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Sample records for ckm-matrixelements vertical stroke

  1. SIMBA - A global fit approach to vertical stroke Vub vertical stroke

    International Nuclear Information System (INIS)

    The parton distribution function for a b quark in the B-meson (called the shape function) plays an important role in the analysis of the B→Xsγ and B→Xul anti ν data, and gives raise to one of the dominant uncertainties in the determination of vertical stroke Vub vertical stroke. We implement a new model independent framework to treat the shape function with reliable theoretical uncertainties based on an expansion in a suitable complete set of orthonormal basis functions. This is a significant improvement over fits to model functions. We present the current status of combined fits to BaBar and Belle data and extract vertical stroke Vub vertical stroke.

  2. The WZNW model on PSU(1, 1 vertical stroke 2)

    Energy Technology Data Exchange (ETDEWEB)

    Goetz, G. [CEA Centre d' Etudes de Saclay, 91 - Gif-sur-Yvette (France). Service de Physique Theorique; Quella, T. [King' s College London (United Kingdom). Dept. of Mathematics]|[Amsterdam Univ. (Netherlands). KdV Institute for Mathematics; Schomerus, V. [CEA Centre d' Etudes de Saclay, 91 - Gif-sur-Yvette (France). Service de Physique Theorique]|[Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany)

    2006-10-15

    According to the work of Berkovits, Vafa and Witten, the non-linear sigma model on the supergroup PSU(1,1 vertical stroke 2) is the essential building block for string theory on AdS{sub 3}xS{sup 3}xT{sup 4}. Models associated with a non-vanishing value of the RR flux can be obtained through a psu(1,1 vertical stroke 2) invariant marginal deformation of the WZNW model on PSU(1,1 vertical stroke 2). We take this as a motivation to present a manifestly psu(1,1 vertical stroke 2) covariant construction of the model at the Wess-Zumino point, corresponding to a purely NSNS background 3-form flux. At this point the model possesses an enhanced psu(1,1 vertical stroke 2) current algebra symmetry whose representation theory, including explicit character formulas, is developed systematically in the first part of the paper. The space of vertex operators and a free fermion representation for their correlation functions is our main subject in the second part. Contrary to a widespread claim, bosonic and fermionic fields are necessarily coupled to each other. The interaction changes the supersymmetry transformations, with drastic consequences for the multiplets of localized normalizable states in the model. It is only this fact which allows us to decompose the full state space into multiplets of the global supersymmetry. We analyze these decompositions systematically as a preparation for a forthcoming study of the RR deformation. (orig.)

  3. The GL(1 vertical stroke 1)-symplectic fermion correspondence

    Energy Technology Data Exchange (ETDEWEB)

    Creutzig, Thomas; Roenne, Peter B.

    2008-12-15

    In this note we prove a correspondence between the Wess-Zumino-Novikov-Witten model of the Lie supergroup GL(1 vertical stroke 1) and a free model consisting of two scalars and a pair of symplectic fermions. This model was discussed earlier by LeClair. Vertex operators for the symplectic fermions include twist fields, and correlation functions of GL(1 vertical stroke 1) agree with the known results for the scalars and symplectic fermions. We perform a detailed study of boundary states for symplectic fermions and apply them to branes in GL(1 vertical stroke 1). This allows us to compute new amplitudes of strings stretching between branes of different types and confirming Cardy's condition. (orig.)

  4. Tensor products of psl(2 vertical stroke 2) representations

    International Nuclear Information System (INIS)

    The aim of this work is to study finite dimensional representations of the Lie superalgebra psl(2 vertical stroke 2) and their tensor products. In particular, we shall decompose all tensor products involving typical (long) and atypical (short) representations as well as their so-called projective covers. While tensor products of long multiplets and projective covers close among themselves, we shall find an infinite family of new indecomposables in the tensor products of two short multiplets. Our note concludes with a few remarks on possible applications to the construction of AdS3 backgrounds in string theory. (orig.)

  5. SL(2 vertical stroke 1) and D(2 vertical stroke 1;{alpha}) as vertex operator extensions of dual affine SL(2) algebras

    Energy Technology Data Exchange (ETDEWEB)

    Bowcock, P.; Taormina, A. [Durham Univ. (United Kingdom). Dept. of Mathematics; Feigin, B.L. [Landau Inst. of Theoretical Physics, Moscow (Russian Federation); Semikhatov, A.M. [Rossijskaya Akademiya Nauk, Moscow (Russian Federation). Fizicheskij Institut

    2000-11-01

    We discover a realisation of the affine Lie superalgebra sl(2 vertical stroke 1) and of the exceptional affine superalgebra D(2 vertical stroke 1;{alpha}) as vertex operator extensions of two sl(2) algebras with ''dual'' levels (and an auxiliary level-1 sl(2) algebra). The duality relation between the levels is (k{sub 1}+1)(k{sub 2}+1)=1. We construct the representation of sl(2 vertical stroke 1){sub k{sub 1}} on a sum of tensor products of sl(2){sub k{sub 1}}, sl(2){sub k{sub 2}}, and sl(2){sub 1} modules and decompose it into a direct sum over the sl(2 vertical stroke 1){sub k{sub 1}} spectral flow orbit. This decomposition gives rise to character identities, which we also derive. The extension of the construction to D(2 vertical stroke 1;k{sub 2}){sub k{sub 1}} is traced to the properties of sl(2)+ sl(2)+ sl(2) embeddings into D(2 vertical stroke 1;{alpha}) and their relation with the dual sl(2) pairs. Conversely, we show how the sl (2){sub k{sub 2}} representations are constructed from sl(2 vertical stroke 1){sub k{sub 1}} representations. (orig.)

  6. On the SU(2 vertical stroke 1) WZNW model and its statistical mechanics applications

    Energy Technology Data Exchange (ETDEWEB)

    Saleur, H. [CEA Centre d' Etudes de Saclay, 91 - Gif-sur-Yvette (France). Service de Physique Theorique]|[University of Southern California, Los Angeles, CA (United States). Dept. of Physics; Schomerus, V. [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany)

    2006-11-15

    Motivated by a careful analysis of the Laplacian on the supergroup SU(2 vertical stroke 1) we formulate a proposal for the state space of the SU(2 vertical stroke 1) WZNW model. We then use properties of sl(2 vertical stroke 1) characters to compute the partition function of the theory. In the special case of level k=1 the latter is found to agree with the properly regularized partition function for the continuum limit of the integrable sl(2 vertical stroke 1)3- anti 3 super-spin chain. Some general conclusions applicable to other WZNW models (in particular the case k=-1/2) are also drawn. (orig.)

  7. Measurement of Cabbibo-suppressed {tau} lepton decays and the determination of vertical stroke V{sub us} vertical stroke

    Energy Technology Data Exchange (ETDEWEB)

    Schenk, Stefan

    2008-07-07

    This work presents simultaneous branching fraction measurements of the decay modes {tau}{sup -}{yields}K{sup -}n{pi}{sup 0}{nu}{sub {tau}} with n=0,1,2,3 and {tau}{sup -}{yields}{pi}{sup -}n{pi}{sup 0}{nu}{sub {tau}} with n=3,4. The analysis is based on a data sample of 427 x 10{sup 6}{tau}{sup +}{tau}{sup -} pairs recorded with the BABAR detector, which corresponds to an integrated luminosity of 464.4 fb{sup -1}. The measured values are B({tau}{sup -}{yields}K{sup -}{nu}{sub {tau}})=(6.57{+-}0.03{+-}0.11) x 10{sup -3}, B({tau}{sup -}{yields}K{sup -}{pi}{sup 0}{nu}{sub {tau}})=(4.61{+-}0.03{+-}0.11) x 10{sup -3}, B({tau}{sup -}{yields}K{sup -}{pi}{sup 0}{pi}{sup 0}{nu}{sub {tau}})=(5.05{+-}0.17{+-}0.44) x 10{sup -4}, B({tau}{sup -}{yields}K{sup -}{pi}{sup 0}{pi}{sup 0}{pi}{sup 0}{nu}{sub {tau}})=(1.31{+-}0.43{+-}0.40) x 10{sup -4}, B({tau}{sup -}{yields}{pi}{sup -}{pi}{sup 0}{pi}{sup 0}{pi}{sup 0}{nu}{sub {tau}})=(1.263{+-}0.008{+-}0.078) x 10{sup -2} and B({tau}{sup -}{yields}{pi}{sup -}{pi}{sup 0}{pi}{sup 0}{pi}{sup 0}{pi}{sup 0}{nu}{sub {tau}})=(9.6{+-}0.5{+-}1.2) x 10{sup -4}, where the uncertainties are statistical and systematic, respectively. All measurements are compatible with the current world averages whereas the uncertainties are significantly smaller by a factor of up to five. The determination of B({tau}{sup -}{yields}{pi}{sup -}{pi}{sup 0}{pi}{sup 0}{pi}{sup 0}{pi}{sup 0}{nu}{sub {tau}}) is the first measurement of this branching fraction. The measured branching fractions are combined with the current world averages. Using the new averages, an updated determination of vertical stroke V{sub us} vertical stroke from hadronic {tau} decays yields vertical stroke V{sub us} vertical stroke =0.2146{+-}0.0025, which improves previous measurements by 19%. Its uncertainty is comparable to the one of the current world average from semileptonic kaon decays. (orig.)

  8. An evaluation of vertical stroke V{sub us} vertical stroke and precise tests of the standard model from world data on leptonic and semileptonic kaon decays

    Energy Technology Data Exchange (ETDEWEB)

    Antonelli, M.; Isidori, G.; Moulson, M.; Palutan, M.; Sciascia, B. [Laboratori Nazionali di Frascati dell' INFN, Frascati, RM (Italy); Cirigliano, V. [Los Alamos National Laboratory, Theoretical Division, Los Alamos, NM (United States); Mescia, F. [Universitat de Barcelona, Dep. ECM and ICC, Barcelona (Spain); Neufeld, H. [Universitaet Wien, Fakultaet fuer Physik, Vienna (Austria); Passemar, E. [Universitat de Valencia - CSIC, Departament de Fisica Teorica, IFIC, Valencia (Spain); Sozzi, M. [Universita di Pisa e Sezione dell' INFN di Pisa, Dipartimento di Fisica, Pisa (Italy); Wanke, R. [Universitaet Mainz, Institut fuer Physik, Mainz (Germany); Yushchenko, O.P. [Institute for High Energy Physics, Protvino (Russian Federation)

    2010-10-15

    We present a global analysis of leptonic and semileptonic kaon decay data, including all recent results published by the BNL-E865, KLOE, KTeV, ISTRA+ and NA48 experiments. This analysis, in conjunction with precise lattice calculations of the hadronic matrix elements now available, leads to a very precise determination of vertical stroke V{sub us} vertical stroke and allows us to perform several stringent tests of the standard model. (orig.)

  9. Structure constants of the OSP(1 vertical stroke 2) WZNW model

    Energy Technology Data Exchange (ETDEWEB)

    Hikida, Y.; Schomerus, V.

    2007-11-15

    We propose exact formulas for the 2- and 3-point functions of the WZNW model on the non-compact supergroup OSP(1 vertical stroke 2). Using the path integral approach that was recently developed in arXiv:0706.1030 we show how local correlation functions in the OSP(p vertical stroke 2) WZNW models can be obtained from those of N=p supersymmetric Liouville field theory for p=1,2. We then employ known results on correlators in N=1 Liouville theory to determine the structure constants of the OSP(1 vertical stroke 2) theory. (orig.)

  10. Branes in the GL(1 vertical stroke 1) WZNW-Model

    Energy Technology Data Exchange (ETDEWEB)

    Creutzig, T.; Schomerus, V. [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Quella, T. [Amsterdam Univ. (Netherlands). KdV Inst. for Mathematics

    2007-08-15

    We initiate a systematic study of boundary conditions in conformal field theories with target space supersymmetry. The WZNW model on GL(1 vertical stroke 1) is used as a prototypical example for which we find the complete set of maximally symmetric branes. This includes a unique brane of maximal super-dimension 2 vertical stroke 2, a 2-parameter family of branes with super-dimension 0 vertical stroke 2 and an infinite set of fully localized branes possessing a single modulus. Members of the latter family can only exist along certain lines on the bosonic base, much like fractional branes at orbifold singularities. Our results establish that all essential algebraic features of Cardy-type boundary theories carry over to the non-rational logarithmic WZNW model on GL(1 vertical stroke 1). (orig.)

  11. Continuum limit of gl(M vertical stroke N) spin chains

    International Nuclear Information System (INIS)

    We study the spectrum of an integrable antiferromagnetic Hamiltonian of the gl(M vertical stroke N) spin chain of alternating fundamental and dual representations. After extensive numerical analysis, we identify the vacuum and low lying excitations and with this knowledge perform the continuum limit, while keeping a finite gap. All antiferromagnetic gl(n+N vertical stroke N) spin chains with n>0 and N≠0 are shown to possess in the continuum limit 2n-2 multiplets of massive particles which scatter with gl(n) Gross-Neveu like S-matrices, namely their eigenvalues do not depend on N. We argue that the continuum theory is the gl(M vertical stroke N) Gross-Neveu model, that is the massive deformation of the gl(M vertical stroke N)1 Wess-Zumino-Witten model. As we can see ion the example of gl(2m vertical stroke 1) spin chains, the full particle spectrum is much richer. Our analysis suggests that for a complete characterization of the latter it is not enough to restrict to large volume calculations, as we do in this work. (orig.)

  12. Characters of admissible representations of the affine superalgebra sl(2 vertical stroke 1; C){sub k}

    Energy Technology Data Exchange (ETDEWEB)

    Bowcock, P.; Hayes, M.; Taormina, A. [Durham Univ. (United Kingdom). Dept. of Mathematical Sciences

    1998-01-26

    We calculate characters and supercharacters for irreducible, admissible representations of the affine superalgebra sl(2 vertical stroke 1;C){sub k} in both the Ramond and Neveu-Schwarz sectors and discuss their modular properties in the special case of level k=-1/2. We also show that the non-degenerate integrable sl(2 vertical stroke 1;C){sub k} characters coincide with some N=4 superconformal characters. (orig.). 31 refs.

  13. Determination of the CKM matrix element vertical stroke V{sub cb} vertical stroke, the B {yields} X{sub s}{gamma} decay rate, and the b-quark mass

    Energy Technology Data Exchange (ETDEWEB)

    Bernlochner, Florian Urs

    2011-09-15

    In this work, the preliminary measurements of two fundamental parameters of the Standard Model of particles physics are presented: the CKM matrix element vertical stroke V{sub cb} vertical stroke, and the b-quark mass. The measurement of the absolute value of the CKM matrix element V{sub cb} uses the full set of recorded data of 429.06 fb{sup -1} of B anti B mesons of the BABAR experiment. The CKM matrix element is obtained by measuring the branching fractions and non-perturbative shape parameters of the two transitions into the charmed 1S ground states, B {yields} Dl{nu}{sub l} and B {yields} D{sup *}l {nu}{sub l}, respectively. The kinematic of the produced lepton is measured and the kinematics of the short-lived charmed mesons is reconstructed from kaon and pion candidates. By combining the reconstructed three-momenta of both particles with the angular information of the decay, three independent variables can be obtained. The measured distributions in these variables are analyzed in a three-dimensional global fit, which simultaneously extracts the decay parameters and branching fractions of both charmed transitions. We find that B {yields} Dl {nu}{sub l}: vertical stroke V{sub cb} vertical stroke =(36.14{+-}0.57{sub stat.}{+-}1.30{sub sys.}{+-}0.80{sub theo.}) x 10{sup -3}, B {yields} D{sup *}l {nu}{sub l}: vertical stroke V{sub cb} vertical stroke =(39.71{+-}0.26{sub stat.}{+-}0.73{sub sys.}{+-}0.74{sub theo.}) x 10{sup -3}, where the uncertainties are statistical, systematic, and theoretical, respectively. In the Standard Model, both measured values of vertical stroke V{sub cb} vertical stroke can be averaged to further minimize the uncertainties. We find Combined: vertical stroke V{sub cb} vertical stroke =(38.29{+-}0.26{sub stat.}{+-}0.64{sub sys.}{+-}0.52{sub theo.}) x 10{sup -3}. Furthermore, several scenarios are explored how possible future unquenched lattice QCD points can be incorporated into the measurement, to further reduce the uncertainty on

  14. Reconstruction of B{sup -} {yields} D{sup *0}e{sup -} anti {nu}{sub e} decays and determination of vertical stroke V{sub cb} vertical stroke

    Energy Technology Data Exchange (ETDEWEB)

    Schubert, J.

    2006-12-01

    In this analysis the decay B{sup -} {yields} D{sup *0}e{sup -} anti {nu}{sub e} is measured. The underlying data sample consists of about 226 million B anti B-pairs accumulated on the {upsilon}(4S) resonance by the BABAR detector at the asymmetric e{sup +}e{sup -} collider PEP-II. The reconstruction of the decay uses the channels D{sup *0} {yields} D{sup 0}{pi}{sup 0}, D{sup 0} {yields} K{sup -}{pi}{sup +} and {pi}{sup 0} {yields} {gamma}{gamma}. The neutrino is not reconstructed. Since the rest frame of the B meson is unknown, the boost w of the D{sup *0} meson in the B meson rest frame is estimated by w. The w spectrum of the data is described in terms of the partial decay width d{gamma}/dw given by theory and the detector simulation translating each spectrum d{gamma}/dw into an expectation of the measured w spectrum. d{gamma}/dw depends on a form factor F(w) parameterizing the strong interaction in the decay process. To find the best descriptive d{gamma}/dw a fit to the data determines the following two parameters of d{gamma}/dw: (i) F(1) vertical stroke V{sub cb} vertical stroke, the product between F at zero D{sup *0}-recoil and the CKM matrix element vertical stroke V{sub cb} vertical stroke; (ii) {rho}{sup 2}{sub A1}, a parameter of the form factor F(w). The former parameter scales the height of d{gamma}/dw and {rho}{sup 2}{sub A1} varies the shape of it. The determined values of F(1) vertical stroke V{sub cb} vertical stroke, {rho}{sup 2}{sub A1} and B(B{sup -} {yields} D{sup *0}e{sup -} anti {nu}{sub e}) are F(1) vertical stroke V{sub cb} vertical stroke =(35.8{+-}0.5{+-}1.5) x 10{sup -3}, {rho}{sup 2}{sub A1}=(1.08{+-}0.05{+-}0.09) and B(B{sup -} {yields} D{sup *0}e{sup -} anti {nu}{sub e})=(5.60{+-}0.08{+-}0.42)%, where the uncertainties are statistical and systematic, respectively. The values of B(B{sup -} {yields} D{sup *0}e{sup -} anti {nu}{sub e}) has been determined by an integration of d{gamma}/dw over the allowed w range using the fitted values of

  15. Stroke

    Science.gov (United States)

    ... emergency. Strokes happen when blood flow to your brain stops. Within minutes, brain cells begin to die. There are two kinds ... blocks or plugs a blood vessel in the brain. The other kind, called hemorrhagic stroke, is caused ...

  16. Measurement of τ decays into a charged hadron accompanied by neutral π-mesons and determination of the CKM matrix element vertical stroke V{sub us} vertical stroke

    Energy Technology Data Exchange (ETDEWEB)

    Adametz, Aleksandra

    2011-07-06

    This thesis presents the branching fraction measurement of the τ{sup -}→K{sup -}(nπ{sup 0})ν{sub τ} (n=0,1,2,3) and τ{sup -}→π{sup -}(nπ{sup 0})ν{sub τ} (n=3,4) decays. The measurement is based on a data sample of 435 million τ pairs produced in e{sup +}e{sup -} collisions and collected with the BABAR detector in 1999-2008. The analysis is validated using precisely known τ decays as control modes. The measured branching fractions are B(τ{sup -}→K{sup -}ν{sub τ})=(7.100±0.033±0.156) x 10{sup -3}, B(τ{sup -}→K{sup -}π{sup 0}ν{sub τ})=(5.000±0.020±0.139) x 10{sup -3}, B(τ{sup -}→K{sup -}(2π{sup 0})ν{sub τ})=(5.654±0.144±0.323) x 10{sup -4}, B(τ{sup -}→K{sup -}(3π{sup 0})ν{sub τ})=(1.642±0.279±0.375) x 10{sup -4}, B(τ{sup -}→π{sup -}(3π{sup 0})ν{sub τ})=(1.216±0.010±0.047) x 10{sup -2}, B(τ{sup -}→π{sup -}(4π{sup 0})ν{sub τ})=(1.041±0.067±0.090) x 10{sup -3}, where the first uncertainty is statistical and the second systematic. The branching fraction B(τ{sup -}→π{sup -}(4π{sup 0})ν{sub τ}) is measured for the first time. The precision of the results is comparable or significantly improved with respect to previous measurements. The branching fraction B(τ{sup -}→K{sup -}ν{sub τ}) is combined with a lattice QCD calculation of the kaon decay constant to obtain the Cabibbo-Kobayashi-Maskawa matrix element vertical stroke V{sub us} vertical stroke =0.2224±0.0025(exp)±0.0029(theo). The branching fractions of the τ decays into a kaon are combined with the current world averages. The resulting averages are used in the determination of the total τ branching fraction, B{sub s}, into strangeness vertical stroke S vertical stroke =1 final states. B{sub s} is used in conjunction with vertical stroke V{sub ud} vertical stroke and a small SU(3)-symmetry breaking correction to compute vertical stroke V{sub us} vertical stroke =0.2176±0.0025(exp)±0.0010(theo).

  17. Stroke

    International Nuclear Information System (INIS)

    The advent of computed tomography (CT) in the early 1970s greatly facilitated the diagnosis and management of stroke and added significantly to our understanding of the pathophysiologic brain alterations it causes in humans. With CT it is now possible for the first time to noninvasively and reliably diagnose and distinguish between stroke resulting from cerebral infraction and that resulting from cerebral hemorrhage. In addition, other brain lesions that at times may clinically present as stroke-like syndromes, such as primary or metastatic brain tumor, brain abscess, or subdural hematoma, can usually be clearly differentiated by the CT examination. In most instances it is no longer necessary to perform cerebral angiography to exclude a possible surgical lesion in patients in whom the clinical diagnosis of stroke may have been in doubt

  18. The universal Racah-Wigner symbol for U{sub q}(osp(1 vertical stroke 2))

    Energy Technology Data Exchange (ETDEWEB)

    Pawelkiewicz, Michal; Schomerus, Volker [DESY Hamburg (Germany). Theory Group; Suchanek, Paulina [DESY Hamburg (Germany). Theory Group; Wroclaw Univ. (Poland). Inst. for Theoretical Physics

    2013-10-15

    We propose a new and elegant formula for the Racah-Wigner symbol of self-dual continuous series of representations of U{sub q}(osp(1 vertical stroke 2)). It describes the entire fusing matrix for both NS and R sector of N=1 supersymmetric Liouville field theory. In the NS sector, our formula is related to an expression derived in an earlier paper (L. Hadaz, M. Pawelkiewicz, and V. Schomerus, arXiv:1305.4596[hep-th]). Through analytic continuation in the spin variables, our universal expression reproduces known formulas for the Racah-Wigner coefficients of finite dimensional representations.

  19. Subliminal galvanic-vestibular stimulation recalibrates the distorted visual and tactile subjective vertical in right-sided stroke.

    Science.gov (United States)

    Oppenländer, Karin; Utz, Kathrin S; Reinhart, Stefan; Keller, Ingo; Kerkhoff, Georg; Schaadt, Anna-Katharina

    2015-07-01

    Stroke of the right cerebral hemisphere often causes deficits in the judgement of the subjective visual vertical (SVV) and subjective tactile vertical (STV) which are related to central vestibular functioning. Clinically, deficits in the SVV/STV are linked to balance problems and poor functional outcome. Galvanic Vestibular Stimulation (GVS) is a non-invasive, save stimulation technique that induces polarity-specific changes in the cortical vestibular systems. Subliminal GVS induces imperceptible vestibular stimulation without unpleasant side effects. Here, we applied bipolar subliminal GVS over the mastoids (mean intensity: 0.7 mA, 20 min duration per session) to investigate its online-influence on constant errors, difference thresholds and range values in the SVV and STV. 24 patients with subacute, single, unilateral right hemisphere stroke were studied and assigned to two patient groups (impaired vs. normal in the SVV and STV) on the basis of cut-off scores from healthy controls. Both groups performed these tasks under three experimental conditions on three different days: a) sham GVS where electric current was applied only for 30s and then turned off, b) left-cathodal GVS and c) right-cathodal GVS, for a period of 20 min per session. Left-cathodal GVS, but not right-cathodal GVS significantly reduced all parameters in the SVV. Concerning STV GVS also reduced constant error and range numerically, though not significantly. These effects occurred selectively in the impaired patient group. In conclusion, we found that GVS rapidly influences poststroke verticality deficits in the visual and tactile modality, thus highlighting the importance of the vestibular system in the multimodal elaboration of the subjective vertical. PMID:25744870

  20. Ischemic Stroke

    Science.gov (United States)

    ... can help you. Learn more What Is Stroke? Hemorrhagic Stroke Ischemic Stroke What is TIA? Stroke Facts Recognizing ... Stroke Survey Faces of Stroke What is stroke? Hemorrhagic stroke Ischemic stroke What is TIA? Stroke facts I ...

  1. Self-dual continuous series of representations for U{sub q}(sl(2)) and U{sub q}(osp(1 vertical stroke 2))

    Energy Technology Data Exchange (ETDEWEB)

    Hadasz, Leszek [Krakow Univ. (Poland). Inst. of Physics; Pawelkiewicz, Michal; Schomerus, Volker [DESY Hamburg (Germany). Theory Group

    2013-05-15

    We determine the Clebsch-Gordan and Racah-Wigner coefficients for continuous series of representations of the quantum deformed algebras U{sub q}(sl(2)) and U{sub q}(osp(1 vertical stroke 2)). While our results for the former algebra reproduce formulas by Ponsot and Teschner, the expressions for the orthosymplectic algebra are new. Up to some normalization factors, the associated Racah-Wigner coefficients are shown to agree with the fusing matrix in the Neveu-Schwarz sector of N=1 supersymmetric Liouville field theory.

  2. Hemispatial neglect and deficits of verticality perception after stroke - neuropsychological results and modulation via galvanic vestibular stimulation

    OpenAIRE

    Utz, Kathrin Susanne

    2011-01-01

    Hemispatial neglect is a multimodal syndrome that often follows unilateral right-brain damage. Patients with hemispatial neglect fail to notice or respond to sensory stimuli presented in the contralesional hemispace, which is not caused by primary motor or sensory deficits. Associated disorders often co-occurring with hemispatial neglect are deficits of verticality perception. Patients with those deficits show significant deviations in their subjective visual or haptic vertical away from the ...

  3. Measurement of the partial branching fraction for inclusive semileptonic B meson decays to light hadrons B {yields} X{sub u}lv and an improved determination of the quark-mixing matrix element vertical stroke V{sub ub} vertical stroke

    Energy Technology Data Exchange (ETDEWEB)

    Volk, Alexei

    2009-07-01

    This thesis presents an analysis of inclusive semileptonic B{yields} X{sub u}e anti {nu}{sub e} decays using approximately 454 million {upsilon}(4S){yields}B anti B decays collected during the years 1999 to 2008 with the BABAR detector. The electron energy, E{sub e}, and the invariant mass squared of the electron-neutrino pair, q{sup 2}, are reconstructed, where the neutrino kinematics is deduced from the decay products of both B mesons. The final hadronic state, X{sub u}, consists of a sum of many hadronic channels, each of which contains at least one u quark. The variables q{sup 2} and E{sub e} are then combined to compute the maximum kinematically allowed invariant mass squared of the hadronic system, s{sub h}{sup max}. Using these kinematic quantities, the partial branching fraction, {delta}B(B {yields} X{sub u}lv), unfolded for detector effects, is measured to be {delta}B(E{sub e}>2.0 GeV, s{sub h}{sup max}<3.52 GeV{sup 2}) (3.33{+-}0.18{+-}0.21) x 10{sup -4} in the {upsilon}(4S) and {delta}B(E{sub e}>1.9 GeV, s{sub h}{sup max}<3.5 GeV{sup 2})= (4.57{+-}0.24{+-}0.32) x 10{sup -4} in the B meson rest frames. The quoted errors are statistical and systematic, respectively. The CKM matrix element vertical stroke V{sub ub} vertical stroke is determined from the measured {delta}B using theoretical calculation based on Heavy Quark Expansion. The result is vertical stroke V{sub ub} vertical stroke =(4.19{+-}0.18{sub -0.20-0.25}{sup +0.26+0.26}) x 10{sup -3}, where the errors represent experimental uncertainties, uncertainties from HQE parameters and theoretical uncertainties, respectively. (orig.)

  4. Pediatric Stroke

    Science.gov (United States)

    ... News About Neurology Image Library Search The Internet Stroke Center Patients & Families About Stroke Stroke Diagnosis Stroke ... communicate with your child’s doctor. Symptoms of a Stroke Stroke is an injury to part of the ...

  5. Measurement of the partial branching fraction for inclusive semileptonic B meson decays to light hadrons B → Xulv and an improved determination of the quark-mixing matrix element vertical stroke Vub

    International Nuclear Information System (INIS)

    This thesis presents an analysis of inclusive semileptonic B→ Xue anti νe decays using approximately 454 million Υ(4S)→B anti B decays collected during the years 1999 to 2008 with the BABAR detector. The electron energy, Ee, and the invariant mass squared of the electron-neutrino pair, q2, are reconstructed, where the neutrino kinematics is deduced from the decay products of both B mesons. The final hadronic state, Xu, consists of a sum of many hadronic channels, each of which contains at least one u quark. The variables q2 and Ee are then combined to compute the maximum kinematically allowed invariant mass squared of the hadronic system, shmax. Using these kinematic quantities, the partial branching fraction, ΔB(B → Xulv), unfolded for detector effects, is measured to be ΔB(Ee>2.0 GeV, shmax2) (3.33±0.18±0.21) x 10-4 in the Υ(4S) and ΔB(Ee>1.9 GeV, shmax2)= (4.57±0.24±0.32) x 10-4 in the B meson rest frames. The quoted errors are statistical and systematic, respectively. The CKM matrix element vertical stroke Vub vertical stroke is determined from the measured ΔB using theoretical calculation based on Heavy Quark Expansion. The result is vertical stroke Vub vertical stroke =(4.19±0.18-0.20-0.25+0.26+0.26) x 10-3, where the errors represent experimental uncertainties, uncertainties from HQE parameters and theoretical uncertainties, respectively. (orig.)

  6. Stroke Treatments

    Science.gov (United States)

    ... T. Quiz 5 Things to Know About Stroke Stroke Treatments A stroke occurs when a vessel in ... Busting Clots to Save Lives Hemorrhagic Stroke Treatment Stroke Prevention The good news is that 80 percent ...

  7. Ischemic Stroke

    Science.gov (United States)

    A stroke is a medical emergency. There are two types - ischemic and hemorrhagic. Ischemic stroke is the most common type. It is usually ... are at risk for having a more serious stroke. Symptoms of stroke are Sudden numbness or weakness ...

  8. Hemorrhagic Stroke

    Science.gov (United States)

    A stroke is a medical emergency. There are two types - ischemic and hemorrhagic. Hemorrhagic stroke is the less common type. It happens when ... an artery wall that breaks open. Symptoms of stroke are Sudden numbness or weakness of the face, ...

  9. Stroke Rehabilitation

    Science.gov (United States)

    A stroke can cause lasting brain damage. People who survive a stroke need to relearn skills they lost because of ... them relearn those skills. The effects of a stroke depend on which area of the brain was ...

  10. Preventing stroke

    Science.gov (United States)

    Stroke - prevention; CVA - prevention; cerebral vascular accident - prevention; TIA - prevention, transient ischemic attack - prevention ... A stroke occurs when the blood supply is cut off to any part of the brain. A stroke is ...

  11. On the fusion in SL(2)-WZNW models and 6j symbols of U{sub q}sl(2) x U{sub q'}osp(1 vertical stroke 2)

    Energy Technology Data Exchange (ETDEWEB)

    Koesling, Jens

    2010-06-15

    We introduce a novel method to determine 6j-symbols of quantum groups. This method is inspired by the methods used in the determination of fusing matrices of WZNW models. With this method we determine the 6j-symbols of the quantum group U{sub q}sl(2) and the super quantum group U{sub q}osp(1 vertical stroke 2). We present the 6j-symbols as a recurrence relation and its initial values. The 6j-symbols transform between the s-channel and the u-channel decomposition of the invariants of the four-fold tensor product of modules of a quantum group. These invariants fulfil certain difference equations. We set one of the representations in the invariant to the fundamental representation, and deduce a system of linear equations for the initial values of the recurrence relation determining the 6j-symbols. (orig.)

  12. Ischemic Stroke

    OpenAIRE

    Eleni Dokoutsidou; Konstantina Antoniou

    2009-01-01

    Stroke is currently the third leading cause of death, ranking after heart disease and cancer and causes 10% of deaths, worldwide.Aim: The aim of the present study was to review the literature about the types of stroke and the risk factors for ischemic stroke.The methodoly that was followed included bibliography review from the both the research and the review literature of Greek and international data base which referred to ischemic stroke.Results: Stroke, according to its’ underlying etio...

  13. [Cerebellar stroke].

    Science.gov (United States)

    Paradowski, Michał; Zimny, Anna; Paradowski, Bogusław

    2015-01-01

    Cerebellar stroke belongs to a group of rare diseases of vascular origin. Cerebellum, supplied by three pairs of arteries (AICA, PICA, SCA) with many anastomoses between them is less susceptible for a stroke, especially ischemic one. Diagnosis of the stroke in this region is harder due to lower sensibility of commonly used CT of the head in case of stroke suspicion. The authors highlight clinical symptoms distinguishing between vascular territories or topographical locations of the stroke, diagnostic procedures, classical and surgical treatment, the most common misdiagnoses are also mentioned. The authors suggest a diagnostic and therapeutic algorithm development, including rtPA treatment criteria for ischemic cerebellar stroke. PMID:26181157

  14. Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Eleni Dokoutsidou

    2009-05-01

    Full Text Available Stroke is currently the third leading cause of death, ranking after heart disease and cancer and causes 10% of deaths, worldwide.Aim: The aim of the present study was to review the literature about the types of stroke and the risk factors for ischemic stroke.The methodoly that was followed included bibliography review from the both the research and the review literature of Greek and international data base which referred to ischemic stroke.Results: Stroke, according to its’ underlying etiology, can be classified into two major categories, ischemic and hemorrhagic. 20% of stroke are of hemorrhagic type, whereas 80% are of ischemic type. Although, ischemic stroke is the most common type, its’ etiology differs. Ischemic stroke is categorized in thrombotic, embolic, lacunar, unknown etiology, transient and due to systematic low blood pressure. In the literature is cited that risk factors for stroke are classified in non-modifiable and modifiable. Non-modifiable risk factors are age, gender, ethnicity and heredity. The most important modifiable risk factors for stroke are high blood pressure and atrial fibrillation. Other modifiable risk factors include high blood cholesterol levels, diabetes mellitus, cigarette smoking (active and passive, carotid artery stenosis, heavy alcohol consumption, drug abuse, lack of physical activity, obesity and unhealthy diet.Conclusions: As it is supported by published evidence, ischemic stroke is of higher incidence compared to hemorrhagic stroke. Risk factor modification remains as the principal aspect of care for ischemic stroke prevention.

  15. Stroke: Overview

    Science.gov (United States)

    ... NICHD Research Information Clinical Trials Resources and Publications Stroke: Overview Skip sharing on social media links Share this: Page Content Stroke is a leading cause of disability and death ...

  16. Know Stroke

    Science.gov (United States)

    ... Home Current Issue Past Issues Special Section Know Stroke Past Issues / Summer 2007 Table of Contents For ... D. Director, National Institute of Neurological Disorders and Stroke Photo courtesy of NIH/NINDS Welcome to this ...

  17. Recovering after stroke

    Science.gov (United States)

    Stroke rehabilitation; Cerebrovascular accident - rehabilitation; Recovery from stroke; Stroke - recovery; CVA - recovery ... WHERE TO LIVE AFTER A STROKE Most people will need stroke ... after they leave the hospital. Stroke rehab will help you ...

  18. Recovery After Stroke: Recurrent Stroke

    Science.gov (United States)

    ... who have had transient ischemic attacks (TIAs) or mini- strokes. TIAs are brief episodes of stroke-like ... exerts on blood vessel walls as your heart pumps. The second, diastolic blood pressure, is the measurement ...

  19. Ischemic Stroke.

    Science.gov (United States)

    Capriotti, Teri; Murphy, Teresa

    2016-05-01

    Each year, more than 795,000 people in the United States suffer a stroke and by 2030, it is estimated that 4% of the U.S. population will have had a stroke. Home healthcare clinicians will be increasingly called upon to assist stroke survivors and their caregivers adjust to disability and assist the survivor during their reintegration into the community. Therapeutic modalities are changing with advanced technology. Great strides are being made in the treatment of acute stroke; particularly endovascular interventions. More patients are surviving the acute stroke event and therefore will need to learn how to live with various degrees of disability. It is important for home healthcare clinicians to understand the process from acute event to medical stabilization, and from rehabilitation to long-term adaptation. PMID:27145407

  20. How a Stroke Is Diagnosed

    Science.gov (United States)

    ... News About Neurology Image Library Search The Internet Stroke Center Patients & Families About Stroke Stroke Diagnosis Stroke ... Diagnosis » How a Stroke is Diagnosed How a Stroke is Diagnosed How a Stroke is Diagnosed Lab ...

  1. B-decay form factors from QCD sum rules

    International Nuclear Information System (INIS)

    In the Standard Model of particle physics there is only one source of CP-violation. Namely, a single complex phase in the unitary 3 x 3 CKM-Matrix governing flavor transitions in the weak interaction. The unitarity is usually visualized by a triangle in the complex ρ - η-plane. Therefore testing this framework comes down to measuring weak decays, relating observables to sides and angles of this so called Unitarity Triangle(UT). Particular interest in this respect is payed to decays of mesons containing a heavy b-quark, giving the opportunity to alone determine all parameters of the UT. Doing this is far from easy. Besides tedious experimental measurements the theoretical calculations are plagued by hadronic quantities which cannot be determined by perturbation theory. In this work several of these quantities so called form factors are computed using the well known method of light cone sum rules(LCSR). Two different setups have been used. One, established in this work, utilizing a correlation function with an on-shell B-Meson and one following the traditional calculation by taking the light meson on-shell. Both using light cone expansion in the respective on-shell mesons distribution amplitudes. While the first approach allows to calculate a whole bunch of phenomenologically interesting quantities by just changing Dirac-structures of the relevant currents it has the drawback that it does not have access to the well developed twist expansion of the latter. To incorporate higher Fock-state contributions the first models for three-particle distribution amplitudes of the B-Meson have been derived. αs-corrections remain out of the scope of this work. Nevertheless does a comparison with more sophisticated methods show an encouraging numerical agreement. In the second setup all known corrections especially the never verified αs-corrections to Twist three terms have been recalculated and a competitive result for the CKM-matrixelement vertical stroke Vub vertical stroke

  2. Healthy Living after Stroke

    Science.gov (United States)

    ... After Stroke Weight Training After Stroke Tips for Improving Fine Motor Skills Functional Tone Management Arm Training Program Constraint-Induced Movement Therapy Emotional & Behavioral Challenges Self-Esteem after Stroke Post-Stroke Mood Disorders One-side ...

  3. Atherosclerosis and Stroke

    Science.gov (United States)

    ... After Stroke Weight Training After Stroke Tips for Improving Fine Motor Skills Functional Tone Management Arm Training Program Constraint-Induced Movement Therapy Emotional & Behavioral Challenges Self-Esteem after Stroke Post-Stroke Mood Disorders One-side ...

  4. Driving After a Stroke

    Science.gov (United States)

    ... After Stroke Weight Training After Stroke Tips for Improving Fine Motor Skills Functional Tone Management Arm Training Program Constraint-Induced Movement Therapy Emotional & Behavioral Challenges Self-Esteem after Stroke Post-Stroke Mood Disorders One-side ...

  5. National Stroke Association

    Science.gov (United States)

    ... Virginia Washington West Virginia Wisconsin Wyoming Go National Stroke Association Our mission is to reduce the incidence ... for all impacted by stroke. Featured Campaign World Stroke Day is Oct. 29 National Stroke Association is ...

  6. Mixed Stroke

    Institute of Scientific and Technical Information of China (English)

    黄如训; 曾进胜

    2000-01-01

    Purpose To summarize the chnical, autoptic and animal experimental dala of stroke, propose the concept of mixed stroke (MS) and demonstrate the enoiogy, pathogenesis, clinical mainfestations, prophylaxis and treatment of MS Background At present. stroke still is classified in the national and international academic fields as two main groups: hemorrhage and ischema In fact, thc cerebral vascular disease with hemorrhage forus and ischema focus at the same time is not rare moreover, this type of stroke has special etiology, pathogenesis and clinical manifestations. But it is always made a main dagnosis and neglected the other nature of coexistent focus on either clinical or pathological diagnosis according to traditional classification of stroke Data sources and methods Mort of pablished originsl articles about MS in our department and laboralory wcre reviewed. Resulta The clinical autoptic and animal experimental dats all prcved that hemorrhage and infarction could occur in the course of a stroke simultaneously or in suecession during a short time, which demonstrated the existence of MS It was found clinically that MS patients all had the hustory of hypcrtension and in the autoptic data the MS patients dying of stroke all had typical hypertensive changes in the heart and kidney. and had hypertensive arteriosclerosis in the cerebral arteriole and small artery. MS was cas lily thdueed in stroke-prone renovascular hypertensivc rats This kind of rats are free from genetic deficiency and arc not affected by senile factor, so their cerebral vascular foci are mainly induced by the single factor -hypertension. TThese indicate definitely that hypertensive cerebral vascular lesion is the basis inducing MS. The main lesions of hypertensive cerebral arteriole and small artery were hyalinosis and fibrinoid of the walls, and the formation of microaneurysms or hyperplasla of iniernal and external layers The math lcsions of hypertensive cerebral capillaries were increasing vascular

  7. Stroke awareness in Denmark

    DEFF Research Database (Denmark)

    Truelsen, Thomas; Krarup, Lars-Henrik

    2010-01-01

    This is the first study to examine the awareness of major stroke symptoms and stroke risk factors among the general population in Denmark. Early recognition of stroke warning signs and means of reducing stroke occurrence could improve the treatment and prevention of stroke.......This is the first study to examine the awareness of major stroke symptoms and stroke risk factors among the general population in Denmark. Early recognition of stroke warning signs and means of reducing stroke occurrence could improve the treatment and prevention of stroke....

  8. Mixed Stroke

    Institute of Scientific and Technical Information of China (English)

    HuangRuxun(黄如训); Zeng Jinsheng(曾进胜)

    2000-01-01

    Purpose To summarize the chnical, autoptic and animal experimental dala of stroke, propose the concept of mixed stroke (MS) and demonstrate the enoiogy, pathogenesis, clinical mainfestations, prophylaxis and treatment of MS Background At present. stroke still is classified in the national and international academic fields as two main groups: hemorrhage and ischema In fact, thc cerebral vascular disease with hemorrhage forus and ischema focus at the same time is not rare moreover, this type of stroke has special etiology, pathogenesis and clinical manifestations. But it is always made a main dagnosis and neglected the other nature of coexistent focus on either clinical or pathological diagnosis according to traditional classification of stroke Data sources and methods Mort of pablished originsl articles about MS in our department and laboralory wcre reviewed. Resulta The clinical autoptic and animal experimental dats all prcved that hemorrhage and infarction could occur in the course of a stroke simultaneously or in suecession during a short time, which demonstrated the existence of MS It was found clinically that MS patients all had the hustory of hypcrtension and in the autoptic data the MS patients dying of stroke all had typical hypertensive changes in the heart and kidney. and had hypertensive arteriosclerosis in the cerebral arteriole and small artery. MS was cas lily thdueed in stroke-prone renovascular hypertensivc rats This kind of rats are free from genetic deficiency and arc not affected by senile factor, so their cerebral vascular foci are mainly induced by the single factor -hypertension. TThese indicate definitely that hypertensive cerebral vascular lesion is the basis inducing MS. The main lesions of hypertensive cerebral arteriole and small artery were hyalinosis and fibrinoid of the walls, and the formation of microaneurysms or hyperplasla of iniernal and external layers The math lcsions of hypertensive cerebral capillaries were increasing vascular

  9. Stroke awareness in Denmark

    DEFF Research Database (Denmark)

    Truelsen, Thomas; Krarup, Lars-Henrik

    2010-01-01

    This is the first study to examine the awareness of major stroke symptoms and stroke risk factors among the general population in Denmark. Early recognition of stroke warning signs and means of reducing stroke occurrence could improve the treatment and prevention of stroke....

  10. [Hippocampal stroke].

    Science.gov (United States)

    Rollnik, J D; Traitel, B; Dietrich, B; Lenz, O

    2015-02-01

    Unilateral cerebral ischemia of the hippocampus is very rare. This paper reviews the literature and presents the case of a 59-year-old woman with an amnestic syndrome due to a left hippocampal stroke. The patient suffered from retrograde amnesia which was most severe over the 2 days prior to presenting and a slight anterograde amnesia. In addition, a verbal memory disorder was confirmed 1 week after admission by neurological tests. As risk factors, arterial hypertension and a relative hyper-beta lipoproteinemia were found. This case shows that unilateral amnestic stroke, e.g. in the hippocampus region, may be the cause of an amnestic syndrome and should be included in the differential diagnostics.

  11. Multiple Strokes

    Directory of Open Access Journals (Sweden)

    Obododimma Oha

    2008-12-01

    Full Text Available This poem playfully addresses the slippery nature of linguistic signification, employing humour and sarcasm in presenting a wide range of human experience. It ironical twists -- and "strokes" (read ambiguously as both a giving a punishment and erotic pleasuring -- move from the naming of location through international discourse of capital to the crumbling relationships between nation states. It reading of the signs of language is tied to the unease and fracture in cultural and political experience.

  12. The "Know Stroke" Campaign

    Science.gov (United States)

    ... Current Issue Past Issues Special Section The "Know Stroke" Campaign Past Issues / Summer 2007 Table of Contents ... campaign for the U.S. Hispanic community. 1 Know Stroke A stroke occurs when the blood supply to ...

  13. Two Kinds of Stroke

    Science.gov (United States)

    ... Issue Past Issues Special Section Two Kinds of Stroke Past Issues / Summer 2007 Table of Contents For ... are often a warning sign for future strokes. Stroke Can Affect Anyone Award-winning actress Julie Harris ...

  14. Recovering after stroke

    Science.gov (United States)

    Stroke rehabilitation; Cerebrovascular accident - rehabilitation; Recovery from stroke; Stroke - recovery; CVA - recovery ... This includes healthy eating, controlling illnesses such as diabetes and high blood pressure, and sometimes taking medicine ...

  15. Questions and Answers about Stroke

    Science.gov (United States)

    ... Find People About NINDS Questions and Answers About Stroke What is a stroke? A stroke occurs when blood flow to the ... need to function. What are the types of strokes? A stroke can occur in two ways. In ...

  16. Prevention Of Stroke

    Directory of Open Access Journals (Sweden)

    Nagaraja D

    2005-01-01

    Full Text Available Stroke is an important cause for neurological morbidity and mortality. Prevention of ischemic stroke involves identification and prevention of risk factors and optimal use of pharmacotherapy. Risk factors have been classified as modifiable and non-modifiable; control of modifiable factors should prevent stroke occurrence. Stroke prevention has been described at three levels: primary, secondary and tertiary. Prolonged hypertension increases an individual′s risk for developing fatal or nonfatal stroke by three times and its control has been shown to prevent stroke. Diabetes mellitus is an important cause for microangiopathy and predisposes to stroke. Statin trials have shown significant reduction in stroke in those who were treated with statins. Stroke risk can be reduced by avoiding tobacco use, control of obesity and avoiding sedentary life style. Anti platelet medications are effective for secondary prevention of stroke. Educating society regarding modifiable risk factors and optimal use of pharmacotherapy form the cornerstone for the prevention of stroke.

  17. Stroke: secondary prevention

    OpenAIRE

    Lip, Gregory YH; Kalra, Lalit

    2010-01-01

    Prevention in this context is the long-term management of people with previous stroke or TIA, and of people at high risk of stroke for other reasons, such as atrial fibrillation. Risk factors for stroke include: previous stroke or TIA; increasing age; hypertension; diabetes; cigarette smoking; and emboli associated with atrial fibrillation, artificial heart valves, or MI.

  18. Leukocytosis in acute stroke

    DEFF Research Database (Denmark)

    Kammersgaard, L P; Jørgensen, H S; Nakayama, H;

    1999-01-01

    Leukocytosis is a common finding in the acute phase of stroke. A detrimental effect of leukocytosis on stroke outcome has been suggested, and trials aiming at reducing the leukocyte response in acute stroke are currently being conducted. However, the influence of leukocytosis on stroke outcome has...

  19. Epilepsy after stroke

    DEFF Research Database (Denmark)

    Olsen, T S; Høgenhaven, H; Thage, O

    1987-01-01

    Development of epilepsy was studied prospectively in a group of 77 consecutive stroke patients. Included were stroke patients less than 75 years old admitted within the first 3 days after the stroke. Excluded were patients with subarachnoid hemorrhage, vertebrobasilar stroke, and patients...

  20. Adapting the Home After a Stroke

    Science.gov (United States)

    ... News About Neurology Image Library Search The Internet Stroke Center Patients & Families About Stroke Stroke Diagnosis Stroke ... after a Stroke Adapting the Home after a Stroke Caregiver Introduction What is Aphasia? Stroke Recovery Guides ...

  1. Sleep disorders and stroke

    OpenAIRE

    Wallace, Douglas M; Ramos, Alberto R.; Rundek, Tatjana

    2012-01-01

    The purpose of this review is to highlight existing literature on the epidemiology, pathophysiology, and treatments of stroke sleep disorders. Stroke sleep disorders are associated with many intermediary vascular risk factors leading to stroke, but they may also influence these risk factors through direct or indirect mechanisms. Sleep disturbances may be further exacerbated by stroke or caused by stroke. Unrecognized and untreated sleep disorders may influence rehabilitation efforts and poor ...

  2. Sleep and stroke

    OpenAIRE

    Dib, Salim; Ramos, Alberto R.; Wallace, Douglas M; Rundek, Tatjana

    2012-01-01

    Obstructive Sleep-Disordered Breathing (OSDB) is an under-recognized risk factor for stroke. OSDB is associatedwith traditional vascular risk factors such as hypertension, obesity, and diabetes, and can influence the risk for stroke through direct and indirect mechanisms. Untreated OSDB may also influence rehabilitation efforts and functional outcome following a stroke, as well as the risk for stroke recurrence. Stroke risk is greatly reduced if the OSDB is adequately treated. Conversely, ...

  3. Sex Disparities in Stroke

    DEFF Research Database (Denmark)

    Dehlendorff, Christian; Andersen, Klaus Kaae; Olsen, Tom Skyhøj

    2015-01-01

    between 2003 and 2012 (N=79 617), and the Danish Register of Causes of Death. Information was available on age, sex, marital status, stroke severity, stroke subtype, socioeconomic status, and cardiovascular risk profile. We studied only deaths due to the index stroke, with the assumption that death.......5%) or 1 month (6.9%), respectively. After the age of 60 years, women had more severe strokes than men. Up to ages in the mid-60s, no difference in the risk of death from stroke was seen between the 2 sexes. For people aged >65 years, however, the risk gradually became greater in men than in women...... and significantly so (>15%) from the mid-70s (adjusted for age, marital status, stroke severity, stroke subtype, socioeconomic status, and cardiovascular risk factors). Results were essentially the same when analyzing deaths within 1 week, 1 month and ischemic and hemorrhagic stroke separately. CONCLUSIONS: Stroke...

  4. Functional recovery in aging mice after experimental stroke.

    Science.gov (United States)

    Manwani, Bharti; Liu, Fudong; Xu, Yan; Persky, Rebecca; Li, Jun; McCullough, Louise D

    2011-11-01

    Aging is a non-modifiable risk factor for stroke. Since not all strokes can be prevented, a major emerging area of research is the development of effective strategies to enhance functional recovery after stroke. However, in the vast majority of pre-clinical stroke studies, the behavioral tests used to assess functional recovery have only been validated for use in young animals, or are designed for rats. Mice are increasingly utilized in stroke models but well validated behavioral tests designed for rats are not necessarily reproducible in mice. We examined a battery of behavioral tests to evaluate functional recovery in an aging murine model of stroke. We found that the vertical pole, hanging wire and open field can accurately assess acute behavioral impairments after stroke in both young and aging male mice, but animals recover rapidly on these tasks. The corner test can accurately and repeatedly differentiate stroke from sham animals up to 30 days post stroke and can be performed reliably in aging mice. Aging male mice had significantly worse behavioral impairment compared to young male mice in the first two weeks after stroke but eventually recovered to the same degree as young mice. In contrast, chronic infarct size, as measured by ipsilateral cerebral atrophy, was significantly lower in aging male mice compared to young male mice. Reactive gliosis, formation of glial scar, and an enhanced innate immune response was seen in the aging brain and may contribute to the delayed behavioral recovery seen in the aging animals.

  5. Stroke in childhood

    OpenAIRE

    Serap Teber; Gülhis Deda

    2011-01-01

    Stroke in childhood is one of the most common causes of death or severe impairment worldwide, with annual incidence estimated from 1,3 to 13 cases/100.000 population. The definition of stroke consists both of arterial ischemic stroke (AIS) and hemorrhagic stroke. The incidence of ischemic and hemorrhagic stroke in children is approximately the same, in contrast to adults, while the incidence is higher in boys than it is in girls. Risks factors for pediatric stroke differ from those for adults...

  6. [Stroke and aging].

    Science.gov (United States)

    Ly, J; Maquet, P

    2014-01-01

    Stroke risk increases with aging and one third of ischemic strokes occurs in very elderly (> or = 80 years). These are responsible of two thirds of the overall stroke-related morbi-mortality. Stroke in very elderly differs from younger individuals by sex ratio (more women), risk factors (more atrial fibrillation and hypertension) and usually a worse functional outcome. Very elderly are likely to benefit from stroke unit care and early revascularisation treatments although they have historically been excluded from this urgent management. These issues are likely to worsen in the future with the increasing impact of stroke on our aging societies.

  7. Difficulty Swallowing After Stroke (Dysphagia)

    Science.gov (United States)

    ... After Stroke Weight Training After Stroke Tips for Improving Fine Motor Skills Functional Tone Management Arm Training Program Constraint-Induced Movement Therapy Emotional & Behavioral Challenges Self-Esteem after Stroke Post-Stroke Mood Disorders One-side ...

