of death within one year after stroke."
Long-Term Mortality, Morbidity and Hospital Care following Intracerebral Hemorrhage: An 11-Year Cohort Study. (Cerebrovasc Dis. 2006) "Conclusion: Following a first ICH, individuals have a poorer short-term prognosis than individuals with IS, yet both ICH and IS imply significant follow-up care."
Mechanisms of early brain injury after subarachnoid hemorrhage. (J Cereb Blood Flow Metab. 2006)
Neuroanatomic correlates of stroke-related myocardial injury (NEUROLOGY 2006)
New-onset hypertension and inflammatory response/poor outcome in acute ischemic stroke (NEUROLOGY 2006) "Conclusions: New-onset high blood pressure in acute ischemic stroke, but not chronic hypertension, is associated with an inflammatory response and poor neurologic outcome."
Poststroke C-Reactive Protein Is a Powerful Prognostic Tool Among Candidates for Thrombolysis (Stroke. 2006) "Background and Purpose- After acute stroke, an increased level of C-reactive protein (CRP) measured at discharge predicts unfavorable outcome. We sought to investigate whether CRP measured before tissue plasminogen activator (tPA) treatments may add prognostic information to guide stroke thrombolysis.Conclusions- Admission CRP predicts mortality among tPA-treated stroke patients. Very early recanalization does not ameliorate the negative prognostic impact of elevated CRP."
Poststroke Dementia. (Cerebrovasc Dis. 2006) "The association between stroke and dementia is frequent. The prevalence of poststroke dementia (PSD) ranges from 6 to 32%, depending on the population studied, the criteria used for the diagnosis of dementia, and the time interval between the stroke and the neuropsychological assessment. The risk of PSD is high immediately after stroke and remains higher than in controls in stroke patients nondemented 3 months after stroke. Not all cases of PSD are vascular in origin, with about one third of demented patients diagnosed as having Alzheimer's disease plus stroke. . The risk of dementia is higher in older patients and in patients with preexisting cognitive decline - no dementia, severe stroke, a history of stroke, white matter changes and cerebral atrophy."
Prediction and prevention of stroke after transient ischemic attack in the short and long term. (Expert Rev Neurother. 2006)
Prediction of cognitive decline after stroke using proton magnetic resonance spectroscopy. (J Neurol Sci. 2006)
Predictors of Cerebral Microbleeds in Acute Ischemic Stroke and TIA Patients. (Cerebrovasc Dis. 2006) "Conclusions: CMB are more frequently noted in hospitalized stroke and transient ischemic attack patients with small vessel ischemia, as well as those with important modifiable vascular risk factors like atrial fibrillation and smoking."
[Prevalence of the metabolic syndrome in ischaemic stroke population.] (Neurol Neurochir Pol. 2006) "Conclusions: Over half of acute ischaemic stroke patients have MetSyn, but in the female population MetSyn is 1.5 times more frequent than in men. It is necessary to pay a special attention to the population with MetSyn because of the high risk of ischaemic stroke."
Previous Use of Aspirin and Baseline Stroke Severity: An Analysis of 17 850 Patients in the International Stroke Trial (Stroke 2006) "Conclusions- In this large prospective and complete data set, we found no evidence of any association of previous aspirin use with baseline stroke severity. The analyses suggest that previously reported positive and negative associations may well have been attributable to the play of chance in small samples, confounding or other biases, rather than a biological effect of aspirin."
Prognostic Significance for Stroke of a Morning Pressor Surge and a Nocturnal Blood Pressure Decline (Hypertension. 2006)
Proportions of Stroke Subtypes Among Men and Women >=40 Years of Age in an Urban Japanese City in 1992, 1997, and 2002. (Stroke. 2006) "CONCLUSIONS: Our study showed that hemorrhagic stroke represented a large proportion of all strokes, especially among women, and lacunar infarction was the most common subtype of ischemic stroke among both men and women in Yao City, which differed from findings in Western countries."
Recurrent stroke and cardiac risks after first ischemic stroke: the Northern Manhattan Study. (Neurology. 2006) "CONCLUSIONS: Cardiac mortality is nearly twice as high as mortality owing to recurrent stroke, but long-term risk of all stroke, fatal or nonfatal, is approximately twice the risk of all cardiac events. The high risk of nonfatal recurrent stroke reinforces the importance of therapies aimed at preventing stroke recurrence in addition to preventing cardiac events."
Reduced vitamin D in acute stroke. (Stroke. 2006)
Regular aspirin-use preceding the onset of primary intracerebral hemorrhage is an independent predictor for death. (Stroke. 2006)
Retinal vessel diameters and risk of stroke (NEUROLOGY 2006) "Conclusions: Larger retinal venular diameters are associated with an increased risk of stroke and cerebral infarction. The role of venules in cerebrovascular disease warrants further exploration."
Seizure development after stroke (International Journal of Clinical Practice 2006) "It was concluded that embolic strokes, being younger than 65 years old, and cortical localisation of stroke were important risks for developing seizures."
Seropositivity to Chlamydia pneumoniae Is Associated With Risk of First Ischemic Stroke (Stroke. 2006)
Stroke Associated with Diabetes among Canadians: Sex and Age Differences. (Neuroepidemiology. 2006) "Conclusions: There is a stronger association between stroke and diabetes in men than in women 45-64 years of age, suggesting men are more susceptible to stroke than women when they have diabetes."
Stroke in Saudi children. Epidemiology, clinical features and risk factors. (Saudi Med J. 2006)
Telomere length predicts poststroke mortality, dementia, and cognitive decline. (Ann Neurol. 2006)
The Impact of a Concurrent Trauma Alert Evaluation on Time to Head Computed Tomography in Patients with Suspected Stroke. (Acad Emerg Med. 2006)
The lifetime risk of stroke: estimates from the Framingham Study. (Stroke. 2006) "CONCLUSIONS: The LTR of stroke in middle-aged adults is 1 in 6 or more, which is equal to or greater than the LTR of AD. Women had a higher risk because of longer life expectancy. BP is a significant determinant of the LTR of stroke, and promotion of normal BP levels in the community might be expected to substantially reduce this risk."
The relationship between higher blood pressure and ischaemic, haemorrhagic stroke among Chinese and Caucasians: meta-analysis. (Eur J Cardiovasc Prev Rehabil. 2006) "CONCLUSION: The risk of stroke associated with hypertension is consistently and significantly greater in Chinese than Caucasians."
The value of self-measured home blood pressure in predicting stroke. (Expert Rev Neurother. 2006)
[Transient ischemic stroke] (Rev Prat. 2006) "According to the new definition proposed by the TIA working group, transient ischemic stroke (TIA) is "a brief episode of neurologic dysfunction caused by focal brain or retinal ischemia, with clinical symptoms typically lasting less than one hour, and without evidence of acute infarction." Patient presenting with a TIA should be investigated and treated urgently because the risk of ischemic stroke is about 10% at one month with 50% of these events occurring during the first 48 hours."
Trends in incidence, lifetime risk, severity, and 30-day mortality of stroke over the past 50 years. (JAMA. 2006)
What's new in stroke prevention and treatment. (Expert Rev Neurother. 2006)
What's New in Stroke? The Top 10 for 2004/05 (J Am Geriatr Soc. 2006)
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