  8. Let's Talk about Hemorrhagic Stroke

    Science.gov (United States)

    ... Pressure Tools & Resources Stroke More Let's Talk About Hemorrhagic Stroke Updated:Dec 9,2015 About 13 percent of ... or near the brain. This is called a hemorrhagic stroke. When a hemorrhagic stroke happens, blood collects in ...

  9. Brain Basics: Preventing Stroke

    Science.gov (United States)

    ... free mailed brochure Cómo Prevenir un Accidente Cerebrovascular Brain Basics: Preventing Stroke Request free mailed brochure Table ... Americans are protecting their most important asset—their brain. Are you? Stroke ranks as the fourth leading ...

  10. Stroke Fact Sheet

    Science.gov (United States)

    ... tells you to. Return to top Does taking birth control pills increase my risk for stroke? Taking birth ... your vagina Return to top Does using the birth control patch increase my risk for stroke? The patch ...

  11. Stroke Trials Registry

    Science.gov (United States)

    ... News About Neurology Image Library Search The Internet Stroke Center Trials Registry Clinical Trials Interventions Conditions Sponsors ... a clinical trial near you Welcome to the Stroke Trials Registry Our registry of clinical trials in ...

  12. Atrial Fibrillation and Stroke

    Science.gov (United States)

    ... Find People About NINDS NINDS Atrial Fibrillation and Stroke Information Page Table of Contents (click to jump ... done? Clinical Trials What is Atrial Fibrillation and Stroke? Atrial fibrillation (AF) describes the rapid, irregular beating ...

  13. Stroke: Hope through Research

    Science.gov (United States)

    ... hormone replacement therapy can reduce some of the effects of menopause and decrease stroke risk. Currently, the NINDS is sponsoring the Women's Estrogen for Stroke Trial (WEST), a randomized, placebo-controlled, double-blind trial, to determine whether estrogen ...

  14. Sleep and Stroke

    OpenAIRE

    M V Padma Srivastav

    2014-01-01

    Circadian variations in conjunction with sleep-related heart rhythm changes and sleepdisordered breathing (SDB) are contributing risk factors for stroke. Strong scientificevidence now exists indicating that SDB contributes to systemic hypertension, aprominent risk factor for stroke, and compelling circumstantial evidence is presentsuggesting that SDB raises the risk for development of stroke through other circulatorymechanisms as well. Preliminary evidence indicates that post-stroke patients ...

  15. Hemorrhagic Stroke in Children

    OpenAIRE

    Jordan M.D., Lori C.; Hillis M.D., Argye E.

    2007-01-01

    Hemorrhagic stroke accounts for approximately half of stroke in childhood. Unlike arterial ischemic stroke, there are no consensus guidelines to assist in the evaluation and treatment of these children. We review the literature on the evaluation, treatment, etiology and neurologic outcome of hemorrhagic stroke in children. Important differences between pediatric and adult hemorrhage are highlighted, as treatment guidelines for adults may not be applicable in all cases. Needed future research ...

  16. Strokes in adults.

    Science.gov (United States)

    Pearce, Lynne

    2016-06-15

    Essential facts There are two types of stroke - around 85% are ischaemic and 15% are haemorrhagic. According to the Stroke Association's State of the Nation report, published in January 2016, stroke occurs around 152,000 times a year in the UK. It is the fourth largest cause of death in the UK and one of the largest causes of disability. PMID:27305230

  17. Early home-supported discharge after stroke

    DEFF Research Database (Denmark)

    Langhorne, P.; Jepsen, Birgitte G.; Larsen, Torben

    2014-01-01

    benefit most are likely to have moderate stroke severity and may be able to cooperate with rehabilitation in the home setting. Staffing requirements will vary according to several factors. These will include (a) the severity and complexity of stroke impairments, (b) the current level of community support......This report is a brief practical problem-based guide to support clinical management in the implementation of early home-supported discharge as an integrated part of stroke care. However, it is clear that skilled members of a multidisciplinary team are needed and they need to work in a coordinated......, (c) the duration of rehabilitation input, and (d) the rehabilitation targets planned. (C) 2014 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins....

  18. Vertical Farming

    OpenAIRE

    Molina Núñez, Antonio José

    2012-01-01

    El fin de la instalación es producir frutas y verduras utilizando la menor superficie posible en planta, debido a la escasez y encarecimiento de esta, incremento de la población y desertificación. Para ello esta modalidad de plantación, Vertical farming, utiliza el desarrollo en altura, aprovechando la superficie lo máximo posible combinado con una nueva técnica, hidroponia, que es la forma de cultivar las plantas sin tierra. Facultad de Ciencias de la Empresa Universidad...

  19. Clinical Epidemiology Of Stroke

    Directory of Open Access Journals (Sweden)

    Nagaraja D

    2005-01-01

    Full Text Available Stroke is a huge public health problem because of its high morbidity and disability. The epidemiology of stroke is of relevance to construct practical paradigms to tackle this major health issue in the community. Recent data have shown that about 72-86% of strokes are ischemic, 9-18% are due to hemorrhage (intracerebral of subarachnoid and the rest are undefined. The risk factors for stroke are multiple and combined. At present, stroke is no more considered as unavoidable and untreatable. It is an emergency and specialized units and teams improve outcome and lower costs. Death related to stroke is declining in many countries and in both sexes. This decrease in multifactorial. The detection and more effective treatment of hypertension may play an important factor, as well as the improved medical care and improvement in diagnostic procedures. While stroke incidence appears stable and stroke mortality is slowly declining, the absolute magnitude of stroke is likely to grow over the next 30 years. as the population ages, the absolute number of stroke victims and demands on healthcare and other support systems is likely to increase substantially in the future. Keeping this in perspective, this chapter shall focus on the epidemiology of stroke in the world and in Indian, in particular.

  20. Registration of acute stroke

    DEFF Research Database (Denmark)

    Wildenschild, Cathrine; Mehnert, Frank; Thomsen, Reimar Wernich;

    2013-01-01

    BACKGROUND: The validity of the registration of patients in stroke-specific registries has seldom been investigated, nor compared with administrative hospital discharge registries. The objective of this study was to examine the validity of the registration of patients in a stroke-specific registry...... (The Danish Stroke Registry [DSR]) and a hospital discharge registry (The Danish National Patient Registry [DNRP]). METHODS: Assuming that all patients with stroke were registered in either the DSR, DNRP or both, we first identified a sample of 75 patients registered with stroke in 2009; 25 patients...... in the DSR, 25 patients in the DNRP, and 25 patients registered in both data sources. Using the medical record as a gold standard, we then estimated the sensitivity and positive predictive value of a stroke diagnosis in the DSR and the DNRP. Secondly, we reviewed 160 medical records for all potential stroke...

  1. Sleep and Stroke

    Directory of Open Access Journals (Sweden)

    M V Padma Srivastav

    2014-03-01

    Full Text Available Circadian variations in conjunction with sleep-related heart rhythm changes and sleepdisordered breathing (SDB are contributing risk factors for stroke. Strong scientificevidence now exists indicating that SDB contributes to systemic hypertension, aprominent risk factor for stroke, and compelling circumstantial evidence is presentsuggesting that SDB raises the risk for development of stroke through other circulatorymechanisms as well. Preliminary evidence indicates that post-stroke patients have ahigher prevalence of SDB, which is likely to compromise their rehabilitation outcomes.Since SDB is modifiable with the application of CPAP and other treatment modalities,there is practical value in investigating patients at risk of stroke or post stroke forpresence of SDB. Successful application of CPAP or BiPAP therapy may improve theoutcome in both instances.Key words : Sleep, Stroke, SDB, CPAP

  2. [Post Stroke Dementia].

    Science.gov (United States)

    Ihara, Masafumi

    2016-07-01

    Post-stroke dementia (PSD) is a clinical entity that encompasses all types of dementia following an index stroke. Current evidence suggests that 25-30% of ischemic stroke survivors develop immediate or delayed vascular cognitive impairment or vascular dementia. The type of stroke can be either ischemic, hemorrhagic or hypoperfusive. There are multiple risk factors for PSD including older age, family history, genetic variants, low educational status, vascular comorbidities, prior transient ischemic attack or recurrent stroke and depressive illness. Pre-stroke dementia refers to the occurrence of cognitive impairment before the index stroke, which may be caused by a vascular burden as well as insidious neurodegenerative changes. Neuroimaging determinants of dementia after stroke include silent brain infarcts, white matter changes, lacunar infarcts and medial temporal lobe atrophy. Published clinical trials have not been promising and there is little information on whether PSD can be prevented using pharmacological agents. Control of vascular disease risk and prevention of recurrent strokes are key to reducing the burden of cognitive decline and post-stroke dementia. Modern imaging and analysis techniques will help to elucidate the mechanism of PSD and establish better treatment. PMID:27395459

  3. Stroke in pregnancy.

    Science.gov (United States)

    Feske, Steven K

    2007-11-01

    Although pregnancy-associated stroke is uncommon, the risk of stroke is greatly increased above the low baseline rate in young patients during late pregnancy and, even more so, during the puerperium. Stroke is a major contributor to the serious morbidity and mortality of pregnancy. The physiological hormonally mediated changes in circulation, vascular tissue structure, and coagulability, and the pathological state of pre-eclampsia-eclampsia contribute to this increased risk of stroke. Pregnancy-associated strokes are roughly evenly divided among hemorrhagic strokes, mainly from rupture of aneurysms and arteriovenous malformations (AVMs); ischemic strokes, mainly from late pregnancy and postpartum cerebral venous thrombosis; and strokes associated with pre-eclampsia-eclampsia, with a contribution from cardioembolism, especially in populations at risk from a high rate of underlying rheumatic valvular heart disease. Awareness of the types of stroke to expect during pregnancy will facilitate early diagnosis. This article discusses the pathogenesis of pregnancy-associated stroke, its epidemiology, and some diagnostic and therapeutic issues unique to pregnancy. PMID:17940923

  4. Etiologic Classification in Ischemic Stroke

    OpenAIRE

    Hakan Ay

    2011-01-01

    Ischemic stroke is an etiologically heterogenous disorder. Classification of ischemic stroke etiology into categories with discrete phenotypic, therapeutic, and prognostic features is indispensible to generate consistent information from stroke research. In addition, a functional classification of stroke etiology is critical to ensure unity among physicians and comparability among studies. There are two major approaches to etiologic classification in stroke. Phenotypic systems define subtypes...

  5. Sleep apnea and stroke.

    Science.gov (United States)

    Culebras, Antonio

    2015-01-01

    Clinical evidence has established that sleep apnea is a risk factor for stroke. Patients with stroke have a high prevalence of sleep apnea that may have preceded or developed as a result of the stroke. Well-established concurrent stroke risk factors for stroke like hypertension and atrial fibrillation respond favorably to the successful treatment of sleep apnea. The gold standard diagnosis of sleep apnea is obtained in the sleep laboratory, but unattended polysomnography is gaining acceptance. Positive airway pressure (PAP) (continuous positive airway pressure [CPAP] or bilevel positive airway pressure [BiPAP]) applications are the gold-standard treatment of sleep apnea. Suggestive evidence indicates that stroke occurrence or recurrence may be reduced with treatment of sleep apnea. PMID:25407131

  6. Inflammatory Disequilibrium in Stroke.

    Science.gov (United States)

    Petrovic-Djergovic, Danica; Goonewardena, Sascha N; Pinsky, David J

    2016-06-24

    Over the past several decades, there have been substantial advances in our knowledge of the pathophysiology of stroke. Understanding the benefits of timely reperfusion has led to the development of thrombolytic therapy as the cornerstone of current management of ischemic stroke, but there remains much to be learned about mechanisms of neuronal ischemic and reperfusion injury and associated inflammation. For ischemic stroke, novel therapeutic targets have continued to remain elusive. When considering modern molecular biological techniques, advanced translational stroke models, and clinical studies, a consistent pattern emerges, implicating perturbation of the immune equilibrium by stroke in both central nervous system injury and repair responses. Stroke triggers activation of the neuroimmune axis, comprised of multiple cellular constituents of the immune system resident within the parenchyma of the brain, leptomeninges, and vascular beds, as well as through secretion of biological response modifiers and recruitment of immune effector cells. This neuroimmune activation can directly impact the initiation, propagation, and resolution phases of ischemic brain injury. To leverage a potential opportunity to modulate local and systemic immune responses to favorably affect the stroke disease curve, it is necessary to expand our mechanistic understanding of the neuroimmune axis in ischemic stroke. This review explores the frontiers of current knowledge of innate and adaptive immune responses in the brain and how these responses together shape the course of ischemic stroke. PMID:27340273

  7. PET studies of stroke

    International Nuclear Information System (INIS)

    PET already has been helpful in ischemic stroke disease. It has given us new data on physiological events occurring after a stroke; PET indices of blood flow and metabolism have provided the basis for staging the severity of tissue injury and predicting outcome, and PET has shown alterations in tissue function in response to therapy. Experience with PET in hemorrhagic disease is more limited, but initial results suggest a useful role for PET in the evaluation of nontraumatic intracranial hemorrhage as well [Ackerman et al., 1983a]. This brief review discusses general problems in the study of stroke disease using PET and then the contribution of PET to the stroke field

  8. Heart Disease and Stroke Prevention

    Science.gov (United States)

    ... disease and stroke prevention Heart Health and Stroke Heart disease and stroke prevention Related information Learn more about ... well-being. Does menopausal hormone therapy (MHT) prevent heart disease? Once you reach menopause, your ovaries stop making ...

  9. Acute stroke imaging research roadmap

    NARCIS (Netherlands)

    Wintermark, Max; Albers, Gregory W.; Alexandrov, Andrei V.; Alger, Jeffry R.; Bammer, Roland; Baron, Jean-Claude; Davis, Stephen; Demaerschalk, Bart M.; Derdeyn, Colin P.; Donnan, Geoffrey A.; Eastwood, James D.; Fiebach, Jochen B.; Fisher, Marc; Furie, Karen L.; Goldmakher, Gregory V.; Hacke, Werner; Kidwell, Chelsea S.; Kloska, Stephan P.; Koehrmann, Martin; Koroshetz, Walter; Lee, Ting-Yim; Lees, Kennedy R.; Lev, Michael H.; Liebeskind, David S.; Ostergaard, Leif; Powers, William J.; Provenzale, James; Schellinger, Peter; Silbergleit, Robert; Sorensen, Alma Gregory; Wardlaw, Joanna; Warach, Steven

    2008-01-01

    The recent "Advanced Neuroimaging for Acute Stroke Treatment" meeting on September 7 and 8, 2007 in Washington DC, brought together stroke neurologists, neuroradiologists, emergency physicians, neuroimaging research scientists, members of the National Institute of Neurological Disorders and Stroke (

  10. Spontaneous ischaemic stroke in dogs

    DEFF Research Database (Denmark)

    Gredal, Hanne Birgit; Skerritt, G. C.; Gideon, P.;

    2013-01-01

    Translation of experimental stroke research into the clinical setting is often unsuccessful. Novel approaches are therefore desirable. As humans, pet dogs suffer from spontaneous ischaemic stroke and may hence offer new ways of studying genuine stroke injury mechanisms.......Translation of experimental stroke research into the clinical setting is often unsuccessful. Novel approaches are therefore desirable. As humans, pet dogs suffer from spontaneous ischaemic stroke and may hence offer new ways of studying genuine stroke injury mechanisms....

  11. Body Mass Index and Stroke

    DEFF Research Database (Denmark)

    Andersen, Klaus Kaae; Olsen, Tom Skyhøj

    2013-01-01

    Although obesity is associated with excess mortality and morbidity, mortality is lower in obese than in normal weight stroke patients (the obesity paradox). Studies now indicate that obesity is not associated with increased risk of recurrent stroke in the years after first stroke. We studied the ...... the association between body mass index (BMI) and stroke patient's risk of having a history of previous stroke (recurrent stroke)....

  12. Stroke (For Kids)

    Science.gov (United States)

    ... on how bad the stroke was and how healthy the person was before the stroke. People who have had ... talk with someone if you have questions or worries about someone who has had a ... you love, especially if this person isn't able to do stuff with you ...

  13. Relational Processing Following Stroke

    Science.gov (United States)

    Andrews, Glenda; Halford, Graeme S.; Shum, David; Maujean, Annick; Chappell, Mark; Birney, Damian

    2013-01-01

    The research examined relational processing following stroke. Stroke patients (14 with frontal, 30 with non-frontal lesions) and 41 matched controls completed four relational processing tasks: sentence comprehension, Latin square matrix completion, modified Dimensional Change Card Sorting, and n-back. Each task included items at two or three…

  14. The Optimal Golf Stroke

    DEFF Research Database (Denmark)

    Buchinger, Mikael; Durigen, Susan; Dahl, Johan Rambech;

    2006-01-01

    The paper presents a preliminary investigation into aspects of the game of golf. A series of models is proposed for the golf stroke, the momentum transfer between club and ball and the flight of the ball.Numerical and asymptotic solutions are presented reproducing many of the features observed...... in the golf stroke of a professional golfer....

  15. Diagnostic neuroimaging in stroke

    International Nuclear Information System (INIS)

    Since the development of cerebral angiography 60 years ago, there has been a proliferation of increasingly sophisticated, expensive, and, fortunately, safe imaging techniques for patients with cerebrovascular disease. In addition, occlusive and hemorrhagic stroke are now recognized as having a wide variety of possible causes. This chapter addresses the different imaging options available for particular kinds of stroke

  16. [Stroke management in Germany].

    Science.gov (United States)

    Fritze, J

    2001-12-01

    Stroke is a leading cause of morbidity and mortality (rank 3) and thus a mass disease. Therefore, immediate access for everybody to stroke treatment services is indispensible. Therapeutic efficacy has been shown for lysis therapy and early rehabilitation in stroke units, respectively. The British-Scandinavian stroke unit concept focusses on immediately starting rehabilitation over 4-6 weeks by a specifically trained and motivated team. Since 1995, so-called stroke units are established in Germany adhering to a specific concept of the German Society for Neurology (DGN). Although referring to the British-Scandinavian concept in terms of efficacy the German concept differs fundamentally by focussing on monitoring as well as lysis therapy and neuroprotection in a short (3-5 days) stay. This is an intensive care unit approach for which scientific evidence is lacking. More essential are reasonable doubts that this concept can ever expand sufficiently to ensure comprehensive care. At least presently, stroke care is provided unevenly, thus contravening legislation (section 70 Social Security Act Vol. V). Acknowledging the restrictions the DGN adapted its concept, now advocating a two-step model comprising intensive care stroke units plus rehabilitative stroke units. PMID:11761782

  17. Stroke burden and stroke care system in Asia

    OpenAIRE

    Suwanwela, Nijasri C.; Niphon Poungvarin; the Asian Stroke Advisory Panel

    2016-01-01

    Background: Stroke is a major cause of death and disability. Asia is the largest and mostly populated continent of the world. The Asian Stroke Advisory Panel (ASAP) consists of stroke neurologists from 12 different countries in 13 Asian regions. It has been established for 17 years, and holds regular meetings for reviewing the stroke activities in Asia. It also helps in conducting several multinational research projects. This study is one of the ASAP projects and aims to explore stroke care s...

  18. Let's Talk about Ischemic Stroke

    Science.gov (United States)

    ... Tools & Resources Stroke More Let's Talk About Ischemic Stroke Updated:Dec 9,2015 The majority of strokes occur when blood vessels to the brain become ... cuts off blood flow to brain cells. A stroke caused by lack of blood reaching part of ...

  19. Stroke and High Blood Pressure

    Science.gov (United States)

    ... Pressure Tools & Resources Stroke More Stroke and High Blood Pressure Updated:Jan 6,2015 Stroke is a leading ... heart disease and stroke. Start exploring today ! High Blood Pressure • Home • About High Blood Pressure (HBP) • Why HBP ...

  20. Hyponatremia in stroke

    Directory of Open Access Journals (Sweden)

    Sheikh Saleem

    2014-01-01

    Full Text Available Introduction: Hyponatremia is a common electrolyte disorder encountered in patients of neurological disorders which is usually either due to inappropriate secretion of Antidiuretic hormone (SIADH or cerebral salt wasting syndrome (CSWS. We conducted this study in a tertiary care hospital to determine the incidence and etiology of hyponatremia in patients of stroke admitted in the hospital. Materials and Methods: It was a prospective study done over a period of two years that included established cases of stroke diagnosed on the basis of clinical history, examination and neuroimaging. 1000 stoke patients were evaluated for hyponatremia (serum sodium <130 meq/l. The data was analysed using Chi-square test using SPSS (Statistical package for social science software. Results: Out of 1000 patients, 353 patients had hyponatremia. Out of this 353 patients, 238 (67% had SIADH and 115 (33% had CSWS. SIADH was seen in 83 patients who had ischemic stroke and 155 patients of hemorrhagic stroke. CSWS was found in 38 patients with ischemic stroke and 77 patients with hemorrhagic stroke. Statistical analysis revealed that hyponatremia significantly affects the outcome of stroke especially when it is due to CSWS rather than SIADH. Conclusion: Incidence of hyponatremia in our study population was 35%. In patients of hyponatremia 67% were having SIADH and 33% were having CSWS. Overall hyponatremia affected the outcome of stroke especially when caused by CSWS. Therefore close monitoring of serum sodium must be done in all patients who are admitted with stroke and efforts must be made to determine the cause of hyponatremia, in order to properly manage such patients thereby decreasing the mortality rate.

  1. Hyponatremia in stroke

    Science.gov (United States)

    Saleem, Sheikh; Yousuf, Irfan; Gul, Azhara; Gupta, Satish; Verma, Sawan

    2014-01-01

    Introduction: Hyponatremia is a common electrolyte disorder encountered in patients of neurological disorders which is usually either due to inappropriate secretion of Antidiuretic hormone (SIADH) or cerebral salt wasting syndrome (CSWS). We conducted this study in a tertiary care hospital to determine the incidence and etiology of hyponatremia in patients of stroke admitted in the hospital. Materials and Methods: It was a prospective study done over a period of two years that included established cases of stroke diagnosed on the basis of clinical history, examination and neuroimaging. 1000 stoke patients were evaluated for hyponatremia (serum sodium <130 meq/l). The data was analysed using Chi-square test using SPSS (Statistical package for social science) software. Results: Out of 1000 patients, 353 patients had hyponatremia. Out of this 353 patients, 238 (67%) had SIADH and 115 (33%) had CSWS. SIADH was seen in 83 patients who had ischemic stroke and 155 patients of hemorrhagic stroke. CSWS was found in 38 patients with ischemic stroke and 77 patients with hemorrhagic stroke. Statistical analysis revealed that hyponatremia significantly affects the outcome of stroke especially when it is due to CSWS rather than SIADH. Conclusion: Incidence of hyponatremia in our study population was 35%. In patients of hyponatremia 67% were having SIADH and 33% were having CSWS. Overall hyponatremia affected the outcome of stroke especially when caused by CSWS. Therefore close monitoring of serum sodium must be done in all patients who are admitted with stroke and efforts must be made to determine the cause of hyponatremia, in order to properly manage such patients thereby decreasing the mortality rate. PMID:24753660

  2. Cerebrorenal interaction and stroke.

    Science.gov (United States)

    Toyoda, Kazunori

    2013-01-01

    Beyond the original meaning of chronic kidney disease (CKD) as high-risk state for future dialysis, CKD is now known as an established risk factor for cardiovascular diseases. Stroke is a major player of cardiovascular disease and has deep two-way relationships with CKD. CKD is an evident risk factor for stroke. Meta-analyses of cohort studies and trials indicate that proteinuria/albuminuria increases the risk of stroke by 71-92%, and reduced glomerular filtration rate increases the risk by 43%. In addition, CKD has a strong relationship with subclinical brain damage including white matter changes, microbleeds, cognitive impairment, and carotid atherosclerosis. CKD is prevalent in acute stroke patients; patients with estimated glomerular filtration rate management of stroke are influenced by CKD. Therapeutic effects of several antithrombotic and thrombolytic agents, including recently-developed novel oral anticoagulants, are affected by renal function. Moreover, reduced glomerular filtration rate is independently associated with increased 1- and 10-year mortalities in the end. Stroke also has deep relationships with end-stage kidney disease. Stroke occurs much more commonly in dialysis patients than general population or CKD patients without need for dialysis. The triggers of ischemic and hemorrhagic stroke in patients with end-stage kidney disease include special characteristics unique to dialysis, such as drastic hemodynamic change, dialysate and anticoagulants, and vascular calcification. As cohorts of dialysis patients become older, more hypertensive, and more diabetic than before, stroke become more prevalent and more serious events in dialysis clinics. Now, clinicians should have much interest in the association between CKD and cerebrovascular diseases, so-called the cerebro-renal interaction.

  3. [Obesity Paradox and Stroke].

    Science.gov (United States)

    Baumgartner, Ralf; Oesch, Lisa; Sarikaya, Hakan

    2016-07-01

    The obesity paradox suggests that overweight and obese patients of older age may have higher survival rates after stroke as compared to normalweight patients. However, the results need a cautious interpretation due to selection bias, treatment bias and different patients’ characteristics. Moreover, randomized studies that prove a benefit of weight reduction are still lacking. As obesity is an independet risk factor for stroke, weight reduction should still be recommended in overweight patients. Randomized-controlled studies are needed to prove the effect of weight reduction on morbidity and mortality after stroke. PMID:27381308

  4. Stroke: current concepts.

    Science.gov (United States)

    Albertson, Megan; Sharma, Jitendra

    2014-11-01

    Cerebrovascular accidents (CVAs) are the leading cause of disability and the fourth leading cause of death in the U.S. The WHO defines stroke as "rapidly developing clinical signs of focal disturbance of cerebral function lasting more than 24 hours with no apparent cause other than of vascular origin." Strokes are subdivided into two major classifications: ischemic (80-87 percent) andhemorrhagic (13-20 percent). Ischemic strokes occur from thrombi, emboli, or global hypoperfusion. Hemorrhagic strokes are either parenchymal (10 percent of all strokes) or subarachnoid (3 percent of all strokes). There are a variety of recognized risk factors for stroke which include: age, race, family history, hypertension, diabetes mellitus, atherosclerosis, cardiac arrhythmias, prosthetic valves, hyperlipidemia, cigarette smoking, and others (drugs or hormones). The initial assessment of a patient suspected of stroke should be done quickly enough to ensure maximal reperfusion of brain tissue. The steps to achieve this goal are: 1) exclude an intracranial hemorrhage, 2) assess for contraindications to thrombolytics, 3) characterize the infarct. The workup for a patient should first include a history (especially the time when neurologic symptoms began), a physical exam (including the NIHSS), and imaging studies (to rule out hemorrhagic components). In addition, several lab studies can also be obtained including: PT/INR, glucose, complete blood count, metabolic panel, creatine kinase, ECG, echocardiogram, lipid panel, carotid Doppler, MRA or CTA. Acute management of a stroke is primarily focused on stabilizing the patient and allowing as much reperfusion as possible for at-risk brain tissue. Stroke management in the acute setting includes: use of thrombolytics if indicated, and re-assessment to monitor progression. Several trials have been completed in pursuit of safety and effectiveness of intra-arterial stroke therapy for patients outside the recommended thrombolytic time window

  5. Strokes in mitochondrial diseases

    Directory of Open Access Journals (Sweden)

    N V Pizova

    2012-01-01

    Full Text Available It is suggested that mitochondrial diseases might be identified in 22—33% of cryptogenic stroke cases in young subjects. The incidence of mitochondrial disorders in patients with stroke is unknown; it is 0.8 to 7.2% according to the data of some authors. The paper gives data on the prevalence, pathogenesis, and clinical manifestations of mitochondrial diseases, such as mitochondrial encephalopathy, lactic acidosis, and stroke-like syndrome (MELAS and insulin-like episodes; myoclonic epilepsy and ragged-red fibers (MERRF syndrome, and Kearns-Sayre syndrome (sporadic multisystem mitochondrial pathology.

  6. Stroke Statistics in Korea: Part II Stroke Awareness and Acute Stroke Care, A Report from the Korean Stroke Society and Clinical Research Center For Stroke

    OpenAIRE

    Hong, Keun-Sik; Bang, Oh Young; Kim, Jong S.; Heo, Ji Hoe; Yu, Kyung-Ho; Bae, Hee-Joon; Kang, Dong-Wha; Lee, Jin Soo; Kwon, Sun U.; Oh, Chang Wan; Lee, Byung-Chul; Yoon, Byung-Woo

    2013-01-01

    The aim of the current Part II of Stroke Statistics in Korea is to summarize nationally representative data on public awareness, pre-hospital delay, thrombolysis, and quality of acute stroke care in a single document. The public's knowledge of stroke definition, risk factors, warning signs, and act on stroke generally remains low. According to studies using open-ended questions, the correct definition of stroke was recognized in less than 50%, hypertension as a stroke risk factor in less than...

  7. Cost of stroke

    DEFF Research Database (Denmark)

    Jennum, Poul; Iversen, Helle K; Ibsen, Rikke;

    2015-01-01

    and compared with 364,433, 103,741 and 500,490 matched controls, respectively. RESULTS: Independent of age and gender, stroke patients had significantly higher rates of mortality, health-related contacts, medication use and lower employment, lower income and higher social-transfer payments than controls......BACKGROUND: To estimate the direct and indirect costs of stroke in patients and their partners. DESCRIPTION: Direct and indirect costs were calculated using records from the Danish National Patient Registry from 93,047 ischemic, 26,012 hemorrhagic and 128,824 unspecified stroke patients....... The attributable cost of direct net health care costs after the stroke (general practitioner services, hospital services, and medication) and indirect costs (loss of labor market income) were €10,720, €8,205 and €7,377 for patients, and €989, €1,544 and €1.645 for their partners, over and above that of controls...

  8. Dysphagia in stroke patients

    OpenAIRE

    Singh, S; Hamdy, S.

    2006-01-01

    Swallowing musculature is asymmetrically represented in both motor cortices. Stroke affecting the hemisphere with the dominant swallowing projection results in dysphagia and clinical recovery has been correlated with compensatory changes in the previously non‐dominant, unaffected hemisphere. This asymmetric bilaterality may explain why up to half of stroke patients are dysphagic and why many will regain a safe swallow over a comparatively short period. Despite this propensity for recovery, dy...

  9. Neonatal Stroke : Risk Factors

    OpenAIRE

    2005-01-01

    Neonatal stroke refers to cerebrovascular events between 28 weeks of gestational age and 28 days postnatal and includes thromboembolic cerebral infarction and all kinds of intracranial haemorrhage. Neonatal stroke may contribute to severe neurological deficit, such as cerebral palsy and even death. International reports suggest the incidence to be approximately 1/4000 live births per year (1). There are several etiological hypothesises regarding risk factors, such as maternal, obstetrical...

  10. Stroke Briefing: Technical Documentation

    OpenAIRE

    Institute of Public Health in Ireland

    2012-01-01

    A stroke happens when blood flow to a part of the brain is interrupted by a blocked or burst blood vessel. A lack of blood supply can damage brain cells and affect body functions. IPH has systematically estimated and forecast the prevalence of stroke on the island of Ireland. This document details the methods used to calculate these estimates and forecasts. Technical documentation      

  11. Endocarditis and stroke.

    Science.gov (United States)

    Grecu, Nicolae; Tiu, Cristina; Terecoasa, Elena; Bajenaru, Ovidiu

    2014-12-01

    Endocarditis is an important, although less common, cause of cerebral embolism. All forms of endocarditis share an initial common pathophysiologic pathway, best illustrated by the non-bacterial thrombotic form, but also a final potential for embolization. Stroke associated with endocarditis has signifficant mortality and morbidity rates, especially due to the frequent concomitant multiple sites of brain embolization. In this article we aim to briefly review endocarditis with a focus on stroke as a complication, while also presenting case correlates from our department.

  12. Stroke risk perception among participants of a stroke awareness campaign

    Directory of Open Access Journals (Sweden)

    Heuschmann Peter U

    2007-03-01

    Full Text Available Abstract Background Subjective risk factor perception is an important component of the motivation to change unhealthy life styles. While prior studies assessed cardiovascular risk factor knowledge, little is known about determinants of the individual perception of stroke risk. Methods Survey by mailed questionnaire among 1483 participants of a prior public stroke campaign in Germany. Participants had been informed about their individual stroke risk based on the Framingham stroke risk score. Stroke risk factor knowledge, perception of lifetime stroke risk and risk factor status were included in the questionnaire, and the determinants of good risk factor knowledge and high stroke risk perception were identified using logistic regression models. Results Overall stroke risk factor knowledge was good with 67–96% of the participants recognizing established risk factors. The two exceptions were diabetes (recognized by 49% and myocardial infarction (57%. Knowledge of a specific factor was superior among those affected by it. 13% of all participants considered themselves of having a high stroke risk, 55% indicated a moderate risk. All major risk factors contributed significantly to the perception of being at high stroke risk, but the effects of age, sex and education were non-significant. Poor self-rated health was additionally associated with high individual stroke risk perception. Conclusion Stroke risk factor knowledge was high in this study. The self perception of an increased stroke risk was associated with established risk factors as well as low perception of general health.

  13. Stroke prevention in atrial fibrillation

    DEFF Research Database (Denmark)

    Freedman, Ben; Potpara, Tatjana S; Lip, Gregory Y H

    2016-01-01

    Atrial fibrillation is found in a third of all ischaemic strokes, even more after post-stroke atrial fibrillation monitoring. Data from stroke registries show that both unknown and untreated or under treated atrial fibrillation is responsible for most of these strokes, which are often fatal...... or debilitating. Most could be prevented if efforts were directed towards detection of atrial fibrillation before stroke occurs, through screening or case finding, and treatment of all patients with atrial fibrillation at increased risk of stroke with well-controlled vitamin K antagonists or non-vitamin K...

  14. What You Need to Know about Stroke

    Science.gov (United States)

    ... mailed brochure What You Need to Know About Stroke Table of Contents Know Stroke Why is Stroke ... a healthy diet and exercising regularly. WHY IS STROKE TREATMENT URGENT? Every minute counts. The longer blood ...

  15. Patient's Guide to Antithrombotic Therapy in Stroke

    Science.gov (United States)

    ... bleeding into the brain. This is called a“hemorrhagic” stroke (see section C). ! Patients who have had strokes ... intermittent compression devices. C. Bleeding in the Brain (Hemorrhagic Stroke) 1. What is a hemorrhagic stroke? ! A hemorrhagic ...

  16. An Economic Evaluation Comparing Stroke Telemedicine to Conventional Stroke Medicine

    Science.gov (United States)

    Budhram, Stanley Chandra

    2011-01-01

    Stroke is not only a serious medical problem, but it also poses an enormous economic burden on society. Stroke ranks the third as the leading cause of death in the United States behind heart disease and cancer. The survivors of stroke suffer from various degrees of long-term disability which create a severe financial burden on society. University…

  17. From stroke unit care to stroke care unit

    NARCIS (Netherlands)

    De Keyser, J; Sulter, G.

    1999-01-01

    In some stroke units continuous monitoring of blood pressure, electrocardiogram, body temperature, and oxygen saturation has become an integral part of the management of acute stroke. In addition, regular measurements of blood glucose are performed. Stroke units equipped with such monitoring facilit

  18. Stroke rehabilitation and discharge planning.

    Science.gov (United States)

    Kerr, Peter

    Nurses play a pivotal role in the rehabilitation and discharge planning process of patients who have had a stroke. The nurse's role in the wider stroke multidisciplinary team is complex and diverse and, as such, stroke nurses may find it hard to describe their role and how it fits into the rehabilitation and discharge planning process. A definition of the stroke nurse role in prominent publications such as those of the Scottish Intercollegiate Guidelines Network and the Royal College of Physicians is lacking. This article emphasises the role of the stroke nurse in the rehabilitation and discharge planning process in the stroke unit, while highlighting the complexity, diversity and importance of this role in providing holistic care and support for patients who have survived a stroke. The author draws on his clinical experience of stroke nursing practice in primary, secondary and tertiary care in west central Scotland. PMID:23082362

  19. The obesity paradox in stroke

    DEFF Research Database (Denmark)

    Andersen, Klaus Kaae; Olsen, Tom Skyhøj

    2015-01-01

    . Data include age, gender, civil status, stroke severity, computed tomography, and cardiovascular risk factors. Patients were followed up to 9·8 years (median 2·6 years). We used Cox regression models to compare risk of death and readmission for recurrent stroke in the four body mass index groups......BACKGROUND: Although associated with excess mortality and morbidity, obesity is associated with lower mortality after stroke. The association between obesity and risk of recurrent stroke is unclear. AIMS: The study aims to investigate the association in stroke patients between body mass index...... and risk of death and readmission for recurrent stroke. METHODS: An administrative Danish quality-control registry designed to collect a predefined dataset on all hospitalized stroke patients in Denmark 2000–2010 includes 45 615 acute first-ever stroke patients with information on body mass index in 29 326...

  20. Brain plasticity and stroke recovery

    OpenAIRE

    Laaksonen, Kristina

    2012-01-01

    Brain plasticity and stroke recovery Recovery from stroke is based on the capability of the brain to reorganize its structure and function after lesion. An acute stroke triggers a cascade of time-dependent metabolic and physiological reactions, which enable changes in the organization and function of widespread cortical regions. A wide range of studies, using various functional imaging methods, have thrown light on the reorganizational changes after stroke. However, less is known about t...

  1. Microwave hemorrhagic stroke detector

    Energy Technology Data Exchange (ETDEWEB)

    Haddad, Waleed S. (Dublin, CA); Trebes, James E. (Livermore, CA)

    2002-01-01

    The microwave hemorrhagic stroke detector includes a low power pulsed microwave transmitter with a broad-band antenna for producing a directional beam of microwaves, an index of refraction matching cap placed over the patients head, and an array of broad-band microwave receivers with collection antennae. The system of microwave transmitter and receivers are scanned around, and can also be positioned up and down the axis of the patients head. The microwave hemorrhagic stroke detector is a completely non-invasive device designed to detect and localize blood pooling and clots or to measure blood flow within the head or body. The device is based on low power pulsed microwave technology combined with specialized antennas and tomographic methods. The system can be used for rapid, non-invasive detection of blood pooling such as occurs with hemorrhagic stroke in human or animal patients as well as for the detection of hemorrhage within a patient's body.

  2. SAR: Stroke Authorship Recognition

    KAUST Repository

    Shaheen, Sara

    2015-10-15

    Are simple strokes unique to the artist or designer who renders them? If so, can this idea be used to identify authorship or to classify artistic drawings? Also, could training methods be devised to develop particular styles? To answer these questions, we propose the Stroke Authorship Recognition (SAR) approach, a novel method that distinguishes the authorship of 2D digitized drawings. SAR converts a drawing into a histogram of stroke attributes that is discriminative of authorship. We provide extensive classification experiments on a large variety of data sets, which validate SAR\\'s ability to distinguish unique authorship of artists and designers. We also demonstrate the usefulness of SAR in several applications including the detection of fraudulent sketches, the training and monitoring of artists in learning a particular new style and the first quantitative way to measure the quality of automatic sketch synthesis tools. © 2015 The Eurographics Association and John Wiley & Sons Ltd.

  3. Recovery of gait after stroke

    NARCIS (Netherlands)

    Kollen, B.J.

    2006-01-01

    In the Netherlands annually about 30,000 people suffer a stroke for the first time. One third of these stroke patients die within the first year, while 41% experience long term disabilities. This makes stroke a major disease in medical and in socio-economic terms. Not just on society but also, and f

  4. Recovery of gait after stroke

    NARCIS (Netherlands)

    Kollen, B.J.

    2006-01-01

    Revised edition of the digital PhD thesis, 14-03-2006 In the Netherlands annually about 30,000 people suffer a stroke for the first time. One third of these stroke patients die within the first year, while 41% experience long term disabilities. This makes stroke a major disease in medical and in soc

  5. Personal accounts of stroke experiences

    NARCIS (Netherlands)

    Wachters-Kaufmann, CSM

    2000-01-01

    As there appeared to be a need for personal accounts of stroke experiences, a book called "Speaking about Stroke" was written for stroke patients and their caregivers. For the past two years, a questionnaire was sent to the people who had ordered the book, to gain an insight into the characteristics

  6. Therapeutic hypothermia for acute stroke

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj; Weber, Uno Jakob; Kammersgaard, Lars Peter

    2003-01-01

    is directly related to stroke severity and outcome, and fever after stroke is associated with substantial increases in morbidity and mortality. Normalisation of temperature in acute stroke by antipyretics is generally recommended, although there is no direct evidence to support this treatment. Despite its...

  7. Stroke and Episodic Memory Disorders

    Science.gov (United States)

    Lim, Chun; Alexander, Michael P.

    2009-01-01

    Memory impairments are common after stroke, and the anatomical basis for impairments may be quite variable. To determine the range of stroke-related memory impairment, we identified all case reports and group studies through the Medline database and the Science Citation Index. There is no hypothesis about memory that is unique to stroke, but there…

  8. Stroke and neuroplasticity

    OpenAIRE

    Zavoreo, Iris; Bašić-Kes, Vanja; Demarin, Vida

    2012-01-01

    Stroke is one of the leading causes of mortality and disability in modern countries. Clinical manifestation of stroke is rapidly developing loss of brain function due to disturbance in the blood supply to the brain. Neuroplasticity, also known as cortical mapping, challenges the idea that brain functions are fixed in certain time. It refers to ability of the human brain to change as result of one’s experience, that the brain is »plastic« and »flexible«. Neuroplasticity can act through two pos...

  9. Endocarditis and Stroke

    Science.gov (United States)

    GRECU, Nicolae; TIU, Cristina; TERECOASA, Elena; BAJENARU, Ovidiu

    2014-01-01

    Endocarditis is an important, although less common, cause of cerebral embolism. All forms of endocarditis share an initial common pathophysiologic pathway, best illustrated by the non-bacterial thrombotic form, but also a final potential for embolization. Stroke associated with endocarditis has signifficant mortality and morbidity rates, especially due to the frequent concomitant multiple sites of brain embolization. In this article we aim to briefly review endocarditis with a focus on stroke as a complication, while also presenting case correlates from our department. PMID:25705308

  10. Biotherapies in stroke.

    Science.gov (United States)

    Detante, O; Jaillard, A; Moisan, A; Barbieux, M; Favre, I M; Garambois, K; Hommel, M; Remy, C

    2014-12-01

    Stroke is the second leading cause of death worldwide and the most common cause of severe disability. Neuroprotection and repair mechanisms supporting endogenous brain plasticity are often insufficient to allow complete recovery. While numerous neuroprotective drugs trials have failed to demonstrate benefits for patients, they have provided interesting translational research lessons related to neurorestorative therapy mechanisms in stroke. Stroke damage is not limited to neurons but involve all brain cell type including the extracellular matrix in a "glio-neurovascular niche". Targeting a range of host brain cells, biotherapies such as growth factors and therapeutic cells, currently hold great promise as a regenerative medical strategy for stroke. These techniques can promote both neuroprotection and delayed neural repair through neuro-synaptogenesis, angiogenesis, oligodendrogliogenesis, axonal sprouting and immunomodulatory effects. Their complex mechanisms of action are interdependent and vary according to the particular growth factor or grafted cell type. For example, while "peripheral" stem or stromal cells can provide paracrine trophic support, neural stem/progenitor cells (NSC) or mature neurons can act as more direct neural replacements. With a wide therapeutic time window after stroke, biotherapies could be used to treat many patients. However, guidelines for selecting the optimal time window, and the best delivery routes and doses are still debated and the answers may depend on the chosen product and its expected mechanism including early neuroprotection, delayed neural repair, trophic systemic transient effects or graft survival and integration. Currently, the great variety of growth factors, cell sources and cell therapy products form a therapeutic arsenal that is available for stroke treatment. Their effective clinical use will require prior careful considerations regarding safety (e.g. tumorgenicity, immunogenicity), potential efficacy, cell

  11. Progressive Micrographia Shown in Horizontal, but not Vertical, Writing in Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Hui-Ing Ma

    2013-01-01

    Full Text Available All published studies on micrographia, a diminution of letter size, examine handwriting in the horizontal direction. Writing horizontally typically requires increased wrist extension as handwriting progresses from left to right. Chinese characters, however, can be written not only horizontally from left to right, but also vertically from top to bottom. We examined the effect of handwriting direction on character size and stroke length. Fifteen participants with Parkinson’s disease (PD and 15 age-matched controls wrote the same Chinese characters both horizontally and vertically. Handwriting performance was recorded with a digitizing tablet, and a custom-written computer program was used to provide objective data about character size and stroke length. The PD group had a linear decrease in overall character size and horizontal strokes along the writing sequence in the horizontal direction, but not in the vertical direction. The controls had shorter horizontal strokes in the horizontal than the vertical direction, but there was no progressive shortening of stroke length along the writing sequence. The results suggest that traditionally reported progressive micrographia in horizontal writing may not be generalizable to vertical writing. The observed decrease of handwriting size in the horizontal direction suggests that micrographia in PD may be associated with wrist extension. For clinical implications, patients may mitigate their micrographia by changing handwriting direction.

  12. Progressive micrographia shown in horizontal, but not vertical, writing in Parkinson's disease.

    Science.gov (United States)

    Ma, Hui-Ing; Hwang, Wen-Juh; Chang, Shao-Hsia; Wang, Tsui-Ying

    2013-01-01

    All published studies on micrographia, a diminution of letter size, examine handwriting in the horizontal direction. Writing horizontally typically requires increased wrist extension as handwriting progresses from left to right. Chinese characters, however, can be written not only horizontally from left to right, but also vertically from top to bottom. We examined the effect of handwriting direction on character size and stroke length. Fifteen participants with Parkinson's disease (PD) and 15 age-matched controls wrote the same Chinese characters both horizontally and vertically. Handwriting performance was recorded with a digitizing tablet, and a custom-written computer program was used to provide objective data about character size and stroke length. The PD group had a linear decrease in overall character size and horizontal strokes along the writing sequence in the horizontal direction, but not in the vertical direction. The controls had shorter horizontal strokes in the horizontal than the vertical direction, but there was no progressive shortening of stroke length along the writing sequence. The results suggest that traditionally reported progressive micrographia in horizontal writing may not be generalizable to vertical writing. The observed decrease of handwriting size in the horizontal direction suggests that micrographia in PD may be associated with wrist extension. For clinical implications, patients may mitigate their micrographia by changing handwriting direction. PMID:23242350

  13. Heart Disease and Stroke

    Centers for Disease Control (CDC) Podcasts

    2013-09-03

    In this podcast, Dr. Tom Frieden, CDC Director, discusses the number one killer in the United States - heart disease and stroke.  Created: 9/3/2013 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 3/6/2014.

  14. Cryptogenic postpartum stroke.

    Science.gov (United States)

    Bereczki, Dániel; Szegedi, Norbert; Szakács, Zoltán; Gubucz, István; May, Zsolt

    2016-01-01

    An estimated 25-40% of ischemic strokes are classified as cryptogenic, which means the cause of the cerebral infarction remains unidentified. One of the potential pathomechanisms - especially among young patients with no cardiovascular risk factors - is paradoxical embolism through a patent foramen ovale. Pregnancy, cesarean delivery and the postpartum period are associated with an increased risk of cerebrovascular events. Factors that may contribute to ischemic strokes during gestation and puerperium include classic cardiovascular risk factors, changes in hemostaseology/hemodynamics, and pregnancy-specific disorders such as pre-eclampsia, eclampsia, postpartum cerebral angiopathy or peripartum cardiomyopathy. In this case report, we present a 36-year-old thrombolysis candidate undergoing mechanical thrombectomy 3 weeks after a cesarean section due to HELLP-syndrome. After evaluation of anamnestic and diagnostic parameters, closure of the patent foramen ovale has been performed. In the absence of specific guidelines, diagnostic work-up for cryptogenic stroke should be oriented after the suspected pathomechanism based on patient history and clinical picture. As long as definite evidences emerge, management of cryptogenic stroke patients with pathogenic right-to-left shunt remains individual based on the mutual decision of the patient and the multidisciplinary medical team. PMID:27591063

  15. Neurorehabilitation after Stroke

    Directory of Open Access Journals (Sweden)

    Rüdiger J. Seitz

    2013-08-01

    Full Text Available Recovery from ischaemic stroke is determined in the acute phase by the lesion impact of ischaemia and subsequently, by functional and structural network changes in the spared brain tissue. Neurorehabilitation supports the restitution of function using repetitive, learning-based and, more recently, technology-based training strategies.

  16. Stroke? Localized, otogenic meningitis!

    DEFF Research Database (Denmark)

    Ingolfsdottir, Harpa Maria; Thomasen, Per Caye

    2011-01-01

    We report the case of a patient admitted with aphasia, treated for a stroke. Subsequently, it was revealed that the symptoms were caused by complicated otitis media with localized meningitis. This case draws attention to the possible intracranial spread of infection when neurological symptoms occur...

  17. Therapeutic hypothermia for acute stroke

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj; Weber, Uno Jakob; Kammersgaard, Lars Peter

    2003-01-01

    Experimental evidence and clinical experience show that hypothermia protects the brain from damage during ischaemia. There is a growing hope that the prevention of fever in stroke will improve outcome and that hypothermia may be a therapeutic option for the treatment of stroke. Body temperature...... is directly related to stroke severity and outcome, and fever after stroke is associated with substantial increases in morbidity and mortality. Normalisation of temperature in acute stroke by antipyretics is generally recommended, although there is no direct evidence to support this treatment. Despite its...... obvious therapeutic potential, hypothermia as a form of neuroprotection for stroke has been investigated in only a few very small studies. Therapeutic hypothermia is feasible in acute stroke but owing to serious side-effects--such as hypotension, cardiac arrhythmia, and pneumonia--it is still thought...

  18. Gangguan Psikotik Akibat Stroke Iskemik

    Directory of Open Access Journals (Sweden)

    Rini Gusya Liza

    2015-05-01

    Full Text Available AbstrakStroke atau yang disebut juga dengan penyakit serebrovaskuler berkontribusi terhadap timbulnya delusi dan halusinasi di kemudian hari.Pengobatan yang diberikan pada kondisi medis sering menghasilkan remisi dari psikosistetapi hal tersebut tidaklah selalu terjadi. Gejala psikosis dapat bertahan lama setelah kondisi medis yangmenyebabkannya sembuh. Dilaporkan seorang pasien yang mengalami gangguan psikotik setelah mengalami strokeiskemik. Gangguan psikotik akibat stroke iskemik merupakan suatu kasus dalam Consultation Liaison Psychiatry.Kata kunci: gangguan psikotik, stroke iskemik, delusi dan halusinasiAbstract Stroke or also called cerebrovascular disease contributed to the emergence of delusions and hallucinations inthe future. Treatment given to medical conditions often produce remission of psychosis but it is not always happen.Psychotic symptoms can persist longer after recovery.  Reported a patient who suffered a psychotic disorder afterischemic stroke. Psychotic disorders due to ischemic stroke is a case in Consultation Liaison PsychiatryKeywords: psychotic disorder, ischemic stroke, delusions and hallucinations

  19. Rehabilitating the Stroke Collection

    Directory of Open Access Journals (Sweden)

    Mary Grimmond

    2006-06-01

    Full Text Available Objective The aim of this project was to complete an analysis of monograph and audiovisual items held in the Central Coast Health Service (CCHS Libraries and containing information relevant to the treatment of acute stroke. Acute stroke is treated by multidisciplinary teams of clinicians based at two hospitals within the CCHS. The adequacy of the library collection was measured by subject coverage and age. Methods The methodology used consisted of three main steps: a literature review; design, administration, and analysis of a questionnaire to members of the CCHS Acute Stroke Team; and an analysis of the libraries’ collections. The research project utilised project management methodology and an evidence based librarianship framework. Results The questionnaire revealed that electronic resources were by far the most frequently used by participants, followed in order by print journals, books, interlibrary loan articles, and audiovisual items. Collection analysis demonstrated that the monograph and audiovisual collections were adequate in both scope and currency to support the information needs of Acute Stroke Team members, with the exception of resources to support patient education. Conclusion The researchers developed recommendations for future collection development in the area of acute stroke resources. Conducting this project within the evidence based librarianship framework helped to develop library staff members’ confidence in their ability to make future collection development decisions, informed by the target group’s information needs and preferences. The collection analysis methodology was designed to be replicated, and new specialist groups within the client base of the library will be targeted to repeat the collection analysis process.

  20. Outcome Determinants of Stroke in a Brazilian Primary Stroke Center

    Directory of Open Access Journals (Sweden)

    Gustavo W. Kuster

    2014-01-01

    Full Text Available Background. Stroke mortality in Brazil is one of the highest among Western countries. Nonetheless, stroke outcome determinants are still poorly known in this country. In this study we evaluate outcome determinants of stroke in a primary stroke center in São Paulo, Brazil. Methods. We evaluated demographic, clinical, and outcome data of patients with ischemic stroke (IS, transient ischemic attack (TIA, and intracerebral hemorrhage (ICH admitted at “Hospital Paulistano,” São Paulo, Brazil. In-hospital mortality and functional outcome determinants were assessed. Univariate and binary logistic regression analysis were performed. Results. Three hundred forty-one patients were included in the study, 52.2% being male with 66.8±15.7 years. The stroke type distribution was IS: 59.2%, TIA: 29.6%, and ICH: 11.1%. ICH was associated with greater severity and poorer functional outcome. The determinants of poorer functional outcome were higher NIHSS, lower Glasgow score, and lower oxygen saturation level. The most important mortality determinant was the presence of visual symptoms. Conclusions. The stroke mortality and stroke outcome determinants found in the present study do not remarkably differ from studies carried out in developed countries. Stroke prognosis studies are crucial to better understand the high burden of stroke in Brazil.

  1. Understanding Stroke - Know Stroke • Know the Signs • Act in Time

    Science.gov (United States)

    ... Home Current Issue Past Issues Special Section Understanding Stroke Know Stroke • Know the Signs • Act in Time Past Issues / ... Julie Harris, and motivational speaker David Layton. Preventing Stroke "Until I had my stroke, I didn't ...

  2. Mathematical Simulation of Transient Parameters of Vertical Grounding Electrodes

    Directory of Open Access Journals (Sweden)

    A. Dziaruhina

    2012-01-01

    Full Text Available The paper contains a mathematical simulation of transient parameters of vertical grounding electrodes for the first and subsequent short strokes of a lightning current. Results of the research show that transient resistances of grounding electrodes change appreciably in time. The transient resistances are always higher in the moment of voltage maximum then in the moment of current maximum. The dependences of transient resistances on grounding electrode length at different ground conductivity and lightning current parameters (first and subsequent short strokes are obtained in the paper. The paper proposes an approximate criterion for estimation of grounding electrode equivalent length at transient condition that considers short stroke parameters of the lightning current and ground conductivity.

  3. Challenging comparison of stroke scales

    Directory of Open Access Journals (Sweden)

    Kavian Ghandehari

    2013-01-01

    Full Text Available Stroke scales can be classified as clinicometric scales and functional impairment, handicap scales. All studies describing stroke scales were reviewed by internet searching engines with the final search performed on January 1, 2013. The following string of keywords was entered into search engines; stroke, scale, score and disability. Despite advantages of modified National Institute of Health Stroke Scale and Scandinavian stroke scale comparing to the NIHSS, including their simplification and less inter-rater variability; most of the stroke neurologists around the world continue using the NIHSS. The modified Rankin scale (mRS and Barthel index (BI are widely used functional impairment and disability scales. Distinction between grades of mRS is poorly defined. The Asian stroke disability scale is a simplified functional impairment, handicap scale which is as valid as mRS and BI. At the present time, the NIHSS, mRS and BI are routine stroke scales because physicians have used to work with these scales for more than two decades, although it could not be an acceptable reason. On the other side, results of previous stroke trials, which are the basis of stroke management guidelines are driven using these scales.

  4. Signatures of Currency Vertices

    Science.gov (United States)

    Holme, Petter

    2009-03-01

    Many real-world networks have broad degree distributions. For some systems, this means that the functional significance of the vertices is also broadly distributed, in other cases the vertices are equally significant, but in different ways. One example of the latter case is metabolic networks, where the high-degree vertices — the currency metabolites — supply the molecular groups to the low-degree metabolites, and the latter are responsible for the higher-order biological function, of vital importance to the organism. In this paper, we propose a generalization of currency metabolites to currency vertices. We investigate the network structural characteristics of such systems, both in model networks and in some empirical systems. In addition to metabolic networks, we find that a network of music collaborations and a network of e-mail exchange could be described by a division of the vertices into currency vertices and others.

  5. Stroke and atrial fibrillation: is stroke prevention treatment appropriate beforehand?

    OpenAIRE

    DEPLANQUE, D; Corea, F; Arquizan, C; Parnetti, L.; Mas, J.; Gallai, V.; Leys, D; the, S

    1999-01-01

    OBJECTIVE—To undertake a pilot study before conducting a large European multicentre prospective study, to determine the proportion of patients with atrial fibrillation who were not receiving antithrombotic treatment before stroke onset, and their characteristics.
DESIGN AND PATIENTS—The stroke in atrial fibrillation ensemble (SAFE) I study was an observational study conducted in 213 patients with atrial fibrillation consecutively admitted in 1997 to three European centres for an acute stroke ...

  6. Guidelines for acute ischemic stroke treatment: part II: stroke treatment

    Directory of Open Access Journals (Sweden)

    Sheila Cristina Ouriques Martins

    2012-11-01

    Full Text Available The second part of these Guidelines covers the topics of antiplatelet, anticoagulant, and statin therapy in acute ischemic stroke, reperfusion therapy, and classification of Stroke Centers. Information on the classes and levels of evidence used in this guideline is provided in Part I. A translated version of the Guidelines is available from the Brazilian Stroke Society website (www.sbdcv.com.br.

  7. Gender differences in acute stroke: Istanbul medical school stroke registry

    OpenAIRE

    Nilüfer Yesilot; Bahar Aksay Koyuncu; Oguzhan Çoban; Rezzan Tuncay; Sara Zarko Bahar

    2011-01-01

    Background : We aimed to investigate gender differences in Turkish stroke patients. Material and Methods : Demographics, risk factors, clinical and etiologic subtypes, laboratory findings, clinical course, and in-hospital prognosis of 1 522 patients with ischemic stroke (IS) and 320 patients with intracerebral hemorrhage prospectively registered in the Istanbul Medical School Stroke Registry (1994-2004) were analyzed separately. Results : The mean age of IS patients was higher in females (n :...

  8. Microwave hemorrhagic stroke detector

    Energy Technology Data Exchange (ETDEWEB)

    Haddad, Waleed S. (Dublin, CA); Trebes, James E. (Livermore, CA)

    2007-06-05

    The microwave hemorrhagic stroke detector includes a low power pulsed microwave transmitter with a broad-band antenna for producing a directional beam of microwaves, an index of refraction matching cap placed over the patients head, and an array of broad-band microwave receivers with collection antennae. The system of microwave transmitter and receivers are scanned around, and can also be positioned up and down the axis of the patients head. The microwave hemorrhagic stroke detector is a completely non-invasive device designed to detect and localize blood pooling and clots or to measure blood flow within the head or body. The device is based on low power pulsed microwave technology combined with specialized antennas and tomographic methods. The system can be used for rapid, non-invasive detection of blood pooling such as occurs with hemorrhagic stoke in human or animal patients as well as for the detection of hemorrhage within a patient's body.

  9. Danger signals in stroke.

    Science.gov (United States)

    Gelderblom, Mathias; Sobey, Christopher G; Kleinschnitz, Christoph; Magnus, Tim

    2015-11-01

    Danger molecules are the first signals released from dying tissue after stroke. These danger signals bind to receptors on immune cells that will result in their activation and the release of inflammatory and neurotoxic mediators, resulting in amplification of the immune response and subsequent enlargement of the damaged brain volume. The release of danger signals is a central event that leads to a multitude of signals and cascades in the affected and neighbouring tissue, therefore providing a potential target for therapy.

  10. Chloride channels in stroke

    Institute of Scientific and Technical Information of China (English)

    Ya-ping ZHANG; Hao ZHANG; Dayue Darrel DUAN

    2013-01-01

    Vascular remodeling of cerebral arterioles,including proliferation,migration,and apoptosis of vascular smooth muscle cells (VSMCs),is the major cause of changes in the cross-sectional area and diameter of the arteries and sudden interruption of blood flow or hemorrhage in the brain,ie,stroke.Accumulating evidence strongly supports an important role for chloride (Clˉ) channels in vascular remodeling and stroke.At least three Clˉ channel genes are expressed in VSMCs:1) the TMEM16A (or Ano1),which may encode the calcium-activated Clˉ channels (CACCs); 2) the CLC-3 Clˉ channel and Clˉ/H+ antiporter,which is closely related to the volume-regulated Clˉ channels (VRCCs); and 3) the cystic fibrosis transmembrane conductance regulator (CFTR),which encodes the PKA-and PKC-activated Clˉ channels.Activation of the CACCs by agonist-induced increase in intracellular Ca2+ causes membrane depolarization,vasoconstriction,and inhibition of VSMC proliferation.Activation of VRCCs by cell volume increase or membrane stretch promotes the production of reactive oxygen species,induces proliferation and inhibits apoptosis of VSMCs.Activation of CFTR inhibits oxidative stress and may prevent the development of hypertension.In addition,Clˉ current mediated by gammaaminobutyric acid (GABA) receptor has also been implicated a role in ischemic neuron death.This review focuses on the functional roles of Clˉ channels in the development of stroke and provides a perspective on the future directions for research and the potential to develop Clˉ channels as new targets for the prevention and treatment of stroke.

  11. Khat and stroke

    Directory of Open Access Journals (Sweden)

    Sanjay V Kulkarni

    2012-01-01

    Full Text Available Khat chewing, though a tradition followed majorly in African countries, has of late spread widely across the globe due to faster transport systems and advanced preservation techniques. Many complications such as psychosis, arterial hypertension, angina pectoris, and myocardial infarction have been reported in connection to khat abuse. We present a case of a young man who presented with acute onset left-sided weakness. He was a known khat addict for over three decades. A diagnosis of left hemiplegia due to right middle cerebral artery infarction was established. Detailed evaluation revealed no significant underlying cause for stroke. Since the main central nervous system effects of khat are comparable with those of amphetamines and there are established reports of stroke in amphetamine abuse, the former was assumed to be the etiological factor. The patient was discontinued from taking khat and was managed conservatively. The subject showed significant recovery with no further complications or similar episodes during follow-up. To the best of our knowledge, this is the second case of stroke associated with khat. Since the management is essentially conservative, a vigilant history eliciting of khat abuse in prevalent countries would cut down unnecessary healthcare costs.

  12. Calorie restriction and stroke

    Directory of Open Access Journals (Sweden)

    Manzanero Silvia

    2011-09-01

    Full Text Available Abstract Stroke, a major cause of disability and mortality in the elderly, occurs when a cerebral blood vessel is occluded or ruptured, resulting in ischemic damage and death of brain cells. The injury mechanism involves metabolic and oxidative stress, excitotoxicity, apoptosis and inflammatory processes, including activation of glial cells and infiltration of leukocytes. In animal models, dietary energy restriction, by daily calorie reduction (CR or intermittent fasting (IF, extends lifespan and decreases the development of age-related diseases. Dietary energy restriction may also benefit neurons, as suggested by experimental evidence showing that CR and IF protect neurons against degeneration in animal models. Recent findings by our group and others suggest the possibility that dietary energy restriction may protect against stroke induced brain injury, in part by inducing the expression of neurotrophic factors, such as brain-derived neurotrophic factor (BDNF and basic fibroblast growth factor (bFGF; protein chaperones, including heat shock protein 70 (Hsp70 and glucose regulated protein 78 (GRP78; antioxidant enzymes, such as superoxide dismutases (SOD and heme oxygenase-1 (HO-1, silent information regulator T1 (SIRT1, uncoupling proteins and anti-inflammatory cytokines. This article discusses the protective mechanisms activated by dietary energy restriction in ischemic stroke.

  13. Cerebrogenic tachyarrhythmia in acute stroke

    OpenAIRE

    A S Praveen Kumar; Babu, E; D K Subrahmanyam

    2012-01-01

    The electrocardiac abnormalities following acute stroke are frequent and seen in both ischemic and hemorrhagic stroke. The changes seen in electrocardiogram (ECG) consist of repolarization abnormalities such as ST elevation, ST depression, negative T waves, and QT prolongation. Among tachyarrhythmias, atrial fibrillation is the most common and occurrence of focal atrial tachycardia is very rare though any cardiac arrhythmias can follow acute stroke. We report a case of focal atrial tachycardi...

  14. Language-specific dysgraphia in Korean patients with right brain stroke: influence of unilateral spatial neglect.

    Science.gov (United States)

    Jang, Dae-Hyun; Kim, Min-Wook; Park, Kyoung Ha; Lee, Jae Woo

    2015-03-01

    The purpose of the present study was to investigate the relationship between Korean language-specific dysgraphia and unilateral spatial neglect in 31 right brain stroke patients. All patients were tested for writing errors in spontaneous writing, dictation, and copying tests. The dysgraphia was classified into visuospatial omission, visuospatial destruction, syllabic tilting, stroke omission, stroke addition, and stroke tilting. Twenty-three (77.4%) of the 31 patients made dysgraphia and 18 (58.1%) demonstrated unilateral spatial neglect. The visuospatial omission was the most common dysgraphia followed by stroke addition and omission errors. The highest number of errors was made in the copying and the least was in the spontaneous writing test. Patients with unilateral spatial neglect made a significantly higher number of dysgraphia in the copying test than those without. We identified specific dysgraphia features such as a right side space omission and a vertical stroke addition in Korean right brain stroke patients. In conclusion, unilateral spatial neglect influences copy writing system of Korean language in patients with right brain stroke. PMID:25729257

  15. Language-specific dysgraphia in Korean patients with right brain stroke: influence of unilateral spatial neglect.

    Science.gov (United States)

    Jang, Dae-Hyun; Kim, Min-Wook; Park, Kyoung Ha; Lee, Jae Woo

    2015-03-01

    The purpose of the present study was to investigate the relationship between Korean language-specific dysgraphia and unilateral spatial neglect in 31 right brain stroke patients. All patients were tested for writing errors in spontaneous writing, dictation, and copying tests. The dysgraphia was classified into visuospatial omission, visuospatial destruction, syllabic tilting, stroke omission, stroke addition, and stroke tilting. Twenty-three (77.4%) of the 31 patients made dysgraphia and 18 (58.1%) demonstrated unilateral spatial neglect. The visuospatial omission was the most common dysgraphia followed by stroke addition and omission errors. The highest number of errors was made in the copying and the least was in the spontaneous writing test. Patients with unilateral spatial neglect made a significantly higher number of dysgraphia in the copying test than those without. We identified specific dysgraphia features such as a right side space omission and a vertical stroke addition in Korean right brain stroke patients. In conclusion, unilateral spatial neglect influences copy writing system of Korean language in patients with right brain stroke.

  16. Cerebrogenic tachyarrhythmia in acute stroke

    Directory of Open Access Journals (Sweden)

    A S Praveen Kumar

    2012-01-01

    Full Text Available The electrocardiac abnormalities following acute stroke are frequent and seen in both ischemic and hemorrhagic stroke. The changes seen in electrocardiogram (ECG consist of repolarization abnormalities such as ST elevation, ST depression, negative T waves, and QT prolongation. Among tachyarrhythmias, atrial fibrillation is the most common and occurrence of focal atrial tachycardia is very rare though any cardiac arrhythmias can follow acute stroke. We report a case of focal atrial tachycardia following acute ischemic stroke in 50-year-old female without structural heart disease, and their mechanisms and clinical implications.

  17. [Pregnancy and acute ischemic stroke].

    Science.gov (United States)

    Bereczki, Dániel

    2016-05-15

    Pregnancy-related ischemic strokes play an important role in both maternal and fetal morbidity and mortality. Changes in hemostaseology and hemodynamics as well as risk factors related to or independent from pregnancy contribute to the increased stroke-risk during gestation and the puerperium. Potential teratogenic effects make diagnostics, acute therapy and prevention challenging. Because randomized, controlled trials are not available, a multicenter registry of patients with gestational stroke would be desirable. Until definite guidelines emerge, management of acute ischemic stroke during pregnancy remains individual, involving experts and weighing the risks and benefits.

  18. Cerebrovascular stroke at high altitude

    International Nuclear Information System (INIS)

    Objective: To asses the high altitude as a risk factor for cerebrovascular stroke in people residing at a height greater than 15,000 feet above sea level. Results: Ten patients suffered from stroke at high altitude while just one case had stroke in indexed age group at lower heights (p-value<0.05). Relative risk was 10 times greater at high altitude. Conclusion: High altitude is a risk factor for stroke in persons residing at altitudes of over 15, 000 ft. (author)

  19. What to Know - and Do! - about Stroke

    Science.gov (United States)

    ... page please turn Javascript on. Feature: Stroke Rehabilitation What to Know – and Do! – About Stroke Past Issues / ... around them recognizes the symptoms and acts quickly. What are the symptoms of a stroke?— The symptoms ...

  20. Stroke and Native Hawaiians/Pacific Islanders

    Science.gov (United States)

    ... Population Profiles > Native Hawaiian/Other Pacific Islander > Stroke Stroke and Native Hawaiians/Pacific Islanders Native Hawaiians/Pacific ... non-Hispanic white adults to die from a stroke in 2010. In general, Native Hawaiian/Pacific Islander ...

  1. Recovery After Stroke: Managing Life at Home

    Science.gov (United States)

    ... installed for safety.  Consider an over-the-stove mirror to help you see stovetop contents if cooking ... Contact your local stroke association.  Subscribe to Stroke Smart magazine at www.stroke.org to view the ...

  2. The burden of stroke in Pakistan.

    Science.gov (United States)

    Khealani, Bhojo A; Wasay, Mohammad

    2008-11-01

    Epidemiologic literature on stroke burden, patterns of stroke is almost non existent from Pakistan. However, several hospital-based case series on the subject are available, mainly published in local medical journals. Despite the fact that true stroke incidence and prevalence of stroke in Pakistan is not known, the burden is assumed to be high because of highly prevalent stroke risk factors (hypertension, diabetes mellitus, coronary artery disease, dyslipidemia and smoking) in the community. High burden of these conventional stroke risk factors is further compounded by lack of awareness, poor compliance hence poor control, and inappropriate management/treatment practices. In addition certain risk factors like rheumatic valvular heart disease may be more prevalent in Pakistan. We reviewed the existing literature on stroke risk factors in community, the risk factor prevalence among stroke patients, patterns of stroke, out come of stroke, availability of diagnostic services/facilities related to stroke and resources for stroke care in Pakistan. PMID:18811747

  3. Stroke: advances in medical therapy and acute stroke intervention.

    Science.gov (United States)

    Barrett, Kevin M; Lal, Brajesh K; Meschia, James F

    2015-10-01

    Evidence-based therapeutic options for stroke continue to emerge based on results from well-designed clinical studies. Ischemic stroke far exceeds hemorrhagic stroke in terms of prevalence and incidence, both in the USA and worldwide. The public health effect of reducing death and disability related to ischemic stroke justifies the resources that have been invested in identifying safe and effective treatments. The emergence of novel oral anticoagulants for ischemic stroke prevention in atrial fibrillation has introduced complexity to clinical decision making for patients with this common cardiac arrhythmia. Some accepted ischemic stroke preventative strategies, such as carotid revascularization for asymptomatic carotid stenosis, require reassessment, given advances in risk factor management, antithrombotic therapy, and surgical techniques. Intra-arterial therapy, particularly with stent retrievers after intravenous tissue plasminogen activator, has recently been demonstrated to improve functional outcomes and will require investment in system-based care models to ensure that effective treatments are received by patients in a timely fashion. The purpose of this review is to describe recent advances in medical and surgical approaches to ischemic stroke prevention and acute treatment. Results from recently published clinical trials will be highlighted along with ongoing clinical trials addressing key questions in ischemic stroke management and prevention where equipoise remains.

  4. Musculoskeletal problems in stroke survivors.

    Science.gov (United States)

    Kendall, Richard

    2010-01-01

    Musculoskeletal problems in stoke survivors are common reasons for disability and pain. Shoulder pain is present in 24% of stroke survivors among all complications, second only to depression in 26%. Diagnosis and treatment of the various shoulder pain etiologies can significantly improve quality of life in these patients. This article reviews the common etiologies and treatments of shoulder and hip pain in stroke survivors.

  5. One Stroke at a Time

    Science.gov (United States)

    Hollibaugh, Molly

    2012-01-01

    At first glance, a Zentangle creation can seem intricate and complicated. But, when you learn how it is done, you realize how simple it is. Zentangles are patterns, or "tangles," that have been reduced to a simple sequence of elemental strokes. When you learn to focus on each stroke you find yourself capable of things that you may have once…

  6. Stroke prevention in atrial fibrillation.

    NARCIS (Netherlands)

    Verheugt, F.W.A.

    2006-01-01

    The only major and potentially fatal risk for patients with atrial fibrillation is the development of systemic thromboembolism. Stroke occurs five times more frequently in patients with atrial fibrillation than in comparable patients in sinus rhythm. The yearly incidence of stroke in atrial fibrilla

  7. Quantitative videofluoroscopic analysis of penetration-aspiration in post-stroke patients

    Directory of Open Access Journals (Sweden)

    Bingjie Li

    2010-01-01

    Full Text Available Background : Dysphagia is a common complication of stroke and is a potential cause for aspiration and malnutrition and is also associated with poor outcome. Videofluoroscopic Swallowing Study (VFSS is the most objective method for evaluation of swallowing disorders. Aim : To investigate the incidence and characteristics of penetration-aspiration in post-stroke patients, and to study the relationship between penetration-aspiration and kinematic parameters of swallow. Materials and Methods : We prospectively studied swallowing function in 105 consecutive post-stroke patients and 100 normal adults by videofluoroscopic swallowing studies. The severity of airway invasion, penetration-aspiration, was studied quantitatively and kinematic parameters of swallow i.e. oral transit time, pharyngeal transit time (PTT, pharyngeal delay timem (PDT, maximal extent of vertical and anterior movement of larynx and hyoid bone for four kinds of boluses were also studied. Logistic regression was used to analyze the association between aspiration and kinematic parameters of swallow. Results : Stroke patients scored significantly higher scores on penetration-aspiration scale than the normal subjects (P < 0.001 during four bolus swallows. Logistic regression analysis showed that PTT, PDT, maximal extent of vertical laryngeal and hyoid movement were statistically associated with the prevalence of aspiration (P < 0.05. Conclusion : Penetration-aspiration is common in stroke patients. Several kinematic parameters of swallow are associated with the presence of aspiration on fluoroscopy. These data demonstrate that VFSS may be helpful for objective identification of dysphagia in stroke patients.

  8. The imaging of ischaemic stroke

    International Nuclear Information System (INIS)

    Stroke is a clinical syndrome of a rapidly developing focal neurological deficit that may be classified for practical purposes into ischaemic and haemorrhagic. The role of imaging is to exclude mimics of ischaemic stroke or intracranial haemorrhage and confirm the presence of an ischaemic stroke. Computed tomography (CT) remains the investigation of choice to exclude acute intracranial haemorrhage but diffusion weighted magnetic resonance (MR) has proved to be a sensitive method of detecting early ischaemic infarction. Perfusion weighted MR allows further assessment at the same examination that could help guide the clinician in the risk/benefit analysis of treatment with thrombolytics or neuroprotective agents under evaluation. This can also be achieved with CT. This review article discusses the imaging of ischaemic stroke, relating the pathophysiology of stroke to it. It deals separately in more detail with these newer MR techniques. Hoggard, N. et al. (2001)

  9. Stroke education in the Philippines.

    Science.gov (United States)

    Navarro, Jose C; Baroque, Alejandro C; Lokin, Johnny K

    2013-10-01

    Education is paramount in effectively reducing the significant burden of stroke in the Philippines. Dedicated academic institutions and dynamic professional organizations in the Philippines have collaborated to involve themselves in the plight against stroke through systematic curriculum development for undergraduates, continuous regulation of quality residency and fellowship training program, hosting up-to-date Continuing Medical Education (CME) activities for local and international audience, and active participation in clinical stroke trials. Most recently, the University of Santo Tomas Faculty of Medicine & Surgery and the Department of Neurology & Psychiatry offered a 72-hour Certification Course in Stroke Medicine that commenced in 2011 in anticipation of the Master on Health Sciences in Stroke Medicine course being prepared for 2013. PMID:23506562

  10. Circadian Variation Of Stroke Onset

    Directory of Open Access Journals (Sweden)

    Kamath vasantha

    2003-01-01

    Full Text Available Diurnal variations in various physiological and biochemical functions and certain pathological events like myocardial infarction and stroke have been documented. We studied prospectively one hundred and seven patients of acute onset stroke confirmed by computed tomography for the exact time of onset, risk factors and type of stroke. Patients who were unclear of time of onset and with a diagnosis of cerebral venous thrombosis or sub-arachnoid hemorrhage were excluded. Infarction was detected in 71 patients and hemorrhage in 33 patients. Men out numbered women (1:6:1. Hypertension was more frequent in hemorrhage in the morning time (5 AM-12 noon and more infarction between 12-6 pm. However there was no relation between the time of onset of stroke and various risk-factors of stroke.

  11. Auditory Hallucinations in Acute Stroke

    Directory of Open Access Journals (Sweden)

    Yair Lampl

    2005-01-01

    Full Text Available Auditory hallucinations are uncommon phenomena which can be directly caused by acute stroke, mostly described after lesions of the brain stem, very rarely reported after cortical strokes. The purpose of this study is to determine the frequency of this phenomenon. In a cross sectional study, 641 stroke patients were followed in the period between 1996–2000. Each patient underwent comprehensive investigation and follow-up. Four patients were found to have post cortical stroke auditory hallucinations. All of them occurred after an ischemic lesion of the right temporal lobe. After no more than four months, all patients were symptom-free and without therapy. The fact the auditory hallucinations may be of cortical origin must be taken into consideration in the treatment of stroke patients. The phenomenon may be completely reversible after a couple of months.

  12. Basics of acute stroke treatment

    International Nuclear Information System (INIS)

    Acute stroke presents an emergency that requires immediate referral to a specialized hospital, preferably with a stroke unit. Disability and mortality are reduced by 30% in patients treated in stroke units compared to those treated on regular wards, even if a specialized team is present on the ward. Systolic blood pressure may remain high at 200-220 mmHg in the acute phase and should not be lowered too quickly. Further guidelines for basic care include: optimal O2 delivery, blood sugar levels below 100-150 mg%, and lowering body temperature below 37.5 C using physical means or drugs. Increased intracranial pressure should be treated by raising the upper body of the patient, administration of glycerol, mannitol, and/or sorbitol, artificial respiration, and special monitoring of Tris buffer. Decompressive craniectomy may be considered in cases of ''malignant'' media stroke and expansive cerebellar infarction. Fibrinolysis is the most effective stroke treatment and is twice as effective in the treatment of stroke than myocardial infarction. Fibrinolysis may be initiated within 3 h of a stroke in the anterior circulation. If a penumbra is detectable by ''PWI-DWI mismatch MRI,'' specialized hospitals may perform fibrinolysis up to 6 h after symptom onset. In cases of stroke in the basilar artery, fibrinolysis may be performed even later after symptom onset. Intra-arterial fibrinolysis is performed in these cases using rt-PA or urokinase. Follow-up treatment of stroke patients should not only address post-stroke depression and neuropsychological deficits, but also include patient education about risk factors such as high blood pressure, diabetes mellitus, and cardiac arrhythmias. (orig.)

  13. Rehabilitative Games for Stroke Patients

    Directory of Open Access Journals (Sweden)

    A. Pyae

    2015-07-01

    Full Text Available Stroke is one of the major problems in medical and healthcare that can cause severe disability and death of patients especially for older population. Rehabilitation plays an important role in stroke therapy. However, most of the rehabilitative exercises are monotonous and tiring for the patients. For a particular time, they can easily get bored in doing these exercises. The role of patient’s motivation in rehabilitation is vital. Motivation and rehabilitative outcomes are strongly related. Digital games promise to help stroke patients to feel motivated and more engaged in rehabilitative training through motivational gameplay. Most of the commercial games available in the market are not well-designed for stroke patients and their motivational needs in rehabilitation. This study aims at understanding the motivational requirements of stroke patients in doing rehabilitative exercises and living in a post-stroke life. Based on the findings from the literature review, we report factors that can influence the stroke patients’ level of motivation such as social functioning, patient-therapist relationship, goal-setting, and music. These findings are insightful and useful for ideating and designing interactive motivation-driven games for stroke patients. The motivational factors of stroke patients in rehabilitation may help the game designers to design motivation-driven game contexts, contents, and gameplay. Moreover, these findings may also help healthcare professionals who concern stroke patient’s motivation in rehabilitative context. In this paper, we reported our Virtual Nursing Home (VNH concept and the games that we are currently developing and re-designing. Based on this literature review, we will present and test out the ideas how we can integrate these motivational factors in our future game design, development, and enhancement.

  14. Hybrid vertical cavity laser

    DEFF Research Database (Denmark)

    Chung, Il-Sug; Mørk, Jesper

    2010-01-01

    A new hybrid vertical cavity laser structure for silicon photonics is suggested and numerically investigated. It incorporates a silicon subwavelength grating as a mirror and a lateral output coupler to a silicon ridge waveguide.......A new hybrid vertical cavity laser structure for silicon photonics is suggested and numerically investigated. It incorporates a silicon subwavelength grating as a mirror and a lateral output coupler to a silicon ridge waveguide....

  15. Atrial Fibrillation and Stroke – Increasing Stroke Risk With Intervention

    Directory of Open Access Journals (Sweden)

    Christopher V. DeSimone; Malini Madhavan; Elisa Ebrille; Alejandro A. Rabinstein; Paul A. Friedman; Samuel J. Asirvatham

    2013-12-01

    Full Text Available In this review, we focus on the important newly recognized appreciation for the paradoxical increase in stroke and TIA as a result of intervention meant to treat atrial fibrillation (AF with the hope of decreasing stroke risk in the long term. The impact of silent cerebral lesions recently appreciated as a potentially major limitation and risk with AF ablation is explained. We categorize our present understanding of how we can minimize risk and provide a platform for what will undoubtedly be newer study, changes in the way procedures are done today, and possibly vascular-based stroke-reduction strategies.

  16. Pre-stroke use of beta-blockers does not affect ischaemic stroke severity and outcome

    NARCIS (Netherlands)

    De Raedt, S.; Haentjens, P.; De Smedt, A.; Brouns, R.; Uyttenboogaart, Maarten; Luijckx, G. J.; De Keyser, J.

    2012-01-01

    Background and purpose: It is unclear whether pre-stroke beta-blockers use may influence stroke outcome. This study evaluates the independent effect of pre-stroke use of beta-blockers on ischaemic stroke severity and 3 months functional outcome. Methods: Pre-stroke use of beta-blockers was investiga

  17. Let's Talk about Emotional Changes After Stroke

    Science.gov (United States)

    ... Stroke More Let's Talk About Emotional Changes After Stroke Updated:Dec 9,2015 Right after a stroke, a survivor may respond one way, yet weeks ... because of biological or psychological causes due to stroke. These changes may vary with time and can ...

  18. Early infection and prognosis after acute stroke

    DEFF Research Database (Denmark)

    Kammersgaard, L P; Jørgensen, H S; Reith, J;

    2001-01-01

    Infection is a frequent complication in the early course of acute stroke and may adversely affect stroke outcome. In the present study, we investigate early infection developing in patients within 3 days of admission to the hospital and its independent relation to recovery and stroke outcome. In...... addition, we identify predictors for early infections, infection subtypes, and their relation to initial stroke severity....

  19. What's Your Stroke I.Q.?

    Science.gov (United States)

    What's Your Stroke I.Q.? Often, it is believed that stroke is a disease of old age. You may be surprised to learn that stroke ... to help prevent it. Test your stroke I.Q. by answering these six questions. By knowing the ...

  20. Stroke rehabilitation: an international perspective.

    Science.gov (United States)

    Teasell, Robert; Meyer, Matthew J; McClure, Andrew; Pan, Cheng; Murie-Fernandez, Manuel; Foley, Norine; Salter, Katherine

    2009-01-01

    There is a revolution underway in stroke rehabilitation. International comparative studies coupled with an impressive evidence base have provided a platform from which an ideal system for stroke rehabilitation can be envisioned. Using the concepts of structure and process of care, different systems of stroke rehabilitation can be compared and evaluated against best evidence. Two structures of care are examined: specialized interdisciplinary stroke rehabilitation units and outpatient programs. Although specialized interdisciplinary stroke rehabilitation units remain the "gold standard" of care, access to them is often limited. Outpatient programs are essential to stroke rehabilitation systems of care; however, while some countries are investing in outpatient programs, others are scaling back. Even though structures of care have been shown to affect processes of care, it is the processes of care that have proven to be more influential in altering patient outcomes. Four key processes of care are examined: time to admission, intensity of therapy, task-specific therapy, and discharge planning. Within international stroke rehabilitation systems, differences in these processes have resulted in significant differences in outcomes. This allows for "real-world" comparisons of how differing processes affect patient outcomes. Those systems whose structures and processes of care best reflect current best evidence appear to achieve better outcomes.

  1. Stroke rehabilitation: recent advances and future therapies.

    LENUS (Irish Health Repository)

    Brewer, L

    2012-09-27

    Despite advances in the acute management of stroke, a large proportion of stroke patients are left with significant impairments. Over the coming decades the prevalence of stroke-related disability is expected to increase worldwide and this will impact greatly on families, healthcare systems and economies. Effective neuro-rehabilitation is a key factor in reducing disability after stroke. In this review, we discuss the effects of stroke, principles of stroke rehabilitative care and predictors of recovery. We also discuss novel therapies in stroke rehabilitation, including non-invasive brain stimulation, robotics and pharmacological augmentation. Many trials are currently underway, which, in time, may impact on future rehabilitative practice.

  2. Stroke Unit: General principles and standards

    Directory of Open Access Journals (Sweden)

    Mehmet Akif Topçuoğlu

    2015-04-01

    Full Text Available Evidence-based medicinal methods have convincingly shown that stroke unit approach reduces mortality and disability rates, improves the quality of life and economic burden resulting from acute ischemic and hemorrhagic stroke. Any contemporary stroke system of care cannot be successful without putting the stroke unit concept in the center of its organization. Stroke units are the main elements of primary and comprehensive stroke centers. As a modernization process, this article focuses on practical issues and suggestions related to integration of the stroke unit approach to a regionally organized stroke system of care for perusal by not only national health authorities and service providers, but also neurologists. Stroke unit quality metrics revisited herein are of critical importance for hospitals establishing or renovating primary and comprehensive stroke centers.

  3. Cause-specific mortality after stroke

    DEFF Research Database (Denmark)

    Mogensen, Ulla Brasch; Olsen, Tom Skyhøj; Andersen, Klaus Kaae;

    2013-01-01

    We investigated cause-specific mortality in relation to age, sex, stroke severity, and cardiovascular risk factor profile in the Copenhagen Stroke Study cohort with 10 years of follow-up. In a Copenhagen community, all patients admitted to the hospital with stroke during 1992-1993 (n = 988) were.......2% for nonvascular disease. Death after stroke was associated with older age, male sex, greater stroke severity, and diabetes regardless of the cause of death. Previous stroke and hemorrhagic stroke were associated with death by stroke, ischemic heart disease was associated with death by heart/arterial disease...... registered on admission. Evaluation included stroke severity, computed tomography scan, and a cardiovascular risk profile. Cause of death within 10 years according to death certificate information was classified as stroke, heart/arterial disease, or nonvascular disease. Competing-risks analyses were...

  4. [Cerebrolysin for acute ischemic stroke].

    Science.gov (United States)

    iganshina, L E; Abakumova, T R

    2013-01-01

    The review discusses existing evidence of benefits and risks of cerebrolysin--a mixture of low-molecular-weight peptides and amino acids derived from pigs' brain tissue with proposed neuroprotective and neurotrophic properties, for acute ischemic stroke. The review presents results of systematic search and analysis of randomised clinical trials comparing cerebrolysin with placebo in patients with acute ischemic stroke. Only one trial was selected as meeting quality criteria. No difference in death and adverse events between cerebrolysin and placebo was established. The authors conclude about insufficiency of evidence to evaluate the effect of cerebrolysin on survival and dependency in people with acute ischemic stroke. PMID:23805635

  5. Plasma cytokines in acute stroke

    DEFF Research Database (Denmark)

    Christensen, Hanne Krarup; Boysen, Gudrun; Christensen, Erik;

    2011-01-01

    GOALS: The aim of this study was to test the relations between plasma cytokines and the clinical characteristics, course, and risk factors in acute stroke. PATIENTS AND METHODS: The analysis was based on 179 patients with acute stroke included within 24 hours of stroke onset. On inclusion and 3...... months later plasma levels of interleukin 1 beta (IL-1beta), tumor necrosis factor alpha (TNF-alpha), interleukin-1 receptor antagonist (IL-1RA), interleukin 6 (IL-6), interleukin 10 (IL-10), soluble tumor necrosis factor receptor 1 (sTNF-R1), and soluble tumor necrosis factor receptor 2 (sTNF-R2) were...

  6. ACUTE STROKE: FUNCTIONAL OUTCOME PREDICTORS

    Directory of Open Access Journals (Sweden)

    Sujatha

    2016-03-01

    Full Text Available BACKGROUND Ischemic strokes account for >80% of total stroke events. Biochemical modalities like serum uric acid, ESR, CRP, Serum Fibrinogen will be a low cost and useful way to predict functional outcome after ischemic stroke. The Barthel ADL index it is an ordinal scale helping us to measure performances in ADL-activities in daily living. The present study aims to study the Biochemical parameters Uric Acid, CRP, ESR and Fibrinogen in Ischemic Stroke patients and to assess functional outcome in these patients using Barthel Index at admission and at discharge. MATERIALS AND METHODS The present study was undertaken under the Department of Internal Medicine, Govt. Stanley Hospital, Chennai, in 75 patients above 18 yrs. of age presenting with symptoms suggestive of acute stroke at medical OPD/wards/ICU, proven by imaging as ischemic stroke after proper consent were subjected to detailed history taking, complete physical examination and the relevant laboratory investigations as per proforma. Subjects were grouped under mild/moderate/severe categories as per Barthel scoring. A prospective observational study design was chosen and descriptive statistics was done for all data and suitable statistical tests of comparison were done. RESULTS The groups contain subjects with the same basic demographic characteristics, age and gender. The duration of stay in hospital increases with Barthel score. There is an increasing trend of diabetes mellitus and hypertension with stroke severity assessed functionally as per Barthel scores. There is an increasing trend of raised CRP, ESR levels, Uric Acid and Fibrinogen levels with stroke severity. By assessing the functional outcome using Barthel index in ischemic stroke patients at admission and discharge, the average Barthel score in patients at the time of admission was 52.27 in comparison to significantly increased Barthel score at discharge (56 with a p-value of 0.0000 according to paired t-test. CONCLUSION CRP

  7. [Cerebrolysin for acute ischemic stroke].

    Science.gov (United States)

    iganshina, L E; Abakumova, T R

    2013-01-01

    The review discusses existing evidence of benefits and risks of cerebrolysin--a mixture of low-molecular-weight peptides and amino acids derived from pigs' brain tissue with proposed neuroprotective and neurotrophic properties, for acute ischemic stroke. The review presents results of systematic search and analysis of randomised clinical trials comparing cerebrolysin with placebo in patients with acute ischemic stroke. Only one trial was selected as meeting quality criteria. No difference in death and adverse events between cerebrolysin and placebo was established. The authors conclude about insufficiency of evidence to evaluate the effect of cerebrolysin on survival and dependency in people with acute ischemic stroke.

  8. [Post-stroke apathy].

    Science.gov (United States)

    López-Dóriga Bonnardeaux, Pedro; Andrino Díaz, Nuria

    2016-01-01

    Apathy is a motivational disturbance that can be defined as a quantitative reduction of goal-directed behaviour. Patients present with loss of motivation, concern, interest, and emotional response, resulting in a loss of initiative, decreased interaction with their environment, and a reduced interest in social life. Apathy not only appears to be common in stroke patients, but it has also been related to a wide range of negative consequences for the patients and their caregivers, including poor functional recovery, loss of social independence, and caregiver distress. Clear definition and consensus diagnostic criteria for apathy are needed to accomplish an accurate assessment and an individualised treatment plan. Although there have been reports of successful behavioural therapy treatment of apathetic states, there is a paucity of controlled clinical trials on the efficacy of apathetic behaviours using pharmacotherapy. PMID:26522489

  9. Mortality after hemorrhagic stroke

    DEFF Research Database (Denmark)

    González-Pérez, Antonio; Gaist, David; Wallander, Mari-Ann;

    2013-01-01

    OBJECTIVE: To investigate short-term case fatality and long-term mortality after intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) using data from The Health Improvement Network database. METHODS: Thirty-day case fatality was stratified by age, sex, and calendar year after ICH...... and SAH using logistic regression. Cox proportional hazards regression analyses were used to estimate the risk of death during the first year of follow-up and survivors at 1 year. RESULTS: Case fatality after ICH was 42.0%, compared with 28.7% after SAH. It increased with age (ICH: 29.7% for 20-49 years......, 54.6% for 80-89 years; SAH: 20.3% for 20-49 years, 56.7% for 80-89 years; both p-trend stroke patients...

  10. Strokes in young adults: epidemiology and prevention

    Directory of Open Access Journals (Sweden)

    Smajlović D

    2015-02-01

    Full Text Available Dževdet Smajlović Department of Neurology, University Clinical Centre Tuzla, School of Medicine, University of Tuzla, Bosnia and Herzegovina Abstract: Strokes in young adults are reported as being uncommon, comprising 10%–15% of all stroke patients. However, compared with stroke in older adults, stroke in the young has a disproportionately large economic impact by leaving victims disabled before their most productive years. Recent publications report an increased incidence of stroke in young adults. This is important given the fact that younger stroke patients have a clearly increased risk of death compared with the general population. The prevalence of standard modifiable vascular risk factors in young stroke patients is different from that in older patients. Modifiable risk factors for stroke, such as dyslipidemia, smoking, and hypertension, are highly prevalent in the young stroke population, with no significant difference in geographic, climatic, nutritional, lifestyle, or genetic diversity. The list of potential stroke etiologies among young adults is extensive. Strokes of undetermined and of other determined etiology are the most common types among young patients according to TOAST (Trial of Org 10172 in Acute Stroke Treatment criteria. Prevention is the primary treatment strategy aimed at reducing morbidity and mortality related to stroke. Therefore, primary prevention is very important with regard to stroke in young adults, and aggressive treatment of risk factors for stroke, such as hypertension, smoking, and dyslipidemia, is essential. The best form of secondary stroke prevention is directed toward stroke etiology as well as treatment of additional risk factors. However, there is a lack of specific recommendations and guidelines for stroke management in young adults. In conclusion, strokes in young adults are a major public health problem and further research, with standardized methodology, is needed in order to give us more

  11. Secondary stroke prevention: challenges and solutions

    OpenAIRE

    Esenwa C; Gutierrez J

    2015-01-01

    Charles Esenwa, Jose GutierrezDepartment of Neurology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USAAbstract: Stroke is the leading cause of disability in the USA and a major cause of mortality worldwide. One out of four strokes is recurrent. Secondary stroke prevention starts with deciphering the most likely stroke mechanism. In general, one of the main goals in stroke reduction is to control vascular risk factors such as hypertension, diabetes, dy...

  12. Pediatric Stroke: Clinical Findings and Radiological Approach

    OpenAIRE

    Alessandra Di Sibio; Massimo Gallucci; Amalia Paonessa; Laura Conti; Alessia Catalucci; Giuseppe Lanni

    2011-01-01

    This paper focuses on radiological approach in pediatric stroke including both ischemic stroke (Arterial Ischemic Stroke and Cerebral Sinovenous Thrombosis) and hemorrhagic stroke. Etiopathology and main clinical findings are examined as well. Magnetic Resonance Imaging could be considered as the first-choice diagnostic exam, offering a complete diagnostic set of information both in the discrimination between ischemic/hemorrhagic stroke and in the identification of underlying causes. In addit...

  13. Post-stroke seizures in consecutive elderly stroke patients

    Institute of Scientific and Technical Information of China (English)

    Yue Chen; Lufang Chen; Yiqing Tao; Maomao Han; Chunlan Cui; Shichao Liu

    2011-01-01

    This prospective study sought to investigate the clinical, radiological and electroencephalographic (EEG) characteristics of seizures in elderly stroke patients, and their outcomes. Over a 2-year study period, 158 consecutive eldedy patients with stroke were examined and followed up. Of these patients, 32 (20%) developed seizures, primarily related to stroke, within a follow up period between 5 months and 2 years. Of these 32 cases, 20 experienced infarctions, and 12 experienced hemorrhages. Involvement of cortical regions was detected in most of the patients exhibiting seizures. In these patients, 44% of the lesions involved cortical areas exclusively or in addition to subcortical areas observed on computed tomography (CT) images. Twenty-five patients (78%)developed early seizures (within 2 weeks after stroke), and half exhibited immediate post-stroke seizures. None of the patients exhibiting early onset seizures developed recurrent seizures or epilepsy, while 57% of late onset seizures (four cases) developed epilepsy. No specific EEG patterns were apparent in those who later developed epilepsy. Overall, early onset seizures after stroke were found to be relatively common, and did not affect outcome. Late onset seizures were less common, but were associated with chronic epilepsy.

  14. Global specialized stroke care delivery models.

    Science.gov (United States)

    Theofanidis, Dimitrios; Savopoulos, Christos; Hatzitolios, Apostolos

    2016-03-01

    Stroke services still vary enormously from country to country, with many countries providing no special services at all. The aim of this article is to provide a concise overview of the various types of acute stroke delivery systems at present available and critically describe merits and shortcomings. A systematic literature review was undertaken from 1990 to July 2014. Several models for stroke services have been developed mostly in the past 3 decades, mainly in the Western world. These include state-of-the-art stroke services ranging from highly specialized stroke centers to mobile stroke units for the community. In this light, the recommendations of the structure and organization of stroke units and stroke centers by the European Stroke Organization were recently published. What differentiates the various models of stroke care delivery across the globe is the diversity of services ranging from low key conventional care to highly sophisticated facilities with life saving interventional features via integrated stroke care infrastructure. Effective in-hospital care for stroke should start in the emergency department where a swift and appropriate diagnosis should be made. The role of all brain neuroimaging procedures should have a defined a priori and proper demarcation between actions according to updated stroke care pathways and clinical protocols, which should be followed closely. These essential actions initiated by well-trained staff in the emergency department, should then be carried on in dedicated stroke facilities that is, a stroke unit.

  15. Diabetes, Heart Disease, and Stroke

    Science.gov (United States)

    ... of Diabetes Educators JDRF American Heart Association MedlinePlus Diabetes Disease Organizations Many organizations provide support to patients ... Disease Organizations (PDF, 293 KB). Alternate Language URL Diabetes, Heart Disease, and Stroke Page Content On this ...

  16. Diabetes, Heart Disease, and Stroke

    Science.gov (United States)

    ... Disease, and Other Dental Problems Diabetic Eye Disease Diabetes, Heart Disease, and Stroke Having diabetes or prediabetes ... can help prevent future health problems. What is diabetes? Diabetes is a disorder of metabolismthe way our ...

  17. Blood glucose in acute stroke

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj

    2009-01-01

    Blood glucose is often elevated in acute stroke, and higher admission glucose levels are associated with larger lesions, greater mortality and poorer functional outcome. In patients treated with thrombolysis, hyperglycemia is associated with an increased risk of hemorrhagic transformation...... of infarcts. For a number of years, tight glycemic control has been regarded as beneficial in critically illness, but recent research has been unable to support this notion. The only completed randomized study on glucose-lowering therapy in stroke has failed to demonstrate effect, and concerns relating...... to the risk of inducing potentially harmful hypoglycemia has been raised. Still, basic and observational research is overwhelmingly in support of a causal relationship between blood glucose and stroke outcome and further research on glucose-lowering therapy in acute stroke is highly warranted....

  18. Relationship between plasma glutamate levels and post-stroke depression in patients with acute ischemic stroke

    Institute of Scientific and Technical Information of China (English)

    钱方媛

    2014-01-01

    Objective To test the association between the plasma glutamate levels during acute ischemic stroke andpost-stroke depression(PSD)initially.Methods Seventy-four ischemic stroke patients admitted to the hospital within the first day of stroke onset were evaluated at a follow-up of 2 weeks.The Beck Depression Inventory(BDI,21-item)and DSM-Ⅳcriteria was used to diagnose post-stroke depression(PSD)at 2 weeks after stroke.

  19. The relation between oxidative stress parameters, ischemic stroke,and hemorrhagic stroke

    OpenAIRE

    İçme, Ferhat; EREL, ÖZCAN; AVCİ, AKKAN; SATAR, SALİM; Gülen, Müge; Acehan, Selen

    2015-01-01

    Background/aim: The aims of this study were to investigate the significance of oxidative stress parameters in the pathogenesis of ischemic stroke and hemorrhagic stroke and to investigate their effects on stroke severity using the National Institutes of Health Stroke Scale (NIHSS). Materials and methods: A total of 92 patients, including 74 with ischemic stroke and 18 with hemorrhagic stroke, and 75 volunteers were enrolled in the study. Total oxidant status (TOS), total antioxidant status (...

  20. Stroke prevention in atrial fibrillation.

    OpenAIRE

    Michael Katsnelson,; Sebastian Koch; Tatjana Rundek

    1997-01-01

    Non-valvular atrial fibrillation is a common and from a neurological perspective the most significant cardiac arrhythmia with a growing world-wide incidence. It also carries a significant associated morbidity and mortality, with cardioembolic strokes arguably being the most disabling sequelae. This brief review will highlight the important studies and the latest treatment modalities available for stroke prevention in patients with non-valvular atrial fibrillation.

  1. Stroke in Canon of Medicine

    Science.gov (United States)

    Alorizi, Seyed Morteza Emami; Nimruzi, Majid

    2016-01-01

    Background: Stroke has a huge negative impact on the society and more adversely affect women. There is scarce evidence about any neuroprotective effects of commonly used drug in acute stroke. Bushnell et al. provided a guideline focusing on the risk factors of stroke unique to women, including reproductive factors, metabolic syndrome, obesity, atrial fibrillation, and migraine with aura. The ten variables cited by Avicenna in Canon of Medicine would compensate for the gaps mentioned in this guideline. The prescribed drugs should be selected qualitatively opposite to Mizaj (warm-cold and wet-dry qualities induced by disease state) of the disease and according to ten variables, including the nature of the affected organ, intensity of disease, sex, age, habit, season, place of living, occupation, stamina and physical status. Methods: Information related to stroke was searched in Canon of Medicine, which is an outstanding book in traditional Persian medicine written by Avicenna. Results: A hemorrhagic stroke is the result of increasing sanguine humor in the body. Sanguine has warm-wet quality, and should be treated with food and drugs that quench the abundance of blood in the body. An acute episode of ischemic stroke is due to the abundance of phlegm that causes a blockage in the cerebral vessels. Phlegm has cold-wet quality and treatment should be started with compound medicines that either solve the phlegm or eject it from the body. Conclusion: Avicenna has cited in Canon of Medicine that women have cold and wet temperament compared to men. For this reason, they are more prone to accumulation of phlegm in their body organs including the liver, joints and vessels, and consequently in the risk of fatty liver, degenerative joint disease, atherosclerosis, and stroke especially the ischemic one. This is in accordance with epidemiological studies that showed higher rate of ischemic stroke in women rather than hemorrhagic one. PMID:26722147

  2. Protein consumptions in stroke patients

    Directory of Open Access Journals (Sweden)

    Zahra Maghsoudi

    2013-01-01

    Full Text Available Background : Stroke is one of the most common causes of disabilities and death all over the world. The mortality rate of stroke is predicted to be doubled by 2030 in the Middle East countries. Nutrition is an effective strategy in prevention and management of stroke. This study assessed the relationship between various protein types and stroke risk. Materials and Methods: This hospital-based case-control study was performed in a University hospital. The data regarding consumption of usual food intake of 69 cases (46 men and 23 women and 60 controls (30 men and 30 women was collected with a food frequency questionnaire (FFQ. The mean consumption of red and white meat and vegetable and processed proteins consumption were compared between two groups. Results: The percent of total of daily protein intake were lower in patients with stroke in both sexes (25.92% vs 30.55% in men and 30.7% vs 31.14% in women. Conclusion: Lower protein consumption may be observed in patients with stroke patients in both sex.

  3. Vertical market participation

    DEFF Research Database (Denmark)

    Schrader, Alexander; Martin, Stephen

    1998-01-01

    Firms that operate at both levels of vertically related Cournot oligopolies will purchase some input supplies from independent rivals, even though they can produce the good at a lower cost, driving up input price for nonintegrated firms at the final good level. Foreclosure, which avoids this stra...

  4. Fatigue after Stroke: The Patient's Perspective

    Directory of Open Access Journals (Sweden)

    Victoria Louise Barbour

    2012-01-01

    Full Text Available Background. Fatigue after stroke is common and distressing to patients. Aims. Our aims were to explore patients' perceptions of post-stroke fatigue, including the causes of fatigue and the factors that alleviate fatigue, in a mixed methods study. Results. We interviewed 15 patients who had had a stroke and were inpatients on stroke rehabilitation wards. A substantial proportion of patients reported that their fatigue started at the time of their stroke. Various different factors were reported to improve fatigue, including exercise, good sleep, rehabilitation and rest. Fatigue influences patients' sense of “control” after their stroke. Conclusion. Our results are consistent with the possibility that poststroke fatigue might be triggered by factors that occur at the time of the stroke (e.g., the stroke lesion itself, or admission to hospital and then exacerbated by poor sleep and boredom. These factors should be considered when developing complex interventions to improve post-stroke fatigue.

  5. Stroke injury, cognitive impairment and vascular dementia.

    Science.gov (United States)

    Kalaria, Raj N; Akinyemi, Rufus; Ihara, Masafumi

    2016-05-01

    The global burden of ischaemic strokes is almost 4-fold greater than haemorrhagic strokes. Current evidence suggests that 25-30% of ischaemic stroke survivors develop immediate or delayed vascular cognitive impairment (VCI) or vascular dementia (VaD). Dementia after stroke injury may encompass all types of cognitive disorders. States of cognitive dysfunction before the index stroke are described under the umbrella of pre-stroke dementia, which may entail vascular changes as well as insidious neurodegenerative processes. Risk factors for cognitive impairment and dementia after stroke are multifactorial including older age, family history, genetic variants, low educational status, vascular comorbidities, prior transient ischaemic attack or recurrent stroke and depressive illness. Neuroimaging determinants of dementia after stroke comprise silent brain infarcts, white matter changes, lacunar infarcts and medial temporal lobe atrophy. Until recently, the neuropathology of dementia after stroke was poorly defined. Most of post-stroke dementia is consistent with VaD involving multiple substrates. Microinfarction, microvascular changes related to blood-brain barrier damage, focal neuronal atrophy and low burden of co-existing neurodegenerative pathology appear key substrates of dementia after stroke injury. The elucidation of mechanisms of dementia after stroke injury will enable establishment of effective strategy for symptomatic relief and prevention. Controlling vascular disease risk factors is essential to reduce the burden of cognitive dysfunction after stroke. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock. PMID:26806700

  6. Stroke injury, cognitive impairment and vascular dementia☆

    Science.gov (United States)

    Kalaria, Raj N.; Akinyemi, Rufus; Ihara, Masafumi

    2016-01-01

    The global burden of ischaemic strokes is almost 4-fold greater than haemorrhagic strokes. Current evidence suggests that 25–30% of ischaemic stroke survivors develop immediate or delayed vascular cognitive impairment (VCI) or vascular dementia (VaD). Dementia after stroke injury may encompass all types of cognitive disorders. States of cognitive dysfunction before the index stroke are described under the umbrella of pre-stroke dementia, which may entail vascular changes as well as insidious neurodegenerative processes. Risk factors for cognitive impairment and dementia after stroke are multifactorial including older age, family history, genetic variants, low educational status, vascular comorbidities, prior transient ischaemic attack or recurrent stroke and depressive illness. Neuroimaging determinants of dementia after stroke comprise silent brain infarcts, white matter changes, lacunar infarcts and medial temporal lobe atrophy. Until recently, the neuropathology of dementia after stroke was poorly defined. Most of post-stroke dementia is consistent with VaD involving multiple substrates. Microinfarction, microvascular changes related to blood–brain barrier damage, focal neuronal atrophy and low burden of co-existing neurodegenerative pathology appear key substrates of dementia after stroke injury. The elucidation of mechanisms of dementia after stroke injury will enable establishment of effective strategy for symptomatic relief and prevention. Controlling vascular disease risk factors is essential to reduce the burden of cognitive dysfunction after stroke. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock. PMID:26806700

  7. [MR investigations in stroke].

    Science.gov (United States)

    Kenéz, József; Barsi, Péter

    2002-03-20

    In the article digital imaging methods are presented with special emphasis on the use on diagnostics of cerebral circulation studies. Recently, fundamental changes have happened in this field, concerning especially the MR investigations. These changes have influenced the therapeutic strategies of ischaemic stroke. Authors give the theoretical background on the diffusion and perfusion MR imaging, emphasising the importance of their "mismatch" and its impact in the estimation of the outcome of ischaemic events. More recently, new, controversial facts arose, regarding the reasons of the introduction of the theory of so called "negative" and "positive" mismatches. As a consequence, a level of uncertainty took place in the judgement of prognostics. The leading institutions are searching the way to solve the problem which seems to be the quantitative evaluation of the diffusion, perfusion and mismatch data. The advent of the multislice spiral CT with very fast imaging and the importance of CT investigations increased. With this new kind of equipment, even perfusion studies can be performed using iodinated contrast medium.

  8. Sonification as a possible stroke rehabilitation strategy.

    Science.gov (United States)

    Scholz, Daniel S; Wu, Liming; Pirzer, Jonas; Schneider, Johann; Rollnik, Jens D; Großbach, Michael; Altenmüller, Eckart O

    2014-01-01

    Despite cerebral stroke being one of the main causes of acquired impairments of motor skills worldwide, well-established therapies to improve motor functions are sparse. Recently, attempts have been made to improve gross motor rehabilitation by mapping patient movements to sound, termed sonification. Sonification provides additional sensory input, supplementing impaired proprioception. However, to date no established sonification-supported rehabilitation protocol strategy exists. In order to examine and validate the effectiveness of sonification in stroke rehabilitation, we developed a computer program, termed "SonicPointer": Participants' computer mouse movements were sonified in real-time with complex tones. Tone characteristics were derived from an invisible parameter mapping, overlaid on the computer screen. The parameters were: tone pitch and tone brightness. One parameter varied along the x, the other along the y axis. The order of parameter assignment to axes was balanced in two blocks between subjects so that each participant performed under both conditions. Subjects were naive to the overlaid parameter mappings and its change between blocks. In each trial a target tone was presented and subjects were instructed to indicate its origin with respect to the overlaid parameter mappings on the screen as quickly and accurately as possible with a mouse click. Twenty-six elderly healthy participants were tested. Required time and two-dimensional accuracy were recorded. Trial duration times and learning curves were derived. We hypothesized that subjects performed in one of the two parameter-to-axis-mappings better, indicating the most natural sonification. Generally, subjects' localizing performance was better on the pitch axis as compared to the brightness axis. Furthermore, the learning curves were steepest when pitch was mapped onto the vertical and brightness onto the horizontal axis. This seems to be the optimal constellation for this two

  9. Gender differences in acute stroke: Istanbul medical school stroke registry

    Directory of Open Access Journals (Sweden)

    Nilüfer Yesilot

    2011-01-01

    Full Text Available Background : We aimed to investigate gender differences in Turkish stroke patients. Material and Methods : Demographics, risk factors, clinical and etiologic subtypes, laboratory findings, clinical course, and in-hospital prognosis of 1 522 patients with ischemic stroke (IS and 320 patients with intracerebral hemorrhage prospectively registered in the Istanbul Medical School Stroke Registry (1994-2004 were analyzed separately. Results : The mean age of IS patients was higher in females (n : 751 (P<0.0001. In males, smoking, ischemic heart disease, peripheral arterial disease, posterior circulation syndromes, and strokes due to large-artery atherosclerosis were more common (P<0.0001 for each. Prestroke disability, atrial fibrillation (P<0.0001, hypertension (P=0.041, modified Rankin Scale (mRS 3-5 at admission (P<0.0001, total anterior circulation syndrome (P<0.0001, and cardioembolic stroke (P<0.0001 were more frequent in females. Female gender was an independent predictor of poor outcome (mRS 3-6. Conclusion : Gender differences were observed exclusively in patients with IS. Although our patients were younger than those reported, gender differences were similar.

  10. Study and Analysis of Six Stroke Engine

    Directory of Open Access Journals (Sweden)

    B. Ramya

    2014-09-01

    Full Text Available Six Stroke engine, the name itself indicates a cycle of six strokes out of which two are useful power strokes. According to its mechanical design, the six-stroke engine with external and internal combustion and double flow is similar to the actual internal reciprocating combustion engine. However, it differentiates itself entirely, due to its thermodynamic cycle and a modified cylinder head with two supplementary chambers: combustion and an air heating chamber, both independent from the cylinder. In this the cylinder and the combustion chamber are separated which gives more freedom for design analysis. In addition to the two valves in the four stroke engine two more valves are incorporated which are operated by a piston arrangement. The Six Stroke is thermodynamically more efficient because the change in volume of the power stroke is greater than the intake stroke and the compression stroke. The main advantages of six stroke engine includes reduction in fuel consumption by 40%, two power strokes in the six stroke cycle, dramatic reduction in pollution, adaptability to multi fuel operation. Six stroke engine’s adoption by the automobile industry would have a tremendous impact on the environment and world economy .

  11. Dynamic Flight Stability of a Model Hoverfly in Inclined-Stroke-Plane Hovering

    Institute of Scientific and Technical Information of China (English)

    Xiaolei Mou; Mao Sun

    2012-01-01

    Most hovering insects flap their wings in a horizontal plane,called ‘normal hovering'.But some of the best hoverers,e.g.true hoverflies,hover with an inclined stroke plane.In the present paper,the longitudinal dynamic flight stability of a model hoverfly in inclined-stroke-plane hovering was studied.Computational fluid dynamics was used to compute the aerodynamic derivatives and the eigenvalue and eigenvector analysis was used to solve the equations of motion.The primary findings are as follows.(1) For inclined-stroke-plane hovering,the same three natural modes of motion as those for normal hovering were identified:one unstable oscillatory mode,one stable fast subsidence mode,and one stable slow subsidence mode.The unstable oscillatory mode and the fast subsidence mode mainly have horizontal translation and pitch rotation,and the slow subsidence mode mainly has vertical translation.(2) Because of the existence of the unstable oscillatory mode,inclined-stroke-plane hovering flight is not stable.(3) Although there are large differences in stroke plane and body orientations between the inclined-stroke-plane hovering and normal hovering,the relative position between the mean center of pressure and center of mass for these two cases is not very different,resulting in similar stability derivatives,hence similar dynamic stability properties for these two types of hovering.

  12. Patent Foramen Ovale and Stroke.

    Science.gov (United States)

    Sun, Yee-Ping; Homma, Shunichi

    2016-07-25

    A patent foramen ovale (PFO) is common and found in nearly 25% of healthy individuals. The majority of patients with PFO remain asymptomatic and they are not at increased risk for developing a stroke. The presence of PFO, however, has been found to be higher in patients with cryptogenic stroke, suggesting there may be a subset of patients with PFO who are indeed at risk for stroke. Paradoxical embolization of venous thrombi through the PFO, which then enter the arterial circulation, is hypothesized to account for this relationship. Although aerated-saline transesophageal echocardiography is the gold standard for diagnosis, aerated-saline transthoracic echocardiography and transcranial Doppler are often used as the initial diagnostic tests for detecting PFO. Patients with cryptogenic stroke and PFO are generally treated with antiplatelet therapy in the absence of another condition for which anticoagulation is necessary. Based on the findings of 3 large randomized clinical trials, current consensus guidelines do not recommend percutaneous closure, though this is an area of controversy. The following review discusses the relationship of PFO and cryptogenic stroke, focusing on the epidemiology, pathophysiological mechanisms, diagnostic tools, associated clinical/anatomic factors and treatment. (Circ J 2016; 80: 1665-1673). PMID:27334127

  13. Sensory syndromes in parietal stroke.

    Science.gov (United States)

    Bassetti, C; Bogousslavsky, J; Regli, F

    1993-10-01

    We studied 20 patients with an acute parietal stroke with hemisensory disturbances but no visual field deficit and no or only slight motor weakness, without thalamic involvement on CT or MRI and found three main sensory syndromes. (1) The pseudothalamic sensory syndrome consists of a faciobrachiocrural impairment of elementary sensation (touch, pain, temperature, vibration). All patients have an inferior-anterior parietal stroke involving the parietal operculum, posterior insula, and, in all but one patient, underlying white matter. (2) The cortical sensory syndrome consists of an isolated loss of discriminative sensation (stereognosis, graphesthesia, position sense) involving one or two parts of the body. These patients show a superior-posterior parietal stroke. (3) The atypical sensory syndrome consists of a sensory loss involving all modalities of sensation in a partial distribution. Parietal lesions of different topography are responsible for this clinical picture, which probably represents a minor variant of the two previous sensory syndromes. Neuropsychological dysfunction was present in 17 patients. The only constant association was between conduction aphasia and right-sided pseudothalamic sensory deficit. We conclude that parietal stroke can cause different sensory syndromes depending on the topography of the underlying lesion. Sensory deficits can be monosymptomatic but never present as a "pure sensory stroke" involving face, arm, leg, and trunk together.

  14. [Falls in patients with stroke].

    Science.gov (United States)

    Aizen, Efraim

    2014-01-01

    Falls are the most common medical complication during the post-stroke period. Falls are of great concern in this population in particular because of their severe consequences. Stroke survivors have an increased frequency of hip fracture and psychosocial problems such as fear of falling. The most important risk factors for falls in these patients are balance and gait deficits. Balance deficits in post-stroke patients entail reduced postural stability during standing and disturbed responses to self-induced and external balance perturbations. Gait deficits in post-stroke patients involve reduced propulsion at push-off, disturbed hip and knee flexion in the swing phase and disturbed stability in the stance phase. Beneficial effects can be expected from fall prevention programs targeting these deficits. The few studies that have evaluated the efficacy of task-oriented exercises have shown that these programs are the most promising in preventing falls in post-stroke patients. Technological advances in assistive devices also have potential for fall reduction. Larger randomized controlled trials are needed to provide more conclusive evidence. PMID:24791565

  15. [New aspects of stroke medicine].

    Science.gov (United States)

    Diener, H C; Frank, B; Hajjar, K; Weimar, C

    2014-08-01

    Systemic thrombolysis with recombinant tissue-type plasminogen activator (rt-PA) remains the only effective and approved medical treatment of acute ischemic stroke. Several studies have demonstrated the importance of rapid recanalization. The efficacy of thrombectomy has so far not been sufficiently shown in randomized clinical trials; therefore, inclusion of suitable patients in one of the currently ongoing randomized trials is of great importance. The early treatment with magnesium after acute ischemic stroke during the pre-hospital phase did not prove to be neuroprotective. Intermittent pneumatic compression of the lower extremities in immobilized stroke patients effectively prevents deep venous thrombosis and pulmonary embolism. In patients with lacunar stroke the combination of aspirin and clopidogrel is not superior to aspirin alone and causes more bleeding complications. The novel oral anticoagulants are superior to warfarin in secondary prevention and carry a lower risk of intracranial and systemic bleeding complications. New studies will investigate whether dabigatran or rivaroxaban are superior to aspirin in secondary prevention after cryptogenic stroke. PMID:24969949

  16. Aspirin After Mini-Stroke May Help Prevent Full-Blown Stroke

    Science.gov (United States)

    ... gov/news/fullstory_158939.html Aspirin After Mini-Stroke May Help Prevent Full-Blown Stroke Study finds risk is reduced by as much ... HealthDay News) -- Taking aspirin immediately after a mini-stroke significantly reduces the risk of a major stroke, ...

  17. Stroke Survivors Often Struggle with Depression

    Science.gov (United States)

    ... fullstory_160835.html Stroke Survivors Often Struggle With Depression Risk was 8 times higher for those who ... Stroke survivors face an increased risk of developing depression, a new study suggests. In the first three ...

  18. Sleep Apnea and Heart Disease, Stroke

    Science.gov (United States)

    ... Pressure High Blood Pressure Tools & Resources Stroke More Sleep Apnea and Heart Disease, Stroke Updated:Sep 16, ... be life-threatening. It’s a condition known as sleep apnea, in which the person may experience pauses ...

  19. Flu and Heart Disease and Stroke

    Science.gov (United States)

    ... What's this? Submit Button Past Newsletters Flu and Heart Disease & Stroke Language: English Español Recommend on Facebook Tweet Share Compartir People with Heart Disease* and Those Who Have Had a Stroke Are ...

  20. What Are Heart Disease and Stroke?

    Science.gov (United States)

    ... Blood Pressure Tools & Resources Stroke More What Are Heart Disease and Stroke? Updated:Dec 8,2015 There are ... include: High blood pressure Smoking Diabetes High cholesterol Heart disease Atrial fibrillation (Abnormal heart rhythm) Call 9-1- ...

  1. Anemia Boosts Stroke Death Risk, Study Finds

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_160476.html Anemia Boosts Stroke Death Risk, Study Finds Blood condition ... 2016 (HealthDay News) -- Older stroke victims suffering from anemia -- a lack of red blood cells -- may have ...

  2. African-Americans and Heart Disease, Stroke

    Science.gov (United States)

    ... Pressure High Blood Pressure Tools & Resources Stroke More African-Americans and Heart Disease, Stroke Updated:Apr 18, ... of getting those diseases are even higher for African-Americans. The good news is, African-Americans can ...

  3. Stroke Rehabilitation: What Research is Being Done?

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Stroke Rehabilitation What Research is Being Done? Past Issues / ... Table of Contents To Find Out More MedlinePlus: Stroke Rehabilitation medlineplus.gov/strokerehabilitation.html National Institute of ...

  4. FastStats: Cerebrovascular Disease or Stroke

    Science.gov (United States)

    ... this? Submit Button NCHS Home Cerebrovascular Disease or Stroke Recommend on Facebook Tweet Share Compartir Data are ... Morbidity Number of adults who ever had a stroke: 6.3 million Percent of adults who ever ...

  5. Professionals' views on interprofessional stroke team functioning

    NARCIS (Netherlands)

    J.M. Cramm (Jane); A.P. Nieboer (Anna)

    2011-01-01

    markdownabstractIntroduction: The quality of integrated stroke care depends on smooth team functioning but professionals may not always work well together. Professionals’ perspectives on the factors that influence stroke team functioning remain largely unexamined. Understanding their e

  6. Air Pollution and Heart Disease, Stroke

    Science.gov (United States)

    ... High Blood Pressure Tools & Resources Stroke More Air Pollution and Heart Disease, Stroke Updated:Aug 30,2016 ... routine or in a less populated place, tiny pollution particles in the air can lead to big ...

  7. Strokes in young adults: epidemiology and prevention

    OpenAIRE

    Smajlović D

    2015-01-01

    Dževdet Smajlović Department of Neurology, University Clinical Centre Tuzla, School of Medicine, University of Tuzla, Bosnia and Herzegovina Abstract: Strokes in young adults are reported as being uncommon, comprising 10%–15% of all stroke patients. However, compared with stroke in older adults, stroke in the young has a disproportionately large economic impact by leaving victims disabled before their most productive years. Recent publications report an increased incidence of str...

  8. Autoimmune Responses to Brain Following Stroke

    OpenAIRE

    Becker, Kyra

    2012-01-01

    This review provides a synthesis of the work done by our laboratory that demonstrates the presence of cellular immune responses directed towards brain antigens in animals following experimental stroke as well as in patients following ischemic stroke. These responses include both antigenspecific Th1(+) responses, which are associated with worse stroke outcome, and antigen-specific Treg responses, which are associated with better stroke outcome. The likelihood of developing a detrimental Th1(+)...

  9. Recognition of tennis strokes using key postures

    OpenAIRE

    Connaghan, Damien; Ó Conaire, Ciarán; Kelly, Philip; O''Connor, Noel E.

    2010-01-01

    In this paper we describe an approach for automatic recognition of tennis strokes using a single low cost camera. Professional tennis is played at high speed so the ability to classify tennis strokes on camera is hindered by the rapid movement of the players. We have developed an accurate recognition system which can automatically index tennis strokes from video footage. We aim to evolve this system so that meta data, such as time codes and descriptions of the strokes played, can be automatic...

  10. Prehospital care of the acute stroke patient.

    Science.gov (United States)

    Rajajee, Venkatakrishna; Saver, Jeffrey

    2005-06-01

    Emergency medical services (EMS) is the first medical contact for most acute stroke patients, thereby playing a pivotal role in the identification and treatment of acute cerebrovascular brain injury. The benefit of thrombolysis and interventional therapies for acute ischemic stroke is highly time dependent, making rapid and effective EMS response of critical importance. In addition, the general public has suboptimal knowledge about stroke warning signs and the importance of activating the EMS system. In the past, the ability of EMS dispatchers to recognize stroke calls has been documented to be poor. Reliable stroke identification in the field enables appropriate treatment to be initiated in the field and potentially inappropriate treatment avoided; the receiving hospital to be prenotified of a stroke patient's imminent arrival, rapid transport to be initiated; and stroke patients to be diverted to stroke-capable receiving hospitals. In this article we discuss research studies and educational programs aimed at improving stroke recognition by EMS dispatchers, prehospital personnel, and emergency department (ED) physicians and how this has impacted stroke treatment. In addition public educational programs and importance of community awareness of stroke symptoms will be discussed. For example, general public's utilization of 911 system for stroke victims has been limited in the past. However, it has been repeatedly shown that utilization of the 911 system is associated with accelerated arrival times to the ED, crucial to timely treatment of stroke patients. Finally, improved stroke recognition in the field has led investigators to study in the field treatment of stroke patients with neuroprotective agents. The potential impact of this on future of stroke treatment will be discussed. PMID:16194754

  11. Stroke survivors' experiences of rehabilitation

    DEFF Research Database (Denmark)

    Peoples, Hanne; Satink, Ton; Steultjens, Esther

    2011-01-01

    INTRODUCTION: The aim was to obtain the best available knowledge on stroke survivors' experiences of rehabilitation. The increase in demands for accountability in health care and acknowledgement of the importance of client participation in health decisions calls for systematic ways of integrating...... needs, 3) Physical and non-physical needs, 4) Being personally valued and treated with respect, 5) Collaboration with health care professionals and 6) Assuming responsibility and seizing control. DISCUSSION: The synthesis showed that stroke survivors' experiences of rehabilitation reflected individual...... this perspective. METHODS AND MATERIALS: A systematic review of qualitative studies was performed. A literature search in MEDLINE, CINAHL, PsycINFO, and EMBASE was conducted. Suitability for inclusion was based on selected criteria: published qualitative studies written in English from 1990 to 2008 on stroke...

  12. Fabry disease and early stroke

    DEFF Research Database (Denmark)

    Feldt-Rasmussen, U

    2011-01-01

    Fabry disease, an X-linked lysosomal storage disorder, results from deficient activity of the enzyme a-galactosidase A. Affected males with the classic phoenotype have acroparaesthesias, hypohidrosis, and corneal opacities in childhood and develop renal failure, cardiac hypertrophy or strokes...... in the third to fifth decade of life. Some female heterozygotes are asymptomatic, some as severely affected as males. The natural history of Fabry patients includes transitory cerebral ischaemia and strokes, even in very young persons of both genders. The mechanism is partly due to vascular endothelial...... accumulation of GL-3. White matter lesions on MRI occur. Both males and females can be safely treated with enzyme replacement; and thus screening for Fabry disease of young stroke populations should be considered. There are, however, no hard data of treatment effect on mortality and morbidity. The analyses...

  13. Fabry disease and early stroke

    DEFF Research Database (Denmark)

    Feldt-Rasmussen, U

    2011-01-01

    Fabry disease, an X-linked lysosomal storage disorder, results from deficient activity of the enzyme α-galactosidase A. Affected males with the classic phoenotype have acroparaesthesias, hypohidrosis, and corneal opacities in childhood and develop renal failure, cardiac hypertrophy or strokes...... in the third to fifth decade of life. Some female heterozygotes are asymptomatic, some as severely affected as males. The natural history of Fabry patients includes transitory cerebral ischaemia and strokes, even in very young persons of both genders. The mechanism is partly due to vascular endothelial...... accumulation of GL-3. White matter lesions on MRI occur. Both males and females can be safely treated with enzyme replacement; and thus screening for Fabry disease of young stroke populations should be considered. There are, however, no hard data of treatment effect on mortality and morbidity. The analyses...

  14. Stroke Prevention in Atrial Fibrillation

    DEFF Research Database (Denmark)

    Massaro, Ayrton R; Lip, Gregory Y.H.

    2016-01-01

    Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, with an estimated prevalence of 1-2% in North America and Europe. The increased prevalence of AF in Latin America is associated with an ageing general population, along with poor control of key risk factors, including...... hypertension. As a result, stroke prevalence and associated mortality have increased dramatically in the region. Therefore, the need for effective anticoagulation strategies in Latin America is clear. The aim of this review is to provide a contemporary overview of anticoagulants for stroke prevention. The use...... of vitamin K antagonists (VKAs, eg, warfarin) and aspirin in the prevention of stroke in patients with AF in Latin America remains common, although around one fifth of all AF patients receive no anticoagulation. Warfarin use is complicated by a lack of access to effective monitoring services coupled...

  15. Multisensory stimulation in stroke rehabilitation

    Directory of Open Access Journals (Sweden)

    Barbro Birgitta Johansson

    2012-04-01

    Full Text Available The brain has a large capacity for automatic simultaneous processing and integration of sensory information. Combining information from different sensory modalities facilitates our ability to detect, discriminate, and recognize sensory stimuli, and learning is often optimal in a multisensory environment. Currently used multisensory stimulation methods in stroke rehabilitation include motor imagery, action observation, training with a mirror or in a virtual environment, or various kinds of music therapy. Several studies have shown positive effects been reported but to give general recommendation more studies are needed. Patient heterogeneity and the interactions of age, gender, genes and environment are discussed. Randomized controlled longitudinal trials starting earlier post stroke are needed. The advance in brain network science and neuroimaging enabling longitudinal studies of structural and functional networks are likely to have an important impact on patient selection for specific interventions in future stroke rehabilitation.

  16. The Brine Shrimp's Butterfly Stroke

    CERN Document Server

    Johnson, Brennan; Dasi, Lakshmi Prasad

    2011-01-01

    We investigate the fluid dynamics of brine shrimp larvae swimming in this gallery of fluid motion video. Time resolved particle image velocimetry was performed using nano-particles as seeding material to measure the time dependent velocity and vorticity fields. The Reynolds number of the flow was roughly 8 and the Womerseley number (ratio of periodic forcing to viscous forcing) was about 5. Vorticity dynamics reveals the formation of a vortex ring structure at the tip of each arm at the beginning of the power stroke. This two vortex system evolves dramatically with time as the stroke progresses. The outer circulation is noted to weaken while the inner circulation strengthens over the power stroke. The gaining strength of the inner vortex correlates with the acceleration and forward movement of the larvae.

  17. Visual attention in posterior stroke

    DEFF Research Database (Denmark)

    Fabricius, Charlotte; Petersen, Anders; Iversen, Helle K;

    Objective: Impaired visual attention is common following strokes in the territory of the middle cerebral artery, particularly in the right hemisphere. However, attentional effects of more posterior lesions are less clear. The aim of this study was to characterize visual processing speed...... and apprehension span following posterior cerebral artery (PCA) stroke. We also relate these attentional parameters to visual word recognition, as previous studies have suggested that reduced visual speed and span may explain pure alexia. Methods: Nine patients with MR-verified focal lesions in the PCA......-territory (four left PCA; four right PCA; one bilateral, all >1 year post stroke) were compared to 25 controls using single case statistics. Visual attention was characterized by a whole report paradigm allowing for hemifield-specific speed and span measurements. We also characterized visual field defects...

  18. Trade elasticity and vertical specialisation

    OpenAIRE

    Ines Buono; Filippo Vergara Caffarelli

    2013-01-01

    This paper shows that vertical specialisation can increase the elasticity of trade to income, hence explaining dramatic events such as the great trade collapse. We argue that a change in the extent of vertical specialisation affects the elasticity of trade to income, while a mere change in global production levels for a given extent of vertical specialisation does not. In the model we show that only large demand shocks induce firms to vary the extent of vertical specialisation. Using panel da...

  19. Atrial fibrillation and stroke: epidemiology.

    Science.gov (United States)

    Reiffel, James A

    2014-04-01

    The statistics for AFib are impressive. (online video available at: http://education.amjmed.com/video.php?event_id=445&stage_id=5&vcs=1). The principal risk with AFib, stroke or thrombotic embolism, is increased 5-fold in some series; AFib accounts for ≥15% of all strokes in the United States, 36% of strokes for individuals aged >80, and up to 20% of cryptogenic strokes, which means >100,000-125,000 embolic strokes per year, of which >20% are fatal. Patients with ischemic stroke and AFib are significantly (PPrevention of these thromboembolic outcomes requires prophylactic anticoagulation therapy. The "gold standard" for anticoagulation has been warfarin, despite its well-known side effects and adherence challenges for patients. The recent approvals of several new, novel oral anticoagulation (NOAC) agents, however, presents physicians with a benefit/risk profile that represents an important advance over warfarin prophylaxis. The principal risk with all oral anticoagulants is bleeding. An important misconception about warfarin is that if anticoagulated patients bleed, the risk can be quickly reversed, but most trial experience has found that warfarin reversal requires 24 hours to halve the INR value. Reversal of anticoagulation with the NOACs is unproven at present; possible approaches are presented in this review, but since the NOACs have both rapid onsets of action and short biologic half-lives, they do not present the same reversal challenges as warfarin. Finally, physicians must be aware of thromboembolic risk assessment. The principal risk assessment scores are CHADS2, updated with the more recent CHA2DS2-VASc to provide more accurate assessment of low-risk patients; this review concludes with a novel flow-chart showing physicians how the CHADS2/CHA2DS2-VASc scoring systems can be used. PMID:24655742

  20. Stroke Prevention Trials in Sickle Cell Anemia

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2006-06-01

    Full Text Available As part of an International Pediatric Stroke Study launched in 2002, the Stroke Prevention Trial in Sickle Cell Anemia (STOP reports a reduction in the number of overt clinical strokes in children with critically high transcranial Doppler velocities (>200 cm/sec who were regularly transfused.

  1. Epidemiology of childhood stroke in Estonia.

    Science.gov (United States)

    Laugesaar, Rael; Kolk, Anneli; Uustalu, Ulle; Ilves, Pilvi; Tomberg, Tiiu; Talvik, Inga; Köbas, Kristel; Sander, Valentin; Talvik, Tiina

    2010-02-01

    We investigated the incidence and 30-day case-fatality of childhood stroke in Estonia, and clinical signs and risk factors of childhood stroke. A retrospective (1995-2003) and prospective study (2004-2006) of childhood stroke (arterial ischemic, hemorrhagic, and sinovenous thrombosis) and transient ischemic attack was conducted. Stroke-incidence calculation was based on the prospective study. Clinical diagnoses of stroke were confirmed by neuroradiology. The incidence rate of childhood stroke in Estonia was 2.73/100,000 person-years for children aged 30 days to 18 years: 1.61/100,000 for arterial ischemic stroke, 0.87/100,000 for hemorrhagic stroke, 0.25/100,000 for sinovenous thrombosis, and 0.37/100,000 for transient ischemic attack. No arterial ischemic stroke patients died within 30 days, but case-fatality for intracerebral hemorrhage was 46%. Focal signs occurred in 100% of arterial ischemic strokes and 64% of intracerebral hemorrhage cases. Risk factors were identified in 35/48 (73%) children with cerebrovascular attacks. Six children with arterial ischemic stroke (6/24, 25%) manifested more than one risk factor. The incidence rate of childhood stroke in Estonia is similar to that in earlier data.

  2. Genetic and Hemostatic Risk Factors for Stroke

    NARCIS (Netherlands)

    E.G. van den Herik (Evita)

    2011-01-01

    textabstractCardiovascular disorders are the main causes of death worldwide, with stroke accounting for 9-10% of all deaths1,2. Moreover, stroke is the most frequent cause of disability in the western world3. In the Netherlands alone, over 39,000 persons are admitted to hospitals with stroke each ye

  3. Family history and stroke outcome in a bi-ethnic, population-based stroke surveillance study

    Directory of Open Access Journals (Sweden)

    Uchino Ken

    2005-10-01

    Full Text Available Background The genetic epidemiology of ischemic stroke remains relatively unstudied, and information about the genetic epidemiology of ischemic stroke in populations with significant minority representation is currently unavailable. Methods The Brain Attack Surveillance in Corpus Christi project (BASIC is a population-based stroke surveillance study conducted in the bi-ethnic community of Nueces County, Texas, USA. Completed ischemic strokes were identified among patients 45 years or older seen at hospitals in the county between January 1, 2000 – December 31, 2002. A random sample of ischemic stroke patients underwent an in-person interview and detailed medical record abstraction (n = 400. Outcomes, including initial stroke severity (NIH stroke scale, age at stroke onset, 90-day mortality and functional outcome (modified Rankin scale ≥2, were studied for their association with family history of stroke among a first degree relative using multivariable logistic and linear regression. A chi-square test was used to test the association between family history of stroke and ischemic stroke subtype. Results The study population was 53.0% Mexican American and 58.4% female. Median age was 73.2 years. Forty percent reported a family history of stroke among a first degree relative. Family history of stroke was borderline significantly associated with stroke subtype (p = 0.0563. Family history was associated with poor functional outcome in the multivariable model (OR = 1.87; 95% CI: 1.14–3.09. Family history was not significantly related to initial stroke severity, age at stroke onset, or 90-day mortality. Conclusion Family history of stroke was related to ischemic stroke subtype and to functional status at discharge. More research is needed to understand whether stroke subtype would be a useful selection criterion for genetic association studies and to hypothesize about a possible genetic link to recovery following ischemic stroke.

  4. CT perfusion in acute stroke

    International Nuclear Information System (INIS)

    Stroke is a heterogeneous syndrome caused by multiple mechanisms, all of which result in disruption of normal cerebral blood flow and thereby cause cerebral dysfunction. Its early diagnosis is important as its treatment is dependent on the time elapsed since ictus. Delay in diagnosis and treatment translates into increase neuronal loss and thereby increased morbidity. CT scan, and in particular perfusion CT, has helped greatly in the early diagnosis of stroke. This article is an endeavor to explain the pathophysiology of cerebral ischemia and the role of CT perfusion in detecting it

  5. Road traffic noise and stroke

    DEFF Research Database (Denmark)

    Sørensen, Mette; Hvidberg, Martin; Andersen, Zorana J;

    2011-01-01

    Epidemiological studies suggest that long-term exposure to road traffic noise increases the risk of cardiovascular disorders. The aim of this study was to investigate the relation between exposure to road traffic noise and risk for stroke, which has not been studied before.......Epidemiological studies suggest that long-term exposure to road traffic noise increases the risk of cardiovascular disorders. The aim of this study was to investigate the relation between exposure to road traffic noise and risk for stroke, which has not been studied before....

  6. Potential blood biomarkers for stroke.

    Science.gov (United States)

    Laborde, Carlos M; Mourino-Alvarez, Laura; Akerstrom, Finn; Padial, Luis R; Vivanco, Fernando; Gil-Dones, Felix; Barderas, Maria G

    2012-08-01

    Stroke is one of the most common causes of death worldwide and a major cause of acquired disability in adults. Despite advances in research during the last decade, prevention and treatment strategies still suffer from significant limitations, and therefore new theoretical and technical approaches are required. Technological advances in the proteomic and metabolomic areas, during recent years, have permitted a more effective search for novel biomarkers and therapeutic targets that may allow for effective risk stratification and early diagnosis with subsequent rapid treatment. This review provides a comprehensive overview of the latest candidate proteins and metabolites proposed as new potential biomarkers in stroke. PMID:22967080

  7. GPS, su datum vertical.

    Directory of Open Access Journals (Sweden)

    Esteban Dörries

    2016-03-01

    Full Text Available La introducción de la metodología GPS en aplicaciones topográficas y geodésicas pone en notoria evidencia la clásica separación de sistemas de referencia en horizontal y vertical. Con GPS el posicionamiento es tridimensional, pero el concepto de altura difiere del clásico. Si se desea utilizar la información altimétrica debe contemplarse la ondulación del geoide.

  8. Lift vs. drag based mechanisms for vertical force production in the smallest flying insects.

    Science.gov (United States)

    Jones, S K; Laurenza, R; Hedrick, T L; Griffith, B E; Miller, L A

    2015-11-01

    We used computational fluid dynamics to determine whether lift- or drag-based mechanisms generate the most vertical force in the flight of the smallest insects. These insects fly at Re on the order of 4-60 where viscous effects are significant. Detailed quantitative data on the wing kinematics of the smallest insects is not available, and as a result both drag- and lift-based strategies have been suggested as the mechanisms by which these insects stay aloft. We used the immersed boundary method to solve the fully-coupled fluid-structure interaction problem of a flexible wing immersed in a two-dimensional viscous fluid to compare three idealized hovering kinematics: a drag-based stroke in the vertical plane, a lift-based stroke in the horizontal plane, and a hybrid stroke on a tilted plane. Our results suggest that at higher Re, a lift-based strategy produces more vertical force than a drag-based strategy. At the Re pertinent to small insect hovering, however, there is little difference in performance between the two strategies. A drag-based mechanism of flight could produce more vertical force than a lift-based mechanism for insects at Re<5; however, we are unaware of active fliers at this scale. PMID:26300066

  9. Lift vs. drag based mechanisms for vertical force production in the smallest flying insects.

    Science.gov (United States)

    Jones, S K; Laurenza, R; Hedrick, T L; Griffith, B E; Miller, L A

    2015-11-01

    We used computational fluid dynamics to determine whether lift- or drag-based mechanisms generate the most vertical force in the flight of the smallest insects. These insects fly at Re on the order of 4-60 where viscous effects are significant. Detailed quantitative data on the wing kinematics of the smallest insects is not available, and as a result both drag- and lift-based strategies have been suggested as the mechanisms by which these insects stay aloft. We used the immersed boundary method to solve the fully-coupled fluid-structure interaction problem of a flexible wing immersed in a two-dimensional viscous fluid to compare three idealized hovering kinematics: a drag-based stroke in the vertical plane, a lift-based stroke in the horizontal plane, and a hybrid stroke on a tilted plane. Our results suggest that at higher Re, a lift-based strategy produces more vertical force than a drag-based strategy. At the Re pertinent to small insect hovering, however, there is little difference in performance between the two strategies. A drag-based mechanism of flight could produce more vertical force than a lift-based mechanism for insects at Re<5; however, we are unaware of active fliers at this scale.

  10. Vertical organic transistors

    International Nuclear Information System (INIS)

    Organic switching devices such as field effect transistors (OFETs) are a key element of future flexible electronic devices. So far, however, a commercial breakthrough has not been achieved because these devices usually lack in switching speed (e.g. for logic applications) and current density (e.g. for display pixel driving). The limited performance is caused by a combination of comparatively low charge carrier mobilities and the large channel length caused by the need for low-cost structuring. Vertical Organic Transistors are a novel technology that has the potential to overcome these limitations of OFETs. Vertical Organic Transistors allow to scale the channel length of organic transistors into the 100 nm regime without cost intensive structuring techniques. Several different approaches have been proposed in literature, which show high output currents, low operation voltages, and comparatively high speed even without sub-μm structuring technologies. In this review, these different approaches are compared and recent progress is highlighted. (topical review)

  11. Recurrent stroke: what have we learnt?

    Science.gov (United States)

    Rabia, K; Khoo, Em

    2007-01-01

    Stroke is the third leading cause of death, a major cause of disability in adults, and is frequently more disabling than fatal. With a decline in mortality from initial cerebral infarction and an increase in the life expectancy of the population, the number of patients with recurrent stroke and ensuing cardiovascular events will become greater. Thus it is important to find out those patients at high risk of stroke recurrence. This case report illustrates the process of recurrent stroke and the resulting disabilities and morbidities in a 42-year- old man. The role of integrated stroke rehabilitation programme is described. PMID:25606084

  12. Sleep-wake disturbances after stroke

    Directory of Open Access Journals (Sweden)

    DENG Li-ying

    2013-06-01

    Full Text Available Sleep-wake disturbances (SWD after stroke is a sleep-wake disorder resulting from central nervous system lesion caused by stroke. SWD includes hypersomnia, excessive daytime sleepiness (EDS, fatigue and so on. The prevalence rate of SWD is only less than sleep-related breathing disturbances (SBD. Recent studies suggest that SWD is frequent and negatively affects rehabilitation and quality of life of patients with stroke, and treatment of poststroke SWD may favorably influence stroke outcome. SWD may become a new target of treatment and rehabilitation of stroke. This paper reviewed the progress of this issue.

  13. Patient Education Among Stroke Survivor Patients

    OpenAIRE

    Martin, Ruth

    2014-01-01

    Stroke is one of the most serious health problems in the world, cited as being the second leading cause of death. After stroke, there is a greater risk of suffering second and further subsequent stroke-events. Given the heavy burden of disease present by stroke, there is a great need to improve patient education for stroke survivors, who are at an increased risk of another cerebrovascular accident. The purpose of this thesis is to develop the quality of patient education in nursing care o...

  14. Post-emergency department management of stroke.

    Science.gov (United States)

    Brown, Devin L; Haley, E Clarke

    2002-08-01

    All stroke patients ideally should be admitted to a stroke unit in which personnel are familiar with strategies for taking care of stroke patients. Prevention of worsening cerebral ischemia by appropriate blood pressure and serum glucose management, fever control, and supplemental oxygen for hypoxemic patients is recommended. Recognition of common complications, such as aspiration pneumonia and deep venous thrombosis, highlights the need for swallowing evaluation and the use of pneumatic compression devices or subcutaneous heparin. Patients should be monitored closely for deterioration in their neurologic status and should have complications appropriately addressed. After evaluation of stroke etiology, appropriate secondary stroke prophylaxis should be selected and initiated before hospital discharge.

  15. Neuroprotection in acute ischemic stroke

    NARCIS (Netherlands)

    De Keyser, Jacques; Uyttenboogaart, Maarten; Koch, Marcus W; Elting, Jan Willem; Sulter, Geert; Vroomen, Patrick C; Luijckx, Gert Jan

    2005-01-01

    Neuroprotection of patients with acute ischemic stroke should start at the scene and continue in the ambulance with the assessment and treatment of the airway, breathing, circulation, body temperature, and blood glucose. The key goal in eligible patients should be fast vessel recanalization with int

  16. Predictors of Perinatal Hemorrhagic Stroke

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2009-04-01

    Full Text Available The prevalence and predictors of perinatal hemorrhagic stroke were determined in a case-control study of infants born from 1993 to 2003 in the Northern California Kaiser Permanente Medical Care Program, Oakland, CA, and reported from the University of California, San Francisco, CA.

  17. Predictors of Perinatal Hemorrhagic Stroke

    OpenAIRE

    J Gordon Millichap

    2009-01-01

    The prevalence and predictors of perinatal hemorrhagic stroke were determined in a case-control study of infants born from 1993 to 2003 in the Northern California Kaiser Permanente Medical Care Program, Oakland, CA, and reported from the University of California, San Francisco, CA.

  18. Sex Hormones and Ischemic Stroke

    DEFF Research Database (Denmark)

    Holmegard, Haya N; Nordestgaard, Børge G; Jensen, Gorm B;

    2016-01-01

    CONTEXT AND OBJECTIVE: Whether endogenous sex hormones are associated with ischemic stroke (IS) is unclear. We tested the hypothesis that extreme concentrations of endogenous sex hormones are associated with risk of IS in the general population. DESIGN, SETTING, AND PARTICIPANTS: Adult men (n...

  19. Sequelae and rehabilitation of stroke.

    Science.gov (United States)

    Ueda, S

    1991-10-01

    During rehabilitation after stroke, evaluation and treatment are carried out for sensorimotor impairments such as hemiplegia or dysphagia, perceptual-cognitive impairments such as unilateral spatial neglect, disabilities such as dependence in activities of daily living, as well as various types of handicaps. Research into these problems is reviewed.

  20. Cortical swallowing processing in early subacute stroke

    Directory of Open Access Journals (Sweden)

    Fischer Maren

    2011-03-01

    Full Text Available Abstract Background Dysphagia is a major complication in hemispheric as well as brainstem stroke patients causing aspiration pneumonia and increased mortality. Little is known about the recovery from dysphagia after stroke. The aim of the present study was to determine the different patterns of cortical swallowing processing in patients with hemispheric and brainstem stroke with and without dysphagia in the early subacute phase. Methods We measured brain activity by mean of whole-head MEG in 37 patients with different stroke localisation 8.2 +/- 4.8 days after stroke to study changes in cortical activation during self-paced swallowing. An age matched group of healthy subjects served as controls. Data were analyzed by means of synthetic aperture magnetometry and group analyses were performed using a permutation test. Results Our results demonstrate strong bilateral reduction of cortical swallowing activation in dysphagic patients with hemispheric stroke. In hemispheric stroke without dysphagia, bilateral activation was found. In the small group of patients with brainstem stroke we observed a reduction of cortical activation and a right hemispheric lateralization. Conclusion Bulbar central pattern generators coordinate the pharyngeal swallowing phase. The observed right hemispheric lateralization in brainstem stroke can therefore be interpreted as acute cortical compensation of subcortically caused dysphagia. The reduction of activation in brainstem stroke patients and dysphagic patients with cortical stroke could be explained in terms of diaschisis.

  1. Sleep-disordered breathing and stroke.

    Science.gov (United States)

    Ali, Latisha K; Avidan, Alon Y

    2008-01-01

    Sleep and stroke have an important and fascinating interaction. Patients with sleep-disordered breathing present with cardiovascular heart disease, cognitive decline, and increased risk of stroke. Stroke adversely affects sleep and factors such as prolonged immobilization, chronic pain, nocturnal hypoxia, and depression, which can also adversely impact sleep quality. Obstructive sleep apnea (OSA), one of the most common and serious sleep disturbances, manifests itself in almost 50% of all stroke patients. Sleep apnea patients who experience a stroke may be at a greater impairment in their rehabilitation potential and have increased risk of secondary stroke and mortality. Given these factors, the practicing neurologist should possess the skills to appropriately recognize, rapidly diagnose, and properly manage stroke patients with OSA.

  2. A systematic approach to the definition of stroke

    OpenAIRE

    Cheung, RTF

    2014-01-01

    The 24-hour time-line for symptomsin the current definition of stroke is arbitrary. Moreover, this definition does not include silent stroke, encourage acute stroke therapy and consider dramatic recovery after successful therapy. Silent stroke, which is five times more common than symptomatic stroke, is a risk factor for future stroke and is associated with adverse neurological and cognitive functions. Whilst pathological confirmation remains the gold standard in defining stroke and its under...

  3. Quality of stroke care at an Irish Regional General Hospital and Stroke Rehabilitation Unit.

    LENUS (Irish Health Repository)

    Walsh, T

    2012-01-31

    BACKGROUND: Robust international data support the effectiveness of stroke unit (SU) care. Despite this, most stroke care in Ireland are provided outside of this setting. Limited data currently exist on the quality of care provided. AIM: The aim of this study is to examine the quality of care for patients with stroke in two care settings-Regional General Hospital (RGH) and Stroke Rehabilitation Unit (SRU). METHODS: A retrospective analysis of the stroke records of consecutive patients admitted to the SRU between May-November 2002 and April-November 2004 was performed applying the UK National Sentinel Audit of Stroke (NSAS) tool. RESULTS: The results of the study reveal that while SRU processes of care was 74% compliant with standards; compliance with stroke service organisational standards was only 15 and 43% in the RGH and SRU, respectively. CONCLUSION: The quality of stroke care in our area is deficient. Comprehensive reorganisation of stroke services is imperative.

  4. Hurdles in stroke thrombolysis: Experience from 100 consecutive ischemic stroke patients

    Directory of Open Access Journals (Sweden)

    Sagar Badachi

    2015-01-01

    Full Text Available Background: Acute management of ischemic stroke involves thrombolysis within 4.5 h. For a successful outcome, early recognition of stroke, transportation to the hospital emergency department immediately after stroke, timely imaging, proper diagnosis, and thrombolysis within 4.5 h is of paramount importance. Aim: To analyze the obstacles for thrombolysis in acute stroke patients. Materials and Methods: The study was conducted in a tertiary care center in South India. A total of hundred consecutive patients of acute ischemic stroke who were not thrombolysed, but otherwise fulfilled the criteria for thrombolysis were evaluated prospectively for various factors that prevented thrombolysis. The constraints to thrombolysis were categorized into: i Failure of patient to recognize stroke symptoms, ii patient′s awareness of thrombolysis as a treatment modality for stroke, iii failure of patient′s relative to recognize stroke, iv failure of primary care physician to recognize stroke, v transport delays, vi lack of neuroimaging and thrombolysis facility, and vii nonaffordability. Results: The biggest hurdle for early hospital presentation is failure of patients to recognize stroke (73%, followed by lack of neuroimaging facility (58%, nonaffordability (56%, failure of patient′s relative to recognize stroke (38%, failure of the primary care physician to recognize stroke (21%, and transport problems (13%. Awareness of thrombolysis as a treatment modality for stroke was seen only in 2%. Conclusion: Considering the urgency of therapeutic measures in acute stroke, there is necessity and room for improvement to overcome various hurdles that prevent thrombolysis.

  5. Direct Observation of Ultralow Vertical Emittance using a Vertical Undulator

    Energy Technology Data Exchange (ETDEWEB)

    Wootton, Kent

    2015-09-17

    In recent work, the first quantitative measurements of electron beam vertical emittance using a vertical undulator were presented, with particular emphasis given to ultralow vertical emittances [K. P. Wootton, et al., Phys. Rev. ST Accel. Beams, 17, 112802 (2014)]. Using this apparatus, a geometric vertical emittance of 0.9 ± 0.3 pm rad has been observed. A critical analysis is given of measurement approaches that were attempted, with particular emphasis on systematic and statistical uncertainties. The method used is explained, compared to other techniques and the applicability of these results to other scenarios discussed.

  6. 5-year survival and rehospitalization due to stroke recurrence among patients with hemorrhagic or ischemic strokes in Singapore

    OpenAIRE

    Sun, Yan; Lee, Sze Haur; Heng, Bee Hoon; Chin, Vivien S

    2013-01-01

    Background Stroke is the 4th leading cause of death and 1st leading cause of disability in Singapore. However the information on long-term post stroke outcomes for Singaporean patients was limited. This study aimed to investigate the post stroke outcomes of 5-year survival and rehospitalization due to stroke recurrence for hemorrhagic and ischemic stroke patients in Singapore. The outcomes were stratified by age, ethnic group, gender and stroke types. The causes of death and stroke recurrence...

  7. Joint dependent passive stiffness in paretic and contralateral limbs of spastic patients with hemiparetic stroke.

    OpenAIRE

    Given, J D; Dewald, J P; Rymer, W Z

    1995-01-01

    Torque-angle relations at the elbow and ankle joints of relaxed normal controls and patients with hemiparetic stroke were compared. Low velocity flexion/hold/extension angular perturbations were applied to the joint under examination. The resulting torque-angle profiles described a hysteresis loop with similar slopes during the extension and flexion stages but separated by a vertical torque offset. Torque-angle responses obtained in the absence of significant muscle activation, as recorded by...

  8. Stroke Statistics in Korea: Part I. Epidemiology and Risk Factors: A Report from the Korean Stroke Society and Clinical Research Center for Stroke

    OpenAIRE

    Hong, Keun-Sik; Bang, Oh Young; Kang, Dong-Wha; Yu, Kyung-Ho; Bae, Hee-Joon; Lee, Jin Soo; Heo, Ji Hoe; Kwon, Sun U.; Oh, Chang Wan; Lee, Byung-Chul; Kim, Jong S.; Yoon, Byung-Woo

    2013-01-01

    The aim of the Part I of Stroke Statistics in Korea is to summarize nationally representative data of the epidemiology and risk factors of stroke in a single document. Every year, approximately 105,000 people experience a new or recurrent stroke and more than 26,000 die of stroke, which indicates that every 5 minutes stroke attacks someone and every 20 minutes stroke kills someone in Korea. Stroke accounts for roughly 1 of every 10 deaths. The estimated stroke prevalence is about 795,000 in p...

  9. Stroke: New Developments and Their Application in Clinical Practice.

    Science.gov (United States)

    Kelly, Peter J; Kavanagh, Eoin; Murphy, Sean

    2016-08-01

    Significant advances have been made in recent years in primary stroke prevention, improved stroke outcomes in high-income populations, emergency stroke therapy, and stroke prevention. In this article, we review recent trends in stroke epidemiology, improvements in delivery of intravenous thrombolysis (via stroke system-wide approaches, application of 'Lean Principles' to improve workflow processes, and re-evaluation of exclusion criteria), recent stroke thrombectomy trials, and new developments in stroke prevention, with emphasis on risk prediction in transient ischemic attack, choice and timing of anticoagulation therapy for secondary stroke prevention, and emerging concepts in risk stratification for management of symptomatic carotid stenosis. PMID:27643898

  10. Acute [corrected] stroke thrombolysis: an update [corrected].

    Science.gov (United States)

    Mehdiratta, Manu; Caplan, Louis R

    2007-01-01

    Acute stroke therapy took a major step forward in 1996 after the approval of Intravenous (IV) tissue plasminogen activator (t-PA) by the US Food and Drug Administration for patients presenting within 3 hours of the onset of stroke symptoms. Since that time, there have been considerable advances in imaging techniques as well as the advent of devices to help in the management of acute stroke patients. As a result, the arsenal to treat acute stroke has grown, and the field of stroke as a subspecialty of neurology has emerged. Despite these advances, only 3% to 8% of eligible patients with acute stroke in the United States are administered thrombolytics.(1) We herein review the use of thrombolytics in stroke and provide an overview of the imaging advances, new devices, and recent trials that are shaping modern stroke therapy. Finally, we provide a practical approach to the management of acute stroke, specifically for the practicing cardiologist, who may encounter stroke during cardiac catheterization, post myocardial infarction (MI), and in a variety of other settings. PMID:17498523

  11. Secondary stroke prevention: challenges and solutions.

    Science.gov (United States)

    Esenwa, Charles; Gutierrez, Jose

    2015-01-01

    Stroke is the leading cause of disability in the USA and a major cause of mortality worldwide. One out of four strokes is recurrent. Secondary stroke prevention starts with deciphering the most likely stroke mechanism. In general, one of the main goals in stroke reduction is to control vascular risk factors such as hypertension, diabetes, dyslipidemia, and smoking cessation. Changes in lifestyle like a healthy diet and aerobic exercise are also recommended strategies. In the case of cardioembolism due to atrial fibrillation, mechanical valves, or cardiac thrombus, anticoagulation is the mainstay of therapy. The role of anticoagulation is less evident in the case of bioprosthetic valves, patent foramen ovale, and dilated cardiomyopathy with low ejection fraction. Strokes due to larger artery atherosclerosis account for approximately a third of all strokes. In the case of symptomatic extracranial carotid stenosis, surgical intervention as close as possible in time to the index event seems highly beneficial. In the case of intracranial large artery atherosclerosis, the best medical therapy consists of antiplatelets, high-dose statins, aggressive controls of vascular risk factors, and lifestyle modifications, with no role for intracranial arterial stenting or angioplasty. For patients with small artery occlusion (ie, lacunar stroke), the therapy is similar to that used in patients with intracranial large artery atherosclerosis. Despite the constant new evidence on how to best treat patients who have suffered a stroke, the risk of stroke recurrence remains unacceptably high, thus evidencing the need for novel therapies. PMID:26300647

  12. Epidemiology of stroke in Shiraz, Iran

    Directory of Open Access Journals (Sweden)

    Babak Daneshfard

    2015-10-01

    Full Text Available Background: Stroke is the main cause of physical disability and the second leading cause of death worldwide. Two-thirds of all strokes occur in the developing countries. Despite being preventable, stroke is increasingly becoming a major health issue in these countries. The aim of this study was to evaluate the epidemiology of stroke in Shiraz, Iran, one of the main referral centers in the southwestern part of Iran.Methods: A cross-sectional study was conducted on all stroke patients admitted to the Namazee Hospital, affiliated to Shiraz University of Medical Sciences, between August 2010 and January 2011. Patients’ demographic data, atherosclerosis risk factors, type of stroke, drug history, outcomes, and neurological signs were recorded. Chi-square test, Kolmogorov–Smirnov test, t-test, and Mann–Whitney U-test were used to analyze the data.Results: A total of 305 patients with stroke, aged 27-97 years (mean ± SD = 68.33 ± 12.99, 269 patients (88.2% had ischemic stroke (IS and 36 (11.8% had hemorrhagic stroke (HS. 133 patients (43.6% were men and 172 (56.4% were women. 11.4% of the patients with IS and 40.6% with HS died during hospitalization, causing 12.1% death in all stroke patients [Odds ratio (Or = 5.34, 95% Confidence intervals (CI = 2.35-12.11]. Hypertension, ischemic heart disease, diabetes, and recurrent stroke were the most common risk factors.Conclusion: This study provides evidence that the epidemiology of stroke in the southwestern part of Iran may be similar to other places. However, it seems necessary and helpful to design a registration system for patients with stroke in Shiraz Namazee Hospital.

  13. An alternative approach to the analysis of sucker-rod dynamics in vertical and deviated wells

    Energy Technology Data Exchange (ETDEWEB)

    Lollback, P.A.; Wang, G.Y.; Rahman, S.S. [The Centre for Petroleum Engineering, School of Applied Science, The University of New South Wales, Sydney (Australia)

    1997-05-01

    A set of partial differential equations which consider the combined effects of fluid column, sucker-rod string and tubing motion were developed to describe the motion of a sucker-rod pumping system. If the tubing is fixed, only the fluid column and rod motion need be considered; however, when the tubing is free to move, energy in the system is lost and, therefore, pump system efficiency declines, hence, the need to consider these effects in the design of the sucker-rod system. Using finite differences this model was used to evaluate performance of sucker-rod pumps (pumping rate as a function of number of strokes, stroke length, rod length, ratio of plunger to cylinder diameter, etc.) in both vertical and deviated wells. The results indicate that the developed model simply and accurately models the dynamic motion of the sucker-rod string. The examples presented illustrate its general applicability in both vertical and deviated wells

  14. Specific antismoking advice after stroke

    DEFF Research Database (Denmark)

    Hornnes, Nete; Larsen, Klaus; Brink-Kjær, Tove;

    2014-01-01

    -smokers in the intervention group than among controls. MATERIAL AND METHODS: Patients admitted with an acute stroke or a transient ischaemic attack were included in a randomised controlled trial focusing on control of lifestyle risk factors and hypertension. Here, we report the intervention focused on smoking cessation. We...... Elsass Foundation, the Lundbeck Foundation and The Danish Heart Foundation (Grant 07-4-B703-A1378-22384F). TRIAL REGISTRATION: This protocol is registered with Clinical Trials.gov (NCT 00253097)....

  15. STROKE PREVENTION IN INTERNIST PRACTICE

    Directory of Open Access Journals (Sweden)

    D. A. Napalkov

    2011-01-01

    Full Text Available Stroke secondary prevention in internist practice is discussed in accordance with up to date guidelines. Modern pharmacotherapy includes antiaggregants or anticoagulants, statins, and antihypertensive drugs. The choice of drugs is mostly founded on the rules of evidence based medicine, which allow adjusting individual treatment depending on clinical conditions. The composition of perindopril and indapamide is a preferred nowadays combination of antihypertensive drugs.

  16. Vertical guidance of shearers

    International Nuclear Information System (INIS)

    Mining Engineers have always been aware of the basic need to avoid contamination of the mined product, by controlling the cutting horizon at the coal face. The ability to maintain the optimum cutting horizon results in more effective roof control and ensures a safer and more efficient working environment, for men and machinery. The cost of treatment in the surface coal preparation plant is reduced. Transportation through the total mine system of material finally destined for the spoil heap is minimised. A reduction in product contamination is achieved and makes more effective use of the mine capacity. These benefits make possible significant improvements in productivity and financial returns. Exploitation of micro computer based systems has enabled the successful development of equipment which employs sensors to detect the very low natural gamma radiation from roof strata; to determine and allow control of the position of the cut relative to the roof and floor. This paper reviews the experience gained by the National Coal Board, particularly in South Yorkshire Area, with the vertical steering of ranging drum shearers. It outlines the benefits and considers the future for this technology and its contribution to total coal face automation

  17. Progressive Micrographia Shown in Horizontal, but not Vertical, Writing in Parkinson’s Disease

    OpenAIRE

    Hui-Ing Ma; Wen-Juh Hwang; Shao-Hsia Chang; Tsui-Ying Wang

    2013-01-01

    All published studies on micrographia, a diminution of letter size, examine handwriting in the horizontal direction. Writing horizontally typically requires increased wrist extension as handwriting progresses from left to right. Chinese characters, however, can be written not only horizontally from left to right, but also vertically from top to bottom. We examined the effect of handwriting direction on character size and stroke length. Fifteen participants with Parkinson’s disease (PD) and 15...

  18. Risk of Stroke in Migraineurs Using Triptans. Associations with Age, Sex, Stroke Severity and Subtype

    DEFF Research Database (Denmark)

    Albieri, Vanna; Olsen, Tom Skyhøj; Andersen, Klaus Kaae

    2016-01-01

    BACKGROUND: Identifying migraineurs by triptan utilization we studied risk for stroke in migraineurs compared to the general population. METHODS: A cohort study including all citizens 25-80years of age in Denmark 2003-2011 was conducted. All persons prescribed triptans, and all those hospitalized...... for a first stroke were identified in the Danish Registries. Information on stroke severity/subtype and cardiovascular risk factors was available for stroke patients. FINDINGS: Of the 49,711 patients hospitalized for a first stroke, 1084 were migraineurs using triptans. Adjusting for age, sex, income...... for severe strokes was lower among migraineurs (RR 0.77; CI 0.65-0.91). Risk was age-related; highest among women 25-45years (RR≈1.7). Risk was unrelated to numbers of dispensations. INTERPRETATION: Migraineurs identified by triptan utilization had higher risk for stroke. Strokes were minor...

  19. Heat stroke: a comprehensive review.

    Science.gov (United States)

    Yeo, Theresa Pluth

    2004-01-01

    Heat stroke (HS) is a serious and potentially life-threatening condition defined as a core body temperature >40.6 degrees C. Two forms of HS are recognized, classic heat stroke, usually occurring in very young or elderly persons, and exertional heat stroke, more common in physically active individuals. An elevated body temperature and neurologic dysfunction are necessary but not sufficient to diagnose HS. Associated clinical manifestations such as extreme fatigue; hot dry skin or heavy perspiration; nausea; vomiting; diarrhea; disorientation to person, place, or time; dizziness; uncoordinated movements; and reddened face are frequently observed. Potential complications related to severe HS are acute renal failure, disseminated intravascular coagulation, rhabdomyolysis, acute respiratory distress syndrome, acid-base disorders, and electrolyte disturbances. Long-term neurologic sequelae (varying degrees of irreversible brain injury) occur in approximately 20% of patients. The prognosis is optimal when HS is diagnosed early and management with cooling measures and fluid resuscitation and electrolyte replacement begins promptly. The prognosis is poorest when treatment is delayed >2 hours. PMID:15461044

  20. Endovascular therapy for acute stroke: Quo vadis?

    Directory of Open Access Journals (Sweden)

    Venkatesh S Madhugiri

    2013-01-01

    Full Text Available Endovascular therapy (EVT has gained vogue in the management of patients with acute stroke. Newer stent-retriever devices have led to better recanalization rates. In many centers, EVT is slowly being used as an add on to or in some instances, even as an alternative to intravenous tissue plasminogen activator (IV tPA. The publication of the results of the SYNTHESIS expansion, Interventional Management of Stroke III and Mechanical Retrieval Recanalization of Stroke Clots Using Embolectomy trials in 2013 has questioned the enthusiastic use of EVT in acute stroke. They demonstrate that EVT (using a variety of devices is no superior to IV tPA in the management of acute stroke. In the light of these controversial findings, we review the current status of EVT in the management of acute stroke.

  1. Rethinking the continuum of stroke rehabilitation.

    Science.gov (United States)

    Teasell, Robert W; Murie Fernandez, Manuel; McIntyre, Amanda; Mehta, Swati

    2014-04-01

    Suffering a stroke can be a devastating and life-changing event. Although there is a large evidence base for stroke rehabilitation in the acute and subacute stages, it has been long accepted that patients with stroke reach a plateau in their rehabilitation recovery relatively early. We have recently published the results of a systematic review designed to identify all randomized controlled trials (RCTs) where a rehabilitation intervention was initiated more than 6 months after the onset of the stroke. Of the trials identified, 339 RCTs met inclusion criteria, demonstrating an evidence base for stroke rehabilitation in the chronic phase as well. This seems at odds with the assumption that further recovery is unlikely and the subsequent lack of resources devoted to chronic stroke rehabilitation and management.

  2. Role of echocardiography in patients with stroke.

    Science.gov (United States)

    Nakanishi, Koki; Homma, Shunichi

    2016-08-01

    Investigation of potential embolic source is an important diagnostic step in treating patients with ischemic stroke and transient ischemic attack. Cardiogenic embolism has been estimated to be the causative factor in 15-30% of all cases of ischemic stroke. Cardioembolic strokes are generally severe and recurrence and mortality rate high. Various cardiac disorders including atrial fibrillation, ventricular thrombus, valvular heart disease, cardiac tumors, and structural heart defects can cause cardioembolic stroke. Although the aortic arch is not a cardiac structure, it is usually considered under source of cardiac embolism (cardioaortic source) and is reviewed in this article. Echocardiography (both transthoracic and transesophageal) is a widely used and versatile technique that can provide comprehensive information of thromboembolic risk in patients with stroke. This article reviews potential cardiac sources of stroke and discusses the role of echocardiography in clinical practice. PMID:27256218

  3. Comprehensive Stroke Centers May Be Associated With Improved Survival in Hemorrhagic Stroke

    OpenAIRE

    McKinney, James S; Cheng, Jerry Q.; Rybinnik, Igor; Kostis, John B.; ,

    2015-01-01

    Background Comprehensive stroke centers (CSCs) provide a full spectrum of neurological and neurosurgical services to treat complex stroke patients. CSCs have been shown to improve clinical outcomes and mitigate disparities in ischemic stroke patients. It is believed that CSCs also improve outcomes in hemorrhagic stroke. Methods and Results We used the Myocardial Infarction Data Acquisition System (MIDAS) database, which includes data on patients discharged with a primary diagnosis of intracer...

  4. Hurdles in stroke thrombolysis: Experience from 100 consecutive ischemic stroke patients

    OpenAIRE

    Sagar Badachi; Thomas Mathew; Arvind Prabhu; Raghunandan Nadig; Gosala R. K Sarma

    2015-01-01

    Background: Acute management of ischemic stroke involves thrombolysis within 4.5 h. For a successful outcome, early recognition of stroke, transportation to the hospital emergency department immediately after stroke, timely imaging, proper diagnosis, and thrombolysis within 4.5 h is of paramount importance. Aim: To analyze the obstacles for thrombolysis in acute stroke patients. Materials and Methods: The study was conducted in a tertiary care center in South India. A total of hundred consecu...

  5. Factors relating to emotional distress after stroke

    OpenAIRE

    Thomas, Shirley Ann

    2006-01-01

    Emotional distress is common after stroke and has a negative impact on rehabilitation outcome. The aim of this thesis was to identify factors relating to emotional distress after stroke to inform future interventions. This thesis developed a theoretical framework to guide the study of emotional distress and included stroke and demographic characteristics, background information, disability (personal and extended activities of daily living and aphasia) and psychosocial factors (coping, locus o...

  6. Secondary stroke prevention: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Esenwa C

    2015-08-01

    Full Text Available Charles Esenwa, Jose GutierrezDepartment of Neurology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USAAbstract: Stroke is the leading cause of disability in the USA and a major cause of mortality worldwide. One out of four strokes is recurrent. Secondary stroke prevention starts with deciphering the most likely stroke mechanism. In general, one of the main goals in stroke reduction is to control vascular risk factors such as hypertension, diabetes, dyslipidemia, and smoking cessation. Changes in lifestyle like a healthy diet and aerobic exercise are also recommended strategies. In the case of cardioembolism due to atrial fibrillation, mechanical valves, or cardiac thrombus, anticoagulation is the mainstay of therapy. The role of anticoagulation is less evident in the case of bioprosthetic valves, patent foramen ovale, and dilated cardiomyopathy with low ejection fraction. Strokes due to larger artery atherosclerosis account for approximately a third of all strokes. In the case of symptomatic extracranial carotid stenosis, surgical intervention as close as possible in time to the index event seems highly beneficial. In the case of intracranial large artery atherosclerosis, the best medical therapy consists of antiplatelets, high-dose statins, aggressive controls of vascular risk factors, and lifestyle modifications, with no role for intracranial arterial stenting or angioplasty. For patients with small artery occlusion (ie, lacunar stroke, the therapy is similar to that used in patients with intracranial large artery atherosclerosis. Despite the constant new evidence on how to best treat patients who have suffered a stroke, the risk of stroke recurrence remains unacceptably high, thus evidencing the need for novel therapies.Keywords: stroke mechanisms, stroke risk, hypertension, diabetes, dyslipidemia

  7. Antithrombotic Medication for Cardioembolic Stroke Prevention

    OpenAIRE

    M. Àngels Font; Jerzy Krupinski; Adrià Arboix

    2011-01-01

    Embolism of cardiac origin accounts for about 20% of ischemic strokes. Nonvalvular atrial fibrillation is the most frequent cause of cardioembolic stroke. Approximately 1% of population is affected by atrial fibrillation, and its prevalence is growing with ageing in the modern world. Strokes due to cardioembolism are in general severe and prone to early recurrence and have a higher long-term risk of recurrence and mortality. Despite its enormous preventive potential, continuous oral anticoagu...

  8. Professionals' views on interprofessional stroke team functioning

    OpenAIRE

    Cramm, Jane Murray; Nieboer, Anna Petra

    2011-01-01

    markdownabstractIntroduction: The quality of integrated stroke care depends on smooth team functioning but professionals may not always work well together. Professionals’ perspectives on the factors that influence stroke team functioning remain largely unexamined. Understanding their experiences is critical to indentifying measures to improve team functioning. The aim of this study was to identify the factors that contributed to the success of interprofessional stroke teams as perceived by te...

  9. Ischemia-Reperfusion Injury in Stroke

    OpenAIRE

    Nour, May; Scalzo, Fabien; Liebeskind, David S.

    2013-01-01

    Despite ongoing advances in stroke imaging and treatment, ischemic and hemorrhagic stroke continue to debilitate patients with devastating outcomes at both the personal and societal levels. While the ultimate goal of therapy in ischemic stroke is geared towards restoration of blood flow, even when mitigation of initial tissue hypoxia is successful, exacerbation of tissue injury may occur in the form of cell death, or alternatively, hemorrhagic transformation of reperfused tissue. Animal model...

  10. Multi-sensor classification of tennis strokes

    OpenAIRE

    Connaghan, Damien; Kelly, Philip; O''Connor, Noel E.; Gaffney, Mark; Ó Mathúna, S. Cian

    2011-01-01

    In this work, we investigate tennis stroke recognition using a single inertial measuring unit attached to a player’s forearm during a competitive match. This paper evaluates the best approach for stroke detection using either accelerometers, gyroscopes or magnetometers, which are embedded into the inertial measuring unit. This work concludes what is the optimal training data set for stroke classification and proves that classifiers can perform well when tested on players who were not used ...

  11. Cerebrovascular Complications of Diabetes: Focus on Stroke

    OpenAIRE

    Ergul, Adviye; Kelly-Cobbs, Aisha; Abdalla, Maha; Fagan, Susan C

    2012-01-01

    Cerebrovascular complications make diabetic patients 2–6 times more susceptible to a stroke event and this risk is magnified in younger individuals and in patients with hypertension and complications in other vascular beds. In addition, when patients with diabetes and hyperglycemia experience an acute ischemic stroke they are more likely to die or be severely disabled and less likely to benefit from the one FDA-approved therapy, intravenous tissue plasminogen activator. Experimental stroke mo...

  12. Impaired Hyperemic Response to Exercise Post Stroke

    OpenAIRE

    Durand, Matthew J.; Murphy, Spencer A.; Schaefer, Kathleen K.; HUNTER, SANDRA K.; Schmit, Brian D.; Gutterman, David D.; Hyngstrom, Allison S.

    2015-01-01

    Individuals with chronic stroke have reduced perfusion of the paretic lower limb at rest; however, the hyperemic response to graded muscle contractions in this patient population has not been examined. This study quantified blood flow to the paretic and non-paretic lower limbs of subjects with chronic stroke after submaximal contractions of the knee extensor muscles and correlated those measures with limb function and activity. Ten subjects with chronic stroke and ten controls had blood flow ...

  13. The Stroke RiskometerTM App: Validation of a data collection tool and stroke risk predictor

    NARCIS (Netherlands)

    P. Parmar (Priya); R. Krishnamurthi (Rita); M.A. Ikram (Arfan); A. Hofman (Albert); S.S. Mirza (Saira Saeed); Y. Varakin (Yury); M. Kravchenko (Michael); M. Piradov (Michael); A.G. Thrift (Amanda G.); B. Norrving (Bo); W. Wang (Wenzhi); D.K. Mandal (Dipes Kumar); S. Barker-Collo (Suzanne); R. Sahathevan (Ramesh); S.M. Davis (Stephen); G. Saposnik (Gustavo); M. Kivipelto (Miia); S. Sindi (Shireen); S.R. Bornstein (Stefan); M. Giroud (Maurice); Y. Béjot (Yannick); M. Brainin (Michael); R. Poulton (Richie); K.M.V. Narayan (K. M. Venkat); M. Correia (Manuel); A. Freire (António); Y. Kokubo (Yoshihiro); D. Wiebers (David); F.K.F. Mensah (Fane ); N.F. Bindhim (Nasser F.); P.A. Barber (P. Alan); N.G. Pandian; G.J. Hankey (Graeme); M.M. Mehndiratta (Man Mohan); S. Azhagammal (Shobhana); N.M. Ibrahim (Norlinah Mohd); M. Abbott (Max); E. Rush (Elaine); P. Hume (Patria); T. Hussein (Tasleem); R. Bhattacharjee (Rohit); M. Purohit (Mitali); V.L. Feigin (V.)

    2015-01-01

    textabstractBackground: The greatest potential to reduce the burden of stroke is by primary prevention of first-ever stroke, which constitutes three quarters of all stroke. In addition to population-wide prevention strategies (the 'mass' approach), the 'high risk' approach aims to identify individua

  14. FACTOR V LEIDEN AND ISCHEMIC STROKE RISK: THE GENETICS OF EARLY ONSET STROKE (GEOS) STUDY

    Science.gov (United States)

    Hamedani, Ali G.; Cole, John W.; Cheng, Yuching; Sparks, Mary J.; O'Connell, Jeffrey R.; Stine, Oscar C.; Wozniak, Marcella A.; Stern, Barney J.; Mitchell, Braxton D.; Kittner, Steven J.

    2011-01-01

    Background and Purpose Factor V Leiden (FVL) has been associated with ischemic stroke in children, but not in adults. Although the FVL mutation is associated with increased risk for venous thrombosis, its association with ischemic stroke in young adults remains uncertain. Therefore, we examined the association between FVL and ischemic stroke in participants of the Genetics of Early Onset Stroke (GEOS) Study. Methods A population-based case-control study identified 354 women and 476 men aged 15–49 years with first-ever ischemic stroke, and 907 controls. Participant-specific data included vascular risk factors, FVL genotype and, for cases, the ischemic stroke subtype by modified TOAST criteria. Logistic regression was used to calculate odds ratios for the entire population and for subgroups stratified by risk factors and ischemic stroke subtype. Results The frequency of the FVL mutation was similar between ischemic stroke patients (3.6%, 95% CI: 2.5%–5.1%) and non-stroke controls (3.8%, 95% CI: 2.7%–5.2%). This frequency did not change significantly when cases were restricted to patients with stroke of undetermined etiology (4.1%, 95% CI: 2.6%–6.4%). Conclusions Among young adults, we found no evidence for an association between Factor V Leiden and either all ischemic stroke or the subgroup with stroke of undetermined etiology. PMID:22100829

  15. Stroke: 'time is brain' after stroke, regardless of age and severity.

    Science.gov (United States)

    Audebert, Heinrich J; Sobesky, Jan

    2014-12-01

    Two recent studies highlight the importance of prompt, coordinated intervention after stroke. A meta-analysis confirms that intravenous thrombolysis is effective within 4.5 h of onset, irrespective of age (below or above 80 years) and stroke severity. Another study demonstrates successful reorganization of care through centralization of stroke services in England. PMID:25330727

  16. Determining Optimal Post-Stroke Exercise (DOSE)

    Science.gov (United States)

    2016-10-04

    Cerebrovascular Accident; Stroke; Cerebral Infarction; Brain Infarction; Brain Ischemia; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases

  17. Atrial fibrillation and risk of stroke

    DEFF Research Database (Denmark)

    Christiansen, Christine Benn; Gerds, Thomas A; Olesen, Jonas Bjerring;

    2016-01-01

    ratios for AF vs. no AF according to prior stroke and the number of additional risk factors. The study cohort comprised of 3 076 355 persons without AF and 48 189 with AF. For men aged 50 years, with no risk factors, the 5-year risk of stroke was 1.1% (95% confidence interval 1.1-1.1); with AF alone 2.......5% (1.8-3.2); with one risk factor and no prior stroke or AF 2.5% (2.3-2.7); and with one factor, no prior stroke and AF 2.9% (1.4-4.3). In men aged 50 years with prior stroke as the only risk factor, 5-year risk was 10.2% (9.1-11.3). In men aged 70 years, the corresponding risks were 4.8% (4.7-4.9), 6......AIM: Although the relation between stroke risk factors and stroke in patients with atrial fibrillation (AF) has been extensively examined, only few studies have explored the association of AF and the risk of ischaemic stroke/systemic thromboembolism/transient ischaemic attack (stroke...

  18. Stroke findings in the Women's Health Initiative.

    Science.gov (United States)

    Wassertheil-Smoller, Sylvia; Kaplan, Robert C; Salazar, Christian R

    2014-11-01

    The Women's Health Initiative (WHI) clinical trials of estrogen with or without progestin versus placebo in 27,341 postmenopausal women are the largest randomized, placebo-controlled, double-blind clinical trials to look at the effect of hormone therapy on the outcomes of stroke, dementia, and cognition. Data from a parallel prospective observational study of 93,676 women examine biomarkers and risk factors associated with stroke. We summarize the results of 29 published articles in the WHI with stroke or cognition as outcomes of interest. Estrogen alone or in combination with progestin resulted in approximately 50% excess risk of ischemic stroke and in a 76% excess risk of dementia in women 65 years or older. Other risk factors for stroke identified in the WHI were panic attacks, depression, use of antidepressants (particularly selective serotonin reuptake inhibitors for hemorrhagic but not ischemic stroke), high triglycerides, low walking speed, long sleep duration, certain inflammatory factors, and systolic blood pressure variability. Hormone therapy has adverse effects on the brain as manifested by higher risks of stroke and dementia. Additional risk factors for stroke identified in WHI should be followed up to determine if reversing them would result in lower stroke rates. PMID:25321421

  19. A CLINICAL STUDY OF STROKE IN YOUNG

    Directory of Open Access Journals (Sweden)

    Kumbha Thulasi Ram

    2015-02-01

    Full Text Available NTRIDUCTION : Stroke is one of the important causes of morbidity and mortality all over the world. Incidence of stroke steadily increases with age. Experts are concerned of the emerging stroke epidemic in India. Stroke affecting the young has potentially devastating consequence son the individual and his family. Certain risk factors are unique to the young. I t needs more studies for identification and modification of risk factors. The study aims to evaluate clinical features, risk factors, etiology and mortality of stroke in young patients. METHODS : 74 young patients satisfying the inclusion criteria were included in this study. A detailed history was taken from young stroke patients, systemic examination and required investigations were done. Data was collected in standardized proforma and analysed. RESULTS: Stroke in young accounts for 7.95% of stroke cases of all age groups. The mean age of the patients was 34.66 ± 7.48 years. Among 74 patients, 47(63.51% were male and 27(36.49% were female. Seizures, decreased consciousness, speech involvement and motor deficit were observed in 33.78%, 44.59%, 22.97% and 100% of cases respectively. 82.43% patients had ischemic and 17.57% patients had hemorrhagic stroke. Among ischemic stroke, large artery atherosclerosis was 16.21%, tuberculous meningoencephalitis with vasculitis was 16.21%, lacunar stroke was 10.81%, CVT was 10.81% and cardio embolic stroke was 6.76%. Smoking (59.45%, alcoholism (58.10%, hypertension (43.24%, coronary artery disease (8.10%, diabetes mellitus (10.81%, elevated total cholesterol (25.67%, elevated low density lipo proteins (22.97%, elevated triglycerides (27.02% and low HDL (22.97% were important risk factors. Carotid doppler was abnormal in 9.45% of patients. 6.76% patients had mitral stenosis in echocardiogram. Low protein C and protein S were found in 1.35% of patients. Eight (10.81% patients died during the hospital stay. INTERPRETATION AND CONCLUSIONS: The major risk

  20. The Christchurch earthquake stroke incidence study.

    Science.gov (United States)

    Wu, Teddy Y; Cheung, Jeanette; Cole, David; Fink, John N

    2014-03-01

    We examined the impact of major earthquakes on acute stroke admissions by a retrospective review of stroke admissions in the 6 weeks following the 4 September 2010 and 22 February 2011 earthquakes. The control period was the corresponding 6 weeks in the previous year. In the 6 weeks following the September 2010 earthquake there were 97 acute stroke admissions, with 79 (81.4%) ischaemic infarctions. This was similar to the 2009 control period which had 104 acute stroke admissions, of whom 80 (76.9%) had ischaemic infarction. In the 6 weeks following the February 2011 earthquake, there were 71 stroke admissions, and 61 (79.2%) were ischaemic infarction. This was less than the 96 strokes (72 [75%] ischaemic infarction) in the corresponding control period. None of the comparisons were statistically significant. There was also no difference in the rate of cardioembolic infarction from atrial fibrillation between the study periods. Patients admitted during the February 2011 earthquake period were less likely to be discharged directly home when compared to the control period (31.2% versus 46.9%, p=0.036). There was no observable trend in the number of weekly stroke admissions between the 2 weeks leading to and 6 weeks following the earthquakes. Our results suggest that severe psychological stress from earthquakes did not influence the subsequent short term risk of acute stroke, but the severity of the earthquake in February 2011 and associated civil structural damages may have influenced the pattern of discharge for stroke patients.

  1. In-hospital stroke: characteristics and outcomes.

    LENUS (Irish Health Repository)

    Briggs, R

    2015-01-01

    In-hospital stroke (IS) made up 6.5% of strokes recorded in the Irish National Stroke Register in 2012. International research has demonstrated poorer outcomes post IS compared to out of hospital stroke (OS). We aimed to profile all IS and OS over a 22 month period and compare the two groups by gathering data from the HIPE portal stroke register. The study site is a primary stroke centre. IS represented 11% (50\\/458) of total strokes with over half (27\\/50, 54%) admitted initially with medical complaints. IS patients had a significantly longer length of stay (79.2 +\\/- 87.4 days vs. 21.9 +\\/- 45.9 days, p < 0.01) and higher mortality (13\\/50 vs. 39\\/408, p < 0.01). Patients in the IS group were also less likely to receive stroke unit care (1\\/50 vs. 136\\/408, p < 0.01). This study demonstrates the significant morbidity and mortality associated with IS and highlights the need for efforts to be made to optimize identification and management of acute stroke in this cohort.

  2. Stroke Hospitalization Down for Many in U.S.

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_158779.html Stroke Hospitalization Down for Many in U.S. But higher ... 11, 2016 (HealthDay News) -- While Americans suffered fewer strokes overall from 2000 to 2010, stroke rates climbed ...

  3. Stroke Stories | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Stroke Rehabilitation Stroke Stories Past Issues / Spring 2013 Table of Contents ... these well-known personalities suffered one or more strokes. In each case, he or she has returned ...

  4. Let's Talk about High Blood Pressure and Stroke

    Science.gov (United States)

    ... Tools & Resources Stroke More Let's Talk About High Blood Pressure and Stroke Updated:Dec 9,2015 What is ... Blood Pressure? How Can I Reduce High Blood Pressure? High Blood Pressure and Stroke What Is Diabetes and How ...

  5. Challenges in the diagnosis and treatment of pediatric stroke

    OpenAIRE

    Jordan, L. C.; Hillis, A. E.

    2011-01-01

    The onset of stroke in children rarely owes to traditional stroke risk factors such as hypertension or diabetes. Rather, stroke in this patient group typically results from the simultaneous occurrence of multiple stroke risk factors, the presence of which necessitates a thorough evaluation. Several challenges exist in the care of children with stroke. Of note, recognition of pediatric stroke onset by parents and caregivers is often delayed, highlighting the need for increased awareness of and...

  6. Quality Improvement in Acute Ischemic Stroke Care in Taiwan: The Breakthrough Collaborative in Stroke.

    Science.gov (United States)

    Hsieh, Fang-I; Jeng, Jiann-Shing; Chern, Chang-Ming; Lee, Tsong-Hai; Tang, Sung-Chun; Tsai, Li-Kai; Liao, Hsun-Hsiang; Chang, Hang; LaBresh, Kenneth A; Lin, Hung-Jung; Chiou, Hung-Yi; Chiu, Hou-Chang; Lien, Li-Ming

    2016-01-01

    In the management of acute ischemic stroke, guideline adherence is often suboptimal, particularly for intravenous thrombolysis or anticoagulation for atrial fibrillation. We sought to improve stroke care quality via a collaborative model, the Breakthrough Series (BTS)-Stroke activity, in a nationwide, multi-center activity in Taiwan. A BTS Collaborative, a short-term learning system for a large number of multidisciplinary teams from hospitals, was applied to enhance acute ischemic stroke care quality. Twenty-four hospitals participated in and submitted data for this stroke quality improvement campaign in 2010-2011. Totally, 14 stroke quality measures, adopted from the Get With The Guideline (GWTG)-Stroke program, were used to evaluate the performance and outcome of the ischemic stroke patients. Data for a one-year period from 24 hospitals with 13,181 acute ischemic stroke patients were analyzed. In 14 hospitals, most stroke quality measures improved significantly during the BTS-activity compared with a pre-BTS-Stroke activity period (2006-08). The rate of intravenous thrombolysis increased from 1.2% to 4.6%, door-to-needle time ≤60 minutes improved from 7.1% to 50.8%, symptomatic hemorrhage after intravenous thrombolysis decreased from 11.0% to 5.6%, and anticoagulation therapy for atrial fibrillation increased from 32.1% to 64.1%. The yearly composite measures of five stroke quality measures revealed significant improvements from 2006 to 2011 (75% to 86.3%, p<0.001). The quarterly composite measures also improved significantly during the BTS-Stroke activity. In conclusion, a BTS collaborative model is associated with improved guideline adherence for patients with acute ischemic stroke. GWTG-Stroke recommendations can be successfully applied in countries besides the United States. PMID:27487190

  7. Canadian stroke best practice recommendations: Stroke rehabilitation practice guidelines, update 2015.

    Science.gov (United States)

    Hebert, Debbie; Lindsay, M Patrice; McIntyre, Amanda; Kirton, Adam; Rumney, Peter G; Bagg, Stephen; Bayley, Mark; Dowlatshahi, Dar; Dukelow, Sean; Garnhum, Maridee; Glasser, Ev; Halabi, Mary-Lou; Kang, Ester; MacKay-Lyons, Marilyn; Martino, Rosemary; Rochette, Annie; Rowe, Sarah; Salbach, Nancy; Semenko, Brenda; Stack, Bridget; Swinton, Luchie; Weber, Valentine; Mayer, Matthew; Verrilli, Sue; DeVeber, Gabrielle; Andersen, John; Barlow, Karen; Cassidy, Caitlin; Dilenge, Marie-Emmanuelle; Fehlings, Darcy; Hung, Ryan; Iruthayarajah, Jerome; Lenz, Laura; Majnemer, Annette; Purtzki, Jacqueline; Rafay, Mubeen; Sonnenberg, Lyn K; Townley, Ashleigh; Janzen, Shannon; Foley, Norine; Teasell, Robert

    2016-06-01

    Stroke rehabilitation is a progressive, dynamic, goal-orientated process aimed at enabling a person with impairment to reach their optimal physical, cognitive, emotional, communicative, social and/or functional activity level. After a stroke, patients often continue to require rehabilitation for persistent deficits related to spasticity, upper and lower extremity dysfunction, shoulder and central pain, mobility/gait, dysphagia, vision, and communication. Each year in Canada 62,000 people experience a stroke. Among stroke survivors, over 6500 individuals access in-patient stroke rehabilitation and stay a median of 30 days (inter-quartile range 19 to 45 days). The 2015 update of the Canadian Stroke Best Practice Recommendations: Stroke Rehabilitation Practice Guidelines is a comprehensive summary of current evidence-based recommendations for all members of multidisciplinary teams working in a range of settings, who provide care to patients following stroke. These recommendations have been developed to address both the organization of stroke rehabilitation within a system of care (i.e., Initial Rehabilitation Assessment; Stroke Rehabilitation Units; Stroke Rehabilitation Teams; Delivery; Outpatient and Community-Based Rehabilitation), and specific interventions and management in stroke recovery and direct clinical care (i.e., Upper Extremity Dysfunction; Lower Extremity Dysfunction; Dysphagia and Malnutrition; Visual-Perceptual Deficits; Central Pain; Communication; Life Roles). In addition, stroke happens at any age, and therefore a new section has been added to the 2015 update to highlight components of stroke rehabilitation for children who have experienced a stroke, either prenatally, as a newborn, or during childhood. All recommendations have been assigned a level of evidence which reflects the strength and quality of current research evidence available to support the recommendation. The updated Rehabilitation Clinical Practice Guidelines feature several

  8. Canadian stroke best practice recommendations: Stroke rehabilitation practice guidelines, update 2015.

    Science.gov (United States)

    Hebert, Debbie; Lindsay, M Patrice; McIntyre, Amanda; Kirton, Adam; Rumney, Peter G; Bagg, Stephen; Bayley, Mark; Dowlatshahi, Dar; Dukelow, Sean; Garnhum, Maridee; Glasser, Ev; Halabi, Mary-Lou; Kang, Ester; MacKay-Lyons, Marilyn; Martino, Rosemary; Rochette, Annie; Rowe, Sarah; Salbach, Nancy; Semenko, Brenda; Stack, Bridget; Swinton, Luchie; Weber, Valentine; Mayer, Matthew; Verrilli, Sue; DeVeber, Gabrielle; Andersen, John; Barlow, Karen; Cassidy, Caitlin; Dilenge, Marie-Emmanuelle; Fehlings, Darcy; Hung, Ryan; Iruthayarajah, Jerome; Lenz, Laura; Majnemer, Annette; Purtzki, Jacqueline; Rafay, Mubeen; Sonnenberg, Lyn K; Townley, Ashleigh; Janzen, Shannon; Foley, Norine; Teasell, Robert

    2016-06-01

    Stroke rehabilitation is a progressive, dynamic, goal-orientated process aimed at enabling a person with impairment to reach their optimal physical, cognitive, emotional, communicative, social and/or functional activity level. After a stroke, patients often continue to require rehabilitation for persistent deficits related to spasticity, upper and lower extremity dysfunction, shoulder and central pain, mobility/gait, dysphagia, vision, and communication. Each year in Canada 62,000 people experience a stroke. Among stroke survivors, over 6500 individuals access in-patient stroke rehabilitation and stay a median of 30 days (inter-quartile range 19 to 45 days). The 2015 update of the Canadian Stroke Best Practice Recommendations: Stroke Rehabilitation Practice Guidelines is a comprehensive summary of current evidence-based recommendations for all members of multidisciplinary teams working in a range of settings, who provide care to patients following stroke. These recommendations have been developed to address both the organization of stroke rehabilitation within a system of care (i.e., Initial Rehabilitation Assessment; Stroke Rehabilitation Units; Stroke Rehabilitation Teams; Delivery; Outpatient and Community-Based Rehabilitation), and specific interventions and management in stroke recovery and direct clinical care (i.e., Upper Extremity Dysfunction; Lower Extremity Dysfunction; Dysphagia and Malnutrition; Visual-Perceptual Deficits; Central Pain; Communication; Life Roles). In addition, stroke happens at any age, and therefore a new section has been added to the 2015 update to highlight components of stroke rehabilitation for children who have experienced a stroke, either prenatally, as a newborn, or during childhood. All recommendations have been assigned a level of evidence which reflects the strength and quality of current research evidence available to support the recommendation. The updated Rehabilitation Clinical Practice Guidelines feature several

  9. Association between acute statin therapy, survival, and improved functional outcome after ischemic stroke: the North Dublin Population Stroke Study.

    LENUS (Irish Health Repository)

    2011-04-01

    Statins improve infarct volume and neurological outcome in animal stroke models. We investigated the relationship between statin therapy and ischemic stroke outcome in the North Dublin Population Stroke Study.

  10. Vertical Collective Action: Addressing Vertical Asymmetries in Watershed Management

    OpenAIRE

    Cárdenas, Juan-Camilo; Rodriguez, Luz Angela; Johnson, Nancy

    2015-01-01

    Watersheds and irrigation systems have the characteristic of connecting people vertically by water flows. The location of users along these systems defines their role in the provision and appropriation of water which adds complexity to the potential for cooperation. Verticality thus imposes a challenge to collective action. This paper presents the results of field experiments conducted in four watersheds of Colombia (South America) and Kenya (East Africa) to study the role that location plays...

  11. Little change of modifiable risk factors 1 year after stroke: a pilot study

    DEFF Research Database (Denmark)

    Hornnes, Nete; Larsen, Klaus; Boysen, Gudrun

    2010-01-01

    Recurrent stroke accounts for about 25% of admissions for acute stroke. For the prevention of recurrent cerebro and cardiovascular disease, stroke patients are advised to change modifiable stroke risk factors before discharge from stroke units.......Recurrent stroke accounts for about 25% of admissions for acute stroke. For the prevention of recurrent cerebro and cardiovascular disease, stroke patients are advised to change modifiable stroke risk factors before discharge from stroke units....

  12. Long Sleep Duration and Risk of Ischemic Stroke and Hemorrhagic Stroke: the Kailuan Prospective Study

    Science.gov (United States)

    Song, Qiaofeng; Liu, Xiaoxue; Zhou, Wenhua; Wang, Ling; Zheng, Xiang; Wang, Xizhu; Wu, Shouling

    2016-01-01

    The objective of this study was to examine the relationship between sleep duration and ischemic and hemorrhagic stroke in a community-based cohort. The current analysis included 95,023 Chinese participants who were free of stroke at the baseline survey (2006–2007). Cox proportional hazards models were used to calculate hazard ratios (HRs) and their confidence intervals (CIs) for stroke, according to sleep duration. After a mean follow-up period of 7.9 years, 3,135 participants developed stroke (2,504 ischemic stroke and 631 hemorrhagic stroke). The full adjusted hazard ratio (95% CI) of total stroke (with 6–8 hours of night sleep being considered for the reference group) for individuals reporting greater than 8 hours was 1.29 (1.01–1.64). More significant association between long sleep duration and total stroke was found in the elderly (HR, 1.47; 95% CI, 1.05–2.07). Compared with participants getting 6–8 hours of sleep, only women who reported sleeping more than 8 hours per night were associated with hemorrhagic stroke (HR, 3.58; 95% CI, 1.28–10.06). This study suggested that long sleep duration might be a potential predictor/ marker for total stroke, especially in the elderly. And long sleep duration increased the risk of hemorrhagic stroke only in women. PMID:27633270

  13. Physical Activity Patterns of Acute Stroke Patients Managed in a Rehabilitation Focused Stroke Unit

    Directory of Open Access Journals (Sweden)

    Tanya West

    2013-01-01

    Full Text Available Background. Comprehensive stroke unit care, incorporating acute care and rehabilitation, may promote early physical activity after stroke. However, previous information regarding physical activity specific to the acute phase of stroke and the comprehensive stroke unit setting is limited to one stroke unit. This study describes the physical activity undertaken by patients within 14 days after stroke admitted to a comprehensive stroke unit. Methods. This study was a prospective observational study. Behavioural mapping was used to determine the proportion of the day spent in different activities. Therapist reports were used to determine the amount of formal therapy received on the day of observation. The timing of commencement of activity out of bed was obtained from the medical records. Results. On average, patients spent 45% (SD 25 of the day in some form of physical activity and received 58 (SD 34 minutes per day of physiotherapy and occupational therapy combined. Mean time to first mobilisation out of bed was 46 (SD 32 hours post-stroke. Conclusions. This study suggests that commencement of physical activity occurs earlier and physical activity is at a higher level early after stroke in this comprehensive stroke unit, when compared to studies of other acute stroke models of care.

  14. Individual limb mechanical analysis of gait following stroke.

    Science.gov (United States)

    Mahon, Caitlin E; Farris, Dominic J; Sawicki, Gregory S; Lewek, Michael D

    2015-04-13

    The step-to-step transition of walking requires significant mechanical and metabolic energy to redirect the center of mass. Inter-limb mechanical asymmetries during the step-to-step transition may increase overall energy demands and require compensation during single-support. The purpose of this study was to compare individual limb mechanical gait asymmetries during the step-to-step transitions, single-support and over a complete stride between two groups of individuals following stroke stratified by gait speed (≥0.8 m/s or phases of a stride, as well as over a complete stride. Robust inter-limb asymmetries in mechanical power existed during walking after stroke; for both groups, the non-paretic limb produced significantly more positive net mechanical power than the paretic limb during all phases of a stride and over a complete stride. Interestingly, no differences in inter-limb mechanical power asymmetry were noted between groups based on walking speed, during any phase or over a complete stride. Paretic propulsion, however, was different between speed-based groups. The fact that paretic propulsion (calculated from anterior-posterior forces) is different between groups, but our measure of mechanical work (calculated from all three directions) is not, suggests that limb power output may be dominated by vertical components, which are required for upright support.

  15. Short- and long-term prognosis for very old stroke patients. The Copenhagen Stroke Study

    DEFF Research Database (Denmark)

    Kammersgaard, Lars Peter; Jørgensen, H S; Reith, J;

    2004-01-01

    BACKGROUND AND PURPOSE: The very old are expected to become a growing part of the stroke population in the industrialised part of the world. The aims of this study were to evaluate clinical characteristics of patients aged 85 years or more at stroke onset and to investigate very old age as an ind...... and rehabilitation after stroke.......BACKGROUND AND PURPOSE: The very old are expected to become a growing part of the stroke population in the industrialised part of the world. The aims of this study were to evaluate clinical characteristics of patients aged 85 years or more at stroke onset and to investigate very old age...... as an independent predictor of short- and long-term outcome. METHODS: In the community-based Copenhagen Stroke Study we recorded admission clinical characteristics in 1197 consecutive stroke patients. Patients were stratified according to age groups on admission. Follow-up was performed at a mean of 7 years after...

  16. Results of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial by stroke subtypes

    DEFF Research Database (Denmark)

    Amarenco, Pierre; Benavente, Oscar; Goldstein, Larry B;

    2009-01-01

    BACKGROUND AND PURPOSE: The SPARCL trial showed that atorvastatin 80 mg/d reduces the risk of stroke and other cardiovascular events in patients with recent stroke or transient ischemic attack (TIA). We tested the hypothesis that the benefit of treatment varies according to index event stroke...... subtype. METHODS: Subjects with stroke or TIA without known coronary heart disease were randomized to atorvastatin 80 mg/d or placebo. The SPARCL primary end point was fatal or nonfatal stroke. Secondary end points included major cardiovascular events (MCVE; stroke plus major coronary events). Cox...... regression models testing for an interaction with treatment assignment were used to explore potential differences in efficacy based on stroke subtype. RESULTS: For subjects randomized to atorvastatin versus placebo, a primary end point occurred in 13.1% versus 18.6% of those classified as having large vessel...

  17. Sex Differences in Stroke Survival: 10-Year Follow-up of the Copenhagen Stroke Study Cohort

    DEFF Research Database (Denmark)

    Andersen, Morten Nonboe; Andersen, Klaus Kaae; Kammersgaard, Lars Peter;

    2005-01-01

    -up period. Predictors of death were identified using a Cox proportional hazards model. RESULTS: Of 999 patients, 559 (56%) were women and 440 (44%) were men. Women were older (77.0 v 70.9 years; P strokes (Scandinavian Stroke Scale: 36.1 v 40.5; P Age-adjusted risk......), and 17.4% versus 18.7% (10-year), respectively. Adjusting for age, stroke severity, stroke type, and risk factors, women had a higher probability of survival at 1 year (hazard ratio 1.47, 95% confidence interval 1.10-2.00); 5 years (hazard ratio 1.47, 95% confidence interval 1.23-1.76); and 10 years......BACKGROUND: Although diverging, most studies show that sex has no significant influence on stroke survival. METHODS: In a Copenhagen, Denmark, community all patients with stroke during March 1992 to November 1993 were registered on hospital admission. Stroke severity was measured using...

  18. Thrombolysis outcomes in acute ischemic stroke patients with prior stroke and diabetes mellitus

    DEFF Research Database (Denmark)

    Mishra, N K; Ahmed, N; Davalos, A;

    2011-01-01

    in Stroke-International Stroke Thrombolysis Register) compared to nonthrombolyzed controls (C; data from Virtual International Stroke Trials Archive). METHODS: We selected ischemic stroke patients on whom we held data on age, baseline NIH Stroke Scale score (NIHSS), and 90-day modified Rankin Scale score (m......BACKGROUND: Patients with concomitant diabetes mellitus (DM) and prior stroke (PS) were excluded from European approval of alteplase in stroke. We examined the influence of DM and PS on the outcomes of patients who received thrombolytic therapy (T; data from Safe Implementation of Thrombolysis......RS). We compared the distribution of mRS between T and C by Cochran-Mantel-Haenszel (CMH) test and proportional odds logistic regression, after adjustment for age and baseline NIHSS, in patients with and without DM, PS, or the combination. We report odds ratios (OR) for improved distribution of m...

  19. Hemorrhagic stroke in the Stroke Prevention by Aggressive Reduction in Cholesterol Levels study

    DEFF Research Database (Denmark)

    Goldstein, L.B.; Amarenco, P.; Szarek, M.;

    2008-01-01

    risk was higher in those having a hemorrhagic stroke as the entry event (HR 5.65, 95% CI 2.82 to 11.30, p age (10 y increments, HR 1.42, 95% CI 1.16 to 1.74, p = 0.001). There were no statistical interactions between these factors......: Hemorrhagic stroke was more frequent in those treated with atorvastatin, in those with a hemorrhagic stroke as an entry event, in men, and increased with age. Those with Stage 2 hypertension at the last visit prior to the hemorrhagic stroke were also at increased risk. Treatment did not disproportionately......BACKGROUND: In the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) study, atorvastatin 80 mg/day reduced the risk of stroke in patients with recent stroke or TIA. Post hoc analysis found this overall benefit included an increase in the numbers of treated patients having...

  20. Sex differences in stroke survival: 10-year follow-up of the Copenhagen stroke study cohort

    DEFF Research Database (Denmark)

    Andersen, Morten Nonboe; Andersen, Klaus Kaae; Kammersgaard, Lars Peter;

    2005-01-01

    -up period. Predictors of death were identified using a Cox proportional hazards model. RESULTS: Of 999 patients, 559 (56%) were women and 440 (44%) were men. Women were older (77.0 v 70.9 years; P strokes (Scandinavian Stroke Scale: 36.1 v 40.5; P Age-adjusted risk......), and 17.4% versus 18.7% (10-year), respectively. Adjusting for age, stroke severity, stroke type, and risk factors, women had a higher probability of survival at 1 year (hazard ratio 1.47, 95% confidence interval 1.10-2.00); 5 years (hazard ratio 1.47, 95% confidence interval 1.23-1.76); and 10 years......BACKGROUND: Although diverging, most studies show that sex has no significant influence on stroke survival. METHODS: In a Copenhagen, Denmark, community all patients with stroke during March 1992 to November 1993 were registered on hospital admission. Stroke severity was measured using...

  1. Malaria and stroke: case report

    Directory of Open Access Journals (Sweden)

    LEOPOLDINO JOSÉ FÁBIO SANTOS

    1999-01-01

    Full Text Available Malaria is a parasitic disease with high prevalence in several regions of the world. Infestation by Plasmodium faciparum can, in some cases, affect the central nervous system producing encephalitis resulting in death or neurological sequelae. The mechanisms involved in the pathophysiology of the cerebral lesion are not totally clear and there are currently two theories (mechanical and humoral concerning this. We report a case of malaria with an atypical evolution, with a stroke lesion in the territory of the middle cerebral artery, with no association with encephalitis. We conclude that the mechanical theory is the one applicable to this patient.

  2. Neurosonology and neuroimaging of stroke

    International Nuclear Information System (INIS)

    The monograph is systematically organized: the first part contains the basic principles of neurosonology and cerebrovascular diseases. Ultrasound principles are described and illustrated with diagrams and images. The anatomy, pathophysiology (intracranial hemodynamics and functional tests, pathogenesis of stroke, vascular pathology) and the cervico-cranial arteries are discussed. Other vascular imaging techniques (CT and MR angiography and dye contrast catheter angiography) are also discussed and compared. The second part contains 30 case scenarios grouped according to the expected difficulty of neurosonology exploration and interpretation

  3. Clinimetrics & determinants of outcome after stroke

    NARCIS (Netherlands)

    Schepers, V.P.M.

    2006-01-01

    This thesis is based on findings of the Functional Prognostication and disability study on stroke, which had two main objectives: (1) to examine which outcome measures are most appropriate, and especially most responsive, for the assessment of functional outcome in stroke patients and (2) to study p

  4. Stroke Prevention: Managing Modifiable Risk Factors

    Directory of Open Access Journals (Sweden)

    Silvia Di Legge

    2012-01-01

    Full Text Available Prevention plays a crucial role in counteracting morbidity and mortality related to ischemic stroke. It has been estimated that 50% of stroke are preventable through control of modifiable risk factors and lifestyle changes. Antihypertensive treatment is recommended for both prevention of recurrent stroke and other vascular events. The use of antiplatelets and statins has been shown to reduce the risk of recurrent stroke and other vascular events. Angiotensin-converting enzyme inhibitors (ACEIs and angiotensin II receptor blockers (ARBs are indicated in stroke prevention because they also promote vascular health. Effective secondary-prevention strategies for selected patients include carotid revascularization for high-grade carotid stenosis and vitamin K antagonist treatment for atrial fibrillation. The results of recent clinical trials investigating new anticoagulants (factor Xa inhibitors and direct thrombin inhibitors clearly indicate alternative strategies in stroke prevention for patients with atrial fibrillation. This paper describes the current landscape and developments in stroke prevention with special reference to medical treatment in secondary prevention of ischemic stroke.

  5. Psychological factors determine depressive symptomatology after stroke

    NARCIS (Netherlands)

    Van Mierlo, Maria L.; Van Heugten, Caroline M.; Post, Marcel W.; De Kort, Paul L.; Visser-Meily, Anne

    2015-01-01

    Objective To identify psychological factors related to poststroke depressive symptoms. Design Cross-sectional study, with patients assessed at 2 months poststroke. Setting Patients with stroke from 6 general hospitals. Participants Stroke patients (N=344; mean age ± SD, 66.9±12.3y). Interventions No

  6. Oral care post stroke: a scoping review.

    Science.gov (United States)

    Kwok, C; McIntyre, A; Janzen, S; Mays, R; Teasell, R

    2015-01-01

    Health concerns post stroke may be the result of, or exacerbated by, neglected oral health care (OHC). However, OHC may be challenging post stroke due to hemiparesis, hemiplegia, a lack of coordination, and/or cognitive deficits. The objective of this study was to conduct a scoping review and summarise the current state of knowledge pertaining to OHC post stroke. A literature search was conducted using the multiple databases (MEDLINE, CINAHL, EMBASE, etc.). Combinations of multiple keywords were searched: oral, dental, health, care, hygiene, teeth, dentures, tooth brushing, stroke, cardiovascular health and cardiovascular disease. A grey literature search was also conducted. Articles included were those published in English between 1970 and July 2013, which focused on at least one aspect of OHC among a stroke population. For clinical trials, ≥50% of the sample must have sustained a stroke. In total, 60 articles met inclusion and focused on three primary area: (i) OHC Importance/Stroke Implications; (ii) Current Research; and (iii) Current Practice. It was found that OHC concerns are mainly related to mastication, dysphagia/nutrition, hygiene, prostheses and quality of life. Research indicates that there is limited specialised and individual care provided, and there are few assessment tools, guidelines and established protocols for oral health that are specific to the stroke population. Further, dental professionals' and nurses' knowledge of OHC is generally inadequate; hence, proper education for health professionals in acute and rehabilitation settings, patients, and caregivers has been discussed. PMID:25244419

  7. Stroke and nutrition: A review of studies

    Directory of Open Access Journals (Sweden)

    Mehdi Foroughi

    2013-01-01

    Conclusions : Adherence to Mediterranean diet or DASH diet and increasing the consumption of antioxidant, vitamins, potassium, calcium food sources, vegetables, fruits, and whole grains intake can lower the risk of stroke. Healthy diet is effective in reducing risk of stroke, however, more studies need to be carried out in this area.

  8. Invariant properties between stroke features in handwriting

    NARCIS (Netherlands)

    Teulings, H L; Schomaker, L R

    1993-01-01

    A handwriting pattern is considered as a sequence of ballistic strokes. Replications of a pattern may be generated from a single, higher-level memory representation, acting as a motor program. Therefore, those stroke features which show the most invariant pattern are probably related to the paramete

  9. Unassisted Assessment of Stroke Severity Using Telemedicine

    NARCIS (Netherlands)

    Van Hooff, Robbert-Jan; De Smedt, Ann; De Raedt, Sylvie; Moens, Maarten; Marien, Peter; Paquier, Philippe; De Keyser, Jacques; Brouns, Raf

    2013-01-01

    Background and Purpose-Quantification of stroke severity through telemedicine consultation is challenging and relies on professional support at the patient's bedside. We aimed to develop a novel scale for assessing stroke severity through telemedicine without assistance from a third party (Unassiste

  10. Impact of implementing evidence-based acute stroke interventions on survival: the South London Stroke Register.

    Directory of Open Access Journals (Sweden)

    Juliet Addo

    Full Text Available BACKGROUND: Studies examining the impact of organised acute stroke care interventions on survival in subgroups of stroke patients remain limited. AIMS: This study examined the effects of a range of evidence-based interventions of acute stroke care on one year survival post-stroke and determined the size of the effect across different socio-demographic and clinical subgroups of patients. METHODS: Data on 4026 patients with a first-ever stroke recruited to the population-based South London Stroke Register between 1995 and 2010 were used. In uni-variable analyses, one year cumulative survival rates in socio-demographic groups and by care received was determined. Survival functions were compared using Log-rank tests. Multivariable Cox models were used to test for interactions between components of care and age group, sex, ethnic group, social class, stroke subtype and level of consciousness. RESULTS: 1949 (56.4% patients were admitted to a stroke unit. Patients managed on a stroke unit, those with deficits receiving specific rehabilitation therapies and those with ischaemic stroke subtype receiving aspirin in the acute phase had better one year survival compared to those who did not receive these interventions. The greatest reduction in the hazards of death among patients treated on a stroke unit were in the youngest patients aged <65 years, (HR 0.39; 95% CI: 0.25-0.62, and those with reduced levels of consciousness, GCS <9, (HR: 0.44; CI: 0.33-0.58. CONCLUSIONS: There was evidence of better one year survival in patients receiving specific acute interventions after stroke with a significantly greater effect in stroke subgroups, suggesting the possibility of re-organising stroke services to ensure that the most appropriate care is made accessible to patients likely to derive the most benefits from such interventions.

  11. Quality Improvement in Acute Ischemic Stroke Care in Taiwan: The Breakthrough Collaborative in Stroke

    Science.gov (United States)

    Chern, Chang-Ming; Lee, Tsong-Hai; Tang, Sung-Chun; Tsai, Li-Kai; Liao, Hsun-Hsiang; Chang, Hang; LaBresh, Kenneth A.; Lin, Hung-Jung; Chiou, Hung-Yi; Chiu, Hou-Chang; Lien, Li-Ming

    2016-01-01

    In the management of acute ischemic stroke, guideline adherence is often suboptimal, particularly for intravenous thrombolysis or anticoagulation for atrial fibrillation. We sought to improve stroke care quality via a collaborative model, the Breakthrough Series (BTS)-Stroke activity, in a nationwide, multi-center activity in Taiwan. A BTS Collaborative, a short-term learning system for a large number of multidisciplinary teams from hospitals, was applied to enhance acute ischemic stroke care quality. Twenty-four hospitals participated in and submitted data for this stroke quality improvement campaign in 2010–2011. Totally, 14 stroke quality measures, adopted from the Get With The Guideline (GWTG)-Stroke program, were used to evaluate the performance and outcome of the ischemic stroke patients. Data for a one-year period from 24 hospitals with 13,181 acute ischemic stroke patients were analyzed. In 14 hospitals, most stroke quality measures improved significantly during the BTS-activity compared with a pre-BTS-Stroke activity period (2006–08). The rate of intravenous thrombolysis increased from 1.2% to 4.6%, door-to-needle time ≤60 minutes improved from 7.1% to 50.8%, symptomatic hemorrhage after intravenous thrombolysis decreased from 11.0% to 5.6%, and anticoagulation therapy for atrial fibrillation increased from 32.1% to 64.1%. The yearly composite measures of five stroke quality measures revealed significant improvements from 2006 to 2011 (75% to 86.3%, pcollaborative model is associated with improved guideline adherence for patients with acute ischemic stroke. GWTG-Stroke recommendations can be successfully applied in countries besides the United States. PMID:27487190

  12. Trade Liberalisation and Vertical Integration

    DEFF Research Database (Denmark)

    Laugesen, Anders Rosenstand

    2016-01-01

    We build a three-country model of international trade in final goods and intermediate inputs and study the relation between four different types of trade liberalisation and vertical integration. Firms are heterogeneous with respect to both productivity and factor (headquarter) intensity. Final......-good producers face decisions on exporting, vertical integration of intermediate-input production, and whether the intermediate-input production should be offshored to a low-wage country. We find that the fractions of final-good producers that pursue either vertical integration, offshoring, or exporting are all...... increasing when intermediate-input trade or final-goods trade is liberalised. Finally, we provide guidance for testing the open-economy property rights theory of the firm using firm-level data and surprisingly show that the relationship between factor (headquarter) intensity and the likelihood of vertical...

  13. Vertical axis wind turbine airfoil

    Science.gov (United States)

    Krivcov, Vladimir; Krivospitski, Vladimir; Maksimov, Vasili; Halstead, Richard; Grahov, Jurij Vasiljevich

    2012-12-18

    A vertical axis wind turbine airfoil is described. The wind turbine airfoil can include a leading edge, a trailing edge, an upper curved surface, a lower curved surface, and a centerline running between the upper surface and the lower surface and from the leading edge to the trailing edge. The airfoil can be configured so that the distance between the centerline and the upper surface is the same as the distance between the centerline and the lower surface at all points along the length of the airfoil. A plurality of such airfoils can be included in a vertical axis wind turbine. These airfoils can be vertically disposed and can rotate about a vertical axis.

  14. [Primary and secondary prevention of stroke].

    Science.gov (United States)

    Trenkwalder, Peter; Rüchardt, Andreas

    2015-10-01

    The basis for primary and secondary prevention of stroke (and also TIA) are both a healthy lifestyle with a healthy diet, non smoking, weight reduction and regular exercise, and consistent treatment of arterial hypertension with a target of choice of the antihypertensive is depending on concomitant diseases, more important than the class of antihypertensive is treatment to target. Reduction of cholesterol with statins in primary prevention is dependant on total cardiovascular risk, in secondary prevention statins are integral part of modern treatment in non cardioembolic stroke. Atrial fibrillation is one of the major causes of stroke and should be treated with anticoagulation depending on the CHA2DS2-VASc score. Platelet inhibition is mandatory lifelong in all non cardioembolic strokes, in primary prevention only for patients with high total cardiovascular risk. Treatment of asymptomatic carotid artery stenosis should be determined on an individual basis. Symptomatic carotid artery stenosis should be treated immediately after the index stroke. PMID:26488098

  15. Dialectical tensions in stroke survivor relationships.

    Science.gov (United States)

    Brann, Maria; Himes, Kimberly Leezer; Dillow, Megan R; Weber, Keith

    2010-06-01

    Stroke is an unpredictable and life-altering medical occurrence that causes immediate change in survivors' relationships. This study unearthed dialectical tensions expressed by spouses of stroke survivors and examined how those dialectical tensions compare to those experienced by stroke survivors themselves. Sixteen spouses of stroke survivors participated in interviews, and four tensions ultimately emerged: self-orientation-partner-orientation, realism-idealism, uncertainty-acceptance, and emotional release-emotional reservation. Three dialectical tensions (i.e., uncertainty-acceptance, realism-idealism, self-orientation-partner-orientation) were similar to those communicated by stroke survivors. Recognizing dialectical tensions experienced and shared can open communication lines and ultimately improve the health of individuals and their relationships. PMID:20512714

  16. The effects of estrogen in ischemic stroke.

    Science.gov (United States)

    Koellhoffer, Edward C; McCullough, Louise D

    2013-08-01

    Stroke is a leading cause of death and the most common cause of long-term disability in the USA. Women have a lower incidence of stroke compared with men throughout most of the lifespan which has been ascribed to protective effects of gonadal steroids, most notably estrogen. Due to the lower stroke incidence observed in pre-menopausal women and robust preclinical evidence of neuroprotective and anti-inflammatory properties of estrogen, researchers have focused on the potential benefits of hormones to reduce ischemic brain injury. However, as women age, they are disproportionately affected by stroke, coincident with the loss of estrogen with menopause. The risk of stroke in elderly women exceeds that of men and it is clear that in some settings estrogen can have pro-inflammatory effects. This review will focus on estrogen and inflammation and its interaction with aging.

  17. Stroke in Patients With Aortic Stenosis

    DEFF Research Database (Denmark)

    Greve, Anders Møller; Dalsgaard, Morten; Bang, Casper N;

    2014-01-01

    , and poststroke survival a secondary outcome. Cox models treating AVR as a time-varying covariate were adjusted for atrial fibrillation and congestive heart failure, hypertension, age≥75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65-74 years and female sex (CHA2DS2-VASc......BACKGROUND AND PURPOSE: There are limited data on risk stratification of stroke in aortic stenosis. This study examined predictors of stroke in aortic stenosis, the prognostic implications of stroke, and how aortic valve replacement (AVR) with or without concomitant coronary artery bypass grafting...... influenced the predicted outcomes. METHODS: Patients with mild-to-moderate aortic stenosis enrolled in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study. Diabetes mellitus, known atherosclerotic disease, and oral anticoagulation were exclusion criteria. Ischemic stroke was the primary end point...

  18. Changes in chronotype after stroke: A pilot study

    Directory of Open Access Journals (Sweden)

    Thomas eKantermann

    2015-01-01

    Full Text Available This study aimed to elucidate associations between stroke onset and severity as well as chronotype (phase of entrainment and internal time of stroke. Fifty-six first-ever ischemic stroke patients participated in a cross-sectional study assessing chronotype (mid-sleep on work-free days corrected for sleep deficit on workdays; MSFsc by applying the Munich ChronoType Questionnaire (MCTQ. The MCTQ was completed twice, on average 68 ± 24 (SD days post stroke and retrospectively for the time before stroke. To assess the impact of stroke in relation to internal time, InTstroke was calculated as MSFsc minus local time of stroke. Stroke severity was assessed via the standard clinical National Institute Health Stroke Scale (NIHSS and modified Ranking Scale (mRS, both at hospital admission and discharge. Overall, most strokes occurred between noon and midnight. There was no significant association between MSFsc and stroke onset. MSFsc changed significantly after stroke, especially in patients with more severe strokes. Changes in MSFsc varied with InTstroke – the earlier the internal time of a stroke relative to MSFsc-before-stroke, the more MSFsc advanced after stroke. In addition, we provide first evidence that MSFsc changes varied between stroke locations. Larger trials are needed to confirm these findings.

  19. Rhetoric and reality in stroke patient care.

    Science.gov (United States)

    Pound, P; Ebrahim, S

    2000-11-01

    The aim of this study was to identify aspects of the process of care that might help explain the improved outcomes associated with stroke units. Three different care settings for stroke patients, an elderly care unit and general medical ward in an inner-city teaching hospital and a stroke unit in another teaching hospital in the same city, were compared using non-participant observational methods. Nurses on the stroke unit and general medical ward usually engaged in standardised and functional interaction with patients, while nurses on the elderly care unit were observed to adopt a more personal and attentive approach with patients. Rehabilitation nursing was rarely observed on the stroke unit, never on the general medical ward but always on the elderly care unit. There was evidence of effective communication between nurses and therapists on the elderly care unit but this was not observed on the stroke unit. On the elderly care unit the team appeared divided, with therapists and nurses on one side and medicine on the other, while on the stroke unit the divide was between doctors and therapists on one hand and nurses the other. On the general medical ward there was no team working. The observed lack of rehabilitation nursing, nurses' disengagement from the team and nurses' observed lack of warmth towards patients on the stroke unit were all surprising findings. Further research needs to examine whether such findings would be reproduced in stroke units elsewhere. If so, it might be that the better outcomes achieved on stroke units are despite rather than because of the nursing they receive there. PMID:11077948

  20. Vitamin D deficiency and stroke

    Directory of Open Access Journals (Sweden)

    2012-12-01

    Full Text Available Vitamin D comprises a group of fat-soluble pro-hormones, obtained from sun exposure, food, and supplements, and it must undergo two hydroxylation reactions to be activated in the body. Several studies have shown the role of vitamin D in mineral metabolism regulation, especially calcium, phosphorus, and bone metabolism. Some factors such as inadequate vitamin intake and liver or kidney disorders can lead to vitamin D deficiency. Furthermore, vitamin D malnutrition may also be linked to susceptibility to chronic diseases such as heart failure, peripheral artery disease, high blood pressure, cognitive impairment including foggy brain and memory loss, and autoimmune diseases including diabetes type I. Recent research has revealed that low levels of vitamin D increase the risk of cardiovascular-related morbidity (Sato et al., 2004 and mortality (Pilz et al., 2008. Also, hypertension contributes to a reduction in bone mineral density and increase in the incidence of stroke and death. This article reviews the function and physiology of vitamin D and examines the effects of vitamin D deficiency on susceptibility to stroke, as a cardiovascular event, and its morbidity and subsequent mortality.

  1. Swallowing disorders after ischemic stroke

    Directory of Open Access Journals (Sweden)

    Gabriela Camargo Remesso

    2011-10-01

    Full Text Available OBJECTIVE: To investigate occurrences of swallowing disorders after ischemic stroke. METHOD: This was a retrospective study on 596 medical files. The inclusion criterion was that the patients needed to have been hospitalized with a diagnosis of ischemic stroke; the exclusion criteria were the presence of associated cardiac problems and hospital stay already more than 14 days. RESULTS: 50.5% were men and 49.5% women; mean age 65.3 years (SD=±11.7 (p<0.001. Among the risk factors, 79.4% had hypertension, 36.7% had diabetes (p<0.001 and 42.7% were smokers. 13.3% of the patients died. Swallowing disorders occurred in 19.6%, among whom 91.5% had mild difficulty and 8.5% had severe difficulty. 87.1% had spontaneous recovery after a mean of 2.4 months. A lesion in the brainstem region occurred in 6.8% (p<0.001. CONCLUSION: Swallowing disorders occurred in almost 20% of the population and most of the difficulty in swallowing found was mild. The predictors for swallowing disorders were older age, diabetes mellitus and lesions in the brainstem region.

  2. Backward integration, forward integration, and vertical foreclosure

    OpenAIRE

    Spiegel, Yossi

    2013-01-01

    I show that partial vertical integration may either alleviates or exacerbate the concern for vertical foreclosure relative to full vertical integration and I examine its implications for consumer welfare.

  3. Coexistence of Strategic Vertical Separation and Integration

    DEFF Research Database (Denmark)

    Jansen, Jos

    2003-01-01

    -part tariff, exclusive dealing) contract with its retailer. Coexistence emerges when more than two vertical Cournot oligopolists supply close substitutes. When vertical integration and separation coexist, welfare could be improved by reducing the number of vertically separating firms. The scope...

  4. The Utility of the Faces Pain Scale in the Assessment of Shoulder Pain in Turkish Stroke Patients: Its Relation with Quality of Life and Psychologic Status

    Science.gov (United States)

    Dogan, Sebnem Koldas; Ay, Saime; Oztuna, Derya; Aytur, Yesim Kurtais; Evcik, Deniz

    2010-01-01

    This study was planned to investigate the utility of the vertical Faces Pain Scale (FPS) in the assessment of pain in stroke patients using the shoulder pain model and to assess its utility in the Turkish patient population. The secondary aim was to analyze the association of FPS with the quality of life and depression in the study population.…

  5. Large Animal Stroke Models vs. Rodent Stroke Models, Pros and Cons, and Combination?

    Science.gov (United States)

    Cai, Bin; Wang, Ning

    2016-01-01

    Stroke is a leading cause of serious long-term disability worldwide and the second leading cause of death in many countries. Long-time attempts to salvage dying neurons via various neuroprotective agents have failed in stroke translational research, owing in part to the huge gap between animal stroke models and stroke patients, which also suggests that rodent models have limited predictive value and that alternate large animal models are likely to become important in future translational research. The genetic background, physiological characteristics, behavioral characteristics, and brain structure of large animals, especially nonhuman primates, are analogous to humans, and resemble humans in stroke. Moreover, relatively new regional imaging techniques, measurements of regional cerebral blood flow, and sophisticated physiological monitoring can be more easily performed on the same animal at multiple time points. As a result, we can use large animal stroke models to decrease the gap and promote translation of basic science stroke research. At the same time, we should not neglect the disadvantages of the large animal stroke model such as the significant expense and ethical considerations, which can be overcome by rodent models. Rodents should be selected as stroke models for initial testing and primates or cats are desirable as a second species, which was recommended by the Stroke Therapy Academic Industry Roundtable (STAIR) group in 2009. PMID:26463926

  6. Lipid management in the prevention of stroke: a meta-analysis of fibrates for stroke prevention

    Directory of Open Access Journals (Sweden)

    Zhou Yu-Hao

    2013-01-01

    Full Text Available Abstract Background Fibrates has been extensively used to improve plasma lipid levels and prevent adverse cardiovascular outcomes. However, the effect of fibrates on stroke is unclear at the present time. We therefore carried out a comprehensive systematic review and meta-analysis to evaluate the effects of fibrates on stroke. Methods We systematically searched Medline, Embase, the Cochrane Central Register of Controlled Trials, reference lists of articles, and proceedings of major meetings to identify studies for our analysis. We included randomized placebo controlled trials which reported the effects of fibrates on stroke. Relative risk (RR was used to measure the effect of fibrates on the risk of stroke under random effect model. The analysis was further stratified by factors that could affect the treatment effects. Results Overall, fibrate therapy was not associated with a significant reduction on the risk of stroke (RR, 1.02, 95% CI, 0.90 to 1.16, P = 0.78. In the subgroup analyses, we observed that gemfibrozil therapy showed a beneficial effect on stroke (RR, 0.72, 95% CI, 0.53 to 0.98, P = 0.04. Similarly, fibrate therapy comparing to placebo had no effect on the incidence of fatal stroke. Subgroup analysis suggested that fibrate therapy showed an effect on fatal stroke when the Jadad score more than 3 (RR, 0.41, 95% CI, 0.17 to 1.00, P = 0.049. Furthermore, a sensitivity analysis indicated that fibrate therapy may play a role in fatal stroke (RR, 0.49, 95% CI, 0.26 to 0.93, P = 0.03 for patients with previous diabetes, cardiovascular disease or stroke. Conclusions Our study indicated that fibrate therapy might play an important role in reducing the risk of fatal stroke in patients with previous diabetes, cardiovascular disease or stroke. However, it did not have an effect on the incidence of stroke.

  7. The comparison of two physiotherapeutic approaches for gait improvement in sub-acute stroke patients.

    Science.gov (United States)

    Krawczyk, Maciej; Szczerbik, Ewa; Syczewska, Małgorzata

    2014-01-01

    The functional gait problems encountered by stroke patients include impaired balance, abnormal gait pattern with marked asymmetry, pathological trunk and spinal motion. Many different methods of physiotherapy are used to improve functional ability (especially gait) in stroke patients, but their efficacy and outcome are often not objectively assessed. The goal of this paper is to compare two therapeutic programs: one that is traditionally used in our rehabilitation facilities (exercises in lying position, "open chain" exercises, isolated movements of extremities with trunk stabilization) and the new one (exercises in vertical position, sitting or standing, "closed chain" exercises involving whole paretic side of the body). Fifty one stroke patients, aged 34 to 79 years, participated in the study. Patients were randomly allocated to one of the two groups. Patients underwent clinical assessment (Fugl-Meyer, Rivermead Motor Assessment, Berg Balance Scale) and instrumented gait analysis (using six-camera VICON 460 system) simultaneously three times: prior to the beginning of the rehabilitation program, after 6 weeks of the program, and after another 6 weeks of physiotherapy, at the end of rehabilitation program. Results demonstrated that both rehabilitation programs improved the gait function and clinical status in patients suffering from stroke. Despite the differences between the two programs the progress achieved by the patients in locomotor function is similar. Two equivalent physiotherapy programs could be applied during rehabilitation process depending on the patient's individual preferences and needs, as the amount of functional improvement provided by them is comparable. PMID:24708038

  8. Overexpression of brain-derived neurotrophic factor in the hippocampus protects against post-stroke depression

    Institute of Scientific and Technical Information of China (English)

    Hao-hao Chen; Ning Zhang; Wei-yun Li; Ma-rong Fang; Hui Zhang; Yuan-shu Fang; Ming-xing Ding; Xiao-yan Fu

    2015-01-01

    Post-stroke depression is associated with reduced expression of brain-derived neurotrophic factor (BDNF). In this study, we evaluated whether BDNF overexpression affects depression-like behavior in a rat model of post-stroke depression. The middle cerebral artery was occluded to produce a model of focal cerebral ischemia. These rats were then subjected to isolation-housing combined with chronic unpredictable mild stress to generate a model of post-stroke depression. ABDNF gene lentiviral vector was injected into the hippocampus. At 7 days after injection, western blot assay and real-time quantitative PCR revealed that BDNF expression in the hippo-campus was increased in depressive rats injected with BDNF lentivirus compared with depressive rats injected with control vector. Furthermore, sucrose solution consumption was higher, and horizontal and vertical movement scores were increased in the open ifeld test in these rats as well. These ifndings suggest that BDNF overexpression in the hippocampus of post-stroke depressive rats alleviates depression-like behaviors.

  9. Acoustic Analysis of Voice in Dysarthria following Stroke

    Science.gov (United States)

    Wang, Yu-Tsai; Kent, Ray D.; Kent, Jane Finley; Duffy, Joseph R.; Thomas, Jack E.

    2009-01-01

    Although perceptual studies indicate the likelihood of voice disorders in persons with stroke, there have been few objective instrumental studies of voice dysfunction in dysarthria following stroke. This study reports automatic analysis of sustained vowel phonation for 61 speakers with stroke. The results show: (1) men with stroke and healthy…

  10. Mixed Cerebrovascular Disease and the Future of Stroke Prevention

    OpenAIRE

    Fisher, Mark; Vasilevko, Vitaly; Cribbs, David H.

    2012-01-01

    Stroke prevention efforts typically focus on either ischemic or hemorrhagic stroke. This approach is overly simplistic due to the frequent coexistence of ischemic and hemorrhagic cerebrovascular disease. This coexistence, termed “mixed cerebrovascular disease”, offers a conceptual framework that appears useful for stroke prevention strategies. Mixed cerebrovascular disease incorporates clinical and subclinical syndromes, including ischemic stroke, subclinical infarct, white matter disease of ...

  11. CT Angiography in Ischemic Stroke: Optimization and Accuracy

    NARCIS (Netherlands)

    C. de Monyé (Cécile)

    2012-01-01

    textabstractStroke is the third leading cause of death after coronary heart disease and cancer. The clinical burden of stroke now exceeds that of coronary heart disease.1 Especially in the aging population stroke is a major disease. By the year 2020 the incidence of stroke in the Netherlands is expe

  12. Stroke

    Science.gov (United States)

    ... Colledge NR, Ralston SH, Penman ID, eds. Davidson's Principles and Practice of Medicine . 22nd ed. Philadelphia, PA: Elsevier; 2014: ... American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. ... Nursing; Council on Clinical Cardiology; Council on Functional Genomics ...

  13. Stroke disease management--a framework for comprehensive stroke care.

    Science.gov (United States)

    Venketasubramanian, N; Chan, B P L; Lim, E; Hafizah, Noor; Goh, K T; Lew, Y J; Loo, L; Yin, A; Widjaja, L; Loke, W C; Kuick, G; Lee, N L; Ong, B S; Koh, S F; Heng, B H; Cheah, J

    2002-07-01

    Disease management is an approach to patient care that coordinates medical resources for the patient across the entire healthcare delivery system throughout the lifetime of the patient with the disease. Stroke is suitable for disease management as it is a well-known disease with a high prevalence, high cost, variable practice pattern, poor clinical outcome, and managed by a non-integrated healthcare system. It has measurable and actionable outcomes, with available local expertise and support of the Ministry of Health. Developing the programme requires a multidisciplinary team, baseline data on target populations and healthcare services, identification of core components, collaboration with key stakeholders, development of evidence-based clinical practice guidelines and carepaths, institution of care coordinators, use of information technology and continuous quality improvement to produce an effective plan. Core components include public education, risk factor screening and management, primary care and specialist clinics, acute stroke units, inpatient and outpatient rehabilitation facilities, and supportive community services including medical, nursing, therapy, home help and support groups for patients and carers. The family physician plays a key role. Coordination of services is best done by a network of hospital and community-based care managers, and is enhanced by a coordinating call centre. Continuous quality improvement is required, with audit of processes and outcomes, facilitated by a disease registry. Pitfalls include inappropriate exclusion of deserving patients, misuse, loss of physician and patient independence, over-estimation of benefits, and care fragmentation. Collaboration and cooperative among all parties will help ensure a successful and sustainable programme. PMID:12161880

  14. Nut consumption and risk of stroke.

    Science.gov (United States)

    Zhang, Zhizhong; Xu, Gelin; Wei, Yongyue; Zhu, Wusheng; Liu, Xinfeng

    2015-03-01

    Nut consumption has been inconsistently associated with risk of stroke. Our aim was to carry out a meta-analysis of prospective studies to assess the relation between nut consumption and stroke risk and mortality. Pertinent studies were identified by a search of PubMed and Embase through June 2014 and by reviewing the references of retrieved articles. Prospective cohort studies that reported relative risks (RRs) with 95% confidence intervals (CIs) for the association between nut consumption and risk of stroke were included. Six articles including nine independent prospective cohorts with 476,181 participants were included in the meta-analysis. The pooled RR of stroke was 0.90 (95% CI 0.83-0.98) comparing the highest with the lowest nut consumption. Stratifying by gender, significant inverse association was observed for females (RR 0.88; 95% CI 0.78-0.98). Sensitivity analysis restricted to studies with adjustment for common confounding factors showed similar results, strengthening the association between nut consumption and stroke risk. Moreover, we observed a trend toward an inverse association between higher nut consumption and stroke mortality (RR 0.86; 95% CI 0.69-1.06), although it is not significant. Current evidence indicated that nut consumption is inversely associated with risk of stroke.

  15. Stroke genetics: prospects for personalized medicine

    Directory of Open Access Journals (Sweden)

    Markus Hugh S

    2012-09-01

    Full Text Available Abstract Epidemiologic evidence supports a genetic predisposition to stroke. Recent advances, primarily using the genome-wide association study approach, are transforming what we know about the genetics of multifactorial stroke, and are identifying novel stroke genes. The current findings are consistent with different stroke subtypes having different genetic architecture. These discoveries may identify novel pathways involved in stroke pathogenesis, and suggest new treatment approaches. However, the already identified genetic variants explain only a small proportion of overall stroke risk, and therefore are not currently useful in predicting risk for the individual patient. Such risk prediction may become a reality as identification of a greater number of stroke risk variants that explain the majority of genetic risk proceeds, and perhaps when information on rare variants, identified by whole-genome sequencing, is also incorporated into risk algorithms. Pharmacogenomics may offer the potential for earlier implementation of 'personalized genetic' medicine. Genetic variants affecting clopidogrel and warfarin metabolism may identify non-responders and reduce side-effects, but these approaches have not yet been widely adopted in clinical practice.

  16. Prevention of stroke: a strategic global imperative.

    Science.gov (United States)

    Feigin, Valery L; Norrving, Bo; George, Mary G; Foltz, Jennifer L; Roth, Gregory A; Mensah, George A

    2016-09-01

    The increasing global stroke burden strongly suggests that currently implemented primary stroke prevention strategies are not sufficiently effective, and new primary prevention strategies with larger effect sizes are needed. Here, we review the latest stroke epidemiology literature, with an emphasis on the recently published Global Burden of Disease 2013 Study estimates; highlight the problems with current primary stroke and cardiovascular disease (CVD) prevention strategies; and outline new developments in primary stroke and CVD prevention. We also suggest key priorities for the future, including comprehensive prevention strategies that target people at all levels of CVD risk; implementation of an integrated approach to promote healthy behaviours and reduce health disparities; capitalizing on information technology to advance prevention approaches and techniques; and incorporation of culturally appropriate education about healthy lifestyles into standard education curricula early in life. Given the already immense and fast-increasing burden of stroke and other major noncommunicable diseases (NCDs), which threatens worldwide sustainability, governments of all countries should develop and implement an emergency action plan addressing the primary prevention of NCDs, possibly including taxation strategies to tackle unhealthy behaviours that increase the risk of stroke and other NCDs. PMID:27448185

  17. Simulation training for hyperacute stroke unit nurses.

    Science.gov (United States)

    Roots, Angela; Thomas, Libby; Jaye, Peter; Birns, Jonathan

    National clinical guidelines have emphasized the need to identify acute stroke as a clinical priority for early assessment and treatment of patients on hyperacute stroke units. Nurses working on hyperacute stroke units require stroke specialist training and development of competencies in dealing with neurological emergencies and working in multidisciplinary teams. Educational theory suggests that experiential learning with colleagues in real-life settings may provide transferable results to the workplace with improved performance. Simulation training has been shown to deliver situational training without compromising patient safety and has been shown to improve both technical and non-technical skills (McGaghie et al, 2010). This article describes the role that simulation training may play for nurses working on hyperacute stroke units explaining the modalities available and the educational potential. The article also outlines the development of a pilot course involving directly relevant clinical scenarios for hyperacute stroke unit patient care and assesses the benefits of simulation training for hyperacute stroke unit nurses, in terms of clinical performance and non-clinical abilities including leadership and communication.

  18. Simulation training for hyperacute stroke unit nurses.

    Science.gov (United States)

    Roots, Angela; Thomas, Libby; Jaye, Peter; Birns, Jonathan

    National clinical guidelines have emphasized the need to identify acute stroke as a clinical priority for early assessment and treatment of patients on hyperacute stroke units. Nurses working on hyperacute stroke units require stroke specialist training and development of competencies in dealing with neurological emergencies and working in multidisciplinary teams. Educational theory suggests that experiential learning with colleagues in real-life settings may provide transferable results to the workplace with improved performance. Simulation training has been shown to deliver situational training without compromising patient safety and has been shown to improve both technical and non-technical skills (McGaghie et al, 2010). This article describes the role that simulation training may play for nurses working on hyperacute stroke units explaining the modalities available and the educational potential. The article also outlines the development of a pilot course involving directly relevant clinical scenarios for hyperacute stroke unit patient care and assesses the benefits of simulation training for hyperacute stroke unit nurses, in terms of clinical performance and non-clinical abilities including leadership and communication. PMID:22241424

  19. Seizures after stroke : a prospective clinical study.

    Directory of Open Access Journals (Sweden)

    Dhanuka A

    2001-01-01

    Full Text Available Stroke is one of the most common causes of epilepsy in elderly. However, there have been very few prospective studies to define the incidence, pattern and outcome of seizures in stroke. Most studies are based on retrospective analysis of hospital records. Hence, we planned this prospective study to see the clinical, radiological and electroencephalographic characteristics of seizures in stroke and their outcome, from a north Indian tertiary care centre. Over a span of approximately 6 years, 269 consecutive patients with stroke were studied and followed up. Thirty-five (13% of these developed seizures, primarily related to stroke, during mean follow up period of 15.9 months. Twenty of these had infarctions while 15 had haemorrhages. Involvement of the cortical region was seen in most of the patients with seizures. In these patients, 86% of the lesions involved cortical areas exclusively or in addition to subcortical areas on CT scan of the brain. Twenty-seven (77% developed early seizures, two third of them had immediate post-stroke seizures. None of the patients with early onset seizures developed recurrent seizures or epilepsy, while 50% of late onset seizures developed epilepsy. No specific EEG pattern was found in those who later developed epilepsy. In the present study, early onset seizures after stroke were rather common and did not affect outcome and did not recur even when not treated with anti-epileptics. Late onset seizures were less common but were associated with recurrent seizures.

  20. Rehabilitation of a patient with stroke

    Directory of Open Access Journals (Sweden)

    Apurba Barman

    2013-01-01

    Full Text Available Stroke is a significant cause of long-term disability world-wide. The post-stroke disabilities are due to loss of locomotion, activity of daily living, cognition and communication skills. Rehabilitation is an integral part of medical management and continues longitudinally through acute care, post-acute care and community reintegration. The objectives of stroke rehabilitation are to maximize the functional independence, minimize the disabilities, reintegrate back into the home and community and improve the self-esteem of patient. A comprehensive stroke rehabilitation service should provide early assessment of impairments and disabilities, management and prevention of complications and well-organized rehabilitation program in both in-patient and out-patient settings. A multidisciplinary or interdisciplinary team approach is necessary to reduce the post-stroke disabilities. It has many members, including physicians, physical therapists, occupational therapists, speech and language pathologists, orthotist, psychotherapists, social workers, vocational rehabilitation therapists, rehabilitation nurse, patients, families and other caregivers. Physicians caring for patients with stroke during rehabilitation must be aware of potential medical complications, as well as a number of special problems that may complicate recovery, including cognitive deficits, aphasia, dysphagia, urinary incontinence, shoulder pain, spasticity, falls and depression. Involvement of patient and caregivers in the rehabilitation process is essential. This article outlines the salient features of the early comprehensive rehabilitation after stroke.

  1. Professionals’ views on interprofessional stroke team functioning

    Directory of Open Access Journals (Sweden)

    Jane Murray Cramm

    2011-07-01

    Full Text Available Introduction: The quality of integrated stroke care depends on smooth team functioning but professionals may not always work well together. Professionals' perspectives on the factors that influence stroke team functioning remain largely unexamined. Understanding their experiences is critical to indentifying measures to improve team functioning. The aim of this study was to identify the factors that contributed to the success of interprofessional stroke teams as perceived by team members.  Methods: We distributed questionnaires to professionals within 34 integrated stroke care teams at various health care facilities in 9 Dutch regions. 558 respondents (response rate: 39% completed the questionnaire. To account for the hierarchical structure of the study design we fitted a hierarchical random-effects model. The hierarchical structure comprised 558 stroke team members (level 1 nested in 34 teams (level 2.  Results: Analyses showed that personal development, social well-being, interprofessional education, communication, and role understanding significantly contributed to stroke team functioning. Team-level constructs affecting interprofessional stroke team functioning were communication and role understanding. No significant relationships were found with individual-level personal autonomy and team-level cohesion.  Discussion and conclusion: Our findings suggest that interventions to improve team members' social well-being, communication, and role understanding will improve teams' performance. To further advance interprofessional team functioning, healthcare organizations should pay attention to developing professionals' interpersonal skills and interprofessional education.        

  2. Physical Activity in Hospitalised Stroke Patients

    Directory of Open Access Journals (Sweden)

    Tanya West

    2012-01-01

    Full Text Available The aim of this paper was to examine the amount and type of physical activity engaged in by people hospitalised after stroke. Method. We systematically reviewed the literature for observational studies describing the physical activity of stroke patients. Results. Behavioural mapping, video recording and therapist report are used to monitor activity levels in hospitalised stroke patients in the 24 included studies. Most of the patient day is spent inactive (median 48.1%, IQR 39.6%–69.3%, alone (median 53.7%, IQR 44.2%–60.6% and in their bedroom (median 56.5%, IQR 45.2%–72.5%. Approximately one hour per day is spent in physiotherapy (median 63.2 minutes, IQR 36.0–79.5 and occupational therapy (median 57.0 minutes, IQR 25.1–58.5. Even in formal therapy sessions limited time is spent in moderate to high level physical activity. Low levels of physical activity appear more common in patients within 14 days post-stroke and those admitted to conventional care. Conclusions. Physical activity levels are low in hospitalised stroke patients. Improving the description and classification of post stroke physical activity would enhance our ability to pool data across observational studies. The importance of increasing activity levels and the effectiveness of interventions to increase physical activity after stroke need to be tested further.

  3. Job strain and the risk of stroke

    DEFF Research Database (Denmark)

    Fransson, Eleonor I; Nyberg, Solja T; Heikkilä, Katriina;

    2015-01-01

    studies to investigate the association between job strain, a measure of work-related stress, and incident stroke. RESULTS: In 1.8 million person-years at risk (mean follow-up 9.2 years), 2023 first-time stroke events were recorded. The age- and sex-adjusted hazard ratio for job strain relative to no job......BACKGROUND AND PURPOSE: Psychosocial stress at work has been proposed to be a risk factor for cardiovascular disease. However, its role as a risk factor for stroke is uncertain. METHODS: We conducted an individual-participant-data meta-analysis of 196 380 males and females from 14 European cohort...... strain was 1.24 (95% confidence interval, 1.05;1.47) for ischemic stroke, 1.01 (95% confidence interval, 0.75;1.36) for hemorrhagic stroke, and 1.09 (95% confidence interval, 0.94;1.26) for overall stroke. The association with ischemic stroke was robust to further adjustment for socioeconomic status...

  4. Professionals’ views on interprofessional stroke team functioning

    Directory of Open Access Journals (Sweden)

    Jane Murray Cramm

    2011-07-01

    Full Text Available Introduction: The quality of integrated stroke care depends on smooth team functioning but professionals may not always work well together. Professionals' perspectives on the factors that influence stroke team functioning remain largely unexamined. Understanding their experiences is critical to indentifying measures to improve team functioning. The aim of this study was to identify the factors that contributed to the success of interprofessional stroke teams as perceived by team members. Methods: We distributed questionnaires to professionals within 34 integrated stroke care teams at various health care facilities in 9 Dutch regions. 558 respondents (response rate: 39% completed the questionnaire. To account for the hierarchical structure of the study design we fitted a hierarchical random-effects model. The hierarchical structure comprised 558 stroke team members (level 1 nested in 34 teams (level 2. Results: Analyses showed that personal development, social well-being, interprofessional education, communication, and role understanding significantly contributed to stroke team functioning. Team-level constructs affecting interprofessional stroke team functioning were communication and role understanding. No significant relationships were found with individual-level personal autonomy and team-level cohesion. Discussion and conclusion: Our findings suggest that interventions to improve team members' social well-being, communication, and role understanding will improve teams' performance. To further advance interprofessional team functioning, healthcare organizations should pay attention to developing professionals' interpersonal skills and interprofessional education.       

  5. Stroke in young women: An interpretative phenomenological analysis.

    Science.gov (United States)

    Leahy, Dorothy M; Desmond, Deirdre; Coughlan, Tara; O'Neill, Des; Collins, D Rónán

    2016-05-01

    Stroke among adults of working age is increasing. We aimed to explore the experience of stroke among young women in Ireland. In total, 12 women (aged between 18 and 50 years) participated in semi-structured interviews. Data were analysed using interpretative phenomenological analysis. Four super-ordinate themes were identified: stroke as an illness of later life ('obviously it's for older people'), post-stroke selves, a desire for peer support and the impact of stroke on relationships. Findings indicate the importance of addressing the specific needs of younger stroke patients from admission to recovery through provision of inclusive all-age acute stroke services with tailored rehabilitation.

  6. Temporal trends in stroke admissions in Denmark 1997–2009

    DEFF Research Database (Denmark)

    Demant, Malene Nøhr; Andersson, Charlotte; Ahlehoff, Ole;

    2013-01-01

    The Stroke burden is increasing in many populations where health institutions may experience more patients. We wanted to examine whether incidence rates and absolute number of hospitalized stroke patients remained stable in Denmark during a 13 years period where exposure to major stroke risk fact...... factors decreased, changes in stroke treatment was implemented, and the age of the population increased.......The Stroke burden is increasing in many populations where health institutions may experience more patients. We wanted to examine whether incidence rates and absolute number of hospitalized stroke patients remained stable in Denmark during a 13 years period where exposure to major stroke risk...

  7. Lacunar strokes: a single institutional experience

    Directory of Open Access Journals (Sweden)

    Osama Shukir Muhammed Amin

    2013-08-01

    Full Text Available Abstract: Objective: Lacunar ischemic strokes comprise approximately 25% of all ischemic strokes. We compared the risk factors and clinical pattern of this type of stroke between males and females. Methods: This observational study involved 50 consecutive patients with their first-ever lacunar stroke and was conducted at the department of neurology of Sulaimaniya general teaching hospital, Iraq from December 1, 2010 to March 1, 2013. Patients’ risk factors, clinical presentation, and strokes’ patterns were noted and a comparison was made between males and females. Results: Males (64% outnumbered females (36% with a male to female ration of 1.7. The mean age of males was 63 years while it was 61 years in females. Although hypertension was more common in females than in males, diabetes and smoking were more common in the latter group; however, there were no statistically significant differences between the 2 genders in terms of hypertension (P-value <0.3 and diabetes (P-value < 0.07 while smoking was strongly associated with male gender (P-value<0.0001. Pure motor hemiparesis, ataxic hemiparesis, pure sensory stroke, and dysarthria-clumsy hand syndrome were more common in males; only senori-motor stroke revealed a statistically significant difference in favor males (P-value<0.0001; 95% CI -1.7 to 19.2. There was no statistically significant difference in terms of which side of the brain was infarcted between males and females (P-value<0.4. Conclusion: Males around the age of 63 years were the main target for these lacunar strokes. Cigarette smoking and sensorimotor strokes were significantly associated with male gender. [Cukurova Med J 2013; 38(4.000: 659-666

  8. Ischaemic strokes : management in first six hours.

    Directory of Open Access Journals (Sweden)

    Dalal P

    2001-04-01

    Full Text Available Cerebrovascular disease (CVD or stroke is one of the foremost causes of high morbidity and mortality for many nations of the world, posing a major socio-economic challenge in the occupational and neuro-rehabilitational programmes of the ′stroke-survivors′. For example, in USA alone it has been estimated that a sum of 3261 million dollars is spent as direct cost for treatment, in addition to 4104 million dollars as indirect costs, consequent on economic losses of ′stroke victims′. Thus, the new concept in stroke pathophysiology and strategies for stroke prevention have assumed global importance. Among all risk factors for strokes, hypertension is one of the most important and treatable factor. Community screening surveys, by well defined WHO protocol, have shown that nearly 15% of urban population is hypertensive (160/95 mm Hg or more. Though high blood pressure has the highest attributable risk for stroke, there are many other reasons such as patient′s compliance in taking medicine and poor followup in clinical practice that may lead to failure in reducing stroke mortality. In subjects, who have transient ischaemic attacks (TIAs, regular use of antiplatelet agents like aspirin is well established in prevention of stroke. It is also mandatory to prohibit tobacco use and adjust dietary habits to control body weight. Associated conditions like diabetes mellitus etc. should also be treated. It is advisable to initiate community screening surveys on well defined populations for early detection of hypertension and TIAs. Primary health care centres should be the base stations for these surveys, because data gathered from urban hospitals will not truly reflect the crude prevalence rates for the community to design practical prevention programmes.

  9. Magnetic resonance imaging to visualize stroke and characterize stroke recovery: a review

    Directory of Open Access Journals (Sweden)

    Bradley J MacIntosh

    2013-05-01

    Full Text Available The global burden of stroke continues to grow. Although stroke prevention strategies (eg. medications, diet and exercise can contribute to risk reduction, options for acute interventions (eg. thrombolytic therapy for ischemic stroke are limited to the minority of patients. The remaining patients are often left with profound neurological disabilities that substantially impact quality of life, economic productivity, and increase caregiver burden. In the last decade, however, the future outlook for such patients has been tempered by movement away from the view that the brain is incapable of reorganizing after injury. Many now view brain recovery after stroke as an area of scientific research with large potential for therapeutic advances, far into the future [1]. As a probe of brain anatomy, function and physiology, magnetic resonance imaging is a noninvasive and highly versatile modality that promises to play a particularly important role in such research, towards improving stroke rehabilitation methods and stroke recovery.

  10. Short- and long-term prognosis for very old stroke patients. The Copenhagen Stroke Study

    DEFF Research Database (Denmark)

    Kammersgaard, Lars Peter; Jørgensen, H S; Reith, J;

    2004-01-01

    BACKGROUND AND PURPOSE: The very old are expected to become a growing part of the stroke population in the industrialised part of the world. The aims of this study were to evaluate clinical characteristics of patients aged 85 years or more at stroke onset and to investigate very old age...... as an independent predictor of short- and long-term outcome. METHODS: In the community-based Copenhagen Stroke Study we recorded admission clinical characteristics in 1197 consecutive stroke patients. Patients were stratified according to age groups on admission. Follow-up was performed at a mean of 7 years after...... stroke onset. By way of multiple logistic regression and survival analyses very old age was independently related to short- and long-term mortality and nursing home placement independent of other clinical characteristics. RESULTS: 16% of patients were 85 years or older at the time of stroke onset. More...

  11. Improving stroke care: Quality of care and health education in patients with a stroke or transient ischemic attack

    NARCIS (Netherlands)

    E. Maasland (Lisette)

    2011-01-01

    textabstractThis thesis focuses on the applicability of results of clinical trials of stroke and TIA patients in everyday practice and on measurement of quality of stroke care. A third aim is to further expand an underexposed aspect of stroke care, namely health education in stroke patients. Chapter

  12. Acute Phase Reactants and Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Mustafa Sahan

    2010-04-01

    Full Text Available Cerebrovascular diseases which called as stroke causes severe mortality and morbidity. Stoke is the third cause of death and first cause of the sequela among in its disorder group. Stroke with a 80-85% has the most frequency and the most cause of death in among the neurological disorders. Besides its lethal effects, sequela of stroke also cause physiological problems on individuals, families and social groups, it also brings some economic problems. [Archives Medical Review Journal 2010; 19(2.000: 85-140

  13. The real stroke burden in the Philippines.

    Science.gov (United States)

    Navarro, Jose C; Baroque, Alejandro C; Lokin, Johnny K; Venketasubramanian, Narayanaswamy

    2014-07-01

    Stroke is the Philippines' second leading cause of death. It has a prevalence of 0·9%; ischemic stroke comprises 70% while hemorrhagic stroke comprises 30%. Age-adjusted hypertension prevalence is 20·6%, diabetes 6·0%, dyslipidemia 72·0%, smoking 31%, and obesity 4·9%. The neurologist-to-patient ratio is 1:330·000, with 67% of neurologists practicing in urban centers. Health care is largely private and the cost is borne out-of-pocket by patients and their families. Challenges include delivering adequate support to the rural communities and to the underprivileged sectors. PMID:24844610

  14. OSA – a risk factor for stroke

    Directory of Open Access Journals (Sweden)

    Ryan CM

    2011-12-01

    Full Text Available Clodagh M RyanCentre for Sleep Health and Research, University of Toronto/Toronto General Hospital, Toronto, CanadaAbstract: Obstructive sleep apnea is a sleep breathing disorder characterized by recurrent and intermittent hypoxia with continued respiratory effort against a closed glottis. The result of this is a cascade of acute and chronic systemic pathophysiological responses that cause endothelial dysfunction, atherosclerosis and lead to cardiovascular and cerebrovascular disease. This article focuses on the clinical evidence linking obstructive sleep apnea and stroke and on the specific mechanisms perpetuating stroke risk in this population.Keywords: stroke, obstructive sleep apnea, brain injury, atherosclerosis, continuous positive airway pressure, outcomes

  15. Modifiable risk factors for ischemic stroke

    Directory of Open Access Journals (Sweden)

    Alexandros Gianoulakis

    2010-07-01

    Full Text Available Ischemic stroke is the third leading cause of death after cardiac disease and cancer in the developed countries. In patients older than 65 years old, ischemic stroke is one of the main causes of disability. They are also responsible for approximately 4.5 million deaths each year globally.The aim of the present study was to review the literature about the modifiable risk factors related to the development of ischemic stroke.The method οf this study included bibliographic research from both reviews and researches from literature, mainly of the last 8 years. The words used in pub med data base, referred to the modifiable risk factors related to the development of ischemic stroke.Results: In the majority of research studies, responsible risk factors for ischemic stroke are classified according to their ability of modification, in modifiable and non–modifiable risk factors. Some of the modifiable risk factors have been fully documented whereas some others need further research. The main modifiable risk factor is hypertension because on the one hand it promotes atherosclerosis and, on the other hand, leads to deteriorative changes and constrictions of small brain vessels. Atrial fibrillation is the most significant risk factor for ischemic stroke, since it is responsible for more than 50% of thromboembolic cases. Also, patients with diabetes mellitus are in higher risk for developing ischemic stroke compared to healthy population, whereas the danger is increasing in insuline-depented individuals. Increase of lipids in blood and disorders of cholesterol are responsible for atherosclerosis in coronary vessels and carotid. More in detail, carotid stenosis >50% in individuals over than 65 years old consist a significant risk factor for ischemic stroke. Though, the relation of smoking to ischemic stroke is still not fully understood, however smokers are in high risk for developing ischemic stroke for the reason that smoking is significantly related to

  16. Positron CT imaging of an impending stroke

    Energy Technology Data Exchange (ETDEWEB)

    Itoh, M.; Hatazawa, J.; Watanuki, S.; Pozzilli, C.; Matsuzawa, T.; Abe, Y.; Fujiwara, T.; Satoh, T.; Fukuda, H.; Wada, T.

    1988-06-01

    We present PET findings of a case of a transient ischemic attack which later progressed to cerebral infarction. Cerebral blood flow at the stroke focus in the right parietal cortex measured after a TIA attack and before stroke was as low as 24 ml/100 g/min with some increase in oxygen extraction fraction and blood volume. The condition was compatible with 'misery perfusion'. This case may be an example suggestive that the 'misery perfusion sign' is a warning of impending stroke and its poor prognosis if left without appropriate treatments.

  17. Migraine and risk of hemorrhagic stroke

    DEFF Research Database (Denmark)

    Gaist, David; González-Pérez, Antonio; Ashina, Messoud;

    2014-01-01

    to select 10,000 controls free from hemorrhagic stroke. Using unconditional logistic regression models, we calculated the risk of hemorrhagic stroke associated with migraine, adjusting for age, sex, calendar year, alcohol, body mass index, hypertension, previous cerebrovascular disease, oral contraceptive......BACKGROUND: We investigated the association between hemorrhagic stroke and migraine using data from The Health Improvement Network database. FINDINGS: We ascertained 1,797 incident cases of intracerebral hemorrhage (ICH) and 1,340 of subarachnoid hemorrhage (SAH). Density-based sampling was used...

  18. Crossed cerebellar diaschisis in ischemic stroke

    DEFF Research Database (Denmark)

    Meneghetti, G; Vorstrup, S; Mickey, B;

    1984-01-01

    Seventy measurements of CBF were performed in 12 stroke patients by 133Xe inhalation and a rapidly rotating single photon emission computerized tomograph. CBF was measured every other day during the acute phase and at 2- and 6-month follow-up visits. A persistent contralateral cerebellar blood flow....... It is concluded from this serial study that crossed cerebellar diaschisis is a common finding in completed stroke. It is probably caused by disconnection of the corticopontine pathways, a disconnection that tends to persist. The phenomenon is in fact less variable than the stroke-related CBF changes...

  19. A Stroke Mimic: A Case Report

    Directory of Open Access Journals (Sweden)

    Annia Martínez Rivas

    2016-03-01

    Full Text Available Diseases mimicking a stroke are a major health problem for a large number of hospitals. This paper aims at presenting a disease that has a stroke-like presentation. The case of a 46-year-old man admitted to the stroke unit with a clinical and radiological diagnosis of cerebral infarction is presented. The patient developed fever and a serious deterioration of consciousness. Changes on computed tomography consistent with a brain abscess were observed. Broad-spectrum antibiotics were administered and a follow-up tomography was performed. Once the treatment was completed, the clinical and radiological suspicion of a brain abscess was confirmed.

  20. Specific antismoking advice after stroke

    DEFF Research Database (Denmark)

    Hornnes, Nete; Larsen, Klaus; Brink-Kjær, Tove;

    2014-01-01

    -smokers in the intervention group than among controls. MATERIAL AND METHODS: Patients admitted with an acute stroke or a transient ischaemic attack were included in a randomised controlled trial focusing on control of lifestyle risk factors and hypertension. Here, we report the intervention focused on smoking cessation. We......%) baseline smokers in the intervention group had stopped smoking versus eight of 56 (14%) among controls (p = 0.112). Living with a partner (p = 0.012), having at least ten years of education (p = 0.012), and not being exposed to smoking at home (p = 0.036) were independent predictors of smoking cessation....... CONCLUSION: We did not achieve our aim of higher smoking cessation rates in the intervention group. Future smoking cessation interventions should be more intensive, focus on patients' social circumstances and, if possible, involve patients' relatives. FUNDING: This study was supported by the Ludvig and Sara...

  1. Stroke due to Hematologic Aspects

    Institute of Scientific and Technical Information of China (English)

    刘泽霖

    2004-01-01

    @@ Stroke due to ‘cerebral vein thrombosis' (CVT) is commonly used to refer to thrombosis of the cerebral venous system, including either dural venous sinuses, or deep and superficial (cortical) cerebral veins. CVT are frightening events due to the severity of their clinical manifestations and their high mortality rate (up to 30% in some casereports).The clinical signs and symptoms of CVT are relatively nonspecific: they include headache, papilledema, vomiting,seizures, focal neurological deficits (motor or sensory) and impaired consciousness. CVT has long been considered as rare and mostly infection-related event; moreover, due to its nonspecific clinical manifestations, the diagnosis has been difficult, delayed and could often be made only post mortem.

  2. Functional recovery in aging mice after experimental stroke

    OpenAIRE

    Manwani, Bharti; Liu, Fudong; Xu, Yan; Persky, Rebecca; Li, Jun; McCullough, Louise D.

    2011-01-01

    Aging is a non modifiable risk factor for stroke. Since not all strokes can be prevented, a major emerging area of research is the development of effective strategies to enhance functional recovery after stroke. However, in the vast majority of pre-clinical stroke studies, the behavioral tests used to assess functional recovery have only been validated for use in young animals, or are designed for rats. Mice are increasingly utilized in stroke models but well validated behavioral tests design...

  3. Neuroprotection for Stroke: Current Status and Future Perspectives

    OpenAIRE

    Christoph Kleinschnitz; Sutherland, Brad A; Jens Minnerup; Buchan, Alastair M.

    2012-01-01

    Neuroprotection aims to prevent salvageable neurons from dying. Despite showing efficacy in experimental stroke studies, the concept of neuroprotection has failed in clinical trials. Reasons for the translational difficulties include a lack of methodological agreement between preclinical and clinical studies and the heterogeneity of stroke in humans compared to homogeneous strokes in animal models. Even when the international recommendations for preclinical stroke research, the Stroke Academi...

  4. Population shifts and the future of stroke: forecasts of the future burden of stroke

    OpenAIRE

    Howard, George; Goff, David C.

    2012-01-01

    Population distribution estimates by age and race/ethnicity from the U.S. Census Bureau for the years 2010 and 2050 were combined with estimates of stroke incidence from population-based surveillance studies to forecast the distribution of incident stroke cases for the years 2010 and 2050. Over these 40 years, the number of incident strokes will more than double, with the majority of the increase among the elderly (age 75+) and minority groups (particularly Hispanics). These increases are lik...

  5. QTc Interval Prolongation and Stroke: Any Differences between Ischemic and Hemorrhagic Strokes?

    OpenAIRE

    Osama Shukir Muhammed Amin; Hawar Adnan Myckan; Emad Hama Hussein

    2014-01-01

    Purpose: Strokes results in a multitude of electrocardiographic (ECG) changes, and a prolongation of the QTc interval is a well-observed one. We analyzed QTc interval prolongation among males and females who presented with acute stroke. Material and Methods: This observational study was conducted at the department of neurology of the Sulaimaniya general teaching hospital, from August 2012 to May 2013, and involved 100 consecutive patients who presented with acute stroke; 50 had ischemic s...

  6. Survival after stroke. Risk factors and determinants in the Copenhagen Stroke Study

    DEFF Research Database (Denmark)

    Kammersgaard, Lars Peter

    2010-01-01

    The eight papers included in this doctoral thesis were made during my position as a clinical research assistant at the Department of Neurology, Bispebjerg Hospital. All papers are based on the Copenhagen Stroke Study, which comprises a cohort of 1197 patients with acute stroke admitted to a single...... stroke unit and recruited from a well-defined area in Copenhagen, Denmark. This thesis focuses on the survival after stroke in relation to several baseline clinical characteristics and risk factors for cardiovascular disease. The thesis comes in three sections with regard to whether factors or clinical...

  7. Innovation in Stroke Care Quality: NIH Stroke Scale Change and Shewhart Charts.

    Science.gov (United States)

    Dobbs, Michael R; Krishnamohan, Prashanth; Jicha, Gregory; Cohen, Amy P

    2015-01-01

    Stroke care, admission through discharge, is a process that should lead to symptomatic improvement. Improvement or decline in conditions of patients with acute stroke during hospitalization can be measured by the National Institutes of Health Stroke Scale (NIH Stroke Scale or NIHSS) at both admission and discharge and may indicate the overall quality of acute stroke care for a patient and the stability of care in the system. Shewhart control charts were analyzed for 98 patients with stroke admissions in a random sample at a tertiary care stroke center to determine the feasibility of examining the NIHSS score change to detect statistical control or identify excess variance in outcomes. The study sample showed a mean improvement of 1.33 points from admission to discharge on the NIHSS. Three statistical outliers were found. Excess statistical variation clustered within a specific stroke team's tenure suggested a need for targeted education and examination for process redesign. Using the NIHSS and the Shewhart control charts identified a systematic process flaw that could be targeted to improve stroke outcomes and move the delivery system toward statistical control.

  8. Management of acute stroke: impact of registration studies.

    Science.gov (United States)

    Adams, Harold P

    2010-09-01

    Stroke is a life-threatening or life-changing disease that is expensive in health care costs and lost productivity. Stroke also is a leading cause of human suffering. While the risk of stroke may be reduced with advances in prevention, recent advances in acute care can limit the consequences of stroke. In particular, the success of reperfusion therapies including intra-arterial interventions and intravenous administration of thrombolytic agents means that some patients with stroke may be cured. Still, the time window for effective treatment of stroke is relatively short. As a result, modern stroke management requires the close collaboration of the public, health care providers, administrators, insurance companies, and the government. Potential strategies to extend modern stroke care to as many patients as possible include 1) educational programs to train community emergency medical service personnel and physicians, 2) development of stroke care plans at community hospitals, 3) an integrated community-comprehensive stroke center program based on consultation, and telemedicine. The goal is to have a highly integrated approach to provide emergency treatment of the stroke that provides key emergency treatment, including intravenous administration of thrombolytic medications, at a community hospital (primary stroke center) with evacuation to a comprehensive stroke center that has resources and expertise that are not available in the primary stroke center. Taiwan is an ideal location for the development of such regional stroke programs.

  9. The Stroke Riskometer™ App: Validation of a data collection tool and stroke risk predictor

    Science.gov (United States)

    Parmar, Priya; Krishnamurthi, Rita; Ikram, M Arfan; Hofman, Albert; Mirza, Saira S; Varakin, Yury; Kravchenko, Michael; Piradov, Michael; Thrift, Amanda G; Norrving, Bo; Wang, Wenzhi; Mandal, Dipes Kumar; Barker-Collo, Suzanne; Sahathevan, Ramesh; Davis, Stephen; Saposnik, Gustavo; Kivipelto, Miia; Sindi, Shireen; Bornstein, Natan M; Giroud, Maurice; Béjot, Yannick; Brainin, Michael; Poulton, Richie; Narayan, K M Venkat; Correia, Manuel; Freire, António; Kokubo, Yoshihiro; Wiebers, David; Mensah, George; BinDhim, Nasser F; Barber, P Alan; Pandian, Jeyaraj Durai; Hankey, Graeme J; Mehndiratta, Man Mohan; Azhagammal, Shobhana; Ibrahim, Norlinah Mohd; Abbott, Max; Rush, Elaine; Hume, Patria; Hussein, Tasleem; Bhattacharjee, Rohit; Purohit, Mitali; Feigin, Valery L

    2015-01-01

    Background The greatest potential to reduce the burden of stroke is by primary prevention of first-ever stroke, which constitutes three quarters of all stroke. In addition to population-wide prevention strategies (the ‘mass’ approach), the ‘high risk’ approach aims to identify individuals at risk of stroke and to modify their risk factors, and risk, accordingly. Current methods of assessing and modifying stroke risk are difficult to access and implement by the general population, amongst whom most future strokes will arise. To help reduce the burden of stroke on individuals and the population a new app, the Stroke Riskometer™, has been developed. We aim to explore the validity of the app for predicting the risk of stroke compared with current best methods. Methods 752 stroke outcomes from a sample of 9501 individuals across three countries (New Zealand, Russia and the Netherlands) were utilized to investigate the performance of a novel stroke risk prediction tool algorithm (Stroke Riskometer™) compared with two established stroke risk score prediction algorithms (Framingham Stroke Risk Score [FSRS] and QStroke). We calculated the receiver operating characteristics (ROC) curves and area under the ROC curve (AUROC) with 95% confidence intervals, Harrels C-statistic and D-statistics for measure of discrimination, R2 statistics to indicate level of variability accounted for by each prediction algorithm, the Hosmer-Lemeshow statistic for calibration, and the sensitivity and specificity of each algorithm. Results The Stroke Riskometer™ performed well against the FSRS five-year AUROC for both males (FSRS = 75·0% (95% CI 72·3%–77·6%), Stroke Riskometer™ = 74·0(95% CI 71·3%–76·7%) and females [FSRS = 70·3% (95% CI 67·9%–72·8%, Stroke Riskometer™ = 71·5% (95% CI 69·0%–73·9%)], and better than QStroke [males – 59·7% (95% CI 57·3%–62·0%) and comparable to females = 71·1% (95% CI 69·0%–73·1%)]. Discriminative

  10. tDCS and Robotics on Upper Limb Stroke Rehabilitation: Effect Modification by Stroke Duration and Type of Stroke

    Directory of Open Access Journals (Sweden)

    Sofia Straudi

    2016-01-01

    Full Text Available Objective. The aim of this exploratory pilot study is to test the effects of bilateral tDCS combined with upper extremity robot-assisted therapy (RAT on stroke survivors. Methods. We enrolled 23 subjects who were allocated to 2 groups: RAT + real tDCS and RAT + sham-tDCS. Each patient underwent 10 sessions (5 sessions/week over two weeks. Outcome measures were collected before and after treatment: (i Fugl-Meyer Assessment-Upper Extremity (FMA-UE, (ii Box and Block Test (BBT, and (iii Motor Activity Log (MAL. Results. Both groups reported a significant improvement in FMA-UE score after treatment (p<0.01. No significant between-groups differences were found in motor function. However, when the analysis was adjusted for stroke type and duration, a significant interaction effect (p<0.05 was detected, showing that stroke duration (acute versus chronic and type (cortical versus subcortical modify the effect of tDCS and robotics on motor function. Patients with chronic and subcortical stroke benefited more from the treatments than patients with acute and cortical stroke, who presented very small changes. Conclusion. The additional use of bilateral tDCS to RAT seems to have a significant beneficial effect depending on the duration and type of stroke. These results should be verified by additional confirmatory studies.

  11. Alligning vertical collection relevance with user intent

    NARCIS (Netherlands)

    Zhou, Ke; Demeester, Thomas; Nguyen, Dong; Hiemstra, Djoerd; Trieschnigg, Dolf

    2014-01-01

    Selecting and aggregating different types of content from multiple vertical search engines is becoming popular in web search. The user vertical intent, the verticals the user expects to be relevant for a particular information need, might not correspond to the vertical collection relevance, the vert

  12. Effect of pre-stroke statin use on stroke severity and early functional recovery: a retrospective cohort study

    OpenAIRE

    Choi, Jay Chol; Lee, Ji Sung; Park, Tai Hwan; Cho, Yong-Jin; Park, Jong-Moo; Kang, Kyusik; Lee, Kyung Bok; Lee, Soo-Joo; Ko, Youngchai; Lee, Jun; Kim, Joon-Tae; Yu, Kyung-Ho; Lee, Byung-Chul; Cha, Jae-Kwan; Kim, Dae-Hyun

    2015-01-01

    Background Experimental studies suggest that pre-stroke statin treatment has a dual effect of neuroprotection during ischemia and neurorestoration after ischemic injury. The aim of this study was to evaluate the effect of pre-stroke statin use on initial stroke severity and early clinical outcome. Methods We used a prospective database enrolling patients with acute ischemic stroke from 12 hospitals in Korea between April 2008 and January 2012. Primary endpoint was the initial stroke severity ...

  13. Predictors of long-term survival among first-ever ischemic and hemorrhagic stroke in a Brazilian stroke cohort

    OpenAIRE

    Goulart, Alessandra C.; Fernandes, Tiotrefis G; Santos, Itamar S.; Airlane P. Alencar; Bensenor, Isabela M; Paulo A Lotufo

    2013-01-01

    Background Few studies have examined both ischemic and hemorrhagic stroke to identify prognostic factors associated to long-term stroke survival. We investigated long-term survival and predictors that could adversely influence ischemic and hemorrhagic first-ever stroke prognosis. Methods We prospectively ascertained 665 consecutive first-ever ischemic and hemorrhagic stroke cases from “The Study of Stroke Mortality and Morbidity” (The EMMA Study) in a community hospital in São Paulo, Brazil. ...

  14. 25-Hydroxyvitamin D and symptomatic ischemic stroke

    DEFF Research Database (Denmark)

    Brøndum-Jacobsen, Peter; Nordestgaard, Børge G; Schnohr, Peter;

    2013-01-01

    OBJECTIVE: We tested the hypothesis that low plasma concentrations of 25-hydroxyvitamin D are associated with increased risk of symptomatic ischemic stroke in the general population. METHODS: We measured plasma 25-hydroxyvitamin D in 10,170 individuals from the general population, the Copenhagen...... City Heart Study. During 21 years of follow-up, 1,256 and 164 persons developed ischemic and hemorrhagic stroke, respectively. In a meta-analysis of ischemic stroke, we included 10 studies, 58,384 participants, and 2,644 events. RESULTS: Stepwise decreasing plasma 25-hydroxyvitamin D concentrations...... were associated with stepwise increasing risk of ischemic stroke both as a function of seasonally adjusted percentile categories and as a function of clinical categories of 25-hydroxyvitamin D (p for trend ≤ 2 × 10(-3) ). In a Cox regression model comparing individuals with plasma 25-hydroxyvitamin D...

  15. Early Arterial Ischemic Stroke in Premature Infants

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2008-05-01

    Full Text Available Presentation, clinical course, and outcomes for 23 premature children with arterial ischemic stroke before 44 weeks gestational age are reported from Riley Hospital for Children, Indianapolis, IN.

  16. Early supported discharge following mild stroke

    DEFF Research Database (Denmark)

    Lou, Stina; Carstensen, Kathrine; Møldrup, Marie;

    2016-01-01

    BACKGROUND: Early supported discharge (ESD) allows mild-to-moderate stroke patients to return home as soon as possible and continue rehabilitation at their own pace in familiar surroundings. Thus, the main responsibility for continued rehabilitation is in the hands of patients and their partners......, who must collaborate to adjust to poststroke everyday life. However, couples' joint experiences of stroke, early discharge and rehabilitation at home remain minimally investigated. AIM: To investigate how mild stroke patients' and their partners' experience and manage everyday life in a context of ESD....... METHODS: We conducted qualitative interviews with a purposive sample of 22 ESD patients and 18 partners. Interviews were conducted 3-6 weeks after stroke, and we used thematic analysis to analyse the data. FINDINGS: The analysis identified three themes. First, 'Home as a healing place' involved...

  17. Genetics of ischemic stroke: Indian perspective

    Directory of Open Access Journals (Sweden)

    Subhash Kaul

    2012-01-01

    Full Text Available A stroke is still a major cause of long-term disability and the third largest killer in the world after heart attack and cancer. Inherited genetic variation has been shown to play a role in its pathogenesis and therefore, there is a need to identify the culprit genetic variants. They may provide novel targets for preventive therapeutics. The most intensively investigated candidate gene is PDE4D. There are several positive replication studies of PDE4D gene with stroke. The genetic contribution to ischemic stroke risk in India has not been explored adequately. Reports on few candidate genes are available but we are still lagging behind in this aspect. Most of the reports are from Andhra Pradesh, a province in south India and a few parts of north India. PDE4D has been identified as a predisposition gene for ischemic stroke in Southern as well as the Northern population of India.

  18. Recovery of Gait After Stroke: What Changes?

    NARCIS (Netherlands)

    Buurke, Jaap H.; Nene, Anand V.; Kwakkel, Gert; Erren-Wolters, Victorien; IJzerman, Maarten J.; Hermens, Hermie J.

    2008-01-01

    Background. Little is known about whether changes in coordination patterns of muscle activation after stroke are related to functional recovery of walking. Objective . The present study investigated the longitudinal relationship between changes in neuromuscular activation patterns of paretic muscles

  19. Diabetes - preventing heart attack and stroke

    Science.gov (United States)

    Diabetes complications - heart; Coronary artery disease - diabetes; CAD - diabetes; Cerebrovascular disease - diabetes ... People with diabetes have a higher chance of having heart attacks and strokes. Smoking and having high blood pressure and high ...

  20. Suicide after a stroke: a population study

    DEFF Research Database (Denmark)

    Teasdale, T W; Engberg, A W

    2001-01-01

    STUDY OBJECTIVE: To establish whether there are increased rates of suicide after a stroke and the degree to which any increase is related to gender, age at stroke, diagnosis, duration of hospitalisation, and time since stroke. DESIGN: Cross linkage of national registers for hospitalisations...... cases of suicide were identified. MAIN RESULTS: Annual incidence rates, both observed and expected, together with standardised mortality ratios (SMR) were computed based on annual population and suicide statistics, stratified by age and gender. The overall annual incidence rate of suicide in the cohort.......76) for patients under 50 years of age group and were least for patients 80 years or older (1.3; 0.95, 1.79). There was no clear relation to stroke diagnosis. Suicides were negatively related to duration of hospitalisation, being lowest for those hospitalised for more than three months (0.88; 0.65, 1...

  1. Blood Pressure Patterns May Predict Stroke Risk

    Science.gov (United States)

    ... blood pressure reading) of more than 6,700 Dutch adults. Participants were ages 55 to 106 and ... stroke or death from other blood pressure-related diseases up to age 80, the study found. Moderately ...

  2. Achieving a holistic perspective in stroke rehabilitation

    DEFF Research Database (Denmark)

    Kristensen, Hanne Kaae; Lund, Hans; Jones, Dorrie;

    2015-01-01

    , was carried out. Consecutive patients with a diagnosis of stroke (n=131; 70 males and 61 females; mean age: 72 years) admitted to a university hospital between May and December 2012 were enrolled by 13 physiotherapists and occupational therapists. Physiotherapist and occupational therapist documentation......Background/Aims: Holistic, multidisciplinary rehabilitation is often the most appropriate for stroke patients. The World Health Organization’s International Classification of Functioning, Disability and Health (ICF) provides a comprehensive conceptual framework and systematic terminology used...... by health professionals worldwide. The purpose of this study was to explore how the components of the ICF were addressed by physiotherapists and occupational therapists in stroke rehabilitation. Methods: A prospective cohort study, including all service levels within Danish stroke rehabilitation...

  3. EVALUATION OF RISK FACTORS IN ACUTE STROKE

    Directory of Open Access Journals (Sweden)

    Putta

    2015-03-01

    Full Text Available Introduction: Cerebrovascular disease is the third most common cause of death in the developed world after cancer and ischemic heart disease. In India, community surveys have shown a crude prevalence rate of 200 per 100000 population for hemiplegia. Aims and objectives: Identification of risk factors for c erebrovascular disease. Materials and Methods: Inclusion Criteria: Cases of acute stroke admitted in S.V.R.R.G.G.H, Tirupati were taken for the study. Exclusion Criteria: Head injury cases, neoplasm cases producing cerebrovascular disease were excluded. Re sults: Stroke was more common in male, 54% patients were male 46% were female. It was more common in 6 th and 7 th decade. More common risk factors were hypertension followed by smoking, diabetes mellitus. More common pathology was infarction. Conclusion: Com mon risk factors for acute stroke are hypertension, smoking, diabetes mellitus, alcoholism, obesity, cardiac disease. Stroke was confirmed by CT scan of brain.

  4. Less Heart Care, More Strokes for Women?

    Science.gov (United States)

    ... Heart Care, More Strokes for Women? Study reflects gender differences in treatment of atrial fibrillation To use the ... subtle symptoms so they need to pay more attention to their blood sugar and blood pressure and ...

  5. [The association between oral diseases and stroke].

    Science.gov (United States)

    Jelito-Barglik, Katarzyna; Pierzchała, Krystyna; Postek-Stefańska, Lidia; Pierzchała, Bogna; Labuz-Roszak, Beata

    2014-01-01

    In recent years there have been many studies concerning the effect of periodontal disease on the vascular system, including the development of stroke, either ischemic or hemorrhagic. The aim of this study was to present the relationship between periodontal disease and stroke based on the available literature. As it is evident from studies, patients with periodontal disease are predisposed to the formation of chronic systemic inflammation, which in turn is a risk facto for cardiovascular diseases, particularly diseases of the large vessels, including atherosclerosis, as well as chronic inflammation in the atherosclerotic plaque Atherosclerosis is a recognized risk factor for stroke. Current knowledge indicates the relationship between periodontal inflammation and stroke. Periodonta diseases are considered as an independent risk factor for vascular disease of the brain. Therefore, the prevention of periodontal disease is important, also early detection and treatment. Dental care should be an essential element of primary and secondary prevention of vascular events of central nervous system. PMID:26030963

  6. Functional disability of ischemic stroke patients

    Directory of Open Access Journals (Sweden)

    Theodore Kapadohos

    2010-04-01

    Full Text Available Stroke is the third leading cause of death and the first cause of disability, in the developed countries and it is frequently described by the literature as a major global health problem. It is estimated that stroke is responsible for approximately 4.5 million deaths per year and over 9 million stroke survivors, globally. Aim: The aim of the present study was to review the literature about the consequences of functional disability that stroke imposes on the survivors’ life and to shortly describe functional instruments used in evaluation of stroke patients.The method οf this study included bibliography research from both the review and the research literature, mainly in the pub med data base which referred to the functional disability of stroke patients, as well as to the scales used for the evaluation of functional state. Results: Despite the accurate diagnosis and the recent therapeutic advances, stroke can still cause long-term disability in the majority of patients which induces significant changes between the patient and his environment. The results of recent studies indicate that the loss of independence that experience stroke survivals has significant consequences on their quality of life and it is likely to lead to family-crisis and social isolation. It is also widely accepted that the economic impact of stroke is considerable, worldwide. Recovery of functional disability after stroke is influenced by many variables, of which the main are the initial severity of stroke, the level of deficit and the level of social and family support. Ιn clinical practise many measurement instruments are applied and capable of providing assessments of functional ability and other related concepts since it is well documented that evaluation of functional state is a matter of great importance for the assessment of patients’ outcome. Conclusions: As it is supported by published evidence, rehabilitation of neurological deficit in conjunction with

  7. AGE AND GENDER DIFFERENCES IN ACUTE STROKE HOSPITAL PATIENTS.

    Science.gov (United States)

    Kes, Vanja Bašić; Jurašić, Miljenka-Jelena; Zavoreo, Iris; Lisak, Marijana; Jelec, Vjekoslav; Matovina, Lucija Zadro

    2016-03-01

    Stroke is the second leading cause of death and the most important cause of adult disability worldwide and in Croatia. In the past, stroke was almost exclusively considered to be a disease of the elderly; however, today the age limit has considerably lowered towards younger age. The aim of this study was to determine age and gender impact on stroke patients in a Croatian urban area during one-year survey. The study included all acute stroke patients admitted to our Department in 2004. A compiled stroke questionnaire was fulfilled during hospitalization by medical personnel on the following items: stroke risk factors including lifestyle habits (smoking and alcohol), pre-stroke physical ability evaluation, stroke evolution data, laboratory and computed tomography findings, outcome data and post-stroke disability assessment. Appropriate statistical analysis of numerical and categorical data was performed at the level of p adult stroke group. Older stroke patients had worse disability at hospital discharge and women had worse disabilities at both stroke onset and hospital discharge, probably due to older age at stroke onset. Younger patients recovered better, while older patients had to seek secondary medical facilities more often, as expected. The most important in-hospital laboratory findings in young stroke patients were elevated lipid levels, while older patients had elevated serum glucose and C-reactive protein. Stroke onset in younger patients most often presented with sudden onset headache; additionally, onset seizure was observed more frequently than expected. Stroke risk factor analysis showed that women were more prone to hypertension, chronic heart failure and atrial fibrillation, whereas men had carotid disease more frequently, were more often smokers and had higher alcohol intake. Additionally, age analysis showed that heart conditions and smoking were more prevalent among older stroke patients. In conclusion, considerable differences were established

  8. The Heart and Stroke Foundation of Ontario

    OpenAIRE

    Graham, Anthony F.

    1987-01-01

    The Heart and Stroke Foundation of Ontario is a non-profit volunteer-driven organization that is active in supporting research and education programs with the ultimate goal of reducing death and disability from heart disease and stroke. The Foundation has over 65 chapters across the province, a full-time staff of 130, and over 70,000 volunteers involved in various programs and fund-raising activities. Several of the Foundation's programs offer direct assistance to family physicians and their ...

  9. Early Detection of Post-Stroke Depression

    OpenAIRE

    de Man - van Ginkel, J.M.

    2012-01-01

    In the first two years after stroke approximately one-third of the patients suffer from depression, also referred to as post-stroke depression (PSD). Patients with PSD suffer from symptoms, such as a diminished interest or pleasure (anhedonia), depressed mood, sleep disturbances, loss of energy, changes in appetite, feelings of inappropriate guilt, concentration difficulties, psychomotor retardation or agitation, and suicidal thoughts. PSD aggravates the burden of physical, psychological and ...

  10. NADPH OXIDASE IN STROKE AND CEREBROVASCULAR DISEASE

    OpenAIRE

    Tang, Xian Nan; Cairns, Belinda; Kim, Jong Youl; Midori A Yenari

    2012-01-01

    NADPH oxidase (NOX) was originally identified in immune cells as playing an important microbicidal role. In stroke and cerebrovascular disease, inflammation is increasingly being recognized as contributing negatively to neurological outcome, with NOX as an important source of superoxide. Several labs have now shown that blocking or deleting NOX in the experimental stroke models protects from brain ischemic. Recent work has implicated glucose as an important NOX substrate leading to reperfusio...

  11. Neonatal stroke: Neonatal neuroimaging & brain plasticity

    OpenAIRE

    van der Aa, N.E.

    2013-01-01

    Despite major improvements in perinatal care, perinatal stroke remains a severe problem of the newborn and is commonly encountered in the care of these infants in the neonatal intensive care setting. The reported incidence of perinatal arterial ischemic stroke (PAIS) varies from 1:1600-1:5000, and most likely depends on how often neuroimaging studies are performed. Periventricular haemorrhagic infarction (PVHI) has a lower incidence, but still occurs in 1-10% of the very preterm born infants,...

  12. Stroke in central nervous system infections

    Directory of Open Access Journals (Sweden)

    Carod-Artal Francisco

    2008-01-01

    Full Text Available Background: Stroke subtypes and etiology may differ between developing and developed countries. Infections are a relatively common cause of stroke in tropical regions. Objective: To review the main infectious diseases associated with stroke. Discussion: Prevalence of stroke in HIV patients is around 1%. Pathogenic mechanisms include HIV vasculopathy, vasculitis, cardioembolism, acquired hypercoagulability, and the effect of opportunistic infections. Treatment with protease inhibitors has been associated with premature atherosclerotic vascular disease. Emerging viral infections that are associated with stroke include viral hemorrhagic fevers, Japanese encephalitis, dengue, and West Nile virus. Vasculitis involving perforating vessels of the brain is a cerebrovascular complication of tuberculous meningitis. Small, medium, and large arteries of the anterior circulation can be involved. A progressive intracranial arteriopathy after Leptospira interrogans infection has been described, which involves the large intracranial arteries. Cerebrovascular complications of mycosis are associated with large vessel vasculitis, direct vessel damage by invasion or embolization, and subarachnoid hemorrhage due to mycotic aneurysm rupture. Pathological findings of cerebral malaria include diffuse cerebral edema, perivascular ring hemorrhages, white matter necrosis, parenchyma petechial hemorrhages, occlusion of brain vessels, and sequestration of infected erythrocytes in cortical and perforating arteries. Stroke can occur in subarachnoid neurocysticercosis and the lesions in such cases consist mostly of deep lacunar infarctions resulting from endarteritis of small penetrating arteries. Cardiac arrhythmias, congestive heart failure, apical aneurysm, and mural thrombus are the conditions that predispose patients with American trypanosomiasis to cardioembolism. Gnathostoma spinigerum infestation is a cause of hemorrhagic stroke in Asia. Conclusion: Infectious and

  13. Copeptin: Limited Usefulness in Early Stroke Differentiation?

    Directory of Open Access Journals (Sweden)

    Johannes von Recum

    2015-01-01

    Full Text Available Background. Stroke can be a challenging diagnosis in an emergency-setting. We sought to determine whether copeptin may be a useful biomarker to differentiate between ischemic stroke (IS, transient ischemic attack (TIA, and stroke-mimics. Methods. In patients with suspected stroke arriving within 4.5 hours of symptom-onset, copeptin-levels were measured in initial blood-samples. The final diagnosis was adjudicated by vascular neurologists blinded to copeptin-values. Results. Of all 36 patients with available copeptin-values (median age 71 years, IQR: 54–76; 44% female, 20 patients (56% were diagnosed with IS, no patient was diagnosed with hemorrhagic stroke, nine patients (25% were diagnosed with TIA, and seven patients (19% were stroke-mimics. Copeptin-levels (in pmol/L tended to be higher in patients with IS [19.1 (11.2–48.5] compared to TIA [9.4 (5.4–13.8]. In stroke-mimics the range of values was extremely broad [33.3 (7.57–255.7]. The diagnostic accuracy of copeptin for IS was 63% with a sensitivity of 80% and a positive predictive value of 64%. Conclusion. In this cohort of patients copeptin-levels within 4.5 hours of symptom onset were higher in patients with IS compared to TIA but the broad range of values in stroke-mimics limits diagnostic accuracy. This trial is registered with UTN: U1111-1119-7602.

  14. Early changes in physiological variables after stroke

    OpenAIRE

    Wong Andrew; Read Stephen

    2008-01-01

    Several aspects of physiology, notably blood pressure, body temperature, blood glucose, and blood oxygen saturation, may be altered after an ischemic stroke and intracerebral hemorrhage. Generally, blood pressure and temperature rise acutely after a stroke, before returning to normal. Blood glucose and oxygen levels may be abnormal in individuals, but they do not follow a set pattern. Several aspects of these physiological alterations remain unclear, including their principal determinants - w...

  15. Bone-density changes after stroke.

    Science.gov (United States)

    Beaupre, Gary S; Lew, Henry L

    2006-05-01

    It has been many years since bone loss and fracture risk were first recognized as serious complications of stroke. Hip fracture is associated with a substantial increase in morbidity and mortality for stroke survivors, and therefore, assessing and maintaining skeletal health after stroke should be an important clinical goal. Recent long-term, prospective studies have illustrated a highly nonuniform pattern of bone changes after stroke. In general, there is significant bone loss on the paretic side, which is greatest in those patients with the most severe functional deficits. In some patients, bone loss in the paretic arm during the first year after stroke is the equivalent of >20 yrs of bone loss in healthy individuals of comparable age. Bone density in the nonparetic upper limb can actually increase after stroke, consistent with an increase in habitual use of the nonparetic hand. Bone density in the paretic lower limb can decrease by >10% in 12 mos poststroke are needed to determine how long excess bone loss continues after stroke. Studies with more subjects and with more varied disability levels are needed to better understand the relationships between functional deficits and bone loss. New metrics are needed to quantify the intensity and duration of physical activity in the upper and lower limbs that are consistent with previous research on the role of mechanical stimuli in bone adaptation. Finally, an assessment of skeletal health and the factors that affect bone quantity and quality should be a standard component in the clinical management of all survivors of stroke. PMID:16628156

  16. Practical Assessment of Dysphagia in Stroke Patients

    OpenAIRE

    Lee, Kyoung Moo; Kim, Hyo Jong

    2015-01-01

    Objective To develop a quantitative and organ-specific practical test for the diagnosis and treatment of dysphagia based on assessment of stroke patients. Methods An initial test composed of 24 items was designed to evaluate the function of the organs involved in swallowing. The grading system of the initial test was based on the analysis of 50 normal adults. The initial test was performed in 52 stroke patients with clinical symptoms of dysphagia. Aspiration was measured via a videofluoroscop...

  17. Death caused by heat stroke: Case report

    OpenAIRE

    Savić Slobodan; Pavlekić Snežana; Alempijević Đorđe; Ječmenica Dragan

    2014-01-01

    Introduction. Heat stroke is the most dangerous among numerous disorders caused by elevated environmental temperature. It is characterized by an increased body temperature of over 40°C, the dysfunction of the central nervous system and the development of multiple organ failure. The aim of this paper was to highlight problems in the clinical and post-mortal diagnosis of fatal heat stroke. Case Outline. A 20-year-old male was found unconscious on the street; ...

  18. The vestibular control of balance after stroke

    OpenAIRE

    Marsden, J. F.; Playford, E. D.; Day, B. L.

    2005-01-01

    Objectives: To examine vestibular control of balance in those who recovered the ability to stand after middle cerebral artery (MCA) stroke.Methods: Sixteen patients with MCA stroke were compared with 10 age matched controls. Two additional patients were studied with isolated corticospinal tract lesions, one each at the level of the pons and medulla. Vestibular evoked postural responses were obtained using galvanic vestibular stimulation (GVS) while patients stood with their eyes closed and he...

  19. Hemodynamic findings in patients with brain stroke

    OpenAIRE

    Siebert, Janusz; Gutknecht, Piotr; Molisz, Andrzej; Trzeciak, Bartosz; Nyka, Walenty

    2012-01-01

    Introduction Standard procedures carried out at a stroke department in patients after a cerebral event may prove insufficient for monitoring hemodynamic indices. Impedance cardiography enables hemodynamic changes to be monitored non-invasively. The aim of the work was to describe hemodynamic parameters in patients with acute phase of ischemic and hemorrhagic stroke and to analyse the correlation between the type of hemodynamic response and long-term prognosis. Material and methods The 45 cons...

  20. Demographic Characteristics of Strokes Types in Sanliurfa

    OpenAIRE

    Yusuf Inanc

    2016-01-01

    Aim: Sanliurfa training and research hospital for diagnosis and treatment of patients with stroke admitted demographic features planned. We aimed to study demographic feature of stroke patient who admitted to Sanliurfa training and research hospital for diagnosis and treatment. Material and Method: 01/10/2011 and 01/9/2012, ischemic and hemorrhagic brain training and research hospital in Sanliurfa vascular disease diagnosis and treatment without any exclusion criteria, patient sequential 454 ...

  1. Epidemiology and etiology of strokes in babies

    Directory of Open Access Journals (Sweden)

    Olga Aleksandrovna Lvova

    2013-01-01

    Full Text Available The paper summarizes an update on the morbidity, mortality, and a risk for recurrence of stroke occurring in babies. It shows a variety of conditions and syndromes which may be responsible for stroke in infancy. Babies with the signs of intrauterine infection and congenital heart disease, the carriers of major thrombophilia gene mutations, may be regarded as a risk group.

  2. Age trajectories of stroke case fatality

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj; Andersen, Zorana Jovanovic; Andersen, Klaus Kaae

    2011-01-01

    Mortality rates level off at older ages. Age trajectories of stroke case-fatality rates were studied with the aim of investigating prevalence of this phenomenon, specifically in case-fatality rates at older ages.......Mortality rates level off at older ages. Age trajectories of stroke case-fatality rates were studied with the aim of investigating prevalence of this phenomenon, specifically in case-fatality rates at older ages....

  3. Clinicoanatomical correlation in stroke related aphasia

    Directory of Open Access Journals (Sweden)

    Vikram Bohra

    2015-01-01

    Full Text Available Context: With advances in neuroimaging, traditional views regarding the clinicoanatomic correlation in stroke patients with aphasia are being challenged and it has been observed that lesions at a given cortical or subcortical site may manifest with different aphasia profiles. Aims: To study as to whether there is a strict clinicoanatomical correlation between the type of aphasia and lesion site in patients with first ever stroke. Settings and Design: Observational study, based in a tertiary care center. Materials and Methods: Stroke patient′s ≥18 years of age were screened and those with first ever stroke and aphasia were subjected to a detailed stroke workup and language assessment using the Hindi version of Western Aphasia Battery (WAB. Statistical analysis was done with χ2 test with Yates correction and Kruskal-Wallis test. The level of significance was set at P < 0.05. Results: Overall aphasia was detected in 27.9% of the 260 screened cases with stroke. Amongst 60 cases with first ever stroke and aphasia, the aphasia type was: Global (33.33%, Broca′s (28.3%, transcortical motor (13.33%, transcortical sensory (10%, Wernicke′s (8.33%, anomic (5%, and conduction (1.67% aphasia. A definite correlation between the lesion site and the type of aphasia as per the traditional classification was observed in 35% cases only. Conclusions: No absolute correlation exists between the lesion site and the type of clinical aphasia syndrome in majority of the patients with cortical and subcortical stroke.

  4. Mechanical Thrombectomy for Stroke After Cardiac Surgery.

    Science.gov (United States)

    Madeira, Márcio; Martins, Catarina; Koukoulis, Giovanna; Marques, Marta; Reis, João; Abecassis, Miguel

    2016-08-01

    Stroke after cardiac surgery remains a devastating complication and its treatment options are limited. Systemic fibrinolysis is a relative contraindication, because it raises the risk of systemic hemorrhage. Endovascular therapy, mechanical thrombectomy, and intra-arterial fibrinolysis have emerged as safer options. We present three patients who developed strokes following cardiac surgery who underwent successful mechanical thrombectomy and review the literature on this subject. doi: 10.1111/jocs.12776 (J Card Surg 2016;31:517-520). PMID:27282492

  5. Trade Liberalisation and Vertical Integration

    DEFF Research Database (Denmark)

    Bache, Peter Arendorf; Laugesen, Anders

    We build a three-country model of international trade in final goods and intermediate inputs and study the relation between different types of trade liberalisation and vertical integration. Firms are heterogeneous with respect to both productivity and factor intensity as observed in data. Final-g...... property rights theory of the firm using firm-level data. Finally, we notice that our model's sorting pattern is in line with recent evidence when the wage difference across countries is not too big.......We build a three-country model of international trade in final goods and intermediate inputs and study the relation between different types of trade liberalisation and vertical integration. Firms are heterogeneous with respect to both productivity and factor intensity as observed in data. Final...... increasing when intermediate-input or final-goods trade is liberalised and when the fixed cost of vertical integration is reduced. At the same time, one observes firms that shift away from either vertical integration, offshoring, or exporting. Further, we provide guidance for testing the open-economy...

  6. Hybrid Vertical-Cavity Laser

    DEFF Research Database (Denmark)

    2010-01-01

    The present invention provides a light source (2) for light circuits on a silicon platform (3). A vertical laser cavity is formed by a gain region (101) arranged between a top mirror (4) and a bottom grating-mirror (12) in a grating region (11) in a silicon layer (10) on a substrate. A waveguide...

  7. Does Stroke Impair Learning in Children?

    Directory of Open Access Journals (Sweden)

    Sonia das Dores Rodrigues

    2011-01-01

    Full Text Available Objective. To assess cognitive development and learning in children who have had strokes. Method. Twenty-nine stroke patients and 18 children with no brain lesions and no learning impairments were evaluated. For the cognitive assessment, Piaget's clinical method was used. Writing, arithmetic, and reading abilities were assessed by the school performance test. Results. The mean age at evaluation was 9.6 years. Among the 29 children, 20 had early lesions (mean of 2.4 years old. The stroke was ischemic in 18 subjects; there were 7 cases of recurrence. Six children could not answer the tests. A high index of cognitive delay and low performance in writing, arithmetic, and reading were verified. Comparison with the control group revealed that the children who have had strokes had significantly lower performances. Conclusion. In this sample, strokes impaired cognitive development and learning. It is important that children have access to educational support and cognitive rehabilitation after injury. These approaches may minimise the effects of strokes on learning in children.

  8. Is it important to classify ischaemic stroke?

    LENUS (Irish Health Repository)

    Iqbal, M

    2012-02-01

    Thirty-five percent of all ischemic events remain classified as cryptogenic. This study was conducted to ascertain the accuracy of diagnosis of ischaemic stroke based on information given in the medical notes. It was tested by applying the clinical information to the (TOAST) criteria. Hundred and five patients presented with acute stroke between Jan-Jun 2007. Data was collected on 90 patients. Male to female ratio was 39:51 with age range of 47-93 years. Sixty (67%) patients had total\\/partial anterior circulation stroke; 5 (5.6%) had a lacunar stroke and in 25 (28%) the mechanism of stroke could not be identified. Four (4.4%) patients with small vessel disease were anticoagulated; 5 (5.6%) with atrial fibrillation received antiplatelet therapy and 2 (2.2%) patients with atrial fibrillation underwent CEA. This study revealed deficiencies in the clinical assessment of patients and treatment was not tailored to the mechanism of stroke in some patients.

  9. Early changes in physiological variables after stroke

    Directory of Open Access Journals (Sweden)

    Wong Andrew

    2008-01-01

    Full Text Available Several aspects of physiology, notably blood pressure, body temperature, blood glucose, and blood oxygen saturation, may be altered after an ischemic stroke and intracerebral hemorrhage. Generally, blood pressure and temperature rise acutely after a stroke, before returning to normal. Blood glucose and oxygen levels may be abnormal in individuals, but they do not follow a set pattern. Several aspects of these physiological alterations remain unclear, including their principal determinants - whether they genuinely affect prognosis (as opposed to merely representing underlying processes such as inflammation or a stress response, whether these effects are adaptive or maladaptive, whether the effects are specific to certain subgroups (e.g. lacunar stroke and whether modifying physiology also modifies its prognostic effect. Hypertension and hyperglycemia may be helpful or harmful, depending on the perfusion status after an ischemic stroke; the therapeutic response to their lowering may be correspondingly variable. Hypothermia may provide benefits, in addition to preventing harm through protection from hyperthermia. Hypoxia is harmful, but normobaric hyperoxia is unhelpful or even harmful in normoxic patients. Hyperbaric hyperoxia, however, may be beneficial, though this remains unproven. The above-mentioned uncertainties necessitate generally conservative measures for physiology management, although there are notably specific recommendations for thrombolysis-eligible patients. Stroke unit care is associated with better outcome, possibly through better management of poststroke physiology. Stroke units can also facilitate research to clarify the relationship between physiology and prognosis, and to subsequently clarify management guidelines.

  10. Cognitive impairment and stroke in elderly patients.

    Science.gov (United States)

    Lo Coco, Daniele; Lopez, Gianluca; Corrao, Salvatore

    2016-01-01

    We reviewed current knowledge about the interaction between stroke and vascular risk factors and the development of cognitive impairment and dementia. Stroke is increasingly recognized as an important cause of cognitive problems and has been implicated in the development of both Alzheimer's disease and vascular dementia. The prevalence of cognitive impairment after stroke is high, and their combined effects significantly increase the cost of care and health resource utilization, with reflections on hospital readmissions and increased mortality rates. There is also substantial evidence that vascular risk factors (such as hypertension, diabetes, obesity, dyslipidemia, and tobacco smoking) are independently associated with an increased risk of cognitive decline and dementia. Thus, a successful management of these factors, as well as optimal acute stroke management, might have a great impact on the development of cognitive impairment. Notwithstanding, the pathological link between cognitive impairment, stroke, and vascular risk factors is complex and still partially unclear so that further studies are needed to better elucidate the boundaries of this relationship. Many specific pharmacological treatments, including anticholinergic drugs and antihypertensive medications, and nonpharmacological approaches, such as diet, cognitive rehabilitation, and physical activity, have been studied for patients with vascular cognitive impairment, but the optimal care is still far away. Meanwhile, according to the most recent knowledge, optimal stroke care should also include cognitive assessment in the short and long term, and great efforts should be oriented toward a multidisciplinary approach, including quality-of-life assessment and support of caregivers. PMID:27069366

  11. Hypercholesterolemia in patients of ischemic stroke

    International Nuclear Information System (INIS)

    Background: Stroke is a common neurological disease that results in significant mortality and morbidity globally. Several risk factors have been identified for stroke among which hyperlipidaemia is one of the modifiable risk factors. Recent clinical trials have shown a reduction in ischemic stroke for patients taking lipid lowering medications. Therefore, the aim of this study was to find out the frequency of hypercholesterolemia in patients of ischemic stroke in Hazara region. Method: This cross sectional study was carried out in the Medical Department of Ayub Teaching Hospital, Abbottabad. Ninety patients of stroke confirmed as ischemic by CT scan brain were enrolled in the study after informed consent. The frequency of hypercholesterolemia in patients was recorded. Results: There were 55 (61.1 percentage) males. The mean age of patients was 64.4±11.5 years. The mean serum cholesterol in all patients was 4.16±1.1 mmol/l. The mean serum cholesterol of male patients was 4.3±1.2 mmol/l and 4.0±10.9 mmol/l in the case of females. Conclusions: Hypercholesterolemia could not be established as a major risk factor for stroke in our setup through this study that allude to the fact that other risk factors might be contributing more to the incidence of cerebrovascular accident in our population. (author)

  12. Age-specific transcriptional response to stroke.

    Science.gov (United States)

    Sieber, Matthias W; Guenther, Madlen; Jaenisch, Nadine; Albrecht-Eckardt, Daniela; Kohl, Matthias; Witte, Otto W; Frahm, Christiane

    2014-07-01

    Increased age is a major risk factor for stroke incidence and post-ischemic mortality. To develop age-adjusted therapeutic interventions, a clear understanding of the complexity of age-related post-ischemic mechanisms is essential. Transient occlusion of the middle cerebral artery--a model that closely resembles human stroke--was used to induce cerebral infarction in mice of 4 different ages (2, 9, 15, 24 months). By using Illumina cDNA microarrays and quantitative PCR we detected a distinct age-dependent response to stroke involving 350 differentially expressed genes. Our analyses also identified 327 differentially expressed genes that responded to stroke in an age-independent manner. These genes are involved in different aspects of the inflammatory and immune response, oxidative stress, cell cycle activation and/or DNA repair, apoptosis, cytoskeleton reorganization and/or astrogliosis, synaptic plasticity and/or neurotransmission, and depressive disorders and/or dopamine-, serotonin-, GABA-signaling. In agreement with our earlier work, aged brains displayed an attenuated inflammatory and immune response (Sieber et al., 2011) and a reduced impairment of post-stroke synaptic plasticity. Our data also revealed a distinct age-related susceptibility for post-ischemic depression, the most common neuropsychiatric consequence of stroke, which has a major influence on functional outcome.

  13. Genetic basis of stroke: An overview

    Directory of Open Access Journals (Sweden)

    Munshi Anjana

    2010-01-01

    Full Text Available Stroke or "brain attack" is a complex disease caused by a combination of multiple risk factors. It has major social and economic consequences. Various epidemiological studies in families and twins have revealed that there is a genetic component to stroke risk. Stroke may be the outcome of single gene disorders or more commonly, a polygenic multifactorial disease. Mutations in several candidate genes have been found to be associated with stroke. However, association studies in population-based samples have failed to identify reliable disease markers. The publication of the "Human Genome Project" has indeed improved our knowledge about the potential role of genetics in complex disorders including stroke. Rapidly expanding field of genetics is in a state of transforming medicine into a new kind in future, the individualized medicine, using tailor made drugs according to the genetic makeup of the individuals. However, this involves integrating genome wide genetic information with medical information. The first genome wide association study on ischemic stroke has been published recently. Further studies will hopefully tell us how far the genetic information will assist us to tailor clinical and therapeutic decisions to an individual′s genotype.

  14. Post-stroke disposition from a geriatric-rehabilitative stroke care area: an Italian experience

    Directory of Open Access Journals (Sweden)

    Marco Masina

    2014-02-01

    Full Text Available A large number of stroke patients cannot be discharged at home. Studies on post stroke disposition have low validity outside the country in which they are carried out because healthcare systems offer different rehabilitative and long-term facilities. Moreover absolute selection criteria for admission to rehabilitation are not available yet. Few studies on post-stroke disposition from Italian stroke units are available. Authors evaluated data of a 18-month period from a geriatric managed stroke care area where comprehensive multi-professional assessment and discharge planning are routinely carried out. Only patients discharged with diagnosis related to acute stroke were considered. Baseline characteristics, clinical, neurological and functional conditions according to the structured multidimensional assessment were prospectively collected in the stroke unit registry. Univariate and multinomial logistic regression were performed to identify independent variables associated with three discharge settings: home, rehabilitation and skilled long-term ward. Out of 188 patients evaluated, 56.4% were discharged home, 18.6% to rehabilitation and 25.0% to long-term ward. Data showed an efficient disposition to intermediate settings with a shorter length of stay compared to other international studies. Factors associated with post-stroke disposition were age, dysphagia, neurological impairment on admission (NIH-SS≥6, after stroke functional status (mRankin≥3, poor pre-stroke functional level (mRankin≥3 and hemorrhagic stroke. Dysphagia, severe neurological impairment and post-stroke disability were associated with discharge to rehabilitation and long term ward. These two settings differed in age and pre-stroke functional condition. Patients discharged to long-term wards were about 10 years older than those admitted to rehabilitative ward. Only 5% of patients discharged to rehabilitation had a pre-stroke mRankin score ≥3. Disposition to a skilled

  15. Post-stroke depression therapy: where are we now?

    Science.gov (United States)

    Nabavi, Seyed Fazel; Turner, Alyna; Dean, Olivia; Sureda, Antoni; Mohammad, Seyed

    2014-01-01

    Post-stroke depression is an important psychological consequence of ischemic stroke, and affects around one third of stroke patients at any time post-stroke. It has a negative impact on patient morbidity and mortality, and as such development of effective post-stroke recognition and treatment strategies are very important. There are several therapeutic strategies for post-stroke depression, including both pharmacological and non-pharmacological approaches. In this review, we present evidence regarding the underlying biology of post-stroke depression, commonalities between post-stroke depression and Major Depressive Disorder and explore several treatment approaches, including antidepressant therapy, psychotherapy, surgical therapy, electroconvulsive therapy, acupuncture, music therapy and natural products. Further experimental and clinical studies are required, particularly in emerging fields such as the role of nutraceuticals in the treatment of stroke. PMID:24852795

  16. Strokes attributable to underuse of warfarin and antiplatelets

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj; Rasmussen, Berit Hammershaimb; Kammersgaard, Lars Peter;

    2007-01-01

    atrial fibrillation, prior myocardial infarction, angina, or prior stroke transient ischemic attack (TIA). Sufficient information on cardiovascular risk factors before stroke was available in 404 patients. A total of 54 patients had atrial fibrillation known before the stroke. Of these, 16 had......Despite their proven efficacy in stroke prevention, warfarin and antiplatelets remain underused. We determined the frequency of ischemic strokes attributable to underuse of warfarin and antiplatelets for stroke prevention in a Danish community. We included all patients with ischemic stroke...... of these strokes could have been prevented. Our findings indicate that underuse of warfarin and antiplatelets is still of considerable magnitude and attributable to 4% to 5% (16 to 22 out of 404) of the ischemic strokes in a Danish urban community....

  17. Poststroke epilepsy in the Copenhagen stroke study: incidence and predictors

    DEFF Research Database (Denmark)

    Kammersgaard, Lars Peter; Olsen, Tom Skyhøj

    2005-01-01

    a cohort of 1197 consecutively and prospectively admitted patients with stroke. Patients were followed up for 7 years. We defined PSE as recurrent epileptic seizures with onset after stroke and requiring antiepileptic prophylaxis. PSE was related to clinical factors (age, sex, onset stroke severity, lesion...... patients with stroke within 7 years after stroke. Age, intracerebral hemorrhage, lesion size, increasing stroke severity, and early seizures are independent predictors of PSE.......Poststroke epilepsy (PSE) is a feared complication after stroke and is reported in 3% to 5% of stroke survivors. In this study we sought to identify incidence and predictors of PSE in an unselected stroke population with a follow-up period of 7 years. The study was community-based and comprises...

  18. Evaluation of stroke services in Anglia stroke clinical network to examine the variation in acute services and stroke outcomes

    Directory of Open Access Journals (Sweden)

    George Abraham

    2011-02-01

    Full Text Available Abstract Background Stroke is the third leading cause of death in developed countries and the leading cause of long-term disability worldwide. A series of national stroke audits in the UK highlighted the differences in stroke care between hospitals. The study aims to describe variation in outcomes following stroke and to identify the characteristics of services that are associated with better outcomes, after accounting for case mix differences and individual prognostic factors. Methods/Design We will conduct a cohort study in eight acute NHS trusts within East of England, with at least one year of follow-up after stroke. The study population will be a systematically selected representative sample of patients admitted with stroke during the study period, recruited within each hospital. We will collect individual patient data on prognostic characteristics, health care received, outcomes and costs of care and we will also record relevant characteristics of each provider organisation. The determinants of one year outcome including patient reported outcome will be assessed statistically with proportional hazards regression models. Self (or proxy completed EuroQol (EQ-5D questionnaires will measure quality of life at baseline and follow-up for cost utility analyses. Discussion This study will provide observational data about health service factors associated with variations in patient outcomes and health care costs following hospital admission for acute stroke. This will form the basis for future RCTs by identifying promising health service interventions, assessing the feasibility of recruiting and following up trial patients, and provide evidence about frequency and variances in outcomes, and intra-cluster correlation of outcomes, for sample size calculations. The results will inform clinicians, public, service providers, commissioners and policy makers to drive further improvement in health services which will bring direct benefit to the patients.

  19. Costs of stroke and stroke services: Determinants of patient costs and a comparison of costs of regular care and care organised in stroke services

    NARCIS (Netherlands)

    M.A. Koopmanschap (Marc); W.J.M. Scholte op Reimer (Wilma); J.D.H. van Wijngaarden (Jeroen); N.J.A. van Exel (Job)

    2003-01-01

    textabstractBACKGROUND: Stroke is a major cause of death and long-term disability in Western societies and constitutes a major claim on health care budgets. Organising stroke care in a stroke service has recently been demonstrated to result in better health effects for patients. Th

  20. Costs of stroke and stroke services: Determinants of patient costs and a comparison of costs of regular care and care organised in stroke services

    NARCIS (Netherlands)

    N.J.A. van Exel (Job); M.A. Koopmanschap (Marc); J.D.H. van Wijngaarden (Jeroen); W.J.M. Scholte op Reimer (Wilma)

    2003-01-01

    textabstractBackground. Stroke is a major cause of death and long-term disability in Western societies and constitutes a major claim on health care budgets. Organising stroke care in a stroke service has recently been demonstrated to result in better health effects for patients. This paper discusses

  1. Clues to occult cancer in patients with ischemic stroke.

    Directory of Open Access Journals (Sweden)

    Suk Jae Kim

    Full Text Available BACKGROUND: We hypothesized that hidden malignancy could be detected in patients with cryptogenic stroke without active cancer when they showed the distinctive characteristics of cancer-related stroke. METHODS AND FINDINGS: Among 2,562 consecutive patients with acute ischemic stroke, patients with cryptogenic stroke were analyzed and categorized into two groups according to the presence of active cancer: cryptogenic stroke with active cancer (cancer-related stroke, CA-stroke group and without active cancer (CR-stroke group. Patients with active lung cancer without stroke were also recruited for comparison purposes (CA-control. Clinical factors, lesion patterns on diffusion-weighted MRI (DWI, and laboratory findings were analyzed among groups. A total of 348 patients with cryptogenic stroke were enrolled in this study. Among them, 71 (20.4% patients had active cancer at the time of stroke. The D-dimer levels were significantly higher in patients with CA-stroke than those with CR-stroke or CA-control (both p<0.001. Regarding lesion patterns, patients with CA-stroke mostly had multiple lesions in multiple vascular territories, while more than 80% of patients with CR-stroke had single/multiple lesions in a single vascular territory (P<0.001. D-dimer levels (OR 1.11 per 1 µg/mL increase; 95% CI 1.06-1.15; P<0.001 and DWI lesion patterns (OR 7.13; 95% CI 3.42-14.87; P<0.001 were independently associated with CA-stroke. Workup for hidden malignancy was performed during hospitalization in 10 patients who showed elevated D-dimer levels and multiple infarcts involving multiple vascular territories but had no known cancer, and it revealed hidden malignancies in all the patients. CONCLUSION: Patients with CA-stroke have distinctive D-dimer levels and lesion patterns. These characteristics can serve as clues to occult cancer in patients with cryptogenic stroke.

  2. The role of neuroimaging in acute stroke

    Directory of Open Access Journals (Sweden)

    Dhamija Rajinder

    2008-01-01

    Full Text Available Background: There is a need for early recognition, diagnosis, and therapy in patients with acute stroke. The most important therapies are thrombolysis or aspirin in hyperacute ischemic stroke and, for secondary prevention, antiplatelet agents, statins, ACE inhibitors (for lowering blood pressure, warfarin, and carotid endarterectomy or stenting. Imaging technology has a crucial role to play in the diagnosis and treatment of stroke. In recent years, significant advances have been made due to the availability of physiological imaging using a variety of techniques, ranging from computerized tomography (CT to magnetic resonance imaging (MRI, which enable clinicians to define brain anatomy and physiology in greater detail than ever before. Objective: In this article we discuss the imaging techniques currently available for patients with acute stroke, with an emphasis on the utility of these techniques for diagnosis and refining patient selection for early interventions. This is placed in the context of the needs of developing countries . Discussion: Although noncontrast CT (NCCT remains the most commonly used imaging modality to differentiate between ischemic and hemorrhagic stroke, to identify early CT changes, and to rule out stroke mimics, it is not sensitive enough to identify the infarct core or the mechanism of ischemic stroke. MRI, including magnetic resonance angiography (MRA, is the most useful imaging modality for the evaluation of acute stroke; it provides information about the mechanism as well as the vascular territory of the stroke. MRI also provides complete information about the status of tissue through diffusion-weighted imaging (DWI and about arterial patency by means of MRA. DWI shows acute lesions within minutes of onset of ischemia, while MRA can evaluate extracranial as well as intracranial vessels Evaluation of the proportion of penumbra vs infarcted tissue is another issue to be considered when instituting thrombolysis, and

  3. Biometeorological phases influence on stroke morbidity

    Directory of Open Access Journals (Sweden)

    Dragan Milojević

    2011-08-01

    Full Text Available Aim To determine influence of biometeorological phases on strokeincidence according to age and gender of patients, place of residence, days in a week, months in a year, type of stroke, additional diagnosis. Methodology Comparative analysis of the data on stroke patients (according to age, months, days, place of residence, age, sex, stroke type, additional diagnosis and number of hospitalization days obtained by examining the records of discharge and admission of patients in the Department of Neurology of Kragujevac and everyday biometeorological phases obtained from the Republic Hydrometeorological Service of Serbia (RHMS of Serbia, for the following years: 2003, 2004, 2007, 2008 and 2009 in Kragujevac.Results 4,700 patients diagnosed with stroke were hospitalized in the observed period. The highest number of strokes was noted in 2003 (1,030, the lowest in 2008 (851. The highest number of strokes was in March (444 and the lowest in February (351.The most frequent days were Mondays (805, and the least frequent Sundays (495. Three fifths of patients were from urban areas and the rest of them were from rural areas. Out of this number 2,382 (50.7% were males and 2.318 (49.3% were females, of which 1.847 (77.6% males and 1,894 (81.7% females were over 70 years old. The average number of hospitalization days was 12.29 days, and most patients were in hospital for less than 10 days (2101 patients. 4,130 (87.9% patients were diagnosed with thromboembolism, 422 (9.0% with intracerebral hemorrhage and 148 (3.2% with subarachnoid hemorrhage. As an additional diagnosis 1,946 (41.4% patients had hypertension, 867(18.6% had heart insufficiency and 15.40% had diabetes. Most strokes with significant correlation were in biometheorological phases 9 and 4 (1,227 and 1,010 strokes and the least were in phase 10 (29. As a daily average, the highest number of strokes was in phase 8 (2.76/ day, the lowest in phase 2 (2.33/day. Conclusion Biometeorological phases have a

  4. Stroke-prone renovascular hypertensive rats

    Institute of Scientific and Technical Information of China (English)

    曾进胜; 贷如训; 苏镇培

    2000-01-01

    Purpose To summarized the methods for establishment, characteristics of vascular lesions in brain and heart and thc application of stroke-pronc renovascular hypertensive rats (RHRSP). Background Spontaneously hypcrtensivc rats (STR) and subtypes of SH R, especially stroke-prone spontaneously hypertensive rats (SHRSP) are considered as most important animal models at present for the studies of hypertension and its complications in heart and brain, evcn SHRSP arc considered as thc unique animal model in which prcvention of stroke can be studied cxperimentally Howcver, the applications of SHR and SHRSP are limited because of the effects of genetic deficits and thc difficulties with breeding Theretore, most of the researches on experimental stroke have been performed on the animal models with normotcnsion and normal structure of cerebral vessels. In fact, there are great differences in structure of cerebrovesscls, autoregulation of cerebral blood flow and extent of lesions in brain tissue, even the reaction to the medication after ischemia between the animals with extcnsive arteriosclerosis and with normal cerebral blood vessels. Obviously, thc relevancc of experimental stroke on normal animals to the stroke on cerebral arteriosclerotic patients clinically remains dubious. Data sources and methods Most published original articles about RHRSP in our laboratory were reviewed Results After the renal arteries were constricted bilaterally with ring-shape silver clips, the stroke-prone rcnovascular hypertensive rats were established. Hypertension was produced in all RHRSP(100%).The peak of blood pressure in RHRSP reached 29.1 ±3.0kPa. The lesions of cerebral arteries and arterioles and the damage of cerebral capillary structure by hypertension were observed in the RHRSP. The incidence of spontaneous stroke was 56.4% with in 40 weeks after the renal artery constriction. Left ventricular hypertrophy and small coronary arterial lesions in myocardium were discovered in all

  5. Hemorrhagic and Ischemic Strokes Compared Stroke Severity, Mortality, and Risk Factors

    DEFF Research Database (Denmark)

    Andersen, Klaus Kaae; Olsen, T. S.; Dehlendorff, Christian;

    2009-01-01

    information for 39 484 patients. The patients underwent an evaluation including stroke severity (Scandinavian Stroke Scale), CT, and cardiovascular risk factors. They were followed-up from admission until death or censoring in 2007. Independent predictors of death were identified by means of a survival model...

  6. Acute stroke unit improves stroke management-four years on from INASC.

    LENUS (Irish Health Repository)

    Shanahan, E

    2015-02-01

    The Irish Heart Foundation carried out the Irish National Audit of Stroke Care (INASC) in 2008. Management practices were significantly poorer than those in the UK Sentinel audits. Since then an acute stroke unit has been established in University Hospital Limerick. A stroke database was established. 12 key indicators of stroke management audited by INASC were identified. Results were compared to those in INASC. 89 stroke patients were admitted. 8 of the 12 key indicators scored significantly better than in INASC. 92.5% had a brain scan within 24hrs (INASC-40%, p = < 0.001). 100% of ischaemic strokes received anti-thrombotics (INASC-85%, p = 0.001). 94% had rehab goals agreed by MDT (22% in INASC p = 0.0000). 55% were treated in stroke unit (2% in INASC, p = 0.0000). MDT input improved with regard to physiotherapy (87% vs 43% in INASC, p = < 0.02) and SALT (74% vs 26%, p = < 0.02). Stroke management has significantly improved from 2008, however some deficiencies remain.

  7. Perception of Kinematic Characteristics of Tennis Strokes for Anticipating Stroke Type and Direction

    Science.gov (United States)

    Shim, Jaeho; Carlton, Les G.; Kwon, Young-Hoo

    2006-01-01

    The purpose of this study was to determine the sources of visual information used by highly skilled tennis players in anticipating their opponent's shots. In Experiment 1, motion analysis of the strokes showed that the relative motion between the racquet and forearm was different between the ground strokes and lobs, but there were no reliable…

  8. Future costs of stroke in the Netherlands: The impact of stroke services

    NARCIS (Netherlands)

    J.N. Struijs; M.L.L. van Genugten; S.M.A.A. Evers; A.J.H. Ament; C.A. Baan; G.A.M. van den Bos

    2006-01-01

    Objectives: In the next decades, the number of stroke patients is expected to increase. Furthermore, organizational changes, such as stroke services, are expected to be implemented on a large scale. The purpose of this study is to estimate the future healthcare costs by taking into account the expec

  9. Neuroserpin polymorphisms and stroke risk in a biracial population: the stroke prevention in young women study

    Directory of Open Access Journals (Sweden)

    Stern Barney J

    2007-10-01

    Full Text Available Abstract Background Neuroserpin, primarily localized to CNS neurons, inhibits the adverse effects of tissue-type plasminogen activator (tPA on the neurovascular unit and has neuroprotective effects in animal models of ischemic stroke. We sought to evaluate the association of neuroserpin polymorphisms with risk for ischemic stroke among young women. Methods A population-based case-control study of stroke among women aged 15–49 identified 224 cases of first ischemic stroke (47.3% African-American and 211 age-matched control subjects (43.1% African-American. Neuroserpin single nucleotide polymorphisms (SNPs chosen through HapMap were genotyped in the study population and assessed for association with stroke. Results Of the five SNPs analyzed, the A allele (frequency; Caucasian = 0.56, African-American = 0.42 of SNP rs6797312 located in intron 1 was associated with stroke in an age-adjusted dominant model (AA and AT vs. TT among Caucasians (OR = 2.05, p = 0.023 but not African-Americans (OR = 0.71, p = 0.387. Models adjusting for other risk factors strengthened the association. Race-specific haplotype analyses, inclusive of SNP rs6797312, again demonstrated significant associations with stroke among Caucasians only. Conclusion This study provides the first evidence that neuroserpin is associated with early-onset ischemic stroke among Caucasian women.

  10. Insulin resistance and the risk of stroke and stroke subtypes in the nondiabetic elderly

    NARCIS (Netherlands)

    R.G. Wieberdink (Renske); P.J. Koudstaal (Peter Jan); A. Hofman (Albert); J.C.M. Witteman (Jacqueline); M.M.B. Breteler (Monique); M. Arfan Ikram

    2012-01-01

    textabstractInsulin resistance, which plays a key role in the development of diabetes mellitus, is a putative modifiable risk factor for stroke. The aim of this study was to investigate if markers of insulin resistance were associated with risk of stroke in the general elderly population. This study

  11. Effect of pre-stroke use of ACE inhibitors on ischemic stroke severity

    Directory of Open Access Journals (Sweden)

    Caplan Louis

    2005-06-01

    Full Text Available Abstract Background Recent trials suggest that angiotensin-converting enzyme inhibitors (ACEI are effective in prevention of ischemic stroke, as measured by reduced stroke incidence. We aimed to compare stroke severity between stroke patients who were taking ACEI before their stroke onset and those who were not, to examine the effects of pretreatment with ACEI on ischemic stroke severity. Methods We retrospectively studied 126 consecutive patients presenting within 24 hours of ischemic stroke onset, as confirmed by diffusion-weighted magnetic resonance imaging (DWI. We calculated the NIHSS score at presentation, as the primary measure of clinical stroke severity, and categorized stroke severity as mild (NIHSS [less than or equal to] 7, moderate (NIHSS 8–13 or severe (NIHSS [greater than or equal to] 14. We analyzed demographic data, risk-factor profile, blood pressure (BP and medications on admissions, and determined stroke mechanism according to TOAST criteria. We also measured the volumes of admission diffusion- and perfusion-weighted (DWI /PWI magnetic resonance imaging lesions, as a secondary measure of ischemic tissue volume. We compared these variables among patients on ACEI and those who were not. Results Thirty- three patients (26% were on ACE-inhibitors. The overall median baseline NIHSS score was 5.5 (range 2–21 among ACEI-treated patients vs. 9 (range 1–36 in non-ACEI patients (p = 0.036. Patients on ACEI prior to their stroke had more mild and less severe strokes, and smaller DWI and PWI lesion volumes compared to non-ACEI treated patients. However, none of these differences were significant. Predictably, a higher percentage of patients on ACEI had a history of heart failure (p = 0.03. Age, time-to-imaging or neurological evaluation, risk-factor profile, concomitant therapy with lipid lowering, other antihypertensives or antithrombotic agents, or admission BP were comparable between the two groups. Conclusion Our results

  12. Stroke outreach in an inner city market: A platform for identifying African American males for stroke prevention interventions

    Directory of Open Access Journals (Sweden)

    Anjail Zarinah Sharrief

    2015-06-01

    Full Text Available AbstractBackground: There are significant racial disparities in stroke incidence and mortality. Health fairs and outreach programs can be used to increase stroke literacy, but they often fail to reach those at highest risk, including African American males. Methods: We conducted a stroke outreach and screening program at an inner city market in order to attract a high-risk group for a stroke education intervention. A modified Framingham risk tool was used to estimate stroke risk and a 10-item quiz was developed to assess stroke literacy among 80 participants. We report results of the demographic and stroke risk analyses and stroke knowledge assessment. Results: The program attracted a majority male (70% and African American (95% group of participants. Self-reported hypertension (57.5%, tobacco use (40%, and diabetes (23.8% were prevalent. Knowledge of stroke warning signs, risk factors, and appropriate action to take for stroke symptoms was not poor when compared to the literature. Conclusions: Stroke outreach and screening in an inner city public market may be an effective way to target a high-risk population for stroke prevention interventions. Stroke risk among participants was high despite adequate stroke knowledge.

  13. Facilities of Early Rehabilitation post Stroke in Poland 2010

    DEFF Research Database (Denmark)

    Opara, Jozef; Langhorne, Peter; Larsen, Torben

    2012-01-01

    ? Aims - Growing costs of health care are encouraging healthcare planners to look for new organizational solutions of services which could enable rehabilitation as early as possible after disease onset. Early post-stroke rehabilitation consists of many elements that provide for early onset rehabilitation......-stroke, i.e. within 3 months of stroke. Comment - Taking into account that about half of stroke survivors will need rehabilitation (30 days after stroke onset), the current facilities of early post-stroke rehabilitation in Poland cannot meet this need. We should do our best to introduce rehabilitation...

  14. The European Stroke Organisation Guidelines: a standard operating procedure

    DEFF Research Database (Denmark)

    Ntaios, George; Bornstein, Natan M; Caso, Valeria;

    2015-01-01

    In 2008, the recently founded European Stroke Organisation published its guidelines for the management of ischemic stroke and transient ischemic attack. This highly cited document was translated in several languages and was updated in 2009. Since then, the European Stroke Organisation has published...... model of a single Guideline Document about a major topic (e.g. management of ischemic stroke) to focused modules (i.e. subdivisions of a major topic). This will enable the European Stroke Organisation to react faster when new developments in a specific stroke field occur and update its recommendations...

  15. Cardiovascular risk factors for acute stroke: Risk profiles in the different subtypes of ischemic stroke.

    Science.gov (United States)

    Arboix, Adrià

    2015-05-16

    Timely diagnosis and control of cardiovascular risk factors is a priority objective for adequate primary and secondary prevention of acute stroke. Hypertension, atrial fibrillation and diabetes mellitus are the most common risk factors for acute cerebrovascular events, although novel risk factors, such as sleep-disordered breathing, inflammatory markers or carotid intima-media thickness have been identified. However, the cardiovascular risk factors profile differs according to the different subtypes of ischemic stroke. Atrial fibrillation and ischemic heart disease are more frequent in patients with cardioembolic infarction, hypertension and diabetes in patients with lacunar stroke, and vascular peripheral disease, hypertension, diabetes, previous transient ischemic attack and chronic obstructive pulmonary disease in patients with atherothrombotic infarction. This review aims to present updated data on risk factors for acute ischemic stroke as well as to describe the usefulness of new and emerging vascular risk factors in stroke patients. PMID:25984516

  16. Survival after stroke. Risk factors and determinants in the Copenhagen Stroke Study

    DEFF Research Database (Denmark)

    Kammersgaard, Lars Peter

    2010-01-01

    stroke unit and recruited from a well-defined area in Copenhagen, Denmark. This thesis focuses on the survival after stroke in relation to several baseline clinical characteristics and risk factors for cardiovascular disease. The thesis comes in three sections with regard to whether factors or clinical...... definitions of the intensity of exposure. Smoking is uniformly associated with a poorer survival after stroke. Stroke unit treatment improves both short- and longterm survival regardless of stroke type, severity, age, and cardiovascular risk factor profile.......-based surveys is emphasized. For factors such as sex, and most cardiovascular risk factors further studies are necessary to clarify the relation to survival because studies disagree. Conclusions from studies of the relation between survival and alcohol intake are still debatable, mostly because of diverging...

  17. Non-Surgical Procedures Open Blocked Arteries to Prevent and Treat Stroke

    Science.gov (United States)

    ... Surgical Procedures Open Blocked Arteries to Prevent and Treat Stroke Stroke is a "Brain Attack" and a ... first sign of stroke, Call 911 Vascular Experts Treat Blocked Carotid Arteries Without Surgery to Prevent Stroke ...

  18. Morbidity predictors in ischemic stroke

    Directory of Open Access Journals (Sweden)

    Panicker J

    2003-01-01

    Full Text Available Background: Although ischemic CVA is one of the leading causes for death and disability, parameters for predicting long-term outcome in such patients have not been clearly delineated, especially in the Indian context. Methods: A prospective hospital-based study of 105 patients of ischemic stroke, focal neurological deficits and functional score was assessed and the C-reactive protein level (CRP was measured. A follow-up was done at 5 days and at 6 months and outcome variable was the functional status at 6 months using Barthel Index of Activities of Daily Living. Accordingly, patients were grouped into 3 - Barthel Index < 41: Severely disabled, Barthel Index 41-60: Moderately disabled and Barthel Index > 60: Mildly disabled. Results: At admission, if upper limb power was less than Medical Research Council (MRC grade 4, or aphasia was present or CRP assay was positive, then at 6 months, these patients most likely belonged to the severely disabled group. If upper limb or lower limb power was greater than MRC grade 3 or there was no aphasia or conjugate gaze deviation or CRP assay was negative, these patients most likely belonged to the mildly disabled group at 6 months. Follow-up rate was 86%. Conclusion: Patients can be stratified according to the predicted prognosis. The treatment and rehabilitation can be properly planned and strictly adhered to in patients predicted to have worse prognosis.

  19. Costs of stroke and stroke services: Determinants of patient costs and a comparison of costs of regular care and care organised in stroke services

    Directory of Open Access Journals (Sweden)

    Koopmanschap Marc A

    2003-02-01

    Full Text Available Abstract Background Stroke is a major cause of death and long-term disability in Western societies and constitutes a major claim on health care budgets. Organising stroke care in a stroke service has recently been demonstrated to result in better health effects for patients. This paper discusses patient costs after stroke and compares costs between regular and stroke service care. Methods Costs were calculated within the framework of the evaluation of three experiments with stroke services in the Netherlands. Cost calculations are base on medical consumption data and actual costs. Results 598 patients were consecutively admitted to hospital after stroke. The average total costs of care per patient for the 6 month follow-up are estimated at €16,000. Costs are dominated by institutional and accommodation costs. Patients who die after stroke incur less costs. For patients that survive the acute phase, the most important determinants of costs are disability status and having a partner – as they influence patients' stroke careers. These determinants also interact. The most efficient stroke service experiment was most successful in co-ordinating patient flow from hospital to (nursing home, through capacity planning and efficient discharge procedures. In this region the costs of stroke service care are the same as for regular stroke care. The other experiments suffered from waiting lists for nursing homes and home care, leading to "blocked beds" in hospitals and nursing homes and higher costs of care. Costs of co-ordination are estimated at about 3% of total costs of care. Conclusion This paper demonstrates that by organising care for stroke patients in a stroke service, better health effects can be achieved with the same budget. In addition, it provides insight in need, predisposing and enabling factors that determine costs of care after stroke.

  20. Developing the Stroke Exercise Preference Inventory (SEPI)

    Science.gov (United States)

    Bonner, Nicholas S.; O’Halloran, Paul D.; Bernhardt, Julie; Cumming, Toby B.

    2016-01-01

    Background Physical inactivity is highly prevalent after stroke, increasing the risk of poor health outcomes including recurrent stroke. Tailoring of exercise programs to individual preferences can improve adherence, but no tools exist for this purpose in stroke. Methods We identified potential questionnaire items for establishing exercise preferences via: (i) our preliminary Exercise Preference Questionnaire in stroke, (ii) similar tools used in other conditions, and (iii) expert panel consultations. The resulting 35-item questionnaire (SEPI-35) was administered to stroke survivors, along with measures of disability, depression, anxiety, fatigue and self-reported physical activity. Exploratory factor analysis was used to identify a factor structure in exercise preferences, providing a framework for item reduction. Associations between exercise preferences and personal characteristics were analysed using multivariable regression. Results A group of 134 community-dwelling stroke survivors (mean age 64.0, SD 13.3) participated. Analysis of the SEPI-35 identified 7 exercise preference factors (Supervision-support, Confidence-challenge, Health-wellbeing, Exercise context, Home-alone, Similar others, Music-TV). Item reduction processes yielded a 13-item version (SEPI-13); in analysis of this version, the original factor structure was maintained. Lower scores on Confidence-challenge were significantly associated with disability (p = 0.002), depression (p = 0.001) and fatigue (p = 0.001). Self-reported barriers to exercise were particularly prevalent in those experiencing fatigue and anxiety. Conclusions The SEPI-13 is a brief instrument that allows assessment of exercise preferences and barriers in the stroke population. This new tool can be employed by health professionals to inform the development of individually tailored exercise interventions. PMID:27711242

  1. Approaches to economic evaluations of stroke rehabilitation.

    Science.gov (United States)

    Craig, Louise E; Wu, Olivia; Bernhardt, Julie; Langhorne, Peter

    2014-01-01

    Many stroke rehabilitation services and interventions are complex in that they involve a number of components, interactions, and outcomes. Much of the onus of stroke care lies with rehabilitation services and because stroke rehabilitation is highly resource intensive, it is important for policy makers to consider the potential trade-offs between all relevant costs and benefits. The primary aim of this systematic review was to assess the methods used to conduct economic evaluations of stroke rehabilitation. Studies that compared two or more alternative stroke rehabilitation interventions or services with the costs and outcomes being examined for each alternative were included. EMBASE, MEDLINE In-Process, and National Health Service's Economic Evaluation Database were searched using search strategies. The methodological quality of the included studies was appraised using a checklist for the conduct and reporting of economic evaluations. Twenty-one studies met the selection criteria. The economic evaluations in the majority of these studies were inadequate based on their ability to identify, measure, and value all resources and benefits pertinent to the complexity of stroke rehabilitation. This study highlights that complex interventions such as stroke rehabilitation have widespread effects, which may not be represented by the changes on a single outcome. This study recommends the adoption of a wider cost and benefit perspective in the economic evaluations of complex interventions. It supports a move away from conventional economic evaluation and decision making, based purely on cost-effectiveness, toward multicriteria decision analysis frameworks for complex interventions, where a broader range of criteria may be assessed by policy makers.

  2. Prognostic significance of serum bilirubin in stroke

    International Nuclear Information System (INIS)

    Background: Oxidative injury is an important cause of the neurologic lesion in stroke. Serum bilirubin is considered a natural antioxidant that may affect the prognosis of stroke. The purpose of this study was to evaluate the prognostic significance of bilirubin in stroke patients. Methods: A prospective cross-sectional study was conducted in Medical Units of Khyber Teaching Hospital, Peshawar. Inpatients admitted with acute attack of stroke were included in this study. Data regarding serum bilirubin and concurrent cerebrovascular risk factors were collected. National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were used to analyse stroke's severity and functional outcomes, respectively. Results: Hypertension, diabetes mellitus and heart diseases were the most common risk factors. Patients were divided into 3 groups on the basis of serum bilirubin, i.e., =0.6 mg/dl (Group-1), 0.7-0.9 mg/dl (Group-2), and =1.0 mg/dl (Group-3). The mean pre-hospitalisation NIHSS score for Groups 1, 2 and 3 was 5.62, 11.66 and 25.33, respectively; and post-hospitalisation score was 0.875, 3.76 and 16.26, respectively. The pre-hospitalisation mRS score was 4 for Group-1, 4.52 for Group-2 and 4.93 for Group-3; while post-hospitalisation Mrs Score was 1.50, 2.38 and 4.26, respectively. Average serum bilirubin level was significantly higher in patients with poor outcomes as compared with good outcomes (p<0.01). Conclusions: This study suggests that higher serum bilirubin levels were associated with increased stroke severity, longer hospitalisation and poor prognosis. (author)

  3. Post-stroke depression: Prevalence and relationship with disability in chronic stroke survivors

    Directory of Open Access Journals (Sweden)

    Srivastava Abhishek

    2010-01-01

    Full Text Available Objectives: To evaluate (1 the prevalence of operationally defined depressive disorder (ICD-10 in chronic stroke subjects and (2 the relationship of post-stroke depression (PSD with disability. Design: Cross-sectional, descriptive study. Setting: Neurological rehabilitation unit of a tertiary care university research center. Materials and Methods: Participants were those with first episode of supratentorial stroke of more than 3 months′ duration with impaired balance and gait who had been referred for rehabilitation. Data were collected on demographic data, stroke data (side and type of lesion and post-stroke duration, cognition (mini mental state examination, depressive ideation (Hamilton Depression Rating Scale - HRDS, impairment (Scandinavian Stroke Scale, balance (Berg Balance Scale, ambulatory status (Functional Ambulation Category, walking ability (speed, and independence in activities of daily living (Barthel Index. Statistical analysis was done using SPSS 13.0. We carried out the chi-square test for ordinal variables and the independent t test for continuous variables. Results: Fifty-one patients (M:F: 41:10 of mean age 46.06 ± 11.19 years and mean post-stroke duration of 467.33 ± 436.39 days were included in the study. Eighteen of the 51 participants (35.29% met the criteria for depression. Demographic variables like male gender, being married, living in a nuclear family, urban background, and higher HRDS score were significantly correlated with PSD (P < 0.05. Depression was related to functional disability after stroke but to a statistically insignificant level (P > 0.05 and was unrelated to lesion-related parameters. Conclusion: Depression occurs in one-third of chronic stroke survivors and is prevalent in subjects referred for rehabilitation. PSD is related primarily to demographic variables and only to a lesser extent to functional disability following stroke.

  4. Persistent post-stroke depression in mice following unilateral medial prefrontal cortical stroke.

    Science.gov (United States)

    Vahid-Ansari, F; Lagace, D C; Albert, P R

    2016-01-01

    Post-stroke depression (PSD) is a common outcome following stroke that is associated with poor recovery. To develop a preclinical model of PSD, we targeted a key node of the depression-anxiety circuitry by inducing a unilateral ischemic lesion to the medial prefrontal cortex (mPFC) stroke. Microinjection of male C57/BL6 mice with endothelin-1 (ET-1, 1600 pmol) induced a small (1 mm(3)) stroke consistently localized within the left mPFC. Compared with sham control mice, the stroke mice displayed a robust behavioral phenotype in four validated tests of anxiety including the elevated plus maze, light-dark, open-field and novelty-suppressed feeding tests. In addition, the stroke mice displayed depression-like behaviors in both the forced swim and tail suspension test. In contrast, there was no effect on locomotor activity or sensorimotor function in the horizontal ladder, or cylinder and home cage activity tests, indicating a silent stroke due to the absence of motor abnormalities. When re-tested at 6 weeks post stroke, the stroke mice retained both anxiety and depression phenotypes. Surprisingly, at 6 weeks post stroke the lesion site was infiltrated by neurons, suggesting that the ET-1-induced neuronal loss in the mPFC was reversible over time, but was insufficient to promote behavioral recovery. In summary, unilateral ischemic lesion of the mPFC results in a pronounced and persistent anxiety and depression phenotype with no evident sensorimotor deficits. This precise lesion of the depression circuitry provides a reproducible model to study adaptive cellular changes and preclinical efficacy of novel interventions to alleviate PSD symptoms. PMID:27483381

  5. INTERNATIONAL SPECIALIZATION AND VERTICAL DIFFERENTIATION

    Directory of Open Access Journals (Sweden)

    Furia Donatella

    2010-07-01

    Full Text Available During the last decades, market segmentation and intra-industry trade have become increasingly relevant. The underlying hypothesis of our work is that distinct articles have heterogeneous potential for vertical differentiation, implying that different patterns of international specialization should be identifiable. We carry out an analysis on revealed comparative advantage (through the Lafay Index in specific sectors of interest. Then we highlight the emergence of diverse degrees of product quality differentiation among sectors (through the Relative Quality Index. Results confirm our hypothesis. Indeed it appears that only certain goods, for which the pace of either creative or technological innovation (or both is particularly fast, present a high degree of vertical differentiation and market segmentation. This allows countries to specialize in a particular product variety and gain market power position for that variety. These findings should be taken in due consideration when designing trade policies.

  6. Vertically Integrated Circuits at Fermilab

    Energy Technology Data Exchange (ETDEWEB)

    Deptuch, Grzegorz; Demarteau, Marcel; Hoff, James; Lipton, Ronald; Shenai, Alpana; Trimpl, Marcel; Yarema, Raymond; Zimmerman, Tom; /Fermilab

    2009-01-01

    The exploration of the vertically integrated circuits, also commonly known as 3D-IC technology, for applications in radiation detection started at Fermilab in 2006. This paper examines the opportunities that vertical integration offers by looking at various 3D designs that have been completed by Fermilab. The emphasis is on opportunities that are presented by through silicon vias (TSV), wafer and circuit thinning and finally fusion bonding techniques to replace conventional bump bonding. Early work by Fermilab has led to an international consortium for the development of 3D-IC circuits for High Energy Physics. The consortium has submitted over 25 different designs for the Fermilab organized MPW run organized for the first time.

  7. Kinematic Fitting of Detached Vertices

    Energy Technology Data Exchange (ETDEWEB)

    Mattione, Paul [Rice Univ., Houston, TX (United States)

    2007-05-01

    The eg3 experiment at the Jefferson Lab CLAS detector aims to determine the existence of the $\\Xi_{5}$ pentaquarks and investigate the excited $\\Xi$ states. Specifically, the exotic $\\Xi_{5}^{--}$ pentaquark will be sought by first reconstructing the $\\Xi^{-}$ particle through its weak decays, $\\Xi^{-}\\to\\pi^{-}\\Lambda$ and $\\Lambda\\to\\pi^{-}$. A kinematic fitting routine was developed to reconstruct the detached vertices of these decays, where confidence level cuts on the fits are used to remove background events. Prior to fitting these decays, the exclusive reaction $\\gamma D\\rightarrow pp\\pi^{-}$ was studied in order to correct the track measurements and covariance matrices of the charged particles. The $\\Lambda\\rightarrow p\\pi^{-}$ and $\\Xi^{-}\\to\\pi^{-}\\Lambda$ decays were then investigated to demonstrate that the kinematic fitting routine reconstructs the decaying particles and their detached vertices correctly.

  8. Strategic Inventories in Vertical Contracts

    OpenAIRE

    Krishnan Anand; Ravi Anupindi; Yehuda Bassok

    2008-01-01

    Classical reasons for carrying inventory include fixed (nonlinear) production or procurement costs, lead times, nonstationary or uncertain supply/demand, and capacity constraints. The last decade has seen active research in supply chain coordination focusing on the role of incentive contracts to achieve first-best levels of inventory. An extensive literature in industrial organization that studies incentives for vertical controls largely ignores the effect of inventories. Does the ability to ...

  9. NASA-Ames vertical gun

    Science.gov (United States)

    Schultz, P. H.

    1984-01-01

    A national facility, the NASA-Ames vertical gun range (AVGR) has an excellent reputation for revealing fundamental aspects of impact cratering that provide important constraints for planetary processes. The current logistics in accessing the AVGR, some of the past and ongoing experimental programs and their relevance, and the future role of this facility in planetary studies are reviewed. Publications resulting from experiments with the gun (1979 to 1984) are listed as well as the researchers and subjects studied.

  10. Vertical axis wind turbine acoustics

    OpenAIRE

    Pearson, Charlie

    2014-01-01

    Increasing awareness of the issues of climate change and sustainable energy use has led to growing levels of interest in small-scale, decentralised power generation. Small-scale wind power has seen significant growth in the last ten years, partly due to the political support for renewable energy and the introduction of Feed In Tariffs, which pay home owners for generating their own electricity. Due to their ability to respond quickly to changing wind conditions, small-scale vertical axis...

  11. Industrial Chain: Industrial Vertical Definition

    Institute of Scientific and Technical Information of China (English)

    YifeiDu; GuojunJiang; ShimingLi

    2004-01-01

    Like value chain and supply chain, “industrial chain” becomes the focus of attention. The implication of “industrial chain” has gained a large range of extension. It not only expresses the industrial “chain” structure and relationship of “back and forward”in order or “up and down” in direction, but also it represents a cluster of large scale of firms in an area or colony. It is a network, or a community. Consequently, we conclude that “industrial chain” is a synthesis of industrial chain, industrial cluster, or industrial network.In this article, firstly we will distinguish industry chain from industry. An industry is the collection of firms that have the same attribute, so an industry can be defined by firm collection of certain attribute. We indicate that industrial chain is a kind of vertical and orderly industrial link. It is defined according to a series of specific product or service created. Secondly we analyze the vertical orderly defiinition process from the aspects of social division of labor and requirement division, self-organization system, and value analysis.Non-symmetry and depending on system or community of large scale of industrial units lead to entire industry to “orderly” structure. On the other hand, the draught of diversity and complexity of requirement simultaneously lead to entire industry to be more “orderly”. Along with processes of self-organization, industrial will appi'oach the state of more orderly and steady, and constantly make industrial chain upgrade. Each firm or unit, who will gain the value, has to establish channels of value, which we called “industrial value chain”. Lastly,we discuss the consequence of vertical and orderly definition, which is exhibited by a certain relationship body. The typical forms of industrial chain include industrial cluster, strategy alliance and vertical integration etc.

  12. Poligonación Vertical

    Directory of Open Access Journals (Sweden)

    Esteban Dörries

    2016-03-01

    Full Text Available La poligonación vertical es un método de medición de diferencias de altura que aprovecha las posibilidades de las estaciones totales. Se presta fundamentalmente para líneas de nivelación entre nodos formando red. El nombre se debe a que las visuales sucesivas se proyectan sobre aristas verticales en lugar de un plano horizontal, como ocurre en la poligonación convencional.

  13. Sleep Duration and the Risk of Mortality From Stroke in Japan: The Takayama Cohort Study

    OpenAIRE

    Toshiaki Kawachi

    2016-01-01

    Background: Few studies have assessed the associations between sleep duration and stroke subtypes. We examined whether sleep duration is associated with mortality from total stroke, ischemic stroke, and hemorrhagic stroke in a population-based cohort of Japanese men and women. Methods: Subjects included 12 875 men and 15 021 women aged 35 years or older in 1992, who were followed until 2008. The outcome variable was stroke death (ischemic stroke, hemorrhagic stroke, and total stroke). R...

  14. Stroke rehabilitation in Canada: a work in progress.

    Science.gov (United States)

    Teasell, Robert; Meyer, Matthew J; Foley, Norine; Salter, Katherine; Willems, Deb

    2009-01-01

    Stroke rehabilitation in Canada continues to function under models and practices that have changed little in the last four decades and struggles to implement new evidence-based or best practices. Ontario, Canada's largest province, has had a coordinated stroke strategy since 2000. The Ontario Stroke System has developed an extensive infrastructure of research syntheses, consensus panel recommendations, practice guidelines, standards of care, and centralized data collection across the continuum of stroke care. This has produced a solid foundation upon which an evidence-based stroke rehabilitation system can be developed. However, failure to invest in stroke rehabilitation or provide incentives to implement change has resulted in the stroke rehabilitation system and critical outcomes remaining largely unchanged. Improvements in time to admission have been countered by rising admission FIM scores such that severe stroke patients often cannot access the stroke rehabilitation system. Many stroke patients are still rehabilitated on general rehabilitation units, therapy intensities remain unacceptably low, and many outpatient programs are being reduced or even closed. Although there are pockets of innovation, the stroke rehabilitation system continues to function more according to traditional ways of practicing. The hope is that with appropriate investments and incentives, Canadians and Ontarians can build upon the existing infrastructure to ensure stroke patients receive optimal rehabilitative care based on best evidence. In the meantime, stroke rehabilitation in Canada remains a work in progress.

  15. Rehabilitation Outcomes: Ischemic versus Hemorrhagic Strokes

    Directory of Open Access Journals (Sweden)

    Robert Perna

    2015-01-01

    Full Text Available Background. Ischemic and hemorrhagic strokes have different pathophysiologies and possibly different long-term cerebral and functional implications. Hemorrhagic strokes expose the brain to irritating effects of blood and ischemic strokes reflect localized or diffuse cerebral vascular pathology. Methods. Participants were individuals who suffered either an ischemic (n=172 or hemorrhagic stroke (n=112 within the past six months and were involved in a postacute neurorehabilitation program. Participants completed three months of postacute neurorehabilitation and the Mayo Portland Adaptability Inventory-4 (MPAI-4 at admission and discharge. Admission MPAI-4 scores and level of functioning were comparable. Results. Group ANOVA comparisons show no significant group differences at admission or discharge or difference in change scores. Both groups showed considerably reduced levels of productivity/employment after discharge as compared to preinjury levels. Conclusions. Though the pathophysiology of these types of strokes is different, both ultimately result in ischemic injuries, possibly accounting for lack of findings of differences between groups. In the present study, participants in both groups experienced similar functional levels across all three MPAI-4 domains both at admission and discharge. Limitations of this study include a highly educated sample and few outcome measures.

  16. Newer Oral Anticoagulants: Stroke Prevention and Pitfalls.

    Science.gov (United States)

    Patel, Anand; Goddeau, Richard P; Henninger, Nils

    2016-01-01

    Warfarin is very effective in preventing stroke in patients with atrial fibrillation. However, its use is limited due to fear of hemorrhagic complications, unpredictable anticoagulant effects related to multiple drug interactions and dietary restrictions, a narrow therapeutic window, frequent difficulty maintaining the anticoagulant effect within a narrow therapeutic window, and the need for inconvenient monitoring. Several newer oral anticoagulants have been approved for primary and secondary prevention of stroke in patients with non-valvular atrial fibrillation. These agents have several advantages relative to warfarin therapy. As a group, these direct oral anticoagulants (DOAC), which include the direct thrombin inhibitor, dabigatran, and the factor Xa inhibitors (rivaroxaban, apixaban, and edoxaban), are more effective than dose adjusted warfarin for prevention of all-cause stroke (including both ischemic and hemorrhagic stroke), and have an overall more favorable safety profile. Nevertheless, an increased risk of gastrointestinal bleeding (with the exception of apixaban), increased risk for thrombotic complication with sudden discontinuation, and inability to accurately assess and reverse anticoagulant effect require consideration prior to therapy initiation, and pose a challenge for decision making in acute stroke therapy. PMID:27347226

  17. Antithrombotic Medication for Cardioembolic Stroke Prevention

    Directory of Open Access Journals (Sweden)

    M. Àngels Font

    2011-01-01

    Full Text Available Embolism of cardiac origin accounts for about 20% of ischemic strokes. Nonvalvular atrial fibrillation is the most frequent cause of cardioembolic stroke. Approximately 1% of population is affected by atrial fibrillation, and its prevalence is growing with ageing in the modern world. Strokes due to cardioembolism are in general severe and prone to early recurrence and have a higher long-term risk of recurrence and mortality. Despite its enormous preventive potential, continuous oral anticoagulation is prescribed for less than half of patients with atrial fibrillation who have risk factors for cardioembolism and no contraindications for anticoagulation. Available evidence does not support routine immediate anticoagulation of acute cardioembolic stroke. Anticoagulation therapy's associated risk of hemorrhage and monitoring requirements have encouraged the investigation of alternative therapies for individuals with atrial fibrillation. New anticoagulants being tested for prevention of stroke are low-molecular-weight heparins (LMWH, unfractionated heparin, factor Xa inhibitors, or direct thrombin inhibitors like dabigatran etexilate and rivaroxaban. The later exhibit stable pharmacokinetics obviating the need for coagulation monitoring or dose titration, and they lack clinically significant food or drug interaction. Moreover, they offer another potential that includes fixed dosing, oral administration, and rapid onset of action. There are several concerns regarding potential harm, including an increased risk for hepatotoxicity, clinically significant bleeding, and acute coronary events. Therefore, additional trials and postmarketing surveillance will be needed.

  18. Pattern and risk factors of stroke in the young among stroke patients admitted in medical college hospital, Thiruvananthapuram

    Directory of Open Access Journals (Sweden)

    Praveen Prasannakumar Subha

    2015-01-01

    Full Text Available Background: Stroke in the young is particularly tragic because of its potential to create a long-term burden on the victims, their families, and the community. There had been relatively few studies on young stroke in Kerala′s socio-economic setup, that too encapsulating the mentioned apparently relevant dimensions of stroke in the young . Objective: To study the prevalence, patterns and risk factors of young stroke. Settings and Design: A cross-sectional study with case control comparison at Government Medical College Hospital, Thiruvananthapuram, Kerala, India. Materials and and Methods: Total 100 stroke patients were identified over a period of 2 months, and data were collected on the basis of questionnaire developed for the purpose. Results: Of 100 stroke patients, 15 had stroke in the young, among which 9 (60% had ishaemic stroke. Hypertension was the most common risk factor. Smoking, alcohol, atrial fibrillation, and hyperlipidemia were found to be more common in cases (young stroke when compared with controls. Alcohol use and atrial fibrillation were significantly higher among young stroke patients. Physical inactivity was significantly lesser in those with stroke in the young than elderly. Atrial fibrillation emerged as an independent risk factor of stroke in the young with adjusted odds ratio of 6.18 (1.31-29.21. Conclusion: In all, 15% of total stroke occurred in young adults <50 years. The proportion of hemorrhagic stroke in young adults is higher than in elderly. Atrial fibrillation is identified as an independent risk factor of stroke in the young. Compared with stroke in elderly alcohol use, smoking, hyperlipidemia, and cardiac diseases, which are known risk factors, are higher in young stroke.

  19. [Vertical fractures: apropos of 2 clinical cases].

    Science.gov (United States)

    Félix Mañes Ferrer, J; Micò Muñoz, P; Sánchez Cortés, J L; Paricio Martín, J J; Miñana Laliga, R

    1991-01-01

    The aim of the study is to present a clinical review of the vertical root fractures. Two clinical cases are presented to demonstrates the criteria for obtaining a correct diagnosis of vertical root fractures. PMID:1659859

  20. [Vertical fractures: apropos of 2 clinical cases].

    Science.gov (United States)

    Félix Mañes Ferrer, J; Micò Muñoz, P; Sánchez Cortés, J L; Paricio Martín, J J; Miñana Laliga, R

    1991-01-01

    The aim of the study is to present a clinical review of the vertical root fractures. Two clinical cases are presented to demonstrates the criteria for obtaining a correct diagnosis of vertical root fractures.

  1. Improving stroke care for patients at Cavan hospital [poster

    LENUS (Irish Health Repository)

    Murugasu, G Dr.

    2013-07-01

    Under the Quality and Continuing Care Directorate (QCCD) in stroke care Cavan General Hospital was identified as a hospital that received a large number of stroke and TIA patients. A programme was established to improve services to this population.

  2. CDC Vital Signs: Preventable Deaths from Heart Disease and Stroke

    Science.gov (United States)

    ... Read the MMWR Science Clips Preventable Deaths from Heart Disease & Stroke Improving care can save more lives Recommend ... death among all ages. Problem Many deaths from heart disease and stroke can be prevented. What do we ...

  3. Presumed Perinatal Stroke: Risk Factors, Clinical and Radiological Findings.

    Science.gov (United States)

    Ilves, Pilvi; Laugesaar, Rael; Loorits, Dagmar; Kolk, Anneli; Tomberg, Tiiu; Lõo, Silva; Talvik, Inga; Kahre, Tiina; Talvik, Tiina

    2016-04-01

    It is unknown why some infants with perinatal stroke present clinical symptoms late during infancy and will be identified as infants with presumed perinatal stroke. The risk factors and clinical and radiological data of 42 infants with presumed perinatal stroke (69% with periventricular venous infarction and 31% with arterial ischemic stroke) from the Estonian Pediatric Stroke Database were reviewed. Children with presumed perinatal stroke were born at term in 95% of the cases and had had no risk factors during pregnancy in 43% of the cases. Children with periventricular venous infarction were born significantly more often (82%) vaginally (P = .0213) compared to children with arterial stroke (42%); nor did they require resuscitation (P = .0212) or had any neurological symptoms after birth (P = .0249). Periventricular venous infarction is the most common type of lesion among infants with the presumed perinatal stroke. Data suggest that the disease is of prenatal origin. PMID:26446909

  4. Air pollution and stroke - an overview of the evidence base.

    Science.gov (United States)

    Maheswaran, Ravi

    2016-08-01

    Air pollution is being increasingly recognized as a significant risk factor for stroke. There are numerous sources of air pollution including industry, road transport and domestic use of biomass and solid fuels. Early reports of the association between air pollution and stroke come from studies investigating health effects of severe pollution episodes. Several daily time series and case-crossover studies have reported associations with stroke. There is also evidence linking chronic air pollution exposure with stroke and with reduced survival after stroke. A conceptual framework linking air pollution exposure and stroke is proposed. It links acute and chronic exposure to air pollution with pathways to acute and chronic effects on stroke risk. Current evidence regarding potential mechanisms mainly relate to particulate air pollution. Whilst further evidence would be useful, there is already sufficient evidence to support consideration of reduction in air pollution as a preventative measure to reduce the stroke burden globally.

  5. Innovations in Stroke Prevention: An Update on Carotid Stenting

    Medline Plus

    Full Text Available INNOVATIONS IN STROKE PREVENTION: AN UPDATE ON CAROTID STENTING NEW YORK-PRESBYTERIAN HOSPITAL NEW YORK, NY July ... MD: Good evening. Welcome to our webcast on innovations in stroke prevention: an update on carotid stenting. ...

  6. New Guidelines for Reducing Stroke Risks Unique to Women

    Science.gov (United States)

    ... studies need to be done to develop a female-specific score to identify women at risk for stroke, said Bushnell, associate professor of neurology and director of the Stroke Center at Wake Forest Baptist ...

  7. Impact of Infection on Stroke Morbidity and Outcomes.

    Science.gov (United States)

    Miller, Chad M; Behrouz, Réza

    2016-09-01

    Each year, millions of persons worldwide are disabled by stroke. The burden of stroke is expected to increase as a consequence of growth in our elderly population. Outcome is dependent upon limitation of secondary medical processes in the acute setting that lead to deterioration and increased long-term disability. The prevalence of infection after stroke is greater that seen in other medical conditions with similar acuity and its impact upon morbidity and mortality is substantial. Physical impairment and immune modulation are chief determinants in rate of infection after stroke. Each of these factors has been a target for therapeutic intervention. Current best practices for acute stroke management implement strategies for prevention, prompt identification, and treatment of infection. Novel therapies are currently being explored which have the opportunity to greatly minimize infectious complications following stroke. Fever commonly accompanies infection and independently influences stroke outcome. Targeted temperature management provides an additional chance to improve stroke recovery. PMID:27485944

  8. Nonfasting triglycerides, cholesterol, and ischemic stroke in the general population

    DEFF Research Database (Denmark)

    Varbo, Anette; Nordestgaard, Børge G; Tybjaerg-Hansen, Anne;

    2011-01-01

    Current guidelines on stroke prevention have recommendations on desirable cholesterol levels, but not on nonfasting triglycerides. We compared stepwise increasing levels of nonfasting triglycerides and cholesterol for their association with risk of ischemic stroke in the general population....

  9. Telmisartan to prevent recurrent stroke and cardiovascular events

    DEFF Research Database (Denmark)

    Yusuf, Salim; Diener, Hans-Christoph; Sacco, Ralph L;

    2008-01-01

    BACKGROUND: Prolonged lowering of blood pressure after a stroke reduces the risk of recurrent stroke. In addition, inhibition of the renin-angiotensin system in high-risk patients reduces the rate of subsequent cardiovascular events, including stroke. However, the effect of lowering of blood...... pressure with a renin-angiotensin system inhibitor soon after a stroke has not been clearly established. We evaluated the effects of therapy with an angiotensin-receptor blocker, telmisartan, initiated early after a stroke. METHODS: In a multicenter trial involving 20,332 patients who recently had...... an ischemic stroke, we randomly assigned 10,146 to receive telmisartan (80 mg daily) and 10,186 to receive placebo. The primary outcome was recurrent stroke. Secondary outcomes were major cardiovascular events (death from cardiovascular causes, recurrent stroke, myocardial infarction, or new or worsening...

  10. Risk of atrial fibrillation and stroke in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Lindhardsen, Jesper; Ahlehoff, Ole; Gislason, Gunnar Hilmar;

    2012-01-01

    To determine if patients with rheumatoid arthritis have increased risk of atrial fibrillation and stroke.......To determine if patients with rheumatoid arthritis have increased risk of atrial fibrillation and stroke....

  11. Stem Cells May Offer New Hope to Stroke Survivors

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_159163.html Stem Cells May Offer New Hope to Stroke Survivors Experimental ... HealthDay News) -- Preliminary research suggests that injecting adult stems cells directly into the brain may give stroke patients ...

  12. The predictive value of the Boston Acute Stroke Imaging Scale (BASIS in acute ischemic stroke patients among Chinese population.

    Directory of Open Access Journals (Sweden)

    Yuanqi Zhao

    Full Text Available OBJECTIVE: Evaluate the predictive value of Boston Acute Stroke Imaging Scale (BASIS in acute ischemic stroke in Chinese population. METHODS: This was a retrospective study. 566 patients of acute ischemic stroke were classified as having a major stroke or minor stroke based on BASIS. We compared short-term outcome (death, occurrence of complications, admission to intensive care unit [ICU] or neurological intensive care unit [NICU], long-term outcome (death, recurrence of stroke, myocardial infarction, modified Rankin scale and economic index including in-hospital cost and length of hospitalization. Continuous variables were compared by using the Student t test or Kruskal-Wallis test. Categorical variables were tested with the Chi square test. Cox regression analysis was applied to identify whether BASIS was the independent predictive variable of death. RESULTS: During hospitalization, 9 patients (4.6% died in major stroke group while no patients died in minor stroke group (p < 0.001, 12 patients in the major stroke group and 5 patients in minor stroke group were admitted to ICU/NICU (p = 0.001. There were more complications (cerebral hernia, pneumonia, urinary tract infection in major stroke group than minor stroke group (p<0.05. Meanwhile, the average cost of hospitalization in major stroke group was 3,100 US$ and 1,740 US$ in minor stroke group (p<0.001; the average length of stay in major and minor stroke group was 21.3 days and 17.3 days respectively (p<0.001. Results of the follow-up showed that 52 patients (26.7% died in major stroke group while 56 patients (15.1% died in minor stroke group (P<0.001. 62.2% of the patients in major stroke group and 80.4% of the patients in minor stroke group were able to live independently (P = 0.002. The survival analysis showed that patients with major stroke had 80% higher of risk of death than patients with minor stroke even after adjusting traditional atherosclerotic factors and NIHSS at baseline (HR

  13. Canadian Stroke Best Practice Recommendations: Managing transitions of care following Stroke, Guidelines Update 2016.

    Science.gov (United States)

    Cameron, Jill I; O'Connell, Colleen; Foley, Norine; Salter, Katherine; Booth, Rhonda; Boyle, Rosemary; Cheung, Donna; Cooper, Nancy; Corriveau, Helene; Dowlatshahi, Dar; Dulude, Annie; Flaherty, Patti; Glasser, Ev; Gubitz, Gord; Hebert, Debbie; Holzmann, Jacquie; Hurteau, Patrick; Lamy, Elise; LeClaire, Suzanne; McMillan, Taylor; Murray, Judy; Scarfone, David; Smith, Eric E; Shum, Vivian; Taylor, Kim; Taylor, Trudy; Yanchula, Catherine; Teasell, Robert; Lindsay, Patrice

    2016-10-01

    Every year, approximately 62,000 people with stroke and transient ischemic attack are treated in Canadian hospitals. For patients, families and caregivers, this can be a difficult time of adjustment. The 2016 update of the Canadian Managing Transitions of Care following Stroke guideline is a comprehensive summary of current evidence-based and consensus-based recommendations appropriate for use by clinicians who provide care to patients following stroke across a broad range of settings. The focus of these recommendations is on support, education and skills training for patients, families and caregivers; effective discharge planning; interprofessional communication; adaptation in resuming activities of daily living; and transition to long-term care for patients who are unable to return to or remain at home. Unlike other modules contained in the Canadian Stroke Best Practice Recommendations (such as acute inpatient care), many of these recommendations are based on consensus opinion, or evidence level C, highlighting the absence of conventional evidence (i.e. randomized controlled trials) in this area of stroke care. The quality of care transitions between stages and settings may have a direct impact on patient and family outcomes such as coping, readmissions and functional recovery. While many qualitative and non-controlled studies were reviewed, this gap in evidence combined with the fact that mortality from stoke is decreasing and more people are living with the effects of stroke, underscores the need to channel a portion of available research funds to recovery and adaptation following the acute phase of stroke. PMID:27443991

  14. Reliability and validity of the Korean standard pattern identification for stroke (K-SPI-Stroke questionnaire

    Directory of Open Access Journals (Sweden)

    Kang Byoung-Kab

    2012-04-01

    Full Text Available Abstract Background The present study was conducted to examine the reliability and validity of the ‘Korean Standard Pattern Identification for Stroke (K-SPI-Stroke’, which was developed and evaluated within the context of traditional Korean medicine (TKM. Methods Between September 2006 and December 2010, 2,905 patients from 11 Korean medical hospitals were asked to complete the K-SPI-Stroke questionnaire as a part of project ' Fundamental study for the standardization and objectification of pattern identification in traditional Korean medicine for stroke (SOPI-Stroke. Each patient was independently diagnosed by two TKM physicians from the same site according to one of four patterns, as suggested by the Korea Institute of Oriental Medicine: 1 a Qi deficiency pattern, 2 a Dampness-phlegm pattern, 3 a Yin deficiency pattern, or 4 a Fire-heat pattern. We estimated the internal consistency using Cronbach’s α coefficient, the discriminant validity using the means score of patterns, and the predictive validity using the classification accuracy of the K-SPI-Stroke questionnaire. Results The K-SPI-Stroke questionnaire had satisfactory internal consistency (α = 0.700 and validity, with significant differences in the mean of scores among the four patterns. The overall classification accuracy of this questionnaire was 65.2 %. Conclusion These results suggest that the K-SPI-Stroke questionnaire is a reliable and valid instrument for estimating the severity of the four patterns.

  15. Magnetic resonance imaging to visualize stroke and characterize stroke recovery: a review.

    Science.gov (United States)

    Macintosh, Bradley J; Graham, Simon J

    2013-01-01

    The global burden of stroke continues to grow. Although stroke prevention strategies (e.g., medications, diet, and exercise) can contribute to risk reduction, options for acute interventions (e.g., thrombolytic therapy for ischemic stroke) are limited to the minority of patients. The remaining patients are often left with profound neurological disabilities that substantially impact quality of life, economic productivity, and increase caregiver burden. In the last decade, however, the future outlook for such patients has been tempered by movement toward the view that the brain is capable of reorganizing after injury. Many now view brain recovery after stroke as an area of scientific research with large potential for therapeutic advances, far into the future (Broderick and William, 2004). As a probe of brain anatomy, function and physiology, magnetic resonance imaging (MRI) is a non-invasive and highly versatile modality that promises to play a particularly important role in such research. Here we provide a basic review of MRI physical principles and applications for assessing stroke, looking toward the future role MRI may play in improving stroke rehabilitation methods and stroke recovery.

  16. Difficulties in post-stroke gait improvement caused by post-stroke depression

    Institute of Scientific and Technical Information of China (English)

    Stanislaw Kijowski

    2014-01-01

    Background Depression is a common problem impeding post-stroke rehabilitation.Up to 70% of patients show depression symptoms during the first twelve months after stroke onset.However,the depression and its effect on functional recovery can be difficult to diagnose.The purpose of this study was to use gait analysis as a tool to compare the recovery after stroke in patients with and without depression and to assess the impact of the initiation time of rehabilitation after stroke onset.Methods One hundred and forty five consecutive patients after first ever stroke admitted for designed rehabilitation program within 2 to 31 months after stroke onset participated.All patients received 4 weeks treatment program included comprehensive rehabilitation consisted of multipurpose activities 5 days a week.These included individual and group exercises,physiotherapy,occupational therapy and gait training.Gait analysis with Kistler force plates was employed to assess gait pattern symmetry before and after the treatment.Gait symmetry was evaluated based on seven gait parameters.Regaining of gait pattern symmetry was assumed as a measure of rehabilitation outcome.Results After rehabilitation program gait symmetry w()ined in patients without depression.Gait asymmetry remained unchanged in patients diagnosed with depression.No major differences in outcome from rehabilitation were noted in regards to the initiation time of rehabilitation after the stroke onset.Conclusions Depression limits gait recovery after stroke.The time of initiation of rehabilitation after stroke onset does not limit the motor recovery after rehabilitation program.

  17. Emerging Tools for Stroke Prevention in Atrial Fibrillation

    OpenAIRE

    Christos Voukalis; Lip, Gregory Y. H.; Eduard Shantsila

    2016-01-01

    Ischaemic strokes resulting from atrial fibrillation (AF) constitute a devastating condition for patients and their carers with huge burden on health care systems. Prophylactic treatment against systemic embolization and ischaemic strokes is the cornerstone for the management of AF. Effective stroke prevention requires the use of the vitamin K antagonists or non-vitamin K oral anticoagulants (NOACs). This article summarises the latest developments in the field of stroke prevention in AF and a...

  18. Psychological distress after stroke and aphasia: the first six months

    OpenAIRE

    Hilari, K.; Northcott, S.; Roy, P; Marshall, J.; Wiggins, R. D.; Chataway, J.; Ames, D.

    2010-01-01

    Objective: We explored the factors that predicted psychological distress in the first six months post stroke in a sample including people with aphasia. Design: Prospective longitudinal observational study. Setting and subjects: Participants with a first stroke from two acute stroke units were assessed while still in hospital (baseline) and at three and six months post stroke. Main measures: Distress was assessed with the General Health Questionnaire-12. Other measures included: NI...

  19. [Nonfasting triglycerides and risk of ischemic stroke--secondary publication

    DEFF Research Database (Denmark)

    Freiberg, J.J.; Tybjaerg-Hansen, A.; Jensen, J.S.;

    2009-01-01

    The role of triglycerides in the risk of ischemic stroke remains controversial. We tested the hypothesis that increased levels of nonfasting triglycerides are associated with ischemic stroke in the general population. Men with a nonfasting triglyceride level 5 mmol/l had a multivariable, adjusted...... hazard ratio for ischemic stroke of 2.5 (95% confidence interval: 1.3-4.8) compared with men with a nonfasting triglyceride level triglycerides is associated with risk of ischemic stroke Udgivelsesdato...

  20. Innate inflammatory responses in stroke: mechanisms and potential therapeutic targets

    OpenAIRE

    Kim, Jong Youl; Kawabori, Masahito; Yenari, Midori A.

    2014-01-01

    Stroke is a frequent cause of long-term disability and death worldwide. Ischemic stroke is more commonly encountered compared to hemorrhagic stroke, and leads to tissue death by ischemia due to occlusion of a cerebral artery. Inflammation is known to result as a result of ischemic injury, long thought to be involved in initiating the recovery and repair process. However, work over the past few decades indicates that aspects of this inflammatory response may in fact be detrimental to stroke ou...